JA YESAVAGE’s research while affiliated with Palo Alto Research Center and other places

Predictions of psychiatric patients' imminent dangerousness by 30 experienced psychologists and psychiatrists were studied. These clinical judges reviewed summary descriptions of 40 male patients newly admitted to an acute-care psychiatric unit and predicted whether each patient would engage in an assault during his first 7 days on the unit. Statistically significant but low levels of reliability were found among individual judges' predictions, but a strong relationship was found between composite judgments by psychologists and psychiatrists. Judges attained a low accuracy rate in predicting patients' violence. Cue-utilization analyses suggested that on the whole both actual violence and judges' forecasts were linearly predictable. Variables in the model of clinical forecasts of violence included patients' assaultiveness prior to admission as well as rated hostility and depressive mood, whereas empirical correlates of violence in this patient sample included the absence of emotional withdrawal and the presence of hallucinatory behavior. The apparent extent to which judges used valid predictors of violence was related to their accuracy. Implications for the prediction of imminent violence in acute psychiatric care settings are discussed.