(2) Risk Assessment Lectures Flashcards

Question

How do we Report the Results? There are two main methods used to communicate the results of a risk assessment, which by itself, is not useful for decision making in the CJS: What are they? and provide an example statement with joe who scored (7) on the Static-99R- What are two considerations to keep in mind when communicating a risk estimate to the parole board?

Answer 1

``` 1. Relative Risk: o Where the offender’s level of risk relative to other offenders. o E.g., Joes’ score of 7 on the Static-99R places him in the 97th percentile which is within the high-risk band for sexual recidivism. ``` ``` 2. Absolute Risk: o Where the offender’s level of risk is compared to other offenders who have the same risk score as them. o E.g., 27% of offenders who also score a 7 on the Static- 99R and share similar characteristics to Joe tend to sexually re-offend in 5 years. ``` ``` Things to keep in mind: o We need to be careful that we use simple terminology clear of jargon to ensure that we are effectively communicating the offender’s risk to individuals in the CJS who are making parole and sentencing decisions. o Research is currently being conducted on developing “common risk language” this is to address the fact that the score cut offs for bands of risk are different for each scale. Thus, it would be beneficial to have a universal level of risk classification system. ```

Answer 2

``` 1. The First Generation: o 1960s-1970s: o Unstructured Professional Judgement method of risk assessment, which is very biased, with no structure to the factors associated with risk used, low interrater reliability and poor predictive accuracy! ``` ``` 2. The Second Generation: o 1970s-1980s: o Actuarial risk assessment method which uses structured risk assessment based on empirically supported static factors to reduce the subjectivity of clinical judgement and increased its predictive accuracy. ``` ``` 3. The Third Generation: o 1980s-1990s: Andrew and Bonta’s Central (8) Risk Factors. o Actuarial risk assessment method which used both static and dynamic risk factors. ``` ``` 4. The Fourth Generation: o 1990s-till now: o Comprehensive risk assessment tools which guide case management: assessment, management, and treatment progress. ``` ``` Where does SPJ fit? o It is not included in the (4) generations of risk assessment:  However, Andrews et al. (2009) argue that SPJ is a variation of the first- generation tools, but evidence supports that SPJ has way more predictive accuracy than UCJ’s. ```

Answer 3

```  No, as we can see from the (4) generations of risk assessment. Only the second-generation actuarial scale used only static risk factors and the third generation uses both.  In terms of SPJ, they can also use both. ```

Answer 4

```  The two primary methods (actuarial and SPJ) which have their own respective strengths, weaknesses and purpose. o E.g., the actuarial scale is more precise gives a risk estimate and has issues with “the broken leg dilemma”. o E.g., if advising the parole board, you may use both actuarial and SPJ.  There are scales for general or offense specific risk assessment scales (i.e., terrorism, IPV, Sexual Offending, Violence etc.).  There are different scales for different populations (i.e., gender, cultures, age etc.).  Not all scales can inform interventions (i.e., actuarial with only predominantly static factors). ``` *even scales designed for the same purpose provide different answers (i.e., there is a lack of consistency between them; predominantly those with DRF’s in them that increases the subjectivity in ratings by various clinicians).

Answer 5

``` 1. Predictive Accuracy: does it make more true positives/negatives than false positives/negatives (i.e., error; are they balanced?). 2. Validation: has the scale been validated in different contexts than western settings across time? ``` 3. Others: a. Is it easy to use? b. Is it easy to learn and train people on? Is it costly to train people? c. Is it quick to rate? d. Consistent ratings across practitioners? i.e., is their strong inter-rater reliability. 4. Does the scale have construct validity? Does the scale measure the risk factors it claims to? The most important two are predictive accuracy and validation.

Answer 6

``` o Actuarial tools are subject to cultural biases, more so SPJ (i.e., their more strict/rigorous with less room for adjustments). o It’s an enduring concern about the cultural appropriateness of risk assessment scales for Aboriginals, can have implications for other jurisdictions (including NZ). ```

Answer 7

``` o Cross-cultural validation: most scales are supported in a white western context and have not been validated in other cultural contexts. o There is inconclusive evidence on the cross- cultural generalizability of scales (i.e., mixed findings; equal predictive accuracy or less accurate for indigenous communities). o Indigenous individuals tend to score higher: which impacts on sentencing and parole conditions (i.e., over- supervision, denied parole, harsher sentences etc.). ``` * This is important because biased scales that present aboriginals as higher risk in cultural contexts where minorities are overrepresented in the CJS is going to lead to people accepting the adequacy of the scale without rigorously testing its cross-cultural appropriateness. * Biases in the CJS and scale interact and negatively impact cultural minorities' quality of life.

Answer 8

``` 1. Item Bias: o Items don’t have the same meaning across cultures, or they do not have the same relationship with offending in all groups (i.e., the items, which measure RFs, are not understood the same across cultures). ``` ``` 2. Construct Bias: o Constructs (i.e., RFs) being measured are not the same across cultures (i.e., the influence of cultural norms means that what is considered to be risk factors differs across cultures and makes some items more or less appropriate. ``` ``` 3. Method Bias: o The administration and assessment conditions the scale is used in can vary across cultures (i.e., language barriers between practitioner and offender, the response styles will vary). ``` ``` 4. Judgement Error: o Biases due to subjective components of assessing risk: heuristics, illusionary correlation, overconfidence and the quality of the information provided (i.e., official records, self-report or observation). ``` ``` 5. Over-Confidence: o Confidence is not associated with accuracy! (i.e., being confidence doesn’t mean the risk judgment is accurate). ```

Answer 9

```  Risk assessment is normatively developed on white western people (i.e., Canadian or US samples which is a small percentage of the world population). ``` ```  It ignores that cultural differences in practice, expectations, beliefs about health and mental illness, what deviancy is, worldviews, social and environmental experiences that influence the predictive accuracy of the scale. ``` ```  Three possible problems: o Overlooking relevant factors to that population not included on the scale. o Including factors that are not relevant or less relevant to the population. o Variation in the expression and manifestation of risk across populations. ``` ```  SPJ maybe better able to accommodate to variation (i.e., cultural responsivity) but is also subject to biases (i.e., +/-‘s to clinical discretion). ```  Actuarial tools are ridged (i. e., do not allow for cultural responsivity) .

Answer 10

```  Cross-Cultural Validation (i.e., testing the predictive accuracy of the scale across groups, time and contexts).  Ensure that practitioners are trained in cross-cultural differences in understanding risk, its links to recidivism and how it is manifested (i.e., adjust the scale accordingly to be responsive to cultural variation).  Reducing Method Bias (i.e., language barriers, understandings of risk, deviancy, well-being, and factors which influence their responsivity to treatment and how the items are explained).  Identification of risk factors which are more/less relevant to the population being studied (i.e., use the Maori culture related needs: MaCRNs; cultural identity, cultural tension, whanau, whakapapa and weight the risk factors accordingly or adding/removing them). ```

Answer 11

``` 1. Safety Concerns regarding the release of high-risk offenders into the population to test actual recidivism rates which makes it unethical and restricts our samples to low-risk offenders. ``` ``` 2. False Positives are common but maybe the result of effective treatment which reduces the risk of recidivism. ``` ``` 3. Recidivism is under- reported (x6) in official records with self-report data also under reporting when recidivists who haven’t been caught will not want to admit to a crime. The use of dichotomous recidivism scoring (yes/no) leaves out important information about the offense type and the severity of the offense. ``` ``` 4. Base Rates: there is more predictive accuracy when the offense type has a higher base rate of recidivism (i.e., more frequent behaviours are easier to predict). ``` ``` 5. Follow-up periods needed to capture information about recidivism makes cross-cultural validation very time consuming. ``` ``` 6. Subjectivity of SPJ: means there is variation across practitioners which makes cross-cultural comparisons hard to make because the groups are not equivalent. ```

Answer 12

```  Not having scales to account for cultural variation has implications on indigenous people (i.e., risk estimates, CJS decisions, responsivity to treatment and rehabilitation etc.). ``` ```  Gap between research and practice (i.e., practice is not up to date with research; it takes time to update treatment to suit theory, it takes time and money to train and update practice, frequently changing treatment and create instability and reduce effectiveness of treatment). ``` ```  Balancing false positives with false negatives. For example, the public would be in favour of false positives in keeping people looked up to reduce risk of harm to the community, but this impairs the rights and freedoms of the offender and impacts their QOL. ```  Risk bands are arbitrary, and variable across clinicians and scales. ```  Focusing on Risk Avoidance is one side of the puzzle, what about protective factors which reduce the risk of recidivism? ```

Answer 13

 Factors which mitigate or predict the reduction in risk of recidivism.  There is a lot of conceptual confusion around what protective factors actually are: are they the opposite of RFs, the absence of RFs or something else? The evidence says they’re their own thing.  Difficulty with extended temporal relationship between variables being studied (i.e., youths vs. adults, onset vs. maintenance).  Protective factors can be measured and are shown to predict the reduced likelihood of recidivism. ```  For example, o Prosocial involvement. o Social Support. o Intelligence. o Attachment. o Employment. ```

Answer 14

 First protective factor tools designed for adults.  Used for in-patients alongside the HCR-20 (SPJ).  It has 17 items: static and dynamic which are broken into (3) sub-scales: ``` o Internal:  Intelligence.  Secure attachment style.  Empathy.  Coping.  Self-control. ``` ``` o Motivational:  Work.  Leisure activities.  Financials management.  Motivation for treatment.  Attitudes towards authority.  Lifegoals.  Medication. ``` o External:  Social network.  Intimate relationship.  Professional care.  Living circumstances.  External control.  There have been additional scales developed to fit other populations: SO, Gender, Age or Disability.  Includes goals: space for SPJ where they develop goals with the offender, and includes actuarial risk scoring for each item to provide a risk estimate.

Answer 15

 Mainly probation officers and psychologists make risk assessments (albeit for different reasoning, monitor risk vs. treatment efficacy).  Risk assessments are used to advise the day-to-day management of offenders and advising the parole board and courts.  ROC*RIC is a static RF Actuarial tool that makes automatic risk estimates of offender’s official records and is widely used in NZ.  ASRS is another static actuarial tool to automatically estimates offender risk but is specific to sexual offending (i.e., adjusts for lower base rates).  Dynamic risk assessment for offender re- entry (DRAOR) is only used by probation officers to monitor for changes in risk.  Stable and Acute (2002) is a dynamic actuarial tool for sexual offending (static and dynamic risk factors).  Violence risk scale (VRS) includes STURP treatment planning and monitoring change in risk and provides estimates of risk for the parole board

Answer 16

```  Three-point scale ranging from 0-2.  Comes with a manual that provides examples on how to score each factor.  The scores from the (3) sub-scales are aggregated to find a total score.  Typically, monitors offenders quite regularly (i.e., weekly for high risk or once a month for lower risk offenders). ``` *Acute sub-scale is for monitoring changes in risk that may require immediate intervention regularly by the probation officer. ``` Stable DRFs:  Peer associates  Attitudes towards authority  Impulse control  Problem-solving  Sense of entitlement  Attachment with others ``` ``` Acute DRFs:  Substance abuse  Anger/hostility  Opportunity/Access to victims  Negative Mood  Employment  Interpersonal Relationships  Living Situation ``` ``` Protective Factors:  Response to advice  Prosocial identity  High expectations  Cost/Benefits  Social support  Social control ```

Answer 17

 Risk assessment is a crucial part of the CJS which has many cultural and ethical implications that need to be addressed.  Validating the predictive accuracy of scales is important to minimize error (i.e., false positives/negatives).  It's important that when picking a scale, you choose one that is appropriate for the population being studied and the task at hand.  The most common and widely used risk assessment methods that have predictive accuracy at above chance levels.  It’s important to have risk assessment tools which have the capacity to monitor change in risk and inform case management and intervention (i.e., the (4) generation of risk assessment).  We need more knowledge on risk factors and desistance from crime to provide balanced scales with more predictive ability, and better treatments for offenders.

Answer 18

 Yes, the dual aims of risk assessment is predicting risk of recidivism which can help triage people into interventions of the right intensity, and provide targets for interventions to manage risk.  Yes, a false negative is an incorrect risk prediction where an offender is expected to not reoffend but they do.  No, Static RFs are not amenable to change even with treatment.  Yes, they can change due to changes in situational factors or maturation over time.  No, the model shows that their risk of recidividm has increase and intervention is needed but it doesn’t garuntee offending will occur!  No, 0.5 score indicates the scale performs at chance levels. Thus, 0.2 is below chance accuracy which sugests it is prediciting in the wrong direction (i.e., low risk offenders are more likely to reoffend than high-risk).  Yes, A score of one means perfect predictive accuracy so a socre of .8 indcates a large effect size.  No, the actuarial scale has more predictive accuracy because it largely focuses on static risk factors, more rigorous and less room for clinician discretion and therefore biases relative to SPJ.  No, it can use static and dynamic risk factors!  Yes, they’re measurable.

Answer 19

 Static RFs, Stable DRFs, Acute DRFs and Protective Factors.  Age of first offence, alcoholism, intoxication, prosocial involvement.  Rigidness of scales to set list of risk factors (population level) without room for adjustment to individual factors that may mitigate risk of offending (i.e., having a broken leg).  They can be used as treatment targets, monitoring changes in risks and compare before/after treatment risk to test treatment efficacy.  To provide a balanced picture of risk of offendng. Protective factors mitigate risk of offending and we need to assess them to 1) provide strength-based treatment thats more effective, increases offenders responsisivity to treatment and can increase QOL; 2) to reduce risk of broken leg dilemma which increases risk of incarcerating people who are lower risk than the scale predicts and infringing on their personal rights and freedoms.  It mesaures the true positive/negatives with false negative/positives. This is important becasue the conclusion of the risk assessment impacts decisions at all stages of the CJS which has a large reppurcisons on the offender and society (i.e., financial/social costs, harm, QOL).  Important issue for cultural concerns; can the scale be validated across cultural samples?  Does it fufil the desired task, does it suit the sample being studied (i.e., gender, race, age, disability etc.), is it cost-effective, is it easy to learn or train, is it quick to rate and does it have good inter-rater reliability? ```  Unstructured Clinical Judgement.  Actuarial (static)  Actuarial (static/dynamic)  Case Management and Treatment Planning ```

Answer 20

Auc/Roc Curve or Cohen's D

Answer 21

No. They refer to higher scores on the scale being associated with more recidivism or mean group scores on the scale are higher for reoffender than non-reoffender groups.