Assessment Of Violence

Question 1

What is Hare Psychopathy checklist

Answer 1

Hare Psychopathy Checklist — designed to assess antisocial psychopaths; score strongly correlated with risk for violence;

Question 2

What is Violence Risk Appraisal Guide

Answer 2

Violence Risk Appraisal Guide (VRAG) — actuarial test;

Question 3

What is HCR 20

Answer 3

Historical/Clinical Risk Management 20 Item (HCR-20) — simpler to use; offers structured clinical judgment; useful for assessing violence in general but not for targeted violence toward specific person;

Question 4

What is the Classification of Viloence Risk

Answer 4

Classification of Violence Risk (COVR) — requires software; study — researchers administered psychological tests and asked for patient’s own assessment of how concerned his therapist should be about violence by patient during ensuing 2 mo; patient self-assessment slightly more accurate than findings on 2 objective instruments;

Question 5

How important is actuarial

Answer 5

actuarial risk assessment — more accurate because of stability of historical factors risk assessment

Question 6

What was the results is Swanson study to observe severity of violence

Answer 6

Swanson et al — administered brief screening test to >10,000 people in community;
2% of those without mental illness reported committing violent act within past year;

risk for violence 5-fold higher among people with schizophrenia or bipolar disorder compared with people with psychotic illness,

people who abuse alcohol twice as likely

those who use illegal drugs 3 times as likely, to commit violent act

prevalence of substance abuse >40% in individuals with schizophrenia, 80% in those with antisocial personality disorder, and 60% in people with bipolar I

people with schizophrenia and substance abuse disorder 17 times more likely than general population to be violent

Question 7

What are findings of Elbogen and Johnson

Answer 7

Elbogen and Johnson showed that history of violence and substance abuse increased probability of violence in patients with severe mental illness

Question 8

What are results of McArthur study

Answer 8

MacArthur study, no correlation found between fearful delusions and violence, but men more likely than women to respond violently to persecutory ideas; systematized delusions more dangerous than general delusions (delusions that involve specific target more likely to be acted on); most psychotic violence related to delusions; some violent acts related to delusion-related hallucinations