Violence Risk Assessment

Question 1

how do evaluators measure predictive validity?

Answer 1

they calculate the area under the curve (AUC);

• rate offenders using tool
• examine who offenders
• calculate AUC

Question 2

e.g., of VRAG limitation; what if someone showed an increase in symptoms of schizophrenia? would this change the rating?

Answer 2

unfortunately not as the items looked at only focus on historical static factors

Question 3

availability heuristic (confirmation bias)

Answer 3

recall certain info more easily if important/noticeable – so we think it’s true

Question 4

example of availability heuristic

Answer 4

confirmation bias

Question 5

an example of representativeness heuristic is

Answer 5

base rate neglect

Question 6

T/F: actuarial tools do not allow for discretion or flexibility

Answer 6

TRUE. if its not on the tool, you can’t consider it. However some discretion may be important such as someone hearing voices saying to kill others should be able to bump up ratings.

Question 7

what are the pros of unstructured clinical judgement?

Answer 7

easy, convenient, individualized

Question 8

anchoring heuristic

Answer 8

overly influenced by whatever info is learned first (e.g. framing)

Question 9

false negative error

Answer 9

thinking someone is low risk but they’re actually high risk

Question 10

what does AUC of .70 mean in comparison to AUC of .50

Answer 10

AUC of .70 means that if you randomly selected a
recidivist and a non-recidivist, there is a 70% chance the
recidivist would score higher than the non-recidivist

AUC of .50 means that the tool is no better than chance

Question 11

representative heuristic (base rate neglect)

Answer 11

rely on stereotypes or evidence that seems prototypical.

Question 12

true negative

Answer 12

low risk because they truly are low risk

Question 13

true positive

Answer 13

high risk because they truly are high risk

Question 14

pros of VRAG

Answer 14

• better reliability
• better predictive validity
• more transparent
• easier to defend

Question 15

when were risk assessment tools first developed

Answer 15

around 1985

Question 16

framing is an example of

Answer 16

anchoring heuristic

Question 17

what are the challenges that evaluators may face?

Answer 17

The challenge is in making an accurate assessment about someone due to;

• limited amount of time
• limited validity
• limited amount of info because usually the person giving the info is wanting the examiner to steer their opinion a way that favours them.
• ensuring that one who has been involved in the case does not affect your decisions

Question 18

T/F: we predict around half of the people we evaluate will reoffend

Answer 18

False.

more like 10%

Question 19

Framing (anchoring heuristic)

Answer 19

drawing different conclusions from the same information, depending on how or by whom that information is presented

Question 20

_______ ______ is poor. ______ tools are better than ________ but still have some problems. So…another option is ______ ________ _______

Answer 20

unstructured judgement is poor. Actuarial tools are better than Unstructured but still have some problems. So… another option is Structured Professional judgement

Question 21

T/F: Predictive validity of VRAG is perfect

Answer 21

FALSE. it’s good but not perfect. AUC = .68 (moderate range)

Question 22

where can risk assessments happen in the justice system, psychiatric, and education

Answer 22

In the Justice system: 
• Placements (e.g., pretrial detention)
• Sentencing (e.g., death penalty)
• Supervision/security (e.g., max security)
• Treatment (e.g., services)
• Release from custody (e.g., parole)

PSYCHIATRIC
• Warn potential victims (duty to protect)
• Civil commitment (i.e., hospitalized –
danger to others)

EDUCATION
• Threaten to harm another student

Question 23

what type of tool is the Violence Risk Appraisal Guide (VRAG)?

Answer 23

actuarial - add up scores, no discretion. it produces estimated probabilities (e.g., 78% chance this person will reoffend)

Question 24

how is information combined in actuarial tools?

Answer 24

adding up the total scores

Question 25

T/F: Tools have higher AUC score than Unstructured Judgement

Answer 25

TRUE.

Question 26

what items does the VRAG look at? historical or static?

Answer 26

both. 12 items looked at. they developed it by selecting factors that predict violence in a sample

Question 27

what are the cons of unstructured clinical judgement?

Answer 27

• lacks reliability
• poor predictive validity
• accurate in NOT MORE THAN 1/3 predictions
• lacks transparency
• difficult to defend

Question 28

what are some of the limitations with risk assessment tools?

Answer 28

• best option but are not crystal balls into the future

- biases can STILL occur even when tools are used

Question 29

how many tools are out there?

Answer 29

over 400

Question 30

what is the purpose of the VRAG?

Answer 30

designed to predict violence in adults

Question 31

what are the pros of having risk assessment tools?

Answer 31

• better inter-rater reliability
• better predictive validity (moderate range)
• more transparent
• easier to defend

Question 32

to use tools such as the HCR-20 V3, you must have

Answer 32

a Ph.Din clinical psychology or a related field

Question 33

false positive error

Answer 33

thinking someone is high risk when they are actually low risk

Question 34

confirmation bias is an example of

Answer 34

availability heuristic

Question 35

base rate neglect (representativeness heuristic)

Answer 35

judging likelihood of an outcome without considering accurate information about the probability of that outcome

e.g., we predict that around half of the people we evaluate will reoffend

Question 36

base rate neglect is an example of

Answer 36

representativeness heuristic

Question 37

example of anchoring heuristic

Answer 37

framing

Question 38

cons of VRAG

Answer 38

• not crystal balls and biases can still occur (this is with all tools)
• VRAG doesn’t allow for any discretion or flexibility and VRAG focuses on static factors (this is an issue with actuarial tools mostly)

Question 39

what is a limitation of the VRAG?

Answer 39

factors on the VRAG are static or unmodifiable and so, risk can change over time but that won’t change a rating.

Question 40

how is information combined in Structured Professional Judgement?

Answer 40

they don’t add up but rather rate low/moderate/high)

Question 41

Confirmation bias (availability heuristic)

Answer 41

look for evidence that confirms our initial impression

e.g. we already made up our mind that one is high risk