Violent Risk Assessment Flashcards
Week 2
what did violence risk assessments used to be called?
assessments of dangerousness
the first comprehensive review of the research literature regarding assessments of dangerousness by mental health professionals was…..
John Monahan. Predicting Violent Behavior: An Assessment of Clinical Techniques (1981)
what type of tool is the VRAG?
actuarial
what are the 12 items in the VRAG?
- Lived with biological parents
- Elementary school maladjustment
- History of alcohol problems
- Marital status (at time of index
offense) - Criminal history prior to index
offense - Failure on prior release
- Age at index offense
- Victim injury for index offense
- Any female victim
10.Personality disorder - Schizophrenia
12.Psychopathy
Does the VRAG predict reoffending? If so, what level of predictive validity does the VRAG have?
yes, MODERATE predictive validity (.68)
whats better, VRAG or Unstructured Clinical Judgement?
VRAG. it has better reliability, better predictive validity, more transparent and easier to defend in court setting.
What type of tool is the Historical Clinical Risk 20 (HCR20)?
structured professional judgement tool
HCR20 can have some _____ by adding case-specific items
Some discretion, can add case-specific items
Does the HCR20 produce a probability estimate?
it does NOT produce a probability estimate
what type of assessment does the HCR20 use?
it makes structured judgements of low, medium, high risk
HCR20’s purpose
designed to predict violence in adults
what type of items does the HCR20 use? statis or dynamic?
Includes dynamic or treatment-relevant factors – 20 items
how was the HCR20 developed?
from literature review of lots of studies
what are the 3 sections of the HCR-20 V3?
1) HISTORICAL (e.g., violence, major mental disorder)
2) CLINICAL (e.g., looks at symptoms of MAJOR mental disorder) – psychotic disorders, mood disorders, or others.
3) FUTURE (living situation, stress or coping)
T/F: when adolescents are together, they’re more likely to commit risky behaviour
true
what are the benefits that youth see in committing crime?
money, feeling of fitting in, excitement as youth feel bored, getting respect
what is the AUC score of the VRAG?
.68. This means that if you were to assess the a that didn’t reoffended person and a person that has committed a crime, there is a 68% that the person who reoffended would score higher than the person who didn’t offend
HCR20 was developed where and when?
late 1990’s at SFU
for the CLINICAL part of HCR-20, you are looking for
Delusions with morbid, paranoid, or violent themes
• Recently acted on a command hallucination
• Mania (with irritable or hostile mood)
for the FUTURE part of HCR-20, you are looking for _______ and indicators are
• Future problems with ability to cope with stresses and life events
-Indicators:
• Living circumstances are likely to be very stressful
• Unlikely to use coping strategies
T/F: with HCR-20, you could rate someone as high risk based on a single judgement
TRUE
after scoring your items on HCR-20, what do you do?
make your own judgements of low medium and high. DO NOT sum up. then do a CASE FORMULATION and SCENARIO-PLANNING
in scenario planning, what is a REPEAT scenario?
same as before
in scenario planning, what is a ESCALATING scenario?
gets worse (e.g., gets a gun)
in scenario planning, what is a TWIST scenario?
behaviours change (e.g., starts to use drugs)
in scenario planning, what is a IMPROVING scenario?
gets better
what is scenario planning good for?
helps us to trouble-shoot and prepare for possibilities.
Used in; working with suicidal people (thinking about how someone could hurt themselves and working preventatively), earthquake planning, and building bridges
which tool is better, VRAG or HCR-20?
the tools don’t really have a significant difference
what is the AUC of HCR-20?
.71 MODERATE RANGE
T/F: tool authors tend to obtain more positive results
TRUE. Tool authors report predictive validity that is 2 times higher than independent authors
why are tool authors finding more positive results?
authorship bias: maybe authors present data in the most positive light
Fidelity: maybe authors conduct better studies (e.g., do a better job in training raters)
authorship bias
tool authors present data in the most positive light that they can
Fidelity
maybe authors conduct better quality studies because they designed the tool
which is better, tools or unstructured judgement?
tools are better.
BUT it may be susceptible to an ALLEGIANCE EFFECT.
• When you working for prosecution, you might rate as higher risk than if you’re working for defence
• Pressure to tell people what they want to hear
can biases occur even when tools are used?
yes
what is the Allegiance Effect Study?
• Paid forensic psychologists to rate files on STATIC 99 & Psychopathy • Told some psychologists that they were working for state (~prosecution) • Told others they were working for defense IF WORKING FOR PROSECUTION, RATED AS HIGH RISK
T/F: unstructured judgement is poor
true
most tools perform similarly in terms of..
prediction
what is the predictive validity of risk assessment tools? how accurately do they predict violence?
MODERATE EFFECT SIZES
which tools are better at predicting violence in reoffending?
ACTUARIAL AND SPJ TOOLS PERFORM SIMILARLY
when was the first violence risk assessment tool developed?
1985
approx how many violence risk assessment tools have been developed?
OVER 400
what type of risk assessment tool is the VRAG?
ACTUARIAL
