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Clinical Forensic Psychologist > Violent Risk Assessment > Flashcards

Violent Risk Assessment Flashcards

Week 2

1
Q

what did violence risk assessments used to be called?

A

assessments of dangerousness

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2
Q

the first comprehensive review of the research literature regarding assessments of dangerousness by mental health professionals was…..

A

John Monahan. Predicting Violent Behavior: An Assessment of Clinical Techniques (1981)

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3
Q

what type of tool is the VRAG?

A

actuarial

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4
Q

what are the 12 items in the VRAG?

A
  1. Lived with biological parents
  2. Elementary school maladjustment
  3. History of alcohol problems
  4. Marital status (at time of index
    offense)
  5. Criminal history prior to index
    offense
  6. Failure on prior release
  7. Age at index offense
  8. Victim injury for index offense
  9. Any female victim
    10.Personality disorder
  10. Schizophrenia
    12.Psychopathy
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5
Q

Does the VRAG predict reoffending? If so, what level of predictive validity does the VRAG have?

A

yes, MODERATE predictive validity (.68)

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6
Q

whats better, VRAG or Unstructured Clinical Judgement?

A

VRAG. it has better reliability, better predictive validity, more transparent and easier to defend in court setting.

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7
Q

What type of tool is the Historical Clinical Risk 20 (HCR20)?

A

structured professional judgement tool

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8
Q

HCR20 can have some _____ by adding case-specific items

A

Some discretion, can add case-specific items

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9
Q

Does the HCR20 produce a probability estimate?

A

it does NOT produce a probability estimate

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10
Q

what type of assessment does the HCR20 use?

A

it makes structured judgements of low, medium, high risk

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11
Q

HCR20’s purpose

A

designed to predict violence in adults

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12
Q

what type of items does the HCR20 use? statis or dynamic?

A

Includes dynamic or treatment-relevant factors – 20 items

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13
Q

how was the HCR20 developed?

A

from literature review of lots of studies

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14
Q

what are the 3 sections of the HCR-20 V3?

A

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)

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15
Q

T/F: when adolescents are together, they’re more likely to commit risky behaviour

A

true

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16
Q

what are the benefits that youth see in committing crime?

A

money, feeling of fitting in, excitement as youth feel bored, getting respect

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17
Q

what is the AUC score of the VRAG?

A

.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

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18
Q

HCR20 was developed where and when?

A

late 1990’s at SFU

19
Q

for the CLINICAL part of HCR-20, you are looking for

A

Delusions with morbid, paranoid, or violent themes
• Recently acted on a command hallucination
• Mania (with irritable or hostile mood)

20
Q

for the FUTURE part of HCR-20, you are looking for _______ and indicators are

A

• 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

21
Q

T/F: with HCR-20, you could rate someone as high risk based on a single judgement

A

TRUE

22
Q

after scoring your items on HCR-20, what do you do?

A

make your own judgements of low medium and high. DO NOT sum up. then do a CASE FORMULATION and SCENARIO-PLANNING

23
Q

in scenario planning, what is a REPEAT scenario?

A

same as before

24
Q

in scenario planning, what is a ESCALATING scenario?

A

gets worse (e.g., gets a gun)

25
Q

in scenario planning, what is a TWIST scenario?

A

behaviours change (e.g., starts to use drugs)

26
Q

in scenario planning, what is a IMPROVING scenario?

A

gets better

27
Q

what is scenario planning good for?

A

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

28
Q

which tool is better, VRAG or HCR-20?

A

the tools don’t really have a significant difference

29
Q

what is the AUC of HCR-20?

A

.71 MODERATE RANGE

30
Q

T/F: tool authors tend to obtain more positive results

A

TRUE. Tool authors report predictive validity that is 2 times higher than independent authors

31
Q

why are tool authors finding more positive results?

A

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)

32
Q

authorship bias

A

tool authors present data in the most positive light that they can

33
Q

Fidelity

A

maybe authors conduct better quality studies because they designed the tool

34
Q

which is better, tools or unstructured judgement?

A

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

35
Q

can biases occur even when tools are used?

A

yes

36
Q

what is the Allegiance Effect Study?

A 
• 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
37
Q

T/F: unstructured judgement is poor

A

true

38
Q

most tools perform similarly in terms of..

A

prediction

39
Q

what is the predictive validity of risk assessment tools? how accurately do they predict violence?

A

MODERATE EFFECT SIZES

40
Q

which tools are better at predicting violence in reoffending?

A

ACTUARIAL AND SPJ TOOLS PERFORM SIMILARLY

41
Q

when was the first violence risk assessment tool developed?

A

1985

42
Q

approx how many violence risk assessment tools have been developed?

A

OVER 400

43
Q

what type of risk assessment tool is the VRAG?

A

ACTUARIAL

Clinical Forensic Psychologist (5 decks)

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