The Historical, Clinical and Risk Management Scales (HCR-20) may be a better predictor of inpatient aggression for selected demographic and clinical groups but homogeneity of study samples has prevented definitive conclusions. The aim of this study, therefore, was to test the predictive validity of the HCR-20 as a function of gender, diagnosis, age, and ethnicity while controlling for potential covariates. A pseudo-prospective cohort study (n=505) was conducted in a UK secure/forensic mental health setting using routinely collected data. The HCR-20 predicted aggression better for women than men, and for people with schizophrenia and/or personality disorder than for other diagnostic groups. In women, the presence of the risk management items (R5) was important while men׳s aggression was best predicted solely by current clinical features from the C5 scale. R5 items were better than C5 items for predicting aggression in people with organic and developmental diagnoses. Our data provide additional information on which HCR-20 raters can formulate overall summary judgements about risk for inpatient aggression based on important demographic and clinical characteristics.
Reports of gender differences amongst arsonists at psychiatric assessment are not uncommon, however some are based on relatively small samples. A new retrospective study highlighting gender differences could help to confirm or refute the current state of knowledge. The aim of the current study was to examine gender differences amongst a sample of 167 adult arsonists (129 males and 38 females). Information was collected from clinical records on sociodemographic, family background and childhood factors; adult adjustment; fire setting history; motives; features of pyromania and other offending, from the case notes of a group of arsonists referred to the West Midlands Psychiatry Service over a 24-year period. Female arsonists were older than males and more likely to have a psychiatric diagnosis. Women more frequently had a history of sexual abuse, while men had a more varied criminal background and more substance abuse problems. Our findings largely support previous research, and are discussed in this context, whilst also bringing attention to a more recently developed theory (Action System Model). Significant gender differences amongst arsonists indicates that different emphases in the treatment of male and female arsonists may be advisable, though a reliable evidence base for treatment has yet to be established.
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