Assessing Risk of Future Violence Among Forensic Psychiatric Inpatients With the Classification of Violence Risk (COVR)

Snowden, Robert Jefferson; Gray, Nicola S.; Taylor, John L.; Fitzgerald, Suzanne

doi:10.1176/ps.2009.60.11.1522

Cited by 36 publications

(13 citation statements)

References 21 publications

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“…Based on this, researchers have developed actuarial risk assessment tools to aid clinicians in evaluating risk of violent behavior in practice (Douglas, Cox et al, 1999; Gardner, Lidz, Mulvey, & Shaw, 1996a, 1996b; McNiel, 1998). Examples include the Violence Risk Appraisal Guide (VRAG) (Quinsey, Harris, Rice, & Cormier, 2006), HCR-20 (Douglas, Ogloff, Nicholls, & Grant, 1999; Douglas & Webster, 1999), and Classification of Violence Risk (COVR) (Monahan et al, 2005; Snowden, Gray, Taylor, & Fitzgerald, 2009; Steadman et al, 2000). Thus, clinicians providing mental health treatment to civilians now have at their disposal a substantial evidence-base evaluating risk of engaging in future violence (Heilbrun, 2009; Otto, 2009).…”

Section: Improving Risk Assessment Of Violence Among Military Veteranmentioning

confidence: 99%

Improving risk assessment of violence among military Veterans: An evidence-based approach for clinical decision-making

Elbogen

Fuller

Johnson

et al. 2010

Clinical Psychology Review

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Despite increased media attention on violent acts against others committed by military Veterans, few models have been developed to systematically guide violence risk assessment among Veterans. Ideally, a model would identify which Veterans are most at risk for violence and increased attention could then be turned to determining what could be done to prevent violent behavior. This article suggests how empirical approaches to risk assessment used successfully in civilian populations can be applied to Veterans. A review was conducted of the scientific literature on Veteran populations regarding factors related to interpersonal violence generally and to domestic violence specifically. A list was then generated of empirically-supported risk factors for clinicians to consider in practice. To conceptualize how these known risk factors relate to a Veteran's violence potential, risk assessment scholarship was utilized to develop an evidencebased method to guide mental health professionals. The goals of this approach are to integrate science into practice, overcome logistical barriers, and permit more effective assessment, monitoring, and management of violence risk for clinicians working with Veterans, both in Veteran Administration settings and in the broader community. It is likely that the use of a systematic, empirical framework could lead to improved clinical decision-making in the area of risk assessment, and help reduce violence among Veterans.

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Section: Improving Risk Assessment Of Violence Among Military Veteranmentioning

confidence: 99%

Improving risk assessment of violence among military Veterans: An evidence-based approach for clinical decision-making

Elbogen

Fuller

Johnson

et al. 2010

Clinical Psychology Review

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“…Patients in category 1 have the lowest score and are considered to be at lower risk of violence than those patients in category 9 (Cooke et al ). Two studies by Doyle et al () and Snowden et al () found the VRAG with moderate predictive validity and significantly correlated with PCL‐SV and HCR‐20. As the PCL‐R/SV needs to be administered to obtain an overall VRAG score, the VRAG will, therefore, have similar practical implementation issues to the PCL‐R/SV in acute care setting.…”

Section: Resultsmentioning

confidence: 96%

The validity and utility of violence risk assessment tools to predict patient violence in acute care settings: An integrative literature review

Ghosh¹,

Twigg

Kutzer³

et al. 2019

Int J Mental Health Nurs

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To examine risk assessment tools to predict patient violence in acute care settings. An integrative review of the literature. Five electronic databases – CINAHL Plus, MEDLINE, OVID, PsycINFO, and Web of Science were searched between 2000 and 2018. The reference list of articles was also inspected manually. The PICOS framework was used to refine the inclusion and exclusion of the literature, and the PRISMA statement guided the search strategy to systematically present findings. Forty‐one studies were retained for review. Three studies developed or tested tools to measure patient violence in general acute care settings, and two described the primary and secondary development of tools in emergency departments. The remaining studies reported on risk assessment tools that were developed or tested in psychiatric inpatient settings. In total, 16 violence risk assessment tools were identified. Thirteen of them were developed to assess the risk of violence in psychiatric patients. Two of them were found to be accurate and reliable to predict violence in acute psychiatric facilities and have practical utility for general acute care settings. Two assessment tools were developed and administered in general acute care, and one was developed to predict patient violence in emergency departments. There is no single, user‐friendly, standardized evidence‐based tool available for predicting violence in general acute care hospitals. Some were found to be accurate in assessing violence in psychiatric inpatients and have potential for use in general acute care, require further testing to assess their validity and reliability.

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“…For structured instruments to be of greatest use to clinicians, the violence rates for high-risk groups in different clinical settings and 31 Wormith (2007) 71 Snowden (2009) 68 Snowden (2007) 67 Seto (1999) 66 Rice (2002b) 65 Rice (2002a) 65 Rettenberger (2007) 64 Polvi (1999) 62 Morrissey (2007) 60 Mills (2006) 59 Looman (2010) 56 Kingston (2008) 50 Ho (2009) 48 Hill (2008a) 47 Helmus (2007) 46 Harris (2003b) 45 Harris (2003a) 45 Grann (2000) 42 Grann (1999) 43 Friendship (2003) 39 Eher (2009) 36 Eher (2008b) 37 Eher (2008a) 37 Douglas (2005a) 35 Dempster (2001) 33 Dempster (1998c) 32 Dempster (1998b) 32 Dahle (2006a) 29 Caperton (2005) 28 Bengtson (2008) 27 Beggs 2008 De Vogel (2004b) 31 Walkington (2006) 70 Viljoen (2008) 69 Reeves (2004) 63 Polvi (1999b) 62 Pedersen (2010) 61 Meyers (2008) 58 McEachran (2001) 57 Lodewijks (2008c) 55 Lodewijks (2008b) 54 Lodewijks (2008a) 53 Kropp (2000) 52 Kloezeman (2004)…”

Section: Discussionmentioning

confidence: 99%

Rates of violence in patients classified as high risk by structured risk assessment instruments

Singh¹,

Fazel

Gueorguieva³

et al. 2014

Br J Psychiatry

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BackgroundRates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.AimsTo analyse the variation in rates of violence in individuals identified as high risk by SRAIs.MethodA systematic search of databases (1995-2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.ResultsInformation was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.ConclusionsAfter controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.

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Assessing Risk of Future Violence Among Forensic Psychiatric Inpatients With the Classification of Violence Risk (COVR)

Abstract: The study provides the first independent validation of the COVR and evidence of the usefulness of the COVR in predicting harmful behavior in forensic inpatient settings in the United Kingdom.

Cited by 36 publications

References 21 publications

Improving risk assessment of violence among military Veterans: An evidence-based approach for clinical decision-making

Improving risk assessment of violence among military Veterans: An evidence-based approach for clinical decision-making

The validity and utility of violence risk assessment tools to predict patient violence in acute care settings: An integrative literature review

Rates of violence in patients classified as high risk by structured risk assessment instruments

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