Confidence and accuracy in assessments of short-term risks presented by forensic psychiatric patients

Desmarais, Sarah L.; Nicholls, Tonia L.; Read, John; Brink, Johann

doi:10.1080/14789940903183932

Cited by 32 publications

(28 citation statements)

References 45 publications

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“…Blending the empirical strength of actuarial techniques with mostly unevaluated management items risks reducing predictive accuracy without conferring benefit. Relatedly, we concur with Grove and Meehl (1996; see also Bengtson & Längström, 2007;Faust, 2004) that permission to countervail actuarial scores based on clinical judgment is likely to lead to decreased accuracy overall (see Desmarais et al, 2010;Douglas et al, 2005;Hanson & Morton-Bourgon, 2009;Michel et al, 2013;Pedersen et al, 2012;Storey et al, 2012;Wormith, Hogg, & Guzzo, 2012). The VRAG-R (and its predecessors) renders a valid assessment at one point in time of offenders' subsequent risk of violence so that custody and other resources pertaining to long-term management can be apportioned most efficiently (Andrews & Bonta, 2010).…”

Section: Replacing the Vrag/sorag Systemmentioning

confidence: 78%

Validation of and revision to the VRAG and SORAG: The Violence Risk Appraisal Guide—Revised (VRAG-R).

Rice¹,

Harris²,

Lang³

2013

Psychological Assessment

140

171

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The violence risk appraisal guide (VRAG) was developed in the early 1990s, and approximately 60 replications around the world have shown its utility for the appraisal of violence risk among correctional and psychiatric populations. At the same time, authorities (e.g., Dawes, Faust, & Meehl, 1989) have argued that tools should be periodically evaluated to see if they need to be revised. In the present study, we evaluated the accuracy of the VRAG in a sample of 1,261 offenders, fewer than half of whom were participants in the development sample, then developed and validated a revised and easier-to-score instrument (the VRAG-R). We examined the accuracy of both instruments over fixed durations of opportunity ranging from 6 months to 49 years and examined outcome measures pertaining to the overall number, severity, and imminence of violent recidivism. Both instruments were found to predict dichotomous violent recidivism overall and at various fixed follow-ups with high levels of predictive accuracy (receiver operating characteristic areas of approximately .75) and to significantly predict other violent outcomes.

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Section: Replacing the Vrag/sorag Systemmentioning

confidence: 78%

Validation of and revision to the VRAG and SORAG: The Violence Risk Appraisal Guide—Revised (VRAG-R).

Rice¹,

Harris²,

Lang³

2013

Psychological Assessment

140

171

View full text Add to dashboard Cite

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“…START has been identified as a promising new instrument for assessing risk for aggression in psychiatric in‐patient settings (Daffern, 2007) and for supporting best practice in managing violence and related risks (UK Department of Health, ; Haque, Cree, Webster, & Hasnie, ). Empirical evidence supports the reliability and validity of START assessments completed in the context of research studies (Desmarais et al, ; Chu, Thomas, Ogloff, & Daffern, ; Chu, Thomas, Ogloff, & Daffern, ; Gray et al, ; Wilson, Desmarais, Nicholls, & Brink, ), as well as in the context of ‘real world’ implementations (i.e., completed by mental health professionals as part of routine practice) (Braithwaite, Charette, Crocker, & Reyes, ; Desmarais, Nicholls, Read, & Brink, ; Nicholls et al, ; Nicholls et al, ; Nonstad et al, ). In addition to the reliability and validity of assessments, recent research supports clinicians' perceptions of START as a useful framework for making judgments about risk and formulating risk management strategies and the feasibility of successfully implementing START in practice (Crocker et al, ; Doyle, Lewis, & Brisbane, ; Khiroya, Weaver, & Maden, ; Kroppan et al, ).…”

Section: The Startmentioning

confidence: 92%

Characteristics of START Assessments Completed in Mental Health Jail Diversion Programs

Desmarais

Dorn

Telford

et al. 2012

Behavioral Sci & The Law

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Many different instruments have been developed to assist in the assessment of risk for violence and other criminal behavior. However, there is limited evidence regarding how these instruments work in the 'real world'. Even less is known about how these instruments might work for assessing risk in jail diversion populations, whether in research or practice. To address these knowledge gaps, the present study examined the characteristics of risk assessments completed by program staff (n=10) on 96 mental health jail diversion clients (72 men and 24 women) using the Short-Term Assessment of Risk and Treatability (START). The findings provide preliminary support for the reliability and validity of START assessments completed in jail diversion programs, the first evidence of the transportability of START outside psychiatric settings, and further evidence regarding the reliability and validity of START assessments completed in the field. They additionally support the consideration of an eighth, general offending risk domain in START assessments.

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“…The current analyses used each daily risk assessment rating as a unit of analysis, which is an acceptable and appropriate comparison method in this area of study (e.g. Almvik et al, 2000;Barry-Walsh, Daffern, Duncan, & Ogloff, 2009;Desmarais, Nicholls, Read, & Brink, 2010). The three assessment measures examine dynamic risk states; individuals' mental state fluctuates and these measures are sensitive to change.…”

Section: Statistical Analysesmentioning

confidence: 98%

Predicting aggression in acute inpatient psychiatric setting using BVC, DASA, and HCR-20 Clinical scale

Chu

Daffern

Ogloff

2013

The Journal of Forensic Psychiatry & Psychology

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The assessment and prevention of aggressive behavior are critical components of contemporary psychiatric inpatient care, treatment, and management. This prospective study compared the predictive validity of three dynamic violence risk assessment measures (i.e. Brøset Violence Checklist (BVC), Dynamic Appraisal of Situational Aggression (DASA), and HCR-20 Clinical scale) for imminent aggression (within the next 24 h). The DASA and BVC were developed specifically to assess imminent violence within psychiatric hospitals, whereas the HCR-20 is a 'general' violence risk assessment measure that can also be used for this purpose. Daily risk ratings were completed for 70 psychiatric inpatients; a total of 3449 ratings for each risk assessment measure were obtained. Results showed that the DASA and BVC were acceptable to outstanding predictive validity and were more accurate than the HCR-20 Clinical scale for predicting inpatient aggression. Actuarial and structured professional ratings were similar for the prediction of verbal threats, but actuarial ratings were more accurate for predicting interpersonal violence. Overall, these findings support the use of structured dynamic risk assessment measures to aid in the prediction of imminent aggression within inpatient psychiatric settings.

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Confidence and accuracy in assessments of short-term risks presented by forensic psychiatric patients

Cited by 32 publications

References 45 publications

Validation of and revision to the VRAG and SORAG: The Violence Risk Appraisal Guide—Revised (VRAG-R).

Validation of and revision to the VRAG and SORAG: The Violence Risk Appraisal Guide—Revised (VRAG-R).

Characteristics of START Assessments Completed in Mental Health Jail Diversion Programs

Predicting aggression in acute inpatient psychiatric setting using BVC, DASA, and HCR-20 Clinical scale

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