Prediction of violence and self-harm in mentally disordered offenders: A prospective study of the efficacy of HCR-20, PCL-R, and psychiatric symptomatology.

Gray, Nicola S.; Hill, Charlotte; McGleish, Andrew; Timmons, David; MacCulloch, Malcolm J.; Snowden, Robert Jefferson

doi:10.1037/0022-006x.71.3.443

Cited by 188 publications

(162 citation statements)

References 37 publications

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“…This is consistent with previous studies in which Factor 2 (containing criminal and impulsivity variables) has been found to be superior to Factor 1 (consisting primarily of personality variables) in predicting future criminal behaviour (Belfrage, Fransson, & Strand, 2000;Gray et al, 2003;de Vogel, de Ruiter, Hildebrand, Brechje, & van de Ven, 2004). The investigation of psychopathy in men and women in our study revealed important commonalities and differences.…”

Section: Resultssupporting

confidence: 92%

Psychopathy and offending behaviour: Findings from the national survey of prisoners in England and Wales

Roberts

Coid

2007

Journal of Forensic Psychiatry & Psychology

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There is debate about whether the psychopath's criminal behaviour is a consequence of abnormal personality traits or a symptom of psychopathy. The aim of this study was to examine independent associations between offending behaviour over the lifetime and psychopathy in a representative sample of male and female offenders. A two-stage survey was carried out among prisoners in all prisons in England and Wales. Psychopathy was measured using the PCL-R in the second stage among 497 male and female prisoners. Independent relationships between the four factors of psychopathy and lifetime offences were examined using multiple regression. Two models of association were compared to test the effects of the fourth (antisocial) factor. Factor 1 (interpersonal) was not associated with any category of serious offending behaviour. Affective deficiency (Factor 2) was independently associated with violent and acquisitive offending in men. The contribution of the antisocial factor to associations with total PCL-R scores, together with its strong intercorrelations with Factor 3 (lifestyle), suggest that it is an integral component of the psychopathy construct. The findings also demonstrate the dilemma of colinearity between the third and fourth factors of psychopathy and their relationship with criminal behaviour, especially in men.

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Section: Resultssupporting

confidence: 92%

Psychopathy and offending behaviour: Findings from the national survey of prisoners in England and Wales

Roberts

Coid

2007

Journal of Forensic Psychiatry & Psychology

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“…This analysis did not address the influence of early maltreatment on the risk of self-harm in individuals with psychosis, given that different factors may influence this relationship (see e.g. Gray et al, 2003).…”

Section: Limitationsmentioning

confidence: 99%

The Relationship Between Childhood Maltreatment and Violence to Others in Individuals With Psychosis: A Systematic Review and Meta-Analysis

Green

Browne

Chou

2017

Trauma, Violence, & Abuse

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Acknowledgements: We are grateful for Dr E Baldwin (PhD, CPsychol, AFBPsS) for her work as an independent second assessor.Declaration of interest: none of the authors has conflict of interest. 2The relationship between childhood maltreatment and violence to others in individuals with psychosis: a systematic review and metaanalysis Abstract Background: There is a growing body of literature identifying a relationship between experiences of

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“…Some instruments, however, have been explicitly designed for, or validated within, specific offender populations. [47][48][49] The first stage of the project involved a scoping exercise to systematically identify available instruments that could be used to screen for self-harm. A search was carried out with the Scopus database [encompassing MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and EMBASE], using appropriate search terms such as 'self-harm', 'self-injury', 'suicide ideation', 'prison', 'jail', 'risk', 'questionnaire' and 'screen'.…”

Section: Scoping Methodsmentioning

confidence: 99%

“…Limited evidence suggests that the Beck Hopelessness Scale (BHS) 46 was predictive of self-harm among offenders with mental disorders. 47 Several other scales are available for assessing the risk of self-harm, for example the Self-Harm Inventory (SHI), 48 but few have been validated for routine use in offender populations. A newer scale, Suicide Concerns for Offenders in Prison Environment (SCOPE), 49 has been specifically developed to assess vulnerability to risk of suicide and non-fatal self-harm behaviour in young adult offenders but, again, has not been tested with regard to routine implementation in prisons, for those of older ages or for prospective predictive validity.…”

Section: Implications For the Prison Systemmentioning

confidence: 99%

Assessing the risk of self-harm in an adult offender population: an incidence cohort study

Horton

Wright²,

Dyer

et al. 2014

Health Technology Assessment

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BackgroundSelf-harm is common among prisoners, particularly female prisoners. In 2007, concerned about the rising incidence, the prison service introduced a care-planning system called Assessment, Care in Custody, and Teamwork (ACCT). To date, it does not incorporate a standardised diagnostic test to estimate the risk of future self-harm.ObjectiveTo identify potential screening instruments, or items from those instruments, to predict the risk of self-harm among prisoners.ParticipantsPrisoners who had been assigned to an ACCT during the recruitment period.DesignA multistage prospective cohort study. Following a pilot study, instruments were administered to prisoners by interview at baseline, and followed up for 6 months (or until point of release if this was sooner) to ascertain self-harm status. Instruments were assessed for unidimensionality, scalability (Mokken) and quantitative structure (Rasch). Area under the curve (AUC) analysis was used to examine the ability of instruments and/or their items to predict future self-harm. Cox proportional hazards regression models were used to examine the multivariate predictive ability of the scales and various sociodemographic and sentencing factors.SettingThree prisons (including one women’s prison) in northern England.Main outcome measuresA set of standardised questionnaires, including the Prison Screening Questionnaire (PriSnQuest), Revised Borderline Symptom List-23 (frequency-based responses) (BSL-23-F), Self-Harm Inventory (SHI), Patient Health Questionnaire (PHQ-9) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), together with sociodemographic and sentencing data.ResultsIn total, 450 prisoners consented to participate in the study, of whom 26% were female. The mean age of participants was 31.2 years. Over half of male prisoners recruited were on remand, compared with just over one-fifth (22.6%) of female prisoners. The average tariff of those sentenced was 41 months, of which 14.7 months, on average, had been served. Just over one-third of ACCTs had been initiated because of a known self-harm event, and over one-quarter (27.8%) of participants self-harmed during the follow-up period. Thus, almost half (46.7%) of those entered into the study were reported to have self-harmed, either from their index ACCT, or subsequently, or both. Cutting was the most frequent behaviour (51%). All screening instruments showed some evidence of unidimensionality, and four out of five showed scaling criteria consistent with ordinal scaling, so verifying the validity of the cut points. However, many showed gender bias and failure to fit the Rasch measurement model. While a resolution was made in most cases, both ordinal raw scores and latent interval scale estimates failed to show predictive value when applied within AUC analysis (0.491–0.566) or adjusted Cox proportional hazards models. However, good predictive values were shown for gender-specific sets of items, thus providing easily applied screening indexes.ConclusionsWhile four out of five potential screening instruments were found to have acceptable psychometric properties within this setting, their predictive validity of all instruments was poor under AUC analysis. Gender-specific item sets were put together to form two screening indexes with formative indicators which gave reasonable AUC values, particularly so for females. The indexes provide identification of low–medium–high risk of self-harm, and so may help to inform potential care pathways and decisions to sign prisoners off from the ACCT. Future work should concentrate on refining a set of predictive screening items among different offender populations and investigating the time point at which this set of items should be administered. Future work may also look at the different magnitudes of risk as indicators for care pathways.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Prediction of violence and self-harm in mentally disordered offenders: A prospective study of the efficacy of HCR-20, PCL-R, and psychiatric symptomatology.

Cited by 188 publications

References 37 publications

Psychopathy and offending behaviour: Findings from the national survey of prisoners in England and Wales

Psychopathy and offending behaviour: Findings from the national survey of prisoners in England and Wales

The Relationship Between Childhood Maltreatment and Violence to Others in Individuals With Psychosis: A Systematic Review and Meta-Analysis

Assessing the risk of self-harm in an adult offender population: an incidence cohort study

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