Predictive validity of the HCR-20 for inpatient self-harm

Predictive Validity of the Short-Term Assessment of Risk and Treatability (START) for Aggression and Self-Harm in a Secure Mental Health Service: Gender Differences

“…As a result, practitioners may have a degree of added confidence in their START assessment rating if the subject in question is female. This is consistent with research with the HCR-20 which found superior predictive efficacy and a greater number of relevant items for aggression and selfharm in women compared with men (O'Shea, Picchioni, et al, 2014a, 2014b. …”

“…The current study adds to a growing body of evidence that risk assessment instruments provide more accurate predictions of inpatient aggression and self-harm for women than for men (O'Shea et al, 2013;O'Shea, Picchioni, et al, 2014a, 2014b. Interpretation of the results of studies of the predictive accuracy of the START, and of the HCR-20, should always consider the proportion of females in the sample since they are likely to inflate the effect sizes detected.…”

“…We also aimed to examine the relative importance of the individual items for each of the groups, as this has important implications for the development of risk management strategies. We hypothesized that the START would perform best in women, due to increasing evidence that risk assessment tools perform more accurately among this group in inpatient settings (e.g., O'Shea et al, 2013;O'Shea, Picchioni, et al, 2014b).…”

“…For example, while cautioning against widespread generalisation due to small sample sizes, Singh et al (2011) found higher diagnostic odds ratios, suggesting better performance, in female samples compared with male samples in a meta-regression analysis of nine risk assessment tools. Further, and perhaps most pertinent to the START which is largely used in secure psychiatric settings, the HCR-20 has been found to predict inpatient aggression and self-harm more accurately in females (O'Shea, Mitchell, Picchioni, & Dickens, 2013;O'Shea et al, 2014aO'Shea et al, , 2014b. The relative importance of individual items in predicting outcome also differs as a function of gender; factors pertaining to future risk are most relevant in women and those relating to current clinical presentation are more relevant in men (O'Shea, Picchioni et al, 2014a, 2014b.…”

Predictive validity of the HCR‐20 for violent and non‐violent sexual behaviour in a secure mental health service

“…We are not aware of any studies that have examined its predictive value with respect to non-violent but inappropriate sexual acts. There is emerging evidence, however, that the HCR-20 may be used with good effect to predict behaviour outside its specific target outcomes, notably self-harm (O'Shea et al, 2014b), possibly because of common risk factors. Our aim, therefore, was to investigate whether the HCR-20 can significantly predict both violent and non-violent inappropriate sexual behaviours by secure unit inpatients.…”