Risk and Protective Factors for Inpatient Aggression

Robbé, Michiel de Vries; Vogel, Viviënne de; Wever, Edwin C.; Douglas, Kevin S.; Nijman, Henk

doi:10.1177/0093854816637889

Cited by 40 publications

(36 citation statements)

References 44 publications

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“…The fact that the SAPROF Japanese version had predictive validity is consistent with a previous study conducted among a Dutch sample of inpatients [ 21 ]. In this Dutch inpatient study, most of the patients (89%) had been diagnosed with at least one personality disorder (particularly Cluster B disorders), while 53% of the patients had been diagnosed with a major mental illness (primarily psychotic disorders, such as schizophrenia) [ 21 ]. The duration of observation for violence was 12 months after the initial assessment.…”

Section: Discussionsupporting

confidence: 89%

Strength-based assessment for future violence risk: a retrospective validation study of the Structured Assessment of PROtective Factors for violence risk (SAPROF) Japanese version in forensic psychiatric inpatients

et al. 2018

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BackgroundThe Structured Assessment of PROtective Factors for violence risk (SAPROF) was recently developed as a strength-based addition to the risk assessment of future violent behavior. We examined the interrater reliability and predictive accuracy of the SAPROF for violence in forensic mental health inpatient units in Japan.MethodsThis retrospective record study provides an initial validation of the SAPROF in a Japanese sample of 95 forensic psychiatric inpatients from a complete 2008–2013 cohort. Violent outcomes were assessed 6 and 12 months after hospitalization.ResultsWe observed moderate-to-good interrater reliability for the SAPROF total score and the internal factors, motivational factors, external factors, and the Final Protection Judgment scores. According to a receiver operating characteristic analysis, the SAPROF total score and all subscale scores predicted violence at both 6 and 12 months after hospitalization with high accuracy. Furthermore, the predictive validity of a combination of the SAPROF with the Historical Clinical Risk Management-20 (HCR-20) outperformed that of the HCR-20 alone.ConclusionsThe results provide evidence of the value of considering protective factors in the assessment of future violence risk among Japanese forensic psychiatric inpatients. The SAPROF might allow for a more balanced assessment of future violence risk in places where the population rates of violent crime are low, such as Japan, but a validation study in a different setting should confirm this. Moreover, future studies should examine the effectiveness of treatment and promoting community re-integration on motivating patients and treatment staff.

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Section: Discussionsupporting

confidence: 89%

Strength-based assessment for future violence risk: a retrospective validation study of the Structured Assessment of PROtective Factors for violence risk (SAPROF) Japanese version in forensic psychiatric inpatients

et al. 2018

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“…The SAPROF and the START Strength scores did not demonstrate significant predictive validity in this female sample. In a previous study, the SAPROF showed better results for women (de Vries Robbé et al, 2016). However, in the referred study, the SAPROF was examined for inpatient violence and not for recidivism after discharge.…”

Section: Discussionmentioning

confidence: 86%

Gender-Sensitive Violence Risk Assessment: Predictive Validity of Six Tools in Female Forensic Psychiatric Patients

Vogel

Bruggeman

Lancel

2019

Criminal Justice and Behavior

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Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management-20 (HCR-20), Historical, Clinical, Risk Management-20 Version 3 (HCR-20 V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist-Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20 V3 , and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20 V3 demonstrated significant predictive accuracy.

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“…Given the severe consequences of inpatient physical violence for victims, it is important to be able to assess, upon admittance, which patients have higher risks to threaten ward safety. The available evidence suggests, however, that the predictive properties of one of the most widely used violent risk assessment instruments (Ramesh et al, 2018), that is, the Historical Clinical Risk Management–20 (Webster et al, 1997), were good during the later phases of treatment, but less during the early treatment phases (de Vries Robbé et al, 2016). Therefore, more research on physically violent inpatients is necessary.…”

Section: Identifying Physically Violent Inpatientsmentioning

confidence: 99%

Physical Violence During Mandatory Psychiatric Treatment: Prevalence and Patient Characteristics

Verstegen

Vogel

Huitema

et al. 2020

Criminal Justice and Behavior

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This study explores variables that predict physical violence in 614 (forensic) psychiatric inpatients. All violent incidents that occurred in a Dutch forensic psychiatric hospital between 2014 and 2019 ( N = 3,713) were coded with the Modified Overt Aggression Scale+ based on daily hospital reports and patients’ medical records. Binary logistic regression analyses examined which patient variables could differentiate between patients with and without physical violence during treatment and between patients with single and multiple incidents of physical violence. Variables included in the analyses were gender, legal status, borderline personality disorder, antisocial personality disorder, schizophrenia spectrum disorder, psychopathy (Psychopathy Checklist–Revised [PCL-R] score), self-harm during treatment, impulsivity, intellectual disability, and length of stay. A clear association was found between self-harm and inpatient physical violence on all outcome measures and in all analyses. Adequate monitoring of self-harm is advised as a strategy to early identify patients with a high risk to threaten ward safety.

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Risk and Protective Factors for Inpatient Aggression

Cited by 40 publications

References 44 publications

Strength-based assessment for future violence risk: a retrospective validation study of the Structured Assessment of PROtective Factors for violence risk (SAPROF) Japanese version in forensic psychiatric inpatients

Strength-based assessment for future violence risk: a retrospective validation study of the Structured Assessment of PROtective Factors for violence risk (SAPROF) Japanese version in forensic psychiatric inpatients

Gender-Sensitive Violence Risk Assessment: Predictive Validity of Six Tools in Female Forensic Psychiatric Patients

Physical Violence During Mandatory Psychiatric Treatment: Prevalence and Patient Characteristics

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