Violence Risk Assessment

Murrie, Daniel C.; Agee, Elisha

doi:10.1176/appi.books.9781615371914.lg28

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They found existing risk assessment tools produced low to moderate positive predictive values for violent offending (the median was 41%), whereas the negative predictive values for were much higher (with a median of 91%.). Violence risk assessment is known to be a challenging and imperfect process, and experts recommend the use of standard, empirically supported, and structured approaches to violence risk assessment are appropriate for individuals both with and without mental illness, despite their limitations . For a clinician evaluating an individual with ASD and violent thoughts, keeping in mind the unique clinical risk factors of this diagnosis in conjunction with his or her standard and structured approach can strengthen the clinician's overall risk formulation.…”

Section: Discussionmentioning

confidence: 99%

Homicidal Ideation and Individuals on the Autism Spectrum

Frizzell

Howard

Norris

et al. 2019

Journal of Forensic Sciences

View full text Add to dashboard Cite

Interest in the relationship between autism and violence has increased in recent years; however, no link has clearly been established between them. Researchers remain curious if autistic people with certain traits (e.g., a history of trauma) are at greater risk of violence than those individuals with autism alone. In this article, we detail two individuals with homicidal ideation (HI) admitted to inpatient psychiatric units who were found to have a diagnosis of autism without language impairment. These cases illustrate the need for mental health providers to consider autism in their differential diagnosis when evaluating an individual with HI. Broadly, we consider how an autistic individual could be susceptible to developing HI and explore treatments specific to autistic individuals that may be helpful in such cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Homicidal Ideation and Individuals on the Autism Spectrum

Frizzell

Howard

Norris

et al. 2019

Journal of Forensic Sciences

View full text Add to dashboard Cite

show abstract

“…Each has its own strengths, specific applications, and limitations. Today structured professional judgment ( Murrie and Agee, 2018 ) is commonly recommended. This approach incorporates but does not completely rely on a risk assessment instrument.…”

Section: Introductionmentioning

confidence: 99%

Differences Between Readmitted and Non-readmitted Women in an Italian Forensic Unit: A Retrospective Study

Rossetto¹,

Clerici

Franconi³

et al. 2021

Front. Psychol.

View full text Add to dashboard Cite

The main objective of this study was to compare readmitted (RW) and non-readmitted (NRW) female psychiatric patients after being conditionally or unconditionally released from Italian inpatient forensic psychiatry services, in order to identify variables that were significantly linked with readmission. This study included all patients who were discharged from the female Residences for the Execution of the Security Measure (REMS) of Castiglione delle Stiviere from January 2008 to June 2015 who were not readmitted until December 31, 2018 (48). In addition, data were collected on female patients who were discharged from the same REMS before 2008 and readmitted from January 2008 to December 2018 (42). A key finding of our study was that the readmission into a female REMS was positively associated with the presence of substance use disorders (SUD) and a primary diagnosis on Axis II. To a lesser extent, younger age, being unconditionally discharged when first released, having had a shorter length of inpatient stay and having committed a crime against property for the first REMS admission was also variables that were apparently linked with readmission. The present research continues the previous research on gender-specific mentally ill offenders. Hence, the decision to proceed separately with a sample of men only and one of women only. For all these reasons, young female patients with personality disorder and SUD perhaps should remain longer in REMS and be released with conditions. In most European countries, the length of stay depends on the clinical condition and risk assessment, with some exceptions where the courts set a maximum length of stay at the outset, as in Italy. All the factors listed above influence the risk assessment. Finally, from integrating these findings into the increasing international literature on conditional release and considering the recent changes in the Italian forensic treatment model, we recommend continuing research on individual risk and protective factors as well as risk assessment instruments on conditionally and unconditionally released inpatients with genders studied separately.

show abstract

“…A clinician's emotional reactions and clinical judgment can be distorted when interacting with a patient whom they fear.The approach to working with a patient who elicits fear begins with conducting a violence risk assessment, assessing both static (eg, violence history, psychopathy, head trauma, male sex) and modifiable dynamic risk factors (eg, substance use, impulsivity, access to a weapon, psychosis, treatment nonadherence) initially and over time, ideally using a structured assessment tool that incorporates professional judgment. 3 Structured assessment tools help to guide the systematic assessment of risk factors but to date have only low to moderate positive predictive value, limiting their clinical utility in identifying those at increased risk. 4 The modest success associated with such tools presumably contributes to the anxiety and fear that clinicians may experience.Identification of interpersonal risk factors "associated with the relationship between the clinician and the patient, particularly when the relationship is… emotionally intense… or has particular psychological meaning to the patient" 5 may be particularly relevant.…”

mentioning

confidence: 99%

“…The approach to working with a patient who elicits fear begins with conducting a violence risk assessment, assessing both static (eg, violence history, psychopathy, head trauma, male sex) and modifiable dynamic risk factors (eg, substance use, impulsivity, access to a weapon, psychosis, treatment nonadherence) initially and over time, ideally using a structured assessment tool that incorporates professional judgment. 3 Structured assessment tools help to guide the systematic assessment of risk factors but to date have only low to moderate positive predictive value, limiting their clinical utility in identifying those at increased risk. 4 The modest success associated with such tools presumably contributes to the anxiety and fear that clinicians may experience.…”

mentioning

confidence: 99%

Guidance for Working With a Patient Who Elicits Fear in the Psychiatrist

Nossel

Löwenthal

2020

JAMA Psychiatry

View full text Add to dashboard Cite

While it is clear that most societal violence is not due to mental illness, there is conflicting evidence regarding whether mental illness itself increases violence risk. 1 Nonetheless, variables associated with mental illness, particularly substance abuse, have been shown to be predictors of violence. 1 As such, psychiatrists do treat individuals at risk of violence and are at times themselves at risk. The rate of nonfatal violent crime against mental health professionals is more than 5 times that for all occupations. 2 While underreporting of assaults seems prevalent, more than one-third of psychiatrists report having been physically assaulted at least once, and psychiatrists in training seem particularly vulnerable. 2 This article provides guidance to psychiatrists and other mental health clinicians regarding working with a patient who evokes anxiety and fear in the clinician regarding their own physical safety or the safety of others. This may involve overt aggression or violent behavior, explicit or implicit threats of violence, or stalking behaviors. The encounter with a patient who elicits fear can be immediate, such as an extremely agitated patient in an inpatient unit, or fear can emerge over time, such as when a psychiatrist is treating an individual as an outpatient who they fear could harm them despite the absence of evidence of imminent risk. This guidance provided in this article applies to both types of encounters.While psychiatrists experience anxiety and fear when treating patients with suicidal ideation, the quality of the anxiety and fear is different and more personally disturbing when clinicians fear for their own safety or that of their loved ones. Clinicians may also feel anger at the patient or feel helpless to effectively intervene. Defenses such as denial, reaction formation, or withdrawal may interfere with the clinician's recognition and management of risk. A clinician's emotional reactions and clinical judgment can be distorted when interacting with a patient whom they fear.The approach to working with a patient who elicits fear begins with conducting a violence risk assessment, assessing both static (eg, violence history, psychopathy, head trauma, male sex) and modifiable dynamic risk factors (eg, substance use, impulsivity, access to a weapon, psychosis, treatment nonadherence) initially and over time, ideally using a structured assessment tool that incorporates professional judgment. 3 Structured assessment tools help to guide the systematic assessment of risk factors but to date have only low to moderate positive predictive value, limiting their clinical utility in identifying those at increased risk. 4 The modest success associated with such tools presumably contributes to the anxiety and fear that clinicians may experience.Identification of interpersonal risk factors "associated with the relationship between the clinician and the patient, particularly when the relationship is… emotionally intense… or has particular psychological meaning to the patient" 5 may be particularly rele...

show abstract

Violence Risk Assessment

Cited by 3 publications

References 0 publications

Homicidal Ideation and Individuals on the Autism Spectrum

Homicidal Ideation and Individuals on the Autism Spectrum

Differences Between Readmitted and Non-readmitted Women in an Italian Forensic Unit: A Retrospective Study

Guidance for Working With a Patient Who Elicits Fear in the Psychiatrist

Contact Info

Product

Resources

About