PSYC 406 Risk Assessment

risk assessment

risk assessment

process of using risk factors to estimate the likelihood(probability) of an outcome occurring in a population

risk factor

a correlate that precedes the outcome in time (ex. prior life event); no causal relationship just correlation

problems with predicting violence

BR is very low, test/predictors have low validity(large misclassification of non-violent persons), the definition of violence is too general

solution for violence BR problem

prediction possible with "previously violent" population

solution for imprecise violence test/predictors

the use of multiple independent predictors increases predictive power

solution for too general violence definition problem

establish time frame, context, and type of violence increases predictive power

risk assessment techniques

global clinical, construct based, actuarial, actuarially anchored, structured clinical judgement (from least to most structured)

clinical risk prediction/clinical judgement

only method used until 1980s; methodology includes interview, personality testing, skill and experience of assessor, global judgement of "dangerousness"; focus on few key factors and make simple judgements (low validity)

construct-based risk prediction

id personality characteristics associated with violence (ex. psychopathy checklist rank high-low level of risk); used to diagnose psychopathy in individuals with a combination of interview and review of the previous history; test assesses antisocial, criminal lifestyle, and a callous remorseless use of other people

psychopathy checklist (PCL-R) score interpretation

20 items: interpersonal and behavioral/historical a max score of 40 30+ score is a strong predictor of future violence

Actuarial (statistical) risk prediction

historical information about person is placed into actuarial formula related to risk for violence (ex. violence risk assessment guide); methods allow for placement of individuals into "risk groups" compared to norm sample (good predictive validity, but heavily focused on historical elements)

actuarial-anchored risk prediction

addresses criticism of strict actuarial approach by allowing clinical info to influence risk judgment; risk is adjusted up/down from an anchor based on the presence/absence of clinical elements that seem to increase/decrease risk (criticism b/c of human decision making, but still most popular approach)

structured clinical (professional) judgement

synthesizes individual factors known to be empirically related to risk into an eval system; clinician considers and rates all of the known factors and makes a judgment of risk(no norm sample or placement in risk groups); useful for particular types of violence(ex. no norm data), but no validity established

What approach is the best?

no clear best, but structured, specific tests are best

protective factors

factors protecting us from becoming violent/falling back into patterns of violence and crime

structures assessment of protective factors for violence risk (SAPROF)

first instrument to assemble empirically validated protective factors(17 internal, motivational, external); further validation work needs to be done

forensic risk assessments

semi-structured interview using variety of instruments(PCL-R), always actuarially anchored, provide explicit judgement of risk(low to high) over specified period; id specific risk factors to be treated/monitored

under-prediction (false negatives) of violence consequence

more violence

over-prediction(false positives) of violence consequences

needless detention of non-dangerous person, cost of incarceration ($125k/yr)