Incremental validity of ambulatory assessment of acute dynamic risk in predicting time to recidivism among prisoners on parole

ABSTRACT

This study investigates the incremental validity of changes in ten stress-related acute dynamic risk factors, collected through automated telephony over 30 consecutive days following parole, for predicting time to recidivism during the following year. Before release, the participants completed self-report assessment of some stable risk factors – impulsiveness and history of problematic substance use – as well as an assessment of symptoms of anxiety experienced during the weeks prior to release. Analysis of the baseline assessments showed that impulsiveness and a history of problematic substance use, but not pre-release symptoms of anxiety, were associated with recidivism during the parole year. Growth modelling using a linear mixed model was used to assess whether inmates on parole showed changes in acute dynamic risk factors during the first month following release. Individual growth model slopes and intercept were then extracted and used as covariates in a series of Cox regression analyses to test whether changes in acute dynamic risk factors could provide incremental predictive validity beyond baseline stable risk factors. Changes in five dynamic risk factors were associated with an increased risk of recidivism, of which daily drug use and daily summary score showed incremental predictive improvement beyond impulsiveness and history of problematic drug use.     

Risk assessment for intimate partner violence: how can the police assess risk?

ABSTRACT

The use of risk assessment tools by frontline police for intimate partner violence has the potential to make a difference to policing. In this paper, the key aspects of intimate partner violence risk assessment are outlined critically with a particular emphasis on how they can be used in practice. Two, evidence-based, exemplars are reviewed. These are the Ontario Domestic Abuse Risk Assessment (ODARA), an example of the actuarial approach, and the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), an example of the structured professional judgement approach. In addition, the victim giving his or her own appraisal of risk is discussed. All three approaches have some validity when administered properly but practical factors reduce this validity. The content of the risk assessment tools are outlined and practical concerns such as training, time to administer, reliability, validity, and the overlap of intimate partner violence with other forms of offending are discussed. A balanced overview of the strengths, weaknesses and future potential of intimate partner violence risk assessment is provided.     

Mandatory life sentences for serious sex offenders in England and Wales: tough,but intelligent too?

Abstract

This paper reviews the changes in risk assessment procedures for sexual offenders over the last 15 years from the viewpoint of two active participants in that change. Best practices with this target group have evolved at a dizzying pace, leaving many practitioners and programme managers uncertain about which tests or procedures they should use and, frankly, wondering why things keep changing. We view this ongoing evolution as very positive. Compared to the early 1990s, evaluators now have better knowledge of the static and dynamic factors associated with sexual recidivism, and a number of empirically validated risk assessment tools. We describe the various risk assessment procedures we have introduced (e.g. STATIC-99, SONAR, STABLE-2007/ACUTE-2007), the reasons why practices have changed and the reasons why practices will continue to change.     

Exploring the validity of the Level of Service Inventory-Revised with Native American offenders

The use of actuarial risk/need assessment tools is an increasingly important part of the correctional landscape. Actuarial tools ideally will provide a valid, dynamic assessment of an offender's overall risk/need level, and will identify their most prevalent criminogenic needs. What results is typically a number or score that can be used to assign an offender to a risk level that is associated with an assumed likelihood of recidivism. Testing the predictive validity of actuarial risk/need assessment tools is of paramount concern, particularly when they are utilized with new (and under-researched) populations. The current study assessed the predictive validity of the Level of Service Inventory-Revised using a sample of Native American and White offenders in a northern midwestern state. Results showed the instrument to have modest predictive validity utilizing the entire sample of offenders, with varying results for subsequent subgroups.     

Risk,reconviction and “sexually risky behaviour” in sex offenders

Abstract

The Challenge Project is a community assessment and treatment programme in southeast London. The Project has been evaluated extensively in relation to community failure, with consideration of static risk prediction tools and the role of key developmental variables. This current paper is an extension of earlier evaluations, considering an extended range of outcomes with a longer-term follow-up period of more than nine years at risk in the community. The official sexual reconviction rate for this sample of sex offenders (of whom 275 were at risk in the community) was 12%. A wider definition of “sexually risky behaviours” as an outcome variable, drawn from a range of police intelligence, suggested a “truer” sexual re-offending rate of 20%. Although static tools were moderately predictive of community failure, the accuracy of risk prediction was enhanced if static tools were considered in conjunction with developmental variables.     

Socially desirable responding and psychometric assessment of dynamic risk in sexual offenders against children

Does socially desirable responding (SDR) represent a threat to the validity of dynamic risk assessment in sex offenders’ self-reports? We studied a sample of men (N?=?218) who completed a psychometric assessment battery while enrolled at Kia Marama, a prison-based treatment program for sexual offenders against children. SDR, as measured by the Marlowe-Crowne scale, was elevated compared to non-offender samples, increased from pre- to post-treatment, and was negatively correlated with dynamic risk (rs?=??.30 to ?.40), consistent with previous research. Measures of dynamic risk factors derived from the psychometric battery were correlated with sexual recidivism, but correlations were little changed when variance associated with SDR was removed using a regression procedure [Mills, J. F., &; Kroner, D. G. (2006). Impression management and self-report among violent offenders. Journal of Interpersonal Violence, 21(2), 178–192.]. These results suggest that there is a substantial component of the variance in psychometric self-reports of sexual offenders that is associated with SDR (approximately 10%), but that it does not compromise the predictive or construct validity of dynamic risk measures derived from these reports.     

Challenges for the theory and application of dynamic risk factors

ABSTRACT

The inclusion of dynamic factors in risk assessment measures used with forensic populations has largely been considered an improvement in both the accuracy and utility of these assessments in informing treatment and sentencing. However, there are important challenges associated with the current approach to the conceptualisation, identification, and use of dynamic factors in risk assessment. Whereas some of these challenges relate to applied settings (such as the use of measures with different offender populations), there are also deeper questions regarding the construct validity of dynamic risk measures and the methodological strategies used to identify them. More emphasis on theoretically driven research is needed, to identify causal and explanatory relationships between dynamic risk factors and recidivism. We hope that highlighting these challenges can help to build a consensus on a future research agenda for dynamic risk factors.     

Problems in the measurement of dynamic risk factors in sexual offenders

ABSTRACT

Having valid and reliable tools to measure ‘dynamic’ risk factors and minimising assessor bias is said to be critical in helping to make decisions regarding how individuals convicted of committing crime should be managed and treated, and how resources within the Justice System should be prioritised. This article outlines the problems and issues associated with the measurement of such putative dynamic risk factors (see Ward, 2015 Ward, T. (2015). Dynamic risk factors: Scientific kinds or predictive constructs. Psychology, Crime and Law, 22(01-02), 2–16. [Google Scholar] [Dynamic risk factors: Scientific kinds or predictive constructs. Psychology, Crime and Law.], 22(1–2), 2–16], this volume for a critique of current conceptions of these), and suggests ways of ensuring that measurement is conducted in the most appropriate way for the population being dealt with. Specifically, we would note that the evidence suggests that psychometric analysis, and structured professional judgment can be used to measure dynamic psychological problems using some tools within some samples. However, their use can be hindered by a number of conceptual factors including how the tests are designed and used, their reliability and validity, the context in which they are used, and the samples used. Finally, we would note that interviews are also an important part in the process of dynamic assessment.     

HCR-20 violence risk assessments as a guide for treating and managing violence risk in a forensic psychiatric setting

Abstract

Over the past decades there has been a vast development in the research into risk factors for violence and the development of risk assessment instruments. One instrument that has been given special attention is the HCR-20 violence risk assessment scheme. However, little attention has been paid to the clinical applicability of this tool, i.e. how does this assessment scheme perform when utilized in clinical practice as a tool to guide intervention and management in order to alleviate risk of violent behaviour? The present study was a true prospective study into the utilization of the HCR-20 as a clinical routine. Data on forensic psychiatric patients (n = 81) from a forensic unit in Denmark are presented. As part of a clinical routine all patients were assessed for risk of future violence utilizing the structured professional judgement model, the HCR-20. Outcome measures were aggressive episodes during hospitalization and new convictions post discharge. The predictive validity of the HCR-20 was lower compared with previous findings. It is argued that this does not necessarily indicate poor predictive accuracy of the HCR-20. Rather, it may indicate that the HCR-20 is suitable for guiding risk management in order to prevent violent behaviour.     

Dynamic risk and sexual offending: the conundrum of assessment

ABSTRACT

The potential to reduce sexual victimisation, promote community safety, and decrease incarceration costs has resulted in considerable progress in terms of how we understand and predict sexual recidivism. And yet, the past decade has seen a degree of fragmentation emerge as research attention has shifted away from relative risk prediction (with its focus on static risk factors) to the identification of factors capable of reducing risk through intervention (i.e. dynamic risk). Although static and dynamic risk are often treated as orthogonal constructs [Beech, A. R., & Craig, L. A. (2012). The current status of static and dynamic factors in sexual offender risk assessment. Journal of Aggression, Conflict and Peace Research, 4(4), 169–185. doi:10.1108/17596591211270671], there are arguments to support a claim that the two are in fact functionally related [see Ward, T. (2015). Dynamic risk factors: Scientific kinds or predictive constructs. Psychology, Crime & Law (in 22(01–02), 2–16); Ward, T., & Beech, A. R. (2015). Dynamic risk factors: A theoretical dead-end? Psychology, Crime & Law, 21(2), 100–113. This discussion clearly affects how we assess dynamic risk. This review considered several commonly used methods of assessment and the evidence offered for their predictive accuracy. Of note were differences in the predictive accuracy of single psychometric measures versus composite scores of dynamic risk domains and the conventions used for establishing effect sizes for risk assessment tools.     

Dynamic risk and violence in individuals with an intellectual disability: tool development and initial validation

Without a violence risk assessment designed for people with an intellectual disability (ID), assessors are reliant upon tools developed for mainstream offenders or develop their own tools. This study describes the early stages of development of the Current Risk of Violence (CuRV), an informant-reported measure of dynamic risk for aggression in adults with an ID. The pool of items was generated from a multitude of sources. Predictive accuracy for aggression was tested prospectively among 64 adults with an ID and history of aggression. The 34-item CuRV was found to be a brief, uncomplicated risk assessment. Initial findings revealed good predictive validity over a five-month period: area under the curve (AUC) range from .72, 95% CI [.59, .85] to .77, 95% CI [.66, .89]. These preliminary findings suggest that the CuRV may assist staff to perform assessments of risk in busy clinical settings. Future research effort is needed to fully explore the psychometric properties of the CuRV.     

How well do dynamic needs predict recidivism? Implications for risk assessment and risk reduction

Purpose

The current study assessed the predictive validity of nine dynamic risk factors in two samples of justice-involved individuals (n = 24,972) to identify promising targets for correctional programming. The study also tested the incremental predictive validity of dynamic risk relative to static indicators of recidivism risk (i.e., criminal history, age and sex).

Methods

The study relied on bivariate correlations and stepwise multivariate logistic regression analyses to test the predictive and incremental validity of dynamic risk constructs measured by the Level of Service Inventory-Revised (LSI-R).

Results

Study findings revealed that while several dynamic risk constructs were significantly related to recidivism (antisocial attitudes, antisocial peers, education/employment, and substance abuse) over a 36-month follow-up period, the inclusion of dynamic risk items on the LSI-R did little to improve the overall predictive validity of the instrument. Across both study samples, static criminal history risk emerged as the most robust predictor of recidivism.

Conclusions

The advantages of third and fourth generation risk-need assessment tools are noted for classification purposes, but the study findings imply that risk prediction is better served by static risk factors. Implications for risk assessment and offender case management are discussed.     

Risk and protective factors of delinquency that are sensitive to migration and culture

ABSTRACT

Present evidence regarding widely used risk assessment tools suggests that such tools may have inferior predictive validity for offenders with a migration background (MB), especially from Turkey and Arab countries. Based on a thorough literature review, we investigated additional risk and protective factors via a postdictive correlational study design. We assumed that delinquency is induced by discrimination, a conflict of values, norms of honour, a disapproval of sexual self-determination, and antisemitism. In contrast, we expected social support to diminish the risk of criminal behaviour. The sampling took place inside and outside prison, where adult men with an Arab or Turkish MB (n?=?140) filled out a questionnaire. Individual norms of honour (r?=?.27?.41), antisemitism (r?=?.31?.37), and a disapproval of sexual self-determination (r?=?.23?.26) were positively correlated with delinquency. The best predictor was the individual’s perception of friends’ norms of honour (r?=?.34?.56). However, only a few significant correlations were found for a perception of individual discrimination (r?=?.08?.14) and an internal conflict of values (r?=?.11?.15), whereas global discrimination (r?=?.20?.29) clearly emerged as a risk factor for delinquency. Social support by nondelinquent peers could be confirmed as having a protective influence against delinquency (r=?.25?.27). Theoretical and practical implications for risk assessment are discussed.     

Static screening instruments for risk of minor and major violence

Background: Screens for violent convictions that are simple, accessible and parsimonious are needed, as a first stage in identifying those at high risk for further assessment. Aims: To construct and validate screening tools for minor and major violence convictions for released prisoners. Methods: Internal validation sample of 1647 serious offenders and an external validation of 46,704 general prisoners. The outcomes were binary indicators for having at least one conviction for minor and major violence. Risk factors were convictions for violence and age. Results: In the external validation sample, the instrument for risk of minor violence (PMIV) identified correctly 60.8% of male and 66.2% of female general prisoners. For risk of major violence, the instrument (PMAV) identified correctly 68.0% of male and 79.3% of female prisoners. Conclusions: The PMIV and PMAV will efficiently assist practitioners in a first stage of screening before in-depth clinical assessment of risk for future violent convictions.     

Testing the three- and four-factor models of the Korean version PCL-R as predictors of two antisocial outcomes – recidivism and risk

Psychopathy has consistently been associated with antisocial outcomes. The three- and four-factor models have been best fitted to data relating to Korean serious offenders (N?=?451), offering construct validity of the Korean Psychopathy Checklist-Revised (PCL-R). However, no study has yet tested the predictive power of the Korean PCL-R to explain two different types of antisocial outcomes: (1) risk of inmates measured by correctional officers during incarceration and (2) recidivism after release. By exploring these two forms of antisociality, here we sought to establish the predictive and construct validities of the Korean version of PCL-R. We found that the deviant lifestyle (Factor 3) performed best for predicting both antisocial forms (risk and recidivism) and that the deficits in interpersonal (Factor 1) and affective (Factor 2) abilities also uniquely predicted one subtype of risk, which suggests the three-factor model is better than the four-factor model in predictions. These findings will be useful for criminal justice experts and practitioners in Korea.     

Red-teaming the panopticon* (mobilising adaptive change in secure and forensic settings)

In England and Wales, secure and forensic psychiatric institutions provide a high-cost, low-volume service that imposes significant restrictions upon detainees. Patients may be detained under the Mental Health Act in such settings for several years or even life, as they are deemed to present a significant risk to themselves or the public. Patients under s37/41 require the Home Office to approve any increase in their freedom. Best practice requires reoffending risk to be assessed before a patient is discharged. Evaluation of risk is an inexact actuarial science operating in a political arena, and research has indicated risk assessment tools have little positive predictive validity. There is concern amongst the wider psychiatric and judicial communities about the ethics of current practice. We examine these issues and consider means of improving risk assessment through red-teaming, increased collaboration between clinician and patient and a paradigm shift towards greater emphasis on patient self-agency.     

Working with sex offenders in a climate of public blame and anxiety: How to make defensible decisions for risk

Abstract

Work with sex offenders takes place in a climate of public blame and anxiety. This requires practitioners to adopt the highest standards of practice to ensure that defensible decisions are made. These are decisions that must withstand hindsight scrutiny in the light of a risk management failure. This paper reviews the key practice points that will assist practitioners in making defensible decisions, and the key challenges for practitioners in this challenging area of work.     

An empirical investigation of written risk communication in forensic psychiatric evaluations

Abstract

There has been an increased interest in approaches for improving violence risk assessment, but less so how to communicate risk assessment results. We studied the written risk communication of 142 cases of forensic psychiatric evaluations in Sweden. The results suggested that risk for criminal recidivism was communicated in the vast majority of the cases (122 out of 142), but that risk was primarily communicated when the risk was perceived to be high. A six-item protocol to assess the content of the risk communication suggested that the communication was well elaborated in 21/122 of the cases, moderately elaborated in 53/122, poorly or very poorly elaborated in 43/122, and non-elaborated in 5/122 of the cases. Level of elaboration was only vaguely related to sociodemographic characteristics pertaining to the assessed (sex, age, citizenship) and the type of crime committed, but highly correlated to clinical diagnoses (DSM-IV) as well as contextual factors of the evaluation (which professional group and which clinic the assessment was performed).     

Good practice in eliciting disclosures from sex offenders

Abstract

Eliciting useful and reliable disclosures from sex offenders is imperative for effective risk management. Responsiveness to accurate self-report by sexual offenders of their risky thinking and problematic behaviours ensures that offenders are dealt with at the correct risk level. This requires practitioners to use a range of constructive strategies and techniques for eliciting disclosures. Drawing on a recent study that investigated the nature and usefulness of disclosures, this paper explores the inherent challenges and identifies best practice in this important area of work.     

Single-item predictive validity of the Short-Term Assessment of Risk and Treatability (START) for violent behaviour in outpatient forensic psychiatry

The single-item predictive validity of the Short-Term Assessment of Risk and Treatability (START) has not been thoroughly investigated, although this has great clinical relevance for the selection of treatment targets. Furthermore, it remains unclear whether the characteristic START additions of scoring strengths next to vulnerabilities and selecting key items, add incremental predictive validity. Finally, predictive validity has primarily been studied in inpatient settings and included mainly patients with a psychotic disorder. We analysed data from a mixed diagnostic sample of 195 forensic psychiatric outpatients with a 3-month and 170 patients with a 6-month follow-up period, using logistic regression analysis. The occurrence of violent or criminal behaviour was established based on the case manager’s recordings in the patient’s file. Only 5 of the 20 START items were found to have predictive validity: Impulse Control, Attitudes, Material Resources, Rule Adherence and Conduct. The last three were the only items for which incremental predictive validity was found with respect to scoring it as a strength and a vulnerability. Selection of key items did not add to the predictive validity. While possibly having therapeutic significance, the scoring of strength next to vulnerability and the selection of key items, may not be beneficial for risk assessment.