Predictive validity of the dynamic risk assessment and management system in individuals with intellectual disability residing in the community

Background. The Dynamic Risk Assessment and Management System (DRAMS) was created to measure dynamic risk in individuals with intellectual disabilities (ID). Steptoe, Lindsay, Murphy, and Young, (2008) examined the construct validity, reliability and predictive validity of the dynamic risk assessment and management system (DRAMS) in offenders with intellectual disability and found that the total DRAMS score and sections on mood, antisocial behaviour and intolerance/agreeableness predicted incidents with a medium effect size for offenders with ID residing in high secure settings.     

Adapting measures of social climate for use with individuals with intellectual developmental disability in forensic settings

The social climate of forensic settings is thought to impact on a number of important clinical and organisational outcomes and is, therefore, an important construct in relation to the successful functioning of forensic units. A variety of self-report questionnaires have been developed to objectively measure the social climate of forensic settings (e.g. the Correctional Institutions Environment Scale and the Essen Climate Evaluation Schema), however these questionnaires have not been validated for individuals with intellectual developmental disabilities (IDD). Given the prevalence of IDD in prison and forensic psychiatric settings and the potential impact of such cognitive deficits on the ability to complete a range of self-report questionnaires, it is important to consider the potential reliability and validity of existing social climate measures in IDD populations. This article will, therefore: (1) examine the cognitive, linguistic and response format difficulties that may arise when administering self-report measures of social climate in IDD populations; (2) consider potential adaptations to existing measures of social climate that might make them more suitable for use with IDD populations; and (3) identify important directions for future research in the area.     

The Static-99R predicts sexual and violent recidivism for individuals with low intellectual functioning*

A current debate is whether actuarial risk assessment tools predict sexual recidivism in sexual offenders with intellectual disabilities (SOIDs). Since intellectual functioning exists on a spectrum, the present study examined the predictive validity of the Static-99R across the range of intellectual functioning. The sample was comprised of 454 adult sexual offenders assessed at an outpatient clinic and followed for an average of 10 years. Offenders in the extremely low/borderline group had higher scores on the Static-99R than other offenders, largely due to their score on the detachment subscale of the Static-99R, but did not have significantly higher recidivism rates. Calibration analyses suggested that the expected and observed recidivism rates did not differ significantly. Intellectual functioning did not add incremental validity to the Static-99R. Further, there was no interaction between intellectual functioning and actuarial risk score. The results suggested that the Static-99R can be used across the range of intellectual functioning, albeit somewhat more cautiously for those at the lowest and highest end of the intellectual functioning distribution.     

A comparison of seclusion rates between intellectual disability and non-intellectual disability services: the effect of gender and diagnosis

Introduction: The use of seclusion as a means of managing the extreme behaviours forensic patients in secure settings is a controversial yet often common practice, despite there being little evidence that seclusion as a practice has any significant therapeutic value for the patient. The aim of this study was to explore the use of seclusion and whether this differs as a function of gender and diagnosis across secure services. Method: This study collated data from 11 medium and low secure hospitals that admit male and female patients, with some services providing services for patients with intellectual disability (with or without co-morbid disorders), and others for patients with mental illness and/or personality disorder only. Results: Both gender and diagnosis were associated with differential seclusion rates. Seclusions were three times longer for patients in the non-ID compared to the ID service. Male seclusions (for any diagnosis) were around twice as long as those in female services. Female ID patients spent significantly less time in seclusion compared to other groups. Female ID was associated with two to three times the number of seclusion events per patient compared to other groups. No statistically significant association between the type of service and the reason for a patient being secluded. Conclusions: A range of organisational factors that determine the use and duration of seclusion are cited and merit further exploration. High rates of psychiatric co-morbidity and the complexity of patients admitted to services may also mediate risk and use of seclusion. The study supports the use of early intervention techniques and the adoption of positive behaviour support.     

Actuarial risk assessment and recidivism in a sample of UK intellectually disabled sexual offenders

Abstract

This study examines the effectiveness of three risk assessment instruments: Static-99, Risk Matrix 2000 (RM2000) and the Rapid Risk of Sex Offender Recidivism (RRASOR), in predicting sexual recidivism among 27 intellectually disabled sex offenders. The overall sexual offence reconviction rate was 30%, while non-recidivists remained offence-free over 76 months of follow-up. Static-99 presented as performing as well as guided clinical judgements in mainstream population studies [area under the curve (AUC)=0.64] exceeding the performance of RM2000 (AUC=0.58) in predicting sexual recidivism. However, the results were not statistically significant. In contrast to previous findings, the RRASOR presented the worst level of prediction (AUC=0.42). These results highlight the need to investigate further with larger sample sizes and in conjunction with more dynamic measures of risk. Proposed relevant factors are discussed in detail.     

Assessing dynamic risk and protective factors in the community: examining the validity of the Dynamic Risk Assessment for Offender Re-entry

Recently, there has been a growing interest in advancing the state of offender risk assessment: particularly through the development of risk instruments to assist with parole management and the incorporation of protective factors specific to re-entry. The current study's aim was to validate a measure of stable and acute dynamic risk factors and protective factors used by probation officers managing offenders in the community: the Dynamic Risk Assessment for Offender Re-Entry (DRAOR). Empirical examination of the structure of DRAOR scores soon after release from prison suggested four components, rather than the theoretically proposed three-subscale structure. Both the original three subscales and the four new subscales showed good convergent validity with other dynamic risk instruments, and reliably predicted new convictions; however, only the new stable component added significant incremental predictive power over existing static and dynamic risk instruments. These findings provide initial support for the validity of the DRAOR; suggestions for future research are discussed.     

Dynamic risk factors: scientific kinds or predictive constructs

ABSTRACT

There are a number of theoretical problems evident in the concept of dynamic risk factors that arise from their (increasing) importation into the explanatory and treatment domains of forensic and correctional practice. More specifically: (a) the concept of dynamic risk factors has not been well defined; (b) relatedly, there is a lack of clarity whether dynamic risk factors refer to causal processes or are predictive constructs; and finally (c) because of the above problems no one is sure how best to integrate them into clinical assessment and treatment. I will examine each of these three conceptual problems in this paper and make some suggestions about how to utilise dynamic risk factors in explanations of offending.     

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.     

WAIS-RC简式与成人智残评定量表在精神伤残评定中的应用

目的 考察中国修订版韦氏成人智力量表(WAIS-RC)简式与成人智残评定量表在精神伤残评定中的适用性.方法 对台州学院司法鉴定所2009年7月-2011年3月进行精神伤残鉴定的案例,用WAIS-RC简式和成人智残评定量表分别评定并与专家鉴定意见进行比较,用SPSS11.5进行统计分析.结果 WAIS-RC简式、成人智残...     

Sexual offenders with learning disabilities: risk,recidivism and treatment

Abstract

While the literature on the assessment, treatment and management of non-learning disabled sexual offenders is well established, it is only in recent years that researchers and clinicians have focused on sexual offenders with learning disabilities. In contrast to mainstream sex offender treatment programmes, there are few evaluated community-based treatment programmes for sexual offenders with learning disabilities, and of the small number of published studies that describe treatment programmes, most are based on small samples and few have been validated empirically. Sexual offenders with learning disabilities differ from their non-disabled counterparts in several important ways, having implications for management and treatment. Due to methodological differences between studies, the prevalence of sexual offending by men with learning disabilities is not clear. However, in some studies, the sexual recidivism rate of offenders with learning disabilities is 6.8 times and 3.5 times that of non-disabled sexual offenders at 2- and 4-years’ follow-up, respectively. Sexual offenders with learning disabilities are also at greater risk of re-offending in a shorter time period. There remains an urgent need for further research into the assessment of risk and whether components from mainstream treatment programmes can be adapted to meet the needs of learning disabled sexual offenders. Approaches to working with sexual offenders with learning disabilities and programme development are discussed.     

Sexual recidivism: A review of static,dynamic and actuarial predictors

The need for accurate risk assessment of sexual offence recidivism has never been greater. It is widely accepted that actuarial risk instruments outperform clinical judgement and the literature has recently witnessed a surge of empirically derived actuarial measures. However, in spite of the increased levels of predictive accuracy, actuarial measures have been criticized as being unrepresentative, lacking specificity, and being heavily reliant on static risk factors without taking into account dynamic risk, psychological emotional states and treatment effects. Rather than offering a critique of the actuarial movement, this paper offers a summary of static and dynamic risk factors associated with sexual offence recidivism as identified from the literature. Implications of incorporating dynamic factors into risk assessments and actuarial measures are discussed.     

Arbitrary decision making in the absence of evidence: an examination of factors related to treatment selection and recidivism for female sexual offenders

ABSTRACT

As criminal justice professionals are asked to assign risk levels and treat females who sexually offend, identifying risk factors for recidivism prediction and treatment targets is important. Although the majority of risk and treatment studies have focused on males, general female offender research and developing research with female sex offenders both provide some evidence for possible factors related to sexual offending behaviour in women. The purpose of this study was to explore what possible factors were related to treatment selection in a sample of 506 females serving prison sentences for a sexual offense, and, in turn, to examine which factors predicted non-sexual and sexual recidivism. Results demonstrated that exploratory variables were significantly related to treatment selection, as opposed to variables previously supported in research. Furthermore, living with a significant other for more than two years, and prior sexual offending arrests predicted sexual recidivism, while decreased age and treatment participation predicted non-sexual recidivism. These findings indicate that while similarities between male and female sexual offenders exist, females still demonstrate gender-specific risk factors.     

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.     

Violence risk and gang affiliation in youth offenders: a recidivism study

Abstract

Youth gangs are ubiquitous around the world and have been problematic for the social and criminal justice agencies. Despite widespread public concern, there has been relatively scarce empirical scrutiny of youth gangs internationally and little outside of America and Europe. In particular, the activities of youth gangs, the function of gang membership, the criminogenic needs of gang-affiliated youth, and the risk of criminal recidivism for gang-affiliated youth remain unclear. Against this background, this study explored the sociodemographic characteristics, risk and rate of criminal recidivism in a cohort of 165 male youth offenders in Singapore, of which 58 were gang-affiliated. Multivariate analyses revealed that gang-affiliated youth offenders were significantly more likely to have histories of substance use, weapon use and violence than nongang-affiliated youth offenders. Gang-affiliated offenders also scored higher on measures of risk for recidivism (SAVRY and YLS/CMI), and engaged in violent and other criminal behaviors more frequently during follow-up. These differences indicate a significant relationship between gang affiliation and criminal recidivism in youth offenders. Furthermore, these findings have important clinical and policy implications, indicating an increased requirement for additional and more intensive assessment and tailored interventions for gang-affiliated youth offenders.     

Prediction of institutional aggression among personality disordered forensic patients using actuarial and structured clinical risk assessment tools: prospective evaluation of the HCR-20, VRS,Static-99, and Risk Matrix 2000

A minority of men and women with intellectual disabilities at times engage in, and are suspected, or convicted, of illegal activity. Recent policy developments in England and Wales emphasise the need to respond appropriately to putative offending risk through the provision of safe and effective community management, treatment, and support services. In line with these concerns, research has focused increasingly on testing the utility of an evolving variety of risk assessment procedures. Here, the authors set out to challenge the repertoire of a number of prominent and/or recently developed risk assessment procedures and the scope of an associated research literature, on the basis that contextual risk factors are receiving insufficient attention in relation to offending among people with intellectual disabilities. Drawing on the wider criminological literature, a novel study is reported that compares key contemporary proximal social and environmental circumstances in the lives of offenders and non-offenders with intellectual disabilities. A contextual risk score is derived, providing statistical support for increased consideration of the impact of relevant social and environmental circumstances. Increased emphasis on key contextual risk factors is recommended to strengthen community service responses to offenders with intellectual disabilities.     

Sexual and violent recidivism by offender type and actuarial risk: reoffending rates for rapists,child molesters and mixed-victim offenders

Abstract

The current study examines sexual and violent reoffence rates for a sample of 2474 sexual offenders over an average of 15 years following release from prison. Reoffence rates are reported as a function of the offenders' victim type and level of risk as assessed by the Automated Sexual Recidivism Scale, a computer scored measure of relevant historical risk factors. Observed sexual recidivism rates for offenders with child victims, adult victims, and mixed victims were quite similar. Results indicate that offenders with exclusively female child victims not only showed a lower rate of sexual reoffending, but that the reoffence rates were relatively low across all levels of actuarial risk. In contrast, those with male child victims and adult victims showed a pronounced escalation of reoffence rates as actuarial risk increased. Results also indicated that adult victim offenders are less consistent in the victim type of their reoffences, with 37% sexually reoffending against child victims. Finally, combined rates of sexual and violent reoffending were particularly high for those with adult victim sexual offence histories. Risk assessment and public policy implications are discussed.     

The relationship between risk,deviance, treatment outcome and sexual reconviction in a sample of child sexual abusers completing residential treatment for their offending

Abstract

The study investigated the relationship between static and dynamic risk and reconviction in a sample of child sexual abusers who had completed a long-term residential treatment programme for their sexual behaviour problems. Results found that only High/Very High risk men as measured by a static risk assessment schedule (Risk Matrix 2000) were reconvicted for sexual offences (17% over a 2-year period, 42% over a 5-year period). Results also showed that it was generally men who were rated as a high level of dynamic risk that were reconvicted for a sexual offence (13% versus 5% over a 2-year period; 44% versus 10% over a 5-year period). The study also indicated the benefits of residential treatment for such High risk/High Deviance men in that no men who left the programme having responded to treatment had been reconvicted for sexual offences at either follow-up period.     

The rights of people with an intellectual disability in The Netherlands: from restriction to development

The purpose of this article is to discuss whether the right to self-determination is the only and the best principle in health law for care providers to support their clients with an intellectual disability, or whether other principles such as the right to development, the right to good care and the right to protection might lead to a better protection of the rights of clients in this field of care. The right to self-determination is the central principle in the Dutch Psychiatric Hospitals (Compulsory Admissions) Act, which at times seems less than beneficial to the legal position of persons with an intellectual disability. The question is whether a new (alternative) legal framework, in which the focus shifts to the right to good care and the right to development, might improve the legal position of people with an intellectual disability.     

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.