暴力危险量表中文版的信度

目的引入、修订具有评估暴力危险及危险变化的暴力危险量表(Violence Risk Scale,VRS),对修订后的暴力危险量表中文版(VRS-C)进行信度检验。方法通过标准的翻译程序形成VRS-C,3位评估者独立评估14个案例以检验评分者信度,以125例来自成都安康医院监管病区、四川华西法医学鉴定中心法医精神病学教研室及华西心理卫生中心的精神疾病患者为被试,对VRS-C的信度进行检验。结果初步修订的VRS-C具有较好的评分者信度(ICC=0.80)、同质性信度(克朗巴赫α系数=0.921)、分半信度(0.906)及题总相关性(0.246～0.849)。结论初步修订的VRS-C具有较好的信度。     

Assessing change in dynamic risk factors in forensic psychiatric inpatients: relationship with psychopathy and recidivism

This study explored change in dynamic risk for violence using the Clinical and Risk Management subscales of the Historical Clinical and Risk Management-20 version 3 (HCR-20 v3) and sought to determine whether change was associated with violent recidivism. The association between the magnitude of change and psychopathy was also assessed. Participants were 40 male (n = 32) and female (n = 8) forensic psychiatric inpatients discharged from a secure forensic mental health service. Results showed that participants significantly improved on the HCR-20v3 Clinical subscale but significantly worsened on the Risk Management subscale. Psychopathy was unrelated to change in Clinical and Risk Management subscales. The hypothesis that changes in dynamic risk would predict recidivism over and above total pre-treatment risk (HCR-20v3 Total score) and psychopathy was not supported. These results suggest that improvements in mental state risk factors alone are insufficient with regard to lowering violence risk.     

Static and Dynamic Patient Characteristics as Predictors of Criminal Recidivism: A Prospective Study in a Dutch Forensic Psychiatric Sample

If clinicians in forensic psychiatry want to reduce risk of reoffending in their patients, they require insight into dynamic risk factors, and evidence that these add predictive power to static risk indicators. Predictors need to be evaluated under clinically realistic circumstances. This study aimed to validate dynamic and static variables as predictors of reconviction in a naturalistic outcome study. Data on static and dynamic risk factors were collected for 151 patients discharged from Dutch forensic psychiatric hospitals. Community follow-up was prospective, with a 5.5 year minimum. A prediction model was developed using Cox regression analysis. The magnitude of the predictive power of this model was estimated using receiver operating characteristic (ROC) analysis. The final prediction model contained four static and no dynamic predictors. The model's ROC area under the curve was .79 (95% CI .69–.89). Clinical risk ratings were non-predictive. Post hoc analyses exploring the influence of subgroups of patients did not yield better models. It is concluded that a small set of static predictors yielded a good estimate of future reconvictions; inclusion of dynamic predictors did not add predictive power.     

DOMESTIC VIOLENCE,DOVE, AND DIVORCE MEDIATION

The primary objective of this article is to describe DOVE, a 19‐item instrument designed to assess and manage the risk of domestic violence between partners during and following their participation in divorce mediation. Assessing risk, more specifically how DOVE can be used to assess risk, is described first. The resulting risk scores (TOTDOVE) are used to assign individuals to risk categories. Problems associated with using categorical, frequency, and probability risk assessment formats in interpreting and communicating risk are discussed in the second segment of the article. A dual, categorical/probability format is advocated. Managing risk using Safety Plan interventions that are linked with risk category and predictor subscores on control, substance abuse, anger, relationship problems, mental health problems, and conflict is covered in the final segment.     

A Comparative Test of Clinical Judgment Versus Actuarial Prediction of Future Violence

This study tested how graduate level psychology graduate students (n = 20) using the Adapted Violence Risk Appraisal Guide (Adapted VRAG) would do relative to practicing psychologists/psychiatrists (n = 16) using clinical judgment when predicting violence in 10 narratives from the MacArthur Violence Risk Assessment study (Monahan et al., The MacArthur violence risk assessment study. . Retrieved 10 Oct 2005). Results indicated that the practicing psychologists/psychiatrists made significantly more correct predictions than the master’s level students. The professional group demonstrated sensitivity levels of 77.7% and specificity of 96.3%. For the use of the adapted VRAG method by the graduate student group, specificity levels were modest at 54.0%. Sensitivity levels, however, were lower than earlier demonstrated levels at 58.0%. These findings are at variance with earlier reports comparing clinical and actuarial methods. The results may reflect the short amount of time the master’s level students were trained using the Adapted VRAG as well as the small number of participants in this study. Additional research comparing other professions is recommended, as well as examining if experience in the forensics field would affect one’s ability to predict violence.     

Differentiating between physically violent and nonviolent stalkers: an examination of Canadian cases

This study is one of a few that empirically investigated factors that differentiated the physically violent stalker from the nonviolent stalker. Using discriminant analysis, 103 Canadian cases of "simple obsessional" stalking were examined. Overall, the success of the model for classifying cases into one of two groups was 81%. Results revealed that the physically violent stalker is more likely to: (a) have a stronger previous emotional attachment toward their victim; (b) be more highly fixated/obsessed with their victim; (c) have a higher degree of perceived negative affect towards their victim; (d) engage in more verbal threats toward the victim; and (e) have a history of battering/domestic abuse towards the victim. Overall, the variables that best differentiate the physically violent stalker from the nonviolent one appear to characterize underlying themes of anger, vengeance, emotional arousal, humiliation, projection of blame, and insecure attachment pathology.     

A Pre-Trial Domestic Violence Intensive Supervision Unit: Exploring Case Seriousness and Successful Disposition

This study measures the seriousness of domestic violence cases from the population of cases (N = 96) sentenced to a pre-trial domestic violence intensive supervision unit in one county probation office in Florida from April 1, 2006, to April 30, 2007. No significant differences were found in seriousness across sex, self-reported drug use, or attorney type. Furthermore, no relationship was found between the number of special conditions imposed by the court and the seriousness index value for a case. However, non-Whites had a significantly higher mean case seriousness index than Whites. Findings suggest that using the seriousness index presented in this study, some of the cases examined were not serious enough to warrant being sentenced to the pre-trial domestic violence intensive supervision unit. Implications for future research, including the use of lethality assessments, are addressed.     

Assessing Violence Risk in Stalking Cases: A Regression Tree Approach

Advances in the field of risk assessment have highlighted the importance of developing and validating models for problematic or unique subgroups of individuals. Stalking offenders represent one such subgroup, where fears of and potential for violence are well-known and have important implications for safety management. The present study applies a Classification and Regression Tree (CART) approach to a sample of stalking offenders in order to help further the process of identifying and understanding risk assessment strategies. Data from 204 stalking offenders referred for psychiatric evaluation to a publicly-funded clinic were used to develop and assess putative risk factors. A series of nested models were used to generate tree algorithms predicting violence in this sample of offenders. Both simplified and more extensive models generated high levels of predictive accuracy that were roughly comparable to logistic regression models but much more straightforward to apply in clinical practice. Jack-knifed cross-validation analyses demonstrated considerable shrinkage in the CART, although the models were still comparable to many other actuarial risk assessment instruments. Logistic regression models were much more resilient to cross-validation, with relatively modest loss in predictive power.     

Quality of criminal responsibility reports submitted to the Hawaii judiciary

This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was “fair” using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and “fair” inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improvement of report quality are proffered, including standardization of procedures and report format and use of forensic assessment instruments.     

Assessing the Risk of Domestic Violence Reoffending: A Validation Study

Little research has been conducted to validate available instruments for assessing the risk of domestic violence reoffending, especially research using some form of prospective design. This study uses a prospective design to determine the reliability and validity of the Domestic Violence Screening Instrument (DVSI). The analysis is based on a sample of 1,465 male domestic violence offenders selected consecutively over a 9-month period. Data on reoffending were collected in a 6-month follow-up period from a subsample of the victims (N = 125) of these perpetrators and from official records for all perpetrators during an 18-month follow-up period. The empirical results suggest that the DVSI was administered reliably, and they provide significant evidence of the concurrent, discriminant, and predictive validity of this instrument. Implications for further research and utilization of the DVSI are discussed.     

The Empirical Limits of Forensic Mental Health Assessment

This article introduces a special issue of Law and Human Behavior, including five articles describing the limits of forensic mental health assessments of (a) risk of violence in female adolescents, (b) sexually violent predators, (c) dangerousness in capital murder cases, (d) child sexual abuse, and (e) PTSD litigants. Knowing the limits of forensic mental health assessment methods is essential in order to recognize their strengths, increase the credibility of forensic mental health assessment, and drive research that will enhance the value of assessments for the courts.