A comparison of actuarial methods for identifying repetitively violent patients with mental Illnesses

This is a progress report on the development of practical methods for the actuarial prediction of violence. The literature indicates that actuarial prediction is more accurate than clinical prediction, but in practice actuarial methods seem to be used rarely. Here we address two obstacles to the clinical use of actuarial prediction methods. First, clinicians may be averse to actuarial methods that require calculations. To remedy this, we developed a regression tree screen that presents actuarial information about violence in a series of yes/no questions. Second, using actuarial methods to identify the small minority of violent patients in a general psychiatric population may be too costly. To remedy this, we developed a method to prescreen patients for intensive evaluation using an inexpensive assessment. We evaluated regression trees and two-stage screening by comparing their accuracies against conventional actuarial methods. The results showed that actuarial predictions based on regression trees and two-stage screens were as accurate as regression-based methods in identifying repetitively violent patients. These easier-to-use methods may therefore be useful techniques for actuarial predictions.     

Book review

Richard Nixon, 1999: victory without war

(New York: Simon and Schuster, 1988; London: Sidgwick and Jackson, 1988)

Anders Stephanson, Kennan and the Art of Foreign Policy. (Harvard University Press, Cambridge, Massachusetts, 1989, pp. xiv + 380, £27.50)

Jacques S. Gansler, Affording Defense. (MIT Press, Cambridge, Massachusetts, 1989, £22.50)

John D. Steinbruner (ed.), Restructuring American Foreign Policy. (The Brookings Institute, Washington, 1989, pp. 260, £8.75 (paperback) & £23.95 (cloth))     

EFFECTS OF SKILL-BASED VERSUS INFORMATION-BASED DIVORCE EDUCATION PROGRAMS ON DOMESTIC VIOLENCE AND PARENTAL COMMUNICATION

This study used a pre- and postevaluation with a control group to compare the effectiveness of two divorce education programs: skill-based Children in the Middle (CIM) and informationbased Children First in Divorce (CFD). Each treatment group consisted of approximately 125 divorcing parents mandated to attend divorce education in Florida. The control group consisted of 64 divorcing parents not mandated to attend divorce education in Alabama for lack of a program. Treatment and control parents lived in comparable cities with comparable demographics. Results indicate that CIM, not CFD, improved parental communication. Both CIM and CFD reduced child exposure to parental conflict. Neither program had effects on domestic violence, actual parental conflict, or child behavior problems. Across all groups, parents with greater divorce knowledge and communication skills experienced more reciprocal discussions with the other parent, less parental conflict, less domestic violence, and they exposed children to less conflict.     

An examination of a desert-based presumptive sentence schedule

To reduce the problem of sentencing disparity (unlike sentences for like offenses), the Committee for the Study of Incarceration proposed a determinate sentence scheme based on a desert theory of punishment. While the proposal at first glance may appear to solve many sentencing problems, this paper attempts to show its defects and some of the problems involved in (1) determinate sentence schedules generally, (2) desert as a principle of punishment, and (3) basing a determinate sentence schedule on a desert theory.