Issues in violent risk assessment: lessons learned and future directions

Realizing that the assessment of dangerousness with a yes/no format as a poor form of violent risk assessment has been the most important lesson learned about violence in the last 20 years. Further examining (a) what outcome and (b) how the indicators of the outcome should be measured has resulted in better violent risk assessment. The most promising methodological innovation in violent risk assessment has been the introduction of the receiver operating characteristic to assess the efficiency of risk prediction. In the future, the tension between prediction and explanation of violence will need to be maintained while focusing on a mechanism-driven strategy of risk management.