question

Reasons for determining an individual's risk of violence

answer

Parole and probation decisions, level of supervision after someone is released from incarceration, and whether to transfer a juvenile to an adult court or not

question

Risk assessment

answer

A psychological assessment designed to identify the likelihood of a person committing violence in the future, along with the severity, imminence, and nature of that violence

question

What is Hart's definition of violence?

answer

Actual, attempted, or threatened physical harm that is deliberate and nonconsenting

question

Does the definition of violence include verbal and emotional violence?

answer

No

question

Is violence a choice?

answer

Yes

question

What is the proximate cause of violence?

answer

The DECISION to act violently

question

An argument against predicting violence

answer

Violence is so rare

question

A good risk assessment is a ____ ______, not a simple prediction

answer

Thorough description

question

O'Connor v. Donaldson (1975)

answer

A person cannot be committed only on the basis of a mental illness but must also exhibit imminent dangerousness

question

Tarasoff v. Regents of the University of California (1976)

answer

Required of mental health professionals a duty to warn that necessitates an evaluation of a patient's potential to become violent toward a specific person

question

Barefoot v. Estelle (1983)

answer

Expert testimony on dangerousness may not always be correct but it is admissible and the adversarial process should properly evaluate it

question

Schall v. Martin (1984)

answer

Preventative detention is allowable based on a prediction that the accused poses a serious risk of future criminal conduct

question

Kansas v. Hendricks (1997) and Kansas v. Crane (2002)

answer

Affirmed the constitutionality of sexually violent predator statuses and the use of dangerousness determinations to commit them

question

What is the single most important case in the history of risk assessment?

answer

Barefoot v. Estelle

question

Amicus brief

answer

A legal document written by a person or entity that is not a party in a given case but that has an interest in the matter before the court

question

Who filed an amicus brief in the Barefoot case?

answer

The American Psychiatric Association

question

What did John Monahan's famous review conclude?

answer

Predictions of dangerousness were wrong two out of three times

question

First generation of research on predictions of dangerousness and violence risk assessments

answer

Occurred during the 1970s, largely focused on institutionalized individuals in psychiatric, forensic, and correctional settings awaiting release; the results were so poor that some called for the abolishment of civil commitment

question

What did Monahan say were the four major shortcomings of the first generation of research?

answer

The studies focused on poor predictors of violence, enabled poorly measured and defined violence outcomes, used narrow samples, and were poorly organized

question

Second generation of risk assessment research

answer

Advanced by focusing on short-term predictions and identifying useful predictor variables that were more definitively associated with violence across domains

question

Third generation

answer

Identification of individual and contextual variables that related to violence

question

What generation encouraged the use of the phrase "risk of violence"

answer

Second

question

What did Monahan believe the word "dangerousness" encouraged?

answer

Dichotomous judgments (the person is dangerous or the person is not dangerous)

question

What are the five different facets of violence risk assessments according to Hart?

answer

Nature, Severity, Frequency, Imminence, and Likelihood

question

What is the traditional approach to violence risk assessment?

answer

Clinical judgment

question

Clinical risk assessments

answer

A form of violence risk assessment where the decision is based on the education and experience of the evaluator and is made without the assistance of any additional formal actuarial or structured assessment tools

question

Actuarial risk assessment instruments (ARAI)

answer

Approach to violence risk assessment that tends to be fixed and based on a mathematical foundation

question

Structured professional judgment

answer

Approach to risk assessment that is a seeming middle ground to purely clinical and actuarial approaches; typically employ a standard framework or tool that identifies a list of factors relevant in arriving at an assessment risk but the approach allows for clinical judgment while still being formal

question

Which approaches is the third generation of research marked by?

answer

Actuarial and structured

question

What has clinical judgment often been disparaged as?

answer

Informal and subjective

question

What has more recent research concluded about clinical judgment?

answer

They are more accurate than chance, or simply flipping a coin, and that long-term predictions may be no less accurate than short-term predictions

question

How do actuarial approaches contrast with clinical approaches?

answer

They tend to be more formal, algorithmic, and objective, and have a statistical basis

question

What was the first widely examined actuarial tool?

answer

Violence Risk Assessment Guide (VRAG)

question

VRAG

answer

Consists of 12 items that are weighted according to the original statistical findings and include total score on the PCL-R, elementary school maladjustment, separation from either parent before age 16, a summary score for nonviolent criminal offenses prior to the current offense, marital status at the time of the current offense, age at the time of the current offense, previous failures on conditional release such as probation or parole, the severity of the victim injury during the current offense, whether the patient met criteria for schizophrenia, wether the patient met criteria for a personality disorder, whether a female victim suffered the current offense, and alcohol abuse history score.

question

The MacArthur Risk Assessment Study

answer

A large multisite study that assessed both male and female acute civil psychiatric patients and developed an Iterative Classification Tree (ICT)

question

Iterative Classification Tree (ICT)

answer

Predicted on an interactive and contingent model of violence that allows many different combinations of risk factors to classify a person as high or low risk; the Classification of Violence Risk (COVR) must be used to place patients in one of the two classification groups (high and low risk)

question

Criticism of actuarial assessments

answer

Lack of generalizability outside the original sample used to construct them

question

Another criticism of actuarial assessments

answer

The nomothetic nature of actuarial approaches versus the idiographic nature of risk assessment

question

Nomothetic

answer

Normally refers to the study of cohorts or groups of people

question

Idiographic

answer

Refers to the study of individuals

question

Actuarial approaches are also criticized for...

answer

Only being focused on prediction and don't consider management or treatment issues

question

Structured professional judgment (SPJ)

answer

A form of violence risk assessment in which an individual uses a structured risk assessment tool that provides guidance regarding the risk factors to consider but does not require a definitive decision

question

Historical, Clinical, Risk Management-20 (HCR-20)

answer

SPJ comprised of 20 items focusing on historical, clinical, and risk areas; in essence, allows a forensic psychologist to override a final score on an instrument

question

True or False: Studies show that the HCR-20 is equal if not superior to actuarial measures in predictive ability

answer

True

question

Spousal Assault Risk Assessment (SARA)

answer

Structured approach for assessing domestic violence

question

Sexual Violence Risk-20 (SVR-20)

answer

Structured approach for assessing sexual violence

question

Static factors

answer

Variables that increase the risk of future violence but are unlikely to change and are often fixed (historical)

question

Examples of static factors (fixed)

answer

Previous violence, young age at first violent incident, relationship instability, employment problems, substance use problems, major mental illness, psychopathy, early maladjustment, personality disorder, prior supervision failure

question

We should not only focus on static factors because it suggests that...

answer

Once an individual's risk has been determined, it is never going to change

question

Dynamic factors

answer

Risk factors that normally change over the course of time and are more likely to be amendable to treatment or intervention to reduce risk

question

Examples of dynamic factors

answer

Lack of insight, negative attitudes, psychiatric symptoms, behavioral and affective instability, unresponsiveness to treatment, plans lack feasibility, exposure to destabilizers, lack of social support, noncompliance with medication, and stress

question

What kind of risk factors tend to be more difficult to identify and study?

answer

Dynamic risk factors

question

What two measures have shown some promise for measuring dynamic variables?

answer

Violence Risk Scale (VRS) and Short-Term Assessment of Risk Treatability (START)

question

Violence Risk Scale (VRS)

answer

Based on the Stages of Change model and is designed to assess the level of change that has taken place in risk after treatment

question

Short-Term Assessment of Risk Treatability (START)

answer

SPJ guide intended to measure 20 dynamic variables in order to make decisions on the level of care for individuals at risk for violence

question

Risk management

answer

A form of risk assessment in which the goal is not only to assess the propensity for future violence but also to reduce or manage that propensity so that it does not result in violent behavior

question

As identified by Heilbrun, what are the main differences between a prediction-oriented model of risk assessment and management?

answer

Goal, nature of the risk factors, nature of post assessment control, and number of administrations

question

Goal of risk assessment

answer

To identify whether an individual is likely to become violent at some point in time

question

Goal of risk management

answer

To reduce the likelihood of aggression

question

Nature of the risk factors in risk assessment

answer

Both static and dynamic

question

Nature of the risk factors in risk management

answer

Focus is primarily on dynamic variables that can change in order to reduce violence

question

Nature of post assessment control in risk assessment

answer

Often lacks the ability to supervise individuals continually

question

Nature of post assessment control in risk management

answer

Must be some ability to monitor and follow people continually in order to assess their progress

question

Number of administrations in risk assessment

answer

Assumes a single administration of a violence risk assessment

question

Number of administrations in risk management

answer

Necessitates multiple administrations of a violence risk assessment

question

True or False: A common part of the violence risk assessment is to make treatment recommendations

answer

True

question

Protective factors

answer

Factors that decrease the likelihood of someone committing violence

question

Ullrich and Coid's potential protective factors

answer

Perceived social support; perceived emotional support; spending spare time with friends/family; belonging to a group, club, or organization; involvement in religious activities; closeness to others; relationship competence; proactive behaviors/initiative; having a place to stay after release; private accommodation; stability of address; having an income; being able to financially manage a household well; being in work, training, or education; and having had any job since release

question

Difficulty in risk assessment because of the nature of violence itself

answer

It is difficult to obtain accurate follow-up information, violence is a behavior that is not readily reported or easily identifiable except in extreme cases

question

Measurement of violence is problematic

answer

Violence has been measured via formal legal charges which misses the majority

question

There is a great deal of variability in the definition of violence

answer

The difficulty comes in comparing results across studies that have divergent definitions of violence

question

Another problem with violence risk assessment is the low base rate of violence

answer

Violence is not a frequently occurring event and therefore it is difficult to study and maintain accurate estimates of risk

question

Definition of base rate

answer

The frequency or prevalence of a particular event, frequently used in the context of violence

question

Are forensic psychologists better at assessing risk for short periods of time or longer periods of time?

answer

Short periods of time

question

When else are forensic psychologists good at assessing risk?

answer

If they have adequate information about their past behavior, especially violent behavior; also, they are also good at assessing risk for settings in which they have past data

question

Are forensic psychologists more accurate in situations in which there are high base rates of violence or low base rates?

answer

High base rates

question

How has the current research discovered psychologists prefer to communicate risk?

answer

In terms of risk management, identification of the relevant risk factors, and the potential interventions to reduce the threat of those risk factors

question

Do psychologists prefer to communicate risk in terms of categorical risk levels or specific probabilities?

answer

Categorical risk levels

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