M H Stone1. 1. Mid-Hudson Forensic Psychiatric Hospital and Columbia College of Physicians & Surgeons, New York, NY 10024, USA.
Abstract
OBJECTIVE: To describe the changes and improvements in accuracy of the prediction of violent recidivism. METHOD: The evolution of better prediction models is described by reviewing the more significant methods used and referring to the results of their application. RESULTS: Development of instruments such as the Psychopathy Checklist-Revised, the Violence Risk Assessment Guide (VRAG), the HCR-20 and the multiple-item comprehensive questionnaire of Monahan and Steadman has substantially improved accuracy in risk assessment. The presence of full-blown psychopathy has proven itself a better predictor of violence than has a diagnosis of antisocial personality disorder according to the Diagnostic and Statistical Manual (DSW-IV). Shortcomings to the efficacy of the current instruments stem from the difficulty in detecting violence-proneness in persons who eventually assault or murder one or two persons (usually family members), but who have no, or a limited, record of past violence. Persons from affluent backgrounds are more adept at evading arrests or convictions than are the poor. Adolescent sons abused by parents are at risk to commit violent acts later on, but the community has little power to detect or intervene until these acts are committed. CONCLUSION: Prediction of violence has significantly improved over the last 20 years, thanks to the development of objective instruments of risk assessment.
OBJECTIVE: To describe the changes and improvements in accuracy of the prediction of violent recidivism. METHOD: The evolution of better prediction models is described by reviewing the more significant methods used and referring to the results of their application. RESULTS: Development of instruments such as the Psychopathy Checklist-Revised, the Violence Risk Assessment Guide (VRAG), the HCR-20 and the multiple-item comprehensive questionnaire of Monahan and Steadman has substantially improved accuracy in risk assessment. The presence of full-blown psychopathy has proven itself a better predictor of violence than has a diagnosis of antisocial personality disorder according to the Diagnostic and Statistical Manual (DSW-IV). Shortcomings to the efficacy of the current instruments stem from the difficulty in detecting violence-proneness in persons who eventually assault or murder one or two persons (usually family members), but who have no, or a limited, record of past violence. Persons from affluent backgrounds are more adept at evading arrests or convictions than are the poor. Adolescent sons abused by parents are at risk to commit violent acts later on, but the community has little power to detect or intervene until these acts are committed. CONCLUSION: Prediction of violence has significantly improved over the last 20 years, thanks to the development of objective instruments of risk assessment.