Risk Assessment

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What is Risk Assessment?

Risk is viewed as a range (Steadman,

2000)

Probabilities change across time

Interaction among offender

characteristics and situation

Risk Assessment has 2 components:

Prediction

Management

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Risk Assessments: Civil Settings

Civil commitment

Child protection

Immigration laws

School and labour regulations

Duty to warn & limits of confidentiality

W. v. Egdell (1990) (UK)

Tarasoff case (1974) (US)

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Risk Assessments: Criminal

Settings

Risk assessments conducted at major

decision points:

Pretrial

Sentencing

Release

Public safety outweighs solicitor-client

privilege

Smith v. Jones

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Predictions:

Decisions Versus Outcomes

DECISION Reoffends Does not

reoffend

Predicted to

reoffend

True positive

(correct)

False positive

(incorrect)

Predicted to

not reoffend

False negative

(incorrect)

True negative

(correct)

OUTCOME

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Base Rates

Represents the % of people within a

given population who commit a criminal

or violent act

Accurate prediction difficult when

base rates are too high or low

False positives tend to occur with low

base rates

Easier to predict frequent vs. infrequent

events

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Methodological Issues

Assumptions of risk assessment and

measurement

Ideal evaluation vs. reality

Three weaknesses of research (Monahan &

Steadman, 1994):

Limited number of risk factors

How criterion variable is measured

How criterion variable is defined

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Other Methodological Challenges

Measuring recidivism

1. Problems with outcome measures

2. Length of outcome period

3. Categories of offenders

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Judgment Error and Biases

Heuristics

Illusory correlation

Ignore base rates

Reliance on salient or unique cues

Overconfidence in judgements

Role of gender

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Unstructured Clinical Judgment

Decisions characterized by professional

discretion and lack of guidelines

Subjective

No specific risk factors

No rules about how risk decisions should

be made

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Dr. James Grigson

Nicknamed “Dr. Death” or “the hanging

shrink”

Forensic psychiatrist in Dallas

Used unstructured clinical judgment

Expelled from professional

association for claims of 100%

accuracy in predicting violence

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Measuring Accuracy of

Dangerousness Predictions

Ultimate Outcome

Clinician’s predictions Homicide No Homicide

Homicide 8 (True Positives) 1,998 (False Positives)

No Homicide 2 (False Negatives) 7,992 (True negatives)

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Actuarial Prediction

Decisions based on risk factors that are

selected and combined based on empirical

or statistical evidence

Evidence favours actuarial assessments

over unstructured clinical judgment

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Static-99-R – An Actuarial

Measure young

have not lived with a lover for 2+ years

index-non-sexual violence

previous nonsexual violence

number of previous sentencing dates

previous sexual offences

physical harm to victim during sex offence(s), or use of weapon or

threats

any non-contact sex offences

any unrelated victims

any stranger victims

any male victims

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Actuarial vs. Clinical Judgment Source # of

studies

Variables Predicted Clinical

Better

Statistical

Better

Tie

Grove et al.

(2000)

136 Success in

school/military;

recidivism; recovery from

psychosis; personality; tx

outcome; dx; job success

and satisfaction; medical

dx; marital satisfaction

8 63 65

Ægisdóttir et

al. (2006)

51 Brain impairment;

personality; length of

stay; dx; adjustment or

prognosis; violence; IQ;

academic performance;

suicide risk; sexual

orientation; MMPI – real

or fake

5 25 18

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Structured Professional Judgment

Decisions guided by predetermined list of

risk factors derived from research

literature

Judgement of risk level is based on

professional judgement

Diverse group of professionals

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Types of Predictors

Static Risk Factors

Historical

Factors that cannot be changed

Dynamic Risk Factors

Fluctuate over time

Factors that can be changed

Acute vs. stable dynamic risk factors

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Important Risk Factors

Dispositional

Historical

Clinical

Contextual

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HCR-20 Historical items

1. Previous violence

2. Young age at first violent incident

3. Relationship instability

4. Employment problems

5. Substance use problems

6. Major mental illness

7. Psychopathy

8. Early maladjustment

9. Personality disorder

10. Prior supervision failure

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HCR-20

Clinical items

1. Lack of insight

2. Negative attitudes

3. Active symptoms of major mental illness

4. Impulsivity

5. Unresponsive to treatment

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HCR-20

Risk management items

1. Plans lack feasibility

2. Exposure to destabilizers

3. Lack of personal support

4. Noncompliance with remediation attempts

5. Stress

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Current Issues

Protective factors

Factors that reduce or mitigate the

likelihood of violence

Use of scientific research

Practitioners not using instruments

Where is the theory?

More attention on WHY is needed

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