Abstract

Violence risk assessment is an essential component of forensic mental health services designed to help mitigate and manage the re-occurrence of violence. Although there is large body of evidence supporting structured risk assessments, there is no empirical evidence regarding scenario planning—a specific component of the structured professional judgment approach to violence risk assessment. The purpose of this study was to investigate the base rates and concurrent validity of inpatient aggression scenarios to provide information about risk scenarios. Among a large representative sample of forensic psychiatric patients (N = 1240), the prevalence of risk scenarios (Repeat, Escalation, Twist, and Improvement scenarios) was investigated by retrospectively coding changes in inpatient aggression. The results suggested that Improvement scenarios, including a continued desistance of aggression, were common. Aggression scenarios shared significant pattern of associations with the Historical-Clinical-Risk Management-20 and the Psychopathy Checklist—Revised. Overall, this study presents initial empirical evidence related to violence risk scenario planning. Implications from these findings include how scenario planning may intersect with evaluator bias in forensic mental health assessments.

摘要

暴力风险评估是法医精神卫生服务的重要组成部分，旨在帮助减轻和管理暴力的再次发生。尽管有大量证据支持结构化风险评估，但没有关于情景规划的经验证据——​​暴力风险评估的结构化专业判断方法的一个特定组成部分。本研究的目的是调查住院攻击情景的基本率和并发有效性，以提供有关风险情景的信息。在法医精神病患者的大型代表性样本 ( N  = 1240) 中，风险情景的普遍性（重复、升级、扭曲和改进）情景）通过回顾性编码住院患者攻击性的变化进行了调查。结果表明，包括持续停止攻击在内的改进方案很常见。攻击情景与历史-临床-风险管理 20 和精神病检查表 - 修订版具有重要的关联模式。总体而言，本研究提供了与暴力风险情景规划相关的初步经验证据。这些发现的含义包括情景规划如何与法医心理健康评估中的评估者偏见相交。