Aim

Although the absolute risk of violence is small for individuals with mental illnesses, a specific subgroup of individuals who appear to be at increased risk for violence includes young people experiencing emerging or early psychosis. Prior research has identified risk factors for violence in this population, though no prior studies using a formal risk assessment tool have been identified. This study used the Historical Clinical Risk Management-20, version 3 (HCR-20) to identify risk of future violence among a sample of young adults with early psychosis and relevant predictors of risk unique to this population.

Methods

The HCR-20 was administered to a sample of young adults with early psychosis (N = 53) enrolled at one OnTrackNY site, part of a statewide program providing early intervention services to young adults presenting with a first episode of non-affective psychosis. A Confirmatory Factor Analysis (CFA) was conducted to explore the relative importance of the HCR-20 items for this population.

Results

The average age of participants was 21.9 years (SD 3.6 years) and most were male (69.8%, n = 37). Most patients were assessed to be at low risk for future violence based on the Case Prioritization summary risk rating (67.9%, n = 36). The CFA identified 4 items that were not of relative predictive value in identifying the risk of violence in this sample: history of substance use (item H5), history of major mental disorder (item H6), living situation (item R2), and personal support (item R3).

Conclusion

This study presents a formal approach to assessing violence risk in a population at elevated risk of violence, demonstrates the feasibility of using a standardized risk assessment tool in early intervention services, and identifies factors of particular importance associated with predicting violence in this population. Future research should implement violence risk assessment with a structured tool such as the HCR-20 and assess its accuracy in predicting future violent behavior in this setting.

中文翻译：

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接受早期精神病治疗的年轻人的暴力风险评估

目标

尽管对于患有精神疾病的人来说，暴力的绝对风险很小，但似乎暴力风险增加的特定人群包括正在出现或早期精神病的年轻人。先前的研究已经确定了该人群中暴力的风险因素，但尚未确定使用正式风险评估工具的先前研究。本研究使用历史临床风险管理-20 第 3 版 (HCR-20) 来确定患有早期精神病的年轻人样本中未来暴力的风险以及该人群特有的相关风险预测因子。

方法

HCR-20 用于在 OnTrackNY 一个站点登记的早期精神病患者 ( N  = 53) 样本，这是全州计划的一部分，该计划为首次出现非情感性精神病的年轻人提供早期干预服务。进行了验证性因素分析 (CFA) 以探索 HCR-20 项目对该人群的相对重要性。

结果

参与者的平均年龄为 21.9 岁（标准差 3.6 岁），大多数为男性（69.8%，n  = 37）。根据病例优先级汇总风险评级（67.9%， n  = 36），大多数患者被评估为未来暴力风险较低。CFA 确定了 4 项在确定该样本中的暴力风险方面没有相对预测价值的项目：药物使用史（H5 项）、严重精神障碍史（H6 项）、生活状况（R2 项）和个人支持（项目 R3）。

结论

本研究提出了一种评估暴力风险较高的人群中暴力风险的正式方法，证明了在早期干预服务中使用标准化风险评估工具的可行性，并确定了与预测该人群中的暴力行为相关的特别重要的因素。未来的研究应使用 HCR-20 等结构化工具实施暴力风险评估，并评估其在这种情况下预测未来暴力行为的准确性。