Risk Assessment

by

Ashley A. Pritchard, Adam J. E. Blanchard, Kevin S. Douglas

• LAST REVIEWED: 13 January 2014
• LAST MODIFIED: 13 January 2014
• DOI: 10.1093/obo/9780195396607-0095

Introduction

Violence risk assessment is the process of identifying the level of risk for future violence posed by offenders, forensic patients, and civil psychiatric patients. In each such context, whether persons are detained or released into the community is a decision governed by law. The field of violence risk assessment has witnessed tremendous growth over the past several decades. With few exceptions, its use in numerous legal settings has been upheld by courts, and in some cases professionals have positive duties to conduct risk assessments and protect potential victims. After early research findings suggesting very poor performance of clinicians in predicting violence, a great deal of research has focused on improving risk assessment. Several hundred studies have now been conducted on structured approaches to risk assessment (e.g., actuarial prediction, structured professional judgment). Similarly, a great amount of scientific attention has been paid to identifying empirically supported violence risk factors. More recently, scholars have been focusing on identifying so-called dynamic risk factors, or those that are changeable and of most relevance to intervention. Current themes in risk assessment include focusing on how risk assessment can inform risk management and risk reduction and how best to integrate risk assessment technology into actual practice.

General Overviews

Early reviews of violence risk assessment tended to focus on failures in clinical prediction and consequent challenges to its use in legal arenas (Ennis and Litwack 1974). Additionally, reviews often attempted to specify what the important risk factors were (Douglas and Webster 1999). Over time, reviews shifted to explicating certain models of risk assessment, such as the actuarial approach (Quinsey, et al. 1998), the risk-need-responsivity approach (Andrews, et al. 2010), the structured professional judgment approach (Douglas and Reeves 2008), or all such approaches (Litwack, et al. 2006). Most recently, there has been a shift toward general overviews that focus on quantifying individual studies meta-analytically (Yang, et al. 2010) as well as on applied aspects of risk assessment such as case formulation (Lewis and Doyle 2009).

• Andrews, D. A., J. Bonta, and J. S. Wormith. 2010. The level of service (LS) assessment of adults and older adolescents. In Handbook of violence risk assessment. Edited by R. Otto and K. S. Douglas, 199–225. New York: Routledge.

  In this book chapter, the authors discuss the history and development of a method of risk and needs assessment called risk-needs-responsivity, or RNR. The RNR approach was developed primarily within correctional settings, and it guides decision-makers through the assessment of risk factors and the development of risk management plans.

• Douglas, K. S., and K. Reeves. 2008. Violence risk assessment. In Encyclopedia of psychology and law. Vol. 2. Edited by B. L. Cutler, 448–451. Thousand Oaks, CA: SAGE.

  This piece provides an overview of various forms of risk assessment, focusing on the structured professional judgment approach.

• Douglas, K. S., and C. D. Webster. 1999. Predicting violence in mentally and personality disordered individuals. In Psychology and law: The state of the discipline. Edited by R. Roesch, S. D. Hart, and J. R. P. Ogloff, 175–239. New York: Plenum.

  DOI: 10.1007/978-1-4615-4891-1

  This chapter first provides a description of the history of risk assessment and its legal context. It then moves into a detailed description of research support for numerous violence risk factors.

• Ennis, B. J., and T. R. Litwack. 1974. Psychiatry and the presumption of expertise: Flipping coins in the courtroom. California Law Review 62:693–752.

  DOI: 10.2307/3479746

  In this article, the authors review the small number of studies on the clinical prediction of violence, and they argue that the evidence indicated that predictive accuracy was low. As such, the authors opine that mental health professionals ought not to be involved in risk assessment within legal arenas.

• Lewis, G., and M. Doyle. 2009. Risk formulation: What are we doing and why? International Journal of Forensic Mental Health 8:286–292.

  DOI: 10.1080/14999011003635696

  In this article, the authors make the argument that risk assessment would benefit from increased attention to the formulation of risk at the individual level. It includes a description of different approaches to formulation.

• Litwack, T., P. Zapf, J. Groscup, and S. D. Hart. 2006. Violence risk assessment: Research, legal, and clinical considerations. In Handbook of forensic psychology. Edited by I. Weiner and A. Hess, 487–533. New York: Wiley.

  This chapter provides a detailed discussion of clinical, actuarial, and structured professional judgment approaches to violence risk assessment. It reviews and critiques individual studies in detail, and it provides guidance for clinicians needing to conduct violence risk assessments. It also provides a detailed legal review.

• Quinsey, V. L., G. T. Harris, G. T. Rice, and C. A. Cormier. 1998. Violent offenders: Appraising and managing risk. Washington, DC: American Psychological Association.

  DOI: 10.1037/10304-000

  In this book, the authors provide a detailed discussion of their views of the benefits of actuarial risk assessment. They also describe a series of research studies that culminated in the development of an actuarial violence risk assessment instrument.

• Yang, M., S. C. P. Wong, and J. Coid. 2010. The efficacy of violence prediction: A meta-analytic comparison of nine risk assessment tools. Psychological Bulletin 136.5: 740–767.

  DOI: 10.1037/a0020473

  This meta-analysis evaluated the predictive accuracy of nine risk assessment instruments across twenty-eight samples. The authors report that there were few differences between the tools. Few tools improved upon the Psychopathy Checklist-Revised, save for the Historical-Clinical-Risk Management 20 (HCR-20) and the Offender Group Reconviction Scale (OGRS).