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Violence risk assessment in male and female mentally disordered offenders: differences and similarities
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.ORCID iD: 0000-0002-8285-0935
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

When assessing the risk of violence, increasing interest has been shown in bringing science and practice closer together. Moving from clinical intuition in the first generation of risk assessment via actuarial scales in the second generation to the structured professional judgments where risk assessments are today produces better, more valid results when assessing the risk of violence. One of the best predictors of violence is gender. Approximately 10% of the violent criminality can be attributed to women; even so, it is increasing, especially among young women. It is therefore important to examine risk assessments from a gender perspective. Another important factor when assessing the risk of violence is psychopathy and there are indications that there might be gender differences in this diagnosis. Thus, a special interest has been focused on psychopathy in this thesis. The purpose with this work is to explore the similarities and differences in assessing risk for violence in male and female mentally disordered offenders, while the overall aim is to validate the violence risk assessment instrument HCR-20 for Swedish offender populations. The risk assessments for all six studies in this thesis were made by trained personnel using the HCR-20 instrument, where psychopathy was diagnosed with the screening version of the Psychopathy Checklist (PCL:SV). The study populations were both male and female mentally disordered offenders in either the correctional or the forensic setting.

The findings show that both the validity and the reliability of the HCR-20 and the PCL:SV were good and the clinical and risk management subscales were found to have better predictive validity than the historical scale. Another finding was that there were more similarities than differences between genders in the HCR-20, while the opposite applied to the PCL:SV, where the antisocial behavior was performed in a different manner. Moreover, it was found that the gender of the assessor might be a factor to take into account when

assessing the risk of violence in women, where the recommendation was that at least one assessor should be female. The conclusions were that the HCR-20 and the PCL:SV can be used In Swedish offender populations with valid results. For female offenders, there are differences in the antisocial behavior that is assessed in order to diagnose psychopathy and these differences tend to underestimate psychopathy among female offenders. Furthermore, the gender of the assessor might be of greater importance than has previously been realized. The overall conclusion was that this thesis supports the structural professional judgment method of making risk assessments in order to prevent violence in the community.

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University , 2006.
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 9
Keywords [en]
Risk assessment, HCR-20, psychopathy, PCL:SV, female offenders, mentally disordered offenders, antisocial behavior, violent recidivism
National Category
Nursing
Identifiers
URN: urn:nbn:se:miun:diva-55ISBN: 91-85317-21-7 (print)OAI: oai:DiVA.org:miun-55DiVA, id: diva2:2048
Public defence
2006-12-04, Campus Sundsvall, Sundsvall, 10:00 (English)
Opponent
Supervisors
Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2009-02-13Bibliographically approved
List of papers
1. Clinical and risk management facotrs in risk prediction of mentally disordered offenders - More important than historical data?: A retrospective study of 40 mentally disordered offenders assessed with the HCR-20 violence risk assessment scheme
Open this publication in new window or tab >>Clinical and risk management facotrs in risk prediction of mentally disordered offenders - More important than historical data?: A retrospective study of 40 mentally disordered offenders assessed with the HCR-20 violence risk assessment scheme
1999 (English)In: Legal and Criminological Psychology, ISSN 1355-3259, E-ISSN 2044-8333, Vol. 4, no 1, p. 67-76Article in journal (Refereed) Published
Abstract [en]

Purpose. The predictive validity of the risk prediction instrument HCR-20 was studied. Methods. Two matched groups of discharged forensic psychiatric patients, one who had recidivated into violent criminality and the other not, were assessed with the HCR-20. This was done retrospective and blind to the outcome. Results. The results show an overall high predictive validity (AUC = .80). However, historical data had none, or a low, validity while clinical and risk management data had a very high validity. Conclusions. One of the most interesting findings in this study is that clinical and risk management factors came out as more predictive of future violence than historical factors, which is very much contrary to findings in past research. We think that one has to bear in mind that both clinical and risk management factors are heavily influenced by historical information. Thus, historical data are probably as important as is generally shown in follow-up studies of violence in various offender groups. However, using the HCR-20, which allows systematic and reliable coding of clinical and risk management factors, seems to make it possible to use these factors more successfully than has been hitherto possible.

Keywords
Kriminologi
National Category
Law and Society
Identifiers
urn:nbn:se:miun:diva-414 (URN)10.1348/135532599167798 (DOI)
Available from: 2008-01-21 Created: 2009-03-24 Last updated: 2017-12-13Bibliographically approved
2. Prediction of Violence Using the HCR-20: A prospective study in two maximum-security correctional institutions
Open this publication in new window or tab >>Prediction of Violence Using the HCR-20: A prospective study in two maximum-security correctional institutions
2000 (English)In: Journal of forensic psychiatry (Print), ISSN 0958-5184, E-ISSN 1469-9478, Vol. 11, no 1, p. 167-175Article in journal (Refereed) Published
Abstract [en]

The HCR-20 and the PCL:SV were used in a prospective study of 41 long-term sentenced offenders in two correctional, maximum-security institutions. The aim was to test the validity of these instruments in the prediction of institutional violence. All assessments were made by a comprehensive examination of the offenders’ files, completed with clinical interviews ranging from 1 to 3 hours. The mean follow-up time was 8 months. Our results show high predictive validity for the HCR-20’s clinical and risk management items, but for almost none of its historical items. The results suggest that violence inside correctional institutions can be predicted with a certain degree of validity by using the HCR-20 and the PCL:SV, even within a selective ‘high-risk’ group of offenders such as that under study here.

National Category
Law and Society
Identifiers
urn:nbn:se:miun:diva-415 (URN)10.1080/095851800362445 (DOI)
Available from: 2008-01-21 Created: 2009-03-24 Last updated: 2017-12-13Bibliographically approved
3. Comparison of HCR-20 scores in violent mentally disordered men an women: Gender differences and similarities
Open this publication in new window or tab >>Comparison of HCR-20 scores in violent mentally disordered men an women: Gender differences and similarities
2001 (English)In: Psychology, Crime and Law, ISSN 1068-316X, E-ISSN 1477-2744, Vol. 7, no 1-4, p. 71-79Article in journal (Refereed) Published
Keywords
Kriminologi
National Category
Law and Society Gender Studies
Identifiers
urn:nbn:se:miun:diva-416 (URN)10.1080/10683160108401784 (DOI)
Available from: 2008-01-21 Created: 2009-03-24 Last updated: 2017-12-13Bibliographically approved
4. Gender differences in psychopathy in a Swedish offender sample
Open this publication in new window or tab >>Gender differences in psychopathy in a Swedish offender sample
2005 (English)In: Behavioral sciences & the law (Print), ISSN 0735-3936, E-ISSN 1099-0798, Vol. 23, no 6, p. 837-850Article in journal (Refereed) Published
Abstract [en]

In this study we examined gender differences in the PCL:SV employing a variety of statistical methods with two subsets of psychopathic individuals drawn from larger samples of 129 female and 499 male Swedish offenders. The larger samples included forensic psychiatric patients, forensic psychiatric evaluees and criminal offenders. We found gender differences in antisocial behavior, as defined in factor 2 of the PCL:SV, with female psychopaths (PCL:SV ≥ 18) displaying significantly more lying, deceitfulness and lack of control, while male psychopaths were more antisocial as measured by the PCL:SV. We conclude that it might be meaningful to use gender specific definitions in the assessment of psychopathy or, alternatively, slightly revise the diagnostic tools. Our results support the use of the three-factor model of the PCL-R and PCL:SV introduced by Cooke and Michie (2001) in female populations.

Keywords
Kriminologi
National Category
Law and Society
Identifiers
urn:nbn:se:miun:diva-417 (URN)10.1002/bsl.674 (DOI)3870 (Local ID)3870 (Archive number)3870 (OAI)
Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2017-12-13Bibliographically approved
5. Reliability and validity evaluation of the psychopathy checklist: Screening version (PCL:SV) in Swedish correctional and forensic psychiatric samles
Open this publication in new window or tab >>Reliability and validity evaluation of the psychopathy checklist: Screening version (PCL:SV) in Swedish correctional and forensic psychiatric samles
Show others...
2005 (English)In: Assessment (Odessa, Fla.), ISSN 1073-1911, E-ISSN 1552-3489, Vol. 12, no 2, p. 145-161Article in journal (Refereed) Published
Abstract [en]

This study evaluated the structural reliability, construct-related validity, and cultural validity generalization of the Hare Psychopathy Checklist: Screening Version (PCL:SV) in a sample of more than 560 male and female Swedish forensic psychiatric treatment patients, forensic evaluation patients, and criminal offenders. Structural reliability was excellent for most indices. PCL:SV scores were higher for males than females for total and Part 1 scores (interpersonal/ affective features) but not for Part 2 (behavioral features). With some exceptions, PCL:SV scores were meaningfully related to aggression to others, a measure of risk for violence, substance use problems, personality disorder (positive), and psychosis (negative). Correlations between PCL:SV and aggression were larger for females than males, although the difference was smaller when personality disorder was held constant. The structural reliability and pattern of validity coefficients were comparable in these Swedish samples to other non-North American samples. Implications for the cross-cultural manifestation and correlates of psychopathy are discussed.

National Category
Law and Society
Identifiers
urn:nbn:se:miun:diva-418 (URN)10.1177/1073191105275455 (DOI)2553 (Local ID)2553 (Archive number)2553 (OAI)
Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2017-12-13Bibliographically approved
6. The assessment of psychopathy in female offenders: How important is the gendre of the assessor?
Open this publication in new window or tab >>The assessment of psychopathy in female offenders: How important is the gendre of the assessor?
(English)Manuscript (Other academic)
National Category
Law and Society
Identifiers
urn:nbn:se:miun:diva-419 (URN)
Available from: 2008-01-21 Created: 2009-03-24 Last updated: 2010-01-14Bibliographically approved

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