PSYC 2400: Risk Assessment

Contents

1. 1. Why Should We Care?
2. 2. Risk Assessment
   1. 2.1 When are they conducted?
   2. 2.2 Goals of Risk Assessment (ACT)
   3. 2.3 Predicting Risk
      1. 3 Major Approaches to Risk Assessment
      2. Categorizing Assessment Tools
      3. Evaluating Risk Assessment Tools

1. Why Should We Care?

• The public cares.
• The media cares: recent news items.
• Risk assessment informs: sentencing (especially dangerous offender hearings), security classification, treatment needs, treatment intensity, parole decisions, level of supervision in the community, notification decisions, release conditions, etc.

2. Risk Assessment

Nowadays, we asses both risk prediction and management – prediction and management are correlated. Before, we used to stop at prediction (people were either dangerous or not). We have also expanded on our assessment instruments: different types of risks, how risks change in different circumstances etc. Risk potential can change over time.

Risk Prediction: assess the risk that people will commit violence in the future.
Risk Management: develop effective intervention strategies to manage that risk (prevention).

Example: comparison of two individuals...

• John: lack of social support, lower education, history of antisocial behaviour, substance abuse, didn’t respond well to prison (carbon copy of Jeffry Dahmer) etc: has not re-offended.
• Henry: no real danger to society, repeated hospitalizations regardless of him taking his medication, paranoid schizophrenia, poor hygiene and diet (which suggests he may not keep taking his medication): has re-offended – he killed his neighbour.
• Results: informal perusals of files are probably not good indicators of whether or not a person will re-offend because regardless of your experience, most people would finish not knowing the answer.

2.1 When are they conducted?

They can be conducted in both civil and criminal settings:

Civil Settings:

• Civil Commitment: if you have a mental illness and you pose a danger to yourself or others.
• Child Protection: protecting children from abuse (and potentially removing them from the home).
• Immigration: prohibiting people from entering the country if they may pose a threat to society.
• School and Labour Regulations: preventing acts that may endanger others.

Criminal Settings: this includes pre-trial, sentencing, release, etc. Public safety outweighs solicitor-client priviledge.

2.2 Goals of Risk Assessment (ACT)

The following is a partial list of the goals of risk assessment in a parole board (in addition to treating offenders as individuals):

1. Improve Accuracy: want to be confident that the person they’re releasing is a low risk and the person they’re not releasing is a high risk.
2. Improve Consistency: risk assessors should come up with the same decision looking at the same sorts of cases. This is a legally, ethically important variable.
3. Improve Transparency: their procedures must be as transparent as possible (to the victim, public, federal government, CJS, etc). Describing why you used the procedure you did is the toughest question to answer; it’s much easier to explain how and what procedures you used.

In Canada, we use the follow 2 types of risk factors to assess risk:

1. Dynamic Risk Factors: variables that are related to recidivism (dynamic, criminogenic needs). These change with time, less convenient and less reliable, less frequently used but they are sensitive to change (with a level of intervention we can change the level of risk).
   1. Acute Factors: change very rapidly, such as current level of substance abuse; your social group; getting divorced; losing your job.
   2. Stable Variables: they change slowly over time, such as levels of impulsivity; attitude towards violence; anything related to inherent dispositions, traits and attitudes.
2. Static Risk Factors: these are variables that are fixed and unchanged (they simply exist in the offenders lives), not hard to measure (convenient), frequently used in risk assessment, can be reliably measure and are very predictive.
   1. Examples of static variables: three categories – demographic variables, history of criminal behaviour, history of mental disorder. The presence of these doesn’t necessarily increase the risk of re-offence. (Examples: The time at which you first offended, family history of alcohol abuse, gender of the offender.)

There are also 4 types of risk factors:

1. Historical: static risk factors that relate to the events that happen in the persons past.
   1. Past criminal behaviour.
   2. Age of onset of antisocial behaviour.
   3. Childhood history of abuse increases risk of violence, especially physical abuse.
   4. Past supervision failure, escape or institution maladjustment.
2. Dispositional: risk factors that reflect the individual’s traits, tendencies or styles.
   1. Demographics: being arrested before 14, males.
   2. Personality: impulsiveness and psychopathy; psychopathy combined with deviant sexual arousal predicts sexual recidivism.
3. Clinical: types and symptoms of disorders.
   1. Substance Use: drug and alcohol abuse is moderately related to recidivism rates.
   2. Mental Disorder: affective disorder with schizophrenia indicates higher rates of violence. TCO (threat/control override) describes symptoms where the person feels they can’t control their environment and they fear people will hurt them; TCO symptoms can predict violence in men (not women).
4. Contextual: risk factors that refer to aspects of the current environment (situational).
   1. Lack of social support: instrumental (necessities of life), emotional, appraisal (give help or courage) and information (new facts).
   2. Access to weapons or victims.

Strongest predictors of general recidivism: first police contact, non-severe pathology (stress or anxiety), family problems, conduct problems, ineffective use of leisure time and delinquent peers.

Big 4 Risk Factors:

1. Criminal History: static
2. Pro-criminal Personality: impulsivity, aggression
3. Pro-criminal attitudes: dynamic, stable
4. Pro-criminal associates: dynamic acute and dynamic stable

Not Risk Factors:

• Low SES (socio-economic status)
• Personal distress/psychopathology (low self-esteem and depression)
• Fear of punishment
• Verbal intelligence
• Remorse/empathy
• Offence severity

2.4 Predicting Risk

There are four possible outcomes when predicting risk:

1. True Positive: correct prediction of re-offending.
2. True Negative: correct prediction of not re-offending.
3. False Positive: offender was predicted to re-offend but did not.
4. False Negative: offender was predicted not to re-offend but did.

Base Rates: the percentage of people within a given population who engage in a specific behaviour or have a mental disorder; it tends to be easier to predict frequent events than non-frequent events.

Methodological Issues in Predicting Risk: three main issues have been identified...

• Limited number of risk factors being studied
• (How the variable is measured) Official records underestimate the number of crimes actually committed (undiscovered true positives).
• (How the variable is defined) In addition to whether or not they committed a violent act, we need to include the type, severity and motivation for violence.

3 Major Approaches to Risk Assessment

1. Unstructured clinical judgment: this is still sometimes used; where clinicians assess the offender with variables they think are important – subjectively selecting, analyzing and interpreting risk factors. Illusionary correlation – where the clinician interprets two variables as correlated but they’re not.
   AUC = 0.55
   1. Advantages: flexible (variables can be adjusted to the offender, the context, etc) and idiographic (case-by-case – personalized rather than generalized).
   2. Disadvantages: inconsistent (different variables might be used and analyzed in different ways) and has low accuracy (cognitively, we can’t process and identify risk predictors in a sensible way, beliefs, schemas about offenders).
2. Actuarial (statistical) tools: where we collect pre-specified risk factors and enter them into a statistical model that combines and weights them (the opposite of unstructured clinical judgment).
   AUC = 0.68 to 0.80
   1. Advantages: consistent (everyone is assessed exactly the same way) and highly accurate.
   2. Disadvantages: nomothetic (generalized – not taking into account the individual... especially does not include uncommon, rare events) and validity across different samples (sometimes people don’t do cross-evaluations so they don’t know if the tool is valid and sometimes the tool isn’t valid at all).
3. Structured professional judgment: where we collect pre-specified risk factors while adding in any case specific details (a hybrid of the previous two approaches); the final assessment is a clinical judgment that’s informed by empirical risk factors.
   AUC = 0.62 to 0.75
   1. Advantages: flexible (allows individual factors to be important) and nomothetic-idiographic.
   2. Disadvantages: moderate accuracy (clinical judgment) and less consistent than actuarial (because it’s idiographic).

Categorizing Assessment Tools

• General Offending:
  • LSI-R (Level of Service Inventory, Revised): static and dynamic risk factors, actuarial.
  • HCR-20: static and dynamic risk factors, SPJ.
  • PCL-R: static and dynamic risk factors, actuarial (not actually a risk assessment)
• Violent Offending:
  • Measures for general offending work well.
  • VRAG: static factors, actuarial.
• Sexual Offending:
  • Static-99: static factors, actuarial.
  • Stable-2007: stable dynamic factors, actuarial.
• Domestic Violence:
  • SARA (Spousal Assault Risk Assessment): stable and dynamic, SPJ
  • ODARA (Ontario Domestic Assault Risk Appraisal guide): stable, incorporates victim assessment, actuarial.

Issue: because there are so many tools, we don’t know which to choose from.

Evaluating Risk Assessment Tools

Short answer: yes, we’re pretty good at it. We are primarily interested in accuracy (do they re-offend and do higher risk offenders re-offend more than low-risk offenders) but it has to be easy-to-use, consistent and gives us a good, fuzzy feeling.
ROC (Receiver Operating Characteristic) Analysis: gives you a particular accuracy measure (AUC – area under the curve) – the probability that an outcome (re-offence) will occur.

3 Actuarial Instruments

1. General Statistical Information on Recidivism (GSIR): instrument with 15 assessment items that are used to generate a % based on how much of a risk the person poses based on past criminal involvement.
   Results: strong predictor of general recidivism but weak predictor of violent recidivism and less predictive with female offenders.
2. Violence Risk Appraisal Guide (VRAG): instrument with 12 items designed to assess the long-term risk for violent recidivism in offenders with mental disorders by examining certain static risk factors (Hare Psychopathy Checklist-Revised score, elementary school maladjustment, personality disorder, etc).
   Disadvantage: not transparent or idiographic.
3. Iterative Classification Tree (ICT): designed to assess the risk for violence in psychiatric patients, classifying patients in low or high risk categories.
   Results: moderately predicts violence

Limitations of Actuarial Instruments: primarily rely on static factors, provide little practical information about what risk factors need to be targeted, don’t allow for the incorporation of treatment gain into the prediction (or indicate when they might fail), and they’re not theoretically derived.

3 Structured Professional Judgment Schemes

1. Level of Service Inventory-Revised (LSI-R): an instrument with 10 subscales that highlight the areas that should be targeted for intervention and helps identify their level of supervision needed based on the likelihood of recidivism. These subscales include both static and dynamic risk factors.
   Results: good for predicting general recidivism, not sexual recidivism.
2. HCR-20: designed to predict violent behaviour with 10 historical factors, 5 clinical factors and 5 risk management factors. The presence of the risk factors is calculated and then we subjectively decide on the level of risk based on case-specific risk factors.
   Risk Ratings:
   • Low Risk: monitor and intervene with low priority and intensity.
   • Mid Risk: monitor and intervene with some priority and intensity.
   • High Risk: monitor and intervene with high priority and intensity.
   Results: moderate to strong prediction of violent recidivism.
3. Violence Risk Scale (VRS): designed to assess the risk of re-offence and treatment goals needed to reduce the risk. Uses some static but mostly dynamic risk factors. It aims to integrate four goal into one risk assessment tool:
1. Assess risk to re-offend;
2. Identify which aspects of an offender need to be targeted in treatment to reduce that risk;
3. Determine whether the offender is in denial about or receptive to changing the aspects that lead him into crime; and
4. Measure whether the changes have occurred once treatment is completed.
Results: moderate prediction of violent and nonviolent recidivism.