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Amelia Jewell, Kimberlie Dean, Tom Fahy, Alexis E Cullen
BACKGROUND: Previous studies have investigated factors associated with outcome at Mental Health Review Tribunals (MHRTs) in forensic psychiatric patients; however, dynamic variables such as treatment compliance and substance misuse have scarcely been examined, particularly in UK samples. We aimed to determine whether dynamic factors related to behaviour, cooperation with treatment, and activities on the ward were prospectively associated with outcome at MHRT. METHODS: At baseline, demographic, clinical, behavioural, and treatment-related factors were ascertained via electronic medical records and census forms completed by the patient's clinical team...
January 17, 2017: BMC Psychiatry
Marlene Macinnes, Gary Macpherson, Jessica Austin, Matthias Schwannauer
Previous research has found an association between childhood trauma and insecure attachment and psychological distress, risk of violence and engagement in therapy. The aim of this study was to investigate the relationships between these factors in a forensic population. Sixty-four participants from three secure psychiatric hospitals completed the Childhood Trauma Questionnaire (CTQ), the Relationship Scales Questionnaire (RSQ) and the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Overall scores from participants' Historical Clinical Risk Management Violence Risk Assessment Scheme, (HCR-20) were calculated...
December 30, 2016: Psychiatry Research
Jane L Ireland, Lee J Priday, Carol A Ireland, Simon Chu, Jennifer Kilcoyne, Caroline Mulligan
BACKGROUND: Risk assessment instruments have become a preferred means for predicting future aggression, claiming to predict long-term aggression risk. AIMS: To investigate the predictive value over 12 months and 4 years of two commonly applied instruments (Historical, Clinical and Risk Management - 20 (HCR-20) and Violence Risk Appraisal Guide (VRAG)). METHOD: Participants were adult male psychiatric patients detained in a high secure hospital...
January 2016: BJPsych Open
Alana N Cook, Heather M Moulden, Mini Mamak, Shams Lalani, Katrina Messina, Gary Chaimowitz
The Hamilton Anatomy of Risk Management-Forensic Version (HARM-FV) is a structured professional judgement tool of violence risk developed for use in forensic inpatient psychiatric settings. The HARM-FV is used with the Aggressive Incidents Scale (AIS), which provides a standardized method of recording aggressive incidents. We report the findings of the concurrent validity of the HARM-FV and the AIS with widely used measures of violence risk and aggressive acts, the Historical, Clinical, Risk Management-20, Version 3 (HCR-20(V3)) and a modified version of the Overt Aggression Scale...
July 14, 2016: Assessment
Kaoru Arai, Ayumi Takano, Takako Nagata, Naotsugu Hirabayashi
BACKGROUND: Most structured assessment tools for assessing risk of violence were developed in Western countries, and evidence for their effectiveness is not well established in Asian countries. AIMS: Our aim was to examine the predictive accuracy of the Historical-Clinical-Risk Management-20 (HCR-20) for violence in forensic mental health inpatient units in Japan. METHODS: A retrospective record study was conducted with a complete 2008-2013 cohort of forensic psychiatric inpatients at the National Center Hospital of Neurology and Psychiatry, Tokyo...
June 13, 2016: Criminal Behaviour and Mental Health: CBMH
Andrea Sada, Rebeca Robles-García, Nicolás Martínez-López, Rafael Hernández-Ramírez, Carlos-Alfonso Tovilla-Zarate, Fernando López-Munguía, Enrique Suárez-Alvarez, Xochitl Ayala, Ana Fresán
INTRODUCTION: Assessing dangerousness to gauge the likelihood of future violent behaviour has become an integral part of clinical mental health practice in forensic and non-forensic psychiatric settings, one of the most effective instruments for this being the Historical, Clinical and Risk Management-20 (HCR-20). OBJECTIVE: To examine the HCR-20 factor structure in Mexican psychiatric inpatients and to obtain its predictive validity and reliability for use in this population...
August 2016: Nordic Journal of Psychiatry
Michael J Vitacco, Holly E Tabernik, Denis Zavodny, Karen Bailey, Christina Waggoner
The present study evaluates data from 116 forensic inpatients who underwent violent risk assessments, which included the Historical, Clinical, Risk-20 (HCR-20), from 2006 to 2013 as part of an opportunity to be conditionally discharged from state forensic facilities. Of the 116 inpatients, 58 were never released, 39 were released and returned to a hospital, and 19 were released and never returned. Results from analyses of variance and multinomial logistic regression found the risk management (R) scale of the HCR-20 successfully predicted group membership in that higher scores were associated with a greater likelihood of not being released from a forensic facility or returning to a forensic facility after release...
March 2016: Behavioral Sciences & the Law
Mary Davoren, Orla Byrne, Paul O'Connell, Helen O'Neill, Ken O'Reilly, Harry G Kennedy
BACKGROUND: Patients admitted to a secure forensic hospital are at risk of a long hospital stay. Forensic hospital beds are a scarce and expensive resource and ability to identify the factors predicting length of stay at time of admission would be beneficial. The DUNDRUM-1 triage security scale and DUNDRUM-2 triage urgency scale are designed to assess need for therapeutic security and urgency of that need while the HCR-20 predicts risk of violence. We hypothesized that items on the DUNDRUM-1 and DUNDRUM-2 scales, rated at the time of pre-admission assessment, would predict length of stay in a medium secure forensic hospital setting...
2015: BMC Psychiatry
Nathan D Gillard, Richard Rogers
Risk assessments for offenders often combine past records with current clinical findings from observations, interviews, and test data. Conclusions based on these risk assessments are highly consequential, sometimes resulting in increased criminal sentences or prolonged hospitalization. Therefore, many offenders are motivated to intentionally minimize risk factors and their negative consequences. Positive impression management (PIM) is especially likely to occur in offenders with high psychopathic traits because goal-directed deception is reflected in several of psychopathy's core traits of the disorder, such as manipulativeness, glibness, and superficial charm...
September 2015: International Journal of Law and Psychiatry
David Ivgi, Arie Bauer, Razek Khawaled, Paola Rosca, Joshua M Weiss, Alexander M Ponizovsky
BACKGROUND: Assessment of risk of violent behavior in forensic psychiatric practice is a complex and responsible clinical task and the use of a valid instrument can make the expert's work more effective. The Historical Clinical and Risk Management scale 20 (HCR-20) is a widely accepted measure of the risk of violence, sexual and criminal behavior. The aim of this study was to validate the HCR-20 in Israeli psychiatric inpatient settings. METHOD: In a prospective design, data were collected on 150 male patients aged 15-65, diagnosed with ICD-10 schizophrenia, who were hospitalized in three wards: an acute psychiatric ward (n=50), a high security ward (n=50), and an open ward (n=50)...
2015: Israel Journal of Psychiatry and related Sciences
Laura E O'Shea, Geoffrey L Dickens
OBJECTIVE: Periodic structured violence risk assessment is the principle method underlying treatment planning for mentally disordered offenders but little is known about how risk changes over time. We aimed to determine whether hospitalised patients underwent reliable clinical change in assessed risk. METHOD: We used a pseudo-prospective longitudinal study design. Demographic, clinical and risk assessment data of adult inpatients (N=480) who had been routinely assessed with the HCR-20 on two to four occasions over a mean period of 17 months (SD=2) were collated...
October 2015: Comprehensive Psychiatry
Ken O'Reilly, Gary Donohoe, Ciaran Coyle, Danny O'Sullivan, Arann Rowe, Mairead Losty, Tracey McDonagh, Lasairiona McGuinness, Yvette Ennis, Elizabeth Watts, Louise Brennan, Elizabeth Owens, Mary Davoren, Ronan Mullaney, Zareena Abidin, Harry G Kennedy
BACKGROUND: There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Although neurocognitive and social cognitive deficits are core features of schizophrenia, evidence of a relationship between cognitive impairments and violence within this patient population has been mixed. METHODS: We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder (n = 89; 10 violent) over a 12 month period...
2015: BMC Psychiatry
Olav B Nielssen
No abstract text is available yet for this article.
November 2015: Australian and New Zealand Journal of Psychiatry
Laura E O'Shea, Dev-Kishan Thaker, Marco M Picchioni, Fiona L Mason, Caroline Knight, Geoffrey L Dickens
BACKGROUND: Violent and non-violent sexual behaviour is a fairly common problem among secure mental health service patients, but specialist sexual violence risk assessment is time-consuming and so performed infrequently. AIMS: We aimed to establish whether a commonly used violence risk assessment tool, the Health Clinical Risk management 20(HCR-20), has predictive validity specifically for inappropriate sexual behaviour. METHODS: A pseudo-prospective cohort design was used for a study in the adult wards of a large provider of specialist secure mental health services...
December 2016: Criminal Behaviour and Mental Health: CBMH
Cevher Gunenc, Laura E O'Shea, Geoffrey L Dickens
Despite evidence about the negative effects of verbal aggression in mental health wards there is little research about its prevalence or about the factors that predict the behaviour among inpatients. This study aimed to determine the prevalence of verbal aggression in a secure mental health service, and to examine the relationship of verbal aggression with risk factors for aggression in the risk assessment tool HCR-20 in order to establish whether, and with which factors, the behaviour can be predicted. Verbal aggression was measured using the Overt Aggression Scale (OAS) over a 3-month period across a heterogeneous patient group (n = 613)...
August 2015: International Journal of Mental Health Nursing
Mary Davoren, Sarah Hennessy, Catherine Conway, Seamus Marrinan, Pauline Gill, Harry G Kennedy
BACKGROUND: Detention in a secure forensic psychiatric hospital may inhibit engagement and recovery. Having validated the clinician rated DUNDRUM-3 (programme completion) and DUNDRUM-4 (recovery) in a forensic hospital, we set out to draft and validate scales measuring the same programme completion and recovery items that patients could use to self-rate. Based on previous work, we hypothesised that self-rating scores might be predictors of objective progress including conditional discharge...
2015: BMC Psychiatry
Rafael Bernardon Ribeiro, John Tully, Maria Fotiadou
There are limited data on women in Medium Secure settings. This study aimed to address this by assessing the characteristics of 45 consecutive admissions to the female ward of a Medium Secure Unit in the United Kingdom over a four-year period. Data on demographics, clinical outcomes and from HONOS-Secure/HONOS and HCR-20 assessments were prospectively collected. Psychiatric diagnoses were recorded using ICD-10 criteria. Data on quality of life from WHO-QoL-BREF surveys were analysed. There was a high proportion of ethnic minorities (57...
March 2015: International Journal of Law and Psychiatry
L E O'Shea, M M Picchioni, J McCarthy, F L Mason, G L Dickens
BACKGROUND: People with intellectual disability (ID) account for a large proportion of aggressive incidents in secure and forensic psychiatric services. Although the Historical, Clinical, Risk Management 20 (HCR-20) has good predictive validity in inpatient settings, it does not perform equally in all groups and there is little evidence for its efficacy in those with ID. METHOD: A pseudo-prospective cohort study of the predictive efficacy of the HCR-20 for those with ID (n = 109) was conducted in a UK secure mental health setting using routinely collected risk data...
November 2015: Journal of Intellectual Disability Research: JIDR
Joakim Sturup, Daniel Karlberg, Björn Fredriksson, Tobias Lihoff, Marianne Kristiansson
BACKGROUND: In Sweden, the number of people serving life sentences has steadily increased. To date, few studies have examined the recidivism rate or the predictive validity of different risk assessment instruments in this group. AIMS: Our aim was to test the predictive validity among inmates serving life sentences of two different instruments used for assessing risk--the Historical, Clinical and Risk Management-20 (HCR-20), most widely used in clinical populations, and the Psychopathy Checklist-Revised (PCL-R), commonly applied in both penal and clinical settings...
April 2016: Criminal Behaviour and Mental Health: CBMH
Safiye Tozdan, Peer Briken, Dahlnym Yoon, Fritjof von Franqué
OBJECTIVE: Investigation of two questions: first, whether sexual/forensic therapists are able to make valid assessments for future criminal behavior and second, whether their treatment changes factors relevant for new offences. METHODS: First, the predictive validity for recidivism of HCR-20 and SAPROF were tested. Second, the dynamic scales of both instruments were analyzed concerning changes during treatment process. RESULTS: Both instruments showed good predictive validity...
April 2016: Psychiatrische Praxis
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