⚠️📊 Quick Overview
This chapter covers risk assessment - evaluating the likelihood of future violence. Key distinction between static (unchangeable) and dynamic (changeable) risk factors, and major assessment tools.
🔒 Static vs 🔄 Dynamic Risk Factors
- Static (cannot change): Gender, age at first offense, criminal history, history of violence, childhood abuse, early separation from parents, ASPD diagnosis
- Dynamic (can target in treatment): Substance abuse, employment, housing, antisocial peers, relationship problems, anger, criminal attitudes, medication compliance
- Protective factors: Social support, stable employment, prosocial relationship, treatment engagement, motivation to change, problem-solving skills, older age
🛠️ Key Risk Assessment Tools
- HCR-20: 20 items across Historical (10), Clinical (5), Risk Management (5) - widely used, good validity
- VRAG: Actuarial tool, 12 items, includes PCL-R score, predicts violent recidivism
- Static-99: Specific to SEXUAL offenders, 10 static items, quick to score
- SAVRY: For ADOLESCENTS, 24 risk + 6 protective items
📊 Three Approaches
- Actuarial: Algorithm-based, consistent, more accurate, cannot adjust for unique factors
- Unstructured Clinical: Clinician intuition, variable, less accurate, flexible
- Structured Professional Judgment: Guided by factors list, good accuracy, allows clinical judgment
🚧 Limitations
Cannot predict with certainty (only probabilities), base rate problem (violence is rare), false positives/negatives, time-limited predictions, individual uniqueness.