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Psychology and the Law ch 8

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PSYC 3310
Regina Schuller

Risk assessment What is risk assessment? • Risk use to be dichotomous (either dangerous or not); now it is seen as a range (person varies in their degree of being dangerous) • Risk assessment has a prediction (committing in the future) and management (develop- ment of interventions to manage/reduce future violence) component •The critical function of risk assessment is violence prevention and NOT prediction Risk assessments: when are they conducted? • Both in civil and criminal contexts - civil: private rights of individuals; criminal: individuals be- ing charged with a crime Civil setting • Civil commitment: requires someone to be hospitalized involuntarily if they have a mental ill- ness and pose a threat to others or themselves - only a psychiatrist can civilly commit Child protection: protect child from abuse (either physical, sexual or neglect) - professionals • need to be familiar w/the risk factors that predict childhood maltreatment • Immigration laws: not allowing someone into Canada if they pose a threat to social, cultural or economic functioning in Canadian society • School and labour regulations: prevent acts that would endanger others • Duty to warn and limits of confidentiality Criminal settings Can happen during pretrial, sentencing or release; person can be denied bail if there is a • likelihood they will commit another crime• One issue is the disclosure of info about ones risk - problem is that clients must be freely able to discuss things w/ their lawyer w/out the info being released (some info will outweigh the confidentiality) • If someone is assessed and has a high risk of reoffending, indefinite or long term incarcera- tion is the only option for these people; long term was only created in 1997 Risk assessment is also used for decisions concerning release from correctional or forensic • psychiatric institutes - if person is sentenced to prison, they can apply to NPB to get early re- lease •Statutory release (being released after serving ⅔ of sentence) will be denied if the per- son is at high release •Only if a risk assessment is done, can a client who is NCRMD can be released from psych ward History of risk assessment Baxstrom vs Herald: showed that mentally ill patients who were incarcerated and then re- • leased, even if they were assessed as being too dangerous, only 20 (7%) of 98 of them were arrested again, and only seven for violent crime Dixon vs attorney general of pennsylvania: followed 400 patients for 3 years; only 60 (15%) • were arrested or rehospitalized for a violent incident •These two studies question the ability for making an accurate risk assessment although they are still being used in court Types of prediction outcomes • True +ve: someone predicted to be violent engages in violence CORRECT • True -ve: person predicted not to be violent does not act violently CORRECT • False +ve: predicted to be violent but is not INCORRECT • False -ve: predicted to not be violent but acts violently INCORRECT •Decreasing the false +ves, will lead to an increase in false -ve’s [they are co-dependent] The base rate problem • Base rate: represents the % of ppl w/in a popn who commit a criminal or violent act - diffi- cult to make predictions when the base rates are too high or low • Low base rates: leads to many false +ve’s occurring - happens since you see something that happens and assume it happens more than often i.e. Having one high shooting and thinking all youths will be violent • Base rates depend on: what is being predicted, group being studies and length of follow-up period over which the individual is monitored • Overall it is easier to predict frequent events over infrequent ones Methodological issues • The ideal way to measure an instrument that can be used for risk assessment is to use the measurement on high risk individuals and allow them to go into society and get follow-ups on their behaviour [this is ethically not allowed] • Reality: sample can only be on people who have low risk of reoffending - this puts a con- straint on the conclusion when applying the measurement to the real world • 3 weaknesses of research on the prediction of violence: 1. 1. Limited number of risk factors that are studied and they do not take into account the reasons for the violence 2. Researchers often use criminal records as their criterion variable, but many crimes are never reported - leads to many false +ve’s actually being undiscovered true +ve’s: overall just using criminal records underestimates violence ← Studies have shown that using official records makes the base rate 4.5% how- ever when patients and collateral reports are added, base rate increases to 27.5% (6 times higher) 3. Problem with how the criterion variable is defined (either someone engages in vio- lence or not); should include the severity, type, target of violence, location and motiva- tion (unplanned or instrumental [violence for a goal]) Judgment error and bias • Clinical decision making can be done by using heuristics - using traits that they intuitively think are important or assume to be associated w/ risk but are not •Read about heuristics on slides + base rate fallacy - slides and notes • Illusory correlation: belief that a correlation exists b/w two things that are either not corre- lated or correlated a lesser extent • Clinicians tend to ignore base rates of violence • They also rely on highly salient or unique cues like bizarre delusions • Ppl are also overconfident w/ their judgments; the association b/w confidence and accuracy is minimal Approaches to the assessment of risk • Unstructured clinical judgment: has substantial amount of professional discretion and lack of guidelines •There are no rules to what risk factors should be considered, what sources of info to use, or how to make a decision on the risk; risk factors can vary among clinicians • Actuarial prediction: risk factors are selected and combined based on empirical research w/ specific outcomes •Problem w/ this is that it relies on stats, so it does not permit measuring changes of risk over time or providing info relevant to intervention• Meehl and colleagues: determined at two different times (50 years apart) that the actuarial prediction is equal or better than unstructured clinical judgments Structured professional judgment (SPJ): a diverse group of professionals work to make • an evaluation of risk (clinicians, probation officers, social workers, etc) - is guided by using a predetermined list of risk factors which were selected from research and literature; the profes- sionals all consider the severity of each risk factor, but the final judgment is base on the eval- uator’s professional judgment • Reliability has not been researched much yet Types of predictors • Risk factor: measurable feature of an individual that predicts the behavior of interest, such as violence • Static risk factors: factors that are not changed by treatment i.e. age of first arrest • Dynamic risk factors / criminogenic needs: fluctuate over time and can change i.e. Anti- social attitude • Risk factors can also be thought of as being on a continuum: Static - stable dynamic (things that change, but over long periods; should be the target of treatment i.e. Coping, attitude and impulsivity) - acute dynamic (change rapidly and often oc- cur just prior to an offen
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