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Risk Assessment. Risk assessment = process of conceptualizing hazards in order to make judgments about their likelihood and the need for preventative measures Examples: Hurricane warnings Insurance premium determination Medical diagnosis and treatment. Types of prediction.
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Risk Assessment • Risk assessment = process of conceptualizing hazards in order to make judgments about their likelihood and the need for preventative measures • Examples: • Hurricane warnings • Insurance premium determination • Medical diagnosis and treatment
Types of prediction • Clinical prediction: based on clinical experience and judgment • Actuarial prediction: based on statistical formulas • Anamnestic prediction: based on analysis of how a particular person has acted in the past in similar situations
Early research onpredictions of dangerousness • Baxstrom v. Herold aftermath: less than 3% of released inmates had to be returned to security hospitals • John Monahan’s studies: psychiatrists and psychologists accurate in predicting dangerousness only 1/3 of the time • The case of Thomas Barefoot (1983)
“Second generation” of research • Shift in focus from “dangerous/not dangerous” to measuring continuum of risk • Focus on cues that are predictive of risk: • History of previous violence • Psychopathy • Hallucinations • Consensus that risk assessment can be made with “moderate to good” accuracy
Prediction of violence • Mental disorder? Vast majority of people with mental disorders are not violent. • Combination of actuarial procedures with clinical judgment can help • Variables related to risk: • Static predictors • Dynamic predictors • Risk management predictors
Psychopathy as a predictor:The case of Ted Bundy • Born illegitimate; posed as his mother’s “brother” for first four years of life • Allegedly molested as a boy • Mutilated animals as a child • Killed 14 women, mostly college students • Escaped and killed three more people • Executed in 1989
Prediction of Sex Offending • Rapists: 22.8% reconvicted for sexual offenses • Child molesters: 20.4% reconvicted • Rapid Risk Assessment of Sexual Recidivism (RRASOR) • Sex Offender Risk Appraisal Guide (SORAG) • Additional scales show low to moderate predictive validity
Prediction of Domestic Violence • Danger signs: • Men who have witnessed family violence as children • Low education and low income • Alcohol abuse • About half of all men who batter their spouses also batter their children • Spousal Assault Risk Assessment Guide
Prediction of Child Abuse • Risks at the ontogenic level: being young, being a single parent, being poor • Risks at the microsystem level: marital discord • Risks at the ecosystem level: employment stress, social support • Risks at the macrosystem leve: cultural values and attitudes
Prediction of Suicide • Low accuracy rates in suicide prediction • Only about 1 out of 100 psychiatric patients commit suicide • Suicide Probability Scale (SPS): 36 items answered on a 1-4 scale • Suicidal Intent Scale (SIS): semistructured interview, strongly associated with feelings of hopelessness