Predictive validity of the HCR-20 for violent and non-violent sexual behaviour in a secure mental health service
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...
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| Veröffentlicht in: | Criminal behaviour and mental health 2016-12, Vol.26 (5), p.366-379 |
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| creator | O'Shea, Laura E. Thaker, Dev-Kishan Picchioni, Marco M. Mason, Fiona L. Knight, Caroline Dickens, Geoffrey L. |
| description | 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. Routine clinical team HCR‐20 assessments were extracted from records, and incidents involving inappropriate sexual behaviour were recorded for the 3 months following assessment.
Results
Of 613 patients, 104 (17%) had engaged in at least one inappropriate sexual behaviour; in 65 (10.6%), the sexual act was violent. HCR‐20 total score, clinical and risk management subscales, predicted violent and non‐violent sexual behaviour. The negative predictive value of the HCR‐20 for inappropriate sexual behaviour was over 90%.
Conclusions
Prediction of violent sexual behaviour may be regarded as well within the scope of the HCR‐20 as a structured professional judgement tool to aid violence risk prediction, but we found that it also predicts behaviours that may be of concern but fall below the violence threshold. High negative predictive values suggest that HCR‐20 scores may have some utility for screening out patients who do not require more specialist assessment for inappropriate sexual behaviour. Copyright © 2015 John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/cbm.1967 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826618770</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826618770</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4217-d0740341110664885a59d012053996528c5c443164fd54ad78718df6183bfe843</originalsourceid><addsrcrecordid>eNp10VtLHDEUB_BQKnW1BT9BCfSlL6NJJrd5tENdBS-l9AK-hGxyho2dy5rMrO63N-IqUvAp5Jwff05yEDqg5JASwo7cojuklVTv0IxyRQumhXqPZqQSqqik5LtoL6UbkimV5APaZTK3SsFnaPUjgg9uDGvAa9sGH8YNHho8LgGf1j8LRnAzRLwOQwv9iG3vcT_0xfM9wf1kW7yApc2lKeLQY5urboqAuyxycwm2HZe5GNfBwUe009g2waftuY9-n3z_VZ8W51fzs_r4vHCcUVV4ojgpOaWU5Pm1FlZUnlBGRFlVUjDthOO8pJI3XnDrlVZU-0ZSXS4a0LzcR1-fcldxuJ0gjaYLyUHb2h6GKRmqmcxaKZLpl__oTX5Kn6fLikumlS5fBbo4pBShMasYOhs3hhLzuAWTt2Aet5Dp523gtOjAv8Dnb8-geAJ3oYXNm0Gm_naxDdz6kEa4f_E2_jO5q4T5ezk39VzMr_kfbS7KB_zBnQM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1846287834</pqid></control><display><type>article</type><title>Predictive validity of the HCR-20 for violent and non-violent sexual behaviour in a secure mental health service</title><source>MEDLINE</source><source>HeinOnline Law Journal Library</source><source>Access via Wiley Online Library</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>O'Shea, Laura E. ; Thaker, Dev-Kishan ; Picchioni, Marco M. ; Mason, Fiona L. ; Knight, Caroline ; Dickens, Geoffrey L.</creator><creatorcontrib>O'Shea, Laura E. ; Thaker, Dev-Kishan ; Picchioni, Marco M. ; Mason, Fiona L. ; Knight, Caroline ; Dickens, Geoffrey L.</creatorcontrib><description>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. Routine clinical team HCR‐20 assessments were extracted from records, and incidents involving inappropriate sexual behaviour were recorded for the 3 months following assessment.
Results
Of 613 patients, 104 (17%) had engaged in at least one inappropriate sexual behaviour; in 65 (10.6%), the sexual act was violent. HCR‐20 total score, clinical and risk management subscales, predicted violent and non‐violent sexual behaviour. The negative predictive value of the HCR‐20 for inappropriate sexual behaviour was over 90%.
Conclusions
Prediction of violent sexual behaviour may be regarded as well within the scope of the HCR‐20 as a structured professional judgement tool to aid violence risk prediction, but we found that it also predicts behaviours that may be of concern but fall below the violence threshold. High negative predictive values suggest that HCR‐20 scores may have some utility for screening out patients who do not require more specialist assessment for inappropriate sexual behaviour. Copyright © 2015 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0957-9664</identifier><identifier>EISSN: 1471-2857</identifier><identifier>DOI: 10.1002/cbm.1967</identifier><identifier>PMID: 26095354</identifier><identifier>CODEN: CBMHEE</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aggression - psychology ; Clinical assessment ; Clinical risk management ; Criminology ; Evaluation ; Female ; Forecasting ; Humans ; Inappropriateness ; Male ; Medical screening ; Mental disorders ; Mental Disorders - psychology ; Mental health professionals ; Mental Health Services ; Middle Aged ; Predictive validity ; Predictive Value of Tests ; Professional judgments ; Prospective Studies ; Psychiatric Status Rating Scales - standards ; Psychometrics - instrumentation ; Reproducibility of Results ; Risk assessment ; Risk Assessment - methods ; Risk Management ; Sex crimes ; Sexual Behavior ; Sexual violence ; Teams ; Violence ; Violence - psychology</subject><ispartof>Criminal behaviour and mental health, 2016-12, Vol.26 (5), p.366-379</ispartof><rights>Copyright © 2015 John Wiley & Sons, Ltd.</rights><rights>Copyright © 2016 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4217-d0740341110664885a59d012053996528c5c443164fd54ad78718df6183bfe843</citedby><cites>FETCH-LOGICAL-c4217-d0740341110664885a59d012053996528c5c443164fd54ad78718df6183bfe843</cites><orcidid>0000-0002-4063-6914</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcbm.1967$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcbm.1967$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,30999,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26095354$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Shea, Laura E.</creatorcontrib><creatorcontrib>Thaker, Dev-Kishan</creatorcontrib><creatorcontrib>Picchioni, Marco M.</creatorcontrib><creatorcontrib>Mason, Fiona L.</creatorcontrib><creatorcontrib>Knight, Caroline</creatorcontrib><creatorcontrib>Dickens, Geoffrey L.</creatorcontrib><title>Predictive validity of the HCR-20 for violent and non-violent sexual behaviour in a secure mental health service</title><title>Criminal behaviour and mental health</title><addtitle>Crim Behav Ment Health</addtitle><description>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. Routine clinical team HCR‐20 assessments were extracted from records, and incidents involving inappropriate sexual behaviour were recorded for the 3 months following assessment.
Results
Of 613 patients, 104 (17%) had engaged in at least one inappropriate sexual behaviour; in 65 (10.6%), the sexual act was violent. HCR‐20 total score, clinical and risk management subscales, predicted violent and non‐violent sexual behaviour. The negative predictive value of the HCR‐20 for inappropriate sexual behaviour was over 90%.
Conclusions
Prediction of violent sexual behaviour may be regarded as well within the scope of the HCR‐20 as a structured professional judgement tool to aid violence risk prediction, but we found that it also predicts behaviours that may be of concern but fall below the violence threshold. High negative predictive values suggest that HCR‐20 scores may have some utility for screening out patients who do not require more specialist assessment for inappropriate sexual behaviour. Copyright © 2015 John Wiley & Sons, Ltd.</description><subject>Adult</subject><subject>Aggression - psychology</subject><subject>Clinical assessment</subject><subject>Clinical risk management</subject><subject>Criminology</subject><subject>Evaluation</subject><subject>Female</subject><subject>Forecasting</subject><subject>Humans</subject><subject>Inappropriateness</subject><subject>Male</subject><subject>Medical screening</subject><subject>Mental disorders</subject><subject>Mental Disorders - psychology</subject><subject>Mental health professionals</subject><subject>Mental Health Services</subject><subject>Middle Aged</subject><subject>Predictive validity</subject><subject>Predictive Value of Tests</subject><subject>Professional judgments</subject><subject>Prospective Studies</subject><subject>Psychiatric Status Rating Scales - standards</subject><subject>Psychometrics - instrumentation</subject><subject>Reproducibility of Results</subject><subject>Risk assessment</subject><subject>Risk Assessment - methods</subject><subject>Risk Management</subject><subject>Sex crimes</subject><subject>Sexual Behavior</subject><subject>Sexual violence</subject><subject>Teams</subject><subject>Violence</subject><subject>Violence - psychology</subject><issn>0957-9664</issn><issn>1471-2857</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp10VtLHDEUB_BQKnW1BT9BCfSlL6NJJrd5tENdBS-l9AK-hGxyho2dy5rMrO63N-IqUvAp5Jwff05yEDqg5JASwo7cojuklVTv0IxyRQumhXqPZqQSqqik5LtoL6UbkimV5APaZTK3SsFnaPUjgg9uDGvAa9sGH8YNHho8LgGf1j8LRnAzRLwOQwv9iG3vcT_0xfM9wf1kW7yApc2lKeLQY5urboqAuyxycwm2HZe5GNfBwUe009g2waftuY9-n3z_VZ8W51fzs_r4vHCcUVV4ojgpOaWU5Pm1FlZUnlBGRFlVUjDthOO8pJI3XnDrlVZU-0ZSXS4a0LzcR1-fcldxuJ0gjaYLyUHb2h6GKRmqmcxaKZLpl__oTX5Kn6fLikumlS5fBbo4pBShMasYOhs3hhLzuAWTt2Aet5Dp523gtOjAv8Dnb8-geAJ3oYXNm0Gm_naxDdz6kEa4f_E2_jO5q4T5ezk39VzMr_kfbS7KB_zBnQM</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>O'Shea, Laura E.</creator><creator>Thaker, Dev-Kishan</creator><creator>Picchioni, Marco M.</creator><creator>Mason, Fiona L.</creator><creator>Knight, Caroline</creator><creator>Dickens, Geoffrey L.</creator><general>Blackwell Publishing Ltd</general><general>Whurr Publishers Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>K7.</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4063-6914</orcidid></search><sort><creationdate>201612</creationdate><title>Predictive validity of the HCR-20 for violent and non-violent sexual behaviour in a secure mental health service</title><author>O'Shea, Laura E. ; Thaker, Dev-Kishan ; Picchioni, Marco M. ; Mason, Fiona L. ; Knight, Caroline ; Dickens, Geoffrey L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4217-d0740341110664885a59d012053996528c5c443164fd54ad78718df6183bfe843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aggression - psychology</topic><topic>Clinical assessment</topic><topic>Clinical risk management</topic><topic>Criminology</topic><topic>Evaluation</topic><topic>Female</topic><topic>Forecasting</topic><topic>Humans</topic><topic>Inappropriateness</topic><topic>Male</topic><topic>Medical screening</topic><topic>Mental disorders</topic><topic>Mental Disorders - psychology</topic><topic>Mental health professionals</topic><topic>Mental Health Services</topic><topic>Middle Aged</topic><topic>Predictive validity</topic><topic>Predictive Value of Tests</topic><topic>Professional judgments</topic><topic>Prospective Studies</topic><topic>Psychiatric Status Rating Scales - standards</topic><topic>Psychometrics - instrumentation</topic><topic>Reproducibility of Results</topic><topic>Risk assessment</topic><topic>Risk Assessment - methods</topic><topic>Risk Management</topic><topic>Sex crimes</topic><topic>Sexual Behavior</topic><topic>Sexual violence</topic><topic>Teams</topic><topic>Violence</topic><topic>Violence - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Shea, Laura E.</creatorcontrib><creatorcontrib>Thaker, Dev-Kishan</creatorcontrib><creatorcontrib>Picchioni, Marco M.</creatorcontrib><creatorcontrib>Mason, Fiona L.</creatorcontrib><creatorcontrib>Knight, Caroline</creatorcontrib><creatorcontrib>Dickens, Geoffrey L.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Criminal behaviour and mental health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Shea, Laura E.</au><au>Thaker, Dev-Kishan</au><au>Picchioni, Marco M.</au><au>Mason, Fiona L.</au><au>Knight, Caroline</au><au>Dickens, Geoffrey L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive validity of the HCR-20 for violent and non-violent sexual behaviour in a secure mental health service</atitle><jtitle>Criminal behaviour and mental health</jtitle><addtitle>Crim Behav Ment Health</addtitle><date>2016-12</date><risdate>2016</risdate><volume>26</volume><issue>5</issue><spage>366</spage><epage>379</epage><pages>366-379</pages><issn>0957-9664</issn><eissn>1471-2857</eissn><coden>CBMHEE</coden><abstract>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. Routine clinical team HCR‐20 assessments were extracted from records, and incidents involving inappropriate sexual behaviour were recorded for the 3 months following assessment.
Results
Of 613 patients, 104 (17%) had engaged in at least one inappropriate sexual behaviour; in 65 (10.6%), the sexual act was violent. HCR‐20 total score, clinical and risk management subscales, predicted violent and non‐violent sexual behaviour. The negative predictive value of the HCR‐20 for inappropriate sexual behaviour was over 90%.
Conclusions
Prediction of violent sexual behaviour may be regarded as well within the scope of the HCR‐20 as a structured professional judgement tool to aid violence risk prediction, but we found that it also predicts behaviours that may be of concern but fall below the violence threshold. High negative predictive values suggest that HCR‐20 scores may have some utility for screening out patients who do not require more specialist assessment for inappropriate sexual behaviour. Copyright © 2015 John Wiley & Sons, Ltd.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>26095354</pmid><doi>10.1002/cbm.1967</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4063-6914</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Criminal behaviour and mental health, 2016-12, Vol.26 (5), p.366-379 |
| issn | 0957-9664 1471-2857 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1826618770 |
| source | MEDLINE; HeinOnline Law Journal Library; Access via Wiley Online Library; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adult Aggression - psychology Clinical assessment Clinical risk management Criminology Evaluation Female Forecasting Humans Inappropriateness Male Medical screening Mental disorders Mental Disorders - psychology Mental health professionals Mental Health Services Middle Aged Predictive validity Predictive Value of Tests Professional judgments Prospective Studies Psychiatric Status Rating Scales - standards Psychometrics - instrumentation Reproducibility of Results Risk assessment Risk Assessment - methods Risk Management Sex crimes Sexual Behavior Sexual violence Teams Violence Violence - psychology |
| title | Predictive validity of the HCR-20 for violent and non-violent sexual behaviour in a secure mental health service |
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