Review of Assessing and managing violence risk in juveniles.

Reviews the book, Assessing and managing violence risk in juveniles by Randy Borum and David Verhaagen (see record 2006-12484-000). This book is a compilation of research findings designed to accomplish the goal of equipping the reader to "conduct risk assessments that are thorough, fair, helpful, and developmentally and empirically sound." New school psychologists will find an excellent framework for learning how to approach the daunting task of assessing risk of violence in children and adolescents. Experienced practitioners will find new research results integrated throughout the book to improve the precision of their risk assessments as well. This book is written for mental health professionals in schools, therapy settings, and juvenile justice systems. Although these three contexts are presented as very different from each other (differences in treatment plans are noted), the basic principles of assessment are applicable to all. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conducting risk evaluations for future violence: Ethical practice is possible.

Psychologists frequently testify in court about an individual's risk for future violence. Decades ago, the basis for such testimony was problematic, but the field has made significant progress. However, recent criticisms raise ethical concerns about risk evaluations and state that current methods do not meet admissibility standards. Responding to such criticisms is important for expert witness involvement in these evaluations. We note that it is feasible to conduct thorough ethical evaluations that will aid judicial and clinical decision making. We argue that the courts find this information necessary, and well-informed professionals can make valid and important contributions in these proceedings. To leave the courts without access to the best science available could cause more harm than good. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric symptoms and community violence among high-risk patients: A test of the relationship at the weekly level.

Given the availability of violence risk assessment tools, clinicians are now better able to identify high-risk patients. Once these patients have been identified, clinicians must monitor risk state and intervene when necessary to prevent harm. Clinical practice is dominated by the assumption that increases in psychiatric symptoms elevate risk of imminent violence. This intensive study of patients (N = 132) at high risk for community violence is the first to evaluate prospectively the temporal relation between symptoms and violence. Symptoms were assessed with the Brief Symptom Inventory and threat/control override (TCO) scales. Results indicate that a high-risk patient with increased anger in 1 week is significantly more likely to be involved in serious violence in the following week. This was not true of other symptom constellations (anxiety, depression, TCO) or general psychological distress. The authors found no evidence that increases in the latter symptoms during 1 week provide an independent foundation for expecting violence during the following week. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychological assessment of risk for crime and violence.

This article provides an overview of the current practices and challenges in psychological risk assessment for crime and violence. Risk assessments have improved considerably during the past 20 years. The dismal predictive accuracy of unstructured professional opinion has largely been replaced by more accurate, structured risk assessment methods. Consensus has not been achieved, however, on the constructs assessed by the various risk tools, nor the best method of combining factors into an overall evaluation of risk. Advancing risk assessment for crime and violence requires psychometrically sound evaluations of psychologically meaningful causal risk factors described using nonarbitrary metrics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The validity and reliability of the Violence Risk Scale: A treatment-friendly violence risk assessment tool.

The development of risk assessment tools that use dynamic variables to predict recidivism and to inform and facilitate violence reduction interventions is the next major challenge in the field of risk assessment and management. This study is the first in a 2-step process to validate the Violence Risk Scale (VRS), a risk assessment tool that integrates violence assessment, prediction, and treatment. Ratings of the 6 static and 20 dynamic VRS variables assess the client's level of risk. Ratings of the dynamic variables identify treatment targets linked to violence, and ratings of the stages of change of the treatment targets assess the client's treatment readiness and change. The VRS scores of 918 male offenders showed good interrater reliability and internal consistency and could predict violent and nonviolent recidivism over both short- and longer term (4.4-year) follow-up. The probability of violent and nonviolent recidivism varied linearly with VRS scores. Dynamic and static variables performed equally well. The results support the contention that the VRS can be used to assess violent risk and to guide violence reduction treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What Do Clinicians Expect? Comparing Envisioned and Reported Violence for Male and Female Patients.

Mental health professionals' (MHPs') accuracy in assessing the risk of violence in female patients is particularly limited. Based on assessments made by 205 MHPs of 605 patients in an emergency room, this study explored potential causes of MHPs' poorer accuracy in assessing women's potential for violence. The dimensions that underlie MHPs' envisioned violence in patients were identified and were compared with those that characterized patients' reported violence during a 6-month follow-up period. There were three key findings from their study. First, violence envisioned by MHPs differed depending on their professional role and varied in its congruence with patients' reported violence. Second, patients' violence was organized by dimensions of domesticity and substance relatedness; women's violent incidents were more domestic than were men's. Third, when MHPs envisioned violence that was highly conditional on psychiatric deterioration and medication noncompliance, violence often did not occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of personality disorder symptoms and the risk for partner violence.

In a community sample (N = 543) followed over 20 years, the authors studied associations among childhood family violence exposure, personality disorder (PD) symptoms, and adult partner violence. PD symptoms (DSM-III-R Clusters A, B, and C) in early adulthood partially mediated the effect of earlier childhood risks on the odds of perpetrating partner violence. The authors tested whether stability of PD symptoms from adolescence to the early 20s differs for individuals who later perpetrated partner violence. Cluster A ("Odd/Eccentric") symptoms declined less with age among partner violent versus nonviolent men and women. Cluster B ("Dramatic/Erratic") symptoms were more stable through late adolescence in partner violent men, compared with nonviolent men and violent women. Cluster C ("Anxious") symptoms were most stable among partner violent men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An ecological-transactional understanding of community violence: Theoretical perspectives.

Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. If mental health providers are to meet the needs of children and communities dealing with community violence, then they will need to integrate principles from various subdisciplines in psychology (e.g., developmental psychology, school psychology, developmental psychopathology) as well as disciplines outside of psychology (e.g., sociology, public health, medicine) to understand fully the developmental impact of exposure to community violence. The development of such a model is necessary to identify the pathways, risk, and protective factors on which prevention and intervention programs can be built. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence exposure and child development. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Child witnesses to domestic violence: A meta-analytic review.

This meta-analysis examined 118 studies of the psychosocial outcomes of children exposed to interparental violence. Correlational studies showed a significant association between exposure and child problems (d? = -0.29). Group comparison studies showed that witnesses had significantly worse outcomes relative to nonwitnesses (d? = -0.40) and children from verbally aggressive homes (d? = -0.28), but witnesses' outcomes were not significantly different from those of physically abused children (d? = 0.15) or physically abused witnesses (d? = 0.13). Several methodological variables moderated these results. Similar effects were found across a range of outcomes, with slight evidence for greater risk among preschoolers. Recommendations for future research are made, taking into account practical and theoretical issues in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent psychosocial risk factors for severe intimate partner violence in young adulthood.

The authors examined prospective measures of psychosocial risk factors as predictors of severe intimate partner violence among a community sample of 610 young adults at risk for intergenerational transmission of depression. The hypothesized risk factors were youth history of depression by age 15 and maternal history of depression. Youth social functioning at age 15 was tested as a mediator of these associations. Results showed that youth history of depression by age 15 predicted victimization at age 20. Severe violence perpetration was predicted by maternal depressive history among women but not men. Youth social functioning was a partial mediator of both associations. In sum, the findings suggest that psychosocial factors observed in adolescence may contribute to the risk of experiencing severe intimate partner violence during young adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Expressed emotion in families: Its significance for mental illness.

Reviews the book, Expressed emotion in families: Its significance for mental illness by Julian Leff and Christine Vaughn (1985). The authors, Leff & Vaughn, along with George Brown, the originator of the "expressed emotion" concept provide an opportunity to observe their minds at work. In presenting the origins and clinical, theoretical, and research developments focused on the initial observations that high levels of expressed emotions in the families of schizophrenic patients can be debilitating, the volume not only provides a wealth of significant information about schizophrenia and how research ideas are formulated, tested, refined, and retested but also provides significant insights into the thought processes--the intuitions, doubts, and confidences--of the researchers every step of the way. The book is a landmark study of the role of emotional attitudes and their expression by family members in the course and outcome of schizophrenia. From its British origins, the research has sparked heuristic cross-cultural replication and innovations. While the book should be essential reading for every family psychologist and psychotherapist, its main audience will probably be researchers interested in family processes and schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing suicidality in adults: Integrating childhood trauma as a major risk factor.

Can knowing whether an adult client was abused as a child assist psychologists when assessing suicidality? Reviewing the files of 200 outpatients revealed, in keeping with previous studies, that child abuse was related not only to previous psychiatric admissions and younger age at first treatment and first admission, but also to past and present suicidality. Current suicidality was predicted better by child sexual abuse (experienced on average 20 years previously) than by a current diagnosis of depression. Evidence that abuse histories are not routinely taken, and recommendations for why, and how, taking abuse histories should be integrated into suicide assessment and treatment, are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of violence prediction: A meta-analytic comparison of nine risk assessment tools.

Actuarial risk assessment tools are used extensively to predict future violence, but previous studies comparing their predictive accuracies have produced inconsistent findings as a result of various methodological issues. We conducted meta-analyses of the effect sizes of 9 commonly used risk assessment tools and their subscales to compare their predictive efficacies for violence. The effect sizes were extracted from 28 original reports published between 1999 and 2008, which assessed the predictive accuracy of more than one tool. We used a within-subject design to improve statistical power and multilevel regression models to disentangle random effects of variation between studies and tools and to adjust for study features. All 9 tools and their subscales predicted violence at about the same moderate level of predictive efficacy with the exception of Psychopathy Checklist—Revised (PCL-R) Factor 1, which predicted violence only at chance level among men. Approximately 25% of the total variance was due to differences between tools, whereas approximately 85% of heterogeneity between studies was explained by methodological features (age, length of follow-up, different types of violent outcome, sex, and sex-related interactions). Sex-differentiated efficacy was found for a small number of the tools. If the intention is only to predict future violence, then the 9 tools are essentially interchangeable; the selection of which tool to use in practice should depend on what other functions the tool can perform rather than on its efficacy in predicting violence. The moderate level of predictive accuracy of these tools suggests that they should not be used solely for some criminal justice decision making that requires a very high level of accuracy such as preventive detention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transgender and gender variant populations with mental illness: Implications for clinical care.

There is a scarcity of literature on clinical care for transgender and gender variant populations with serious mental illness. At times, gender identity issues among individuals with serious mental illness have been labeled as delusions that should not be reinforced by providers. However, there are significant limitations to attributing gender variance among populations with mental illness solely to a psychotic process. The following case study research demonstrates the variation in gender identity issues among individuals with serious mental illness. These individuals may experience gender dysphoria exclusively in the context of acute psychosis or may have gender identity issues that are distinct from the mental illness. Denial of an individual's gender variant presentation by treatment staff may heighten distress, thus interfering with a collaborative treatment alliance while posing additional barriers to recovery from mental illness. Implications and applications for clinical training and further research will be presented in order to promote awareness and competent care of gender issues when co-occurring with mental illness. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The accuracy of recidivism risk assessments for sexual offenders: A meta-analysis of 118 prediction studies.

This review compared the accuracy of various approaches to the prediction of recidivism among sexual offenders. On the basis of a meta-analysis of 536 findings drawn from 118 distinct samples (45,398 sexual offenders, 16 countries), empirically derived actuarial measures were more accurate than unstructured professional judgment for all outcomes (sexual, violent, or any recidivism). The accuracy of structured professional judgment was intermediate between the accuracy found for the actuarial measures and for unstructured professional judgment. The effect sizes for the actuarial measures were moderate to large by conventional standards (average d values of 0.67–0.97); however, the utility of the actuarial measures will vary according to the referral question and samples assessed. Further research should identify the psychologically meaningfully factors that contribute to risk for reoffending. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A research agenda for school violence prevention.

Comments on the literature review by E. P. Mulvey and E. Cauffman (see record 2001-18772-002) that called for the promotion of healthy school environments to reduce school violence. The authors note several significant omissions and inaccurancies that undermined Mulvey and Cauffman's efforts to advance knowledge and research about school violence prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building a model for prevention practice: Depression as an example.

Preventing mental illness has become increasingly emphasized as a priority for psychologists. Unfortunately, clinicians who want to incorporate prevention activities into their practice have few available models to guide how they might accomplish such a task. Using the literature on the prevention of depression, the authors make specific recommendations to clinicians who are interested in expanding their practice by offering preventive interventions in addition to their usual treatment activities. Topics discussed include choosing target populations for the intervention, using a theoretical orientation to guide the intervention, selecting specific ingredients to include in the intervention, deciding among different intervention modalities, and obtaining financial reimbursement for prevention work. Prevention work can be a novel solution to help meet the unsatisfied needs of patients, clinicians, and society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal risk factors for intimate partner violence among men in treatment for alcohol use disorders.

Objective: This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders. Method: Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years. Participants completed measures assessing initial alcohol problem severity, baseline beliefs related to alcohol use, antisocial personality characteristics, alcohol and drug use, relationship adjustment, and IPV. Results: According to couples' reconciled reports, 42% of participants perpetrated IPV at baseline. Among this group, the IPV recurrence rate was 43% at 6-month follow-up and 36% at 12-month follow-up. For participants without IPV perpetration at baseline, new incidence of IPV was 15% and 7% at the 6-month and 12-month follow-up points, respectively. Fixed marker predictors of IPV rates included baseline alcohol problem severity variables, baseline beliefs related to alcohol use, and antisocial personality characteristics. Variable risk factor predictors included alcohol and drug use variables, relationship adjustment factors, and anger. Alcohol use variables and anger were associated with new incidents of IPV among those without reported IPV at baseline only. Conclusions: Findings suggest that assessing and monitoring IPV occurrence by both partners is important for men in treatment for alcohol use disorders. Results indicate vulnerability factors that may identify individuals at risk for IPV and provide targets for IPV prevention among those with alcohol use disorders. These findings can aid in the development of more comprehensive models that more precisely predict IPV. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A call for a social network-oriented approach to services for survivors of intimate partner violence.

Despite the many hard-won victories of the antidomestic violence movement, it has had less success in reaching one of its own primary goals: that of making intimate partner violence a problem of the community rather than a problem between two individuals. Most mainstream domestic violence service models have not prioritized ongoing engagement of survivors' informal social support networks as a core part of their work. Yet the perpetration of domestic violence occurs within a community context that contributes to the maintenance or alleviation of the problem. Given extensive research on the centrality of social networks to the fabric of survivors' daily lives, as well as their ongoing safety and emotional well-being, it is critical to consider how domestic violence services and systems can align with these social networks more effectively. Following a review of research on the role of informal social support in survivors' lives, this article calls for a shift in mainstream domestic violence services toward a more network-oriented approach, one that highlights potential partnerships between professionals and survivors' informal social support networks. Such a shift would require a reconceptualization of the role of the domestic violence practitioner and the scope and nature of services. It would also raise a series of emergent research questions about how informal network members can best support survivors, how domestic violence services can help survivors engage with existing and new supporters, and the extent to which specific types of network-oriented practices can indeed improve survivors' safety and well-being. (PsycINFO Database Record (c) 2011 APA, all rights reserved)