Evidence for Risk Estimate Precision: Implications for Individual Risk Communication

Actuarial risk assessment instruments using well-established predictor variables measured at the individual level (e.g., age, criminal history, psychopathy) discriminate well between recidivists and non-recidivists across diverse samples. Data indicating the relative risk of recidivism can inform policy decisions about allocating resources according to risk within a correctional system, consistent with the first of the risk–need–responsivity (RNR) principles. Evidence for the precision of absolute risk as applied to an individual based on scores from many samples, however, has proven challenging. In this paper, we present a study examining the association of actuarial risk estimate precision with sample size using the Post Conviction Risk Assessment (PCRA; Lowenkamp et al., 2013), in samples of up to 26,642 offenders. Results indicate that the precision of individual estimates can be demonstrated with sufficient sample size. We believe that the implications of absolute risk for the communication of an individual offender's risks have been poorly understood. We argue that the purpose of individual-level risk communication is to ensure the effective application of policy, which requires matching a new case to aggregate data. We illustrate how an offender's risk might thus be communicated, and conclude that this function is distinct from management of an individual's criminogenic needs and identification of effective and suitable treatments. Copyright © 2015 John Wiley & Sons, Ltd.     

精神病态的家庭风险因素

精神病态(psychopathy)是一种个体表现在人际关系、情感、生活方式和反社会特征等方面的人格障碍, 其特征为自我中心、欺骗、冲动、缺乏共情、缺乏罪恶感等。以往研究偏向于精神病态的生理机制, 认为精神病态具有高度的遗传性, 近期越来越多的研究发现家庭因素对精神病态的重要影响。这些因素包括：产前风险因素、破碎家庭、不良的教养方式、不安全的亲子依恋关系和童年期虐待等。未来的研究应探讨家庭因素对各个精神病态亚型的作用机制, 探索抑制精神病态表达的保护性环境因子, 并构建精神病态的生物心理社会模型等。     

Risk factors for eating disorders

The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances in understanding the etiology of eating disorders require a new generation of studies that integrate these domains. They discuss how more sophisticated and novel conceptualizations of risk and causal processes may inform both nosology and intervention efforts.     

Risk Management Principles for Nanotechnology

Risk management of nanotechnology is challenged by the enormous uncertainties about the risks, benefits, properties, and future direction of nanotechnology applications. Because of these uncertainties, traditional risk management principles such as acceptable risk, cost–benefit analysis, and feasibility are unworkable, as is the newest risk management principle, the precautionary principle. Yet, simply waiting for these uncertainties to be resolved before undertaking risk management efforts would not be prudent, in part because of the growing public concerns about nanotechnology driven by risk perception heuristics such as affect and availability. A more reflexive, incremental, and cooperative risk management approach is required, which not only will help manage emerging risks from nanotechnology applications, but will also create a new risk management model for managing future emerging technologies.     

Risk factors for child neglect

Child neglect is the most prevalent form of child maltreatment in the US, yet it has received comparatively little research attention. This is no doubt in part due to difficulty defining and operationalizing the construct of neglect. Despite these challenges, a small body of literature investigating risk factors for child neglect has accumulated. This paper reviews this literature, providing effect sizes when possible. Parental demographic, psychological, and behavioral characteristics as well as child, family, and neighborhood factors are reviewed. Although few factors have been examined in more than one study, when taken together, the findings suggest that parental behavioral and psychological characteristics may have the largest relations to neglect, and that limited socioeconomic resources are the most consistently documented risk factor for neglect.     

Risk Perception Among Women at Risk for Hereditary Breast and Ovarian Cancer

This paper is a summation of selected history and literature on risk perception as it pertains to genetic counseling and testing, with a focus on hereditary breast and ovarian cancer, the area which has seen the greatest focus of research. Risk perception is a complex and incompletely understood concept which seeks to capture the myriad meanings that an individual attaches to the experience of being at increased risk. It is now evident that “risk”, as perceived by the patient, is different from the objective, quantifiable risk estimate often provided to them during genetic counseling. What is also clear is that the complicated set of factors influencing risk perception are not yet well understood, nor are the mechanisms the lead from perceived risk to behavioral change in the patient. In situations where specific behavioral changes such as increased cancer screening are an inherent goal of the genetic risk assessment and counseling process, gaining a better understanding of the specific factors motivating change will be essential.     

Risk factors for child physical abuse

We review the risk and protective factors for child physical abuse (CPA). An etiological model based on moderate to strongly supported risk factors would begin with distal perpetrator variables of being abused as a child/teen and receiving less family social support as a child. Next might come current family variables such as parents' youth, father's drinking, and family's living in a community that is impoverished and/or has a lower percentage of two parent families. More proximal variables that increase the probability of parents, especially mothers, employing severe or abusive physical tactics could include mothers' dysphoria (e.g., unhappiness, emotional distress, anxiety, loneliness and isolation, depression, somatic complaints, interpersonal problems, feelings of incompetence as a parent, a tendency toward becoming upset and angry), and stress (more stressful life events, including parenting and other family stresses) and coping (most likely a protective factor, including problem solving and social support). Finally, risk factors that are proximal to abuse could include mothers' high reactivity (impulsivity, high negative affect and autonomic nervous system arousal), high-risk parenting (harsh discipline strategies, verbal aggression, yelling), and negative attributions, and children's behavior problems (e.g., socialized aggression, attention deficits, and internalizing and externalizing problems).     

Risk for Suicide among Medicaid Beneficiaries

Demographic, diagnostic, and service expenditure characteristics of Florida Medicaid enrollees who died by suicide were investigated. Among persons receiving Medicaid and Supplemental Security Income (SSI), findings indicate the most powerful predictors of suicide were involuntary psychiatric examination, mental health hospitalization, and high mental health service use. Among Medicaid enrollees not receiving SSI, strongest suicide predictors were mental health hospitalization, high expenditures for physical health medications, and involuntary psychiatric examination. Findings suggest reducing involuntary psychiatric examinations and mental health hospitalizations while improving physical health may reduce suicide in the Medicaid population. Comprehensive hospital discharge planning, adherence monitoring with follow‐up care, training mental health providers in assessing suicide lethality, and providing adequate assessment time are all crucial to achieve these objectives.     

Risk factors for child psychological abuse

We review the risk and protective factors for child emotional abuse. Two main directions can be derived from this review. First and foremost, definitional issues must be resolved. Second, some clues as to important future research directions emerged from the current risk factor literature. Distal historical variables (e.g., relationships with fathers perceived as less caring, and being yelled at daily as a child), current enduring personality factors (e.g., aggression and hostility, neuroticism), environmental stressors (e.g., very low income) and proximal variables (verbal and physical aggression between parents) all appear to be related to child psychological abuse. Once definitional issues are resolved, models beginning with these risk factors should be developed and tested.     

Risk factors for child sexual abuse

We review the risk and protective factors for child sexual abuse. Overall, characteristics of perpetrators, victims, and families of victims were moderate to strong risk factors for child sexual abuse. However, it is difficult to distinguish between risk factors for extra-familial and intra-familial child sexual victimization because most of the studies combined these two types of child sexual abuse, although the risk factors for these two types of child sexual abuse most likely differ. Research in this area is difficult because etiological and prevention models of victimization would differ substantially from those of perpetration. Given the low yearly prevalence of child sexual victimization, very large samples would be necessary to obtain sufficient power. Thus, most studies have used lifetime prevalence, which may provide much useful information but which add substantial time confounds. Finally, child sexual victimization is probably a misnomer, as the nature, impact, and etiology of sexual victimization most likely differs over the large age span of childhood and gender. Because improved models and prevention programs require improved etiological models (based on knowledge of risk and protective factors), we hope that this review will focus stakeholders on the need for continued research in this area.     

Risk Taking for Sexual Versus Monetary Outcomes using the Balloon Analogue Risk Task

The present study examined risk-taking behavior in relation to sexual and monetary outcomes using the Balloon Analogue Risk Task (BART). Adult men (n = 61) completed two modified BART tasks (one with monetary outcomes and one with sexual outcomes) and a battery of self-report measures concerning sexual and nonsexual constructs. Several findings are reported. First, risk-taking behavior concerning sexual outcomes can be evoked and quantified using the modified BART task reported here. Second, risk-taking for money was associated with latent factors associated with criminal behavior, drug use, and gambling. Third, risk taking for sexual outcomes was associated with the latent factors of sexual excitability and criminal behavior. Results suggest that stimulus-specific measures of risk taking are better associated with some outcomes. Study findings are discussed in terms of their relevance to laboratory research on the behavioral processes that underlie risky decision making.

     

Risk Perception: Using Conditional Versus General Base Rates for Risk Communication1

In general, people judge their chance of experiencing a health risk as being less than the general base rate because of their favorable status on risk factors (e.g., history of stroke). Presenting base rates for high and low risk groups (conditional base rates) were hypothesized to lessen people's tendency to adjust downward from the base rate because risk factors are included in conditional base rates (CBRs). Young (M= 19 years) and older women (M= 46 years) were presented with either a general base rate (GBR) or CBRs for high‐ and low‐risk groups for 5 health risks. The CBR groups were significantly less likely to adjust their probability judgments from the base rate for the risk group that they believed applied to them (e.g., smoker vs. nonsmoker). The CBR effect was replicated in a second experiment in which women (M = 19 years) were informed of either a GBR, a CBR for a high‐risk group, or a CBR for a low‐risk group. The findings suggest that people might estimate subjective probabilities by considering both the base rate for a health risk and self‐assessments on risk factors. Biases about one's status on risk factors, however, may limit people's identification with relevant risk groups and warrant further investigation.     

Risk factors for male-to-female partner sexual abuse

We review the risk and protective factors for male-to-female sexual abuse. Although partner sexual abuse is a low base rate behavior, which can attenuate correlation coefficients, several relations had moderate effect sizes. Younger (under 30) and older (over 50) women, compared to those between 30 and 50 years old, were more likely to report being victims of partner sexual abuse, as were unemployed women and women from low-income households. Prior unwanted sexual experiences (from a wide variety of perpetrators) and the severity of male-to-female partner physical aggression were associated with male-to-female partner sexual abuse. It is difficult to form conclusions from only six empirical studies. More empirical studies are needed to ascertain the populations most at risk for partner sexual abuse.     

Risk factors for male-to-female partner physical abuse

We review the risk and protective factors for male-to-female partner physical abuse and present effect sizes. We distinguish among the various operationalizations of physical aggression (e.g., men in court mandated abuse programs, men identified through a single item on the CTS). Overall, however, several risk factors showed moderate to strong effect sizes. Perpetrator factors include SES, education, history of child sexual victimization, exposure to parental physical and/or verbal aggression, violent adult models in childhood, non-family aggression by parent, elevated levels of state and trait anger and hostility; various personality disorders; various Axis I psychopathology, particularly depression alcohol and drug abuse; deficits in spouse-specific assertiveness; and attitudes that condone abuse. Risk factors for women being victimized included less education, unemployment, and history of child emotional/verbal victimization.     

Risk Compensation: Implications for Safety Interventions

Several theories of driving behavior have suggested that individuals will react to environmental changes in a compensatory fashion such that riskier behaviors result from perceptions that the environment has become safer. Specifically, both Peltzman (1975) and Wilde (1982a) have proposed such compensation mechanisms, although Wilde takes a more stringent approach. Unfortunately, the majority of studies on the topic have attempted to test the compensation mechanism using aggregate accident data. Studies that have investigated risk compensation at the level of the individual have failed to assess subjective risk, a critical variable for the interpretation of the risk associated with specific behaviors. It is argued that risk compensation can only operate at the individual level and that previous studies testing the validity of risk compensation are difficult to interpret due to levels of analysis issues or unmeasured variables. In the current investigation, two judgment/decision making studies were designed to test risk compensation. Individual level analyses indicated that there was modest support for Peltzman's mild interpretation of the risk compensation mechanism, but that individuals do not compensate for changes in the environment enough to return to their original levels of risk as Wilde has predicted.     

感染对缺血性脑卒中发病的影响

缺血性脑卒中的发生除传统高危因素外还和动脉的炎性反应有关,如血管壁内炎性细胞的聚集,早期参与触发动脉粥样硬化的形成,晚期促进动脉粥样硬化斑块的破裂和血栓的形成.微生物的慢性感染已被发现有增加卒中发生的危险,而机体产生免疫反应的强弱程度也起到重要作用.微生物的感染通过多个机制影响卒中的发生.概述了感染、炎症与缺血性脑卒中发病方面的研究现状以及由此带来的对缺血性脑卒中预防与治疗决策的可能影响.     

感染对缺血性脑卒中发病的影响

缺血性脑卒中的发生除传统高危因素外还和动脉的炎性反应有关,如血管壁内炎性细胞的聚集,早期参与触发动脉粥样硬化的形成,晚期促进动脉粥样硬化斑块的破裂和血栓的形成。微生物的慢性感染已被发现有增加卒中发生的危险,而机体产生免疫反应的强弱程度也起到重要作用。微生物的感染通过多个机制影响卒中的发生。概述了感染、炎症与缺血性脑卒中发病方面的研究现状以及由此带来的对缺血性脑卒中预防与治疗决策的可能影响。     

Risk factors for depression in early adolescence

The purpose of this study was to identify salient risk factors for depression in early adolescence from a group of common predictors. The following nine predictors were examined: (1) perceived quality of peer relationships, (2) perceived parental nurturance, (3) perceived parental rejection, (4) self-esteem, (5) body image, (6) pubertal status, (7) SES, (8) conduct problems, and (9) hyperactivity/inattention. The sample of 2,014 12 and 13 year olds was also divided by gender to examine potential sex differences in risk factors for depression. Finally, several mediational models were investigated. Self-esteem emerged as the strongest predictor of depression in both genders; parental behavior also emerged as an important risk factor. Therefore, these two variables are discussed as targets for those developing intervention and prevention programs.