Using dynamic risk and protective factors to predict inpatient aggression: Reliability and validity of START assessments

The Short-Term Assessment of Risk and Treatability (START; C. D. Webster, M. L. Martin, J. Brink, T. L. Nicholls, & S. L. Desmarais, 2009; C. D. Webster, M. L. Martin, J. Brink, T. L. Nicholls, & C. Middleton, 2004) is a relatively new structured professional judgment guide for the assessment and management of short-term risks associated with mental, substance use, and personality disorders. The scheme may be distinguished from other violence risk assessment instruments because of its inclusion of 20 dynamic factors that are rated in terms of both vulnerability and strength. This study examined the reliability and validity of START assessments in predicting inpatient aggression. Research assistants completed START assessments for 120 male forensic psychiatric patients through review of hospital files. They also completed Historical-Clinical-Risk Management-20 (HCR-20; C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997) and Hare Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) assessments. Outcome data were coded from hospital files for a 12-month follow-up period using the Overt Aggression Scale (OAS; S. C. Yudofsky, J. M. Silver, W. Jackson, J. Endicott, & D. W. Williams, 1986). START assessments evidenced excellent interrater reliability and demonstrated both predictive and incremental validity over the HCR-20 Historical subscale scores and PCL:SV total scores. Overall, results support the reliability and validity of START assessments and use of the structured professional judgment approach more broadly, as well as the value of using dynamic risk and protective factors to assess violence risk. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The gender paradigm in domestic violence research and theory: Part 1—The conflict of theory and data

Feminist theory of intimate violence is critically reviewed in the light of data from numerous incidence studies reporting levels of violence by female perpetrators higher than those reported for males, particularly in younger age samples. A critical analysis of the methodology of these studies is made with particular reference to the Conflict Tactics Scale developed and utilised by Straus and his colleagues. Results show that the gender disparity in injuries from domestic violence is less than originally portrayed by feminist theory. Studies are also reviewed indicating high levels of unilateral intimate violence by females to both males and females. Males appear to report their own victimization less than females do and to not view female violence against them as a crime. Hence, they differentially under-report being victimized by partners on crime victim surveys. It is concluded that feminist theory is contradicted by these findings and that the call for “qualitative” studies by feminists is really a means of avoiding this conclusion. A case is made for a paradigm having developed amongst family violence activists and researchers that precludes the notion of female violence, trivializes injuries to males and maintains a monolithic view of a complex social problem.     

Gender and psychopathy: an overview of important issues and introduction to the special issue

One of the most important concepts to ever emerge in forensic psychology and law is psychopathy. It would be difficult to exaggerate the profound effect the construct has had on research and practice in correctional psychology, psychiatry, and criminology. Much less pronounced has been an interest in understanding the potential relevance and practical implications that this personality disorder might have for providing insights into antisocial behaviors and crimes committed by girls and women. In this paper we provide an overview of some of the pressing issues confronting clinicians and researchers and provide an introduction to this special issue dedicated to gender and psychopathy.     

Traffic crash involvement: experiential driving knowledge and stressful contextual antecedents

Researchers have rarely examined stressful environments and psychological characteristics as predictors of driving behavior in the same study. The authors hypothesized that (a) safer drivers more accurately assess physical and emotional traffic hazards and (b) stress and emotional states elevate crash risk. The hypotheses were evaluated with procedural and declarative tacit driving knowledge tests requiring assessment of emotional and contextual hazards and with accident reports describing crash antecedents, including stressful events and environmental conditions. Analyses identified separate driving knowledge factors corresponding to emotional and contextual hazards that were significantly related to the crash criteria. Accident report analyses show that stress significantly elevates at-fault crash risk. The results demonstrate the importance of experiential knowledge acquired without instruction (procedural or tacit knowledge) and provide safety recommendations.     

Adolescent perception of self as a close friend: culture and gendered contexts

Although it is well-recognized that self-perceptions organize and guide behavior, little research has been reported regarding adolescent self-perception as a close friend. The present study describes data from American and Japanese samples of adolescents. Multiple regression analyses found significant predictors of Close Friend Self-Perception scores for American females to be Global Self-Worth, Classmate Support and Close Friend Support, and for American males to be Parent Support, Classmate Support and Close Friend Support. Significant predictors of Close Friend Self-Perception scores for Japanese females were found to be Global Self-Worth and Close Friend Support and for Japanese males to be Athletic Self-Perception, Global Self Worth, and Close Friend Support.     

The Variability of Criterion‐Related Validity Estimates Among Interviewers and Interview Panels

The authors examined differences in criterion‐related validity estimates among ratings from individual interviewers and interview panels within a structured interview. Senior non‐commissioned officers (NCOs) in the U.S. Army (N=64) conducted panel interviews with 944 junior NCOs during a concurrent validation project. Analysis of the data revealed considerable variation in interviewer validity coefficients in relation to multiple performance criteria. Results also indicated the importance of adopting a multivariate perspective when evaluating interviewer validity differences in that the amount of variation in validity coefficients differed both by interview dimension and criterion. A similar pattern of findings emerged when analyses were performed on ratings averaged within interview panel. Nonetheless, when meta‐analysis was used to estimate the amount of true variance in interviewer‐ and panel‐level validity coefficients, most or all of the variance for some interview‐criterion combinations appeared to be due to statistical artifacts.     

The Short-Term Assessment of Risk and Treatability (START): a prospective validation study in a forensic psychiatric sample

A new assessment scheme--the Short-Term Assessment of Risk and Treatability (START)--presents a workable method for assessing risks to self and others encountered in mentally and personality disordered clients. This study aimed to demonstrate (a) prevalence and severity of risk behaviors measured by the START, (b) psychometric properties of START, (c) similarities and differences in START scores across different mental health professionals, and (d) concurrent validity of START with diverse negative outcomes. Treatment team members completed the 20-item, dynamically focused START for 137 forensic psychiatric inpatients. Prevalence and severity of START risk domains were measured for 51 patients detained in the hospital for 1 year. Results revealed high rates of generally low-level adverse events. With some exceptions, START scores were meaningfully associated with outcomes measured by a modified Overt Aggression Scale.     

Psychopathy in women: a review of its clinical usefulness for assessing risk for aggression and criminality

Despite a flurry of studies examining psychopathy in women, and the recent release of the second version of the Hare Psychopathy Checklist--Revised manual, there is still little consensus whether the lateral extension of the current conceptualization of psychopathy to women is appropriate. In particular, very little agreement exists concerning the clinical utility of the Hare psychopathy measures to assess women's risk of future offending and violence. This article presents a comprehensive review of studies of the association between psychopathy, antisocial behavior, and violence, in diverse samples of women, and looks at similarities and differences between these constructs in males and females. Findings from inmates and offenders, civil and forensic psychiatric patients, substance abusers, and community samples indicate a consistently lower base rate of psychopathy among women than among men. With some exceptions, correlates of psychopathy in women relevant to risk assessments for crime and violence tend to be modest and significant, generally mirroring what we see in men. Clinicians and policy makers charged with the care and management of women at risk for criminal offending and violence are likely to find the PCL-R and PCL:SV have clinical utility; however, cautious application is called for and ongoing research is required.     

Quick to Act,Quick to Forget: The Link Between Impulsiveness and Prospective Memory

Several traits of impulsiveness (e.g. lack of planning and perseverance, difficulty focusing attention) seem intimately connected to the skills required for successful prospective memory performance. This is the first study to examine whether the various inter‐correlated dimensions of impulsiveness are related to problems with prospective memory. Undergraduate students (N = 184) completed the Barratt Impulsiveness Scale 11, the Prospective Memory Questionnaire, the Prospective and Retrospective Memory Questionnaire, and two objective prospective memory tests. Results revealed consistent correlations between the various dimensions of impulsiveness (attentional, motor, non‐planning) and self‐reported problems with prospective memory. Subsequent regression analyses indicated that attentional impulsiveness is a unique predictor of self‐reported problems with internally cued prospective memory, and non‐planning impulsiveness is a unique predictor of self‐reported problems with episodic and overall prospective memory. Similarly, findings from the objective prospective tests showed that non‐planning impulsiveness was related to worse performance on the two prospective memory tests. Whereas non‐planning impulsiveness was also related to using fewer prospective memory‐aiding strategies, mediation analyses showed that use of these strategies does not account for any of the detected relationships. Because the findings suggest that a failure to plan does not underlie the detected effects, other potential explanations for the relationships are discussed. Copyright © 2013 European Association of Personality Psychology