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The First Step in the Validation of a new Screen for Violence Risk in Acute Psychiatry: The Inpatient Context

Published online by Cambridge University Press:  24 April 2010

P. Hartvig ,
J.O. Roaldset ,
T.A. Moger ,
B. Østberg  and
S. Bjørkly
P. Hartvig*
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway
J.O. Roaldset
Affiliation:
Psychiatric Department, Ålesund Hospital, N-6026Ålesund, Norway
T.A. Moger
Affiliation:
Department of Biostatistics, University of Oslo, P.O. Box 1122, N-0317 Oslo, Norway
B. Østberg
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway
S. Bjørkly
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway Institute of Health and Social Sciences, Molde University College, Norway, Box 2110, N-6402 Molde, Norway
*
⁎Corresponding author. Tel.: +47 22 02 92 20; fax: +47 22 02 92 21. E-mail address:paal.hartvig@kompetanse-senteret.no
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Abstract

Background

Instruments for evaluating the risk of violence towards others have mostly been developed for assessment of risk for recidivism into violent crime in forensic psychiatry. In general psychiatry there is a considerable need for specialised, brief and structured assessment tools to inform risk decisions.

Method

The study aimed to validate a brief structured clinical risk assessment screen of inpatient violence (V-RISK-10), a 10-item structured clinical checklist with a good vignette-based interrater reliability (ICC=0.87). In this study it was used for risk assessment of a one-year sample of patients (N = 1.017) admitted to two acute psychiatric units. Risk assessments at admission were compared to prospective records of aggressive and violent acts during the hospital stay.

Results

Results showed a base rate for aggression of 9%. The predictive validity of the V-RISK-10 was estimated by Receiver Operating Characteristics (ROC). It yielded an area under the curve (AUC) of 0.83, with sensitivity/specificity of 0.81/0.73 and corresponding positive and negative predictive values (PPV/NPV) of 0.24/0.97. The screen was easy-to-use and showed a short completion time.

Conclusion

Despite promising results further validation studies are required before the V-RISK-10 is adopted into routine clinical practise.

Keywords

Violence risk screeningAcute general psychiatry
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 2 , March 2011 , pp. 92 - 99
Copyright
Copyright © Elsevier Masson SAS 2010

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Footnotes

1

Tel.: +47 70 10 50 00; fax: +47 70 10 6554.

2

Tel.: +47 22 85 11 49; fax: +47 22 85 13 13.

3

Tel.: +47 71 21 40 12; fax: +47 71 21 40 50.

References

Almvik, R.Woods, P.Rasmussen, K.The Brøset Violence Checklist, sensitivity, specificity and interrater reliability. J Interpers Violence 2000; 15: 284–296CrossRefGoogle Scholar
Bjørkly, S.Prediction of aggression in psychiatric patients. A review of prospective prediction studies. Clin Psychol Rev 1995; 15: 475–501CrossRefGoogle Scholar
Bjørkly, S.Report form for aggressive episodes: preliminary report. Percept Mot Skills 1996; 83: 1139–1152CrossRefGoogle ScholarPubMed
Bjørkly, S.Interrater reliability of the report form for aggressive episodes in group ratings. Percept Mot Skills 1998; 87: 1405–1406CrossRefGoogle ScholarPubMed
Bjørkly, S. Empirical evidence of a relationship between insight and risk of violence-A review of the literature. http://www.sciencedirect.com. Aggress Violent Behav 2006;11:414–23.CrossRefGoogle Scholar
Hartvig, P.Alfarnes, A.A.Skjønberg, M.Moger, T.A.Østberg, B.Brief checklists for assessing violence risk among patients discharged from acute psychiatric facilities: A preliminary study. Nord J Psychiatry 2006; 60: 243–248CrossRefGoogle ScholarPubMed
Hartvig, PØstberg, BAlfarnes, SAMoger, TASkjønberg, MBjørkly, S. Violence Risk Screening-10 (V-RISK-10). http://www.forensic-psychiatry.no, 2007.Google Scholar
Hiday, V.A.Putting community risk in perspective: a look at correlations, causes and controls. Int J Law Psychiatry 2006; 29: 316–331CrossRefGoogle Scholar
Kling, R.Corbiere, M.Milord, R.Morrison, J.G.Craib, K.Yassi, A., et al.Use of a violence risk assessment tool in an acute care hospital. AAOHN J 2006; 54: 481–487CrossRefGoogle Scholar
Krakowski, M.I.Czobor, P.Psychosocial risk factors associated with suicide attempts and violence among psychiatric inpatients. Psychiatr Serv 2004; 55: 1414–1419CrossRefGoogle ScholarPubMed
McNiel, D.Binder, R.L.Screening for risk of inpatient violence, validation of an actuarial tool. Law Hum Behav 1994; 18: 579–586CrossRefGoogle Scholar
McNiel, D.Gregory, A.L.Lam, J.M.Binder, R.L.Sullivan, G.L.Utility of decision support tools for assessing acute risk of violence. J Consult Clin Psychol 2003; 71: 945–953CrossRefGoogle Scholar
Mellesdal, L.Aggression on a psychiatric acute ward: a three-year prospective study. Psychol Rep 2003; 92: 1229–1248CrossRefGoogle ScholarPubMed
Monahan, J.Mental disorder and violent behaviour: Perceptions and evidence. Am Psychol 1992; 47: 511–521CrossRefGoogle ScholarPubMed
Nicholls, T.L.Ogloff, J.R.P.Douglas, K.S.Research report. Assessing risk for violence among male and female civil psychiatric patients: The HCR-20, PCL:SV, and VSC. Behav Sci Law 2004; 22: 127–158CrossRefGoogle Scholar
Ogloff, J.R.P.Daffern, M.The dynamic appraisal of situational aggression: An instrument to assess risk for imminent aggression in psychiatric inpatients. Behav Sci Law 2006; 24: 799–813CrossRefGoogle ScholarPubMed
Quinsey, V.L.Rice, M.E.Harris, G.T.Cormier, C.A.Violent offenders: Appraising and managing risk. 1998 American Psychological AssociationCrossRefGoogle Scholar
Steinert, T.Prediction of inpatient violence. Acta Psychiatr Scand 106Suppl. 4122000; 133-141CrossRefGoogle Scholar
Watts, D.Bindman, J.Slade, M.Holloway, F.Rosen, A.Thornicroft, G.Clinical assessment of risk decision support (CARDS): The development and evaluation of a feasible violence risk assessment for routine psychiatric practice. J Ment Health 2004; 13: 569–581CrossRefGoogle Scholar
Webster, C.D.Douglas, K.S.Eaves, D.Hart, S.D.HCR-20. Assessing risk for violence (Version 2). 1997 Simon Fraser UniversityGoogle Scholar
Webster, C.D.Nicholls, T.L.Desmarais, S.L.Brink, J.The Short-Term Assessment of Risk and Treatability (START). Assessment 2006; 13: 313–327Google Scholar
Wong, S.C.P.Gordon, A.Violence Risk Scale. 2nd Ed 1997 University of SaskatchevanGoogle Scholar
Woods, P.Almvik, R.The Brøset violence checklist (BVC). Acta Psychiatr Scand 2002; 412: 103–105CrossRefGoogle Scholar
Woods, P.Ashley, C.Violence and aggression: a literature review. J Psychiatr Ment Health Nurs 2007; 14: 652–660CrossRefGoogle ScholarPubMed
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