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Developing a clinically useful actuarial tool for assessing violence risk

  • John Monahan (a1), Henry J. Steadman (a2), Pamela C. Robbins (a2), Eric Silver (a3), Paul S. Appelbaum (a4), Thomas Grisso (a4), Edward P. Mulvey (a5) and Loren H. Roth (a5)...
Abstract
Background

A new actuarial method for violence risk assessment – the Iterative Classification Tree (ICT) – has become available. It has a high degree of accuracy but can be time and resource intensive to administer.

Aims

To increase the clinical utility of the ICT method by restricting the risk factors used to generate the actuarial tool to those commonly available in hospital records or capable of being routinely assessed in clinical practice.

Method

A total of 939 male and female civil psychiatric patients between 18 and 40 years old were assessed on 106 risk factors in the hospital and monitored for violence to others during the first 20 weeks after discharge.

Results

The ICT classified 72.6% of the sample as either low risk (less than half of the sample's base rate of violence) or high risk (more than twice the sample's base rate of violence).

Conclusions

A clinically useful actuarial method exists to assist in violence risk assessment.

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Copyright
Corresponding author
John Monahan, PhD, School of Law, University of Virginia, 580 Massie Road, Charlottesville, VA 22903-1789, USA. Tel: (804) 924 3632; Fax: (804) 982 2845; e-mail: jmonahan@law5.law.virginia.edu
Footnotes
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See editorial pp. 307–311, this issue

Declaration of interest

Research was funded by the John D. and Catherine T. MacArthur Foundation and by the US National Institute of Mental Health.

Footnotes
References
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Developing a clinically useful actuarial tool for assessing violence risk

  • John Monahan (a1), Henry J. Steadman (a2), Pamela C. Robbins (a2), Eric Silver (a3), Paul S. Appelbaum (a4), Thomas Grisso (a4), Edward P. Mulvey (a5) and Loren H. Roth (a5)...
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