[Instruments for the assessment of violent behavior towards others among the mentally ill population].
Dangerousness is the propensity for performing aggressive and/or criminal acts. The tension between denying the liberty of a suspect and the necessity to protect the environment he/she threatens makes evaluation of the "extent of dangerousness" a significant factor in decisions regarding compulsory intervention and denial of rights. EvaLuation of dangerousness aims to protect the Life of the patient--prevent harm and defend public safety. Most decisions concerning the "extent of dangerousness" of an individual are based on clinical evaluation, patient interview and structured evaluation. The examination can be performed directly with the patient, psychodiagnostic tests or via proxy reports of his/her behavior. The cLinicaL method, influenced by the examiner's clinical experience, training, bias and prejudices is subjective versus an actuarial examination that involves a mathematical model. The authors reviewed three instruments: (A) Psychopathology Checklist-Revised [PCL-R), a widely used instrument to assess violent behavior, based on psychopathic personality structure: 20 coded items based on a semi-structured interview and/or on data from the patient file. (B) Historical, Clinical, Risk-Management (HCR-20, V2]: 20 risk factors for violent behavior based on "historical items", "clinical items", "regulation of dangerousness" and "risk management". Inter-rater reLiability ranges from 0.76-0.96. (C) MacArthur VioLence Risk Assessment is a computer program based on a CLassification Tree [CT] and a comparison of different CT's.
Bauer
Arye
A
Department of Forensic Psychiatry, Ministry of Health. arye.bauer@moh.health.gov.il
Birger
Moshe
M
Melamed
Yuval
Y