title: The predictive validity of common risk assessment tools in men with intellectual disabilities and problematic sexual behaviors.
abstract: This CIHR-funded study examined whether certain current risk assessment tools were effective in appraising risk of recidivism in a sample of sex offenders with intellectual disabilities (ID). Fifty men with ID who had engaged in problematic sexual behavior (PSB) were followed for an average of 2.5 years. Recidivism was defined and measured as any illegal or problematic behavior, as well as any problematic but not necessarily illegal behavior. At the beginning of the study, each participant was rated on two risk assessment tools: the Violence Risk Appraisal Guide (VRAG) and the Sex Offender Risk Appraisal Guide (SORAG). During each month of follow-up, participants were also rated on the Short-Dynamic Risk Scale (SDRS), an assessment tool intended to measure the risk of future problematic behaviors. Data was analyzed using t-tests, Cohen's d and area under the curve (AUC) to test predictive validity of the assessment tools. Using the AUC, results showed that the VRAG was predictive of sexual (AUC=0.74), sexual and/or violent (AUC=0.71) and of any criminally chargeable event (AUC=0.69). The SORAG was only significantly predictive of sexual events (AUC=0.70) and the SDRS was predictive of violent events (AUC=0.71). The t-test and Cohen's d analyses, which are less robust to deviations from the assumptions of normal and continuous distribution than AUC, did not yield significant results in each category, and therefore, while the results of this study suggest that the VRAG and the SORAG may be effective tools in measuring the short term risk of sexual recidivism; and the VRAG and SDRS may be effective tools in appraising long term risk of sexual and/or violent recidivism in this population, it should be used with caution. Regardless of the assessment tool used, risk assessments should take into account the differences between sex offenders with and without ID to ensure effective measurement.
authors.affiliation: Sexual Behaviours Clinic, Integrated Forensics Program, The Royal, Canada; University of Ottawa Institute of Mental Health Research, Canada. Electronic address: paul.fedoroff@theroyal.ca.
authors.forename: J Paul
authors.initials: JP
authors.lastname: Fedoroff
authors.affiliation: DS Consulting, Pelham Psychotherapy Practice, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Richards
authors.affiliation: Sexual Behaviours Clinic, Integrated Forensics Program, The Royal, Canada; University of Ottawa Institute of Mental Health Research, Canada. Electronic address: rebekah.ranger@theroyal.ca.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Ranger
authors.affiliation: University of Ottawa Institute of Mental Health Research, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Curry
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D057237:Criminals / Q000706:statistics & numerical data*; D005555:Forensic Psychiatry; D006801:Humans; D008607:Intellectual Disability; D008297:Male; D008875:Middle Aged; D009864:Ontario; D000066553:Problem Behavior; D012008:Recurrence; D018570:Risk Assessment; D012742:Sex Offenses / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Intellectual disability; Predictive validity; Risk assessment; Sex offenders