title: Predicting Institutional Aggression in Offenders with Intellectual Disabilities Using the Violence Risk Appraisal Guide.
abstract: BACKGROUND
  One of the most extensively tested risk assessment instruments in offenders with an intellectual disability (OIDs) is the Violence Risk Appraisal Guide (VRAG). The purpose of this prospective study was to test the ability of this instrument to predict institutional aggression in OIDs.
  
  
  METHODS
  VRAG scores were collected for 52 OIDs, and staff registered aggressive incidents during a period of 6 months. Predictive accuracy was analysed using several performance indicators.
  
  
  RESULTS
  The VRAG was not able to significantly predict aggressive behaviour, although a trend towards significance was found for interpersonal physical aggression. Furthermore, the VRAG was only accurate in prospectively identifying low-risk individuals.
  
  
  CONCLUSIONS
  Compared to other studies, demonstrating good predictive validity for institutional aggression in OIDs, the VRAG performed poorly in this study. The usefulness of this instrument in identifying high-risk offenders is questioned. Until further evidence is available from studies using multiple performance indicators, clinicians have to be very careful in relying on the results of a risk assessment tool.
authors.affiliation: OPZC Rekem, Knowledge Centre Forensic Psychiatric Care (KeFor), Rekem, Belgium.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pouls
authors.affiliation: OPZC Rekem, Knowledge Centre Forensic Psychiatric Care (KeFor), Rekem, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Jeandarme
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D057237:Criminals / Q000523:psychology*; D005555:Forensic Psychiatry; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D014754:Violence / Q000523:psychology*; D055815:Young Adult
keywords: 
  VRAG
  ; institutional aggression; intellectual disability; predictive validity; risk assessment