Risk and Dangerousness Assessments When Requested Will they reoffend Are they likely to reoffend Civil commitment o Psychiatric Keeping someone in psychiatric treatment against their will because 1 A danger to themselves 2 A danger to others 3 Gravely disabled and can t care for themselves Keeping someone in treatment against their will after they have o Sex offender served time Pre sentencing Pre release parole In facility management How we behave is 45 personality 45 environment A personality environment interaction is the biggest predictor of behavior Key Issues Prediction of future behavior o What s the risk that this person is going to do this bad act again Not a yes no answer degree of risk o Framed as a yes no question but it isn t o What factors play a role in the increase decrease of their risk Examples drugs depression etc Base rate issue again o Trying to predict something that s an infrequent event Clinical vs Statistical Under what circumstances are clinicians better able to predict Research knowledge helps Clinical in 50 60s Statistical in the 70 80s Unstructured clinical opinion doesn t do a good job of predicting reoffending Actuarial Scales Static Predictors all the historical factors that you can t change which are associated with the risk of reoffending o Examples age criminal record type of victim Dynamic Predictors factors that are changeable that are associated with risk o Chronic things that are difficult to change Examples personality disorders anger problem etc o Acute things that are more short term in nature Examples victim access drug access command hallucinations VRAG Violence Risk Appraisal Guide o Requires a copy of their criminal record or comparable way to have this information o Static risk factors age history of violent behavior history of relationship instability history of employment instability history of drug alcohol use major disorder any psychopothy antisocial diagnosis any early developmental conduct disorders history of escape from custody failure of compliance with supervision o Normed only on men o Scoring the VRAG 1 Lived with both biological parents to age 16 except for death of parent 2 Elementary school maladjustment 3 History of alcohol problems 4 Marital status at time of index offense 5 Criminal history the index offense 6 Failure on prior conditional release a For convictions and charges for nonviolent offenses prior to a Includes parole violation or revocation breach of or failure to comply with recognizance or probation bail violation and any new charges including the index offense while on a conditional release 7 Age at index offense at most recent birthday 8 Victim injury 9 Any female victim for index offense 10 Meets DSM III criteria for any personality disorder 11 Meets DSM III criteria for schizophrenia 12 Hare Psychopathy Checklist HCR 20 Work very well Case Example 20 year old male Referred due to assault and battery conviction Pre sentencing Prior convictions Prior arrest for public intoxication Family history o Lives at home with his parents o Only child o No report of abuse o Spends little time with family o Assault and battery probation complete o Breaking and entering probation extended for public intoxication arrest Few friends mostly alone no girlfriend Reports feeling some depression has taken antidepressants in the past Flat affect somber Cooperative but not spontaneous in responding Slightly above average IQ in normal range Got depressed and then would drink more MMPI o F and back F are elevated so he ma have been faking a little but mostly just got tired o L is elevated trying to make himself look good o Validity scales check out o High D depression o High paranoia o High schizophrenia o High Pd antisocial acts out o High S socially isolated o High Pt ruminating thoughts o Quite symptomatic Recidivism Rate o Treatment program drug testing for the alcohol abuse o Young high risk o Never had a significant relationship high risk o Social support network o Mental health counseling for depression delusions etc o Has already violated probation o Depression gets him delusional not full blown psychotic o Put on antidepressants and anti anxiety medications Not medications with addiction risks Doesn t need an antipsychotic Look at history look at testing and figure out what treatment and supervision one needs Expert Testimony Example Video Only addressed 2 out of 4 Daubert requirements and didn t do so fully o Didn t address an error rate o Didn t address peer review o Debatably generally accepted o Not well tested Good demeanor and good at explaining everything Doesn t give a single thing of scientific evidence Mostly clinical not versed in research