Skip to main content
SpringerLink
Log in

The Impact of Confidence on the Accuracy of Structured Professional and Actuarial Violence Risk Judgments in a Sample of Forensic Psychiatric Patients

  • Published:
Law and Human Behavior

Abstract

Some previous research indicates that confidence affects the accuracy of probabilistic clinical ratings of risk for violence among civil psychiatric inpatients. The current study investigated the impact of confidence on actuarial and structured professional risk assessments, in a forensic psychiatric population, using community violence as the outcome criteria. Raters completed the HCR-20 violence risk assessment scheme for a sample of 100 forensic psychiatric patients. Results showed that accuracy of both actuarial judgments (HCR-20 total scores) and structured professional judgments (of low, moderate, and high risk) were substantially more accurate when raters were more confident about their judgments. Findings suggest that confidence of ratings should be studied as a potentially important mediator of structured professional and actuarial risk judgments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andreason, N. C., McDonald-Scott, P., Grove, W. M., Keller, M. D., Shapiro, R. W., & Hirschfeld, R. M. A. (1982). Assessment of reliability in multi-center collaborative research using a videotape approach. American Journal of Psychiatry, 139, 876–882.

    Google Scholar 

  • Arbisi, P. A. (2003). Review of the HCR-20: Assessing risk for violence. In B. S. Plake, J. C. Impara, & R. A. Spies (Eds.), The fifteenth mental measurements yearbook [Electronic version]. Retrieved May 7, 2003, from the Buros Institute's Test Reviews Online website: http://www.unl.edu/buros

  • Arkes, H. R. (2001). Overconfidence in judgmental forecasting. In J. S. Armstrong (Ed.), Forecasting principles handbook (pp. 442–459). Norwell, MA: Kluwer.

    Google Scholar 

  • Augimeri, L. K., Koegl, C. J., Webster, C. D., & Levene, K. S. (2001). Early assessment risk list for boys (EARL-20B): Version 2. Toronto, ON: Earlscourt Child and Family Centre.

    Google Scholar 

  • Boer, D. P., Hart, S. D., Kropp, P. R., & Webster, C. D. (1997). Manual for the sexual violence risk—20: Professional guidelines for assessing risk of sexual violence. Vancouver, BC: British Columbia Institute Against Family Violence.

    Google Scholar 

  • Borum, R. (1996). Improving the clinical practice of violence risk assessment: Technology, guidelines, and training. American Psychologist, 51, 945–956.

    Google Scholar 

  • Borum, R., Bartel, P, & Forth, A. (2001). Manual for the structured assessment for violence risk in youth (SAVRY): Consultation version. Tampa, FL: Florida Mental Health Institute, University of South Florida.

    Google Scholar 

  • Borum, R., Otto, R. K., & Golding, S. (1993). Improving clinical judgment and decision making in forensic evaluation. Journal of Psychiatry and Law, 21, 35–76.

    Google Scholar 

  • Brennan, R. L. (2001). Generalizability theory. New York, NY: Springer.

    Google Scholar 

  • Buchanan, A. (2001). [Review of the book, HCR-20: Assessing risk for violence, Version 2]. Criminal Behaviour and Mental Health, 11, S77–S89.

    Google Scholar 

  • Cicchetti, D. V., & Sparrow, S. A. (1981). Developing criteria for establishing interrater reliability of specific items: Applications to assessment of adaptive behavior. American Journal of Mental Deficiency, 86, 127-137.

    Google Scholar 

  • Cooper, C. (2003). Review of the HCR-20: Assessing risk for violence. In B. S. Plake, J. C. Impara, & R. A. Spies (Eds.), The fifteenth mental measurements yearbook [Electronic version]. Retrieved May 7, 2003, from the Buros Institute's Test Reviews Online website: http://www.unl.edu/buros

  • Cronbach, L. J., Gleser, G. C., Nanda, H., & Rajaratnam, N. (1972). The dependability of behavioral measurements: Theory of generalizability for scores and profiles. New York, NY: John Wiley & Sons.

    Google Scholar 

  • Dawson, N. V., Conners, A. F., Speroff, T., Kemka, A., Shaw, P., & Arkes, H. R. (1993). Homodynamic assessment in managing the critically ill: Is physician confidence warranted? Medical Decision Making, 13, 258–266.

    Google Scholar 

  • Dolan, M., & Doyle, M. (2000). Violence risk prediction: Clinical and actuarial measures and the role of the Psychopathy Checklist. British Journal of Psychiatry, 177, 303–311.

    Google Scholar 

  • Douglas, K. S. (2002). HCR-20 violence risk assessment scheme: Overview and annotated bibliography [On-line]. Available from http://www.sfu.ca/psychology/groups/faculty/ hartviolink.htm

  • Douglas, K. S., & Kropp, P. R. (2002). A prevention-based paradigm for violence risk assessment: Clinical and research applications. Criminal Justice and Behavior, 29, 617–658.

    Google Scholar 

  • Douglas, K. S., Ogloff, J. R. P., & Hart, S. D. (2003). Evaluation of the structured professional judgment model of violence risk assessment among forensic psychiatric patients. Psychiatric Services.

  • Douglas, K. S., Ogloff, J. R. P., Nicholls, T. L., & Grant, I. (1999). Assessing risk for violence among psychiatric patients: The HCR-20 violence risk assessment scheme and the Psychopathy Checklist: Screening version. Journal of Consulting and Clinical Psychology, 67, 917–930.

    Google Scholar 

  • Douglas, K. S., & Webster, C. D. (1999). Predicting violence in mentally and personality disordered individuals. In R. Roesch, S. D. Hart, & J. R. P. Ogloff (Eds.), Psychology and law: The state of the discipline (pp. 175–239). New York: Plenum.

    Google Scholar 

  • Ennis, B. J., & Litwack, T. R. (1974). Psychiatry and the presumption of expertise: Flipping coins in the courtroom. California Law Review, 62, 693–752.

    Google Scholar 

  • Faust, D., & Ziskin, J. (1988). The expert witness in psychology and psychiatry. Science, 241, 31–35.

    Google Scholar 

  • Grann, M., & LångströmN. (in press). Actuarial assessment of risk for violence: To weigh or not to weigh? Criminal Justice and Behavior.

  • Grove, W. M., & Meehl, P. E. (1996). Comparative efficiency of informal (subjective, impressionistic) and formal (mechanical, algorithmic) prediction procedures: The clinical-statistical controversy. Psychology, Public Policy, and Law, 2, 293–323.

    Google Scholar 

  • Grove, W. M., Zald, D. H., Lebow, B. S., Snitz, B. E., & Nelson, C. (2000). Clinical versus mechanical prediction: A meta-analysis. Psychological Assessment, 12, 19–30.

    Google Scholar 

  • Hart, S. D. (1998). The role of psychopathy in assessing risk for violence: Conceptual and methodological issues. Legal and Criminological Psychology, 3, 121–137.

    Google Scholar 

  • Hart, S. D. (2001a). Assessing and managing violence risk. In K. S. Douglas, C. D. Webster, S. D. Hart, D. Eaves, & J. R. P. Ogloff (Eds.), HCR-20 violence risk management companion guide (pp. 13–25). Burnaby, BC: Mental Health Law and Policy Institute, Simon Fraser University.

    Google Scholar 

  • Hart, S. D. (2001b). Complexity, uncertainty, and the reconceptualization of risk assessment [On-line]. Available from http://www.sfu.ca/psychology/groups/faculty/hart

  • Hoyt, W. T., & Melby, J. N. (1999). Dependability of measurement in counseling psychology: An introduction to generalizability theory. Counseling Psychologist, 27, 325–352.

    Google Scholar 

  • Kropp, P. R., & Hart, S. D. (2000). The spousal assault risk assessment (SARA) guide: Reliability and validity in adult male offenders. Law and Human Behavior, 24, 101–118.

    Google Scholar 

  • Kropp, P. R., Hart, S. D., Webster, C. D., & Eaves, D. (1999). Manual for the spousal assault risk assessment guide (3rd ed.). Toronto, ON: Multi-Health Systems.

    Google Scholar 

  • Landis, J., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    Google Scholar 

  • Laws, R. (2000, November). Risk for sexual violence protocol (RSVP): A new guide for assessment and management. Symposium presented at the founding conference of the International Association of Forensic Mental Health Services, Vancouver, Canada.

  • Litwack, T. R., & Schlesinger, L. B. (1999). Dangerousness risk assessments: Research, legal and clinical considerations. In A. K. Hess & I. B. Weiner (Eds.), Handbook of forensic psychology (2nd ed., pp. 171–217). New York: Wiley.

    Google Scholar 

  • Luke, D. A., & Homan, S. M. (1998). Time and change: Using survival analysis in clinical assessment and treatment evaluation. Psychological Assessment, 10, 360–378.

    Google Scholar 

  • McNiel, D. E., & Binder, R. L. (1994). Screening for risk of inpatient violence: Validation of an actuarial tool. Law and Human Behavior, 18, 579–586.

    Google Scholar 

  • McNiel, D. E., Sandberg, D. A., & Binder, R. L. (1998). The relationship between confidence and accuracy in clinical assessment of psychiatric patients' potential for violence. Law and Human Behavior, 22, 655–669.

    Google Scholar 

  • Meehl, P. E. (1954). Clinical versus statistical prediction. Minneapolis, MN: University of Minnesota Press.

    Google Scholar 

  • Monahan, J., & Steadman, H. J. (Eds.). (1994). Violence and mental disorder: Developments in risk assessment. Chicago, IL: University of Chicago Press.

    Google Scholar 

  • Monahan, J., Steadman, H. J., Silver, E., Appelbaum, P. S., Robbins, P. C., Mulvey, E. P., et al. (2001). Rethinking risk assessment: The MacArthur study of mental disorder and violence. New York: Oxford University Press.

    Google Scholar 

  • Mossman, D. (1994). Assessing predictions of violence: Being accurate about accuracy. Journal of Consulting and Clinical Psychology, 62, 783–792.

    Google Scholar 

  • Mossman, D. (2000). Evaluating violence risk 'by the book': A review of HCR-20: Assessing risk for violence, Version 2 and The manual for the sexual violence risk—20. Behavioral Sciences and the Law, 18, 781–789.

    Google Scholar 

  • Mossman, D., & Somoza, E. (1991). ROC curves, test accuracy, and the description of diagnostic tests. Journal of Neuropsychiatry and Clinical Neurosciences, 3, 330–333.

    Google Scholar 

  • Otto, R. K. (2000). Assessing and managing violence risk in outpatient settings. Journal of Clinical Psychology, 56, 1239–1262.

    Google Scholar 

  • Quinsey, V. L., Harris, G. T., Rice, G. T., & Cormier, C. A. (1998). Violent offenders: Appraising and managing risk. Washington, DC: American Psychological Association.

    Google Scholar 

  • Rabinowitz, J., & Garelik-Wyler, R. (1999). Accuracy and confidence in clinical assessment of psychiatric inpatients risk of violence. International Journal of Law and Psychiatry, 22, 99–106.

    Google Scholar 

  • Sporer, S. L., Penrod, S., Read, D., & Cutler, B. (1995). Choosing, confidence, and accuracy: A meta-analysis of the confidence-accuracy relation in eyewitness identification studies. Psychological Bulletin, 118, 315–327.

    Google Scholar 

  • Stephenson, G. M. (1984). Accuracy and confidence in testimony: A critical review and some fresh evidence. In D. J. Muller, D. E. Blackman, & A. J. Chapman (Eds.), Psychology and law (pp. 229–248). New York: Wiley.

    Google Scholar 

  • Vincent, G. M., Ross, D. J., Whittemore, K., Eaves, D., Hart, S. D., Ogloff, J. R. P., et al. (2001, April). Using the HCR-20: File-based researcher ratings vs. file + interview-based clinician ratings. Paper presented at the Founding conference of the International Association of Forensic Mental Health Services, Vancouver, BC, Canada.

  • Webster, C. D., Douglas, K. S., Eaves, D., & Hart, S. D. (1997). HCR-20: Assessing risk for violence (Version 2). Burnaby, BC: Mental Health, Law, and Policy Institute, Simon Fraser University.

    Google Scholar 

  • Werner, P. D., Rose, T. L., & Yesavage, J. A. (1983). Reliability, accuracy, and decision-making strategy in clinical predictions of imminent dangerousness. Journal of Consulting and Clinical Psychology, 51, 815–825.

    Google Scholar 

  • Witt, P. H. (2000). A practitioner's view of risk assessment: The HCR-20 and SVR-20. Behavioral Sciences and the Law, 18, 791–798.

    Google Scholar 

  • Yarmey, A. D. (1979). The psychology of eyewitness testimony. London, Macmillan.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mental Health Law & Policy, Florida Mental Health Institute, University of South Florida, Tampa, Florida

    Kevin S. Douglas

  2. Mid-Sweden University, Sundsvall, Sweden

    Kevin S. Douglas

  3. School of Psychology, Psychiatry, and Psychological Medicine, Monash University, Australia

    James R. P. Ogloff

  4. Victorian Institute of Forensic Mental Health (Forensicare), Thomas Embling Hospital, Fairfield, Victoria, Australia

    James R. P. Ogloff

Authors
  1. Kevin S. Douglas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James R. P. Ogloff
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Douglas, K.S., Ogloff, J.R.P. The Impact of Confidence on the Accuracy of Structured Professional and Actuarial Violence Risk Judgments in a Sample of Forensic Psychiatric Patients. Law Hum Behav 27, 573–587 (2003). https://doi.org/10.1023/B:LAHU.0000004887.50905.f7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:LAHU.0000004887.50905.f7

Search

Navigation