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Risk assessment: actuarial prediction and clinical judgement of offending incidents and behaviour for intellectual disability services
- Authors:
- LINDSAY William R., BEAIL Nigel
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(4), December 2004, pp.229-234.
- Publisher:
- Wiley
Research on prediction of violent and sexual offending behaviour has developed considerably in the mainstream criminological literature. Work on actuarial instruments, dynamic variables, clinical judgement and structured clinical judgement is reviewed. A number of studies comparing actuarial instruments in terms of their predictive validity are reviewed. Relative effectiveness and applicability to intellectual disability is considered. A framework for dynamic variables is outlined and the importance of dynamic variables for inclusion in risk prediction is established. Strengths and limitations of clinical judgement are reported and the importance of reliability is noted. Finally, structured clinical judgement is reviewed in terms of the way in which it combines the other three groups of variables. The information regarding different methods of risk assessment is integrated with research and opinion. Risk prediction will always be a judgement and as such there will always be errors in judgement. As clinicians, researchers and policy makers it is our duty to employ the latest research information to make predictions that are as accurate as possible. However, we must also help to promote a culture that can be tolerant of inevitable errors.
Assessment and treatment of sexual offenders with intellectual disabilities: a handbook
- Editors:
- CRAIG Leam A., LINDSAY William R., BROWNE Kevin D., (eds.)
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2010
- Pagination:
- 375p.
- Place of publication:
- Chichester
Contributors from the field of forensic psychology contribute to cover theory, research and practical intervention for those working with intellectually disabled sex offenders. Latest research findings on the characteristics and prevalence of sexual offenders with intellectual disabilities are summarised. Key topics covered include: theories of sexual offending, developmental pathways, risk assessment, personality disorders and psychopathy, community and prison based treatment programmes, and legal and mental health services. The available literature on sexual offenders with intellectual disabilities is reviewed along with the latest treatment approaches and legislative developments.
The dynamic risk assessment and management system: an assessment of immediate risk of violence for individuals with offending and challenging behaviour
- Authors:
- LINDSAY William R., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(4), December 2004, pp.267-274.
- Publisher:
- Wiley
Research on dynamic risk assessment has developed over the last 10 years and a number of variables have emerged as being possible predictors of future sexual and violent offences. These variables include hostile attitude/anger and compliance with routine. In 2002, Thornton developed a framework for dynamic risk assessment which also includes distorted and dysfunctional attitudes, socio-affective functioning, self-management and, for sex offenders, sexual interests. In 2000, Hanson & Harris provided empirical support for the predictive power of a number of dynamic factors which they split into stable and acute variables. In their research they found poor social supports, antisocial lifestyle, and poor self-management strategies to be important in addition to co-operation with supervision and hostile attitude. The present report describes the development of the Dynamic Risk Assessment and Management System (DRAMS) an assessment for dynamic/proximal risk factors in people with intellectual disabilities. In a field trial, the DRAMS was administered by staff unfamiliar with the formal requirements of the assessment. They were familiar with other ward-based assessments. Ten subjects were assessed for reliability purposes (total of 45 assessments) and five subjects were assessed consistently over a 3-month period. Eighteen aggressive incidents were recorded in these five subjects and the relationship between DRAMS assessments and the incidents was calculated. Assessments were recorded on the day of the incident, the day before the incident and on a control day, which was at least 7 days before or after an incident. Four items achieved high reliability mood, psychotic symptoms, self-regulation, compliance with routine in addition to total score. Two items achieved intermediate reliability antisocial behaviour and problems with thinking/attitudes, and three items were not applicable to this client group in that none of the participants was ever rated on them substance abuse, renewal of emotional relationships and victim access. One item had poor reliability therapeutic alliance. There were significant differences between the DRAMS assessment on the control day and assessments both on the day prior to the incident and the day of the incident for three of the six subscales and total score. Initial results would suggest that the DRAMS is a reliable instrument apart from the therapeutic alliance category. Initial signs suggest that it may be predictive of aggressive incidents in residential settings. Several developments to other settings and the client groups are discussed.