The Utility of Patients' Self-Perceptions of Violence Risk: Consider Asking the Person Who May Know Best
UMass Chan Affiliations
Department of PsychiatryDocument Type
Journal ArticlePublication Date
2013-05-01Keywords
ViolenceRisk Assessment
Self Concept
Diagnostic Self Evaluation
Behavioral Disciplines and Activities
Mental and Social Health
Psychiatry
Psychiatry and Psychology
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Show full item recordAbstract
OBJECTIVE: The authors compared the predictive accuracy of two risk assessment methods that are feasible to use in routine clinical settings: brief risk assessment tools and patients' self-perceptions of risk. METHODS: In 2002-2003, clinical interviewers met with 86 high-risk inpatients with co-occurring mental and substance use disorders (excluding schizophrenia) to carefully elicit the patients' global rating of their risk of behaving violently and to complete two brief risk assessment tools-the Clinically Feasible Iterative Classification Tree (ICT-CF) and the Modified Screening Tool (MST). Two months after discharge, patients were reinterviewed in the community to assess their involvement in violence. RESULTS: Patients' self-perceptions of risk performed quite well in predicting serious violence (area under the curve [AUC]=.74, sensitivity=50%), particularly compared with the ICT-CF (AUC=.59, sensitivity=40%) and the MST (AUC=.66, sensitivity=30%). Self-perceived risk also added significant incremental utility to these tools in predicting violence. CONCLUSIONS: Patients' self-perceptions hold promise as a method for improving risk assessment in routine clinical settings. Assuming it replicates and generalizes beyond the research context, this finding encourages a shift away from unaided clinical judgment toward a feasible method of risk assessment built on patient collaboration.Source
Psychiatr Serv. 2013 May 1;64(5):410-5. doi: 10.1176/appi.ps.001312012. Link to article on publisher's siteDOI
10.1176/appi.ps.001312012Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46083PubMed ID
23318677Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1176/appi.ps.001312012