Evidence for risk estimate precision: implications for individual risk communication

Same Score, Different Audience, Different Message: Perceptions of Sex Offense Risk Depend on Static-99R Risk Level and Personality Factors of the Recipient

There are multiple ways to report risk scale results. Varela et al. (2014) found that Static-99R results were interpreted differently by prospective jurors based on risk level (high vs low) and an interaction between risk level and risk communication format (categorical, absolute estimate, and risk ratio). We adapted and extended Varela et al.'s (2014) study using updated Static-99R norms, recruiting a population-wide sample (n = 166), and adding variables assessing the personality factors 'cognitive motivation' (i.e., need for cognition) and 'attitudinal affect' (i.e., attitudes toward sex offenders, authoritarianism). We found a main effect of risk level and no effect of either communication format or the interaction between the two. Adding the personality variables increased explained variance from 9% to 34%, suggesting risk perception may be more about the personality of the person receiving the information than the information itself. We also found an interaction between attitudes toward sex offenders and risk level. Our results suggest risk perception might be better understood if personality factors are considered, particularly attitudes toward sex offenders. Because biases/personality of the person receiving the information are unknown in real world settings we argue that sharing multiple methods for communicating risk might be best and more inclusive.

Improving Risk Communication: Developing Risk Ratios for the VRAG-R

We developed a set of risk ratios for the Violence Risk Appraisal Guide-Revised (VRAG-R) to broaden the range of risk communication options available when using this tool and to provide information needed for future efforts to apply The Council of State Governments Justice Center's standardized five-level risk framework to the scale. A slightly reduced version of the VRAG-R normative data set was used for the analyses (N = 1,238). Contrary to previous research developing risk ratios, logistic regression provided a more accurate estimate of observed violent recidivism rates than Cox regression for both total VRAG-R scores and VRAG-R decile bins. Further analyses indicated the relationship between the VRAG-R and violent recidivism was consistent over a 15-year follow-up period. Due to the difficulties with interpreting odds ratios, the final risk ratios were computed using rate ratios derived from a logistic regression model using a 5-year fixed follow-up period. These risk ratios, and templates for how the ratios might be used in an assessment report, are presented in the appendices.

Who Are the Compliant Correctional Clients? New Evidence on Protective Factors among Federal Supervised Releases

Protective factors facilitate success on community supervision, but relatively little is known about correctional clients who are highly compliant particularly in the federal system. Drawing on a near population of federal clients on supervised release in the Midwestern United States, the current study examined variables associated with compliant supervision status. One day on supervision contributed to a 1% reduction in the logged odds of supervision compliance. Clients with no drug history had 793% increased odds, clients with sustained remission had 620% increased odds, and clients with early remission had 458% increased odds of compliant supervision status relative to clients actively using drugs. Among the federal Post Conviction Risk Assessment (PCRA) indices, only PCRA Criminal History was significant as clients with less extensive criminal history were more likely to be compliant supervision clients. A one-unit change in PCRA Criminal History status was associated with 25% reduced odds of supervision compliance. Total conditions were inversely associated with compliant supervision status with each additional condition associated with a 19% reduced likelihood of compliant supervision status. None of the demographic variables was significantly associated with compliant supervision status. Implications of the findings for the protective factor paradigm in corrections are discussed.

Estimating the probability of sexual recidivism among men charged or convicted of sexual offences: Evidence-based guidance for applied evaluators

Risk assessment is routinely applied in forensic decision-making. Although relative risk information from risk scales is robust across diverse samples and settings, estimates of the absolute probability of sexual recidivism are not. Nonetheless, absolute recidivism estimates are still necessary in some evaluations. This paper summarizes research and offers guidance on evidence-based practices for assessing the probability of recidivism, organized largely around questions commonly asked in court. Overall, estimating the probability of sexual recidivism is difficult and should be undertaken with humility and circumspection. That being said, research favours empirical-actuarial risk tools for this task, more structured scales, and the use of multiple scales. Professional overrides of risk scale results should not be used under any circumstances. Paradoxically, however, professional judgement is still required in some circumstances. Risk scales do not consider all relevant risk factors, but the added value of external risk factors reaches a point of diminishing returns and may or may not be incremental (or worse, can degrade accuracy). There are reasons actuarial risk scales may both underestimate recidivism (e.g., undetected offending, short follow-ups) and overestimate recidivism (e.g., inclusion of sex offences not of interest in some referral questions, data on declining crime and recidivism rates, newer studies demonstrating overestimation of recidivism). Given all these considerations and the need for humility, in the absence of exceptional circumstances, I would not deviate too far from empirical estimates.

Sex Offender Risk Assessment: Where Are We and Where Are We Going?

PURPOSE OF REVIEW

Risk assessment is one of the most ubiquitous tasks in the criminal justice system, informing virtually every decision made about offenders. This review, intended for researchers and practitioners, outlines some of the most important recent advances, emerging issues, and recommendations in sex offender risk assessment.

RECENT FINDINGS

The underlying nature and purpose of risk scales is reviewed, with implications for how we should evaluate them. Limits of recidivism probability estimates are discussed, and efforts to advance a common language for describing risk levels are highlighted. Advances in risk communication and field validity are summarized. The utility of protective risk factors in risk assessments is debated. Emerging areas in assessing offender change and assessments with child pornography offenders are discussed. Despite critical advances in the last few years, there are still important gaps in knowledge, particularly for risk communication, field implementation, offender change, and child pornography offenders.

De Novo Advanced Adult-Onset Offending: New Evidence from a Population of Federal Correctional Clients

Adult antisocial behavior is almost always predated by delinquency during childhood or adolescence; however, there is also evidence of adult-onset criminal offending. This study examined this controversial subgroup of offenders using self-reported and official data from a total population of federal correctional clients selected from the Midwestern United States. Difference of means t-tests, chi-square tests, and logistic regression models found that 11.7% of clients had an adult onset of offending and 2.7% of clients (n = 23) had an onset occurring at age 60 years or older. This group-introduced as de novo advanced adult-onset offenders-had high socioeconomic status, mixed evidence of adverse childhood experiences, and virtually no usage of drugs with the exception of alcohol. These offenders were primarily convicted of social security and white-collar crimes and evinced remarkably low psychopathology and criminal risk. More research is needed to replicate the phenomenon of de novo advanced adult-onset offending.

Big data for bipolar disorder

The delivery of psychiatric care is changing with a new emphasis on integrated care, preventative measures, population health, and the biological basis of disease. Fundamental to this transformation are big data and advances in the ability to analyze these data. The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events. The primary sources of big data today are electronic medical records (EMR), claims, and registry data from providers and payers. In the near future, data created by patients from active monitoring, passive monitoring of Internet and smartphone activities, and from sensors may be integrated with the EMR. Diverse data sources from outside of medicine, such as government financial data, will be linked for research. Over the long term, genetic and imaging data will be integrated with the EMR, and there will be more emphasis on predictive models. Many technical challenges remain when analyzing big data that relates to size, heterogeneity, complexity, and unstructured text data in the EMR. Human judgement and subject matter expertise are critical parts of big data analysis, and the active participation of psychiatrists is needed throughout the analytical process.

Prevention of Child Sexual Abuse by Targeting Pre-Offenders Before First Offense

The population of potential child abuse offenders has largely been unstudied. In the current study, we examine whether a six-component model used for primary diabetes prevention could be adapted to child sexual abuse pre-offenders, whereby individuals who are prone to sexual abuse but have not yet committed an offense can be prevented from committing a first offense. The six components include: define and track the magnitude of the problem, delineate a well-established risk factor profile so that at-risk persons can be identified, define valid screening tests to correctly rule in those with the disease and rule out those without disease, test effectiveness of interventions-the Dunkelfeld Project is an example, produce and disseminate reliable outcome data so that widespread application can be justified, and establish a system for continuous improvement. By using the diabetes primary prevention model as a model, the number of victims of child sexual abuse might be diminished.