The Short- to Medium-Term Predictive Validity of Static and Dynamic Risk-of-Violence Measures in Medium- to Low-Secure Forensic and Civil Inpatients

Testing the Factor Structure of the Psychopathy Checklist: Screening Version (PCL:SV) in an Australian Violent Offender Population

Although psychopathy is a correlate of recidivism, including violent offending, the inclusion of antisocial behavior items in the Psychopathy Checklist (PCL) assessment instruments has been debated. Further, the latent factor structure underpinning the PCL measures has not been comprehensively validated in Australia. This study examined the construct validity of the PCL:SV in a sample of 192 Australian male violent offenders using structural equation modeling. The incremental validity of including the antisocial behavior items for predicting recidivism was also assessed. Approximately one-third of the sample had high scores on the PCL:SV. Construct analyses indicated strongest support for two distinct three-factor models of PCL psychopathy, with the established two- and four-factor models demonstrating poorer fit. The Antisocial factor improved predictive accuracy incrementally relative to the other three factors (Interpersonal, Affective, and Lifestyle). Area under the curve analyses revealed predictive accuracy for recidivism only for factors containing the antisocial behavior items. Findings contribute to the construct and predictive validity of the PCL measures and are discussed relative to contemporary forensic risk assessment practice.

Care provider allocation on admissions to acute mental health wards: The development and validation of the Admission Team Score List

Currently, support tools are lacking to prioritize steps in the care coordination process to enable safe practice and effective clinical pathways in the first phase of acute psychiatric admissions. This study describes the development, validity, and reliability of an acute care coordination support tool, the Admission Team Score List (ATSL). The ATSL assists in care provider allocation during admissions. Face validity and feasibility of the ATSL were tested in 77 acute admissions. Endscores of filled out ATSL's were translated to recommended team compositions. These ATSL team (ATSL-T) compositions were compared to the actually present team (AP-T) and the most preferred team (MP-T) composition in hindsight. Consistency between the ATSL-T and the MP-T was substantial; K_w  = 0.70, P < 0.001, 95% CI [0.55-0.84]. The consistency between the ATSL-T and AP-T was moderate; K_w  = 0.43, P < 0.001, 95% CI [0.23-0.62]. The ATSL has an adequate (inter-rater) reliability; ICC = 0.90, P < 0.001, 95% CI [0.65-0.91]. The ATSL study is an important step to promote safety and efficient care based on care provider allocation, for service users experiencing an acute admission. The ATSL may stimulate structured clinical decision-making during the hectic process around acute psychiatric admissions.