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Structured professional judgment of violence risk in forensic clinical practice: A prospective study into the predictive validity of the Dutch HCR-20

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In this prospective study, the Dutch version of the HCR-20 (an instrument assessing risk factors for violence in the past, present and future) was coded independently by three rater groups (researchers, treatment supervisors and group leaders) for 127 male mentally disordered offenders admitted to a forensic psychiatric hospital. During case conferences, the three raters discussed their ratings and reached consensus on their ratings and final risk judgment. HCR-20 ratings were related to incidents of physical violence during treatment. Overall, the predictive validity of the HCR-20 was good. We found no differences between researchers and treatment supervisors in predictive accuracy. Group leaders performed worse compared to the other two rater groups. The consensus rating was the best predictor. Implications for structured violence risk assessment in clinical practice are discussed.
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Keywords: HCR-20; Risk assessment; predictive validity; violence

Document Type: Research Article

Affiliations: 1: Dr Henri van der Hoeven Kliniek, Department of Research, Dr Henri van der Hoeven Kliniek, PO Box 174, 3500 AD, Utrecht, The Netherlands 2: Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, 3500 AS, Utrecht, The Netherlands

Publication date: 2006-06-01

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