Harris Grant T, Rice Marnie E
Research Department, Mental Health Centre Penetanguishene, Penetanguishene, Ontario L9M 1G3, Canada.
Ann N Y Acad Sci. 2003 Jun;989:198-210; discussion 236-46. doi: 10.1111/j.1749-6632.2003.tb07306.x.
The appraisal of risk among sex offenders has seen recent advances through the advent of actuarial assessments. Statistics derived from Relative Operating Characteristics (ROCs) permit the comparison of predictive accuracies achieved by different instruments even among samples that exhibit different base rates of recidivism. Such statistics cannot, however, solve problems introduced when items from actuarial tools are omitted, when reliability is low, or when there is high between-subject variability in the duration of the follow-up. We present empirical evidence suggesting that when comprehensive actuarial tools (VRAG and SORAG) are scored with high reliability, without missing items, and when samples of offenders have fixed and equal opportunity for recidivism, predictive accuracies are maximized near ROC areas of 0.90. Although the term "dynamic" has not been consistently defined, such accuracies leave little room for further improvement in long-term prediction by dynamic risk factors. We address the mistaken idea that long-term, static risk levels have little relevance for clinical intervention with sex offenders. We conclude that highly accurate prediction of violent criminal recidivism can be achieved by means of highly reliable and thorough scoring of comprehensive multi-item actuarial tools using historical items (at least until potent therapies are identified). The role of current moods, attitudes, insights, and physiological states in causing contemporaneous behavior notwithstanding, accurate prediction about which sex offenders will commit at least one subsequent violent offense can be accomplished using complete information about past conduct.
通过精算评估的出现,性犯罪者的风险评估在近期取得了进展。从相对操作特征(ROC)得出的统计数据允许比较不同工具所实现的预测准确性,即使是在再犯基准率不同的样本之间。然而,当精算工具中的项目被遗漏、可靠性较低或随访期间个体间变异性较高时,此类统计数据无法解决所带来的问题。我们提供的实证证据表明,当综合精算工具(VRAG和SORAG)以高可靠性计分、无遗漏项目,且性犯罪者样本有固定且均等的再犯机会时,预测准确性在ROC曲线下面积接近0.90时达到最大化。尽管“动态”一词尚未得到一致定义,但这样的准确性使得动态风险因素在长期预测方面几乎没有进一步改进的空间。我们讨论了一种错误观念,即长期的静态风险水平与性犯罪者的临床干预几乎无关。我们得出结论,通过使用历史项目对综合多项目精算工具进行高度可靠且全面的计分(至少在确定有效治疗方法之前),可以实现对暴力犯罪再犯的高度准确预测。尽管当前情绪、态度、洞察力和生理状态在引发即时行为中的作用不容忽视,但利用关于过去行为的完整信息,可以准确预测哪些性犯罪者将至少实施一次后续暴力犯罪。