Pujol Robinat Amadeo, Mohíno Justes Susana, Gómez-Durán Esperanza L
Servicio de Clínica Médico-Forense, Instituto de Medicina Legal de Cataluña, Barcelona, España; Departamento de Medicina. Facultad de Medicina y Ciencias de la Salud. Universitat Internacional de Catalunya. Barcelona. España.
CASM Benito-Menni. Sant Boi de LLobregat. Barcelona. España.
Med Clin (Barc). 2014 Mar;142 Suppl 2:16-23. doi: 10.1016/S0025-7753(14)70067-3.
Over the last 20 years there have been steps forward in the field of scientific research on prediction and handling different violent behaviors. In this work we go over the classic concept of "criminal dangerousness" and the more current of "violence risk assessment". We analyze the evolution of such assessment from the practice of non-structured clinical expert opinion to current actuarial methods and structured clinical expert opinion. Next we approach the problem of assessing physical violence risk analyzing the HCR-20 (Assessing Risk for Violence) and we also review the classic and complex subject of the relation between mental disease and violence. One of the most problematic types of violence, difficult to assess and predict, is sexual violence. We study the different actuarial and sexual violence risk prediction instruments and in the end we advise an integral approach to the problem. We also go through partner violence risk assessment, describing the most frequently used scales, especially SARA (Spouse Assault Risk Assessment) and EPV-R. Finally we give practical advice on risk assessment, emphasizing the importance of having maximum information about the case, carrying out a clinical examination, psychopathologic exploration and the application of one of the described risk assessment scales. We'll have to express an opinion about the dangerousness/risk of future violence from the subject and some recommendations on the conduct to follow and the most advisable treatment.
在过去20年里,在预测和处理不同暴力行为的科学研究领域取得了一些进展。在这项工作中,我们回顾了“犯罪危险性”这一经典概念以及当前更为流行的“暴力风险评估”概念。我们分析了此类评估从非结构化临床专家意见的实践到当前精算方法和结构化临床专家意见的演变。接下来,我们通过分析HCR - 20(暴力风险评估)来探讨评估身体暴力风险的问题,并且我们还回顾了精神疾病与暴力之间关系这一经典且复杂的主题。最难评估和预测的暴力类型之一是性暴力。我们研究了不同的精算和性暴力风险预测工具,最后我们建议采用综合方法来解决这个问题。我们还探讨了伴侣暴力风险评估,描述了最常用的量表,特别是SARA(配偶攻击风险评估)和EPV - R。最后,我们给出了风险评估的实用建议,强调获取关于案件的最大信息量、进行临床检查、心理病理学探索以及应用所描述的风险评估量表之一的重要性。我们必须就该对象未来暴力的危险性/风险发表意见,并就后续行为和最可取的治疗提出一些建议。