Kikuchi Akiko, Soshi Takahiro, Kono Toshiaki, Koyama Mayuko, Fujii Chiyo
Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Front Psychiatry. 2021 May 5;12:645927. doi: 10.3389/fpsyt.2021.645927. eCollection 2021.
This study aimed to evaluate the predictive validity and reliability of the Short-Term Assessment of Risk and Treatability (START) in the context of the Japanese forensic probation service. START is a structured professional judgement guide for risk domains concerning negative behaviors such as violence, self-harm, suicide, substance abuse, unauthorized leave, victimization, and self-neglect. In this study, rehabilitation coordinators evaluated community-dwelling patients who were treated under the Medical Treatment and Supervision Act at baseline and followed-up for 6 months. The results revealed that START vulnerability scores significantly predicted self-harm, suicide, physical aggression, substance abuse, and self-neglect. START strength scores predicted physical violence and unauthorized leave. Specific risk estimates predicted physical violence and self-neglect. Risk judgement for future substance use may require adjustments for cultural differences, because of the lower prevalence in Japan. These results suggest that START offers a feasible and valid tool that allows clinicians to plan treatment and promote recovery of forensic patients in Japan.
本研究旨在评估《短期风险与可治疗性评估(START)》在日本法医缓刑服务背景下的预测效度和可靠性。START是一份针对暴力、自我伤害、自杀、药物滥用、擅自离开、受害和自我忽视等负面行为风险领域的结构化专业判断指南。在本研究中,康复协调员对根据《医疗治疗与监督法》接受治疗的社区居住患者进行了基线评估,并随访了6个月。结果显示,START脆弱性评分显著预测了自我伤害、自杀、身体攻击、药物滥用和自我忽视。START优势评分预测了身体暴力和擅自离开。特定风险估计预测了身体暴力和自我忽视。由于日本药物使用的患病率较低,未来药物使用的风险判断可能需要针对文化差异进行调整。这些结果表明,START提供了一种可行且有效的工具,使临床医生能够为日本法医患者制定治疗计划并促进其康复。