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ADHD 在高危青年罪犯 VRAG-R 之外的预测和增量有效性。

The predictive and incremental validity of ADHD beyond the VRAG-R in a high-risk sample of young offenders.

机构信息

Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany.

Institute for Forensic Psychology and Psychiatry, University Hospital, Homburg, Saarland, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2022 Dec;272(8):1469-1479. doi: 10.1007/s00406-021-01352-x. Epub 2021 Dec 3.

Abstract

The VRAG-R is a well-established actuarial risk-assessment instrument, which was originally developed for assessing violent recidivism risk in adult male offenders. Whether or not the VRAG-R can also predict violent recidivism in young offenders is unclear so far. In the emergence of juvenile offending, attention-deficit/hyperactivity disorder (ADHD) seems to be of major importance suggesting that it could be relevant for risk assessment as well. Thus, we examined the predictive accuracy of the VRAG-R in a high-risk sample of N = 106 (M = 18.3 years, SD = 1.8) young offenders and assessed the incremental predictive validity of ADHD symptomatology beyond the VRAG-R. Within a mean follow-up time of M = 13 years (SD = 1.2), n = 65 (62.5%) young offenders recidivated with a violent offense. We found large effect sizes for the prediction of violent and general recidivism and re-incarcerations using the VRAG-R sum scores. Current ADHD symptomatology added incremental predictive validity beyond the VRAG-R sum scores concerning the prediction of general recidivism but not of violent recidivism. The results supported the use of the VRAG-R for predicting violent recidivism in young offenders. Because ADHD symptomatology improves the predictive performance of the VRAG-R regarding general recidivism, we argue that addressing ADHD symptoms more intensively in the juvenile justice system is of particular importance concerning a successful long-term risk management in adolescents and young adults.

摘要

VRAG-R 是一种经过充分验证的、用于评估成人男性罪犯暴力再犯风险的计算工具。到目前为止,VRAG-R 是否也能预测青少年罪犯的暴力再犯风险还不清楚。在青少年犯罪中,注意缺陷多动障碍(ADHD)似乎非常重要,这表明它也可能与风险评估有关。因此,我们在一个高危青少年罪犯样本中(N=106,M=18.3 岁,SD=1.8 岁)检验了 VRAG-R 的预测准确性,并评估了 ADHD 症状在 VRAG-R 之外对风险评估的增量预测效度。在平均 13 年(M=13 岁,SD=1.2 岁)的随访时间内,n=65(62.5%)名青少年罪犯再次犯有暴力罪。我们发现,使用 VRAG-R 总分预测暴力和一般再犯和重新监禁的效果非常大。目前的 ADHD 症状在预测一般再犯方面,除了 VRAG-R 总分之外,还增加了增量预测效度,但对暴力再犯没有影响。结果支持使用 VRAG-R 预测青少年罪犯的暴力再犯。因为 ADHD 症状改善了 VRAG-R 在一般再犯方面的预测性能,我们认为在青少年司法系统中更深入地解决 ADHD 症状问题对于青少年和年轻成年人成功的长期风险管理尤为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/055f/9653327/b4e4d1bc5b7d/406_2021_1352_Fig1_HTML.jpg

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