Wolf Viviane, Mayer Juliane, Steiner Ivonne, Franke Irina, Klein Verena, Streb Judith, Dudeck Manuela
Department of Forensic Psychiatry and Psychotherapy, kbo-Isar-Amper-Clinic Taufkirchen (Vils), Taufkirchen (Vils), Germany.
Department of Forensic Psychiatry, Psychiatric Services of Grisons, Chur, Switzerland.
Front Psychiatry. 2024 Jan 29;15:1346815. doi: 10.3389/fpsyt.2024.1346815. eCollection 2024.
Given that risk assessment tools are commonly based on male samples, the applicability to justice-involved women remains to be clarified. This study aimed at assessing (1) the predictive validity of the HCR-20 V3, the prevailing, yet primarily male-based violence risk assessment instrument, and (2) the incremental validity of the FAM, a gender-responsive supplement, for both inpatient violence and violent recidivism in justice-involved women.
The sample included 452 female forensic inpatients with substance use disorder discharged from German forensic psychiatric care between 2001 and 2018.
ROC analyses revealed good predictive accuracy for the HCR-20 V3 while the FAM failed to provide incremental validity. Further, binary logistic regression determined several predictors of violence including personality disorder, covert/manipulative behavior, suicidal behavior/self-harm, and problematic intimate relationship.
These findings support the applicability of the HCR-20 V3 in justice-involved women with substance use disorder, while highlighting the clinical relevance of the FAM in supporting a gender-informed risk management.
鉴于风险评估工具通常基于男性样本，其对涉及司法程序的女性的适用性仍有待明确。本研究旨在评估：（1）HCR-20 V3（一种普遍使用但主要基于男性的暴力风险评估工具）的预测效度；（2）性别敏感补充工具FAM对涉及司法程序女性的住院暴力和暴力再犯的增量效度。
样本包括2001年至2018年间从德国法医精神病护理机构出院的452名患有物质使用障碍的女性法医住院患者。
ROC分析显示HCR-20 V3具有良好的预测准确性，而FAM未能提供增量效度。此外，二元逻辑回归确定了暴力的几个预测因素，包括人格障碍、隐蔽/操纵行为、自杀行为/自我伤害以及有问题的亲密关系。
这些发现支持HCR-20 V3在患有物质使用障碍的涉及司法程序女性中的适用性，同时强调了FAM在支持基于性别的风险管理方面的临床相关性。
