McNiel D E, Sandberg D A, Binder R L
Department of Psychiatry, School of Medicine, University of California, San Francisco, USA.
Law Hum Behav. 1998 Dec;22(6):655-69. doi: 10.1023/a:1025754706716.
The authors studied the relationship between confidence and accuracy in clinical assessments of psychiatric patients' short-term risk of violence. At the time of entry to the hospital, physicians (N = 78) estimated the probability that each of 317 patients would physically attack other people during the first week of psychiatric hospitalization. The clinicians also indicated the degree of confidence they had in their estimates of violence potential. Nurses rated the occurrence of inpatient physical assaults with the Overt Aggression Scale. The results showed that when clinicians had a high degree of confidence, their evaluations of risk of violence were strongly associated with whether or not patients became violent. At moderate levels of confidence, clinicians' risk estimates had a lower, but still substantial relationship with the later occurrence of violence. However, when clinicians had low confidence, their assessments of potential for violence had little relationship to whether or not the patients became violent. The findings suggest that the level of confidence that clinicians have in their evaluations is an important moderator of the predictive validity of their assessments of patients' potential for violence.
作者们研究了在对精神病患者短期暴力风险进行临床评估时，信心与准确性之间的关系。在患者入院时，78名医生对317名患者在精神科住院第一周内对他人进行身体攻击的可能性进行了估计。临床医生还表明了他们对暴力可能性估计的信心程度。护士使用 overt Aggression Scale（明显攻击量表）对住院患者身体攻击的发生情况进行评分。结果显示，当临床医生有高度信心时，他们对暴力风险的评估与患者是否会变得暴力密切相关。在中等信心水平时，临床医生的风险估计与后来暴力事件的发生有较低但仍很显著的关联。然而，当临床医生信心较低时，他们对暴力可能性的评估与患者是否变得暴力几乎没有关系。研究结果表明，临床医生对其评估的信心水平是其对患者暴力可能性评估预测效度的一个重要调节因素。
