Assessing the future risk of youth violence

Determining the future risk of violence is an important forensic task. It can contribute to decisions about the appropriate level of care or structure. Research has repeatedly shown that clinical judgment about the risk of future violence is little better than chance. Tools to determine this risk significantly affect a young person’s life and must be reliable and valid. Tools developed to date to determine youth risk for future violence, delinquency, and behavior problems include SAVRY, PCL-YV, YLS-CMI, and CARE.

The Structured Assessment of Risk for Violence in Youth (SAVRY) (Borum, Bartel, & Forth, 2002) is composed of 24 risk elements (Historical, Social/Contextual, and Individual) drawn from the existing literature on adolescent development and on aggression in youth. Six additional protection factors are also provided. Dangerousness was once thought to be static and not subject to change, however more recently it has been seen as more contextual or situation dependent. Additionally, SAVRY developers have included dynamic risk factors because personality and behavior traits are not stable in adolescence. The theory behind these assessments has moved from a violence prediction model to a more clinical model of risk assessment and behavior management. The task is to determine the nature and degree of risk that an individual may present for certain types of behaviors, and under what conditions and contexts.

SAVRY is for youth ages 12-18. He is professionally qualified. The sample size is small. Studies have found correlations with past violence to be moderate to good (r = 0.32 to 0.56), explaining 18 to 20% of the variance, with an error rate of 21%. Reliability is good. It does not recommend level or types of services.

The Hare Psychopathy Checklist: Youth Version (PCL: YV) (Forth, Kosson, & Hare, 2003) is a 20-item rating scale for the assessment of psychopathic traits in male and female offenders aged 12–18. old. While Drs. Forth, et al, believe that identifying youth with psychopathic traits is critical to understanding the factors that contribute to the development of adult psychopathy, the application of the concept of psychopathy to youth is highly controversial. The PCL for Youth was adapted from Hare’s Psychopathy Checklist – Revised (PCL-R), one of the most widely used measures of psychopathy in adults. Using a semi-structured interview and collateral information, the PCL:YV measures interpersonal, affective, and behavioral characteristics related to the concept of psychopathy.

The PCL-YV is for youth ages 12-18. It is professionally qualified. Studies have found correlations with past violence to be poor to good (r = 0.10 to 0.48), with an error rate of 21 to 37%. Reliability is excellent. It does not recommend level or types of services.

The CARE (Child and Adolescent Risk Evaluation, (Seifert, 2003) assesses the risk of violence and assesses all potential problem areas, including past behavior, community, family, peers, work/school, neurological health, and The first tool for developed by Seifert (2003) was CARE (Seifert, 2003) It is an easy-to-use tool for assessing the risk of youth violence and creating a multifaceted case management plan More than 1,000 youth with a history of ethnically diverse were in the first CARE sample Ages ranged from 2 to 19 years, more than half had a history of assault Significantly higher CARE scores were seen in those with a history of assault and these youth were more likely to commit an assault assault in the next six months.

While it is true, as Dr. Borum et al. suggest, that environmental stressors can predict the immediacy of a violent act, it is the development of interpersonal skills, personality, morality, and problem-solving skills that it can create the potential for violence. occur in the face of an environmental stressor. The CARE is based on developmental theory and suggests which areas of development may be delayed and need intervention.

CARE assesses both risk and protective factors. As with the more popular adult actuarial risk tools, CARE is based on the idea that the more risk factors an offender has, the greater the offender’s risk of recidivism. No factor predicts youth violence. Each additional factor increases a youth’s risk of being violent. CARE is the only youth violence risk tool with a case management tool to determine the intensity and type of services needed.
The CARE total score appears to be significantly associated with a history of assaults (r = 62, p = 0.00) and assaults committed after administration of the instrument (r = 0.62, p = 0.00). The split-half reliability is .85 and the test-retest reliability is .75. The error rate is 13%. Recommends the level and types of services needed.

There are 4 CARE Subscales. (Seifert, 2006) that are intended to be used with the original CARE (see above). These are: Chronic Violence, Attachment Problems, Psychiatric Problems and Sexual Behavior Problems. All use CARE items that are more highly correlated with the construct. The sample is 912 and is the same as the original CARE. You can assess the risk of violence and sexual crimes in the future. While there is controversy about labeling children, this is seen as a prevention tool to ensure children get the services they need as soon as possible so they don’t go too deep into the juvenile justice system.

Traditional tests, such as the MMPI-A and the MACI, were not created and have not been tested for their association with risk of violence. In addition, popular tools, such as CAFAS (Hodges, 1990, 1994, 2003), CALOCUS (American Association of Community Psychiatrists, 1999), and MAYSI (Grisso, Barnum, Fletcher, Cauffman, & Peuschold, 2001) do not assess risk of violence.
Completion of the risk assessment tool first requires the clinician to collect a complete psychosocial history, based on record review, direct interviews with the child or adolescent, and interviews with collateral informants such as parents, teachers, therapists, agency workers social services etc . . (American Academy of Child and Adolescent Psychiatry; Rich, 2003). Each risk tool has characteristics that are unique to that tool. By comparing tools, a professional can determine which tool(s) best suits their needs and their population(s). The tools listed here are not exhaustive, but include the tools most used by professionals.

The SAVRY and EARL-20 are evidence-based, structured tools for guided clinical assessment. That is, the factors included in the tools are based on relevant literature in the field, including published studies, and the instruments provide defined factors to be addressed and a specific framework to be followed by the physician completing the assessment (Rich, 2003 ). The PCL and YLSI have empirically based scoring systems and cutoff scores. The DVI is a self-report and includes suggestions for treatment just like the YLS/CMI.

There is a professional debate about the use of actuarial tools and risk assessment with minors. The argument against guided clinical judgment is research showing that, for adults, clinical judgment about future risk of violence is no better than chance (Rice, Harris, Quinsey, 2002l). The argument against risk tools that go beyond a guided clinical assessment and use similar scoring systems and cut scores to adult risk tools are fears that the labels will not change over time and inability of existing tools to take into account the plasticity of young people. developing. This article proposes that violence is an interpersonal behavior that has a developmental trajectory, influenced by the environment, the bond with the caregiver, neurological development, and characteristics of the child, such as temperament, genetics, and intelligence. A risk tool that measures dynamic factors that change over time, as well as historical factors, could capture a measure of risk at a point in time. The measure should present treatment options, rather than just measure risk. CARE is such a tool.

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