Calvin M. Langton

Evaluating the Predictive Accuracy of Six Risk Assessment Instruments for Adult Sex Offenders

Five actuarial instruments and one guided clinical instrument designed to assess risk for recidivism were compared on 215 sex offenders released from prison for an average of 4.5 years. The Violence Risk Appraisal Guide, Sex Offender Risk Appraisal Guide, Rapid Risk Assessment of Sexual Offense Recidivism, and Static-99 predicted general recidivism, serious (violent and sexual) recidivism, and sexual recidivism. The Minnesota Sex Offender Screening Tool–Revised and a guided clinical assessment (Multifactorial Assessment of Sex Offender Risk for Recidivism) predicted general recidivism but did not significantly predict serious or sexual recidivism. On its own, the Psychopathy Checklist–Revised predicted general and serious recidivism but not sexual recidivism. The results support the utility of an actuarial approach to risk assessment of sex offenders.

Actuarial assessment of risk for reoffense among adult sex offenders: evaluating the predictive accuracy of the Static-2002 and five other instruments

This study extended previous research comparing a set of widely employed actuarial risk assessment schemes as well as a new instrument, the Static-2002, in a sample of 468 sex offenders followed for an average of 5.9 years. All of the risk assessment instruments (Violence Risk Appraisal Guide [VRAG], Sex Offender Risk Appraisal Guide [SORAG], Rapid Risk Assessment for Sex Offense Recidivism [RRASOR], Static-99, Static-2002, and Minnesota Sex Offender Screening Tool-Revised [MnSOST-R]) were found to predict the recidivism outcomes for which they were designed. Although significant, indices of accuracy were generally lower than those reported by the developers of these instruments, even under conditions that have been shown to optimize predictive performance. For serious recidivism, the predictive accuracy of the Static-2002 and SORAG was significantly superior to that of the RRASOR, and the SORAG was significantly superior to the MnSOST-R as well. There were no significant differences among instruments in accuracy of predicting sexual recidivism.

Denial and minimization among sexual offenders: posttreatment presentation and association with sexual recidivism

The relationship between sexual recidivism and posttreatment denial and minimization was examined among 436 sex offenders followed up for an average period of more than 5 years. Treatment completion status and psychopathic traits, both established predictors of sexual recidivism also associated with denial and minimization, were included in survival analyses to remove their confounding influence on the focal relationships. The potential role of actuarial risk as a moderating variable was also investigated. A dichotomous variable reflecting denial and minimization failed to predict sexual recidivism. However, among a subset of 102 sex offenders who received no additional treatment after completing an initial program, the interaction between actuarial risk and scores on a continuous measure of minimization predicted sexual recidivism. Implications for assessment, particularly the need to move beyond dichotomous operationalizations of denial and minimization, and treatment were discussed.

Reliability and Validity of the Static-2002 Among Adult Sexual Offenders With Reference to Treatment Status

Psychometric properties were reported for the Static-2002 using a sample of 464 sexual offenders followed for an average of 5.9 years after release. Correlations between theoretically relevant variables (using indices of lifestyle instability, sexual deviance, psychopathy) and the Static-2002 content area subscales reflected the conceptual emphasis underlying the content areas. An exploratory factor analysis revealed a five-factor solution generally congruent with the conceptual structure of the Static-2002. Survival analyses indicated not all of the content areas had incremental validity in the prediction of either sexual or any violent recidivism. Moderate-to-high levels of predictive accuracy for total score were achieved for treatment completers, dropouts, and refusers across four recidivism outcomes. Three risk categories were identified with significantly different rates of both sexual and any violent recidivism; failure rates and likelihood ratios for these risk categories over 5-, 7-, and 10-year follow-up periods were reported.

Predicting Recidivism in Sex Offenders Using the VRAG and SORAG: The Contribution of Age-at-Release

Sex offenders (N = 468) were released from custody and recidivism outcome recorded. The Violence Risk Appraisal Guide (VRAG) and Sex Offender Risk Appraisal Guide (SORAG) were scored for each offender. Results indicated that, for the majority of actuarial items contained in the VRAG and SORAG and for VRAG and SORAG bin scores, offenders with lower actuarial scores were released from custody at a significantly older age. Actuarial scores were regressed on age-at-release and residuals saved as age-corrected actuarial scores. Using ROC analysis, predictive accuracy was evaluated comparing original actuarial scores with age-corrected scores. For most item scores and both bin scores, the ability to predict recidivism was significantly reduced after the effects of age-at-release had been removed.

Predicting Recidivism in Sex Offenders Using the SVR-20: The Contribution of Age-at-release

Sex offenders (N = 468) were released from custody and recidivism outcome was recorded. The Sexual Violence Risk-20 (SVR-20) was scored for each offender and the relationship between age-at-release and SVR-20 item and total scores was examined. SVR-20 total scores were not correlated with age-at-release (r = .-057). SVR-20 scores were combined with a score representing the age of the offender at their release from custody. On the basis of ROC analysis, predictive accuracy was significantly enhanced when age-atrelease was included in the risk score. We suggest that the SVR-20, and perhaps other similar risk instruments, could be improved by including age-at-release information. We discuss the possibility that the advantage obtained by empirical actuarial instruments may be due in part to their close relation with age-at-release.

Assessment and Treatment of Adolescents Who Sexually Offend Clinical Issues and Implications for Secure Settings

Some adolescents who have committed a sexual crime are placed by the courts in secure residential settings. Given the heterogeneity of this client group, it is important for clinicians in these settings to complete comprehensive assessments to determine the course and content of specialized treatment, if necessary. With a focus on residential care, suggestions are provided for the assessment of strengths, risks, and needs. Particular attention is paid to issues related to informed consent, interviewing, and risk assessment. Also reviewed are various treatment issues with implications in secure settings, including the delivery of therapeutic services, use of manuals, therapeutic relationships and context, and self-care for providers. The growing evidence base for cognitive-behavioral treatment for adolescents who have sexually offended is outlined, and common treatment goals for youth who have offended sexually are critically examined. With an emphasis on treatment tailored to the unique needs of each adolescent, suggestions are offered regarding goals such as increasing accountability, recovery from posttraumatic distress, developing offense-prevention strategies, and enhancing awareness of victim impact, prosocial sexual attitudes, and healthy sexual interests. Additional issues that are considered with implications for clinicians working in secure settings include sibling sexual abuse and offenses involving child abuse imagery.

Mental Health Diagnoses and Recidivism in Paroled Offenders

Although the issue of mental illness among offender populations has received attention in the last number of years, there are a number of issues related to mental illness among such groups that require more study. One such topic relates to the association between mental illness, actuarially assessed risk of recidivism, and observed rates of reoffending. In the present investigation, file information was reviewed to determine the presence of a variety of mental health conditions. Actuarially based risk assessment data were also collected for participants as well as information regarding suspension, new charges, and convictions. A sample of 136 offenders housed in a halfway house operated by Correctional Service of Canada was included in the present investigation. Results indicated very high rates of serious mental illness in this high-risk population. Offenders with borderline personality disorder and attention deficit hyperactivity disorder were significantly more likely to recidivate or be suspended. Suspensions refer to administrative decisions to place an offender in jail due to problematic behaviour (typically involving a breach of his release conditions or new charges/convictions). Offenders with a diagnosis of paraphilic disorder were significantly less likely to recidivate or be suspended. Results are discussed in light of the available literature.

Personality Traits as Predictors of Inpatient Aggression in a High-Security Forensic Psychiatric Setting: Prospective Evaluation of the PCL-R and IPDE Dimension Ratings

The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist—Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.

Prediction of institutional aggression among personality disordered forensic patients using actuarial and structured clinical risk assessment tools: prospective evaluation of the HCR-20, VRS, Static-99, and Risk Matrix 2000

Abstract Entry to the Dangerous and Severe Personality Disorder (DSPD) service in England and Wales is heavily determined by risk status, and therefore requires valid procedures for monitoring changes in risk over time in order to make risk management decisions and determine patients’ suitability for transfer to lower security settings. Yet little is known about the validity of current risk assessment tools with the new DSPD population. This study reports a prospective evaluation of the predictive accuracy of the HCR-20, VRS, Static-99, and Risk Matrix 2000 with 44 consecutive admissions to the DSPD unit at a high secure forensic psychiatric hospital. Thirty eight per cent of the sample exhibited interpersonal physical aggression (IPA) on one or more instances over an average 1.5 year period following admission, and a similar percentage caused damage to property (DTP) on one or more occasions over the same period. All tools predicted DTP. HCR-20 Total and scale scores predicted IPA with structured final risk judgements also predicting repetitive (2 + incidents of) IPA. HCR-20 Risk Management scores were significantly associated with imminence of IPA. Results were discussed in terms of the practical utility of these tools with high risk forensic psychiatric inpatients.