The Predictive Validity of the HCR20v3 to Forensic Inpatient Violence
Research type
Research Study
Full title
The Predictive Validity of the HCR20v3 within Scottish Forensic Inpatient Facilities: A Closer Look at Key Demographic and Clinical Variables.
IRAS ID
187594
Contact name
Kerry Johanna Smith
Contact email
Sponsor organisation
The State Hospital Carstairs
Duration of Study in the UK
1 years, 10 months, 21 days
Research summary
The proposed study aims to assess the predictive validity of the Historical Clinical Risk-Management-20 version 3 (HCR20v3;Douglas et al, 2013)with regards to forensic inpatient violence within Scottish high and medium secure facilities. HCR20 version 2 was the most frequently used violence risk-assessment tool available and showed acceptable predictive accuracy for forensic inpatient violence. However, very few studies have tested the predictive accuracy of HCR20v3 and no study has been conducted with forensic inpatients. Subsequently, there is a gap in the evidence base for the use of HCR20v3 with forensic inpatients which the proposed study aims to fill. Furthermore, it remains useful to understand relationships between demographic variables and inpatient violence. At present, these are unclear, with current research lending support instead to clinical variables in violence prediction. The proposed study then aims to understand the relevance of key demographic variables in forensic inpatient violence prediction. Lastly, in forensic inpatients, the clinical (C) scale of HCR20v2 was frequently found to be the strongest predictor of violence. However, alongside HCR20v3’s C scale remaining untested with this patient group, in patients with schizophrenia who typically make up the majority of forensic inpatients, knowledge is limited around relationships between variables implicated within C scale items and violence. In particular, previous studies have found ‘insight’ (assessed within item C1) to be predictive of violence, however alternative studies have failed to replicate these findings. Similarly, within item C3 (symptoms of major mental disorder) lack of clarity exists regarding relationships between positive psychotic symptoms and violence. Notably, a lack of evidence exists generally between insight and positive symptoms and forensic inpatient violence specifically, with the majority of studies conducted with civil-psychiatric and community samples. This study therefore also hopes to clarify the predictive abilities of positive symptoms and insight towards violence in forensic inpatients with schizophrenia.
REC name
London - City & East Research Ethics Committee
REC reference
15/LO/1874
Date of REC Opinion
19 Oct 2015
REC opinion
Favourable Opinion