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J Am Acad Psychiatry Law. 2019 May 16. pii: JAAPL.003843-19. doi: 10.29158/JAAPL.003843-19. [Epub ahead of print]

Assessing Inpatient Victimization Risk Among Insanity Acquittees Using the HCR-20V3.

Author information

1
Dr. Grossi is a Licensed Clinical Psychologist, and Dr. Griswold is a Postdoctoral Fellow, Eastern State Hospital, Williamsburg, Virginia. Dr. Green is a Licensed Clinical Psychologist in independent practice. Ms. Cabeldue is a Doctoral Candidate, Fairleigh Dickinson University, Teaneck, New Jersey. Dr. Belfi is Clinical Instructor, Department of Psychiatry, NYU School of Medicine, and Deputy Director of Operations, Kirby Forensic Psychiatric Center, New York, New York. A portion of this paper was presented at the American Psychology-Law Society Conference, Seattle, Washington, March 2017. This work was supported in part by a grant from the American Academy of Psychiatry and the Law Institute for Education and Research. lauramgrossi@gmail.com.
2
Dr. Grossi is a Licensed Clinical Psychologist, and Dr. Griswold is a Postdoctoral Fellow, Eastern State Hospital, Williamsburg, Virginia. Dr. Green is a Licensed Clinical Psychologist in independent practice. Ms. Cabeldue is a Doctoral Candidate, Fairleigh Dickinson University, Teaneck, New Jersey. Dr. Belfi is Clinical Instructor, Department of Psychiatry, NYU School of Medicine, and Deputy Director of Operations, Kirby Forensic Psychiatric Center, New York, New York. A portion of this paper was presented at the American Psychology-Law Society Conference, Seattle, Washington, March 2017. This work was supported in part by a grant from the American Academy of Psychiatry and the Law Institute for Education and Research.

Abstract

Victimization of individuals with mental illness may involve serious emotional or physical injury to already vulnerable persons. Further, victimization may contribute to subsequent victimization experiences, exacerbate psychiatric symptoms, and prolong hospitalization, among other undesirable secondary outcomes. Nonetheless, limited prior research has focused on predicting victimization in forensic psychiatric settings, and no research has attempted to do so with the Historical, Clinical, Risk Management-20 Version 3 (HCR-20V3) tool. This study involved retrospective ratings of the HCR-20V3 for 169 hospitalized insanity acquittees and examined the utility of HCR-20V3 ratings in predicting victimization. Although the HCR-20V3 was not explicitly developed to aid in evaluations of victimization risk, other structured professional judgment tools intended to predict violence risk have demonstrated potential for predicting victimization, due to the existence of common risk factors and overlap between patients who engage in violence and those who are victimized. Results from this study suggest that evaluators may consider the Clinical scale score of the HCR-20V3 and elevations on its items assessing violent ideation or intent, instability, and treatment or supervision response in identifying those at increased risk for future victimization. The Historical and Risk Management scales were less relevant in predicting victimization.

PMID:
31097527
DOI:
10.29158/JAAPL.003843-19

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