Screening for Risk of Inpatient Violence

• NCJ Number: 152064
• Journal: Law and Human Behavior Volume: 18 Issue: 5 Dated: (October 1994) Pages: 579-586
• Author(s): D E McNiel; R L Binder
• Date Published: 1994
• Length: 8 pages
• Grant Number(s): SO7-RR05775
• Sponsoring Agency: National Institutes of Health
• Publication Format: Article
• Publication Type: Research (Applied/Empirical)
• Language: English
• Country: United States of America
• Note: Portions of paper presented at the American Psychology-Law Society Biennial Meeting, 1992, San Diego

Annotation

A screening checklist for assessing the risk of violence at the time of psychiatric hospitalization was developed; checklist items and a cutoff point for low versus high risk of violence were selected based on a previous statistical study of violence prediction.

Abstract

The checklist was based on five correlates of violent behavior: history of physical attacks and/or fear-inducing behavior within 2 weeks before admission, absence of suicidal behavior, schizophrenic or manic diagnosis, male gender, and currently married or living together. Violence during hospitalization was measured using the Overt Aggression Scale. Application of the checklist to a sample of 338 patients admitted to a university-based inpatient unit revealed promising results in identifying patients who later displayed aggressive behavior in the hospital, as indicated by its positive predictive value (59 percent), negative predictive value (70.6 percent), sensitivity (57.2 percent), specificity (70 percent), total predictive value (65.4 percent), and likelihood ratio (1.97). Results demonstrated the potential value of incorporating actuarial methods in evaluating violence risk. By systematically including proven correlates of violent behavior, screening checklists served to ensure that clinical decisionmaking for individual patients took these correlates into account. 28 references and 2 tables