Convergent and predictive properties of three risk assessment instruments in a Canadian forensic mental health sample

The use of risk assessment instruments is essential for the assessment, treatment, and management of violence risk; it is thus critical to examine their properties when implemented in novel settings with diverse forensic subpopulations. This study evaluated the convergent and predictive properties o...

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Authors: Cheng, Jeremy Chi Yeung (Author) ; Olver, Mark E. (Author) ; Haag, Andrew M. (Author) ; Wormith, J. S. (Author)
Format: Electronic Article
Language:English
Published: 2025
In: The journal of forensic psychiatry & psychology
Year: 2025, Volume: 36, Issue: 4, Pages: 526-549
Online Access: Volltext (lizenzpflichtig)
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520 |a The use of risk assessment instruments is essential for the assessment, treatment, and management of violence risk; it is thus critical to examine their properties when implemented in novel settings with diverse forensic subpopulations. This study evaluated the convergent and predictive properties of three risk assessment instruments in a sample of 109 forensic patients found Not Criminally Responsible on Account of Mental Disorder (NCR). A retrospective longitudinal cohort design was employed to examine the Historical Clinical Risk Management-20 Version 3 (HCR-20V3), Revised Violence Risk Appraisal Guide (VRAG-R), and Level of Service/Case Management Inventory (LS/CMI) rated from archived hospital records. LS/CMI risk scores and risk bands predicted general (area under the curve [AUC] = .70–.73) and violent (AUC = .76–.91) recidivism with moderate to large effects and performed similarly to the VRAG-R and HCR-20V3. Calibration analyses demonstrated that LS/CMI scores overpredicted the risk of general recidivism in Moderate to Very High risk bands. Results supported the convergent validity and discrimination properties of study measures; however, mixed evidence was found for the calibration properties of the LS/CMI. The potential utility of risk instruments in the appraisal and management of offending behavior among forensic mental health patients is discussed. 
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