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Risk assessment instruments have become a preferred means for predicting
future aggression, claiming to predict long-term aggression risk.
To investigate the predictive value over 12 months and 4 years of two
commonly applied instruments (Historical, Clinical and Risk Management -
20 (HCR-20) and Violence Risk Appraisal Guide (VRAG)).
Participants were adult male psychiatric patients detained in a high
secure hospital. All had a diagnosis of personality disorder. The focus
was on aggression in hospital.
The actuarial risk assessment (VRAG) was generally performing better than
the structured risk assessment (HCR-20), although neither approach
performed particularly well overall. Any value in their predictive
potential appeared focused on the longer time period under study (4
years) and was specific to certain types of aggression.
The value of these instruments for assessing aggression in hospital among
patients with personality disorder in a high secure psychiatric setting
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