Study: Risk tools don't work with psychopaths

If you want to know whether that psychopathic fellow sitting across the table from you will commit a violent crime within the next three years, you might as well flip a coin as use a violence risk assessment tool.

Popular risk assessment instruments such as the HCR-20 and the VRAG perform no better than chance in predicting risk among prisoners high in psychopathy, according to a new study published in the British Journal of Psychiatry. The study followed a large, high-risk sample of released male prisoners in England and Wales.

Risk assessment tools performed fairly well for men with no mental disorder. Utility was decreased for men diagnosed with schizophrenia or depression, became worse yet for those with substance abuse, and ranged from poor to no better than chance for individuals with personality disorders. But the instruments bombed completely when it came to men with high scores on the Psychopathy Checklist-Revised (PCL-R) (which, as regular readers of this blog know, has real-world validity problems all its own). 

"Our findings have major implications for risk assessment in criminal populations," noted study authors Jeremy Coid, Simone Ullrich and Constantinos Kallis. "Routine use of these risk assessment instruments will have major limitations in settings with high prevalence of severe personality disorder, such as secure psychiatric hospitals and prisons."

The study, "Predicting future violence among individuals with psychopathy," may be requested from the first author, Jeremy Coid (click HERE).