Long-awaited HCR-20 update to premiere in Scotland

The long-awaited international launch of the third version of the popular HCR-20 violence risk assessment instrument has been announced for next April in Edinburgh, Scotland.

The HCR-20 is an evidence-based tool using the structured professional judgment method, an alternative to the actuarial method that predicts violence at least as well while giving a more nuanced and individualized understanding. It has been evaluated in 32 different countries and translated into 18 languages.

A lot has changed in the world of risk prediction since the second edition premiered 15 years ago. Perhaps the major change in the third edition is the elimination of the need to incorporate a Psychopathy Checklist (PCL-R) score; research determined that this did not add to the instrument's predictive validity. Additionally, like the sister instrument for sex offender risk assessment, the RSVP, the HCR:V3 will focus more heavily on formulating plans to manage and reduce a person's risk, rather than merely predicting violence.

The revision process took four years, with beta testing in England, Holland, Sweden and Germany. Initial reports show very high correlations with the second edition of the HCR-20, excellent interrater reliability, and promising validity as a violence prediction tool.

The HCR:V3 will be launched at a one-day conference jointly organized by The Royal Society of Edinburgh and Violence Risk Assessment Training. Developers Christopher Webster, Stephen Hart and Kevin Douglas will be on hand to describe the research on the new instrument and its utility in violence risk assessment.

More information on the April 15, 2013 training conference is available HERE. A Webinar PowerPoint on the revision process is HERE.

Violence risk instruments overpredicting danger

Tools better at screening for low risk than pinpointing high risk 

The team of Seena Fazel and Jay Singh are at it again, bringing us yet another gigantic review of studies on the accuracy of the most widely used instruments for assessing risk of violence and sexual recidivism.

This time, the prolific researchers -- joined by UK statistician Helen Doll and Swedish professor Martin Grann -- report on a total of 73 research samples comprising 24,847 people from 13 countries. Cumulatively, the samples had a high base rate of reoffense, with almost one in four reoffending over an average of about four years.

Bottom line: Risk assessment instruments are fairly good at identifying low risk individuals, but their high rates of false positives -- people falsely flagged as recidivists -- make them inappropriate “as sole determinants of detention, sentencing, and release.”

In all, about four out of ten of those individuals judged to be at moderate to high risk of future violence went on to violently offend. Prediction of sexual reoffense was even poorer, with less than one out of four of those judged to be at moderate to high risk going on to sexually offend. In samples with lower base rates, the researchers pointed out, predictive accuracy will be even poorer.

What that means, in practical terms, is that to stop one person who will go on to become violent again in the future, society must lock up at minimum one person who will NOT; for sex offenders, at least three non-recidivists must be detained for every recidivist. This, of course, is problematic from a human rights standpoint. 

Another key finding that goes against conventional wisdom was that actuarial instruments that focus on historical risk factors perform no better than tools based on clinical judgment, a finding contrary to some previous review.

The researchers included the nine most commonly used risk assessment tools, out of the many dozens that have now been developed around the world:

• Level of Service Inventory-Revised (LSI-R) 
• Psychopathy Checklist-Revised (PCL-R) 
• Sex Offender Risk Appraisal Guide (SORAG) 
• Static-99 
• Violence Risk Appraisal Guide (VRAG) 
• Historical, Clinical, Risk management-20 (HCR-20) 
• Sexual Violence Risk-20 (SVR-20) 
• Spousal Assault Risk Assessment (SARA) 
• Structured Assessment of Violence Risk in Youth (SAVRY) 

Team leader Fazel, of Oxford University, and colleagues stressed several key implications of their findings:

One implication of these findings is that, even after 30 years of development, the view that violence, sexual, or criminal risk can be predicted in most cases is not evidence based. This message is important for the general public, media, and some administrations who may have unrealistic expectations of risk prediction for clinicians. 

A second and related implication is that these tools are not sufficient on their own for the purposes of risk assessment. In some criminal justice systems, expert testimony commonly uses scores from these instruments in a simplistic way to estimate an individual’s risk of serious repeat offending. However, our review suggests that risk assessment tools in their current form can only be used to roughly classify individuals at the group level, and not to safely determine criminal prognosis in an individual case. 

Finally, our review suggests that these instruments should be used differently. Since they had higher negative predictive values, one potential approach would be to use them to screen out low risk individuals. Researchers and policy makers could use the number safely discharged to determine the potential screening use of any particular tool, although its use could be limited for clinicians depending on the immediate and service consequences of false positives. 

A further caveat is that specificities were not high -- therefore, although the decision maker can be confident that a person is truly low risk if screened out, when someone fails to be screened out as low risk, doctors cannot be certain that this person is not low risk. In other words, many individuals assessed as being at moderate or high risk could be, in fact, low risk. 

The study, Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24,827 people: systematic review and meta-analysis, is published in the British Medical Journal and is freely available online (HERE).

My blog post on these researchers' previous meta-analytic study, Violence risk meta-meta: Instrument choice does matter, is HERE.

The homicidal triad: Predictor of violence or urban myth?

For at least half a century, legend has told of a "triad" of ominous childhood behaviors -- cruelty to animals, firesetting, and enuresis – said to predict future violence.

The so-called "Macdonald triad" (also known as the homicidal triad or the Hellman and Blackman triad) is taught in criminology and psychology courses, used by forensic practitioners in assessing risk, and has even made its way into Law and Order: Special Victims Unit. Especially, it’s become a staple among aficionados of the trendy serial killer.

But is the syndrome valid?

Providing the most definitive exploration to date is Kori Ryan, a former criminology student at the California State University, Fresno who delved into the "evolutionary history" of this tantalizing construct for her as-yet unpublished master's thesis. Her ultimate conclusion:

Even though the literature on violent behavior contains many references to the Macdonald triad (and its aliases), collectively these studies do not provide sufficient evidence of its ability to predict violence, nor, in fact, of its existence as a bona fide phenomenon.

Instead, childhood enuresis, firesetting and animal cruelty more likely represent three among many indicators of severe childhood abuse. In other words, the presence of one or more of these elements in the histories of some violent offenders can be explained by the fact that violent offenders are often the products of child abuse. More importantly, relying upon these behaviors as predictors of future violence would lead to many false positives, punishing children who might not be violent in the future.

One of many misleading websites

Roots of the legend 

Gulliver's Travels

Forensic psychiatrist John Macdonald is generally credited with "discovering" the triad. In a 1963 article in the American Journal of Psychiatry, entitled "The Threat to Kill," he gave his clinical impression that "a history of great parental brutality, extreme maternal seduction, or the triad of childhood firesetting, cruelty to animals and enuresis" can signal those who will eventually threaten homicide. His article was based on his work with 100 patients at the Colorado Psychopathic Hospital in Denver, Colorado who had threatened -- but not necessarily committed -- violence. 

Over the next few decades, the idea "attracted a dedicated following" and gradually expanded to encompass various forensic groups, including sexual sadists, recidivist firesetters and -- most salacious -- serial killers.

Ryan traces the history of cultural interest in these behaviors all the way back to Greek mythology and early Western fiction, such as Jonathan Swift's 1726 Gulliver's Travels, in which Gulliver puts out a fire with his own urine, much to the chagrin of the Imperial Majesty, thereby linking urination with fire and revenge.

Early psychoanalytic thinkers also placed heavy emphasis on these behaviors, seeing them as products of arrested psychosexual development and sublimated sexual and sadistic urges. Psychoanalyst Melanie Klein, for example, saw bedwetting as a daughter’s sadistic revenge against her mother.

Empirical research: Triad goes bust

Two psychiatrists were the first to empirically evaluate the Macdonald triad, according to Ryan. Studying 84 incarcerated offenders in 1966, Hellman and Blackman reported a positive association between the triad and future violence. Accordingly, some took to labeling the phenomenon as the “"Hellman and Blackman triad."

But subsequent attempts to replicate Hellman and Blackman's findings were unsuccessful. Even John Macdonald himself voiced later doubt about the triad's validity. After trying to test his own clinical theory, Macdonald reported in his 1968 book, Homicidal Threats, that he could find no statistically significant association between homicide perpetrators and early problems with firesetting, cruelty to animals, or enuresis.

Likewise, in an examination of 206 sex offenders at the Massachusetts Treatment Center for Sexual Dangerous Persons, Prentky and Carter (1984) found "no compelling evidence" for the idea that the triad predicted adult criminality. They did, however, note that the individual components of the triad were common among people raised in highly abusive home environments.

Some years later, this was also the conclusion of Jonathan Pincus, in his 2001 book on convicted murderers. Pincus described "a forensic assessment protocol in which bed-wetting, firesetting, and cruelty to animals (among other behaviors) are considered 'hallmarks' of childhood abuse," notes Ryan.

Indeed, it seems far more likely that one of Macdonald’s five original indicators that didn’t go on to fame has more explanatory power as a cause of later violence: parental brutality.

Dangerous ramifications

"The frequency with which discussions of violent offenders (of various types) include mention of the Macdonald triad suggests its general acceptance as a predictor of violent behavior," notes Ryan.

This continuing prominence owes in large part to the triad's promotion by prominent FBI profilers in the 1988 book, Sexual Homicide: Patterns and Motives. Like Macdonald’s, the FBI study was anecdotal, small-scale and lacking in any statistical analyses or control groups. Studying 36 sex killers, Douglas, Burgess and Ressler found that many manifested one or more elements of the triad. Unfortunately, notes Ryan, the authors did not report which factors were present in which subjects, or how many of these killers evidenced all three components of the triad.

Ryan warns that promotion of the triad has real-world ramifications, in that children who exhibit one or more of these behaviors "might be falsely labeled as potentially dangerous."

For example, police officers exposed to the triad in undergraduate criminology courses may target young offenders who have lit a fire or harmed an animal -- both fairly common behaviors among troubled youth -- as future sex fiends or serial killers. (Enuresis, with less face validity as an indicator of sadism, has tended to drop from more contemporary renditions of the triad.)

Ignoring the miniscule base rate of serial killers, even veterinarians are encouraged to identify those who hurt pet animals as potentially lethal: "Many known serial killers began their careers by hurting pet animals," warn the authors of a 2004 article in one veterinary journal. "It is well known in the criminology field that people who perpetrate acts of cruelty on animals, frequently escalate to torturing humans, usually the young and helpless."

Rather than throwing the baby out with the bathwater, Ryan says researchers could do more research to understand these behaviors in context. For example, might arson be a coping mechanism in children who have experienced severe emotional abuse, rather than a marker for future aggression? Are some elements of the triad indicators for future violence when they co-occur? More fundamentally, is there any set of behaviors that can legitimately be considered a behavioral syndrome predictive of later violence?

The study is: The Macdonald triad: Predictor of violence or urban myth? The abstract is HERE; the full text can be requested from the author via ResearchGate (HERE). The author, Kori Ryan, can be contacted HERE.*

*Links updated 12/1/16.

Good tidings: Violence at all-time low

How does this sound for entertainment: Your date asks you out to the theater to watch a live cat slowly lowered into a fire and burned to death, howling with pain as it is singed, roasted, and finally carbonized?

If that isn't your idea of a good time, don't hop into the next time machine heading back to medieval Europe.

In 16th-century Paris, throngs –- including kings and queens -- flocked to watch such gruesome spectacles, shrieking with laughter as cats and other animals were tortured to death on stage.

"The Catherine Wheel"

Torture and violence were woven into the fabric of life, from the sexualized sadism of London, where elaborately designed and decorated torture devices were the pinnacle of artistic creativity, to the widespread practice of hacking off the nose of anyone who disrespected you (the source of the strange idiom, "to cut off your nose to spite your face").

In contrast, whether we know it or not, we are now enjoying the most peaceful period in all of human history. Indeed, the precipitous decline in violence of all types may be “the most significant and least appreciated development in the history of our species,” argues Steven Pinker, a renowned professor of psychology at Harvard University, in an epic tome, The Better Angels of Our Nature: Why Violence Has Declined.

"The Judas Cradle"

Given the tenor of the daily news headlines, Pinker knows his claim sounds far-fetched. But in 800 pages of research and analysis, augmented by hundreds of charts and tables, he convincingly establishes that violence is indeed heading in one direction: down.

The decline is drastic across-the-board, in both state-sanctioned and individual violence: International wars, civil wars, terrorism (an obsession far out of proportion to its prevalence), slavery, sexual violence, child abuse, infanticide....

Click HERE to read my full Amazon review of this recommended text. If you appreciate the review, please click on "yes."

Predicting behavior: The case of the missing militant

There is an oft-repeated axiom in our field that the most reliable predictor of future behavior is what a person has done in the past.

But is this axiom valid?

Let's take the example of Ronald Stanley Bridgeforth, featured on America's Most Wanted.

Forty-three years ago, while being detained on suspicion of trying to buy merchandise with a stolen credit card, the 24-year-old Black militant pulled out a revolver and shot at police. He jumped bail and, three years later, became a suspect in the killing of a police sergeant during an armed invasion of a police station in San Francisco.

Would this information lead you to predict that he was likely to engage in more violence in the future?

If so, you would be wrong.

Bridgeforth vanished from the radar screen, and eventually police figured he might have died. But the former community activist was far from dead. After fleeing to Africa, he moved to Ann Arbor, Michigan, married, and raised two sons. Under the assumed name of Cole Jordan, he worked as a janitor, earned a bachelor’s degree from Wayne State University and a master's degree in counseling from Eastern Michigan University, became a licensed professional counselor, and eventually worked his way up to the rank of a full-time faculty member at Washtenaw Community College.

Bridgeforth with attorney Paul Harris (L) and wife Diane (R)

Last week, Bridgeforth finally turned himself in. Authorities were not closing in, but he had a troubled conscience. He plans to plead guilty in the assault case, in which he faces a maximum of five years in prison. Prosecutors announced they will not prosecute him in the infamous murder of Sgt. John Young at San Francisco's Ingleside Station on Aug. 29, 1971. That case unraveled two years ago in part due to allegations (aired in a documentary, Legacy of Torture) that police used torture with electric shock, cattle prods, beatings, sensory deprivation and asphyxiation to obtain confessions from three of the nine suspects.

One might argue that Bridgeforth is an exception to the rule. Only, he's not. Time and again, we hear about a long-time fugitive who lived a quiet life, surrounded by friends and co-workers who had no clue about his or her violent past.

David Gonzales, William Walter Asher III, Katherine Ann Power, Claude Daniel Marks and Donna Jean Willmott, to name just a few.

These cases are testament to the weak validity of the axiom that past behavior is a good predictor of the future. There are several flaws with the theory, among them:

• The base rate: Most serious crimes have a low base rate of recidivism. That makes us most likely to be correct if we predict that the behavior will NOT reoccur. For example, because of the base rate of rearrest for murder, we would be wrong in the broad majority of cases if we predicted that someone who has killed once will most likely kill again. The same is true for sexual offending. In one recent study, 95 out of 100 people arrested on sex charges had no prior sex crimes; an inordinate focus on the five percent lends an illusion of a higher base rate of reoffending than the evidence warrants.

• Desistance: A second major problem with static predictions is that people change. In fact, even hard-core criminals almost universally desist from crime as they age. This holds true across all eras and cultures. As scholars Shadd Maruna and Laub and Sampson have shown, crime is mainly a young man's game. As they age, offenders settle down and become less impulsive. Or, they simply burn out.

• Environmental context: The axiom of past as prelude also ignores the circumstances that contribute to offending. Criminologists have long known about the critical importance of context. For example, peer influence is critical to crime by adolescents and young adults, who have the highest rates of offending. Lifestyle circumstances that can -- and often do -- change over time influence other types of crimes as well, such as robberies and drug offenses. For Bridgeforth and others of the 1960s-1970s era, the context was a militant revolutionary movement that swept up many idealistic young people.

• Unproven allegations: The Bridgeforth case also highlights the problem of relying on allegations of past misconduct that may not be reliable. Bridgeforth has denied the charge that he was the getaway car driver in the San Francisco police killing, and now prosecutors have chosen not to prosecute him.   

Ultimately, the past-as-prelude axiom may hold better for some behaviors than others. Perhaps it is more reliable when predicting scripted or compulsive acts that a person engages in with high frequency over a lengthy period of time. However, it is less reliable when applied to context-influenced behaviors with low base rates of reoccurrence.

And never should we ignore the influence of aging. Bridgeforth is not the same man at 67 as he was at 24. Think back to your own adolescence or early adulthood; are you the same person now as you were then?

The viewpoint that past is prelude is fundamentally pessimistic, leaving little room to acknowledge that human beings are highly adaptive, and often capable of learning from mistakes and changing our lives.

Call for papers on violence risk assessment

The field of violence risk assessment has expanded rapidly over the past several decades. But despite a plethora of new risk assessment tools, confusion abounds as to how to understand their accuracy and utility. And controversy is growing over how well these tools actually predict violence in the individual case.

To address these gaps, forensic scholars John Petrila and Jay Singh of the University of South Florida have teamed up to edit a special issue of the respected journal, Behavioral Sciences and the Law on the topic of "measuring and interpreting the predictive validity of violence risk assessment."

The goal of the special issue is to provide a comprehensive and accessible resource for researchers, clinicians, and policymakers interested in the measurement of predictive validity or the use of such findings in clinical or legal practice.

The editors invite empirical and conceptual papers on the measurement of predictive validity as it relates to violence risk assessment. In addition, papers focusing on the implications of the measurement of predictive validity for public protection and individual liberty are also welcome, as are legal perspectives on these issues.

Papers should be no longer than 35 pages, including tables, figures and references. The deadline for submissions is July 1, 2012. Authors should send two electronic copies of any submission, one blinded for peer review, to John Petrila, JD or Jay P. Singh, PhD.

Combating the pull to overpredict violence

Like the moon's effect on tides, the pull to overpredict violence exerts a powerful influence, even on seasoned forensic evaluators who know its strength.

When directly informed that an event has a low base rate of occurrence -- for example, that a homicide offender has only a 1 in 100 likelihood of being arrested for another homicide -- both laypeople and professionals will markedly overpredict violence.

In an article in the Journal of the American Academy of Psychiatry and Law, eminent forensic psychologist Stanley Brodsky and postdoctoral fellow Sarah L. Miller analyze why this is so.

For one thing, the risk of underpredicting violence has more potential to negatively impact the evaluator. Bad publicity, public outrage, even civil litigation. Not to mention the harm committed by a high-risk individual who reoffends. 

Far safer to "err on the side of public safety," goes clinical lore. A claim of dangerousness is well nigh impossible to disprove. And especially in the context of civil commitment of sex offenders, the issue is not framed as punishment but, rather, as "an acceptable restriction of individual rights in the interest of public safety and rehabilitation." It's not as if these guys are sympathetic characters, with a constituency of supporters looking out for their rights.

Certain psychological mechanisms also contribute to bias in the direction of overpredicting risk. These include confirmation bias, or seeking information to support a preconceived conclusion, and illusory correlation, in which the evaluator assumes two things are related just because they co-occurred.

The purpose of Brodsky and Miller's well-argued review is to make evaluators more aware of the natural overprediction tendency, and to provide a checklist that evaluators can use to assess and correct their potential biases.

It's a great idea, although I am a bit skeptical that such a simple approach will make much of an impact in the adversarial arena.

The full article is available for free download HERE.

Violence risk in schizophrenics: Are forensic tools reliable predictors?

The high-profile cases of Jared Lee Loughner and Anders Behring Breivik have contributed to high public demand for accurate prediction of violence potential among the mentally ill. While the number of risk assessment tools designed for this purpose has exploded in the past two decades, no systematic review has been conducted to investigate how accurate these tools are for predicting risk in individuals with schizophrenia.

But never fear: Jay Singh of the University of Oxford and colleagues (whose recent meta-review questioned overbroad claims about the accuracy of actuarials in risk assessment) have stepped into the breach, this time examining whether existing tools have proven efficacy for this task.

Reporting in this month's special issue of Schizophrenia Bulletin on violence and schizophrenia, the authors state that despite the existence of at least 158 structured tools for predicting outpatient violence risk, only two studies have measured instruments' predictive validity in discharged patients diagnosed with schizophrenia.

Instead of reporting on instruments' accuracy for specific patient groups, most studies report predictive validity estimates for heterogeneous groups of psychiatric patients. This forces clinicians and the public to assume that these group-level data apply to any individual diagnostic group.This assumption turns out to be a problem, due in part to the large differences in base rates of violence in psychiatric patients. We know, for example, that individuals with substance abuse disorders are more prone to violence, in general, than those diagnosed with major depression.

Examining the psychometric and predictive features of 10 widely used tools for assessing risk in mentally disordered offenders and civil psychiatric patients, the authors found "little direct evidence to support the use of these risk assessment tools in schizophrenia, specifically."

Overall, schizophrenics have low base rates of violence, with an estimated prevalence of between 10 and 15 percent. As I've discussed here in the context of sex offenders, the rarer a behavior is, the harder it is to successfully predict, leading to erroneous predictions of high risk in people who are not truly dangerous. The authors quote another research finding that in order to prevent one stranger homicide by a schizophrenic, governments would need to detain a whopping 35,000 patients.

That sounds to me like a black swan problem.

As in their previous meta-meta-analysis, the authors critique the almost exclusive use of the area under the curve (AUC) statistic to validate risk assessment instruments. Proponents of the AUC like it because it measures predictive utility independent of the base rate of the behavior in question. But this is as much a weakness as a strength, leading to a false sense of confidence in our ability to accurately predict the risk of individuals in heterogeneous groups of patients:

"High" AUC values for heterogeneous groups of psychiatric patients may have led researchers, clinicians, and policymakers to believe that instruments perform well for all diagnostic groups. However, it is problematic to suggest that structured instruments would be able to identify high-risk individuals with the same accuracy in groups with higher and lower base rates of violence.

In another interesting finding, Singh and colleagues found that the item content of violence risk tools varies markedly, with many tools including unique factors not contained in other instruments. This is a problem, unless these items are truly correlated with risk.

The authors call for updated reviews of the risk and protective factors underlying violence in different psychiatric groups -- including, for example, executive dysfunction in schizophrenics -- before additional risk assessment tools are constructed.

The review is available by contacting Dr. Singh (click HERE), who shortly will be coming to America to accept a post with the Mental Health Law and Policy Department of the University of South Florida.

Related blog post: Violence risk meta-meta: Instrument choice does matter (June 19, 2011)

Group rape getting long-overdue spotlight

Groups of men and boys have been raping lone, vulnerable girls and women since time immemorial. (Read Judges 19 in the Old Testament for one chilling account.) In fact, group rape is woven so tightly into the fabric of Western civilization that hardly anyone ever stops to think about it. Until now, that is.

When I did my first literature review of the topic back in 2003, for an article conceptualizing it as a theatrical production of hegemonic masculinity, I was astonished by the paucity of research. That is starting to change, thanks in large part to the tireless efforts of two prolific young scholars in the UK, Miranda Horvath of Middlesex University and Jessica Woodhams of the University of Birmingham.

Horvath and Woodhams secured funding from the British Psychological Society to put together an international consortium of researchers, academics and practitioners to further study the topic. We’re collaborating on an edited volume, which I’m pretty sure will be the first book in the history of the world on the topic of multiple-perpetrator rape. (It’s due out from Routledge in February 2013.)

I’m here in London giving a talk on the role of masculinity and culture in multiple-perpetrator rape, at the second of three research seminars. As I found in an analysis of international media coverage (which I will present in the upcoming book), Western societies display a cultural schizophrenia toward this phenomenon: Even as the public at large condemns group rape, contradictory messages permit and even reinforce it, fueling a cycle of masculine misconduct. 

London after the riots

Piccadilly Circus, 2011 (by K. Franklin)

London is a fitting backdrop for a seminar on group violence. Even as the city frenetically prepares to host the 2012 Olympics, it struggles to regain equilibrium in the wake of last month’s severe and economically costly rioting. 

Yesterday, I watched live BBC coverage of a government hearing into the police response to the rioting. Although the hearing covered a broad range of issues, Britain’s popular media latched onto a quote by Justice Secretary Ken Clarke, blaming the rioting on a "feral underclass." With coded racial language like that, it's no surprise that the rioting has led to increased racial prejudice and xenophobia among the British public, according to a just-released study. A greater number of respondents who felt that British society and culture were under threat are now expressing hostility toward Muslims, blacks and eastern Europeans.

London 2011 (K. Franklin)

Bolstering the racialized image in the public's mind is the much-ballyhooed statistic that three-quarters of those convicted of riot-related crimes had prior criminal records.  Of course, as the police were the first to admit during yesterday’s hearing, those with prior criminal histories were easiest to find, and so were rounded up after the riots. In other words, if you weren’t a known criminal you were less likely to get arrested, thereby producing a misleading statistic.

More broadly, why would anyone be surprised that members of an unemployed and disenfranchised underclass would be the first to rise up in protest over a police killing? Or that the have-nots would seize any opportunity to steal from the haves? Britain's confronting the problem today, but the rioting should serve as a wake-up call to every nation with severe economic and social disparities.

Ironically, by seizing upon the isolated quote and statistic, the popular media distorted what the justice secretary and other government leaders were saying. They were actually promoting the concept of rehabilitation. Calling the penal system "broken," the Secretary commented:

It's no good just punishing them. We're failing to make sure that those that are capable of being reformed are reformed and are actually sorting out their drugs, their drink, given a slightly more sensible approach to the values of society so that at least fewer of them will start causing trouble again the next time they have a chance.

Next up: Sexual violence conference

Stay tuned: Tomorrow I will be giving the opening keynote at a conference on sexual violence prevention, also here at Middlesex University in North London. Time allowing, I'll have more to report from my visit.

Dangerous People: An international discourse

Dangerous People marks an important moment in risk discourse. Leading scholars from around the Western world join together to discuss the problematic science, ethics and morality underlying contemporary approaches to populations deemed high risk. These include not only sex offenders (the focus of this week's New York Times op-ed) but also suspected terrorists, illegal immigrants, violent youth, and the mentally ill.

Not surprisingly, contradictions over risk prediction play out even within the pages of this international and interdisciplinary work. Consider these offerings:

• Forensic psychologist David Cooke and statistician Christine Michie of Scotland issue their strongest warning yet about the fraud being perpetrated by proponents of “actuarial” risk prediction, whose illusion of scientific certainty camouflages predictions that are highly inaccurate and misleading:

At the heart of the matter is the fact that simple linear models cannot explain complex behavior…. Individuals are violent for different reasons: any one individual may be violent for different reasons on different occasions. This inherent complexity dooms simple-minded statistical prediction.... The only way to deal with this complexity is to think psychologically, not statistically.

• Lorraine Johnstone, another Scot, warns that the actuarials' inaccuracies are dangerously magnified with juvenile offenders, who present a "moving target" because they are still in the process of developing.

• Yet, on the other side of the fence, law professor Christopher Slobogin of the USA continues in his vociferous campaign for preventive detention of a litany of groups -- including the mentally ill, enemy combatants, violent juveniles and persons who spread communicable diseases -- based on these very same faulty statistical methods.

Meanwhile, legal scholars Eric Janus and John La Fond continue to shine a spotlight on the United States' costly experiment with civil detention of sex offenders.

Janus's intriguing theory is that the Sexually Violent Predator (SVP) laws are a tool of conservative ideologues to roll back feminist gains in the struggle against sexual violence and gender inequality. He advocates for a return to an empirically guided, public-health approach as the sanest way to combat sexual violence while also safeguarding tax dollars from waste.

"Predictably," agrees La Fond, "the American SVP experiment has been an abysmal and costly failure. Other countries should learn from our terrible mistakes."

Overviews of practices in other Western nations -- including Australia, England and Canada -- suggest that despite this warning, various U.S.-style detention schemes based on remote future risks are gaining traction internationally.

Several chapters in the volume, however, focus on a somewhat different model out of Scotland, the Order for Lifelong Restriction (OLR). This order, rendered at the time of initial sentencing, involves the imposition of an indeterminate sentence to be followed by lifelong supervision. To maximize consistency, risk assessors are accredited by a special Risk Management Authority. Although Scotland abides by the European Convention on Human Rights, which contains a guarantee against arbitrary detention, concerns have been raised about lengthy detention and lifelong sentences for juveniles. Additionally, as the volume editors point out, "it is too early to say whether the Scottish system has been successful in reducing violent and sexual recidivism."

On a somewhat different note, Jennifer Skeem, Jillian Peterson and Eric Silver challenge the widespread assumption that mental illness is a direct cause of criminality in mentally ill offenders. Rather, they say, many mentally ill people may engage in criminal behavior because they are poor, and therefore exposed to contextual risk factors for crime. We should stop regarding mental illness as a master status, they argue, in favor of a more nuanced approach to mentally ill offenders.

Many of the chapters in this timely collection -- edited by Australian legal scholars Bernadette McSherry and Patrick Keyzer -- will no doubt prove prophetic. The current state of fear-based hysteria, like all social movements, will wane in time. Politicians and the public will realize how costly and ineffective are many of the currently cherished practices and will reverse course. As the editors conclude:

What is clear from many of the chapters in this book is that schemes for imprisoning or detaining people for what they might do are costly, likely to contravene international human rights obligations, and have not proven to be effective in reducing crime, particularly sex offences. Detaining more and more people gives rise to the risk that detention regimes will collapse under the weight of numbers.

Yet in the short term, those who most need to hear this collective discourse -- including politicians, judges, prison officials, and even our very own misguided forensic practitioners -- are not listening. Isolated within a like-minded community, they are too busy searching for the magic potion that will make the world safe and appease a frightened public.

My Amazon review is HERE. If you appreciate this review, please go to Amazon and click "Yes" (this review was helpful). 

Violence risk meta-meta: Instrument choice does matter

Despite popularity, psychopathy test and actuarials not superior to other prediction methods 

The past couple of decades have seen an explosion of interest in forensic assessment of risk for future violent and sexual recidivism. Accordingly, evaluators can now choose from an array of more than 120 different risk assessment tools. But should this choice be based on individual preference, or are some instruments clearly superior to others?

Several systematic reviews and metaanalyses have addressed this question, but their conclusions often conflict. In the first systematic review of these reviews (called a “meta-review”), Jay Singh and Seena Fazel of Oxford University found that methodological shortcomings may contribute to the confusion. Problems they identified in the 40 metaanalyses and reviews they studied included authors' failure to adequately describe their study search procedures, failure to check for overlapping samples or publication bias, and failure to investigate the confound of sample heterogeneity.

The Oxford scholars, along with Martin Grann of Sweden's Centre for Violence Prevention, set out to rectify this problem via a more methodologically rigorous meta-review, using optimal data analyses and reporting procedures. For this purpose, they used the Preferred Reporting Items for Systematic Reviews and Metaanalyses, a 27-item checklist designed to enable a transparent and consistent reporting of results.

For their meta-meta (a metaanalysis of the metaanalyses), they collected data from 68 studies involving about 26,000 participants in 13 countries, focusing on the accuracy of the nine most commonly used forensic risk assessment instruments:

• Psychopathy Checklist (PCL-R)
• Static-99
• Historical, Clinical, Risk Management-20 (HCR-20)
• Violence Risk Appraisal Guide (VRAG)
• Sexual Violence Risk-20 (SVR-20)
• Level of Service Inventory (LSI-R)
• Sex Offender Risk Appraisal Guide (SORAG)
• Spousal Assault Risk Assessment (SARA)
• Structured Assessment of Violence Risk in Youth (SAVRY)

Big differences in predictive validity

As it turns out, these widely used instruments vary substantially in predictive accuracy. Performing the best was the SAVRY, a risk assessment instrument designed for use with adolescents. At the bottom were the Level of Service Inventory and the Psychopathy Checklist. This is not too surprising, as the LSI-R is used with a wide variety of general offenders, and the PCL-R was not designed for risk prediction in the first place.

The present metaanalysis would therefore argue against the view of some experts that the PCL- R is unparalleled in its ability to predict future offending.

Statistical method matters: DOR outperforms AUC

The researchers compared several different methods of measuring predictive accuracy. They found that a popular statistic called the Area Under the Curve (AUC) was the weakest. Use of the AUC statistic may help to explain why some metaanalyses were unable to find significant differences among instruments, the authors theorize.

Better methods for comparing instruments’ predictive accuracy include calculating positive and negative predictive values and also using something called the Diagnostic Odds Ratio, or DOR. This is the ratio of the odds of a positive test result in an offender (true positive) relative to the odds of a positive result in a non-offender (false positive). The authors’ summary performance scores pooled results from all four statistical methods.

Actuarials not superior; race also matters

The poor performance of the Psychopathy Checklist (PCL-R) was not the only finding that may surprise some forensic evaluators. The researchers also found no evidence that actuarial tools – such as the widely touted Static-99 – outperform structured clinical judgment methods like the HCR-20 or the SVR-20.

They also found that an offender's race is critical to predictive accuracy. Risk assessment instruments perform best on white offenders, most likely because white offenders predominate in the underlying studies. This is consistent with other research, including a study by Dernevick and colleagues finding that risk assessment instruments are poor at predicting misconduct in terrorists.

Caution is therefore warranted when using any risk assessment tool to predict offending in samples dissimilar to their validation samples, the authors stress.

This systematic review appears to be the most methodologically rigorous such study to date, in a rapidly evolving field. I recommend obtaining both articles (see below for author contact information) and studying them carefully. The stakes are high, and it behooves us to use the instruments that are the most accurate for the specific purpose at hand.

The studies are:

• Singh, J.P., et al., A comparative study of risk assessment tools: A systematic review and metaregression analysis of 68 studies involving 25,980 participants, Clinical Psychology Review (2011), doi:10.1016/j.cpr.2010.11.009. [Contact the author.]

• Singh, J.P. and Fazel, S., Forensic Risk Assessment: A Metareview, Criminal Justice and Behavior (2010) [Contact the author.]

Special journal issue on psychology-law available for free!

A special issue of Current Directions in Psychological Science showcasing the latest psychological research applied to the legal system has received enormous interest. As a result, the editors and Sage Publications are making the full contents available free to the public through June 15, 2011. The articles cover a wide range of topics of interest to my readers, including competency, violence risk assessment, profiling, false confessions, eyewitness evidence, and jury decision making. You are encouraged to download these articles for later reading, and to freely share these links with colleagues. 

  FULL CONTENTS - CLICK ON BELOW LINKS TO DOWNLOAD  

Comment From the Editor
Randall W. Engle
 
Editor's Introduction: Special Issue on Psychology and Law
Ronald P. Fisher
 
Resolving the Offender "Profiling Equations" and the Emergence of an Investigative Psychology  
David V. Canter
 
Forensic Interviewing Aids: Do Props Help Children Answer Questions About Touching?
Debra Ann Poole, Maggie Bruck, and Margaret-Ellen Pipe
 
Interviewing Cooperative Witnesses
Ronald P. Fisher, Rebecca Milne, and Ray Bull
 
Current Issues and Advances in Misinformation Research
Steven J. Frenda, Rebecca M. Nichols, and Elizabeth F. Loftus
 
Eyewitness Identification
Neil Brewer and Gary L. Wells
 
Outsmarting the Liars: Toward a Cognitive Lie Detection Approach
Aldert Vrij, Pär Anders Granhag, Samantha Mann, and Sharon Leal
 
Suspect Interviews and False Confessions
Gisli H. Gudjonsson and John Pearse
 
Current Directions in Violence Risk Assessment
Jennifer L. Skeem and John Monahan
 
Future Directions in the Restoration of Competency to Stand Trial  
Patricia A. Zapf and Ronald Roesch
 
The Utility of Scientific Jury Selection: Still Murky After 30 Years
Joel D. Lieberman
 
Expert Psychological Testimony  
Brian L. Cutler and Margaret Bull Kovera
 
The Psychology of Trial Judging  
Neil Vidmar
 
Jury Decision Making: Implications For and From Psychology
Brian H. Bornstein and Edie Greene

Special issue, Current Directions in Psychological Science

The February issue offers a cutting-edge roundup of psychology-law topics, with contributions from many luminaries. Click on an author link to request a reprint.

• Expert Psychological Testimony by Brian L. Cutler and Margaret Bull Kovera (I haven't finished reading this one yet, but I see that it discusses the critical issue of adversarial allegiance, identified by Murrie, Boccaccini and their colleagues in regard to the Psychopathy Checklist)

• Future Directions in the Restoration of Competency to Stand Trial by Patricia A. Zapf and Ronald Roesch

• Current Directions in Violence Risk Assessment by Jennifer L. Skeem and John Monahan

• The Psychology of Trial Judging by Neil Vidmar

• Jury Decision Making: Implications For and From Psychology by Brian H. Borstein and Edie Greene

• Suspect Interviews and False Confessions by Gisli H. Gudjonsson and John Pearse

• The Utility of Scientific Jury Selection: Still Murky After 30 Years by Joel D. Lieberman

• Resolving the Offender "Profiling Equations" and the Emergence of an Investigative Psychology by David V. Canter

• Forensic Interviewing Aids: Do Props Help Children Answer Questions About Touching? by Debra Ann Poole, Maggie Bruck, Margaret-Ellen Pipe

• Interviewing Cooperative Witnesses by Ronald P. Fisher, Rebecca Milne, and Ray Bull

• Current Issues and Advances in Misinformation Research by Steven J. Frenda, Rebecca M. Nichols, and Elizabeth F. Loftus

• Eyewitness Identification by Neil Brewer and Gary L. Wells

• Outsmarting the Liars: Toward A Cognitive Lie Detection Approach by Aldert Vrjj, Par Anders Granhag, Samantha Mann, and Sharon Leal

Arizona rampage: Analyzing the analyzers

It's an endless loop tape, spinning us in a vortex of irrationality so all-encompassing it almost starts to seem normal.

After every high-profile crime, experts charge out of their corners with their pet solutions: Restrict high-capacity gun magazines. Increase mental health services. Revise school or workplace procedures.

Conservative media psychiatrist Sally Satel is even using the Arizona tragedy as a platform for laws requiring schools and businesses to report to authorities any student or employee who it "ejects or otherwise removes …. out of concern about behavior and dangerousness." Talk about a civil liberties nightmare!

Memorial crime control

Such opportunistic crime-control advocacy works best during moments of public crisis. When the hysteria reaches critical mass, politicians appease anxious constituencies through yet another feel-good law. Then, the latest crisis dies down and people get back to their normal lives. Watching Fox-TV, they remain blissfully shielded from the dark side of memorial crime control.

Rather than capturing the monsters of the public's imagination -- lunatic rampagers, sexual predators, and homicidal gangsters -- this inexorable web of draconian laws ends up ensnaring the most vulnerable, mainly young African American and Latino men from poor communities.

Do you recognize the name Rodrigo Caballero? Unlikely. He is just one tiny speck in a mass of captive and unknown dark bodies, a 16-year-old mentally ill California boy sentenced to 110 years in prison for attempted murder. Any cathartic efforts of memorial crime control are short-lived, while the costly and unanticipated social costs live on. Young Mr. Caballero isn't due out of prison until 2110, long after he and all of the rest of us will be dead.

No profile of would-be assassins

There will always be the next rare event to fuel this cycle of knee-jerk response, ostensibly aimed at protecting us from every remote contingency. Hindsight bias is a powerful heuristic that obscures an unfortunate truth: It is very hard to accurately predict -- much less prevent -- individual-level violence. As I wrote four years ago, after Cho Seung-Hui's deadly rampage at Virginia Tech:

Many people -- and especially many adolescent and young adult men -- are troubled. Many are severely depressed. Many express disturbing, violent fantasies. Fortunately, only a tiny fraction commit lethal acts against others. And unfortunately, those who do often do not stand out ahead of time.

This is what forensic psychologist Robert Fein found when he conducted a Secret Service study of all political assassins and would-be assassins in the United States over the past 60 years. Contrary to popular mythology, the assassins fit no singular "profile." They were neither monsters nor martyrs, Fein said:

The reality of American assassination is much more mundane, more banal, than assassinations depicted [in movies].

The myth of the deranged killer

Jared Loughner’s delusional ramblings, revealed to the world by intrepid Internet sleuths, are the only explanation some people need. But they are something of a red herring.

First, as advocates for the mentally ill are quick to point out, the link between psychosis and violence is far from settled. Most people with severe mental disorders do not become violent. Any increased risk is miniscule compared with the risk posed by use of alcohol or drugs, according to large-scale studies. As Vaughan Bell puts it in his lucid summary of this research:

Psychiatric diagnoses tell us next to nothing about someone's propensity or motive for violence…. It's likely that some of the people in your local bar are at greater risk of committing murder than your average person with mental illness.

But even when an assassin does harbor delusional beliefs, this is not sufficient explanation. Loughner's gender likely played a role, too, as men commit far more violence than women. Yet we would never think we had explained the Tucson rampage with the statement: "Loughner was a man."

In fact, the Secret Service study found that the assassins who were delusional -- about one-fourth of the total -- acted based on the same types of motivations as non-delusional assassins. As reporter Douglas Fox summarized:

Some hoped to achieve notoriety by killing a well-known person. Others wanted to end their pain by being killed by Secret Service. Still others hoped to avenge a perceived, idiosyncratic grievance unrelated to mainstream politics. Some hoped, unrealistically, to save the country or call attention to a cause. And some hoped to achieve a special relationship with the person they were killing.

Selecting one's lens: Micro or macro?

In our professional role, forensic psychologists use a micro lens, focusing on the individual level of analysis. But when commentators focus solely on individual-level factors, they divert the public from contextual factors that may be more amenable to prevention.

In other words, at the micro level there is no question that Loughner is a troubled young man. But at the macro level, his choice of targets certainly reflects the political tensions in the United States and especially in Arizona, which even the local sheriff described as a "Mecca for prejudice and bigotry."

Sarah Palin is able to evade responsibility for her violent rhetoric by strategically refocusing on the culturally entrenched myth of the dangerous schizophrenic, and calling Loughner "deranged" and "evil."

Ironically, it is the mentally unstable like Loughner who are most vulnerable to extremist rhetoric, and other memes floating around in our cultural ethos. As prominent forensic psychologist and law professor Charles Patrick Ewing noted:

These influential politicians and commentators who use violent rhetoric and images -- such as putting a member of Congress in the crosshairs, telling supporters that it is time to 'reload' and suggesting that voters unhappy with Congress resort to 'Second Amendment remedies' -- must realize that they have an incredibly wide audience. At least some members of that audience (both sane and insane) will view their inflammatory statements as an invitation to violence…. The blame for these killings does not lie with the perpetrator alone."

"Stochastic terrorism" is the term invoked by one professor of communications to describe this phenomenon, of "use of mass communications to stir up random lone wolves to carry out violent or terrorist acts that are statistically predictable but individually unpredictable."

What if Abdul had done it?

That the micro lens is a deliberate choice becomes clearer if we ask ourselves how media coverage might be different if a Muslim from the Middle East had shot U.S. Rep. Gabrielle Giffords. Would the focus still be on individual pathology? Or would it be on his political affiliations and the content of his rhetoric?

The din of rhetoric about mental illness drowns out the voices of those framing Loughner's attempted assassination as an act of political terrorism. People like Jesse Muhammed, Sahar Aziz, and Cenk Uygur, who asks incredulously:

Is this a joke? He shot a politician in the head. He called it an "assassination." What part of that was unclear? … [W]hy does the act have to be either psychotic or political? It's obviously both.… The conservative hate-mongers don't create psychos…. [But] they channel their fear, anger and paranoia…. They load them up with violent imagery, whether it's talk of cross-hairs or second amendment remedies or the tree of liberty being refreshed with blood. Then when they get a violent reaction they pretend to be surprised and outraged that anyone would suggest they were the least bit culpable. The reality is that it is a simple formula -- violent imagery in, violent results out.

In the final analysis, the causes of violence are multifaceted and difficult to disentangle. And it is impossible to predict which troubled, angry and alienated young man will engage in lethal violence. But one thing is certain: More laws are not the answer. They cast too wide a net, and distract from the search for deeper solutions.

Related blog posts:

Loughner update: Skirmishing over competency (March 22, 2011) 

Can school shootings be prevented? (April 19, 2007)
Systems failure or black swan? New frame needed to stop memorial crime control frenzy (Oct. 19, 2010)
Backlash growing against criminal profiling (Sept. 14, 2010)