Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-11T17:45:51.563Z Has data issue: false hasContentIssue false
  • English
  • Français

V-RISK-10: Validation of a Screen for Risk of Violence After Discharge from Acute Psychiatry

Published online by Cambridge University Press:  08 July 2010

J.O. Roaldset ,
P. Hartvig  and
S. Bjørkly
J.O. Roaldset*
Affiliation:
Psychiatric Department, Ålesund Hospital, 6026Ålesund, Norway Faculty of Medicine, The Norwegian University of Science and Technology, 7489 Trondheim, Norway
P. Hartvig
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway
S. Bjørkly
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway Institute of Health and Social Sciences, Molde University College, Norway, Box 2110, 6402 Molde, Norway
*
⁎johnolr@gmail.comjohn.olav.roaldset@helse-sunnmore.no
Get access

Abstract

Background

Current violence risk assessment instruments are time-consuming and mainly developed for forensic psychiatry. A paucity of violence screens for acute psychiatry instigated the development and validation of the V-RISK-10. The aim of this prospective naturalistic study was to test the predictive validity of the V-RISK-10 as a screen of violence risk after discharge from two acute psychiatric wards.

Methods

Patients were screened with V-RISK-10 before discharge, and incidents of violence were recorded 3, 6, 9 and 12 months after discharge. A total of 381 of the 1017 patients that were screened completed the follow up.

Results

The ROC-AUC values for any violent behaviour were 0.80 and 0.75 (p < 0.001) for the 3 and 12 months follow-up periods, respectively, and significant for both genders. The most accurate risk estimates were obtained for severe violence. For persons without a known history of violence prior to the screening, AUCs were 0.74 (p = 0.004) and 0.68 (p = 0.002).

Conclusions

Results indicate that the V-RISK-10 is a valid and clinically useful screen for violence risk after discharge from acute psychiatry, and even significant for patients without a known previous history of violence.

Keywords

Violence risk assessmentScreeningEmergency psychiatryProspective
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 2 , March 2011 , pp. 85 - 91
Copyright
Copyright © Elsevier Masson SAS 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Banks, S.Robbins, P.C.Silver, E.Vesselinov, R.Steadman, H.J.Monahan, J., et al.A multiple-models approach to violence risk assessment among people with mental disorder. Crim Justice Behav 2004; 31: 324–340CrossRefGoogle Scholar
Bjørkly, S.Hartvig, P.Heggen, F.-A.Brauer, H.Moger, T.A.Development of a brief screen for violence risk (V-RISK-10) in acute and general psychiatry: an introduction with emphasis on findings from a naturalistic test of interrater reliability. Eur Psychiatr 2009; 24: 388–394CrossRefGoogle ScholarPubMed
Buchanan, A.Risk of violence by psychiatric patients: beyond the “actuarial versus clinical” assessment debate. Psychiatr Serv 2008; 59: 184–190CrossRefGoogle ScholarPubMed
Dean, K.Walsh, E.Moran, P.Tyrer, P.Creed, F.Byford, S., et al.Violence in women with psychosis in the community: prospective study. Br J Psychiatr 2006; 188: 264–270CrossRefGoogle ScholarPubMed
Douglas, K.S.Ogloff, J.R.Nicholls, T.L.Grant, I.Assessing risk for violence among psychiatric patients: the HCR-20 violence risk assessment scheme and the Psychopathy Checklist: screening version. J Consult Clin Psychol 1999; 67: 917–930CrossRefGoogle ScholarPubMed
Doyle, M.Dolan, M.Predicting community violence from patients discharged from mental health services. Br J Psychiatry 2006; 189: 520–526CrossRefGoogle ScholarPubMed
Doyle, M.Dolan, M.Violence risk assessment: combining actuarial and clinical information to structure clinical judgements for the formulation and management of risk. J Psychiatr Ment Health Nurs 2002; 9: 649–657CrossRefGoogle ScholarPubMed
Harris, A.Lurigio, A.J.Mental illness and violence: a brief review of research and assessment strategies. Aggression Violent Behav 2007; 12: 542–551CrossRefGoogle Scholar
Harris, G.T.Rice, M.E.Camilleri, J.Applying a forensic actuarial assessment (the Violence Risk Appraisal Guide) to nonforensic patients. J Interpers Violence 2004; 19: 1063–1074CrossRefGoogle Scholar
Hartvig, P.Alfarnes, S.Ostberg, B.Skjonberg, M.Moger, T.A.Brief checklists for assessing violence risk among patients discharged from acute psychiatric facilities: a preliminary study. Nord J Psychiatry 2006; 60: 243–248CrossRefGoogle ScholarPubMed
Hartvig P, Ostberg B, Alfarnes S, Moger TA, Skjønberg M, Bjørkly S. Violent Risk Screen 10 (V-RISK-10). www.forensic-psychiatry.no. Oslo 2007.Google Scholar
Hartvig, P.Roaldset, J.O.Moger, T.A.Østberg, B.Bjørkly, S.The first step in the validation of a new screen for violence risk in acute psychiatry: the inpatient context. Eur Psychiatr 2011; 26: 85–91CrossRefGoogle ScholarPubMed
Hosmer, D.Lemeshow, S.Applied Logistic Regression. New York: Wiley: 2000CrossRefGoogle Scholar
Lidz, C.W.Mulvey, E.P.Gardner, W.The accuracy of predictions of violence to others. JAMA 1993; 269: 1007–1011CrossRefGoogle Scholar
McCusker, P.J.Issues regarding the clinical use of the Classification of Violence Risk (COVR) assessment instrument. Int J Offender Ther Comp Criminol 2007; 51: 676–685CrossRefGoogle ScholarPubMed
Monahan, J.S.H.Silver, E., et al.The MacArthur Study of Mental Disorder and Violence. New York: Oxford university Press: 2001Google Scholar
Monahan, J.Steadman, H.J.Appelbaum, P.S.Robbins, P.C.Mulvey, E.P.Silver, E., et al.Developing a clinically useful actuarial tool for assessing violence risk. Br J Psychiatr 2000; 176: 312–319CrossRefGoogle ScholarPubMed
Monahan, J.Steadman, H.J.Robbins, P.C.Appelbaum, P.Banks, S.Grisso, T., et al.An actuarial model of violence risk assessment for persons with mental disorders. Psychiatr Serv 2005; 56: 810–815CrossRefGoogle ScholarPubMed
Norko, M.A.Baranoski, M.V.The state of contemporary risk assessment research. Can J Psychiatr 2005; 50: 18–26CrossRefGoogle ScholarPubMed
Palmstierna, T.Only about 1 in 30 predictions of assault by discharged psychiatric patients will be correct. BMJ 319 1999; 1270CrossRefGoogle Scholar
Scott, C.L.Resnick, P.J.Violence risk assessment in persons with mental illness. Aggression Violent Behav 2006; 11: 598–611CrossRefGoogle Scholar
Snowden, R.P.Gray, N.D.P.Taylor, J.M.Fitzgerald, S.P.Assessing risk of future violence among forensic psychiatric inpatients with the Classification of Violence Risk (COVR). Psychiatr Serv 2009; 60: 1522–1526CrossRefGoogle Scholar
Swanson, J.W.Van Dorn, R.A.Swartz, M.S.Smith, A.Elbogen, E.B.Monahan, J.Alternative pathways to violence in persons with schizophrenia: the role of childhood antisocial behavior problems. Law Hum Behav 2008; 32: 228–240CrossRefGoogle ScholarPubMed
Tardiff, K.Marzuk, P.M.Leon, A.C.Portera, L.A prospective study of violence by psychiatric patients after hospital discharge. Psychiatr Serv 1997; 48: 678–681Google ScholarPubMed
Watts, D.Bindman, J.Slade, M.Holloway, F.Rosen, A.Thornicroft, G.Clinical assessment of risk decision support (CARDS): the development and evaluation of a feasible violence risk assessment for routine psychiatric practice. J Ment Health 2004; 13: 569–581CrossRefGoogle Scholar
Wootton, L.Buchanan, A.Leese, M.Tyrer, P.Burns, T.Creed, F., et al.Violence in psychosis: estimating the predictive validity of readily accessible clinical information in a community sample. Schizophr Res 2008; 101: 176–184CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.