Abstract

BackgroundPsychiatric expert opinions are supposed to assess the accused individual’s risk of reoffending based on a valid scientific foundation. In contrast to specific recidivism, general recidivism has only been poorly considered in Continental Europe; we therefore aimed to develop a valid instrument for assessing the risk of general criminal recidivism of mentally ill offenders.MethodData of 259 mentally ill offenders with a median time at risk of 107 months were analyzed and combined with the individuals’ criminal records. We derived risk factors for general criminal recidivism and classified re-offences by using a random forest approach.ResultsIn our sample of mentally ill offenders, 51% were reconvicted. The most important predictive factors for general criminal recidivism were: number of prior convictions, age, type of index offence, diversity of criminal history, and substance abuse. With our statistical approach we were able to correctly identify 58-95% of all reoffenders and 65-97% of all committed offences (AUC = .90).ConclusionsOur study presents a new statistical approach to forensic-psychiatric risk-assessment, allowing experts to evaluate general risk of reoffending in mentally disordered individuals, with a special focus on high-risk groups. This approach might serve not only for expert opinions in court, but also for risk management strategies and therapeutic interventions.

Highlights

  • Psychiatric expert opinions are supposed to assess the accused individual’s risk of reoffending based on a valid scientific foundation

  • Most of the existing studies are restricted in scope and mainly focus on the predictive validity of existing actuarial risk assessment instruments (ARAIs), or are interested in criminal recidivism with regard to a specific subgroup of offenders [1,2,3,4,5,6]

  • Additional forensic data encompassed two variables coding for the index offence, six variables coding for criminal history, and two variables coding for the consequences following the conviction on the index offence charge

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Summary

Introduction

Psychiatric expert opinions are supposed to assess the accused individual’s risk of reoffending based on a valid scientific foundation. In contrast to specific recidivism, general recidivism has only been poorly considered in Continental Europe; we aimed to develop a valid instrument for assessing the risk of general criminal recidivism of mentally ill offenders. Psychiatric expert opinions, including risk assessments for criminal recidivism, frequently play a substantial role for the reasons of court orders – in particular if there is evidence that the accused is mentally impaired. Besides assessing the offender’s mental state, the expert witness is supposed to provide information about the risk of recidivism, i.e. the types of expected offences, degree of likeliness, and degree of dangerousness [8], the latter being more a legal than a psychiatric evaluation. Because of the potentially severe consequences of risk assessments, the methods being used should be standardized; instruments and analyses should be valid and reliable

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