Clinicians often rely on readily observable intermediate outcomes (e.g., symptoms) to assess the likelihood of events that occur outside of treatment (e.g., relapse). Similarly, those monitoring clients with histories of criminal involvement attempt to prevent adverse outcomes considered likely and intervene when symptoms/risk factors fluctuate. Our aim was to develop a stronger understanding of associations between evolving symptoms/risk factors and case outcomes, yielding clearer practice implications. We used longitudinal, multiple reassessment risk data from 3,421 individuals paroled in New Zealand. We used joint modeling to test the association between individual trajectories of psychosocial risk factor scores, assessed using Dynamic Risk Assessment for Offender Re-entry, and recidivism (official records of parole violations or criminal charges resulting in reconviction). We examined whether recent clinically relevant features of risk presentation (e.g., current levels, recent rate of change) predicted recidivism better than the entirety of the risk assessment trajectory. Although each model demonstrated similar predictive validity, measures of model fit indicated that models using current trajectory features outperformed those using the entire assessment history to predict recidivism. Change in dynamic risk factors is consistently associated with recidivism outcomes. When using changeable factors to monitor clients' current risk for recidivism, practitioners should focus on current presentation rather than the entire assessment history, although differences in predictive discrimination are small. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Read full abstract