Protective Factors For Violence Risk Research Articles

The Validity of Violence Risk Assessment in Young Adults: A Comparative Study of Juvenile and Adult Risk Assessment Tools

Few studies have addressed the application of violence risk assessment for individuals transitioning from youth to adulthood. For 202 young adults released from Dutch juvenile justice institutions this study investigated the predictive validity and potential disparities in impact of juvenile risk assessment tools (i.e., SAVRY [Structured Assessment of Violence Risk in Youth], and SAPROF-YV [Structured Assessment of Protective Factors for violence risk-Youth Version]), and comparable adult risk assessment tools (i.e., HCR-20V3 [Historical Clinical Risk management-20 Version 3], and SAPROF [Structured Assessment of Protective Factors for violence risk]). Assessments with juvenile and adult risk assessment tools yielded similar predictive validity for violent and non-violent recidivism. Risk and protective factors related to treatability, parents, community participation, resilience, and personality showed individual predictive validity. These findings offer flexibility when applying risk assessment in clinical practice. The choice between youth and adult assessment tools should be made considering the individual’s developmental stage.

Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth.

The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher and lower likelihoods of violent and any reoffending at opposite ends of their trichotomous ratings. Summing items weighted using their promotive and risk odds ratios produced statistically significant improvements in predictive accuracy, improvements found also with a cross-validation sample of 171 justice-involved youth. The nature of strengths and implications for the development of SPJ tools and training in their use were discussed.

The Structured Assessment of Protective Factors for violence risk (SAPROF): A meta-analysis of its predictive and incremental validity.

Although the inclusion of protective factors in risk assessment is believed to improve prediction, most risk assessment tools emphasize risk factors. In response, the Structured Assessment of Protective Factors for violence risk (SAPROF) has been developed, which focuses exclusively on protective factors and is used in conjunction with a structured risk assessment tool. It has received increasing attention from both researchers and forensic mental health practitioners, and additional versions have been developed for use with adolescents (SAPROF-YV) and sex offenders (SAPROF-SO). To assess their psychometric performance, we conducted a meta-analysis of validation studies. Our final sample included 39 articles with 5,434 subjects from 16 countries. Overall, the SAPROF(-YV/-SO) showed good interrater reliability and moderate-to-good predictive performance for the absence of recidivism and institutional misconduct. All three instruments exhibited incremental validity when used in conjunction with a risk-focused assessment tool. Our meta-analysis additionally showed that changes on the SAPROF are associated with decreased violent and general recidivism after controlling for baseline risk. We also uncovered several shortcomings in current research with the SAPROF(-YV/-SO). Studies did not report calibration indices and most studies were retrospective and limited to male offenders. The present findings provide support for the relevance of protective factors in risk assessment, but future research should focus on their hypothesized role in treatment and risk management. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supplemental Material for The Structured Assessment of Protective Factors for Violence Risk (SAPROF): A Meta-Analysis of Its Predictive and Incremental Validity

Supplemental Material for The Structured Assessment of Protective Factors for Violence Risk (SAPROF): A Meta-Analysis of Its Predictive and Incremental Validity

Do adolescent risk assessment tools capture self-reported reasons for desistance? An examination of the content validity of protective factors

ABSTRACT This study used a novel approach to assess the content validity of three adolescent risk assessment tools: the Structured Assessment of Violence Risk in Youth (SAVRY; Borum et al., 2006), the Structured Assessment of Protective Factors for Violence Risk – Youth Version (SAPROF-YV; de Vries Robbé et al., 2015), and the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Viljoen et al., 2014). In-person interviews and online surveys were conducted with people with a history of adolescent offending (n = 103), which included open-ended questions about their desistance from offending, followed by direct questions based on the tools’ protective factors. Responses were coded using directed content analyses based on the tools’ item definitions. In open-ended questions, across participants all items were mentioned, and all items were rated as important by at least some participants. Only a few additional themes emerged that were not captured by the tools. In addition, participants primarily discussed the presence of protective factors rather than the removal of risk factors, suggesting they represent distinct constructs. Overall the findings support the content validity of the SAVRY, SAPROF-YV, and START:AV protective factors, and highlight the value of perspectives from people with lived experience in risk assessment research.

Examination of the Structured Assessment of Protective Factors for Violence Risk - Youth Version (SAPROF-YV) in Canadian Adolescents

The Structured Assessment of Protective Factors for Violence Risk - Youth Version (SAPROF-YV) is a new measure of protective factors. It is used with a risk-focused tool, such as the Structured Assessment of Violence Risk in Youth (SAVRY), to provide a more balanced and comprehensive assessment of violence risk in adolescents. Our study investigated the relationship between the SAPROF-YV and aggression in a sample of 69 adolescents. Using a retrospective follow-up study design, we reviewed files at an inpatient treatment centre and a probation office. The SAPROF-YV showed good convergent and discriminant validity with the SAVRY. The SAPROF-YV was predictive of the absence of minor verbal aggression. While the SAPROF-YV added incremental predictive validity to SAVRY Protective factors for minor verbal aggression, it did not add incrementally to SAVRY Risk factors in the prediction of any type of aggression. We discuss implications for future research and clinical applications.

Risk Assessment in Juvenile and Young Adult Offenders: Predictive Validity of the SAVRY and SAPROF-YV.

Most juvenile risk assessment tools heavily rely on a risk-focused approach. Less attention has been devoted to protective factors. This study examines the predictive validity of protective factors in addition to risk factors, and developmental differences in psychometric properties of juvenile risk assessment. For a national Dutch sample of 354 juvenile and young adult offenders (16-26 years) risk and protective factors were retrospectively assessed at discharge from seven juvenile justice institutions, using the Structured Assessment of Violence Risk in Youth (SAVRY) and Structured Assessment of Protective Factors for violence risk – Youth Version (SAPROF-YV). Results show moderate validity for both tools predicting general, violent, and nonviolent offending at different follow-up times. The SAPROF-YV provided incremental predictive validity over the SAVRY, and predictive validity was stronger for younger offenders. Evidently both the SAVRY and SAPROF-YV seem valid tools for the assessment of recidivism risk in juvenile and young adult offenders. Results highlight the importance of protective factors, especially in juvenile offenders, emphasizing the need for a balanced risk assessment.

Validating the SAPROF with Forensic Mental Health Patients

ABSTRACT Assessing and managing level of violence risk among forensic mental health patients is a primary role of clinical staff. Forensic risk assessments are typically focused on risk factors and deficits, whereas patient protective factors are either partially included or excluded by clinicians. The Structured Assessment of Protective Factors for Violence Risk (SAPROF) is a recently developed measure of protective factors designed to augment the conventional use of risk assessment tools with a correctional/forensic population. In the current study, the psychometric properties of the SAPROF were examined in a sample of 50 forensic inpatients and outpatients found Not Criminally Responsible (NCR) at a psychiatric hospital in Ontario, Canada. The SAPROF was found to have adequate internal, intrarater, and interrater reliability. Using a subsample of inpatients only, incremental predictive validity was demonstrated for institutional misconducts at six-month follow-up over the HCR-20 V3. Taken together, the results suggest that the SAPROF may be a useful addition to clinical practice and inform review board decisions about risk prediction, risk management, and treatment planning.

Protective Factor Assessments: What Are We Measuring?—An Investigation of the Internal Validity of the Structured Assessment of Protective Factors for Violence Risk

The use of instruments measuring protective factors is on the rise in risk evaluation, management, and treatment planning. Although assessment tools must have good internal validity to be generalizable and reproducible, little is known about the internal validity of protective factor instruments. The present study evaluated the factor structure of the Structured Assessment of Protective Factors for Violence Risk (SAPROF) via confirmatory and exploratory factor analyses of forensic risk assessments of 143 individuals convicted of violent and sexual violent offenses in Switzerland. The SAPROF did not show any differences by type of offenses. Although our confirmatory factor analysis did not confirm the classic SAPROF scale’s structure, the results of the exploratory analysis were in line with previous theoretical research as it revealed a four-factor model comprising Resilience, Reintegration, Treatability, and Living Conditions. These results have implications for the use of the SAPROF in forensic risk assessments and treatment management plans.

Clinicians’ perceptions of the implementation of the Structured Assessment of Protective Factors for violence risk (SAPROF) on an inpatient forensic unit

The Structured Assessment of PROtective Factors for Violence Risk (SAPROF) is an assessment tool that examines protective factors when assessing for violence risk. There is limited research on clinicians’ perceptions of the use and implementation of risk assessment tools, and this study aimed to examine the experiences of clinicians using the SAPROF in a low secure forensic rehabilitation inpatient unit in Canada. An exploratory research design was used, and five clinicians participated in semi-structured interviews. Data was analyzed using a thematic approach and three central themes were identified: understanding of the patient from a strengths-based point of view, providing clinicians with a focus on how to help the patient, and bringing in opportunities to collaborate as a team. The findings highlight the additional value of the SAPROF as tool in helping forensic teams to adopt strengths based approaches to risk assessment, enhancing treatment planning and inter-professional collaboration.
 
 Keywords: strengths, risk assessment, SAPROF, consensus scoring, recovery

Latent constructs in the measurement of risk and protective factors for violent reoffending using the HCR-20v3 and SAPROF: implications for conceptualizing offender assessment and treatment planning

ABSTRACTThis paper describes a retrospective data analysis, examining the relationship between protective factors against violence, as measured by the Structured Assessment of Protective Factors for Violence Risk (SAPROF), and conceptually similar risk factors assessed in the Historical-Clinical-Risk Management-20 Version 3. The sample comprised 201 adult male violent offenders who completed a violence intervention programme in an Australian prison. Structural equation modelling revealed that conceptually similar risk and protective factors loaded onto correlated, but independent, factors. This suggests that these items from the two assessment tools may assess distinct latent constructs relevant to violence risk. SAPROF items did not, however, load onto the domains that are commonly targeted in violence treatment programmes. This study’s conclusion that assessment of protective factors may offer supplementary conceptual value in clinical practice with violent offenders is tempered by limitations, including the retrospective file review design, small sample, and lack of predictive validity of SAPROF ratings.

Risk and protective factors in criminal recidivist inmates

Introduction: In the last decades, the areas of criminal recidivism and risk assessment have been gaining prominence in the scientific community [1]. The literature confirms we must assess the risk and protective factors to know how to intervene with those who are serving prison sentences [2]. It also points to the importance of certain variables such as age [3] and criminal versatility [4]. The main goals of this study are to characterize the risk and protective factors of a sample of prison inmates; to verify the association between the risk, current age and age at the time of the first arrest; and to analyse the differences in the risk according to criminal versatility. Materials and methods: The current study has an exploratory, quantitative and comparative design, with a non-probability convenience sample composed by 73 male inmates, who have more than one conviction leading to imprisonment. For data collection we used the Historical, Clinical and Risk Management Scheme [5] (HCR-20) and the Structured Assessment of Protective Factors for Violence Risk [6] (SAPROF), as well as a form to assess age and criminal versatility. The investigation was approved by the Ethics Committee of Fernando Pessoa University, as well as by both the General Management of Social Reintegration and Prison Services and Setúbal’s prison establishment. Results: The results point to a high risk of recidivism among inmates (low risk - 15.1%; medium risk – 43.8% and high risk – 41.1%). There are some risk factors prominently present in the sample, such as previous violence, substance abuse, impulsiveness and negative attitudes. The absence of certain protective factors such as empathy, adaptative coping, self-control and motivation for treatment can also be noted. No association could be found between the inmates’ current age and risk (r=−.18, p=.13), but we confirmed a negative association between age at first arrest and risk (r=−.34, p=.00). The were no statistically significant differences between the means of the criminal versatility groups for risk [F(2.69) = 2.92, p=.06], but a negative association could be found between criminal versatility and risk (r=−.28, p=.02). Discussion and conclusions: Although most of the participants have a high or medium risk of recidivism, their risk factors and absent protective factors are mostly dynamic, leading us to the conclusion that intervention in these cases would lower the risk. The negative association between age at first arrest and risk, as well as the negative association between criminal versatility and risk are supported by the previous literature. Age and criminal versatility are two factors that deserve to be studied in future works. The present investigation raises some serious questions about the rehabilitative work that can be done in prison establishments.

Gender-Sensitive Violence Risk Assessment: Predictive Validity of Six Tools in Female Forensic Psychiatric Patients

Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20V3demonstrated significant predictive accuracy.

Strength-based assessment for future violence risk: a retrospective validation study of the Structured Assessment of PROtective Factors for violence risk (SAPROF) Japanese version in forensic psychiatric inpatients

BackgroundThe Structured Assessment of PROtective Factors for violence risk (SAPROF) was recently developed as a strength-based addition to the risk assessment of future violent behavior. We examined the interrater reliability and predictive accuracy of the SAPROF for violence in forensic mental health inpatient units in Japan.MethodsThis retrospective record study provides an initial validation of the SAPROF in a Japanese sample of 95 forensic psychiatric inpatients from a complete 2008–2013 cohort. Violent outcomes were assessed 6 and 12 months after hospitalization.ResultsWe observed moderate-to-good interrater reliability for the SAPROF total score and the internal factors, motivational factors, external factors, and the Final Protection Judgment scores. According to a receiver operating characteristic analysis, the SAPROF total score and all subscale scores predicted violence at both 6 and 12 months after hospitalization with high accuracy. Furthermore, the predictive validity of a combination of the SAPROF with the Historical Clinical Risk Management-20 (HCR-20) outperformed that of the HCR-20 alone.ConclusionsThe results provide evidence of the value of considering protective factors in the assessment of future violence risk among Japanese forensic psychiatric inpatients. The SAPROF might allow for a more balanced assessment of future violence risk in places where the population rates of violent crime are low, such as Japan, but a validation study in a different setting should confirm this. Moreover, future studies should examine the effectiveness of treatment and promoting community re-integration on motivating patients and treatment staff.

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

L’évaluation des facteurs de protection à l’aide de la SAPROF

Risk assessment has greatly changed over the last 40 years. It has moved from a strictly clinical procedure based on clinical judgement, to a structured approach based on scientific literature. While the main goal of first generation structured methods was to estimate the probability of recidivism, we are increasingly interested in knowing more about the reasons that push delinquents to commit new crimes in order to properly intervene and treat the causes at hand. The last generations of instruments now aim to estimate intervention needs and guide rehabilitation practices. Although practitioners largely resort to protective factors to establish avenues to work on, no tool was available until recently to systematically evaluate protective factors. The present article proposes a description of the different measurement and conceptualization issues surrounding protective factors, in addition to addressing the nature of the effect of these factors on recidivism. This paper describes The Structured Assessment of Protective Factors for Violence Risk (SAPROF), a structural professional judgement tool that focus solely on protective factors for violence risk. The SAPROF investigates internal, motivation and external protective factors and has incremental validity over risk assessment instruments. The paper also discusses validation results of the SAPROF, as well as its limitations. The paper finally addresses the crucial question of interfacing risk and protective factors when it comes to estimating the risk for recidivism.

Validity and Predictive Accuracy of the Structured Assessment of Protective Factors for Violence Risk in Criminal Forensic Evaluations

Some actuarial and structured professional judgment (SPJ) risk-assessment instruments have already demonstrated their validity and predictive accuracy in expert criminal forensic evaluations. In contrast, little is known about the effectiveness of instruments identifying protective factors in risk of recidivism prediction. The present study was designed to evaluate the validity and predictive accuracy of the Structured Assessment of Protective Factors for Violence Risk (SAPROF) in 94 violent and sexual violent offenders assessed in a Swiss pretrial criminal forensic context. The SAPROF showed good interrater reliability, and was significantly correlated to predominately dynamic instruments but not to predominately actuarial instruments. However, in terms of predictive accuracy, the SAPROF did not perform as well as expected when compared with other instruments and with previous SAPROF accuracy validation studies. These results have implications for the use of the SAPROF in criminal forensic contexts risk assessment.

Risk and Protective Factors for Inpatient Aggression

Dynamic risk and protective factors serve to assess the violence risk level of (forensic) psychiatric patients and offer guidance to clinical interventions. Risk assessment scores on Historical Clinical Risk Management–20 (HCR-20) risk factors and Structured Assessment of Protective Factors for violence risk (SAPROF) protective factors at different treatment stages were compared with violent incidents during treatment for 399 multidisciplinary coded assessments on 185 male and female forensic psychiatric patients. At later stages of treatment, less risk factors and more protective factors were observed, and predictive validities were higher. The HCR-20 and SAPROF scores showed good overall predictive validity for inpatient violence. The combination of risk factors and protective factors was a good predictor of incidents of aggressive behavior for different groups of patients, such as patients with violent or sexual offending histories, patients with major mental illnesses or personality disorders, and patients with a high score on psychopathy. Implications of these findings and recommendations for future research are discussed.

Enquête internationale sur les pratiques d’évaluation du risque de violence : présentation des données belges

ObjectiveMental health professionals are routinely called upon to assess the violence risk presented by their patients, frequently aided by structured instruments. Though surveys of risk assessment and management have been conducted, these efforts have been largely circumscribed to individual countries and have not compared the practices of members of different professional disciplines. MethodA web-based survey was developed to examine the international use of structured instruments in the violence risk assessment process across five continents and to compare the perceived utility of such instruments by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations following the Dillman total Survey Design method. Belgium resultsThe Belgium sample was composed of 86 mental health professionals (69 psychologists, 12 psychiatrists, 1 nurse and 4 other professionals). Respondents had an average age of 43.93 years and 10.85 years of which was spend in practice. Over half of their time in the past 12 months was spent on clinical activities, most often in forensic hospitals followed by private practice and correctional institutions. Additional responsibilities over the past 12 months included administrative duties, teaching with comparatively little time being spent on research pursuits. Respondents reported having conducted an average of 211.68 violence risk assessment in their lifetimes, over half of which with the aid of a structured instrument. In the past 12 months, respondents conducted an average of 40.76 violence risk assessments, again over half of which using a structured instrument. Over both their lifetimes and the past 12 months, respondents reported that the instrument most commonly using in the violence risk assessment process were the: PCL-R (Psychopathy Checklist Revised; Hare 1991, 2003), the HCR-20 (Historical Clinical Risk; Webster, Douglas, Eaves, et Hart, 1997), the VRAG (Violence Risk Appraisal Guide; Quinsey, Harris, Rice et Cormier, 2006) and the SAPROF (Structured Assessment of PROtective Factors for violence risk; de Vogel, de Ruiter, Bouman, & de Vries Robbé, 2011). The PCL-R and the HCR-20 are the most used instruments. As for the perceived usefulness of these instruments by respondents, the utility for risk assessment was described as “quite useful” and “useful” for the PCL-R, HCR-20 and the SAPROF. The usefulness of the VRAG was more nuanced. To develop a violence risk management plan or implement violence risk management plan, the instruments were used less frequently, however, the HCR-20 was the instrument found most useful, followed by PCL-R and SAPROF.

Assessing protective factors of youth who sexually offended in singapore: preliminary evidence on the utility of the DASH-13 and the SAPROF.

Sexual offending has attracted increasing public concern because of its long-term effects. Although there is an increasing amount of research on the risk factors for recidivism among youth who have sexually offended, there is a dearth of research on the protective factors for desistence from recidivism. The current study investigated the associations between protective factors and recidivism among 97 Singaporean youth who sexually offended (YSO). In addition, the predictive validity with regard to two new measures of protective factors—the Desistence for Adolescents Who Sexually Harm (DASH-13), and Structured Assessment of Protective Factors for Violence Risk (SAPROF)—were also evaluated. Results indicated that both the DASH-13 and the SAPROF were inversely related to the Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR). However, neither the DASH-13 nor the SAPROF were found to have adequate predictive validity or incremental validity for sexual or nonsexual recidivism. The implications for the assessment and management of YSO are discussed.