Information de reference pour ce titreAccession Number: | 00042727-200507000-00009.
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Author: | Monahan, John Ph.D.; Steadman, Henry J. Ph.D.; Robbins, Pamela Clark B.A.; Appelbaum, Paul M.D.; Banks, Steven Ph.D.; Grisso, Thomas Ph.D.; Heilbrun, Kirk Ph.D.; Mulvey, Edward P. Ph.D.; Roth, Loren M.D.; Silver, Eric Ph.D.
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Institution: | Dr. Monahan is affiliated with the University of Virginia School of Law, 580 Massie Road, Charlottesville, Virginia 22903 (e-mail, [email protected]). Dr. Steadman and Ms. Robbins are with Policy Research Associates in Delmar, New York. Dr. Appelbaum, Dr. Banks, and Dr. Grisso are with the department of psychiatry at the University of Massachusetts Medical School in Worcester. Dr. Heilbrun is with the department of psychology at Drexel University in Philadelphia. Dr. Mulvey and Dr. Roth are with the department of psychiatry at the University of Pittsburgh School of Medicine. Dr. Silver is with the department of sociology at the Pennsylvania State University in University Park.
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Title: | An Actuarial Model of Violence Risk Assessment for Persons With Mental Disorders.[Article]
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Source: | Psychiatric Services. 56(7):810-815, July 2005.
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Abstract: | Objectives: An actuarial model was developed in the MacArthur Violence Risk Assessment Study to predict violence in the community among patients who have recently been discharged from psychiatric facilities. This model, called the multiple iterative classification tree (ICT) model, showed considerable accuracy in predicting violence in the construction sample. The purpose of the study reported here was to determine the validity of the multiple ICT model in distinguishing between patients with high and low risk of violence in the community when applied to a new sample of individuals.
Methods: Software incorporating the multiple ICT model was administered with independent samples of acutely hospitalized civil patients. Patients who were classified as having a high or a low risk of violence were followed in the community for 20 weeks after discharge. Violence included any battery with physical injury, use of a weapon, threats made with a weapon in hand, and sexual assault.
Results: Expected rates of violence in the low- and high-risk groups were 1 percent and 64 percent, respectively. Observed rates of violence in the low- and high-risk groups were 9 percent and 35 percent, respectively, when a strict definition of violence was used, and 9 percent and 49 percent, respectively, when a slightly more inclusive definition of violence was used. These findings may reflect the "shrinkage" expected in moving from construction to validation samples.
Conclusions: The multiple ICT model may be helpful to clinicians who are faced with making decisions about discharge planning for acutely hospitalized civil patients.
Copyright (C) 2005 American Psychiatric Association.
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References: | 1. Gutheil T, Appelbaum P: Clinical Handbook of Psychiatry and Law, 3rd ed. Philadelphia, Lippincott, Williams, and Wilkins, 2000
2. Monahan J, Steadman H, Appelbaum P, et al: Developing a clinically useful actuarial tool for assessing violence risk. British Journal of Psychiatry 176:312-319, 2000
3. Monahan J, Steadman H, Silver E, et al: The MacArthur Study of Mental Disorder and Violence. New York, Oxford University Press, 2001
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5. Steadman H, Silver E, Monahan J, et al: A classification tree approach to the development of actuarial violence risk assessment tools. Law and Human Behavior 24:83-100, 2000
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8. Gardner W, Lidz C, Mulvey E, et al: A comparison of actuarial methods for identifying repetitively violent patients with mental illness. Law and Human Behavior 20:35-48, 1996
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10. Banks S, Robbins P, Silver E, et al: A multiple models approach to violence risk assessment among people with mental disorder. Criminal Justice and Behavior 31:324-340, 2004
11. Efron B: Estimating the error rate of a prediction rule: some improvements on cross-validation. Journal of the American Statistical Association 78:316-331, 1983
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Language: | English.
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Document Type: | Article.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1075-2730
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NLM Journal Code: | 9502838, b8t
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