The dimensions of dangerousness: Evaluating the accuracy of psychometric predictions of violence among forensic patients.

Abstract

Treatment of dangerousness in both sociolegal research and clinical practice has neglected to consider the multidimensional nature of the construct. An attempt was made to develop a psychometric instrument sensitive to several facets of dangerous behavior among forensic patients. Two trained nonclinical raters used the scale in assessing the dangerousness of 210 patients interviewed in a pretrial forensic clinic. Reliability, item and factor analysis refined the instrument into a 15-item Dangerous Behavior Rating Scheme. Profiles of patients during a two-year follow-up were constructed from contacts with the correctional system and five psychiatric hospitals, and rated on dangerousness to others by nine independent judges. A Pearson product-moment correlation of +0.34 was yielded between aggregated factor scores derived from the instrument and follow-up dangerous behavior. Given the limited ability of either clinicians or psychometric instruments to predict dangerous behavior, and given the socially constructed nature of the dangerousness phenomenon, predictions about future violence should be adopted into practice only under restricted conditions. A number of these limitations are summarized.