Clinical versus actuarial predictions of violence of patients with mental illnesses.

This study compared the accuracy of an actuarial procedure for the prediction of community violence by patients with mental illness with the accuracy of clinicians' ratings of concern about patients' violence. Data came from a study in which patients were followed in the community for 6 months after having been seen in a psychiatric emergency room. Accuracy of actuarial prediction was estimated retrospectively, with a statistical correction for capitalization on chance. Actuarial prediction had lower rates of false-positive and false-negative errors than clinical prediction. The seriousness of the violence correctly identified by the actuarial predictor (the true positives) was similar to the seriousness identified by clinicians. Actuarial predictions based only on patients' histories of violence were more accurate than clinical predictions, as were actuarial predictions that did not use information about histories.

[1]  Mark Warr.  Public perceptions and reactions to violent offending and victimization. , 1994 .

[2]  John Monahan,et al.  Clinical Prediction of Violent Behavior , 1982 .

[3]  B. Efron.  Estimating the Error Rate of a Prediction Rule: Improvement on Cross-Validation , 1983 .

[4]  J. Monahan.  Mental disorder and violent behavior. Perceptions and evidence. , 1992, The American psychologist.

[5]  D Mossman,et al.  Resampling Techniques in the Analysis of Non-binormal ROC Data , 1995, Medical decision making : an international journal of the Society for Medical Decision Making.

[6]  E. Mulvey,et al.  Regression analyses of counts and rates: Poisson, overdispersed Poisson, and negative binomial models. , 1995, Psychological bulletin.

[7]  M E Rice,et al.  Violent recidivism: assessing predictive validity. , 1995, Journal of consulting and clinical psychology.

[8]  Paul Slovic,et al.  Probability, danger, and coercion , 1995 .

[9]  M. Hersen,et al.  Handbook of prescriptive treatments for adults , 1994 .

[10]  Don M. Gottfredson,et al.  Prediction and Classification in Criminal Justice Decision Making , 1987, Crime and Justice.

[11]  J. Hanley,et al.  The meaning and use of the area under a receiver operating characteristic (ROC) curve. , 1982, Radiology.

[12]  Edward P. Mulvey,et al.  A comparison of actuarial methods for identifying repetitively violent patients with mental Illnesses , 1996 .

[13]  R. Dawes,et al.  Heuristics and Biases: Clinical versus Actuarial Judgment , 2002 .

[14]  H J Steadman,et al.  Predicting dangerousness among the mentally ill: art, magic and science. , 1983, International journal of law and psychiatry.

[15]  E. Mulvey.  Assessing the evidence of a link between mental illness and violence. , 1994, Hospital & community psychiatry.

[16]  J. Swanson,et al.  Violence and psychiatric disorder in the community: evidence from the Epidemiologic Catchment Area surveys. , 1990, Hospital & community psychiatry.

[17]  Vernon L. Quinsey,et al.  The violence prediction scheme: Assessing dangerousness in high risk men. , 1994 .

[18]  L. Derogatis,et al.  The Brief Symptom Inventory: an introductory report , 1983, Psychological Medicine.

[19]  G. Harris,et al.  The Violent Patient , 1994 .

[20]  M. Drake.  Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) , 1988 .

[21]  A. Blumstein.  Criminal careers and "career criminals" , 1986 .

[22]  John Monahan,et al.  Violence and mental disorder: Developments in risk assessment. , 1994 .

[23]  E. Mulvey,et al.  The accuracy of predictions of violence to others. , 1993, JAMA.

[24]  C. Zimmer,et al.  The influence of social networks and social support on violence by persons with serious mental illness. , 1994, Hospital & community psychiatry.

[25]  Douglas Mossman,et al.  Assessing predictions of violence: being accurate about accuracy. , 1994, Journal of consulting and clinical psychology.