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Self-harm is a cause of concern for health-care professionals. The Short-Term Assessment of Risk and Treatability (START) is a short-term assessment instrument used to rate the likelihood of risk behaviours, including self-harm. As result of the assessment, interventions that are implemented to reduce the risk of self-harm may reduce the strength of the predictive validity of a risk assessment tool. The aim of this study was explore the impact of risk management interventions on the capacity of START to predict self-harm. It was predicted that the interventions would weaken the ability of START to predict self-harm in patients who received the intervention.

Secondary analysis of routinely collected data in a large sample of women in an inpatient secure care setting. Demographic and clinical information, self-harm episodes, safety management interventions and START assessments were extracted and used to build an anonymous database.

START significantly predicted self-harm in those with and without the safety management intervention. However, the strength of the predictive validity was smaller in those who received the intervention compared to those without.

The results suggest that the implementation of safety management interventions needs to be taken into account when assessing future risk of self-harm.

To the best of the authors’ knowledge, this is the first study to explore the impact of safety management interventions on the predictive validity of START in a large sample of women.

Recently, correctional agencies have argued that there are differences between factors influencing men and women’s involvement in the criminal justice system. The purpose of this paper is to examine the validity of a gender-informed risk/need assessment tool.

The sample consisted of 620 women offenders admitted to federal Canadian custody, as well as a matched-comparison group of 647 men. Items were selected from routine assessments in an administrative database based on an extensive literature review of factors related to criminal risk for women.

Results showed that the items included in this assessment and the overall rating of risk/need significantly predicted any return to custody for both women and men. As well, ratings incrementally predicted any return to custody over and above other established tools.

The gender-informed risk/need assessment tool, informed by the literature, performed well for both men and women. The research highlights the complementary, not competing, perspectives of gender-neutral and gender-responsive risk and need factors.

Factors commonly considered gender-salient predicted risk for men and women. The present study demonstrates that risk assessments tools for men and women should look beyond the factors routinely assessed in the research to identify novel dynamic factors that contribute to risk for men and women and could be targeted for intervention.

This paper aims to present an overview of a variety of risk assessment issues that are of particular relevance for work with juvenile fire setters in clinical and forensic settings. The paper seeks to consider Juvenile Fire Setting (JFS)‐Youthful Misuse of Fire (YMF) across a broad array of clinical domains, including developmental, prognostic, and the diagnostic utility anticipated by using the DSM‐5. National standards and risk assessment levels are to be examined.

The paper includes a comprehensive review of the research and practices related to juvenile fire setters. This review included assessment and intervention resources that are used in diverse practice environments. The authors reviewed the literature to establish a nexus between risk assessment and community‐based interventions which were illustrated by a nationally recognized YMF mental health program (FATJAM).

The paper provides empirically‐based insights into key issues for working with these forensic cases. It offers discussion regarding diagnostic issues that are relevant to the DSM‐5.

Because of the conceptual or theoretical approach used, the research basis for generalizations is restricted to the practice‐based analyses provided by the authors. Therefore, practitioners and researchers are urged to further test the observations and conclusions presented.

This paper is unique in that it increases the knowledge base related to the diagnostic applications with the DSM‐5, as well as evidence‐based interventions for JFS as it pertains to public safety.

Despite the rising number of females in forensic psychiatry, research about their characteristics remains limited and is currently lacking in Belgium. Optimizing knowledge about the characteristics of these women will lead to a better understanding of this specific group. Therefore, the aim of the study was to gain insight into the characteristics of female forensic psychiatric patients in Flanders, Belgium.

A case file study was carried out in the forensic psychiatric hospital Sint-Jan-Baptist in Zelzate, Belgium. The files of female patients admitted in the period 2006–2017 were analysed (N = 82) based on a checklist including sociodemographic, mental health care and offence-related characteristics as well as historical risk factors.

The study revealed that female patients have been confronted with a large number of adverse experiences during both childhood and adulthood, were frequently diagnosed with borderline personality disorder and usually had an extensive mental health treatment history with many drop-outs. The majority of the female patients had committed violent offences towards relatives.

These findings are similar to those of other jurisdictions and highlight the importance of a gender-responsive treatment. This kind of treatment should include trauma-informed care, gender-sensitive risk-assessment and adapted versions of dialectical behavioural therapy and schema-focussed therapy. Additionally, treatment should focus on breaking the intergenerational transmission of violence and mental health problems by targeting parenting skills.

To the best of the authors’ knowledge, this is the first study that scientifically scrutinized the detailed characteristics of female forensic psychiatric patients in Flanders, Belgium. Recommendations for gender-responsive treatment and directions for future research are discussed.

Offenders with intellectual disability (ID) have been largely neglected in past forensic literature on assessment of dynamic risk factors. The purpose of this paper is to evaluate the predictive validity of the Short-Term Assessment of Risk and Treatability (START), in a sample of males with IDs in a low-secure hospital (n=28).

A prospective analysis was conducted, with START scores as the predictor variables, and the number of recorded aversive incidents as the outcome measure.

Receiver operating characteristic analysis demonstrated that total START risk scores had a significant high predictive accuracy for incidents of physical aggression to others (area under the curve (AUC)=0.710, p<0.001) and property damage/theft (AUC=0.730, p<0.001), over a 30-day period, reducing to medium predictive validity over a 90-day period. Medium predictive validity was also identified for incidents of verbal aggression, suicide, self-harm, and stalking and intimidation. START strength scores were also predictive of overt aggression (AUC=0.716), possible reasons for this are explored.

The small sample size limits the generalisability of the findings, and further research is required.

The paper offers preliminary support for the use of the START with ID offenders in low-secure settings. Given the lack of validation of any previous dynamic risk assessment tools, multi-disciplinary teams in such settings now have the option to use a tool which has potentially good validity with an ID population.

This study represents the first attempt to examine the predictive validity of the START with ID offenders, and a step forward in the understanding of dynamic risk factors for violence in this population. The significant predictive relationship with incidents of physical aggression and property damage offers clinicians a preliminary evidence base supporting its use in low-secure settings.

The purpose of this paper is to explore the validity and reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) to determine if it has predictive accuracy in relation to physical aggression, severe verbal aggression, property damage and self-harm, in a medium secure setting. In addition, the authors hoped to provide some of the first descriptive data available for the START:AV among a UK adolescent population in a medium secure adolescent unit.

The sample consisted of 90 female and male adolescents, with and without developmental disabilities. It was important to explore the measure’s predictive accuracy across specific population groups, such as between males and females, as well as those with developmental disabilities, and those without.

Some significant relationships were found between the START:AV and adverse outcomes. For instance, total strength and vulnerability scores were predictive for verbal and physical aggression. Differences in predictive validity were evident when comparisons were made between males and females, with relationships being evident amongst the male population only. When splitting the male sample into developmental disability and non-developmental disability groups, significant relationships were found between strength and vulnerability scores and verbal and physical aggression.

A number of practical implications are considered, such as the START:AV is relevant for use with adolescents in hospital settings and the significant inverse relationship between strength scores and negative outcomes supports the importance of considering protective/strength factors when working with at risk youths.

There is currently limited validation data for the START:AV in the UK or elsewhere.

In psychological testing, the term ‘ecological validity’ (EV) refers to the degree to which a test assesses (or estimates) via a proxy task a person's ability to do a ‘real‐life’ task. While EV has been a critical evaluative component of some areas of psychological testing, it has not featured to date as important in the area of risk assessment. If the goal of risk assessment is to enhance risk management, then this is a critical oversight. It would appear that all forms of risk assessment measures are lacking EV. EV is important because risk management occurs in the community. The ARMIDILO is mentioned as an instrument that has attempted to include environmental variables to enhance EV and thus facilitate the risk manageability of ID sex offenders. It is proposed that the EV of other risk measures could be enhanced by the inclusion of similar environmental variables.

Rates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation.

A sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately.

Individual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant.

Identifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy.

To the best of the authors’ knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.

The purpose of this study was to explore the predictive validity of the revised Problem Identification Checklist (PIC‐R) in predicting inpatient and community violence using a retrospective design. The Historical Scale (H‐Scale) of the HCR‐20 was employed to control for static risk factors. The predictive accuracy between predictors and outcome measures was evaluated using Receiver Operating Characteristics (ROC) analysis. The PIC‐R significantly predicted inpatient violence (AUC range 0.77‐0.92) over a 12‐month follow‐up period but did not predict community violence. Conversely, the H‐Scale significantly predicted community violence (AUC 0.82) but did not predict inpatient violence over a 12‐month follow‐up period. The findings offer preliminary validation for the predictive accuracy of the PIC‐R for violence in a UK inpatient population. Additionally, the findings suggest that short‐term risk of violence within a psychiatric inpatient population may be more related to dynamic and clinical risk variables rather than to static ones.

Empirical research concerning the reliability and predictive validity of the juvenile psychopathy construct, as assessed by the Psychopathy Checklist: Youth Version (PCL: YV; Forth et al, 2003) is reviewed. The results of an updated meta‐analysis (k = 38) investigating the interrater reliability of the PCL: YV are presented, along with an examination of meta‐analytic findings on the predictive accuracy of the tool. Considerations with respect to gender, ethnicity and development are explored. Some discussion points are offered regarding potential clinical applications of the construct of juvenile psychopathy and the PCL: YV with violent and other criminally adjudicated youths.