Violence Risk in
Adolescents
Dr Charlotte Rennie
Project funded by the National Forensic
Mental Health Research and
Development Programme
Plan
 Review
of the Literature
 Youth
Level of Service/Case Management
Inventory
 Structured Assessment of Violence Risk in
Youth
 Psychopathy Checklist: Youth Version
 Study
outline
 Study findings
 Conclusions
 Implications
Youth Level of Service

Prior and Current
Offences/Disposals






3 or more prior
conviction/episodes of offending
2 or more failures to comply
Prior supervision
Ever in detention
3 or more current episodes of
offending
Family Circumstances/Parenting







Education/Employment







Disruptive classroom behaviour
Disruptive behaviour on school
property
Low achievement
Problems with peers
Problems with teachers
Truancy
Unemployment/not seeking
employment
Inadequate supervision
 Peer Relations
Difficulty in controlling behaviour
 Some delinquent acquaintances
Inappropriate discipline
 Some delinquent friends
Inconsistent parenting
 Few or no positive
Poor relations/father-child
acquaintances
Poor relation/mother-child
 Few or no positive friends
Youth Level of Service

Substance Abuse







Occasional drug abuse
Chronic drug abuse
Chronic alcohol abuse
Substance use interferes
with life
Substance use linked to
offences
Personality/Behaviour







Leisure/Recreation



Limited organised activities
Could make better use of
time
No personal interests

Inflated self esteem
Physically aggressive
Tantrums
Short attention span
Poor frustration tolerance
Inadequate guilt feelings
Verbally aggressive,
impudent
Attitudes/Orientation





Antisocial/prosocial
attitudes
Not seeking help
Actively rejecting help
Defies authority
Callous, little concern for
others
YLS/CMI Predictive Validity
 Studies
have found that the YLS/CMI
can predict recidivism
 Jung
& Rawana (1999)
 Catchpole & Gretton (2003)
 Schmidt et al., (2005)
 Marshall et al., (2006)
SAVRY

Historical Risk Factors

Individual/Clinical Risk Factors
 Negative Attitudes
History of Violence
 Risk Taking/Impulsivity
 History of Non-Violent Offending
 Substance Use Difficulties
 Early Initiation of violence
 Anger Management Problems
 Past Supervision/Intervention Failures
 Callous/Lacking Empathy
 History of Self-Harm or Suicide
 Attention Deficit/Hyperactivity
Attempts
Difficulties
 Exposure to Violence in the Home
 Poor Compliance
 Childhood History of Maltreatment
 Low Interest/Commitment to School
 Parental/Caregiver Criminality
 Early Caregiver Disruption
 Protective Factors
 Poor School Achievement
 Prosocial Involvement
 Strong Social Support
 Social/Contextual Risk Factors
 Strong Attachment and Bonds
 Peer Delinquency
 Positive Attitude Towards Intervention
 Peer Rejection
and Authority
 Stress and Poor Coping
 Strong Commitment to School
 Poor Parental Management
 Resilient Personality Traits
 Lack of Personal/Social Support
 Community Disorganisation

SAVRY Predictive Validity
 Studies
have found the SAVRY Total
and Risk Rating are able to predict
violent offending
 McEachran
(2001)
 Gretton & Abramowiz (2002)
 Catchpole & Gretton (2003)
 Lodewijks, et al., (2008)
 Gammelgård et al., (2008)
 Meyers & Schmidt (2008)
Psychopathy as a predictor of
violence

Adult literature, psychopathy linked
with violence and antisocial behaviour

UK studies indicate that psychopathy
demonstrates similar predictive
accuracy to those found in the US


Dolan & Khawaja (2002)
Doyle et al., (2002)
PCL:YV

Interpersonal





Impression management
Grandiose sense of selfworth
Pathological lying
Manipulation for personal
gain
Affective





Lack of remorse
Shallow affect
Callous/lack of empathy
Failure to accept
responsibility
Behavioral






Stimulation seeking
Parasitic orientation
Lacks goals
Impulsivity
Irresponsibility
Antisocial





Poor anger control
Early behavior problems
Serious criminal behavior
Serious violations of
conditional release
Criminal versatility
PCL: YV Predictive Validity
 Studies
in North America and Netherlands
have shown that the PCL: YV can predict
recidivism and institutional infractions
 Corrado
et al., (2004)
 Gretton et al. (2004)
 Schmidt et al., (2005)
 Das et al., (2007)
 Lodewijks et al. (2008)
 Studies
in the UK have also shown that the
PCL: YV can predict institutional infractions
 Dolan

& Rennie (2006b; 2006c)
Marshall et al., (2006)
Comparative Studies
 Catchpole
& Gretton (2003)
 YLS/CMI,
SAVRY, and PCL:YV were able
to similarly predict general and violent
reoffending in a group of 74 (male &
female) violent young offenders.
 Sample
size was small
 Statistical analyses restricted to total scores
 Mixed sample
 No incremental validity
Comparative Studies
 Walsh
et al., (2008)
 YLS/CMI,
SAVRY and PCL: YV were able
to predict general and violent recidivism to
varying degrees of accuracy, but the
SAVRY offered the most in incremental
validity in a group of 105 young offenders
(male and female)
 Mixed
sample
 Retrospective study
 SAVRY protective factors
Aims

To examine the ability of the
YLS/CMI, SAVRY and PCL: YV to
predict the occurrence of institutional
infractions and community recidivism

To examine incremental validity of the
YLS/CMI, SAVRY and PCL: YV
Participants
 135
males - mean age 16.14 (SD 0.93) years
 114
(84.4%) White British
 Index
offence - 60% violent
 Age
1st arrest - 12.77 (SD = 1.73) years
 Age
1st AS behaviour - 11.07 (SD = 2.52) years
 Sentence
length 17.62 (SD = 12.09) months
Results
 YLS/CMI
Total Score – 23.62 (SD 7.42)
 SAVRY
Total Score – 25.60 (SD 8.21)
 SAVRY Risk Rating
10.4%- low risk
37.8% - moderate risk
51.9% - high risk
 PCL:
YV Total Score – 21.08 (SD 6.72)
Results: Institutional violence
& rule breaking
6
month follow-up
 Institutional violence
 actual
assaults on others rather than property
damage or threats of violence
 Rule
breaking
 security
breaches, substance misuse, property
damage, attempted escapes
 Of
the 135, 61 were still in custody
 20 (32.8%) institutional violence
 22 (36%) rule breaking
AUC - Institutional Violence
 SAVRY
Historical – AUC .70** (95%CI .55 - .84)
 SAVRY
Risk Total - AUC .67* (95%CI .52 - .82)
 PCL:
YV Interpersonal - AUC .73** (95%CI .59 - .87)
 PCL:
YV Total - AUC .71** (95%CI .56 - .85)
***p<0.001; **p<0.01; *p<0.05
Rule Breaking
 SAVRY,
PCL: YV and YLS/CMI could
not predict rule breaking behaviour
over 6 month follow-up
Regression Analysis

Regression analysis revealed that the
SAVRY Risk Total and the PCL: YV
Total could add to the incremental
validity of the YLS/CMI Total for the
prediction of institutional violence,
but did not add to the incremental
validity of each other
Results: Recidivism
 12
month follow-up
 Home Office Police National Computer
(HOPNC)
 Violent
 robberies,
assaults, murder, sexual assaults
kidnapping and all weapons charges
 Non-violent

 Of
Drug offences, burglary/theft, negligence, frauds,
escapes, arson, obstructions of justice, and minor
offences were classed as non-violent
the 135, 111 followed-up
 41 (36.9%) violent offences
 77 (69.4%) any offence
AUC - Violent Recidivism
 SAVRY
Historical – AUC .66** (95%CI .54 - .77)
 SAVRY
Risk Total – AUC .64** (95%CI .54 - .74)
 SAVRY
Risk Rating – AUC .63** (95%CI .54 - .74)
***p<0.001; **p<0.01; *p<0.05
AUC - Any Recidivism
Area
95% CI
Lower Bound
Upper Bound
SAVRY Historical
.69**
.58
.79
SAVRY Individual
.67**
.56
.78
SAVRY Risk Total
.68**
.57
.80
SAVRY Risk Rating .68**
.57
.80
SAVRY Protective
.71***
.61
.81
PCL: YV Affective
.64*
.52
.75
PCL: YV Lifestyle
.67**
.55
.79
PCL: YV Total
.62*
.50
.74
YLS Offending
.68**
.57
.78
YLS Total
.64*
.52
.75
YLS Summary
.67**
.56
.78
Regression Analysis

SAVRY Risk Total added incremental validity to
the PCL: YV Total and YLS/CMI Total for violent
and general recidivism

SAVRY Risk Rating added incremental validity to
the PCL: YV and YLS/CMI for violent and general
recidivism

SAVRY Protective factor added to the incremental
validity of the SAVRY Risk Total for the prediction
of general recidivism
Survival Analysis
 Outcome
- time to an event
 To determine the proportion of
participants who have not re-offended
at each month of the follow-up period
(“survival”)
 Offending patterns over time to see not
only whether certain risk groups reoffend in greater proportions but
whether they do so more quickly
 Censored data
Survival Analysis
Proportion not committing a violent offence %
Kaplin-Meier Survival Curve for violent recidivism over 12 months
SAVRY Risk Rating
high
low
moderate
high-censored
low-censored
moderate-censored
100
80
60
40
20
0
0
2
4
6
8
10
Time period to first violent offence (months)
12
Survival Analysis
Kaplin-Meier Survival Curve for general recidivism over 12 months
SAVRY Risk Rating
high
low
moderate
high-censored
low-censored
moderate-censored
Proportion not committing any offence %
100
80
60
40
20
0
0
2
4
6
8
10
12
Time period to first general offence (months)
MSR were 5.7 times more likely to re-offend sooner than
LSR and the HSR were 8.4 times more likely to re-offend
sooner than the LSR
Conclusions

SAVRY was a better predictor of violent infractions
than the YLS/CMI but comparable to the PCL: YV

SAVRY was a better predictor of violent and
general recidivism then the PCL: YV and YLS/CMI

SAVRY Risk Total and Risk Rating performed
equally well

Protective factors should be incorporated into risk
management
Limitations
 High
risk sample
 Reporting of institutional infractions
 Reliance on criminal records data
 High levels of re-offending rates
 Severity of violence
Clinical Implications
 Quantity
and quality of clinical
information
 Improvements in file recording and
report writing
 Discharge planning
 Categorise those who are likely to
require more intensive monitoring and
targeted interventions
 Case formulation
Implications
 Labelling
 Misclassification
Future Research
 Gender
 Mental
Health
 Transitional Period
 Change over time/intervention
 Implementation into services
Contact Details
 charlotte.rennie@manchester.ac.uk
 charlotte.rennie@merseycare.nhs.uk
 Tel:
0151 471 2628