Gender-Sensitive Violence Risk Assessment: Predictive Validity of Six Tools in Female Forensic Psychiatric Patients

Vivienne de Vogel*, Mieke Bruggeman, Marike Lancel

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    7 Citations (Scopus)


    Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management-20 (HCR-20), Historical, Clinical, Risk Management-20 Version 3 (HCR-20(V3)), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist-Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20(V3), and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20(V3) demonstrated significant predictive accuracy.

    Original languageEnglish
    Pages (from-to)528-549
    Number of pages22
    JournalCriminal Justice and Behavior
    Issue number4
    Publication statusPublished - Apr-2019


    • risk assessment
    • gender
    • female forensic psychiatric patients
    • recidivism
    • mortality
    • WOMEN
    • HCR-20(V3)

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