Violent behavior on inpatient psychiatric units: the HCR-20 violence risk assessment scheme

Abstract

This study investigated the validity of the Historical/Clinical/Risk Management (HCR-20) violence risk assessment scheme for predicting violent behavior by psychiatric inpatients. Participant~' (N = 55) medical records were monitored for violent behavior during the first 28 days of hospitalization. The frequency and severity of incidences of verbal violence, property destruction, and physical violence were rated using the Modified Overt Aggression Scale (MOAS). Regression analysis indicated that the variance in the HCR-20 Total score was significantly associated with variance in MOAS scores of physical violence (F = 2.97, p=.04). The Clinical scale (C scale) of the HCR-20 was found to have the greatest degree of shared variance with MOAS scores of the three types of violent behavior. The results of this study contribute to the evidence base supporting the use of the C scale of the HCR-20 when making predictions of violent behavior in a multi-ethnic sample of forensic psychiatric inpatients.