ETHICAL ISSUES IN RISK ASSESSMENTS July 27, 2009

Presented by: Bruce E. Mapes, Ph.D. PO Box 1028 Exton, PA

RISK - DEFINITION Risk is a threat or hazard that isnt completely understood and therefore can be forecast only with uncertainty. Risk involves the ideas of nature, severity, frequency, imminence, and likelihood – not just probability.

definition Risk is context specific Risk is never known but estimated.

RISK ASSESSMENT IS: Gathering information to assist in decision-making. An individualized process

RISK ASSESSMENT ISNT: Simply providing a diagnosis or prognosis Simply considering a set of test items or risk factors determined before the evaluation.

GOALS OF RISK ASSESSMENT To contain and reduce the individuals risk. To guide interventions. To improve the consistency of decisions. To improve the transparency of decisions to protect the rights of the individual, as well as the community and potential victims.

ESTIMATING FIRST OFFENSE Intent Plan Means Opportunity Coin Toss

ESTIMATING RECIDIVISM History (static factors) Dynamic Factors Acute Factors

Your Perspective LEVEL#%VOR Low90030%270 High10090%90

DETECTION RATES FREQVICTIMS / 20 YRS 5 YRS15 YRS20 YRS LOW418.5%47.8%68.4% HIGH2064.1% %

WHO IS MORE DANGEROUS? Adult male sex offender –Selects young boy victims –Selects young girls victims

RESEARCH CRITERION Re-arrest / hospitalization for anything Re-arrest / hospitalization for violence Charged for anything or new offense Convicted for anything or new offense

VICTIMIZATION STUDIES Besserer and Trainor (2000) 78% of sexual assaults not reported to anyone. 59% not important enough

POLICE RECORDS 50% of sexual assault victims will report Incest victims unlikely to report first offense and almost never report the second Previous victims who went through the system unlikely to report a new offense

CLINICAL RECORDS Diagnoses to justify services Lack information about crimes Confidentiality Different providers

HOW CHARGED? Plea bargain = 25 victims become 1 Specific offense may not be prosecuted

LENGTH OF FOLLOW-UP Highest number within first five years after release from prison In reality risk period may be 20 – 25 years Current studies 6 months to sixteen years

DEVIATIONS FROM GROUP For sex offending, the risk of sexual assaults increases to the age of 26 and then decreases to the age of 40, and it is almost nonexistent after the age of 60.

PA AGES AT CONVICTION (n = 6406) 63.7% < 40 years old 31 % = 41 – 60 years old 5.6 % > 60 (7 > 80 years)

SURVIVOR ANALYSIS 23% of the individuals receiving the same score as John on the Knapp Risk Assessment Protocol (KRAP) were re- arrested in 2 years, 34% were re-arrested in 5 years, and 43% were re-arrested in 10 years.

HOW DO WE REPORT RISK? Risk prediction (dichotomous) Risk Estimate (Survival analysis) Risk Statement

MENTAL HEALTH ISSUES There is no Axis 1 diagnosis with a significant relationship to violence. Iterative Classification Tree (Monahan)

SUBSTANCE ABUSE ISSUES May be related to first offense Recidivists more likely to have co- occurring Antisocial Personality Disorder Substance use may be a means, rather than the end.

FRONTAL LOBE ISSUES Frontal lobe impairment may increase risk for getting caught, rather than for violence.

THE PRIMARY QUESTIONS? To what degree does a person make a choice to be violent? To what degree does he or she not make a choice? If he or she does not make a choice, what do we do?