1. Lifetime prisoners in Sweden- A comparative study of the three risk assessment instruments LSI-R, VRAG and PCL-R Ulrika Haggård M.S.W, PhD

2. Changes in the legislation In 2006 changed the legislation of converting lifetime sentence to time-fixed sentence The factors accounted for in the decisions made by the Örebro court is: 1. The crime committed leading to lifetime sentence 2. Time spent in prison 3. Misbehavior during imprisonment 4. Future plans 5. Risk of recidivism

3. Material and method Inclusion criteria: Convicted to lifetime imprisonment between 1965-2007 (N=248) Inclusion criteria: Convicted to lifetime imprisonment between 1965-2007 (N=248) Information was retrieved from: Information was retrieved from: - The correctional act - Forensic psychiatric evaluations, - Risk assessments (Kumla), - The National register of crime ‘ - Assessment with the VRAG, PCL-R and LSI-R was made Information of recidivism was retrieved from the National registered penal records - Intraclass correlation was used for interrater reliability - ROC-analysis was used for the comparison of validity between the risk instruments.

4. LSI-R… Why another risk assessment instrument? LSI-R is based on the risk-need-responsibility theory 1.The LSI-R is mainly based on dynamic factors with focus on risk reduction actions and risk management. 2.Easy to use and without requirement of an academic education. 3.Less subjective 4.Easy to understand

5. Reliability of the risk assessment instruments LSI-R, VRAG and PCL-R InstrumentICC Confidence interval LSI-R (In) 0.910.05-0.98 VRAG0.780.15-0.95 PCL-R0.680.24-0.92

6. Prediction of misconduct during imprisonment (AUC of ROC), n=242 Instrument Misconduct (>10) Threat and violence LSI-R (In) 0.71 (0.64-0.78) 0.65 (0.58-0.72) VRAG 0.70 (0.62-0.77) 0.67 (0.60-0.74) PCL-R 0.70 (0.68-0.77) 0.69 (0.62-0.76)

7. Recividism at follow-up 57 of the prisoners had been released from prison. 57 of the prisoners had been released from prison. 35 % had recidivated in any crime (convictions) 35 % had recidivated in any crime (convictions) 9 % had recidivated in violent crimes. 9 % had recidivated in violent crimes. 4 % had recidivated in sexual crimes. 4 % had recidivated in sexual crimes.

8. Validity of the risk assessment instruments Instruments AUC of ROC Confidence interval LSI-R (ut)0.800.67-0.93 PCL-R0.780.64-0.91 VRAG0.730.57-0.88

9. Conclusions LSI-R is a dynamic and strait forward and use- friendly instrument The reliability seems to be higher than the other instruments The validity is in line with the other instruments Needs more research for application in different settings and materials

10. Thank you for your attention! Contact information: Ulrika Haggård Email: ulrika.haggard@ki.se eller ulrika.haggard@rmv.seulrika.haggard@ki.seulrika.haggard@rmv.se Phone: +46 8 6071530 or +46 73 6596000