Predictors of Historical Clinical Risk Management-20 Version 3 (HCR–20:V3) summary risk ratings

Abstract

How individual risk factors on structured professional judgement (SPJ) assessment tools translate into SPJ final risk formulations is unclear due to a lack of structured criteria. Understanding pathways to risk formulations is vital, as they serve as intervention targets for risk management. This study examined how Historical Clinical Risk Management-20 Version 3 (HCR–20:V3) raters weighed varied information sources to complete summary risk ratings (SRRs). Four independent raters retrospectively coded an archived sample of 32 inpatients at a Canadian forensic psychiatric hospital. HCR–20:V3 SPJ SRRs were regressed on the 20 individual items and sample covariates to identify unique predictors of risk formulations across each rater. Raters consistently used HCR–20:V3 items and composite subscales for SRRs. Despite strong inter-rater agreement on the SRRs, there were variations across raters regarding which items informed each SRR. Rater-unique biases were also shown to influence SRRs. Implications for forensic practice and risk management are discussed.

Keywords:

• HCR–20:V3
• risk assessment
• summary risk ratings
• structured professional judgement
• risk management
• final risk formulations

Ethical standards

Declaration of conflicts of interest

Jeremy Cheng has declared no conflicts of interest.

Andrew M. Haag has declared no conflicts of interest.

Mark Olver has declared no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Acknowledgements

Special acknowledgements are made to Chayse Haldane, Troy Rieck, Alicia MacNeil, Robi Wirove and Arielle Boyes.

Additional information

Funding

Jeremy Cheng was supported by a Doctoral Fellowship from the Social Sciences and Humanities Research Council of Canada