Investigating the Validity of the Classification of Violence Risk in a UK Sample

Abstract

We attempted to cross-validate the Classification of Violence Risk, or COVR (Monahan, Steadman, Appelbaum et al., 2005), in a sample of acute psychiatric patients in the North West of England. The study used a prospective design to follow-up 93 patients assessed using the COVR for 20 weeks post-discharge. Overall, the COVR did not demonstrate significant predictive validity with respect to violence. More than half of patients classified as average risk by the COVR were violent in the follow-up compared to less than 20% of those in the very low risk group, but none of the high-risk participants were violent. In contrast, violence was significantly predicted by key variables, including female gender, violence preceding admission, and personality disorder. There is a need for more cross-validation research of the COVR.

Keywords:

• violence
• risk assessment
• psychiatry
• gender
• risk factors

Acknowledgments

This study was supported by a grant from the Department of Health National Forensic Research and Development program. We are very grateful to Professor John Monahan, University of Virginia, for the helpful comments and advice provided on an earlier draft of this paper.