Predictive Validity and Other Psychometric Properties of the Short-Term Assessment of Risk and Treatability (START) in a Norwegian High Secure Hospital

Abstract

Short- to medium-term risk assessment in psychiatric hospitals is a topic of clinical relevance that deserves attention from the research community. In this paper, the Short Term Assessment of Risk and Treatability, or START (Webster, Martin, Brink, Nicholls, & Middleton, 2004), a new structured instrument for judgment of dynamic risk and treatment factors is briefly described. Internal reliability properties are analyzed and the predictive validity for severe violence in a Norwegian high secure psychiatric hospital is investigated. The results indicate that the START has promise as a valid tool for short-term violence risk assessment. The authors make an argument for the importance and relevance of dynamic risk and strength factors in the short to medium term.

Keywords:

• START
• psychiatry
• assessment
• risk
• violence
• prediction

Acknowledgments

Thanks to Professor C. D. Webster for his inspiration and helpfulness, and our colleagues in Canada, Great Britain and the Netherlands for their sharing and support in working on the START.