Assessing Short-term, Dynamic Changes in Risk: The Predictive Validity of the Brockville Risk Checklist

Abstract

In the present study, we examined the predictive utility of the Brockville Risk Checklist (BRC), a structured assessment tool for clinical care planning, using a semi-parametric regression technique. We examined BRC scores and the frequency and type of incidents (aggression, noncompliance, etc.) over 13 assessments for 121 psychiatric patients at a medium-secure forensic unit. Most patients were male (95%), on average 40.9 (SD = 13.0) years old, and diagnosed with a psychotic disorder (78%). Generalized estimating equation (GEE; Liang & Zeger, 1986) modeling was used in this study to determine if changes in dynamic risk scores over time predicted outcomes (presence or absence of an incident) during the approximately six-week follow-up period. Results showed that scores on the Harm to Others scale assessed at one case conference significantly predicted changes in aggressive and total incidents recorded in the subsequent case conference. The BRC shows promise as a dynamic measure of inpatient aggression, predicting verbal or physical incidents an average of six weeks later.

Keywords:

• dynamic risk
• risk assessment
• aggression
• psychiatric forensic inpatients
• time series