A Comparison of the HCR-20^V3 Among Male and Female Insanity Acquittees: A Retrospective File Study

Abstract

The current retrospective risk assessment study evaluated the use of the Historical-Clinical-Risk Management-20 Version 3 (HCR-20^V3) in a sample of 100 male and 24 female insanity acquittees, comparing the presence of risk factors and its validity in assessing violence in a state forensic hospital across males and females. Over an average of 15.5 months, 44.4% of the total sample engaged in any act of violence within the institution, highlighting the need for effective risk assessment and management tools. An equivalent proportion of males and females engaged in violence (42.0% of males and 54.2% of females). Results indicated higher interrater reliability on scoring risk factors among males as compared to females, calling for future research into the role of item indicators across genders and possible differences in interpretations of scoring guidelines. Results indicated that females exhibited similar numerical ratings of presence risk factors as males, although they were rated higher on Past Problems in Relationships and Traumatic Experiences. The relationships between scale scores and violence were higher among males than females. However, gender was not a significant moderator in logistic regression analyses predicting likelihood of violence. Additional research is necessary to evaluate how ratings of risk factors are translated into summary risk estimates, opinions about dangerousness, and treatment interventions, with a particular focus on how such decision-making is influenced by the gender of examinees.

Keywords:

• Gender
• HCR-20
• risk assessment
• institutional aggression