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Related Experiment Videos

Dangerousness commitments: indices of future violence potential?

R A Zeiss1, E D Tanke, H H Fenn

  • 1Veterans Affairs Palo Alto Health Care System, CA 94304, USA.

The Bulletin of the American Academy of Psychiatry and the Law
|January 1, 1996
PubMed
Summary

Long-term clinical predictions of dangerousness in psychiatric patients show varying accuracy. Patient assaultiveness became more evident in later years, and prediction accuracy was influenced by ethnic group.

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Area of Science:

  • Forensic Psychiatry
  • Clinical Psychology
  • Mental Health Law

Background:

  • Assessing long-term dangerousness in psychiatric inpatients is crucial for civil commitment decisions.
  • Previous research has yielded mixed results regarding the accuracy of these predictions.
  • Understanding factors influencing prediction accuracy is essential for improving patient care and public safety.

Purpose of the Study:

  • To evaluate the accuracy of long-term clinical predictions of dangerousness among psychiatric inpatients.
  • To identify factors that influence the accuracy of these dangerousness predictions.
  • To explore the relationship between extended civil commitment and subsequent assaultive behavior.

Main Methods:

  • Retrospective review of hospital and criminal records for psychiatric patients undergoing extended civil commitment (Postcertification for the Imminently Dangerous statute, N=31).

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  • Comparison with a matched control group (N=31) initially placed on 14-Day Certifications for Dangerousness to Others but not extended commitments.
  • One- to five-year follow-up assessing documented physically assaultive behavior.

    • Main Results:

    • Patients in the extended commitment group exhibited significantly higher rates of documented physical assault (61%) compared to the control group (26%) over the follow-up period.
    • Differences in assaultiveness between groups emerged and became significant in years subsequent to the first year.
    • Prediction accuracy varied based on the patient's ethnic group.

    Conclusions:

    • Inclusion in an extended civil commitment group indicates a greater long-term potential for assault among psychiatric inpatients.
    • The predictive accuracy of dangerousness improves over longer follow-up periods.
    • Ethnic background is a significant factor influencing the accuracy of predicting dangerousness in this population.