IPT Book Reviews

Title: Violent Offenders: Appraising and Managing Risk  Positive Review Positive Review
Authors: Vernon L. Quinsey, Grant T. Harris, Marnie E. Rice, and Catherine A. Cormier
Publisher: American Psychological Association, 1998

American Psychological Association
APA Order Department
P.O. Box 92984
Washington, DC 20090-2984
(800) 374-2721
$39.95 (c)

This 356-page book reports on a program of research that began 25 years ago at the maximum-security Oak Ridge Division of the Penetanguishene Mental Health Centre in Ontario, Canada. Most of the research has been reported over the years in different book chapters and articles, but the authors bring it together and draw conclusions about the prediction of violent behavior.

This is an especially timely topic with the sexual predator laws in many states that require predictions to be made concerning the likelihood that a sex offender will reoffend after his release from prison. The sexual predator laws require the justice system to make decisions that balance the civil liberties of the offender against the safety of the community. Such a balance requires mental health professionals to assess the likelihood that the offender will commit a new sexual offense. This group of researchers has produced some of the most important research addressing this topic.

The first section of the book puts the task of violence prediction in historical and methodological context. The difficulties in predicting violence and the weaknesses of the research through the early 80s are discussed, along with the solutions that have been used to overcome these shortcomings. The inability of psychologists to make accurate predictions of violence based on their clinical judgment is addressed, and the authors conclude that it is doubtful whether clinical judgments can ever improve the predictive accuracy of actuarial prediction schemes alone.

The second section describes the new generation of follow-up studies, whose predictive accuracy was consistently higher than those obtained in the earlier studies. A chapter in this section is devoted to sex offenders, and the authors note that, of all the types of offenders discussed in the book, the literature on sex offenders is by far the largest. The chapter describes the researchers' efforts to identify characteristics of men that differentiate them from nonoffenders and nonsexual offenders as well as characteristics that predict future sexual recidivism. The probability of recidivism is related to psychopathy as measured by the Hare PCL-R, the number of previous sexual offenses, the age, gender, and relationship of previous victims, and phallometrically measured sexual deviance. Factors which clinicians have believed were related to recidivism, such as a history of having been sexually abused as a child and general psychological problems, have not been found to relate to recidivism.

In the third section the authors present their work on the development of actuarial instruments for the prediction of violent recidivism. They first describe their general approach in constructing their instrument, and then describe their Violence Risk Appraisal Guide (VRAG). They next describe their work in developing special instruments for prediction of violent recidivism in selected subpopulations, including sex offenders. Although in their original presentation of the VRAG (Webster et al., 1994) the authors recommended making small adjustments to the VRAG score based on clinical judgment, they now believe that there is "an extremely high probability that clinically adjusted VRAG predictions are less accurate than unadjusted scores" (p. 163). The third section ends with a chapter titled "Fifteen arguments against actuarial risk appraisal" which answers the objections that are commonly made against this approach.

The fourth section, on altering the risk of violence, contains a chapter on treatment and management. Current treatment methods are not very effective in reducing the likelihood of violent recidivism among serious adult offenders, particularly those who are psychopaths.

Several appendices at the end include the scoring criteria for the VRAG and the SORAG (Sex Offender Risk Appraisal Guide) and normative data. There are guidelines for the necessary information to be gathered, along with a detailed example of a psychosocial history and the VRAG scoring from this history.

This book contains the most recent information in this rapidly changing field and the instructions on how to use the VRAG and SORAG are clear, detailed and comprehensive. This book is essential for any psychologist or attorney who may become involved in situations where this type of risk assessment is made.

Reviewed by Hollida Wakefield, Institute for Psychological Therapies.

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Webster, C. D., Harris, G. T., Rice, M., Cormier, C., Quinsey, V. L. (1994). The Violence Prediction Scheme: Assessing Dangerousness in High Risk Men  (Paperback). Toronto, Canada: Centre of Criminology, the University of Toronto.

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