Assessing Inpatient Victimization Risk Among Insanity Acquittees Using the HCR-20V3

Article Figures & Data

Table 1

Differences Between Victimized and Nonvictimized Acquittees

Demographic Characteristic	Victimized			Nonvictimized			Comparison
Demographic Characteristic	n	M	SD	n	M	SD	t	p	d
Age at Evaluation 1	58	42.36	11.18	110	45.20	4.04	1.33	.19	0.22
Time between evaluations	56	16.55	5.90	96	15.06	5.83	−1.51	.13	0.26
Total arrests	58	20.74	34.25	110	25.89	39.68	0.84	.40	0.14
Longest prior sentence	31	22.12	30.61	55	17.06	32.58	−0.71	.48	0.16
Demographic Characteristic	n	Yes	No	n	Yes	No	χ²	p
Male	58	49 (84.4%)	9 (15.5%)	111	91 (82.0%)	20 (18.0%)	0.17	.68
Violent charge	58	53 (91.3%)	3 (8.7%)	110	106 (96.4%)	4 (3.6%)	1.86	.17
Primary Diagnosis	n	Yes	No	n	Yes	No	χ²	p
Psychotic disorder	58	37 (64.9%)	21 (36.2%)	109	69 (63.3%)	40 (36.7%)	< 0.01	.95
Mood disorder	58	10 (17.2%)	48 (82.8%)	109	15 (13.8%)	94 (86.2%)	0.36	.55
Substance use disorder	58	1 (1.72%)	57 (98.2%)	109	7 (6.4%)	102 (93.6%)	1.83	.18

Time between evaluations = time in months elapsed between Evaluation 1 and Evaluation 2.

Table 2

Interrater Reliability for Items and Scales of the HCR-20^V3

Scale and Item	Intraclass Correlation Coefficient
Historical Scale (n = 86 paired ratings)
H1. Violence	1.00
H2. Other antisocial behavior	0.86^**
H3. Relationships	0.56^**
H4. Employment	0.60^**
H5. Substance abuse	0.95^**
H6. Major mental disorder	0.84^**
H7. Personality disorder	0.93^**
H8. Traumatic experiences	0.78^**
H9. Violent attitudes	0.51^*
H10. Treatment or supervision response	0.79^**
Historical Scale Total	0.86^**
Clinical Scale (n = 86 paired ratings)
C1. Insight	0.92^**
C2. Violent ideation or intent	0.60^**
C3. Symptoms of major mental disorder	0.87^**
C4. Instability	0.80^**
C5. Treatment or supervision response	0.85^**
Clinical Scale Total	0.89^**
Risk Management (n = 86 paired ratings)
R1. Professional services and plans	0.73^**
R2. Living situation	0.59^**
R3. Personal support	0.71^**
R4. Treatment or supervision response	0.79^**
R5. Stress and coping	0.59^**
Risk Management Scale Total	0.85^**

Table 3

Frequency and Severity of Victimization

Incident Severity	Victimized, n (%)	Victimization Mean	Range of Incidents
Any victimization	58 (34.3)	0.75	1–10
START Outcome Scale Level 2	21 (13.0)	0.16	1–3
START Outcome Scale Level 3	46 (28.6)	0.57	1–9
START Outcome Scale Level 4	2 (1.2)	0.01	1–1

N = 169 subjects. Victimization Mean = the number of incidents at each level of incident severity; Range of Incidents = minimum and maximum number of incidents, only including cases where there was at least one incident of victimization; Any victimization = victimization at SOS Level 2, 3, or 4.

Table 4

HCR-20^V3 Scales as Predictors of Victimization

Variable	Predicting Presence of Victimization					Predicting Number of Victimization Incidents
Variable	β	Standard Error	Wald	p	Exp(β)	Standardized β	t	p
H Scale	< 0.01	0.07	< 0.01	.99	1.00	0.10	1.07	.29
C Scale	0.38	0.12	10.54	< .01^*	1.46	0.28	2.68	< .01^*
R Scale	−0.13	0.13	1.03	.31	0.88	−0.05	−0.53	.60
Time	0.04	0.03	1.18	.28	1.04	0.16	1.97	.05

HCR-20^V3, Historical, Clinical, Risk Management-20 Version 3; H Scale, Historical scale; C Scale, Clinical scale; R Scale, Risk Management scale; Time, time in months elapsed between Evaluation 1 and Evaluation 2.
↵* p < .01.

Table 5

Differences in Mean HCR-20^V3 Scores by Victimization Status

HCR-20^V3 Component	Victimized			Nonvictimized			Comparison
HCR-20^V3 Component	n	M	SD	n	M	SD	t	p	d
H1. Violence	58	1.98	0.13	111	2.00	0.00	1.39	.17	0.23
H2. Other antisocial behavior	58	1.10	0.83	110	1.02	0.94	0.58	.56	0.10
H3. Relationships	58	1.81	0.44	109	1.74	0.53	0.82	.41	0.13
H4. Employment	57	1.30	0.65	106	1.20	0.71	0.88	.38	0.15
H5. Substance abuse	58	1.67	0.69	108	1.56	0.80	0.99	.33	0.16
H6. Major mental disorder	58	1.95	0.29	111	1.96	0.19	0.42	.67	0.07
H7. Personality disorder	58	1.19	0.85	111	1.09	0.84	0.73	.47	0.12
H8. Traumatic experiences	58	1.53	0.63	110	1.45	0.69	0.74	.46	0.12
H9. Violent attitudes	58	0.76	0.73	111	0.60	0.73	1.31	.19	0.21
H10. Treatment or supervision response	58	1.76	0.47	111	1.69	0.61	0.70	.48	0.11
H Scale	57	15.07	2.93	102	14.37	2.87	1.46	.15	0.24
C1. Insight	58	1.86	0.40	111	1.82	0.43	0.62	.53	0.10
C2. Violent ideation or intent	58	0.45	0.65	111	0.19	0.48	2.94	< .01^*	0.48
C3. Symptoms of major mental disorder	58	1.50	0.71	111	1.26	0.81	1.90	.06	0.31
C4. Instability	58	1.21	0.85	111	0.74	0.79	3.55	< .01^*	0.58
C5. Treatment or supervision response	58	1.59	0.62	111	1.24	0.78	3.12	< .01^*	0.51
C Scale	58	6.60	2.05	111	5.25	2.25	3.82	< .01^*	0.62
R1. Professional services and plans	58	1.71	0.53	111	1.64	0.63	0.69	.49	0.11
R2. Living situation	58	1.86	0.35	111	1.74	0.52	1.84	.07	0.30
R3. Personal support	58	1.55	0.65	111	1.55	0.66	0.02	.98	0.00
R4. Treatment or supervision response	58	1.81	0.44	111	1.70	0.50	1.45	.15	0.24
R5. Stress and coping	58	1.74	0.44	111	1.67	0.56	0.95	.34	0.15
R Scale	58	8.67	1.68	111	8.3	2.07	1.19	.24	0.19

Medium effect sizes are set in bold. HCR-20^V3, Historical, Clinical, Risk Management-20 Version 3.
↵* p < .01.

Table 6

HCR-20^V3 Items as Predictors of Victimization

Variable	Predicting Presence of Victimization					Predicting Number of Victimization Incidents
Variable	β	Standard Error	Wald	p	Exp(β)	Standardized β	t	p
C2. Violent ideation or intent	0.50	0.33	2.27	.13	1.65	0.10	1.22	.22
C4. Instability	0.52	0.24	4.79	.03	1.68	0.31	3.68	< .01^*
C5. Treatment or supervision response	0.35	0.28	1.48	.22	1.41	<0.01	0.09	.93
Time	0.03	0.03	1.16	.28	1.03	0.18	2.30	.02