Dynamic Risk Factors in Violence Risk Assessment: A Multiple Time-Point Evaluation of the HCR-20 and START

The consideration of dynamic risk factors when conducting risk assessments is generally considered best practice. However, little empirical research can speak to intraindividual change over time in putatively dynamic risk factors included in violence risk assessments instruments, and even fewer studies can speak to whether this change is associated with violence. The present study investigated change on putatively dynamic scales included on the Historical-Clinical-Risk Management-20 (HCR-20) and the Short-Term Assessment of Risk and Treatability (START), using a prospective repeated measures design with a civil psychiatric and a correctional sample. Intraindividual change on these scales was seen in a notable proportion of the assessments. More change was seen on the HCR-20 when the reassessment interval was over two months compared to less than two months, whereas the proportion of change on the START scales was consistent across different reassessment intervals. As well, fluctuations on these scales were predictive of subsequent violence.