Assessment tools used to predict how likely a psychopathic
prisoner is to re-offend if freed from jail are "utterly useless" and
parole boards might just as well flip a coin when deciding such risks,
Publishing a study that found risk score tools are only around
46% accurate on how likely psychopathic convicts are to kill, rape or assault
again, they said probation officers and judges should set little or no store by
They warned that clinicians carrying out such
classifications must be aware of their severe limitations, and make sure
prisoners undergo a comprehensive psychiatric diagnosis before any risk
assessment is made.
"If you apply these (tests) to somebody who is a
psychopath, they're utterly useless, you might as well toss a coin," said
Dr Jeremy Coid, director of the forensic psychiatry research unit at Queen Mary
University of London who led the study."They will not predict accurately
at all," he told reporters at a briefing in London about his findings.
Coid and other forensic psychiatrists say the findings which
also showed the tools perform only moderately well in prisoners with disorders
like schizophrenia, depression and drug and alcohol dependence could have major
implications for risk assessment in criminal justice systems.
"There are increasing expectations of public protection
from violent behaviour, and psychiatrists can be seriously criticised if they make
wrong decisions," he said. Dr Seena Fazel, a consultant forensic
psychiatrist at Britain's University of Oxford, said the reliability of the
tests' predictive ability was so low that it might be best not to use them at
all and warned that at the very least, their results should only be noted by
parole boards, rather than acted upon. "If you're going to use these
instruments, be aware of their strengths and limitations," he told
The estimated prevalence of adult psychopathy in the general
population is around 1%, but that rises to between 15% and 25% among men in
Coid, whose study was published in the British Journal of
Psychiatry, analysed data from 1 396 male prisoners in England and Wales who
were interviewed between 6 and 12 months before their release.
All the men were serving sentences of two or more years for
a sexual or violent offence. The prisoners were assessed for personality
disorders, symptoms of schizophrenia, depression and drug and alcohol
dependence, and were measured for psychopathy on a reputable scale known as Hare
Psychopathy Check List.
After their release, data on their re-offending rates was
added to the study, and showed that among three different re-offending risk
assessment tools used before their release, the accuracy among psychopaths was
While the tools were more accurate in predictions for
prisoners with no mental health disorders at around 75% accuracy they were only
around 60% right when it came to prisoners diagnosed with schizophrenia and
For prisoners with anti-social personality disorders the
predictive value of the tests ranged from poor to little more than chance, with
an average 53.2% predictive accuracy. And for the 70 prisoners rated as
psychopathic, none of the tests was statistically better than chance.
Coid said the results suggest it is time to question the
expectations put on psychiatrists and psychologists asked to forecast future
behaviour of offenders, and to consider what can happen to their reputations if
predictions are wrong."The easy solution is to be highly restrictive on
who is released, and be risk averse."
"However, even for
serious offenders, most will be released at some stage and someone has to carry
out a risk assessment," he said. "We need to prioritise the
development of new assessment tools for these hard-to-predict groups."
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