Assessing the reliability, predictive and construct validity of historical, clinical and risk management-20 (HCR-20) in Mexican psychiatric inpatients

Nord J Psychiatry. 2016 Aug;70(6):456-61. doi: 10.3109/08039488.2016.1159330. Epub 2016 Apr 12.

Abstract

Introduction: Assessing dangerousness to gauge the likelihood of future violent behaviour has become an integral part of clinical mental health practice in forensic and non-forensic psychiatric settings, one of the most effective instruments for this being the Historical, Clinical and Risk Management-20 (HCR-20).

Objective: To examine the HCR-20 factor structure in Mexican psychiatric inpatients and to obtain its predictive validity and reliability for use in this population.

Method: In total, 225 patients diagnosed with psychotic, affective or personality disorders were included. The HCR-20 was applied at hospital admission and violent behaviours were assessed during psychiatric hospitalization using the Overt Aggression Scale (OAS). Construct validity, predictive validity and internal consistency were determined.

Results: Violent behaviour remains more severe in patients classified in the high-risk group during hospitalization. Fifteen items displayed adequate communalities in the original designated domains of the HCR-20 and internal consistency of the instruments was high.

Conclusion: The HCR-20 is a suitable instrument for predicting violence risk in Mexican psychiatric inpatients.

Keywords: Assessment; mental disorders; validation; violence risk.

MeSH terms

  • Adult
  • Aggression / psychology
  • Female
  • Forecasting
  • Hospitalization
  • Hospitals, Psychiatric*
  • Humans
  • Inpatients / psychology*
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology*
  • Mexico / epidemiology
  • Middle Aged
  • Population Groups
  • Reproducibility of Results
  • Risk Management / methods*
  • Violence / psychology*
  • Young Adult