Predicting violence in female forensic inpatients with substance use disorders - the utility of a gender-responsive assessment

Viviane Wolf; Juliane Mayer; Ivonne Steiner; Irina Franke; Verena Klein; Judith Streb; Manuela Dudeck

doi:10.3389/fpsyt.2024.1346815

Predicting violence in female forensic inpatients with substance use disorders - the utility of a gender-responsive assessment

Front Psychiatry. 2024 Jan 29:15:1346815. doi: 10.3389/fpsyt.2024.1346815. eCollection 2024.

Authors

Viviane Wolf¹, Juliane Mayer¹, Ivonne Steiner¹, Irina Franke^{2

3}, Verena Klein¹, Judith Streb³, Manuela Dudeck³

Affiliations

¹ Department of Forensic Psychiatry and Psychotherapy, kbo-Isar-Amper-Clinic Taufkirchen (Vils), Taufkirchen (Vils), Germany.
² Department of Forensic Psychiatry, Psychiatric Services of Grisons, Chur, Switzerland.
³ Department of Forensic Psychiatry and Psychotherapy, Ulm University, Guenzburg, Germany.

Abstract

Introduction: Given that risk assessment tools are commonly based on male samples, the applicability to justice-involved women remains to be clarified. This study aimed at assessing (1) the predictive validity of the HCR-20 V3, the prevailing, yet primarily male-based violence risk assessment instrument, and (2) the incremental validity of the FAM, a gender-responsive supplement, for both inpatient violence and violent recidivism in justice-involved women.

Methods: The sample included 452 female forensic inpatients with substance use disorder discharged from German forensic psychiatric care between 2001 and 2018.

Results: ROC analyses revealed good predictive accuracy for the HCR-20 V3 while the FAM failed to provide incremental validity. Further, binary logistic regression determined several predictors of violence including personality disorder, covert/manipulative behavior, suicidal behavior/self-harm, and problematic intimate relationship.

Discussion: These findings support the applicability of the HCR-20 V3 in justice-involved women with substance use disorder, while highlighting the clinical relevance of the FAM in supporting a gender-informed risk management.

Keywords: justice-involved women; recidivism; risk assessment; substance use disorder; violence.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. As part of a broad research project on risk assessment in justice-involved women, this research was funded by the Bavarian State Ministry of Families and Social Affairs (ZFBS), Office of Corrections, with a grant of EUR 420,300 (grant number ZBFS-X/1-10.700-5/3/9). This grant financed the work of VW, JM, and IS.