Evaluation of whether commonly used risk assessment tools are applicable to women in forensic psychiatric institutions

By providing a structured assessment of specific risk factors, risk assessment tools allow statements to be made about the likelihood of future recidivism in people who have committed a crime. These tools were originally developed for and primarily tested in men and are mainly based on the usual criminological background of men. Despite significant progress in the last decade, there is still a lack of empirical research on female offenders, especially female forensic psychiatric inpatients. To improve prognosis in female offenders, we performed a retrospective study to compare the predictive quality of the following risk assessment tools: PCL-R, LSI-R, HCR-20 v3, FAM, and VRAG-R. Data were collected from the information available in the medical files of 525 female patients who had been discharged between 2001 and 2017. We examined the ability of the tools to predict general and violent recidivism by comparing the predictions with information from the Federal Central Criminal Register. Overall, the prediction instruments had moderate to good predictive performance, and the study confirmed their general applicability to female forensic psychiatric patients. The LSI-R proved to be particularly valid for general recidivism, and both, LSI-R and HCR-20 v3, for violent recidivism. • LSI-R is best suited for predicting general recidivism in female forensic psychiatric patients. • HCR-20 v3 is best suited for predicting violent recidivism in female forensic psychiatric patients. • All instruments exhibit low sensitivity and are not suitable as the sole basis for discharge decisions. • Study's strength: large sample size, long observation period.