Assessing Future Risk of Youth Violence

Determination of future risk of violence is an important forensic task. It can contribute to decisions about the appropriate level of care or structure. Research has demonstrated repeatedly that clinical judgment about the risk of future violence is little better than chance. Tools to determine this risk affect a youth’s life significantly and should be reliable and valid. Tools developed to date to determine youth risk of future violence, delinquency, and behavior problems include the SAVRY, PCL-YV, YLS-CMI, and the CARE.

The Structured Assessment of Violence Risk in Youth (SAVRY) (Borum, Bartel, & Forth, 2002) is composed of 24 risk items (Historical, Social/ Contextual, and Individual) drawn from existing literature on adolescent development and on aggression in youth. An additional six Protective Factors are also provided. It was once thought that dangerousness was static and not subject to change, however more recently it is viewed as more contextual or dependent on situations. Additionally, the developers of the SAVRY have included dynamic risk factors because personality and behavior traits are not stable in adolescence. The theory underlying these assessments has shifted from CMI Level 5 a violence prediction model to a more clinical model of risk assessment and behavior management. The task is to determine the nature and degree of risk an individual may pose for certain kinds of behaviors, and under what conditions and contexts.

The SAVRY is for youth ages 12 to 18. It is professionally scored. The sample size is small. Studies have found correlations with past violence to be moderate to good (r = .32 to .56), explaining 18 to 20% of the variance, with an error rate of 21%. Reliability is good. It does not recommend level or types of services.

The Hare Psychopathy Check List: Youth Version (PCL: YV) (Forth, Kosson, & Hare, 2003) is a 20-item rating scale for the assessment of psychopathic traits in male and female offenders aged 12 to 18 years of age. While Drs. Forth, et al, believe that identifying youth with psychopathic traits is critical to understanding the factors that contribute to the development of adult psychopathy, the application of the concept of psychopathy to youth is very controversial. The youth PCL was adapted from the Hare Psychopathy Checklist -Revised (PCL-R), one of the most widely used measures of psychopathy in adults. Using a semi-structured interview and collateral information, the PCL: YV measures interpersonal, affective, and behavioral features related to the concept of psychopathy.

The PCL-YV is for youth ages 12 to 18. It is professionally scored. Studies have found correlations with past violence to be poor to good (r = .10 to .48), with an error rate of 21 to 37%. Reliability is excellent. It does not recommend level or types of services.

The CARE (Child and Adolescent Risk Evaluation, (Seifert, 2003) assesses the risk for violence and evaluates all possible problem areas, including past behavior, community, family, peer, job/school, neurological, and mental health. The first tool to be developed by Seifert (2003) was the CARE (Seifert, 2003). It is an easy to use tool for assessing the risk of youth violence and creating a multifaceted case management plan. More than 1000 youth with ethnically diverse backgrounds were in the first CARE sample. The ages ranged from 2 through 19 years, over half had a history of assaults. Significantly higher CARE scores were seen in those with assaultive histories and these youth were more likely to commit an assault within the next six months.

While it is true, as is suggested by Dr. Borum and others, that environmental stressors can predict the immediacy of a violent act, it is the development of interpersonal skills, personality, morality, and problem solving ability that can create the potential for violence to occur in the face of an environmental stressor. The CARE is based on developmental theory and suggests what areas of development may be delayed and in need of intervention.