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Tijdschrift voor Psychiatrie 52 (2010) 5, 331 - 341

Review article

The current psychometric state of risk assessment scales for adults in the Netherlands

G.T. Blok, E. de Beurs, A.G.S. de Ranitz, T. Rinne

background Although Dutch forensic psychiatry is making increasing use of structural risk assessment scales, the controversy about the value and usefulness of these instruments continues unabated.
aim To provide an overview of the psychometric qualities of the instruments used most often in the Netherlands for risk assessment in adults.
method Dutch data about the Historical, Clinical, and Risk Management (hcr-20), the Sexual Violence Risk-20 (svr-20), the Psychopathy Checklist-Revised (pcl-r) and two Dutch instruments, the ‘Historische, Klinische en Toekomstige Risico-indicatoren-30’ (hkt-30) and the ‘Forensisch Psychiatrische Profielen’ (fp-40) were reviewed. In addition, data relating to the unstructured clinical judgement were studied.
results The inter-rater reliability values of the instruments discussed were in general satisfactory, but the internal consistency was often unsatisfactory. Except in some studies, the predictive validity was in general reasonable.
conclusion At present, caution is called for with regard to the assessment of the riskof recividism when this is based purely on risk assessment scales or purely on the unstructured judgement. Perhaps it is simply not possible to predict recividism more accurately. Until there are some new developments in this area, it seems advisable to combine as many data as possible about a person under investigation derived from assessment scales and clinical judgement and to compare the outcome with the conclusions of the other professionals.

keywords forensic psychiatry, risk assessment reliability, validity