Possibilities of Psychological Examination in Assessing of Violence Risk in Patients under Court-ordered Compulsory Medical Treatment

Background: violence risk assessment in persons acquitted by reason of insanity is difficult. It seems appropriate to consider the possibilities of psychological assessment based on the biopsychosocial model in addition to clinical ones. Standard survey methods do not provide sufficient information. The schema therapy approach is proposed as an alternative.

The Aim of study was to assess violence risk in patients under compulsory treatment using new instruments for psychological examination.

Patients: 137 male patients aged 18–62 years (М = 37.03; SD = 9.65) under compulsory treatment.

Methods: author's scale, Young Shema Questionnaire, Schema Mode Inventory, Historical Clinical Risk Management-20.

Results: patients are characterized by violence risk factors (overall scale: M = 19.57; SD = 7.92; Me = 19). Anamnestic factors (M = 10.89; SD = 3.65; Me = 11) and risk management factors (M = 5.25; SD = 2.78; Me = 5) prevailed over clinical ones (M = 3.43; SD = 2.52; Me = 3). The relationships shown: a) «Lack of self-control» with the overall score of violence risk (rs = 0.331; p ≤ 0.001) and its clinical signs (rs = 0.328; p ≤ 0.001); b) «Distrust» with the overall score also (rs = 0.304; p ≤ 0.001) and its anamnestic signs (rs = 0.311; p ≤ 0.001). The greatest contribution to the degree of violence risk is made by the schemes and modes: “Negativism/pessimism” (β = 0.573; p ≤ 0.001), “Failure” (β = 0.331; p ≤ 0.01), “Detached self-consoler” (β = −2.165; p ≤ 0.001), “Enraged child” (β = 3.327; p ≤ 0.001), “Angry child” (β = −2.430; p ≤ 0.05).

Conclusions: severity of schemes and modes indices can play an important role in predicting relapse of socially dangerous act. This methods can be used to assess the violence risk severity as an additional one.

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