Predicting institutional aggression and seclusion within a medium secure forensic hospital using the Psychopathy Checklist - Revised (PCL-R) and the Violence Risk Appraisal Guide (VRAG)

The current study investigated the ability of the Psychopathy Checklist---Revised (PCL-R) and Violence Risk Appraisal Guide (VRAG) to predict frequency and duration of seclusions on a medium-secure forensic unit. A retrospective file review of information since the time of admission was collected on a sample of the first 130 patients assessed with the PCL-R and VRAG. The utility of the risk assessments to predict recorded number of seclusions was considered over a period of two years, while duration of time in seclusion was calculated across total inpatient stay. The predictive accuracy and relationships among the predictor and outcome variables were evaluated using correlational analyses and regression procedures. PCL-R (Total, Factor 1, and Factor 2) scores were significantly related to outcome variables. The PCL-R Factor 2 score was the most robust predictor of frequency of seclusions while Factor 1 was most predictive of duration of seclusions. Despite the VRAG having the PCL-R as one of its static items, it failed to reach significance for all outcome variables. The PCL-R appears to show promise in predicting seclusions among adult mentally disordered offenders within 24 weeks of admission.