Toward a convergent validity of the Risk For Sexual Violence Protocol (RSVP) among male forensic patients Thierry. H. Pham+* & Claire Ducro+** +Center of Research in Social Defense (CRDS), Tournai, Be *University of Mons, Be **University Charles-de-Gaulle (EA 1059), Lille, Fr

Risk for Sexual Violence Protocol (Hart, Kropp & Laws., 2003) Sex violence history - Chronicity - Diversity - Ecaladation - Physical coercion - Psychological coercion Psychological adjustment - Extreme minimization - Attitudes supporting sexual violence - Problems with self awareness - Problems with stress and coping - Problems resulting from child abuse Mental disorder - Sexual violence - Psychopathic personality - Major mental illness - Problems with substance abuse - Violent or suicidal ideation Social adjustment - Problems with intimate relationship - Problems with non intimate relationship - Problem with non employment - Non sexual criminality Manageability - Problems with planning - Problems with treatment - Problems with supervision

RSVP works among French speaking population Ducro, C. (2009). Psychopathie et évaluation du risque auprès d’une population carcérale francophone. Université de Tours-UMONS. Co-direction avec Christian Reveillère. Ducro, C. Pham. H.T.., & Reveillere, C. (2010). Précisions conceptuelles et Validation discriminante de deux instruments d’évaluation du risque de récidive auprès d’agresseurs sexuels issus du système judiciaire Français. Journal de médecine légale, Droit Médical, Victimologie, Dommage Corporel, 53(6), 260-273. Ducro, C. Pham, H.T. (2014). Risque de récidive des auteurs d’agressions sexuelles. La Lettre du psychiatre.

Method

Implementation among forensic patients in a security hospital

Characteristics Includes 350 patients. 40% forensic patients have committed Sex offences Weak turn over in the hospital: 60 releases per year Length of stay: 8 years Patients are evaluated on IQ, Axis I-II, Static and SPJ. PCL-R when cluster B diagnosis. Mean IQ (WAIS/R)=72

Method 71 Male adults forensic patients: Social Defense Law. Psychopathy Checklist revised (Hare, 2003). Sex Offender Risk Appraisal Guide (Quinsey, Harris, Rice, & Cormier, 2006) Risk for Sexual Violence Protocol (Hart, Kropp & Laws, 2003) Evaluations are mainly conducted by trained psychologists

AGE, LENGTH OF STAY & IQ N = 71 Mean SD Min-Max Age 47,38 10.90 21-77 Years of length of stay 10,93 7,18 0,5-36 Median 10,14 Total WAIS IQ 72,97 18,25 45-120

Axis I & 2 disorders (N=71) Axis 1 disorders : Mini International Neuropsychiatric Interview for DSM-IV major mental disorders (MINI) Axis 2 disorders : Structured clinical interview for DSM-IV personality disorders (SCID-II)

PCL-R scores Mean SD N = 71 Total score 17,76 7,02 Interpersonal factor 7,43 3,67 Lifestyle/antisocial factor 8,97 4,24 Facet 1 2,57 2,14 Facet 2 4,84 2,15 Facet 3 4,70 2,31 Facet 4 4,16 2,56

SORAG scores Mean SD N = 71 Total score 10,83 10,36 Risk category 5.00 1,92

Risk category and probability of recidivism

RSVP Total score (p<.001)

RSVP Factor scores (p<.01)

RSVP Correlations Recent Future Past .62 .72 .82

RSVP, SORAG, PCL-R total scores Correlations between RSVP, SORAG, PCL-R total scores

Total RSVP .40 SORAG SORAG RISK .22 FCT 1/4 .10 FCT 2/4 .23 FCT 3/4 N = 71 Total RSVP SORAG .40 SORAG RISK FCT 1/4 .22 FCT 2/4 .10 FCT 3/4 .23 FCT 4/4 .24 TOTAL PCLR .29

RSVP risk factors and PCL-R scores

Psychological adjustment FCT 1/4 FCT 2/4 FCT 3/4 FCT 4/4 Total PCL-R RSVP Past Sex violence history .28** .11 .12 .25* Psychological adjustment .21* -.04 .09 .03 .07 Mental disorder .30** .22* .29** .47** .48** Social adjustment .00 -.02 .36** .24* Manageability .17 .19

RSVP Recent Sex violence history Psychological adjustment FCT 1/4 FCT 2/4 FCT 3/4 FCT 4/4 Total PCL-R RSVP Recent Sex violence history .09 -.03 .00 -.01 .03 Psychological adjustment .01 .07 -.06 .04 Mental disorder .23* .17 .15 .20 .29** Social adjustment -,04 -.07 -.04 Manageability .12 .11 .06

RSVP future Sex violence history Psychological adjustment FCT 1/4 FCT 2/4 FCT 3/4 FCT 4/4 Total PCL-R RSVP future Sex violence history .21* .02 .10 .32** .19 Psychological adjustment .07 .08 -.02 Mental disorder .03 .09 .30** .17 Social adjustment -.05 .12 Manageability .13 .06 .18

RSVP risk factors and SORAG scores

Psychological adjustment SORAG RSVP past Total score Risk category Sex violence history .35** Psychological adjustment .25** .28** Mental disorder .19* .21** Social adjustment .29** Manageability .26**

N = 71 Recent Sex violence history Psychological adjustment SORAG Recent Total score Risk category Sex violence history .22** .20** Psychological adjustment .18* .23** Mental disorder .13 .12 Social adjustment .15* .15 Manageability .19* .16*

Psychological adjustment SORAG RSVP future Total score Risk category Sex violence history .43** .44** Psychological adjustment .18* .23** Mental disorder .12 Social adjustment .19* ,20** Manageability .20**

Discussion V trend for past, recent and future RSVP scores. Recent scores are less related to SORAG and psychopathy scores. Institutional forensic context vs ambulatory. Recent scores would be problematic as predictor in the future- mosts clinicians rely on?

Discussion PCL-R interpersonal and antisocial facets (but not Affect facet) are related to RSVP and SORAG. But correlations are from small to medium size effect. One RSVP evaluation only: periodic evaluations are necessary (each year ?).

Thierry.pham@crds.be