Protective Factors in Violence Risk Assessment: Predictive Validity of the SAPROF and HCR-20 V3

Research and practice in violence risk assessment in forensic mental health primarily focuses on risk factors; however consideration of protective factors may improve the accuracy and utility of assessments. Using a pseudo-prospective design, the predictive and incremental validity of protective factors was explored using the Structured Assessment of Protective Factors (SAPROF) and Historical Clinical Risk Management-20 (HCR-20^V3) in 75 male inpatients in a secure setting. Over a 12-month period, protective factors significantly predicted the absence of inpatient (institutional) violence and risk factors, particularly dynamic factors, predicted the presence of violence. Hierarchical logistic regression did not establish the incremental validity of the SAPROF. Preliminary evidence for the predictive and incremental validity of the Integrative Final Risk Judgment was found with individuals judged high risk being almost seven times more likely to engage in violence than those assessed as moderate risk. High risk ratings were associated with fewer protective factors and more risk factors. Therefore, whilst dynamic risk factors are clear targets for risk management, consideration of protective factors may contribute to overall estimates of risk and provide additional targets for intervention.