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Psychiatrische Beurteilung des Gewaltrisikos im Jugendalter

Structured psychiatric assessment of risk for violent recidivism in juvenile offenders

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Zusammenfassung

Die psychiatrische Einschätzung des Gewaltrisikos Jugendlicher stellt einen kritischen und notwendigen Teil der Praxis sowohl in der forensischen Begutachtung als auch in Kliniken dar. Methodisch neue Ansätze bieten strukturierte Risikobeurteilungsskalen und Checklisten, die die „psychopathy“ erfassen. Das an das Historical, Clinical, Risk Management Scheme (HCR-20) angelehnte Structured Assessment of Violence Risk in Youth (SAVRY) wurde in neu übersetzter deutscher Version an einer Stichprobe forensisch begutachteter Jugendlicher (n=83) hinsichtlich der Validität zur Vorhersage erneuter krimineller Rückfälle untersucht. „Receiver-operating-characteristic“- (ROC-)Analysen wiesen in Abhängigkeit von der Rückfallqualität mittlere (allgemeine Delinquenz), mäßige (Gewaltrückfall) und hohe (schwerer Gewaltrückfall) Effektstärken nach. In Survivalanalysen wurden als hochriskant eingestufte jugendliche Probanden signifikant schneller und in stärkerem Umfang allgemein und gewalttätig rückfällig als solche mit mäßigem oder niedrigem Risikolevel. Die Anwendung strukturierter Prognoseinstrumente zur Einschätzung des Gewaltrisikos erscheint für das Jugendalter, und ebenso für deutsche Kollektive, konzeptuell sinnvoll. Unter Berücksichtigung von Rückfallmustern und dynamischen Risiken werden Ansätze für präventive, therapeutische und reintegrierende Maßnahmen aufgezeigt.

Summary

The psychiatric assessment of violence in youth represents a critical and essential part of forensic expertise and clinical practice. New methodical approaches are offered by structured risk rating scales and checklists which encompass psychopathy. The recently translated German version of Structured Assessment of Violence Risk in Youth (SAVRY), which is based on the Historical, Clinical, Risk Management Scheme (HCR 20), was evaluated in a sample of forensically assessed youth (n=83) regarding the predictive validity for criminal recidivism. Receiver operating characteristic (ROC) analyses attested medium (general delinquency), moderate (violent reoffending) and high (serious violent reoffending) effect strength, depending of the type of offence. Survival analyses showed that juveniles rated as high risk for violence were significantly faster and in a higher proportion recidivistic than those with a moderate or low risk. The results indicate the applicability of risk assessment instruments for German juveniles. Approaches for preventive, therapeutic and reintegrating measures are demonstrated, taking relapse patterns and dynamic risk aspects into consideration.

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Authors and Affiliations

  1. Institutsambulanz Wolfratshausen, Heckscher Klinikum für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Obermarkt 18a, 82515, Wolfratshausen, Deutschland

    M. Rieger & F. J. Freisleder

  2. Abteilung Forensische Psychiatrie, Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität, München, Deutschland

    C. Stadtland & N. Nedopil

Authors
  1. M. Rieger
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  2. C. Stadtland
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  3. F. J. Freisleder
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  4. N. Nedopil
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Correspondence to M. Rieger.

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Rieger, M., Stadtland, C., Freisleder, F. et al. Psychiatrische Beurteilung des Gewaltrisikos im Jugendalter. Nervenarzt 80, 295–304 (2009). https://doi.org/10.1007/s00115-008-2574-3

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