Protective factors: Validation of the structured assessment of protective factors for violence risk in forensic psychiatry

Background and aims of the thesis This thesis concerns protective factors for violence risk and a tool specifically developed to assess these factors in risk assessment: the Structured Assessment of Protective Factors for violence risk (SAPROF; de Vogel, de Ruiter, Bouman, & de Vries Robbé, 2007; 2009). The aim of this thesis was to explore the potential additional value of protective factors for assessing violence risk and for guiding positive treatment interventions. More specifically, this thesis focuses on validating the psychometric properties and clinical applicability of the SAPROF for forensic psychiatric treatment. Overall conclusions The general conclusion of this thesis is that the SAPROF shows sound psychometric properties. The protective factors in the SAPROF show good predictive validity for no violent incidents during treatment as well as for desistance from violent re-offending long after treatment. Good results are found across different groups of patients. Two findings in this thesis are especially meaningful: 1. protective factors demonstrate to provide incremental predictive validity over risk factors in predicting violent recidivism, in other words future violent behavior can be assessed more accurately when protective factors are incorporated in the risk assessment; 2. improvements on protective factors during treatment show to be related to reductions in violent recidivism after treatment, in other words the more protective factors are developed during treatment the less likely in becomes that a person will recidivate after treatment. These results provide strong support for the value of the SAPROF as a protection-focused tool which can bring balance and increased accuracy to violence risk assessment, offers potential for treatment evaluation and may provide positive guidance for effective treatment interventions and risk management strategies for violent and sexual offenders.