Predictive Validity of the HCR-20v3 Compared to the HCR-20v3 with the FAM in Women

Abstract Recent findings have highlighted unique risk factors for female-perpetrated violence as well as limitations in its risk assessment. To address these shortcomings, the Female Additional Manual (FAM) was designed as a complementary tool for the gender-neutral framework of the Historical, Clinical, Risk Management-20 (HCR-20). Little research has been undertaken exploring the predictive validity of the FAM, particularly when used with the most recent version of the HCR-20 (HCR-20v3), leaving equivocal evidence in regards of its use in clinical practice. The present study compared the predictive validity of the HCR-20v3 with and without the FAM for inpatient violence. The sample consisted of 42 female forensic psychiatric patients in a low to medium secure unit in the UK. Results revealed a significant difference in the predictive validity of the HCR-20v3 compared to the FAM when assessing for physical violence and no significant differences between the instruments’ validity in predicting nonphysical and any violence. In line with existing literature, the HCR-20v3 was an overall good predictor of violence. While the FAM was less accurate than the HCR-20v3 at predicting physical violence, it achieved moderate to large effect size in predicting each category of violence. The findings provide a degree of support for using the HCR-20v3 when assessing the risk of violence in women but do not demonstrate improved predictive power when adding the FAM.