Actuarial versus clinical assessments of dangerousness

In their book, Violent Offenders, V. L. Quinsey, G. T. Harris, M. E. Rice, and C. A. Cormier (1999) proposed the "complete replacement" of clinical assessments of dangerousness with actuarial methods, such as the Violence Risk Appraisal Guide (VRAG). In this article, the author argues that (a) research to date has not demonstrated that actuarial methods of risk assessment are superior to clinical methods; (b) because most clinical determinations of dangerousness are not "predictions" of violence, as well as for other reasons, it is very difficult to meaningfully compare clinical and actuarial assessments of dangerousness; and (c) even the best researched and validated actuarial tool for assessing dangerousness to date, the VRAG, has not vet been validated in a manner that would make it appropriate for use in determining when individuals should be confined on the grounds of their dangerousness. Therefore, although clinicians who engage in risk assessments certainly should be knowledgeable about arguably relevant actuarial assessment schemes and other assessment guides the HCR-20), it is premature, at best, to replace clinical risk assessments with actuarial assessments.