Usefulness and practicality of structured risk assessment instruments in forensic psychiatry

Using structured risk assessment instruments to predict criminal offences in individual cases has several methodological limitations. Nevertheless actuarial risk assessment instruments enjoy an increase in popularity in research and forensic practice. This review highlights and discusses general difficulties in forensic research concerning low base rates of delinquency, the area under the curve as the gold standard in risk prediction research and the problem of heterogeneous samples, with regard to individual risk prediction. To determine the relapse probability as low, medium or high will always be a political, legal and ethical question. Statistics are unlikely to resolve this problem.