1. Recent studies have shown that actuarial studies perform
significantly better than clinical instruments in predicting violent behavior, in particular the results of the MacArthur Study of Mental Disorder and Violence (Rice, Harris and Quinsey, 2002, 589-593). In this study, civil psychiatric patients were rated while in hospital on a wide range of predictor variables, released into the community, and followed for a year. Violence included self-reported acts and those reported by official and other sources. Diagnoses of schizophrenia, or major mental disorder without substance abuse, threat-control override symptoms, delusions at the time of admission, and persecutory delusions, were all indicators of reduced violence risk on release. Hallucinations, command hallucinations, grandiose delusions, score on the Global Assessment of Functioning, total score on the Brief Psychiatric rating Scale, and diagnosis of mania and depression were all unrelated to future violence. The largest predictors of violence were score on the screening version of the Psychopathy checklist, diagnosis of antisocial personality disorder, drug or alcohol abuse, and anger as measured by the Novaco Anger Scale. The risk factors for violence appear to be the same among other groups studied: incest offenders, wife beaters, stalkers, and juveniles. There is no convincing evidence that dynamic variables, including treatment, play a role in determining who is likely to engage in future violence.
2. Legally, all 50 states have passed some form of mandatory
child abuse and neglect reporting law (Smith, 2003). The Federal DHS, Children's Bureau has published a "how to" site to instruct people on how to report abuse and neglect. All states require certain professionals to report suspected child abuse, including all healthcare providers. Eighteen states have statutes requiring anyone to report such abuse. Failure to report child abuse can result in crimi...