Assessing the cognitive contributors to violence: A pilot and feasibility study protocol

Background: In recent years there has been considerable progress in the development,validation and use of violence risk assessments (VRA). Their predictive ability however remains modest and, due to the repetitive use of certain risk factors, collectively, they appear to have hit an allegorical ‘glass ceiling’. Further limiting VRA is the use of self-report, collateral information, and file reviews to assess risk-related factors, rather than validated performance measures. In parallel, findings from neuropsychology and neurobiology have highlighted brain regions associated with violent behaviour. Thus, it is hypothesised that VRA may benefit from the integration of behaviourally measured neuropsychological risk factors.
Methods/Design: The study follows a feasibility and pilot design with a prospective,observational approach. It aims to investigate the feasibility of using a neuropsychological battery to aid in the identification of violence risk in an inpatient and community setting, and to pilot a neuropsychological battery examining risk factors for violence. The primary outcomes of interest are violent incidents or offences recorded during the 6-month follow-up periods.
Discussion: It is our hope that the results of this study will contribute to the development of a structured tool to aid in the identification and assessment of cognitive impairments shown to be predictive of violence risk.