Assessing Dangerousness: Myths and Research. Ronald Schouten, MD, JD Associate Professor of Psychiatry Harvard Medical School Director, Law & Psychiatry Service Massachusetts General Hospital. Overview. How we perceive risk and make decisions What do we know about violence?
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Ronald Schouten, MD, JD
Associate Professor of Psychiatry
Harvard Medical School
Director, Law & Psychiatry Service
Massachusetts General Hospital
Risk = Likelihood x Severity of consequences
What Do We Know About Violence?
Mental Illness and Violence
“Severe mental illness alone does not significantly predict future violence; rather, historical, dispositional, and contextual factors are associated with future violence.”
Elbogen, E. B., Johnson, S. C. (2009). The intricate link between
violence and mental disorder. Archives of General Psychiatry, 66 (2),
Self report of violence in previous year:DX%None2OCD11Bipolar/mania11Panic disorder12Major depression12Schizophrenia13Cannabis use/dependence19Alcohol use/dependence25Other use/dependence35
Pathway to Violence6.Attack5.Breach4.Preparation3.Research & Planning2.Ideation1.GrievanceCalhoun and Weston, “Contemporary Threat Management” (2003)
Specific Situations: Domestic Violence/Stalking
Assessing the Evidence
The Misinformation Challenge
“It ain’t so much the things we don’t know that get us into trouble. It’s the things we know that ain’t so.”
(Charles Farrar Browne)