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
“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%None 2OCD 11Bipolar/mania 11Panic disorder 12Major depression 12Schizophrenia 13Cannabis use/dependence 19Alcohol use/dependence 25Other use/dependence 35
Pathway to Violence Mentally Ill6.Attack5.Breach4.Preparation3.Research & Planning2.Ideation1.GrievanceCalhoun and Weston, “Contemporary Threat Management” (2003)
“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)