The Predictive Ability of the Classification of Violence Risk (COVR) in a Forensic Psychiatric Hospital

Objective: Aggression is a common problem in psychiatric and correctional facilities. An actuarial instrument, the Classification of Violence Risk (COVR), has demonstrated utility in predicting community aggression among civilly committed psychiatric patients and, more recently, an ability to predict institutional aggression in a forensic facility. This prospective study aimed to extend validation of the use of the COVR in a forensic facility. Methods: The study, conducted at a large U. S. forensic facility, used nursing records to document incidents of physical aggression by 146 patients for 20 weeks after COVR administration. Correlational and chi square analyses were conducted to evaluate the efficacy of the COVR in predicting aggression. Results: The COVR showed modest predictive ability for institutional aggression, with a correlation of .331 and an area under the curve of .725. Conclusions: Results support use of the COVR in a forensic facility; its ability to predict institutional aggression is similar to that found for community aggression. (Psychiatric Services 62: 430-433, 2011)