Sensitivity and specificity of the Bröset Violence Checklist as predictor of violence in forensic
psychiatry
Sammanfattning
Background : Violence and aggressive behavior within psychiatric facilities are serious work
environment problems, which have negative consequences for both patients and staff. It is
therefore of great importance to reduce both the number and the severity of these violent
incidents to improve quality of care. Aims : To evaluate the specifi city and sensitivity of the
Brøset Violence Checklist (BVC) as a predictor of violent incidents for Danish forensic
psychiatry patients. Method: A total of 156 patients were assessed three times daily with the
BVC for 24 months. All aggressive or violent incidents were recorded using the Staff
Observation Aggression Scale-Revised (SOAS-R). SOAS-R scores of 9 or more defi ned violent
incidents. Data were analyzed using standard logistic regression models as well as models
incorporating a random person effect. We used receiver operating curve (ROC) analysis to
evaluate different BVC thresholds. Results: Of a total of 139,579 BVC registrations we found
1999 scores above 0 and 419 violent incidents. The BVC score was a strong predictor of
violence. For the standard cut-off point of 3, specifi city was 0.997 and sensitivity was 0.656.
For the general risk of violence seen in this study, the risk of violence given a BVC score 3
(positive predictive value) was 37.2%, and the risk of violence given a BVC score 3 (negative
predictive value) was 0.1%. Conclusion: The BVC showed satisfactory specifi city and
sensitivity as a predictor of the short-term risk of violence against staff and others by patients
in a forensic setting.