Predictive validity of the Short-Term Assessment of Risk and Treatability (START) for multiple adverse outcomes: the effect of diagnosis

Rebecca Marriott, Laura E O'Shea, Marco M Picchioni, Geoffrey L Dickens

Research output: Contribution to journalArticle

1 Citation (Scopus)
10 Downloads (Pure)

Abstract

The Short-Term Assessment of Risk and Treatability (START) assists risk assessment for seven risk outcomes based on scoring of risk and protective factors and assignment of clinically-informed risk levels. Its predictive validity for violence and self-harm has been established in males with schizophrenia, but accuracy across pathologically diverse samples is unknown. Routine START assessments and 3-month risk outcome data of N = 527 adult, inpatients in a UK secure mental health facility were collected. The sample was divided into diagnostic groups; predictive validity was established using receiver operating characteristics regression (rocreg) analysis in which potential covariates were controlled. In most single-diagnosis groups START risk factors ('vulnerabilities'), protective factors ('strengths'), and clinically-informed estimates predicted multiple risk outcomes with effect sizes similar to previous research. Self-harm was not predicted among patients with an organic diagnosis. The START risk estimates predicted physical aggression in all diagnostic groups, and verbal aggression, self-harm and self-neglect in most diagnostic groups. The START can assist assessment of aggressive, self-harm, and self-neglect across a range of diagnostic groups. Further research with larger sample sizes of those with multiple diagnoses is required.

Original languageEnglish
Pages (from-to)435-443
Number of pages9
JournalPsychiatry Research
Volume256
Early online date8 Jul 2017
DOIs
Publication statusPublished - Oct 2017

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Aggression
Health Facilities
Research
Violence
ROC Curve
Sample Size
Inpatients
Schizophrenia
Mental Health
Regression Analysis
Protective Factors

Cite this

Marriott, Rebecca ; O'Shea, Laura E ; Picchioni, Marco M ; Dickens, Geoffrey L. / Predictive validity of the Short-Term Assessment of Risk and Treatability (START) for multiple adverse outcomes : the effect of diagnosis. In: Psychiatry Research. 2017 ; Vol. 256. pp. 435-443.
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Predictive validity of the Short-Term Assessment of Risk and Treatability (START) for multiple adverse outcomes : the effect of diagnosis. / Marriott, Rebecca; O'Shea, Laura E; Picchioni, Marco M; Dickens, Geoffrey L.

In: Psychiatry Research, Vol. 256, 10.2017, p. 435-443.

Research output: Contribution to journalArticle

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