The predictive validity of the short-term assessment of risk and treatability (START) for multiple adverse outcomes in a secure psychiatric inpatient setting

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

    Research output: Contribution to journalArticlepeer-review

    23 Citations (Scopus)
    354 Downloads (Pure)

    Abstract

    The Short-Term Assessment of Risk and Treatability (START) aims to assist mental health practitioners to estimate an individual’s short-term risk for a range of adverse outcomes via structured consideration of their risk (“Vulnerabilities”) and protective factors (“Strengths”) in 20 areas. It has demonstrated predictive validity for aggression but this is less established for other outcomes. We collated START assessments for N = 200 adults in a secure mental health hospital and ascertained 3-month risk event incidence using the START Outcomes Scale. The specific risk estimates, which are the tool developers’ suggested method of overall assessment, predicted aggression, self-harm/suicidality, and victimization, and had incremental validity over the Strength and Vulnerability scales for these outcomes. The Strength scale had incremental validity over the Vulnerability scale for aggressive outcomes; therefore, consideration of protective factors had demonstrable value in their prediction. Further evidence is required to support use of the START for the full range of outcomes it aims to predict.
    Original languageEnglish
    Pages (from-to)150-162
    Number of pages13
    JournalAssessment
    Volume23
    Issue number2
    Early online date27 Feb 2015
    DOIs
    Publication statusPublished - 1 Apr 2016

    Keywords

    • START
    • Risk assessment
    • Protective factors
    • Aggression/violence
    • Self-harm
    • Vulnerability
    • Self-neglect

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