Gender Comparisons in a Forensic Sample: Patient Profiles and HCR-20:V2 Reliability and Item Utility

Given documented gender differences in risk factors and manifestations of violence, researchers have advocated for gender-sensitive approaches to violence risk assessment. This study compares male (n = 292) and female (n = 68) forensic psychiatric patients on an array of demographic, clinical, behavioral, and legal variables to gain a clearer understanding of the prevalence of different risk factors and types of violence in this population. We investigate the interrater reliability and item utility of the Historical, Clinical, Risk Management-20 (HCR-20:V2), and examine whether individual HCR-20 items exhibit differential relationships to the tool's summary risk rating across gender. More women carried a diagnosis of borderline personality disorder, whereas antisocial personality disorder, substance use problems and extensive criminal histories were more often noted in men. These clinical differences were reflected in the distribution of HCR-20 item and subscale scores across gender. Interrater re...