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Observational Study
. 2025 Jan 13;68(1):e19.
doi: 10.1192/j.eurpsy.2025.3.

Predictive accuracy of the Violence Risk Assessment Checklist for Youth in acute institutions: A prospective naturalistic multicenter study

Anniken Lucia Willumsen Laake  1   2 , John Olav Roaldset  2 , Tonje Lossius Husum  1 , Stål Kapstø Bjørkly  3 , Carina Chudiakow Gustavsen  4 , Sara Teresia Grenabo  5 , Øyvind Lockertsen  1   2
Affiliations
Observational Study

Predictive accuracy of the Violence Risk Assessment Checklist for Youth in acute institutions: A prospective naturalistic multicenter study

Anniken Lucia Willumsen Laake et al. Eur Psychiatry. .

Abstract

Background: Acute health and social services for children and adolescents often struggle with youth aggression and violence. Early identification of violence risk during institutional stay can help prevent violent incidents. As such, this study assessed the predictive accuracy of the Violence Risk Assessment Checklist for Youth (V-RISK-Y) aged 12-18 in two different juvenile settings providing 24-hour services for youth. Institutions were included from child and adolescent inpatient psychiatry and residential youth care under child protective services.

Methods: A prospective, naturalistic observational study design was employed. V-RISK-Y was administered for youth admitted to four acute inpatient psychiatric units and four acute residential youth care institutions. Incidents of violence and threats during the youth's stay were registered by institutional staff. In total, 517 youth were included in analyses, 59 of whom were registered with at least one incident of violence or threats during their stay. Area under curve (AUC) and logistic regression analyses were used to assess predictive accuracy and validity of V-RISK-Y.

Results: For the overall sample, V-RISK-Y had good predictive accuracy, and the sum score of V-RISK-Y significantly predicted registered violent incidents. Stratified analyses indicated good predictive accuracy of V-RISK-Y for the inpatient units, but not for the residential youth care institutions.

Conclusions: Findings imply that V-RISK-Y is accurate in identifying violence risk for youth admitted to inpatient psychiatric units but has limited predictive accuracy in residential youth care institutions. Future research should explore approaches to correctly identify violence risk in residential care settings.

Keywords: V-RISK-Y; emergency psychiatry; residential youth care; violence risk screening; youth violence.

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Conflict of interest statement

Some of the authors of this paper (SB; JOR) were involved in the development of V-RISK-10 and V-RISK-Y. These authors have not received, and will not receive, any financial benefits from the use of the instrument, which it is freely available online. The first author was not involved in the development of these instruments and is employed by an institution other than the one where the instruments were developed. Authors have strived to conduct the study with objectivity and transparency, with the goal of enhancing the scientific understanding of V-RISK-Y. We believe that the design of the study mitigate potential bias that could arise from the authors involvement in the instrument development.

Figures

Figure 1.
Figure 1.
Flow chart for included cases.
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