Violence Risk Assessment — MRCPsych Paper B MCQ

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ModerateForensic PsychiatryViolence Risk AssessmentMRCPsych Paper B

A forensic psychiatrist wishes to use a structured professional judgement instrument to formulate and manage an adult patient's risk of future violence. Which of the following instruments is most appropriate?

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Correct answer: B — HCR-20 Version 3

The correct answer is **B, HCR-20 Version 3**. It is a structured professional judgement instrument used to formulate and manage violence risk in adults. Its 20 factors are organised into Historical, Clinical and Risk Management domains, but its purpose is not simply to generate a numerical score; it supports individualised formulation, scenario planning and management. The PCL-R assesses psychopathic traits and may contribute information to a risk assessment, but it is not itself an SPJ violence-risk instrument. The VRAG-R is an actuarial violence-recidivism instrument, while Static-99R is an actuarial instrument focused on sexual recidivism. AUDIT screens for hazardous and harmful alcohol use rather than violence risk.

Reference: Royal College of Psychiatrists. Outcome measures in psychiatry (College Report CR240), section 'Risk and offending', 2024. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr240-outcome-measures-in-psychiatry.pdf?sfvrsn=3d5adc4e_11