Gender Differences in Structured Risk Assessment: Comparing the Accuracy of Five Instruments Jeremy Coid, Min Yang, Simone Ullrich, and Tianqiang Zhang Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Forensic Psychiatry Research Unit Steve Sizmur Ministry of Justice (formerly the Home Office), England and Wales Colin Roberts University of Oxford David P. Farrington University of Cambridge Robert D. Rogers University of Oxford Structured risk assessment should guide clinical risk management, but it is uncertain which instrument has the highest predictive accuracy among men and women. In the present study, the authors compared the Psychopathy Checklist—Revised (PCL–R; R. D. Hare, 1991, 2003); the Historical, Clinical, Risk Management–20 (HCR-20; C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997); the Risk Matrix 2000 –Violence (RM2000[V]; D. Thornton et al., 2003); the Violence Risk Appraisal Guide (VRAG; V. L. Quinsey, G. T. Harris, M. E. Rice, & C. A. Cormier, 1998); the Offenders Group Reconviction Scale (OGRS; J. B. Copas & P. Marshall, 1998; R. Taylor, 1999); and the total previous convictions among prisoners, prospectively assessed prerelease. The authors compared predischarge measures with subsequent offending and instruments ranked using multivariate regression. Most instruments demon- strated significant but moderate predictive ability. The OGRS ranked highest for violence among men, and the PCL–R and HCR-20 H subscale ranked highest for violence among women. The OGRS and total previous acquisitive convictions demonstrated greatest accuracy in predicting acquisitive offending among men and women. Actuarial instruments requiring no training to administer performed as well as personality assessment and structured risk assessment and were superior among men for violence. Keywords: risk assessment, gender differences, actuarial instruments Structured risk-assessment instruments outperform clinical judgment for the prediction of subsequent violence and sexual behavior (Grove, Zald, Lebow, Snitz, & Nelson, 2000; Hanson & Bussiere, 1996; Hanson & Morton-Bourgon, 2004; Hood, Shute, Feilzer, & Wilcox, 2002; McNeil, Sandberg, & Binder, 1998). However, most instruments have been standardized on samples of male prisoners and psychiatric patients. It remains unclear whether risk-assessment instruments demonstrate acceptable levels of pre- dictive accuracy for use with female offender populations, and if so, which instrument should be recommended for routine use, and for which offending outcomes. Current lack of knowledge over risk prediction among women may be partly due to the overrepresentation of men in prisons and secure hospitals where the development of risk-assessment instru- ments has been undertaken and where large samples are required to achieve adequate reliability. It may also be due to the fact that women offenders reoffend at a lower rate than men, according to official statistics (Coid, Hickey, Kahtan, Zhang, & Yang, 2007; Cuppleditch & Evans, 2005; Kershaw, Goodman, & White, 1999). Furthermore, certain actuarial instruments that have been devel- oped on mixed sex samples ascribe a negative weighting to female gender in terms of future risk of offending (Copas & Marshall, 1998). Compared with men, women offenders may not be seen as a “problem” in terms of future risk to the public. The majority of studies on risk of violence in women offenders have been carried out with the Psychopathy Checklist—Revised (PCL–R; Hare, 1991, 2003) or the Psychopathy Checklist: Screen- ing Version (PCL:SV; Hart, Cox, & Hare, 1995). It was demon- Jeremy Coid, Min Yang, Simone Ullrich, and Tianqiang Zhang, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Forensic Psychiatry Research Unit, London, England; Steve Sizmur, Ministry of Justice (formerly the Home Office), England and Wales, Westminster, London; Colin Roberts, Centre for Criminology, University of Oxford, Oxford, England; David P. Farrington, Institute of Criminology, University of Cambridge, Cambridge, England; Robert D. Rogers, Department of Psychiatry, University of Oxford. Steve Sizmur is now at the Picker Institute, Oxford, England. This study was funded by the Ministry of Justice (formerly the Home Office), England and Wales. Correspondence concerning this article should be addressed to Jeremy Coid, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Forensic Psychiatry Research Unit, William Harvey House, 61 Bartholomew Close, London EC1A 7BE, United King- dom. E-mail: j.w.coid@qmul.ac.uk Journal of Consulting and Clinical Psychology © 2009 American Psychological Association 2009, Vol. 77, No. 2, 337–348 0022-006X/09/$12.00 DOI: 10.1037/a0015155 337