University of Twente Student Theses


Validating the HKT-R over time : a new perspective on the validity and predictive value of the Historisch Klinisch Toekomst - revised

Möller, Jonas (2018) Validating the HKT-R over time : a new perspective on the validity and predictive value of the Historisch Klinisch Toekomst - revised.

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Abstract:Introduction. In the Netherlands, the Historisch Klinisch Toekomst – Revised (HKT-R) is one of the most popular instruments to assess the risk of recidivism into violent behavior among offenders with a psychiatric diagnosis. The HKT-R contains three scales including historical items that are unchangeable such as demographics, clinical and future-related items focused on the present and the future which are therefore changeable or so-called dynamic. In this study, the validity and predictive value of the HKT-R were tested in cross-sectional analyses as well as its’ applicability to predict change in aggressive behavior over the course of a treatment period. Methods. The study had a naturalistic prospective design. 50 patients in closed forensic centers were included in the study. Participants’ risk of recidivating was assessed during admission, halfway through treatment and before discharge, using the HKT-R. Concurrently, aggressive behavior was assessed using the Social Dysfunction Aggression Scale-9 (SDAS-9). Correlational, linear regression analyses, computation of change scores and linear mixed model analyses were used to examine the validity and predictive value of the HKT-R. Results. The clinical scale of the HKT-R was the only one to correlate significantly with SDAS-9 score for all measurements (r₁= .44, p= .001, r₂= .59, p< .001, r₃= .67, p< .001), showing adequate validity. In cross-sectional analyses the future-related scale only correlated significantly halfway through treatment and before discharge while the historical scale correlated only during admission significantly with the SDAS-9 score. The only significant correlation for change scores was found when the change score of the clinical scale for the entire treatment period was included (r₁₋₃= .38, p= .006). According to the linear mixed models, the clinical and the future-related scale covaried significantly with the SDAS-9 score over time. Discussion. The clinical scale of the HKT-R displayed reasonable construct validity as well as some predictive value in predicting the SDAS-9 score. The future-related score should be examined in further research since it did not show stable construct or predictive validity. The historical scale showed moderate construct validity only during admission. In contrast to previous follow-up studies, the historical score was the weakest predictor for aggressive behavior in terms of the SDAS-9 score which might be explained through differences in the set-up of the studies. Additionally, this study indicated that the clinical scores corresponded to some kind of change in participants’ behavior during treatment. Overall, this research does not support the suitability of the HKT-R to predict changes in aggressive behavior. On the other hand, it supports the idea that aggressive behavior in psychiatric patients might be reduced through treatment interventions and that this change might be, at least partly, displayed in the clinical scale.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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