Protective factors in risk assessment schemes for adolescents in mental health and criminal justice populations : a systematic review and meta-analysis of their predictive efficacy

The consideration of protective factors has been integrated into a number of instruments whose aim is assess the risk of adverse outcomes among adolescents in high-risk mental health and criminal justice populations; however, little is known about their contribution to accurate risk prediction. We systematically reviewed the evidence for predictive efficacy of nine selected tools that require assessors to consider protective factors. Three tools had been tested for predictive ability but only one (the structured assessment of violence risk in youth) had been examined in multiple studies. Meta-analysis revealed that risk prediction based on the results did not improve over that based on a deficits model. Important decisions based on results of some protective factor-based tools should be treated with extreme caution since they lack empirical support. The importance of protective factors in problematic behavior has been demonstrated elsewhere, but this has not translated into significantly improved tools for use in clinical risk assessment in mental health and criminal justice populations