High‐risk inferences in assessing high risk: outstanding concerns in the clinical use of the PCL‐R

The PCL‐R has been heralded as the ‘unparalleled’ (Salekin et al, 1996) risk assessment tool for assessing risk of violent and non‐violent recidivism. In the UK, the PCL‐R looks likely to become an industry standard assessment in psychological evaluation of individuals thought to have a dangerous and severe personality disorder. However, current knowledge about the PCL‐R is unsatisfactory, and a number of issues need to be addressed before clinicians can be confident in the use of this measure. This paper highlights these issues from the perspective of the practising clinician. Questions are raised about the theoretical, methodological and treatment implications of the use of the PCL‐R. Future research needs are established in this context of caution over the use of the measure in routine clinical and academic assessment.