Prediction in Psychiatry: An Example of Misplaced Confidence in Experts

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Abstract
Although prediction is usually considered an integral part of science, there appears to be at least one situation in which prediction is as much guesswork as science. This is the prediction of a patient's potential dangerousness by psychiatrists. Our paper reports the findings of a three year longitudinal study of specific psychiatric predictions of dangerousness. We report data on: the impact of non-psychiatric factors in these decisions; the justifications offered by psychiatrists for a finding of dangerousness; the extent to which the psychiatric recommendations are accepted by the court; and the level of accuracy of the psychiatric predictions. Our data suggest that the confidence placed in psychiatry's ability to predict the potential of dangerous behavior is unjustified.