Implications of Machine-Learning , Internet-Tests to Save Lives and Money : " 7-Point Violence Profile : " Review of 212 Studies , 320 , 051 Persons , Over 95 Years , With a Cross-Validation Among 136 Homicidal , Overdosing-Substance-Abusing , Sex-Offending , Suicide-Completers , and Controls

Analysis of 136 persons with psychopathology, suicidal ideation, violence included: (a) 79 adults [12 homicidal, 13 overdosing-substance-abusers, 15 sex-offending, 15 suicide-completers, 24 controls (23 women, 56 men) Mage=38.29]; (b) 57 teens [11 homicidal, 7 overdosing-substance-abusers, 10 sex-offending, 17 suicide-completers, 12 controls (15 girls, 42 boys) Mage= 15.37] given (Standard Predictor of Violence Potential (SP), Quick Test (QT), Beck Scale (BSS), MMPI-2/A, Raven Matrices). Significant (p < .05) ANOVA Fs were: (a) adults (SP, BSS, MMPI-2 [VRIN, F, FB, FP, L, K, S, Hs (1), D (2), Pd (4), Mf (5), Pa(6), Pt(7), Sc (8), Ma (9), Si (10), MAC-R, APS, AAS], Raven; (b) teens (SP, BSS, MMPI-A [F1, F, L, K, D (2), Pa (6), Sc (8)], QT. At-risk, adults, teens had the same ―7-point violence profile‖ (SP -, ―F/L-2-4-6-8-AAS(ACK)‖) [insignificant differences (p < .05) ANOVA-Fs: SP, BSS, MMPI-2/A: F, L, K, D (2), Pd (4), Pa (6), Sc (8)].


The Costs of Using Current Ways of Finding Risk
There are costs of using current ways without MLIT, which have a sensitivity-specificity of .91-.99 (Zagar et al., 2008;2010;2013;2016).The challenge in finding at-risk was deceptive self-presentation among those with neurological and psychiatric illnesses not discovered with current ways.The twelve issues of using the current ways at intake, discharge or promotion include: (1) the psychiatric over hospitalization avoided due to insensitive, nonspecific diagnosis; (2) the civilian homicides, overdoses, and suicides, not found at courts, hospitals and human resources; (3) the air, bus, train, and truck transport deaths, not predicted and prevented during routine physicals; (4) the cumulative daily and yearly, veteran suicides, not found, when former military are discharged, or seek medical attention; (5) the professional athlete, coach, and trainer crimes and sex-offending, that cause loss of earnings, ticket and merchandise sales; (6) the nonprofit, religious groups pedophilia payouts, and lost collections, due to not screening at intake and promotion; (7) the jailing nonviolent and or mentally ill offenders, rather than diverting to electronic monitoring bracelets or other diversions; (8) the health care worker, physician, professor, teacher, and caretaker losses from violence to self and others, from not assessing; (9) the public-safety, personnel suicides, deaths-in-the-line-of-duty, and malfeasance payouts from not screening; (10) the mentally ill, mass murderers or active shooters, not found when seeking medical services, employment or police contact by failing to discover bipolar, schizophrenic, paranoid or other psychiatrically impaired persons; (11) the energy worker (coal, electricity, nuclear, oil, petroleum, and solar) losses from violence at routine physicals; and (12) the military (including national guard) homicides and suicides, by not screening at draft, promotion, discharge from service, or post-battlefield experience.See Table 4.The importance of using MLIT added to the current approaches is also emphasized in the nearly 129,435 U.S. 2016 combined homicides, mass murders, overdosing-substance-abusing, sex offenses, and suicides (FBI, 2012, Zagar, et al. 2016, CDC, 2017, 2018).There are also 861,837 U.S. convicted sex-offenders (U.S.Department of Justice, Bureau of Justice Statistics, 1997, National Center for Missing andExploited Children, 2017).

MLIT Actuarial Assessment
Zagar and Grove (2010) with N=2,722 showed that homicide, sex offending, and assault was predicted accurately and precisely (AUC for 1,595 adults = .99,AUC for 1,127 youth =.91 and AUC = .96for 2,722 combined).Zagar, Kovach, Basile, Hughes, Grove et al., 2013, andZagar, et al., 2016 showed that MLIT, actuarial assessment is more objective, reliable, sensitive, specific and valid, than current approaches with .97vs .39,for homicide, sex-offending and suicide.In a 50 year meta-analysis of suicide research, Franklin, Fox, Bentley, Kleiman, Huang, et al., (2017) discovered that MLIT was superior to find risk factors for suicidal thoughts and behavior.For suicide, Walsh, Ribeiro, and Franklin (2017) developed MLIT algorithms that accurately predicted future suicide attempts (AUC = 0.84, precision = 0.79, recall = 0.95, Brier score = 0.14).In neurology, Titano, Badgely, Schefflein, Pain, Andres, Michael et al., 2018 showed that the MLIT algorithm could decide whether a CAT scan of an emergency room patient demonstrated signs of a stroke, by using automated deep-neural-network surveillance of cranial images for acute neurologic events that are 150 times faster than a human judge.In retinal disease, DeFauw, Ledsam, and Ronneberger (2018) found that clinically applicable deep learning was superior, because there is a shortage of experts who can interpret the millions of diagnostic eye exams performed each year.Artificially intelligent assistants help immensely.
So MLIT actuarial assessment is the future for at-risk persons.The purpose of this study is to show that adding MLIT to the current ways of assessing persons in courts, hospitals, and human resources if more widely used would eventually save lives and expense.The aim is to confirm or cross-validate in an independent randomly selected sample that this -7point violence profile‖ exists.We will not cover the entire literature on these tests and the diversions, interventions or treatments, of these at-risk states and tests used in finding these at-risk.The results of a small cross-validation sample of 136 are presented which demonstrate the persistent results of this earlier research reviewed.Finally, there is discussion of how to save lives and expense by applying MLIT in the twelve above mentioned issues listed in Table 4. On the MMPI, MMPI-2/A over 95 years (1923 to 2017), there were 141 studies of 128,435 homicidal or violent prone, overdosing-substance-abusing, sex-offending, and suicide-completers, in five countries and two continents.Among these studies, there was a consistent pattern of the elevated deception, depression, psychopathic deviate, paranoia, schizophrenia and addiction scales or -L/F-2-4-6-8-AAS (ACK)‖ MMPI/MMPI-2/MMPI-A subtests across the abovementioned at-risk groups.See Tables 1a, 1b, 1c, and 1d.

MMPI/MMPI
Figure 2. 40,300,000 Deceptive, Neurologic and Psychiatric Self-Presentations Over 95 years, among 70 studies of 160,130, there were also consistent results of finding -return to court‖ or violence re-offending or -dangerous‖ behavior (probation and parole decision making tests).Researchers repeatedly proved that one can predict -return-to-court‖ or dangerous violent reoffending or -dangerous‖ behavior, to detect, apprehend, re-convict, and imprison the recidivist prone person.Combining the MMPI-2/A and probation and parole decision making tests like the Standard Predictor of Violence Potential resulted in 212 studies of 320,051 over 95 years, which conclusively are consistent with the "7-point violence profile."

Reviews of Dangerous and Violent Behavior: Probation and Parole Decision Making Tests: Teens and Adults
Next, there were 70 studies of 191,611 offenders over 95 years measuring with -return to court‖, probation parole, decision-making tests over a 1-10 year follow-up using 1-71 questions.Test sensitivity-specificity was from .59-.99 [receiver operating characteristic (ROC) or area under the curve (AUC)].See Tables 2a, 2b, 2c, and 2d.These tests are divided into teen and adult populations.In Table 2a, over 71 years, there were 13 studies of 31,581 delinquents with a unit item, regression, correlation, phi coefficient, receiver operating characteristic (ROC), or area under the curve (AUC) sensitivity or specificity in analyzing data.For the adult criminals, the 57 studies of 160,130 subjects over 95 years are presented in Tables 2b and 2c, with 1 to 71 item tests and followed for 1-10 years with unit item statistics, coefficient alpha, Pearson product moment correlation, multiple regression, base expectancy, point bi-serial correlation, discriminant analysis, ROC, AUC, sensitivity, and specificity.So, looking across the homicidal, overdosingsubstance-abusing, sex-offending, and suicide-completers in 142 studies of 128,135 subjects over 70 years, and 70 studies of 191,611 delinquents and criminals for a combined 212 studies of 320,051 individuals, there was a consistent, replicated -7-point violence profile.‖See Table 2e for a summary.
The null hypotheses of the cross-validation of the "7-point violence profile" are: (1) there are no differences between adult homicidal and controls; (2) there are no differences between adult overdosing-substance-abusing and controls; (3) there are no differences between adult sex-offending and controls; (4) there are no differences between adult suicide-completers and controls; (5) there are no differences between teen homicidal and controls; (6) there are no differences between teen overdosing-substance-abusing and controls; (7) there are no differences between teen sex-offending and controls; and (8) there are no differences between teen suicide-completers and controls.The alternate hypotheses of the cross-validation of the "7-point violence profile" are: (1) adult and teen homicidal, overdosing-substance-abusing, sex-offending, and suicide-completers will be similar; and (2) homicidal, overdosing-substance-abusing, sex-offending and suicide-completers will have a similar "7-point violence profile."

Participants and Population: Random Selection
The random sample of referrals and five adult and five teen study groups came from a Midwestern city with approximately 2,000,000 workers and students, during 26 years (1992 to 2018).See Figure 3.In any given day of the year, from 1992 to 2019, within Cook County, Chicago, Illinois, there were 50,000 Juvenile, and 90,000 Adult Court prisoners.This study's sample was independent of those reported, in prior research (Zagar, Arbit, Hughes, Bussell, and Busch, 1989;Busch, Zagar, Arbit, Hughes, and Bussell, 1990;Zagar, Arbit, Busch, Hughes, and Sylvies, 1991;Zagar, Zagar, Busch, Grove, Hughes, et al., 2009;Zagar and Grove, 2010;Zagar, et al., 2013).Burgess (1928) and improved by Nuffield (1982) and Quinsey, et al. (1998).M = male, F = female.ROC= receiver operating characteristic (which is roughly equivalent to the AUC or area under the curve), a = alpha; ptb = point bi-serial; base exp.=base expectancy; regress.=regression; discrim.= discriminant analysis; b=beta coefficient; sensitivity = identifying the re-offender precisely; specificity is not over identifying someone as an offender.Burgess (1928) and improved by Nuffield (1982) and Quinsey, et al. (1998).M = male, F = female.ROC= receiver operating characteristic (which is roughly equivalent to the AUC or area under the curve), a = alpha; ptb = point bi-serial; base exp.=base expectancy; regress.=regression; discrim.= discriminant analysis; b=beta coefficient; sensitivity = identifying the re-offender precisely; specificity is not over identifying someone as an offender.A random subsample of 4,987 was obtained by using a random number table from these convenience samples of 50,000 people referred for assessment by courts, industry, hospitals, schools, and universities, and 5,000 delinquent and criminal court persons, This random subsample consisted of all cases with full test data since they were referred by the court, hospitals, industry or university for testing, and had complete examinations.Adults and youth without examinations or without full test data were excluded from the random subsample and comprised the larger population.
Then, these 4,987 adults and teens were randomly sampled with a random number table.Thus, the adult and teen study groups were a selection of 136 persons, which made up the five groups of homicidal, overdosing-substance-abusing, sex-offending, suicide-completer, and control adults and teens, making up ten study groups.This random selection had a goal of at least a minimum of ten and maximum of 25, within each of the ten study groups.Summarizing, there were two sets of study groups, five adult and five teen (homicidal, overdosing-substance-abusing, sex-offending, suicide-completers, and controls) that made up the ten study groups in this random subsample.
This adult subsample study groups included some people most at-risk for violence, including those with issues related to alcoholism, assault, autism, behavior and emotional school disturbance, career delinquency or criminality, cognitive delay, credibility issues, such as facetiousness and malingering, divorce or separation, domestic violence, hyperactivity, lack of work skills, learning disability, physical, sex-offending or homicidal tendencies, marital challenges, mental illness, pedophilia, post-chemotherapy, sexual or verbal abuse, school dropout, somatoform disorders, substance addiction, suicide attempt or ideation, underachievement, and vocational guidance.The referrals were for competence to stand trial, developmental disability, hearing, motor, speech, or visual challenges, employment hiring, promotion or termination, high school, college, graduate school or seminary entrance, local, national or international adoption, parole or probation hearings, physical or personal injury, pre-sentencing, pre-trial, travel with pet on airlines, and workers compensation issues.
Selection of referrals for the adult study groups is similar to the selection of the standardization samples for the MMPI-2/A and other personality and ability tests, which are basically convenience samples from clinical and school professionals recruited by the testing corporations, who along with volunteer test subjects are chosen to meet certain age, gender, race, socio-economic status (SES) and specialized population characteristics, and are given a small stipend to take the test.This is the same as court, hospital, industry or insurance referrals, who pay for the examination and report.SES was measured by family annual income, in 2010 dollars, with a national median of $71,900 (U.S. Census Bureau, 2018).Low SES consisted of incomes from $0 to $30,000, and middle SES from $30,001 to $100,000.

Adult Homicidal Study Group
Among the twelve homicidal adults there were nine men and three women.The M age = 39.23 and the SD = 9.36 yr., or middle age.They had M education = 15.38, and the SD = 2.06 yr., or some college.There were three Euro-Americans (25%), six African-Americans (50%), two Hispanic-Americans (17%) and one other (Asian, Filipino, or Native American Indian) [8%].Occupations included professional coach, electric station controller, firefighter, handyman, mechanic, physician, police officer, port shipping supervisor, programmer, rabbi, sales person, and teacher with Army, Marines and Navy veterans.-Homicide‖ is defined as adjudication and conviction before a judge in court for killing of another individual(s), and by Illinois state law.

Adult Overdosing-Substance-Abusing Study Group
Among the thirteen overdosing-substance-abusing adults, there were nine men and four women.The M age = 38.29,SD = 12.40 yr., or middle age.The M education = 15.08 and the SD = 2.68 yr., or some college.There were three Euro-Americans (23%), seven African-Americans (54%), two Hispanic-Americans (15%) and one other (Asian, Filipino, or Native American Indian) [8%].Occupations included college coach, finance manager, football professional, lawyer, physician, pilot, policeman, professor, rabbi, refinery supervisor, scout leader, train engineer, and truck driver with Army, Coast Guard and Navy veterans.
Overdosing-substance-abusing is weekly alcohol abuse, substance-abuse, and alcohol and substance-abuse such as amphetamines, aromatics (paint or glue) barbiturates, cocaine, fetal polysubstance-abuse history, hallucinogens, heroin, glue sniffing, marijuana, nicotine, opiates, PCP and other substances.Many were hospitalized, either as an inpatient or outpatient, following an episode of loss of consciousness.Some died.Suicide conformed with the definition in the Diagnostic Statistical Manual-Fifth Edition [DSM-V] (American Psychiatric Association, 2013) and the International Classification of Diseases [ICD-10] (World Health Organization, 2013): and the state of Illinois statutes.Suicide completers died.Suicide attempters had a documented police report of a suicide attempt, along with hospital medical records.Suicide ideation was recorded court, medical, school or work record to suicide intentions and ideation discussed and reported.

Adult Sex-Offending Study Group
Among the fifteen persons, there were ten men and five women.They had M age = 36.07and the SD = 11.03yr., or middle age.The M education = 15.53 and the SD = 3.17 yr., or some college.There were four Euro-Americans (27%), eight African-Americans (53%), two Hispanic-Americans (14%) and one other (Asian, Filipino, or Native American Indian) [6%].Occupations included Olympic coach, construction worker, firefighter, mechanic, minister, nurse, physician, policeman, priest, professor, professional baseball player, restaurant waiting, sales, speech therapist, and teacher, including Air Force, Army and Navy veterans.
Sex-offending was molestation, pedophilia or rape, and by operational definition was identified and convicted individuals, who had raped a female or male, with evidence presented in court, and met the criterion for rape or aggravated criminal sexual assault as defined in Illinois laws.By definition, a -sexual molester‖ was an identified, detected, and convicted individual who molested a minor, supported by evidence presented in court.-Molestation‖ -pedophilia‖ and -rape‖ were consistent with the definition of pedophilia in the Diagnostic Statistical Manual-Fifth Edition (DSM-V; American Psychiatric Association, 2013) and the International Classification of Diseases Tenth Edition (World Health Organization, 2013).

Adult Suicide-Completer Study Group
Among fifteen individuals, there were ten men and five women.The M age = 34.20 and the SD = 11.09yr. or middle age; The M education = 14.20 and the SD = 2.65 yr., or some college.There were four Euro-Americans (27%), eight African-Americans (53%), two Hispanic-Americans (14%) and one other (Asian, Filipino, or Native American Indian)
Among the eleven homicidal teens, there were ten boys and one girl.The M age = 16.19 with the SD = 0.87 yr.The M education = 9.27 with the SD = 1.35 yr., or some high school.There were three Euro-Americans (27%), five African-Americans (45%), two Hispanic-Americans (18%) and one other (Asian, Filipino, or Native American Indian) [10%].-Homicide‖ is defined as adjudication and conviction before a judge in court, and by Illinois state law.

Teen Overdosing-Substance-Abusing Study Group
Among seven overdosing teens, there were five boys and two girls.The M age = 13.71 with the SD = 1.60 yr.The M education = 8.28 with the SD=1.60 yrs., or beginning high school.There were two Euro-Americans (29%), three African-Americans (43%), one Hispanic-American (14%) and one other (Asian, Filipino, or Native American Indian) [14%].Overdosing-substance-abusing is weekly alcohol abuse, substance-abuse, and alcohol and substance-abuse with the definition in the Diagnostic Statistical Manual-Fifth Edition [DSM-V] (American Psychiatric Association, 2013) and the International Classification of Diseases [ICD-10] (World Health Organization, 2013), and Illinois state law.

Teen Sex-Offending Study Group
Among ten sex-offending teens, there were nine boys and one girl.The M age = 15.40 with the SD = 0.84 yr.The M education = 9.20 with the SD = 0.63 yr., or some high school.There were three Euro-Americans (30%), five African-Americans (50%), two Hispanic-Americans (20%) and one other (Asian, Filipino, or Native American Indian) [10%].The same operational definition of sex-offending adults applies for sex-offending teens except the place of adjudication and conviction may be in juvenile or family court.
Sex-offending was molestation, pedophilia or rape and by operational definition were identified and convicted individuals who had raped a female or male, with evidence presented in court, and met the criterion for rape or aggravated criminal sexual assault as defined in Illinois laws.By definition, a -sexual molester‖ was an identified, detected, and convicted individual who molested a minor, supported by evidence presented in court.-Molestation‖ -pedophilia‖ and -rape‖ were consistent with the definition of pedophilia in the Diagnostic Statistical Manual-Fifth Edition (DSM-V), the American Psychiatric Association, 2013 and the International Classification of Diseases Tenth Edition (World Health Organization, 2013).

Teen Suicide-Completer Study Group
Among 17 suicide-completing teens, there were ten boys and seven girls.The M age = 15.12 with the SD = 1.59 yr.The M education = 9.27 with the SD = 1.35 yr., or some high school.There were four Euro-Americans (24%), ten African-Americans (59%), two Hispanic-Americans (12%), and one other (Asian, Filipino, or Native American Indian) [5%].Suicide completion is death by one's own hand consistent Diagnostic Statistical Manual-Fifth Edition (DSM-V; American Psychiatric Association, 2013), the International Classification of Diseases Tenth Edition (World Health Organization, 2013), and Illinois law.

Teen Control Study Group
Among 12 control teens, there were six boys and six girls.The M age = 15.91,SD=1.56 yr., The M education = 10.08,SD=1.68 yrs., or some high school.There were three Euro-Americans (25%), six African-Americans (50%), two Hispanic-Americans (17%) and one other (Asian, Filipino, or Native American Indian) [8%].Controls were randomly selected from 50,000 clinic-referred youth and adults.Referrals were for developmental, hearing, learning, motor, speech, visual, or other issues to assess level of function for interventions, schooling, or treatment.

Combined, Adult and Teen Study Groups' Characteristics Compared with U.S. and E.U. Populations
Given (1977) showed that murder rates among groups as diverse as 13 th -century Englishmen; 19 th -century Euro-American gold miners in Colorado, California, and Alaska, Hispanics in urban Mexico City, Caracas, and Bogota; Asians in urban Hong Kong and Tokyo, and 21 st U.S. and E.U. populations, were the same.These groups can be tentatively assumed to be representative of the U.S. and E.U. population demographics.(Speder, 2005) records, the U.S. and E.U. gender, race/ethnicity, and family compositions were obtained.The purpose was to compare with the random samples of the combined adult and teen, the adult, and the teen homicidal, overdosing-substance-abusing, sex-offending, and suicide-completer, and controls with the U.S. and E.U. populations.
X 2 were computed to show that the U.S. and E.U. population and the study groups' demographics were similar.See Table 3a.The purpose of the comparisons was to give one an idea of the generalizability of the results.X 2 were calculated between the combined adults, and teens on gender ratios, race/ethnicity ratios and family composition ratios and the demographics of the overall populations of the U.S. and E.U.In summary, the study groups (combined, adults and teens) had more African Americans and fewer Euro-Americans, than the U.S. population.
Summing up, the study groups (combined, adults and teens) had more boys, more single parents, and fewer mother + father families, than the E.U. population.In the comparison, of the overall U.S. population and the combined adults and teens gathered in Cook County, Illinois for this study, the African-American ratio and the Euro-American ratio was significantly (p < .01)different, i.e., in the general U.S. population, there were fewer African Americans, more Euro-Americans.
For the overall E.U. population compared to study group of combined adults and teens, the combined group were significantly (p < .01)different, i.e., in the general E.U. population, there were fewer boys and more girls, and fewer single parents and more mother + father families.The majority of the significant comparisons were on demographics, which have been shown to be predictive of criminal behavior (homicide and sex-offending): gender ratio (most violent criminals are male), race/ethnicity (more risk factors, and thus, greater representation of minorities in violent criminal groups due to poverty), and broken families (since these family structures are risk factors for violence).Thus, there were no unexpected differences between the study groups of combined adults and teens, adults and teens and the general U.S. population.

Measures: A Set of MLIT to Find Most At-Risk
Several tests were chosen, after an exhaustive review of the research, on the sensitivity and the specificity of actuarial evaluations.Tests with high reliability and validity were chosen.A longer list of questions was thought to be required to achieve both sensitivity and specificity.There is considerable empirical literature attesting to the test-retest reliability of these tests in a variety of populations over time.A brief description of the selected tests follows, along with the data collection, decision making algorithm, statistics and experimental design. 11 (F15a) Ammons Quick Test (QT) is a brief, norm-referenced assessment of receptive vocabulary, in a four-choice, picture format with three alternate forms, which takes five to 15 minutes to administer (Ammons and Ammons, 1962;Zagar et al., 2013).The QT was developed before the Peabody Picture Vocabulary Test (Dunn and Dunn, 1959;Vance and Singer, 1979;Dunn and Dunn, 1997), and is commonly used to screen in prisons for intellectual or learning disabilities.The QT can be employed with children through adults and has been used with patients, students, and employees (Mednick, 1969;Advokat, Eustis, and Pickering, 2005;Zagar, Kovach, Busch, Zablocki, Osnowitz, et al., 2013).(F15b) Beck Suicide Scale (BSS) is a 21-item test with three-choice format, which requires five minutes to complete.The BSS is intended to assess potential for suicide.
The BSS uses self-descriptive statements on depression and suicide thoughts, like crying, failure, fatigue, guilt, insomnia, and irritability.This assessment also deals with pessimism, punishment, sadness, weight loss, and withdrawal and has a reliability and validity from .70 to .90 (Beck, 1978(Beck, , 1991)).The BSS was given to 50 outpatients, and the correlation between their self-report of suicidal thoughts and independent clinicians rating suicidal ideation was .95(Beck and Steer, 1981).Within a group of 25 outpatients, the Cronbach's alpha or coefficient of internal consistency was .97(Beck, 1978;1981).The 50 inpatients and 25 outpatients self-reports of suicidal thoughts were more severe, than the independent clinicians ratings of suicidal ideation (Beck, Steer, and Renairi, 1988).Among 50 inpatients, the correlation between self-reports of suicidal thoughts and independent clinician ratings of suicidal ideation was .96(Beck, Kovacs, and Weisman, 1975).Among 90 suicidal (41 men, 59 women), the coefficient of internal consistency on the suicidal scale was .89,while the correlation of self-reported suicidal thoughts and independent clinician ratings of suicidal ideation, was .83(Beck, Kovacs and Weisman, 1979).The test-retest reliability was .41(Beck and Lester, 1976).The best measure of the criterion of suicidal ideation is the one, which has the behaviors, which encompass the attributes of suicide (Beck, Resnik, and Lettieri, 1974;Beck, Morris, and Beck, 1974;Beck, Weisman, Lester, and Trexler, 1976;Bedrosian and Beck, 1979).(F15c) MMPI Second Edition (MMPI-2) and / or the Adolescent Edition (MMPI-A) is an evaluation of mental health, personality and deceptive self-presentation.Across the three editions, with item duplication, the computerized test takes less than 60 minutes to complete.The MMPI-2 for adults has 567 true-false format questions, while the MMPI-A for adolescents has 478 true-false items.Administration via machine-learning on the internet, allows for instantaneous scoring and report generation, with a precision that exceeds 90%, in detecting mental illness.The MMPI alone is not sufficient in assessing violent-prone persons, because within the more than 100 scales, there is no reliable, sensitive-specific, valid measure of violence.This is why, many court, hospital and human resource professionals add a probation parole decision making risk test, like the Standard Predictor to the MMPI.Over 19,000 empirical studies and 250 appellate court cases attest to the usefulness of this assessment, which originated in the 1930s.The QT, MMPI, SP and the other tests in this study, assess employees in airlines, military, nonprofits/religious organizations, power generation industries, police and fire public safety, trucking and ports, veterans, worker compensation and personal injury insurance clients, and also prisoners (Butcher and Pancheri, 1976;Butcher, Dahlstrom, Graham, Tellegen, and Kaemmer, 1989;Butcher, 1996;Pope, Butcher, and Seelen, 2004;Butcher, Gucher, and Hellervik, 2009).The MMPI-RF was not included.(F15d) Raven Advanced Progressive Matrices (‗Raven test': Raven, 1965Raven, , 1990) is a norm-referenced measure of visual, nonverbal problem solving, which has been standardized in more than 54 countries (Flynn, 1984(Flynn, , 1987)).The 48 challenging problems are presented in a multiple-choice format of 6 or 8.The computer administration and scoring takes 25 to 45 minutes, depending upon the problem or puzzle capability of the test subject (Shultz, Kaye, and Hoyers, 1980;Dillon, Pohlman, and Lohmen, 1981;Pietariu, 1986).(F15e) Standard Predictor of Violence Potential (SP) is an assessment of adults, with 96 true-false or multiple-choice format items and an Area under the Curve (AUC) = .99.The SP for Adolescents has 116 items with AUC = .91.The test-retest reliability was .75-.76 and Cronbach's alpha of .75-.78 with sensitivity of 97% and specificity of 97%.The SP includes specific, historical self-descriptions and requires 15 minutes to complete.The SP has no items from any of the other tests and is a free standing instrument with 96 or 116 independent items, distinct from the other tests.This measure was successful in discriminating randomly selected violent offenders (1,595 adults and 1,127 adolescents) from matched controls with AUC = .96in a combined adult and adolescent version, based on a sample of 2,722 (Zagar and Grove, 2010).This AUC is noteworthy because most tests in the literature attempting to predict criminal recidivism or -return to court‖ have AUCs from .7 to .8 (Moosman, 2013).(F16) Data Collection Testing of these individuals was done to assess current functioning and address the hypotheses, as well as the more immediate issues of offering interventions, assessing fitness for duty, schooling, screening, and/ or medical or psychological treatment.Then, records for these individuals were obtained from court, industry, hospital, school, and/or universities.The records were checked and accepted as accurate, with regard to convictions and illnesses.Records were examined for previous court contacts for neglect, substance-dependency, physical and sexual abuse, delinquent and criminal oneness such as truancy, disorderly conduct, solicitation, phone harassment, forgery, mob action, violating a court order, drug possession or sales, property damage, auto theft, theft, burglary, robbery, unlawful weapon possession [firearm(s)], arson, assault or battery, aggravated criminal sexual assault, and homicide (same procedure as used in Zagar, Busch, Grove, andHughes, 2009, andZagar, Kovach, Basile, Hughes, Grove, et al., 2013).Of the 146 participants, approximately 20 traveled in for the examinations from adjoining states of Indiana, Michigan, Minnesota, Wisconsin, and New Jersey, referred from airlines, courts, energy production industries, insurance firms, trucking companies, and lawyers.This sample included some people most at-risk for violence, including those with issues related to alcoholism, assault, autism, behavior and emotional school disturbance, career delinquency or criminality, cognitive delay, credibility issues such as malingering and facetiousness, divorce or separation, domestic violence, hyperactivity, lack of work skills, learning disability, physical, sex-offending or homicidal tendencies, marital challenges, mental illness, pedophilia, post-chemotherapy, sexual or verbal abuse, school dropout, somatoform disorders, substance addiction, suicidal attempt or ideation, underachievement, and vocational guidance.The referrals were for competence to stand trial, developmental disability, hearing, motor, speech, or visual challenges, employment hiring, promotion or termination, high school, college, graduate school or seminary entrance, local, national or international adoption, parole or probation hearings, physical or personal injury, pre-sentencing, pre-trail, seminary, travel with pet on airlines, and workers compensation issues.Of course records are not infallible and some individuals with mental illness may go undetected, or not have hospital or legal records.(F17) Psychological Examinations According to the published test manual instructions, two different psychologists administered the QT, the BSS, the MMPI-2/A, Raven and the SP Adult or Adolescent Version The order of test administration was randomized.For the hand scoring of the raw test data, the two independent psychologists had inter-observer agreement (Pearson rs = .93-.94).All of the MMPI data were scored using the Pearson Assessment and University of Minnesota Press computerized Clinical Interpretative Report.The instruments had high test-retest reliability, large standardizations samples, good internal consistency, and high concurrent and construct validity.When possible the tests were administered on the internet.(F18) Records After physical and psychological examinations, current medical and other records were coded using the International Classification of Diseases (ICD-9;World Health Organization, 1977) and the Diagnostic Statistical Manual V (American Psychiatric Association.2013) and juvenile and adult court and school and industry records were reviewed by two independent psychologists, with coefficients of inter observer agreement of r=.92-.94.(F19) The Decision-making Algorithm For adults or adolescents, using the record and test data, two independent psychologists' classified individuals with the following algorithm, to assess mental health including substance-abuse using test results: (a) s QT score below 70 is consistent with cognitively delayed functioning, as was (b) Raven's with a score below 70.(c) A (BSS score of 10-20 or more, in the moderate to severe range of major depression, with suicide ideation.(d) The MMPI-2 (MMPI-2) or the MMPI-A with significantly (p < .01)elevated validity and/or basic clinical scales consistent with a t score of 65 or above.Finally, (e) the SP Adult version cut-off was 70.6%, the lowest score of convicted violent offenders; the SP Adolescent version cut-off was 82.9%, the lowest score of convicted adolescent violent offenders (Zagar and Grove, 2010).With this decision-making algorithm, for the two independent psychologists, Pearson product moment coefficients of inter-observer agreement were .92-.96 (p < .01).The results of this algorithm were compared with records of the individuals' actual histories.(F20) Statistics and Experimental Design For adults, adolescents, and the combined group (adults plus adolescents), the means and standard deviations were computed for age, sex, race, SES, years of education completed, occupation, and offenses.For adults, adolescents, and the combined group, the test scale means and standard deviations were normally distributed according to the Komolgorov-Smirnov Test and met the assumptions of homogeneity of variance on Bartlett's test.In simple terms, the data was normally distributed and homogenous, conditions for both t-tests and analysis of variance (ANOVAs).For the domains and tests employed, the sample size was sufficient (Kirk, 1982).The criterion for mental health including substance-abuse, abuse, and delinquency or crime was the individuals' actual records.These included court or health records of mental illness, substance-abuse, violence, and / or abuse.For example, if the records showed a finding of mental illness, it was assumed that the individual had mental illness, and so forth for the various criteria, substance-abuse, violence, and/or abuse.This carefully selected set of tests was administered either by paper-and-pencil or over the internet with a 6.21 Results

Analysis of Variance (ANOVA)
Since theoretical considerations drove the comparisons, over modeling (Type 1 error) was avoided.The distribution of means and standard deviation t-scores of tests or risks for each subgroup, are shown in Table 3a and 3b.The five study groups' subgroups, whether adult or teen, had unequal sizes, so for clarity, means and standard deviations t-scores were presented to allow comparison across tests and subtests, which had also different numbers of items.The adult and teen study groups had significant (p < .05)differences when at-risk were compared with controls.Also, adult and teen subgroups of homicidal, overdosing-substance-abusing, sex-offending, suicide-completers, and controls had similar t-score means and standard deviations in the same consistent, replicated pattern of risks, the -7-point violence profile‖ was expected.See Table 3a, 3b, 3c, and Figures 4 and 5.
total test time of 110-440 min.for 823 items.In the internet format, tests with automated reports cost 70 to 80% less than current paper-and-pencil version reports.Also, percentiles, raw and t scores, and cut-offs were available instantaneously, except for MMPI clinical interpretative report, which does not provide percentiles but t-scores.When the paper-and-pencil versions were used, two independent psychologists verified the entry independently, matching the computerized reports with r=.98 consistency, because most jails and prisons and some other situations, do not allow computers.First, the adult 5 group data were subjected one way ANOVA.Then the teen data were subject to ANOVA.All of the psychometric measures or dependent measures met the assumptions of normality (Kolmogorov Smirnov Tests) and homogeneity of variance (Bartlett's Tests).In viewing Figure 4, the adult average and standard deviation t-scores of the BSS, MMPI-2, QT, and SP, were significantly (p<.05.) higher for the four at-risk study groups (homicidal, overdosing-substance-abusing, sex-offending, suicide-completers) compared with control study group.This is consistent with what was found among the teens and confirms similar profiles from 320,051 subjects in 212 studies over 95 years.The suicidal-overdosing followed by the sex-offending, and the homicidal study groups had t-scores at least one standard deviation above normal (t mean = 50; t standard deviation = 10).The small sample sizes may account for homicidal study group having lower violence potential scores than the other at-risk study groups.

Teen Suicide-Completers vs. Control Study Groups
In Table 3b and Figure 5, the distributions of means and standard deviations t-scores of teen suicide-completer and control study groups are shown.Significantly (p<.05), the teen suicide-completers compared with control study group had higher SP scores, increased exaggeration (F1), lie (L), defensiveness (K), depression (D) (2), psychopathic deviate (Pd) (4), paranoia (Pa) (6), schizophrenia (Sc) 8), addiction acknowledgement (ACK) MMPI-A scores, and elevated BSS scores, but lower Raven problem solving IQs.In viewing Figure 5, it is clearly seen that the teen average and standard deviation t-scores of the BSS, MMPI-A, QT, and SP, were significantly (p<.05.) higher for the four at-risk study groups (homicidal, overdosing-substance-abusing, sex-offending, suicide-completers) compared with controls.This is consistent with what was found among the adult study groups and is consonant similar profiles from 320,051 subjects in 212 studies over 95 years.In this comparison of teen study groups, the homicidal study group, followed by the sex-offending study group, had the highest violence potential scores.

Comparing Adult and Teen Study Groups Average t-Scores
When the adult (N=79) and teen (N=57) homicidal, overdosing, sex-offending, suicide-completer, and control study groups average and standard deviation t-scores of the SP, BSS, and MMPI-2/A were compared, they were similar.The ANOVA Fs were insignificant (p < .05).This means that the adult and teen study groups of homicidal, overdosing, sex-offending, suicide-completers, and controls were homogenous.This also can be interpreted as the BSS MMPI-2/A, QT, Raven, and SP were consistent in measuring the constructs across homogenous at-risk groups, whether adult or teen.See Table 3c.In Table 3d there is a summary of the "7-point violence profile" across adult and teen homicidal, overdosing, sex-offending and suicidal-completers, namely the BSS, SP, Raven, and MMPI-2/A faking, depression, psychopathic deviate, paranoia and schizophrenia scales or -F-2-4-6-8.‖

Internal, External, Construct, and Statistical Conclusion Validity Threats
Variations in means, standard deviations and ANOVA Fs are due to error in tests or testing, differences in the history of individuals within subgroups, generalizability, measured traits, measurement, reliability, sampling variations, selection error, setting of the test administration, time of original data collection, scaling, statistical analyses, validity and probably many unknown factors.Despite this variability and the overlap of ranges, when at-risk male and female, adult and teen, homicidal, overdosing-substance-abusing, sex-offending, suicide-completer study groups were compared with control study groups, the data were robust enough to identify significant differences.Researchers in the past century have found overlap and variability in assessing at-risk.Such variability is the reason why, careful attention to detail and longitudinal data collection from multiple examinations in many settings is necessary in this kind of study.For over a century, the Circuit Court of Cook County has collected multiple examinations and records from many sources.The risks found among high-density urban, adult and teen, homicidal, overdosing, sex-offending, and suicide-completers were similar to the findings in abovementioned research findings around the world.Homicidal Adults & Teens SP, BSS, MMPI-2/A‖F-L-2-4-6-8-AAS (ACK)‖ Overdosing-Substance-Abusing Adults and Teens SP, BSS, MMPI-2/A -F-2-4-6-8-AAS(ACK)‖ Sex-Offending Adults and Teens SP, BSS, MMPI-2/A -F-L-2-4-6-8-AAS(ACK)‖ Suicide-Completer Adults and Teens SP, BSS, MMPI-2/A -F-L-2-4-6-8-AAS(ACK)‖ "7-Point Violence Profile" (SP, BSS & MMPI-2/A) SP BSS infrequency/lie (deception), depression, psychopathic-deviance, paranoia, schizophrenic thinking, addiction

Discussion of How Using MLIT Widely Might Save Lives & Trillions
Whether among adults or teens, there were significant (p < .05)fluctuations in the deceptive self-presentation, psycho-pathology, suicide ideation, violence potential, receptive vocabulary and problem solving IQ t-scores, when homicidal, overdosing-substance-abusing, sex-offending and suicide-completer study groups were compared with control study groups.These results paralleled 212 studies of 320,051 homicidal, overdosing-substance-abusing, sex offending, and suicide-completer persons over 95 years consistently replicating these prior results.Most of the at-risk study groups had elevated SP, BSS, and MMPI/MMPI-2/MMPI-A scores [lie/infrequency, depression, psychopathic deviate, paranoia, schizophrenia and addiction (admission or acknowledgement)].
Informed professionals know this often repeated profile.Also, this confirms the often proven notion that actuarial MLIT with 97% sensitivity and specificity, were an improvement over current ways, which have a combined accuracy and precision of less than chance (39%).Given that each homicidal, overdosing-substance-abusing, sex-offending and suicide-completer study group case costs about $1,000,000 in lost lifetime earnings and considerable grief, actuarial MLIT offer leaders a solution.Based on U.S. 2016 data, 119,965 homicides, mass murder victims, overdosing-substance-abusing, and suicide-completers (FBI, 2012, Zagar, et al., 2016, CDC, 2017, 2018) losses amount to $119,965,000,000 (119,965 at $1,000,000 each) of lifetime earnings, should not leaders promote wider use of MLIT to save money and lives?The limitations of this study are the small sample size and narrow age, family composition, gender, occupation, and racial makeup of the study groups.Despite these impediments, the data are consistent with a "7-point violence profile" for adult and teen, homicidal, overdosing, sex-offending, and suicide-completer study groups.The largest expenses that are incurred by not using MLIT more widely are in psychiatric hospitalization, air transportation suicide victims, criminal athlete and sports club losses, the U.S. Roman Catholic Church pedophilia payouts including lost collections, daily U.S. veteran suicides, and excessive, historically and internationally, the highest imprisonment rate of nonviolent U.S. citizen-taxpaying-voters, who could be moved to electronic monitoring bracelets which cry out to be answered by current leaders.See Table 4. Illinois ER Visits Resulting in Psychiatric Hospitalization

Psychiatric Inpatient Hospitalizations Avoided
At-risk people come to hospital Emergency Rooms (ERs).In 2014, there were 136,300,000 ER visits.Over 10% (16,200,000) resulted in hospitalization.Just over 10% of those hospitalized made up the 2,100,000 psychiatric hospitalizations.The average psychiatric hospitalization cost increased 21% from $5,800 in 2003, to $7,000 in 2019.
Compared with maternal neonatal, medical, surgical, and injury hospital stays, the psychiatric hospitalization was the longest (Weiss, Barrett, and Steiner, 2014).A short psychiatric ER visit for a medical exam or interview costs $56, which is more than all other ER visits.In 2003, the normal length for a psychiatric stay was 6.9 days, which went up to 7.4 days in 2011.
See Figure 6 for the increase in Illinois ER visits from 2006 to 2017.By using MLIT, actuarial assessment and psychiatric patients can be diverted from the hospital ER or soon after admission, lowering the psychiatric inpatient hospitalizations, saving $214,126,500 per year, just in Illinois.
Because of the failure to use MLIT in assessing at-risk over the past 28 years, there are 5,880,000 unnecessary psychiatric hospitalizations that cost $41,160,000,000.See Table 4.One percent of all health expenditures were for mental health and substance-abuse.In 2009, the spending on substance-abuse prescription medications was $887,000,000.Providers for mental health and substance-abuse received $171,720,000,000.This can be broken down into $147,381,000,000 for mental health.The remaining was spent on substance-abuse.A total of $10,461,000,000 was spent for inpatient, outpatient and residential services (U.S.Department of Health and Human Services, 2009; 2014).

Civilian Homicides, Overdoses and Suicides
In 2017, the U.S. annual 21,130 homicides, 66,839 overdoses, 9,832 sex-offenses, and 30,634 suicides sum up to 129,435 yearly violence victims.Since many of these are the result of a long history of mental illness, psychopathology and lack of work, using MLIT to intercept, and divert them to jobs would save lost lifetime earnings, medical, court and jail expenses, that over 28 years, equal 3,799,448 victims at a $1,000,000 loss per person or $3,799,448,000,000 (Criminal Justice Information Services, 2018).Summer Chicago, 2018;Zagar, et al., 2013;2016).See Table 5.
Using the same research on MLIT actuarial assessment of at-risk over a decade, the President of Cook County reduced the population of Cook County jails by 56%, diverting mostly nonviolent offenders.U.S. President Obama copied this approach in releasing 6,800 federal prisoners (by commutation or pardon).7.3 Air,Bus,Train,and Truck Transportation Costs From 1992 to 2015, there were 911 international and U.S., pilot-assisted, aircraft suicides (CAMI, 2006(CAMI, , 2014)).With $1,000,000 lifetime earnings loss and a $1,000,000 military and airline training expense that is a loss of $1,822,000,000.See Figure 7. Bus and truck driver deaths make up 1% of the 40,000 yearly U.S. roadway fatalities (Toy, 2018).That is 400 lives lost at $1,000,000 lost lifetime earnings, which sum up to $400,000,000 in annual expenses.Over 30 years the loss is $1,200,000,000.
Annually, there are roughly 100 train deaths (Abbott, et al., 2003;Rauti and Dogram, 2004;Weiss and Farrell, 2006).Yearly, these train accidents with a lost lifetime earnings cost of $1,000,000 are an expense of $100,000,000 that over 30 years cost $3,000,000,000.Every year there are 200 large truck accidents which cost $40,000,000 each and total to $8,000,000,000.Over 30 years that is an expense of $240,000,000,000 (Miller, 1997;Zaloshnja, Miller, and Spicer, 2000;National
Among 529,000 veterans, 2% had PTSD, 10% were disabled and 19% mentally ill (Coughlin, et al. 2013; U.S. Department of Veteran Affairs, Office of the Actuary, 2014).See Figure 8 for the 236,870 cumulative veteran suicides from 1990 through 2018 at $1M lost lifetime wages and $1M lost military training costs equals a $473.77T loss (Zagar, et al., 2016).Figure 8. 236,870 Cumulative Veteran Suicides (1990-2018)  The military invests at least $1,000,000 in training and salary on each, and there are on average, U.S. worker lifetime earnings of $1,000,000 to consider.This $477,740,000,000 is a loss that is predictable and preventable.To the families and communities, these tragedies are serious matters.

Sports Organizations: High School, College and Professional and Athletes
The loss in revenue, honor, reputation, sales, endorsements, and the effect of violence in sports on the family, the community, and the social fabric cannot be completely given a cost (Zagar, Zagar, Bartikowski, and Busch, 2009), but in Table 4, it is estimated that there are 3,000 victims with a cost of 55,952,733,308.A case study might be the recent professional, football player, homicide case, Hernandez.During Hernandez's college career in Florida, Tebow tried to intervene in a bar fight.During the pre-employment screening of Hernandez, the New England Patriots administered personality tests (Zagar, Zagar, Busch, Garbarino, Ferrari, et al., 2016).
These were consistent with an aggressive, angry and assaulting person, -living on the edge of acceptable behavior.‖According to Clegg (2013), the football club was cautioned about Hernandez -becoming a problem for the team.‖Jones (2013) noted that the East Coast professional football club lost $15,037,000 in the signing bonus, and took a major hit to their salary cap with his guaranteed salary.Rishe (2013) believed the loss was closer to $12,700,000.
An inspection of the expense of violence to sports organizations is crucial.Loss of fans, advertising, sales of memorabilia, and endorsements, are challenging issues to quantify, but others are not.In the Hernandez case, a homicide in 2016 dollars costs $4,660,986, while the lost wages of $15,037,000, $20,000 in the average felony trial expense, and 57 years in jail, his life expectancy on a life sentence, at the average prison cost of $27,500 is $1,567,500.
The East Coast team paid $250,000 to buy back Hernandez sports shirts, shredding them.So this adds up to a $19,717,986 loss.The ultimate tragedy is that Hernandez eventually committed suicide in jail.This is a predictable and preventable loss that could have been avoided with MLIT actuarial assessment, followed up with anger management training, cognitive behavior therapy, and medication and mentoring, as already demonstrated in the decade long Chicago teen diversion -Culture of Calm‖ and -One Summer Chicago‖ programs.
A series of sports organization examples follows.Michael Vick lost even more dog fighting.First he lost a $130,000,000 contract that was voided.Add the $20,000 average felony trial expense and two years at $27,500 per year average prison cost, this equals $55,000.This totals up to a $130,075,000 loss.Generally, costs to victims comprise out-of-pocket expenses for medical bills, property loss, reduced productivity at work, home, and school, and non-monetary losses (fear, pain, suffering, and lost quality of life).
Of course, the intangible loss of quality of life is often much greater, than the tangible or out-of-pocket expenses.Intangible losses are assigned by jury award, and are not predictable.Economists place monetary values on intangible losses in the following categories: productivity; medical care and ambulance; police and fire services; mental health care; social victim service; and property loss and damage (Miller, Cohen, and Wiersema, 1996).For example, the average pedophilia crime costs $120,681 in 2012 U.S. dollars.On average, a robbery costs $9,752.A fatal crime with assault costs $3,239,964.
These expenses do not include punitive damages, but only the portion of awards meant to compensate the victim's pain, suffering, and lost quality of life.These examples demonstrate how experts quantify costs of violence.Recently, Penn State University paid out $59,700,000 to 26 victims for pedophilia, at an average award of $1.6M to each victim.Jerry Sandusky was a college football coach.The 2016 cost of pedophilia of ten boys is $124,632.This all amounts to a $1,246,320 loss.
He was 67 at the time of his arrest, and earned an average college football coach salary of $53,670 per year for 30 years.The average felony trial expense is $20,000 plus $100,000 bail.He received a sentence of 60 years at $27,500 which equals $16,500,000.There was a payout of $59,700,000 from Penn State University, so this is a total loss of $77,446,320.If one adds the cost of the trials for the former Penn State president and athletic director and their incarceration and the loss in athletic event revenue and reduced alumni donations, this expense increases.
Ohio State may lose $100 million for over 50 victims.Baylor University will lose $223 million over a sex scandal.Michigan State put aside $500,000,000 for 324 sexually abused, college athletes, and many Olympic level competitors.
A similar situation exists at University of Southern California, where pedophile victims and expense exist.
and that from February 21-24, 2019, there will be a historic meeting on -the Protection of Minors in the Church.‖ There is an estimated 9-14% decline in U.S. Roman Catholic affiliation, due to the pedophilia scandals.The percentage of Catholics in the U.S. population will drop to 0%, in 500 years.
Figure 9. 1994-2016 Projected 198 Bankrupt U.S. Catholic Dioceses From Pedophilia Payouts and Lost Collections (Zagar, et al., 2016) Given each pedophilia-affected zip code per year, estimated U.S. Roman Catholic loss was 1.3% in total charitable contributions.Harvard trained economist, Microsoft postdoctoral fellow, University of California San Diego business professor Perez-Truglia [Rotondaro, 2016] computed this annual lost collections and donation revenue.With 1.3% times 3,000 scandals, the loss is equal to $1,770,000 per year.
Non-itemized contributions are 25% of all giving.Perez-Truglia assumed similar effects on non-itemized givers.A pedophilia scandal costs $590,000,000 per year equal to $1,770,000,000 plus $590,000,000 which equals to $2,366,000,000 per year (Ruhl and Ruhl, 2016).Charitable giving does not bounce back.
Economic effects are localized to the area or diocese.Applying the $2,366,000,000 loss from 2002-2013 equals to 11 years at $2,366,000,000 totaling to $26,026,000,000 loss.Add the $4,520,363,843 cumulative pedophilia settlements.This amounts to a $30,546,363,843 current loss.An example of the current situation, the Chicago Archdiocese just sold the parking lot west of Holy Name Cathedral for $100,000,000, a generous price, but the new diocesan chief financial officer notes that there is still a $200,000,000 sex abuse debt.This mitigates the problem, but does not solve it.Probably the cardinal's residence and other properties will need to be sold.MLIT of 117,531 at $100 costs $11,753,100.We've proposed to the Chicago Archdiocese and the U.S. Roman Catholic Church since 1992 that this objective, reliable, sensitive, specific and valid approach be used with the current ways that miss 69% of the risk.Hopefully given these facts, there will be a change of heart.

Releasing Nonviolent Offenders to Electronic Monitoring and Other Diversions
Figure 10.1095-2015 U.S. Prison Rate vs. Psychiatric Hospital Bed Rate (Zagar, et al., 2016) One third of the annual cost of crime in the U.S. or $37,000,000,000 is the expense of running the U.S. prison system.1905 1910 1915 1920 1925 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005  Around 1980, the poor without support migrated from psychiatric beds to jail cells.In Cook County, Chicago, Illinois, the County President released 56% nonviolent offenders to electronic bracelets and other diversions, with no recidivism, or no lowering of community safety (Olson and Taheri, 2012;Zagar, Grove, and Busch, 2013).There is a cost incentive to releasing nonviolent offenders to electronic bracelets or other diversions.
In New York, the annual prison expense is $3,267,105,290.Nonviolent prisoners make up $2,705,422,825 of that cost.
From state to state, the return on investment or ROIs of moving nonviolent offenders to electronic bracelets and assuring the safety of the community by using MLIT tests to screen these prisoners ranges from $2 to $20.The cumulative savings across 50 states, and the federal prison system, over 28 years, is 30,033,589 offenders or $845,348,791,552.
There are many examples of physicians murdering a domestic partner, nurses killing a patient, overwhelmed therapists overdosing, and health care workers molesting patients.In the current news, a nurse impregnated a comatose patient, who gave birth to a child.The total cost of these risks is $19,137,230,000 over 28 years.

Public Safety, Police, Firefighters, and Emergency Medical Technicians
Annually, one of 154 police officials are accused of inappropriate or illegal, violent behavior.One out of 1,549 deaths is caused by public safety personnel, who acted illegally or inappropriately.Among 1,200,000 public safety officers, there are 200 yearly wrongful injury or death claims.
Since 2004, misconduct legal claims against the Chicago Police Department cost $542,000,000 (Schroeder, 2016) with 450 current outstanding police misconduct lawsuits.Between January 2009 and November 2011, the City of Chicago treasurer paid out $455,000 for 441 lawsuits.This is a rate of $5.54 annually for every Chicago city resident.
In Los Angeles the payout rate for police misconduct was half of Chicago's or $2.66.In New York City was double Chicago's rate or $9.93 [Caputo, 2012].New York City officials paid out $100,000 yearly, costing $1,000,000,000 in a decade (Fields and Jones, 1999;Fyfe and Kane, 2005).
The combined U.S. annual police suicide and yearly killed-in-the-line-of-duty are 300 (Aamodt and Stainaker, 2006;Badge of Life, 2012;National Law Enforcement Fund, 2015).So, over 30 years that is 7,532 deaths.See Figure 12 for the number of police officers killed and the suicides (Aamodt and Stainaker, 2006;Badge of Life, 2012;National Law Enforcement Fund, 2015).
For every police officer killed or police officer suicide, multiply $1,000,000 for the minimum cost of training and replacing that public safety officer, and a lifetime earnings loss of $1,000,000.So, 7,532 times $2,000,000 is $15,064,000,000 (USA Today, 2018).Unwittingly, academics and the media present newspaper articles promoting more mental health services when in fact MLIT, actuarial assessment would not only lower the suicides, but decrease the illegal violent behavior, the killed-in-the-line-of-duty, and the payouts at a fraction of the cost of the current methods of background-credit checks, interviews-judgment, medical exams, and paper-and-pencil tests.

Mass Murder and Terrorist Victims Expense
According to the FBI, from 2000 to 2013, there were 160 active shooters.An active shooter is a person killing or attempting to murder people in a confined, populated area.In contrast, mass murders have at least four victims (Blair and Schweit, 2014).Active shooting incidents have the highest casualties.Among 39 incidents, there were 117 deaths; 40% committed suicide and 56-66% had mental illness (Blair and Schweit, 2014).See Figure 12.
Figure 12. 161 Active Shooter Incidents: 1,046 Dead at $1M; $1,047,000,000 Lifetime Lost Wages (FBI, 2014) Many think that severely mentally ill people are harmless.Indeed, most are.However, some persons with mental health issues commit mass murders, active shooting incidents, suicides and homicides.Their violent actions are related to personal mental health problems in 20% to 59% of the incidents studied.
In the year following the Sandy Hook Connecticut School massacre, there were 30 mass shootings with 100 victims.In 2013, there were 300 mass murders; 59% of these mass murderers had psychiatric illness.
7.11 Energy (Coal, Electricity, Gas, Nuclear, Oil, Petroleum, and Solar 4,000 U.S. nuclear power plant controllers supply 20% of the electricity.The probability of a depressed or suicidal controller is ample reason to consider MLIT tests (Bostok and Daley, 2007).In the past, the senior author personally examined a cluster of three completed suicides at a Midwestern nuclear plant.
There are about 600,000 workers involved in the various sectors of energy production (Bromet, Dew, Parkinson, and Schulberg, 1988; U.S. Energy Information Administration, 2009; U.S. Nuclear Regulatory Commission, 2013).There are 474,830 U.S. energy workers, and over 28 years, 25,552 commit homicide, overdose-substance-abuse, sex-offense or suicide, with lifetime earning loss of $1,000,000 or $1,012,000,000 in total loss (Statista, 2018).If one adds the military training expense, since most energy workers are veterans, this loss is doubled.

Military Homicide and Suicide Costs
Within the military, there were psychiatric, substance-abuse and violence issues.In 2006, after boot camp training, the U. S. Army had a rejection rate of 1,472 of 43,574 recruits.Nineteen percent of these recruits were discharged for unidentified psychiatric issues.One point two percent of U.S. Marines were discharged because of substance-abuse.One percent of enlisted recruits dropped out.Recruitment interviews were consistent with 13.9% soldiers considering suicide, 5.3% with a suicide plan, and 2.4% attempted suicide, with between 47-60% of these cases existing prior to joining the military.See Figure 13.
Costly offenses are perpetrated by military personnel.In 2004, there were 1,798 sexual assault claims, of which 672 resulted in punitive damages (USDOD Sexual Assault Prevention and Response, 2006).Thirty-two percent of enlisted women felt sexually harassed (Bostok and Daley, 2007).This could be explained by the fact that 13% of U.S. Navy enlisted men had committed sexual assault prior to service (Stander, Merrill, Thomsen, Crouch, and Milner, 2008).There were 506 homicides and suicides in the military (Zagar, et al., 2016) over 28 years with a total expense of $1,012,000,000.See Figure 13 for military homicides, mass murders and suicides.The U.S. President could call together first a meeting of the National College Athletic Association, then the Olympic Committee, then the professional organizations for baseball, basketball, football, hockey, and soccer to discuss how to safeguard the country, and the profitability of college and professional sports, and their impact on future youth by using MLIT with medical exams, to not only protect the players from themselves, but also the owner's investment.The President could bring in the head of the Boy and Girl Scouts and suggest that they use medical exams and MLIT with all scout leaders.Owners and athletic directors would see payouts decrease and profits rise.The U.S. President, working with the Pope, could within a year call a meeting in Chicago.In Chicago, the President could use the hotels and convention halls to bring together the government and business heads to accomplish adding MLIT to current ways.The Pope could promote the use of MLIT with current methods for intake in seminaries and promotion of religious and nonprofit teachers by having a convention at Vincentian DePaul and Jesuit Loyola Universities, who have available campuses and dormitories during the summer.Financial and legal jeopardy would be avoided.
7.13.7 Diverting Nonviolent and/ or Mentally Ill Offenders to Electronic Monitoring Bracelets and Other Diversions The U.S. President can call a meeting of the county presidents, governors and mayors, and suggest that MLIT be used in cities, counties and states at intake and release of offenders from jail or prison, and demonstrate that nonviolent offenders moved to electronic bracelet monitoring or other diversions, saves valuable taxpayer funds for other needs such as infrastructure, health and education.There would be a significant drop in the Chicago homicide rate.
7.13.8Health Care Workers, Physicians, Professors, Teachers, and Caretaker Violence The U.S. President could work with the insurance companies and emergency room department heads of the various hospitals.He could leverage his advantage of increasing profits for both, and work with military and veteran hospitals to give an executive order to screen all health workers in federal government positions by taking MLIT as part of the intake and promotional medical exam.
7.13.9Public-Safety, Personnel Suicides, Deaths-in-the-Line-of-Duty, & Malfeasance Payouts The U.S. President may use executive order and find federal grant money to begin first with Chicago and then New York to offer funds to add MLIT to current ways of intake of new police, fire and emergency medical technician cadets, and the promotion of public safety personnel to lower malfeasance, killed in the line of duty, and suicide completion.

Mentally Ill Mass Murderers or Active Shooters
Using presidential suggestion and executive order, MLIT could be used in gun and rifle screening for employees at overseas State Department embassies since the tests are available in many languages.Also, MLIT could be used in screening of immigrants with a criminal or medical history.
7.13.11Energy Worker (Coal, Electricity, Nuclear, Oil, Petroleum, and Solar Violence A presidential executive order could focus on the Nuclear Regulatory Commission and Energy Department, to improve safety of workers in various energy sectors. 7.13.12Military (Including National Guard and Military Academies) Homicides and Suicides The U.S. President as Commander-in Chief can order the military base in Illinois to start using MLIT in draft and enlistment programs.

Conclusion and Summary
The bottom line is that without leadership, MLIT cannot safeguard communities.There is hope for a safer world and a peaceful next generation, because with probability models, namely actuarial assessments, there is the potential for violence prediction or forecasting because one collects the full information in a MLIT.Amazingly, this is based on nearly a century of data incorporating a few hundred studies, on nearly a third of a million persons, over many continents and countries, where violence was predicted in many independent trials, which give relevant quantified values from which the probability of the future can be predicted in a -7-point violence profile‖.This is based on limited data from the past, to predict or forecast future violent behavior.Thus, MLIT and professionals who use them, are witnesses for hope of a safer, peaceful world, where families can raise children, who go to school and places of worship, and then find gainful jobs to continue the cycle, peacefully and safely.

Figure 1 .
Figure 1.Current Ways versus MLIT with Standard Predictor of Violence Potential Sensitivity Specificity and Adult Probation-Parole Decision-Making Tests including the SP: Adults (3 Only Zagar and Grove 2010 and Zagar et al., 2013 used random sampling.All participants were adolescents.*Unit = refers to the actuarialapproach to parole decision making that involves a univariate comparison to reoffending outcome statistic developed byBurgess (1928) and improved byNuffield (1982) andQuinsey, et al. (1998).M = male, F = female.ROC= receiver operating characteristic (which is roughly equivalent to the AUC or area under the curve), a = alpha; ptb = point bi-serial; base exp.=base expectancy; regress.=regression; discrim.= discriminant analysis; b=beta coefficient; sensitivity = identifying the re-offender precisely; specificity is not over identifying someone as an offender.Table 2d.70 Teen and Adult Probation-Parole Decision-Making Tests including the SP: Adult (4 Only Zagar and Grove 2010 and Zagar et al., 2013 used random sampling.All participants were adolescents.*Unit = refers to the actuarial approach to parole decision making that involves a univariate comparison to reoffending outcome statistic developed byBurgess (1928) and improved byNuffield (1982) andQuinsey, et al. (1998).M = male, F = female.ROC= receiver operating characteristic (which is roughly equivalent to the AUC or area under the curve), a = alpha; ptb = point bi-serial; base exp.=base expectancy; regress.=regression; discrim.= discriminant analysis; b=beta coefficient; sensitivity = identifying the re-offender precisely; specificity is not over identifying someone as an offender.Violence Profile in Homicidal, Overdosing-Substance-Abusing, Sex-Offending &Suicide-Completers Table 2d.Summary of 320,051 Homicidal, Overdosing, Sex-Offending, Suicidal, & Offenders in 212 Studies Confirming a "7-Point Violence Profile" (5

Figure 13 .
Figure 13.U.S. Department of Defense (DOD) Military 1980-2013 Homicides Suicides and Mass Murders 7.13 Action Plan: Presidential Executive Order and/or Papal Directive Action PlanSo the action plan to begin to save lives and expense on these twelve sectors follows.7.13.1 Psychiatric Over-HospitalizationOn a practical level, the U.S. President can call and set up a meeting.There would be the CEO and CFO of Blue Cross Blue Shield of Illinois, the neurosurgeon leader of the Department of Housing and Urban Development, the Exelon CEO Northwestern Memorial Hospital Board of Directors, physician head of the Emergency Department, and the Northwestern Memorial Hospital President, who could devise a plan to begin using actuarial MLIT in the emergency room and hospital.Savings are in the hundreds of millions in Illinois alone, and trillions in the U.S.7.13.2 Civilian Homicides, Overdoses, and SuicidesThe U.S. President could offer the Chicago and Illinois insurance executives combined with the political leaders, the Chicago mayor and county president, a grant of $50 to $100 million to start a project that modelled the Obama -Culture of Calm‖ $78M Department of Justice grant.The focus would be jobs, anger management, and mentoring for adult gang members that are Milted, and then given jobs planting trees for the Park District, repairing potholes for the Department of Transportation, painting infrastructure, or working in the Department of Streets and Sanitation.Chicago's homicide rate would drop.7.13.3 Air, Bus, Train, and Truck Transport DeathsThe U.S. President could by executive order ask the Federal Aviation Administration to require all pilots, air traffic controllers, flight attendants, airplane mechanics and TSA agents, as part of the medical exam for job entry and promotion, to take MLIT, thereby identifying overdosing-substance-abusing, sex-offending and suicide-completers, before a possible fatality.By doing the same in the Interstate Commerce Commission, the American Truckers Association, the Transportation Department and other federal agencies, the U.S. President could require the same of interstate bus drivers, tank truck operators, especially railroad engineers transporting volatile fluids.Transportation injuries and deaths would decrease dramatically.7.13.4 Cumulative Daily, Yearly and Decades Long Veteran SuicidesThe U.S. President with executive order can direct the Head of the Veterans Administration to require Lovell Hospital at Great Lakes Naval Base in North Chicago Illinois, a conjoint private military, Navy and veterans facility to begin using the MLIT in the emergency room and clinics for veterans reluctant to admit weakness, after serving bravely in wars to identify homicidal, overdosing-substance-abusing, sex-offending, but most importantly suicide-completers.The model from the psychiatric over-hospitalization and military-private-veteran Lovell Hospital could be shared with all U.S. hospitals.A significant decrease in veteran suicides would result.7.13.5 Professional Collegiate and Olympic Athlete, Coach, and Trainer and Scouting Crimes & Sex-Offending , Religious Groups Pedophilia Payouts and Lost Collections " MMPI/MMPI2/A scores.

Table 2a .
70 Teen and Adult Probation-Parole Decision-Making Tests including the SP: Teens (1 of 5) Only Zagar and Grove 2010 and Zagar et al., 2013 used random sampling.All participants were adolescents.*Unit = refers to the actuarial approach to parole decision making that involves a univariate comparison to reoffending outcome statistic developed by

Table 2b .
70 Teen and Adult Probation-Parole Decision-Making Tests including the SP: Adults (2 of 5) Only Zagar and Grove 2010 and Zagar et al., 2013 used random sampling.All participants were adolescents.*Unit = refers to the actuarial approach to parole decision making that involves a univariate comparison to reoffending outcome statistic developed by [6%].Occupations included bookkeeper, Buddhist monk, bus driver, delivery person, doctor, emergency medical technician, judge, lawyer, minister, nuclear plant controller, nurse, pilot, policeman, priest, and stewardess with Army, Marine and Navy veterans, and one special-forces military.Suicide completion was death by one's own hand, consistent Diagnostic Statistical Manual-Fifth Edition (DSM-V); American Psychiatric Association, 2013, and the International Classification of Diseases Tenth Edition (World Health Organization, 2013), and Illinois laws.
Among 24 persons, there were 18 men and six women.The M age = 41.75,SD = 14.67 yr.The M education = 16.00 and the SD = 1.89 yr., or a college degree.There were seven Euro-Americans (29%), thirteen African-Americans (54%), three Hispanic-Americans (12%) and one other (Asian, Filipino, or Native American Indian) [5%].Occupations included bookkeeper, bus driver, college track coach, emergency medical technician, engineer, firefighter, finance manager, golf professional, minister, nurse, Olympic athlete, occupational therapist, payroll personnel, physical therapist, pilot, police woman, priest, programmer, psychiatrist, rabbi, scout leader, stewardess, train engineer, and university volleyball champion with Air Force, Army, Coast Guard, Marine, and Navy veterans.The control group comprised inpatient and out-patients referred to hospital, industry, and university clinics from 1992 to 2018, by health care workers.Part or full time and summer work included babysitting, car washing, cashier, coding, cooking, delivery, dishwashing, farming, housekeeping, janitor, landscaping, nanny, painting, restaurant work, sales, snow removal and volunteering at nonprofit and religious organizations.

Table 3a .
Demographics Adult and Teen, Adult, Teen: At-Risk Groups with U.S. E.U.Population and X 2 Juvenile Offenders and Victims 2006 National Report, U.S. Department of Justice.b U.S. Census Bureau, 2006.c United Nations Economic Commission, Statistical Yearbook of • the Economic Commission of Europed, 2003.d Speder (2005) Demographic Research: Diversity of Family Structure in Europe.E.U. includes Austria, Denmark, Finland, France, Germany, Greece, Ireland, Luxembourg, The Netherlands, Portugal, Spain, Sweden, United Kingdom (England and Wales), Andorra, Cyprus, Liechtenstein, Monaco, Norway, Switzerland, Turkey, Albania, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovak Republic, Slovenia, *p< .01.In the U.S. Census Bureau, the United Nations Economic Commission, Statistical Yearbook of the Economic Commission of Europe, Trends in Europe and North America, the U.S. Department of Justice, Juvenile Offenders and Victims 2006 National Report, the National Longitudinal Survey of Youth, and the Demographic Research on the Diversity of Family Structure in Europe

Table 3a .
Adult (N=79) Homicidal, Overdosing, Sex-Offending, Suicide-Completers, and Controls Average and Standard Deviation t-scores and ANOVA Fs with -7-Point Violence Profile‖ Note.-The MMPI-2 and MMPI-A have different items, sets, and length, i.e. 567 vs. 468 items with the same 13 basic clinical and 3 validity scales; scores cannot be added; +p < .01*p < .05.

Table 3c .
Similar Adult & Teen "7-Point Violence Profile" for Homicidal, Overdosing, Sex-Offending, Suicidal, & Controls Average and Standard Deviation Scores and ANOVA Fs Note.-The MMPI-2 and MMPI-A have different items, sets, and length, i.e. 567 vs. 468 items with the same 13 basic clinical and 3 validity scales; scores cannot be added; +p < .01*p < .05.

Table 4 .
28 Year (199228 Year ( -2019Loss of Lives or Victims and Money in 2019 U.S. nonviolent offenders rather than electronic monitoring; (8) the health care worker physician professor teacher caretaker losses from violence; (9) the public safety suicides, deaths in line of duty and malfeasance payouts; (10) the mass murder or active shooting incidents; (11) the energy (coal, electricity, nuclear, oil, petroleum, solar) losses from violence; and (12) the military homicides and suicides.

Table 5 .
Number of Chicago Youth in Summer Jobs Programs to Divert from Violent Crime Over 10 Years This same research on at-risk that showed delinquents do not have executive function or decision making.Using this research, the U.S. Supreme Court in Miller v.Florida and Graham v. Alabama ordered 2,500 life sentences without parole juveniles to be re-examined and re-sentenced, often to time served.The Illinois governor along with other governors used this research to begin justice reform in various states.Based on this research, shared with the U.S. President Trump on 29 June, 2015, the Executive Branch and Congress passed the First Step Criminal Justice Reform Bill, which is projected to release 10,000+ jailed offenders.
Center for Statistics and Analysis Advanced Research and Analysis, 2003; U.S. Department of Transportation, National Highway Traffic Safety Administration, 2014; Schneider and Palcski, 2018).
At 22 suicides daily, with 365 days, that is 8,030 veteran deaths yearly.From 1990, when the Desert Storm War in Iraq began, through 2018 as the U.S. continues to fight in Afghanistan, Iraq, Syria and Yemen, the annual 8,030 lost over 30 years, combines to 238,870 veteran suicide deaths.Despite many efforts of this research group to the DOD and VA Suicide Prevention Units, the Secretaries of the Air Force, Army, and Navy, and various generals, this loss continues.Many veterans work in the infrastructure and in public safety, for which this is a significant loss.
Most recently, federal prosecutors are treating the 198 U.S. Roman Catholic dioceses and university athletic departments as "criminal enterprises."Just as with the jailed former Penn State University president and athletic director, bishops and cardinals, who received probation in the past, will likely face prison terms like the college officials.
Over time, especially since 1960, there was a movement of psychiatric bed patients to jail cell prisoners.See Figure10.There is a significant ( p < .01)inverse correlation r = -0.852 between psychiatric bed cells and imprisoned offenders (U.S. Bureau Justice Statistics, 2014; Statistical Abstract).