Kim A. Reeves

Prevalence of physical violence in intimate relationships, part 2: Rates of male and female perpetration.

Physical violence perpetrated by men against their female partners is widely recognized as a serious social problem. Whether women’s use of physical violence against their male partners represents a serious social problem remains a question under debate. We examined research published in the last 10 years to summarize the current state of knowledge regarding the prevalence of physical IPV perpetrated by men and women in heterosexual relationships. Our specific aims were to (a) describe the prevalence of physical IPV perpetration in industrialized, English-speaking nations, and (b) explore study and sample characteristics that affect prevalence. Literature searches undertaken in 3 databases (PubMed, PsycINFO, and Web of Science) identified 750 articles published between 2000 and 2010. We included 111 articles that reported 272 rates of physical IPV perpetration in our review: 25 articles reported 34 rates for men, 14 articles reported 24 rates for women, and 72 articles reported 214 rates for both men and women. The vast majority of studies were conducted in the United States (k = 95, 85.6%) and most (k = 81, 73.0%) measured IPV using a Conflict Tactics Scale-based approach. We calculated unweighted, pooled prevalence estimates for female and male perpetration overall and by sample type, country, measurement time frame, and measurement approach. Across studies, the overall pooled prevalence estimate was 24.8%. Consistent with prior reviews, pooled prevalence was slightly greater for female- compared to male-perpetrated physical IPV: more than 1 in 4 women (28.3%) and 1 in 5 men (21.6%) reported perpetrating physical violence in an intimate relationship. This pattern of results remained when we calculated pooled prevalence estimates by sample and study characteristics, with few exceptions. Findings underscore the need for interventions that acknowledge the use of violence by women in intimate relationships.

International Perspectives on the Practical Application of Violence Risk Assessment: A Global Survey of 44 Countries

Mental health professionals are routinely called upon to assess the risk of violence presented by their patients. Prior surveys of risk assessment methods have been largely circumscribed to individual countries and have not compared the practices of different professional disciplines. Therefore, a Web-based survey was developed to examine methods of violence risk assessment across six continents, and to compare the perceived utility of these methods by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations. Surveys were completed by 2135 respondents from 44 countries. Respondents in all six continents reported using instruments to assess, manage, and monitor violence risk, with over half of risk assessments in the past 12 months conducted using such an instrument. Respondents in Asia and South America reported conducting fewer structured assessments, and psychologists reported using instruments more than psychiatrists or nurses. Feedback regarding outcomes was not common: respondents who conducted structured risk assessments reported receiving feedback on accuracy in under 40% of cases, and those who used instruments to develop management plans reported feedback on whether plans were implemented in under 50% of cases. When information on the latter was obtained, risk management plans were not implemented in over a third of cases. Results suggest that violence risk assessment is a global phenomenon, as is the use of instruments to assist in this task. Improved feedback following risk assessments and the development of risk management plans could improve the efficacy of health services.

The subjective experience of trauma and subsequent PTSD in a sample of undocumented immigrants

Although a subjective component of trauma is commonly recognized in diagnosing posttraumatic stress disorder (PTSD), there are few studies that specifically address Criterion A2, and none addressing this issue among undocumented immigrants. We assessed 212 arriving undocumented immigrants with diverse trauma histories to investigate concordance between objective and subjective factors of trauma (Criteria A1 and A2) and across different types of trauma and PTSD. Concordance between Criteria A1 and A2 varied, with highest rates found for political violence. Interpersonal violence in general was associated with higher rates of PTSD. We identified a dose-response effect for PTSD, but this was not dependent on other events (i.e., other doses) meeting Criterion A2. Discussion focuses on Criterion A within the phenomenology of PTSD and the need to gauge subjective interpretations of trauma events among this population.

The effects of torture-related injuries on long-term psychological distress in a Punjabi Sikh sample.

Torture survivors often report chronic debilitating physical and psychological distress. Prior research on the relationship between physical and psychological trauma suggests that the 2 are not independent. Injury sustained during torture may increase the likelihood of subsequent distress as either a moderator or mediator. For long-term psychopathology in a sample of Punjabi Sikh survivors of human rights violations (N = 116), chronic injuries mediated the path between torture and posttraumatic stress disorder, specifically the severity of numbing symptoms. Although injuries were associated with major depression, torture was not, and injuries did not moderate the relationship between major depression and torture. Chronic injuries may represent trauma severity or persistent traumatic cues. These findings emphasize connections between physical and psychological trauma and the importance of an interdisciplinary approach to torture treatment.

Risk assessment in intimate partner violence: a systematic review of contemporary approaches

Intimate partner violence (IPV) has profound and widespread health and economic implications at an individual, familial, and societal level. Violence risk assessment measures offer an evidence-informed approach to ascertain the degree of threat an abuser poses, transparent and defensible indicators for intervention and treatment decisions, and can be used to inform professionals, perpetrators, and victims alike regarding the nature and intensity of services required to help prevent IPV. This article summarizes the state of knowledge regarding risk assessment for IPV through a systematic examination of all English publications from westernized nations from 1990 to 2011. Three search engines—PsychINFO, ScienceDirect, and Social Sciences Citation Index—identified 3,361 potentially relevant articles. After dropping duplicates and removing articles that did not explicitly examine risk assessment for IPV, 39 articles remained. Several themes emerged: (a) There is a relatively small body of empirical evidence evaluating risk assessment measures in the context of IPV; (b) continued advancements are needed in the methodological rigor of the research; (c) investigations should expand cross-validation research to diverse samples (e.g., gay, lesbian, bisexual, and transgender [GLBT]; male victims/female perpetrators); and (d) an exciting development in IPV risk assessment research is evidence that risk assessments can serve to reduce risk levels (Belfrage et al., 2011). In terms of clinical implications, the review demonstrated considerable promise of several measures but generally reveals modest postdictive/predictive validity. Limited evidence for the superiority of IPV specific risk assessment measures over general violence risk assessment measures was revealed; however, this may largely be a reflection of study limitations. Given the challenges in comparing across studies and the heterogeneity of partner abusers, it seems premature to recommend one preferred assessment measure/approach to clinicians.

Evaluation of a Violence Risk (Threat) Assessment Training Program for Police and Other Criminal Justice Professionals

Although a great deal of research has focused on the development and validation of violence risk (threat) assessment instruments, few studies have examined whether professionals can be trained to use these instruments. The present study evaluated the impact of a violence risk assessment training program on the knowledge, skills, and attitudes of 73 criminal justice professionals, including police officers, civilian support staff, and prosecutors. The program covered principles of violence risk assessment, the nature of mental disorder and its association with violence risk, and the use of various structured professional judgment (SPJ) risk assessment instruments. Comparisons of pre- and post-training evaluations indicated significant improvements on measures of knowledge about risk assessment, skills in the analysis of risk in a case vignette, and perceived confidence in conducting violence risk assessments. Findings support the utility of risk assessment training for criminal justice professionals and the utility of SPJ violence risk assessment instruments generally.

Intimate partner abuse of older men: considerations for the assessment of risk.

SUMMARY Intimate partner abuse among older persons, though less common than among the general population, is a significant concern. Drawing from the intimate partner abuse and elder abuse literatures, this paper presents considerations for the assessment of risk for intimate partner abuse perpetrated against older men, with reference to the prevalent gendered view of abuse between intimate partners. Potential victim and perpetrator risk factors specific to this context are discussed and existing risk assessment tools are introduced. Implications and future research directions are discussed with regard to the application of risk assessment technology to this context.

Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

Abstract With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.