“If I Can’t Have Her, No One Can”: Predicting the Risk of Intimate Partner Assault
Deborah J. Wilson
Southern Arkansas University
Whitney M. Gass
Southern Arkansas University
Author Note:
Deborah J. Wilson, Ph.D. is an Assistant Professor of Psychology in the Behavioral and Social Sciences Department at Southern Arkansas University.
Whitney M. Gass, MA is an Instructor of Criminal Justice in the Behavioral and Social Sciences Department at Southern Arkansas University.
Correspondence concerning the content of this article can be addressed to Deborah J. Wilson via email at djwilson@saumag.edu
Abstract
Intimate partner violence is a serious, sometimes lethal social problem that cuts across economic status, education, race, and religion. In the United States it is estimated that 25-40% of women will in their lifetime be the victim of intimate partner violence with rates as high as 70% world-wide. An increased number of homicide-suicide domestic violence incidents resulted in a need for instruments that are useful in assessing partner assault risk. An overview is provided of The Historical Clinical Risk Management-20 (HCR-20), The Danger Assessment, the Spousal Assault Risk Assessment (SARA), and the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), tools often cited in the literature as credible for assessing risk of violence and establishing a prevention plan.
“If I Can’t Have Her, No One Can”: Predicting the Risk of Intimate Partner Assault
Intimate partner violence (IPV) is a serious sometimes lethal social problem that cuts across economic status, education, race, and religion. Although rates of IPV vary across countries, an estimated 15-70% of women world-wide will experience some form of IPV in their lifetime (Belfrage et al., 2012). In the United States, an estimated 25-40% of women will be the victim of IPV in their lifetime with perpetrator reoffense rates between 40-80% (Belfrage et al., 2012; Mass, Fleming, Herrenkohl, & Catalano, 2010; Ponzetti, Cate, & Koval, 1982). Among women who are battered, 56% experienced violence while pregnant and 95% were battered again within 3 months of delivery (Huth-Bocks, Levendosky, & Bogat, 2002; Neggers, Goldenberg, Cliver, & Hauth, 2004). According to Huth-Bocks et al. (2002), women who are physically abused while pregnant are at a greater risk of being killed by their partner
Each year in the United States approximately 1,110 women are killed by a former or current intimate partnerCampbell (1995) estimated that 70% of all murdered women are killed by men with whom they have been or currently are involved with intimately. Among those committing intimate partner homicide, identified stable predictors include the perpetrator’s history of being physically abusive, having antisocial attitudes and behaviors, exerting social and financial control over the victim, having access to lethal weapons, stalking, and making specific threats to kill (Bell, Cattaneo, Goodman, & Dutton, 2008; Cole, Logan, & Shannon, 2005; Ponzetti et al., 1982). In couples where homicide resulted, Mercy and Saltzman (1989) found greater frequency and severity of abuse, larger educational and age differences, and higher spousal homicide rates among African Americans.
Barnett, Miller-Perrin, and Perrin (2005) defined IPV as “verbal abuse, threats, and physical assaults ranging from mild, moderate, to severe, and using a weapon” (p. 253).
IPV is a more encompassing term currently used instead of spouse abuse, domestic violence, or marital violence. Because 40-80% of perpetrators reoffend and often with increasing violence, clinicians and agents of the courts need reliable methods to assess the risk of reoffending and identify those who pose a high risk for deadly reoffense (Belfrage et al., 2012; Kropp & Hart, 2000). According to Campbell (2005), the field of domestic violence risk assessment is “relatively young and not extensive” (p. 653). Campbell further stated that while some risk assessment tools and procedures exist, there are distinctions between cases of intimate partner reassault, which occurs in approximately 25-30% of cases and intimate partner homicide, which occurs in about .04% of cases.
Historically, expert opinion and clinical judgment have been the primary means of risk assessment (Vitacco et al., 2012). Garb and Grove (2005) found “high levels of error” in decisions about risk where experts alone formed the conclusion. Furthermore, Bell et al. (2008) purported that practitioners were less accurate than victims in predicting their risk of being reasaaulted. Campbell (2005) reported that only 4% of female intimate partner homicide victims contacted shelters, but that among those killed, about 50% shared their belief that they would be murdered. This disparity between homicide victims’ beliefs they will be killed and accessing shelters and shelter services suggests a need for first responders in IPV events such as clinicians, social workers, and law enforcement personnel to have access to instruments that are valid predictors of future episodes of violence especially homicide (Cattaneo, Bell, Goodman, & Dutton, 2007; Hotaling & Sugarman, 1986).
Violence Assessment Categories
According to Au et al. (2008), violence-related assessment falls into two categories, violence screening or violence risk assessment.
Violence screening involves using routine procedures to query victims about kinds and severity of abuse experienced (Campbell, 2005; Henning, Jones, & Holdford, 2005). Violence screening provides insight into the severity and nature of abuse. Violence risk assessment is a process of collecting an array of information from the victim, the perpetrator, and criminal records to develop a well informed judgment about future aggressive acts (Cadsky, Hanson, Crawford, & Lalonde, 1996; Campbell, 2005). The purpose for conducting the violence risk assessment is to formulate a prevention plan to thwart additional acts of violence (Dolan & Doyle, 2000; Saunders, 1995). Au et al. (2008) posited the ultimate goal for risk assessment is prevention of further violence.
Violence Risk Assessment Tools
The Historical Clinical Risk Management-20 (HCR-20), The Danger Assessment, the Spousal Assault Risk Assessment (SARA), and the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER) are consistently cited in the literature (Campbell et al., 2003; Vitacco et al., 2012; Williams & Houghton, 2004) as credible tools for assessing risk of violence and establishing a prevention plan. While no instrument or process can perfectly predict the risk for intimate partner violence, these instruments provide a systematic way to assess risk for violence and reoffense.
Historical Clinical Risk Management-20
The Historical Clinical Risk Management-20 (HCR-20) is a violence risk assessment instrument designed for use in forensic psychiatric, civil psychiatric, and prison institutional and community settings (Webster, Douglas, Eaves, & Hart, 1997).
The HCR-20 adds structure to decisions made by mental health, forensic, and corrections professionals about the possibility of violent behavior, and guides in risk reducing treatment and management strategies (Mills, Kroner, & Hemmati, 2007; Webster et al., 1997). It is intended for use in cases involving any type of general violence.
The HCR-20 assesses 20 risk factors with three subscales; historical, clinical, and risk management. The 10 historical items are specifically coded from 0 to 2 and include assessment in the area of Previous Violence, 0-No previous violence to 2-Definite/serious previous violence (three or more acts of violence or any act of serious violence), Substance Abuse Problems, 0-No substance use problem to 2-Definite/serious substance abuse problem. The five clinical items are rated from 0 to 2 for the presence of negative attitudes, impulsivity, and lack of insight. The five risk management items assess adjustment to future circumstances and are also rated on a scale of 0 to 2. Items include statements about lack of personal support, noncompliance with remediation attempts, and stress.
The authors describe the HCR-20 as a scheme and not a test as such, reliability and validity information is somewhat limited. Webster et al. (1997) reported that the HCR-20 positively correlated with identifying the existence of violence in forensic psychiatric and correctional samples.
Administration and interpretation of the HCR-20 requires a high level of expertise such as graduate-level coursework and professional licensure or certification typically associated with Level B appraisal instruments. The publisher also stipulates that professionals using this instrument should have the following: (a) expertise in interviewing, administering, and interpreting standardized tests, (b) diagnosing mental disorders, and (c) be well read in the professional literature regarding the causes and treatment of violence.
The complete kit including coding sheets, the HCR-20 manual, and the Violence Risk Management Companion Guide may be purchased from the Mental Health, Law, and Policy Institute for approximately $200.
Danger Assessment
The Danger Assessment (DA) is an instrument developed by Jacquelyn Campbell (1986) to aide in determining the risk of intimate partner homicide. The instrument is considered most useful for increasing the accuracy of clinical predictions in clinical settings. The DA was developed by Campbell following years of directly working with battered women, shelter workers, law enforcement officials, and other clinical experts on battering (Campbell, 2005).
The DA is comprised of two parts: a calendar and a 20-item scoring instrument. The calendar provides a visual device for tracking the frequency and severity of intimate partner violence over the past year. The victim records the days battering occurred and ranks severity on a scale of 1 (slap, pushing, no injuries and/or lasting pain) through 5 (use of weapon, wounds from weapon). The calendar further serves to increase the victim’s recall of the violent incidents and raise the victim’s awareness by targeting the tendency for the victim to use minimization and denial of the violence (Campbell, 2005).
The scored portion of the DA consists of 20 items rated using yes/no responses to risk factors associated with intimate partner homicide (Campbell, 2005). The rated items include risk factors such as past death threats, partner’s employment status, partner’s access to a gun, and forced sex. The number of yes responses is totaled and victims with scores of seven and above are considered to be significantly at risk. Internal consistency of the DA among homicide cases is .73 and .76 for control cases.
Campbell (2005) reported an average score of 7.4 was obtained from a sample of abused women who were murdered compared with an average score of 3.2 for women in the control study. For professionals working with intimate partner crime victims, the challenge is to identify which women are at the greatest risk for being severely assaulted. As such, the DA is a useful tool for law enforcement, health care professionals, and domestic violence advocates. DA training is available online at http://www.dangerassessment.org/ along with post-training certification (Campbell et al., 2003).
Spousal Assault Risk Assessment
The Spousal Assault Risk Guide (SARA) was developed in 1998 by P. Randall Kropp, Stephen D. Hart, Christopher D. Webster, and Derek Eaves. The SARA resulted from grant funding by the British Columbia Ministry of Women’s Equality and other agencies as part of the Project for the Protection of Victims of Spousal Assault. There were 2,309 participants in the normative sample. Structural reliability for the SARA is strong (r = .78) and validity studies have been conducted that yielded strong positive correlations with other assault risk measures (Kropp, Hart, Webster, & Eaves, 1998).
The SARA is comprised of 20 standard risk factors divided in two categories. Category 1 contains 10 factors used to assess a general risk of violence including questions about history of spousal assault, substance abuse, and homicidal/suicidal ideation. Category 2 contains 10 items specifically designed to assess the risk of spousal violence including history of spousal assault, violation of court order, escalation of frequency and severity of assault, and use of weapons and death threats (Kropp & Hart, 2000). Risk factors are coded on a scale of 0 to 2, summed and categorized as low, moderate, or high and whether the risk for violence is partner directed or directed towards others.
A structured professional judgment results from the SARA assessment process that can aid court and correctional system personnel about the risk for reoffense and implementation of proactive management to reduce revictimization. Kropp, Hart, Webster, and Eaves (1998) stated in the manual that the SARA can be used by mental health professionals, correctional staff, lawyers, and victims’ advocates to determine the quality of prior risk assessments.
Unlike other intimate partner risk assault instruments, the SARA does not have a set of user qualifications because it is not a controlled psychological test and was developed for use by professionals from different fields. Kropp et al. (1995) recommended minimal user qualifications for administering the instrument since research suggests professionals with only minimal training in spousal assault and assessment, such as police officers, can use the instrument effectively (Belfrage et al., 2012).
The SARA, complete with forms and manual, may be ordered from Multi-Health Systems, Inc. at a total cost of just under $200. Au et al. (2008) offered one criticism of the SARA process stating it is time consuming and those involved in making a determination about risk in the field (e.g., police officers) may not have the time to administer the test. The SARA comprises a two step process that includes interviewing the victim and the accused, a review of records such as police reports victim statements, and criminal records. When time is of the essence, other appraisal processes should be considered (Au et al.).
Brief Spousal Assault Form for the Evaluation of Risk
The Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), an abbreviated version of the SARA, was designed by Kropp, Hart and Belfrage (2005) to yield a structured professional judgment without the time constraints of other instruments such as the SARA.
Belfrage et al. (2012) noted the instrument is specifically designed for use by police officers and other criminal justice professionals who are challenged with making judgments about risk for reoffense.
The B-SAFER is comprised of 10 risk factors coded on a scale of 0 to 2 and divided in two categories, history of IPV and current psychological and social functioning (Au et al., 2008). Questions in category 1 appraise negative attitudes about spousal assault, history of serious physical or sexual violence, threats and ideation of violence, and escalation of ideation or incidents (Au et al., 2008). Psychosocial adjustment is assessed in category 2, which includes questions about the presence of a mental disorder, substance abuse, and problems with relationships and employment. The B-SAFER comes with worksheets to assist administrators in documenting the presence of each risk factor “Currently” and “In the past.” Following careful consideration of individual risk factors, users recommend risk management strategies and document how the opinion was reached (Au et al., 2008). The B-SAFER is a Level B appraisal item that requires the user to be knowledgeable about clinical assessment using standardized testing and the interpretation of the testing results. The B-SAFER kit includes a manual and forms for approximately $100 and can be purchased from ProActive ReSolutions, Inc.
Summary
Given the high rates of IPV perpetrator recidivism and because an estimated 70% of all murdered women are killed by current or past intimate partners, there is a considerable need for professionals to be knowledgeable and proficient in IPV risk assessment for perpetrator identification and management, as well as homicide prevention (Campbell, 1995; Saunders, 1995; Wilson, Townes, & Ronk, 2012).
A review of four frequently used risk assessment instruments revealed variability in the kind of violence being assessed (e.g., general or intimate partner directed), degree of violence (low, medium, or high risk), level of user expertise required, and cost. The Historical Clinical Risk Management-20 (HCR-20) appears especially useful when the goal is assessing risk of general violence (Webster, Douglas, Eaves & Hart, 1997), while the Danger Assessment (DA) is particularly geared toward assessing risk of intimate partner homicide (Campbell, 1995). The Spousal Assault Risk Assessment Guide (SARA) appears to be the most comprehensive risk assessment; therefore, greater time is required to gather all the information and arrive at a judgment about spousal assault risk (Kropp, Hart, Webster, & Eaves, 1998). To address the time constraint, Kropp, Hart and Belfrage (2005) developed a shortened version of the SARA, the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER).
Our review of relevant scientific literature reveals that there are useful tools available to human services workers and other professionals assisting families suffering with IPV, which they can use to identify and assess specific aspects of the violence. The professionals using these instruments can screen, assess, and identify factors in the violence dynamics that can aid decision makers by providing them with a predictive risk assessment designed to keep the victim safe. Tools such as the HCR-20, DA, SARA, and B-SAFER may also be useful in formulating behavior management plans or safer sentencing for those who perpetrate acts of IPV.
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