Association Between Women's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand

Neuropathic pain and its association with intimate partner violence: The patient's perception in contrast to the intimate partner violence scale

INTRODUCTION

The potential contribution of intimate partner violence (IPV) to the development of neuropathic pain (NP) is not fully elucidated. Therefore, this study aimed to describe self-reported IPV in patients with NP undergoing treatment and to associate the findings with the values ​​obtained on the Intimate Partner Violence Scale (EVIPI, from Portuguese Escala de Violência entre Parceiros Íntimos).

METHODS

This study was conducted with a group of patients undergoing treatment for chronic NP. The EVIPI was used to assess exposure to violence. This instrument was administered to participants who had been in an intimate relationship in the last six months.

RESULTS

The study involved 124 participants, of whom 73 (58.9 %) had been in a relationship in the last six months. All selected participants self-declared being in a heterosexual relationship. Among them, 44 (60.3 %) were women, 53 (72.6 %) self-identified as white, and 33 (45.2 %) had incomplete basic education. When asked if they had experienced any form of violence within the intimate relationship in the last six months, 68 (93.2 %) self-reported that they had not. Additionally, 66 (90.4 %) reported that they had not experienced childhood violence. Cross-tabulation between the EVIPI and self-reported exposure to violence did not show a significant association in the three categories of the EVIPI. Despite the lack of statistical significance, among those who denied having suffered violence in childhood, 29 and 19 participants scored positive in the "injury and physical violence" and "behavioral control" categories of the EVIPI, respectively. Among those who denied having suffered IPV, 30 and 19 participants scored positive in the "injury and physical violence" and "behavioral control" categories of the EVIPI, respectively.

CONCLUSIONS

No significant association was found between the markers evaluated; however, there was a gap in understanding the concept of violence, as most participants denied exposure to violence despite the EVIPI results indicating certain levels of exposure.

Development and Validation of the Psychological Abuse in Relationships Scale

Psychological abuse within intimate relationships is a highly prevalent subtype of intimate partner violence (IPV) that is frequently associated with other types of IPV such as sexual or physical violence. Psychological abuse can cause enduring harm, including the loss of agency and self-belief, and entrapment in a relationship. Previous measures of psychological abuse have been characterized by inconsistencies in conceptualization and measurement contributing to problems in identifying its prevalence, impact, and patterns. To address many of the existing challenges and gaps, we developed a new measure of psychological abuse, building upon scale development work to date, and in consultation with lived experience and academic experts. A sample of 765 adult women in Australia completed our survey of 31 psychologically abusive behaviors to establish reliability and validity evidence for a new measure of psychological abuse victimization and impact. Exploratory factor analysis generated a scale comprising 20 items and four factors-Severe Psychological Abuse, Coercive Emotional Abuse, Restrictive Isolating Abuse, and Financial Abuse-with Cronbach's alphas ranging from 0.73 to 0.85 and overall explained variance of 57.2%. Exhibiting evidence of validity and reliability, the Psychological Abuse in Relationships Scale is a contemporary, concise, and comprehensive measure of psychological IPV that will improve the ability of researchers to identify this common and harmful type of abuse.

Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey

BACKGROUND

Gender differences in the associated health outcomes of different forms of intimate partner violence (IPV) are understudied. The long-term effects of IPV on specific physical health conditions are also under-researched in comparison to the effects on general health and mental health.

OBJECTIVES

To examine gender differences in the association between IPV and specific physical health conditions, accounting for differences in the types and number of types of IPV experienced.

DESIGN

We used data from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional survey using a stratified, multistage random sampling design to cover the household population of England aged 16 years and older.

METHODS

Descriptive and multivariable regression analyses of 4120 women and 2764 men who had ever had a partner. Lifetime IPV by types (physical, sexual, psychological, and economic), any lifetime and recent IPV, the number of IPV types experienced, and multiple chronic health conditions experienced over the past 12 months were included in the analyses.

RESULTS

Gender differences were observed in both the prevalence of IPV and associated health conditions. Women were more likely to experience any type and a higher number of IPV types than men. Women's exposure to any lifetime and 12-month IPV were significantly associated with an increased likelihood of reporting 12 and 11 conditions, respectively, while men's exposure to any lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively. Specific IPV types had varied health impacts, particularly among women. A cumulative association was evident for women but not for men.

CONCLUSION

Healthcare systems need to be mobilised to address IPV as a priority health issue for the female population. Our findings highlight the need for gender-informed approaches in IPV intervention strategies and healthcare provision, emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.

The Association Between Victimization and Perpetration of Physical Intimate Partner Violence and Unmet Healthcare Needs Among Married Women in South Korea

This study assessed physical intimate partner violence (IPV) experiences and examined their association with unmet healthcare needs among married women in South Korea. We analyzed data from a nationally representative longitudinal survey of 6,533 women at baseline. Participants were asked yes/no questions about their experiences of physical IPV victimization and perpetration over the past year. The responses were classified into four categories of IPV experience: "none," "victimization only," "perpetration only," and "both victimization and perpetration." At baseline, 0.9% reported being victimized only, and 25.9% reported both victimization and perpetration. The prevalence of unmet healthcare needs over the past year at baseline was 0.8%. Compared to women without any IPV experience, women in the IPV "victimization only" category had greater unmet healthcare needs (OR: 5.49, 95% CI [2.30, 13.12]) after adjusting for sociodemographic variables. Experiencing IPV perpetration only and both IPV victimization and perpetration were not statistically significantly associated with unmet healthcare needs. These results imply that physical IPV victims face difficulties accessing healthcare services which could exacerbate health inequalities over time. Moreover, this study suggests that it is necessary to distinguish IPV victims from those who experience IPV victimization only and those who experience both IPV victimization and perpetration.

Economic Abuse by An Intimate Partner and Its Associations with Women's Socioeconomic Status and Mental Health

What is the prevalence and impact of economic abuse by an intimate partner in the population? Does experience of economic abuse compound the effects of other intimate partner violence (IPV) types on women's mental health and financial wellbeing? This study used a population-based and representative sample of 1,431 ever-partnered New Zealand women to explore associations between their experience of economic abuse and a range of mental health and financial outcomes. Logistic regression was conducted, and Adjusted Odds Ratios (AORs) were reported. Overall, 15% of ever-partnered women experienced any economic abuse, with the most prevalent act "refused to give money for household expenses," reported by 8.8% of the sample. Women who experienced economic abuse presented increased risk for poor mental health (AORs ranging from 2.59 for poor mental health to 4.89 for having a diagnosed health mental health condition) and financial insecurity outcomes (AORs ranging from 3.09 for receiving government benefits to 4.72 for experiencing food insecurity) compared with women who experienced no IPV or women who had experienced any IPV (physical, sexual, psychological or controlling behavior) excluding economic abuse. Findings suggest that economic abuse may compound effects of IPV and highlight the importance of acknowledging and addressing economically abusive behaviors and their long-term detrimental impact on women's mental health and financial security. Implementing wider forms of safety planning that address issues of economic independence and security, and social support are needed to augment plans that focus on physical safety.

Intimate Partner Violence and Mental Distress, Post-Traumatic Stress Symptoms and Life Satisfaction in Colombian Women

Intimate partner violence (IPV) against women is a major global public health and human rights issue, with significant consequences for women's health and well-being. This study aimed to determine the relevance of IPV on women's mental distress, post-traumatic stress symptoms and life satisfaction, and to examine whether age, education, socioeconomic status, social support and self-esteem are associated with mental health and well-being. The sample consisted of 255 women aged 18 to 71 living in Colombia who were assessed using six self-reported questionnaires. Hierarchical multiple regression analyses showed that more IPV was associated with women's increased mental distress, post-traumatic stress symptoms and decreased life satisfaction. Although self-esteem and, to a lesser extent, social support were important predictors of women's mental distress and well-being, psychological IPV was the main predictor of women's post-traumatic stress symptoms, followed by lower self-esteem and younger age. The most important predictor of women's mental distress was lower self-esteem, followed by more psychological IPV and lower social support. The main predictor of women's life satisfaction was high self-esteem, followed by high social support, less psychological IPV and higher age and education. It is concluded that IPV, especially psychological IPV, is a serious threat to women's mental health and well-being, while high self-esteem and, to a lesser extent, high social support are associated with better mental health and well-being.

"Using the right tools and addressing the right issue": A qualitative exploration to support better care for intimate partner violence, brain injury, and mental health

BACKGROUND

Intimate partner violence (IPV) is a global public health crisis. Often repetitive and occurring over prolonged periods of time, IPV puts survivors at high risk of brain injury (BI). Mental health concerns are highly prevalent both among individuals who have experienced IPV and those who have experienced BI, yet the interrelatedness and complexity of these three challenges when experienced together is poorly understood. This qualitative study explored care provision for IPV survivors with BI (IPV-BI) and mental health concerns from the perspectives of both survivors and providers.

METHODS

This qualitative interpretive description study was part of a broader research project exploring employment, mental health, and COVID-19 implications for survivors of IPV-BI. Participants (N = 24), including survivors and service providers, participated in semi-structured group and individual interviews between October 2020 and February 2021. Interviews were recorded, transcribed, and thematically analyzed.

FINDINGS

Four themes were developed from interview findings: 1) identifying BI and mental health as contributing components to survivors' experiences is critical to getting appropriate care; 2) supporting survivors involves a "toolbox full of strategies" and a flexible approach; 3) connecting and collaborating across sectors is key; and 4) underfunding and systemic barriers hinder access to care. Finally, we share recommendations from participants to better support IPV survivors.

CONCLUSIONS

Identifying both BI and mental health concerns among IPV survivors is critical to providing appropriate supports. Survivors of IPV experiencing BI and mental health concerns benefit from a flexible and collaborative approach to care; health and social care systems should be set up to support these collaborative approaches.

Domestic, family and sexual violence polyvictimisation and health experiences of Australian nurses, midwives and carers: a cross-sectional study

BACKGROUND

Domestic, family and sexual violence is a prevalent health and social issue. Nurses may be exposed to higher rates of this violence in their personal lives compared to the community, but little is known about their polyvictimisation experiences or health and well-being impacts.

METHODS

An online descriptive, cross-sectional survey of women nurses, midwives and carer members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch) (response rate: 15.2% of nurses sent an invitation email/28.4% opened the email). Violence survey measures included: intimate partner violence (Composite Abuse Scale); child abuse and sexual violence (Australian Bureau of Statistics Personal Safety Survey items). Health measures included: Short Form-12; Fast Alcohol Screening Test; Patient Health Questionnaire-4; Short Screening for DSM-IV Posttraumatic Stress Disorder; well-being measures included: Connor-Davidson Resilience Scale, social support, and financial stress. Proportions were used to describe the prevalence of violence by sociodemographic characteristics and health and well-being issues; logistic regression predicted the odds of experiencing overlapping types of violence and of experiencing health and well-being outcomes.

RESULTS

5,982 participants (from a parent study of 10,674 nurses, midwives and carers) had experienced at least one type of lifetime violence; half (50.1%) had experienced two or three types (polyvictimisation). Survivors of child abuse were three times more likely to experience both intimate partner violence and non-partner adult sexual assault. Any violence was associated with poorer health and well-being, and the proportion of affected participants increased as the types of violence they had experienced increased. Violence in the last 12-months was associated with the poorest health and well-being.

CONCLUSIONS

Findings suggest a cumulative, temporal and injurious life course effect of domestic, family and sexual violence. The polyvictimisation experiences and health and well-being associations reported by survivor nurses, midwives and carers underscores the need for more accessible and effective workplace interventions to prevent and mitigate psychosocial ill health, especially in the recent aftermath of violence.

Damned if she does: The subordinate male target hypothesis and discrimination of social dominant female minority members

According to the subordinate male target hypothesis (SMTH), racism is based on an ethnicity-by-gender interaction, with a stronger link between experiencing racist discrimination and subordinate or dominant ethnic group status for men compared to women. This study reevaluates the SMTH, originally focused on objective discrimination, by applying it to self-reported active harm as a theoretically derived measure of racist discrimination and by exploring interindividual differences in female ethnic minority members' discriminatory experiences. We proposed that social dominance orientation (SDO) among female ethnic minorities would influence SMTH predictions. We tested this using multiple linear regression analyses among a sample of New Zealand Europeans as the majority in New Zealand and non-Europeans as the minority. As hypothesized, male non-Europeans reported disproportionally more active harm than female non-Europeans. Unexpectedly, not only female but also male, non-Europeans high in SDO reported more active harm than non-Europeans low in SDO. Therefore, applied to self-reported racist experiences, oppression of ethnic minorities is driven by interindividual differences rather than by gender. Together, these findings provide evidence that the SMTH cannot be unreservedly extended to reports of racist discrimination and that other processes may underlie these subjective experiences of discrimination that need to be considered in more detail.

Gender-based violence and its health risks on women in Yaoundé, Cameroon

INTRODUCTION

Gender-based violence (GBV) is a major public health problem that disproportionately affects women. In Cameroon, as well as other countries worldwide, GBV has immediate effects on women's health, with one in three women experiencing physical or sexual violence from an intimate partner, affecting their physical and reproductive health. The objective of this study was to determine the health risks associated with GBV among women in Yaoundé.

METHODS

A cross-sectional study was conducted in Yaoundé (Cameroon), from August to October 2022. Adverse health outcome included mental disorders, physical trauma, gynaecological trauma, behavioral disorders, and any other disorder. Tests of associations were used to establish relationships between qualitative variables. Associations were further quantified using crude odds ratio (OR) for univariate analysis and adjusted odds ratio (aOR) for multivariate analysis with 95% confidence interval (CI). Independent variables included: Physical violence, Sexual violence, Economic violence, Emotional violence, Age, Number of children, and Marital status. Variables with p-value˂0.05 were considered statistically significant.

RESULTS

A total of 404 women aged 17 to 67 years were interviewed. Emotional violence was the most commonly reported violence (78.8%), followed by economic violence (56.9%), physical violence (45.8%) and sexual violence (33.7%). The main reasons for violence were jealousy (25.7%), insolence (19.3%) and the refusal to have sexual intercourse (16.3%). The prevalences of adverse health outcomes were physical trauma (90.9%), followed by mental disorders (70,5%), gynaecological trauma (38.4%), behavioral disorders (29.7%), and other (5.5%). Most victims reported at least one of the above-mentioned conditions (80.2%). Women who were victims of any kind of violence had a higher likelihood of experiencing adverse health outcomes: physical violence [OR = 34.9, CI(10.8-112.9), p < 0.001]; sexual violence [OR = 1.5, CI(0.9-2.7), p = 0.11]; economic violence [OR = 2.4, CI(1.4-3.9), p = 0.001]; and emotional violence [OR = 2.9, CI(1.7-4.9), p < 0.001]. Using multiple binary logistic regression, only physical violence [aOR = 15.4, CI(6.7-22.5), p = 0.001] remained highly associated with an increased likelihood of having adverse health outcomes.

CONCLUSION

This study underscores the urgent need for comprehensive interventions to address GBV, including improved reporting and documentation of cases, increased awareness among healthcare providers, the establishment of support networks for victims, primary and secondary prevention of GBV. It is essential that the Government of Cameroon, through the Ministries in charge of Health and Women's Empowerment, minimizes the health effects of GBV through early identification, monitoring, and treatment of GBV survivors by providing them with high-quality health care services.

Impact evaluation of invisible intimate partner violence on maternal healthcare utilization in Pakistan

INTRODUCTION

Existing research has shown that intimate partner violence (IPV) may hinder maternal access to healthcare services, thereby affecting maternal and child health. However, current studies have ignored whether emotional intimate partner violence (EV) could negatively affect maternal healthcare use. This study aims to evaluate the impact of invisible IPV on maternal healthcare utilization in Pakistan.

METHODS

We analyzed nationally representative data from the Pakistan Demographic and Health Survey database from 2012-2013 and 2017-2018. Exposure to physical intimate partner violence (PV) and EV was the primary predictor. Based on women's last birth records, outcomes included three binary variables indicating whether women had inadequate antenatal care (ANC) visits, non-institutional delivery, and lack of postnatal health check-ups. A logistic regression model was established on weighted samples.

RESULTS

Exposure to EV during pregnancy was significantly associated with having inadequate ANC visits (aOR = 2.16, 95% CI: 1.06 to 4.38, p = 0.033) and non-institutional delivery (aOR = 2.24, 95% CI: 1.41 to 3.57, p = 0.001). Lifetime exposure to EV was associated with increased risks of inadequate ANC visits (aOR = 1.48, 95% CI: 1.00 to 2.19, p = 0.049). Lifetime exposure to low-scale physical intimate partner violence (LSPV) (adjusted OR (aOR) = 1.73, 95% CI: 1.29 to 2.31, p < 0.001) was associated with increased risks of having no postnatal health check-ups.

CONCLUSIONS

Pregnant women who experienced EV and LSPV are at greater risk of missing maternal healthcare, even if the violence occurred before pregnancy. Therefore, in countries with high levels of IPV, early screening for invisible violence needs to be integrated into policy development, and healthcare providers need to be trained to identify EV and LSPV.

Factors associated with non-help-seeking among women victims of physical or sexual intimate partner violence in Peru: Findings from the National Demographic and Family Health Survey, 2017 to 2019

OBJECTIVE

To evaluate the factors associated with non-help-seeking in victims of physical or sexual intimate partner violence (IPV) in Peru.

METHODS

This was an analytical cross-sectional study of 3-year data from the Peruvian Demographic and Health Survey. The sample comprised women aged 18 to 49 who had experienced physical or sexual IPV at some time in their lives. The dependent variable was non-help-seeking after suffering physical or sexual IPV. Adjusted prevalence ratios (aPR) with their 95% confidence interval (CI) were calculated to assess the factors associated with non-help-seeking. In addition, a sensitivity analysis was carried out in which only women who suffered physical or sexual IPV in the last year were considered.

RESULTS

Data from 15,265 female victims of physical or sexual IPV were analyzed. It was found that 57.4% did not seek help after suffering physical or sexual IPV. The main reasons for non-help-seeking included thinking it was unnecessary (42.3%) and embarrassment (14.9%). Age between 30 and 49 years old (PRa:1.15; 95%CI [1.06, 1.25]) and residing in a rural area (PRa:1.07; 95%CI [1.00, 1.13]) were associated with a higher probability of non-help-seeking. On the other hand, having a secondary education level (PRa:0.91; 95% CI [0.86, 0.97]) or higher (PRa:0.90; 95%CI [0.82, 0.99]), having a partner who drinks alcohol (PRa:0.94; 95%CI [0.89, 0.99]), having experienced physical or sexual IPV during a pregnancy (PRa:0.87; 95%CI [0.80, 0.94]), and having experienced moderate (PRa:0.81; 95%CI [0.76, 0.86]), or severe physical or sexual IPV (PRa:0.74; 95%CI [0.67, 0.82]), were associated with a lower probability of non-help-seeking. These associations were consistent in the sensitivity analysis.

CONCLUSION

Half of the women who experience physical or sexual IPV do not seek help. There are sociodemographic factors related to this non-seeking of help that are useful for identifying and prioritizing interventions to reduce IPV and improve the health status of women.

Ethnic-specific prevalence rates of intimate partner violence against women in New Zealand

OBJECTIVE

This study presents age-standardised ethnic-specific prevalence rates of intimate partner violence against women in New Zealand, by physical and/or sexual intimate partner violence, psychological intimate partner violence, controlling behaviours and economic abuse.

METHODS

Data are from 1,431 ever-partnered women in the representative and cross-sectional He Koiora Matapopore, the 2019 New Zealand Family Violence Study.

RESULTS

High lifetime prevalence of intimate partner violence is present across all ethnic groups in NZ, with over half of all women reporting any intimate partner violence (55.8%). Substantial ethnic disparities exist in intimate partner violence rates, with Māori women reporting the highest prevalence of intimate partner violence (64.6%), followed by NZ European women (61.6%).

CONCLUSIONS

Intimate partner violence prevention and intervention services are needed at the population-level, and services must be culturally responsive and attuned to the needs of communities that bear the greatest burden.

IMPLICATIONS FOR PUBLIC HEALTH

Ethnic differences in intimate partner violence prevalence likely contribute to health disparities at the population-level, reinforcing calls for prevention and necessitating healthcare systems to be culturally informed and mobilised to address intimate partner violence as a priority health issue.

Evidence of Gender Asymmetry in Intimate Partner Violence Experience at the Population-Level

Claims of "gender symmetry" in intimate partner violence (IPV) prevalence are contested, with resolution of the issue complicated by methodological and measurement challenges. This study explores gendered differences in the distribution of IPV exposure at the population-level, considering multiple types of IPV exposure. The subjects comprised of 1,431 ever-partnered women and 1,355 ever-partnered men. Data from a nationally representative population-based cross-sectional survey were used to compare men and women's IPV experiences. Twenty-three IPV acts were assessed across IPV types (moderate physical, severe physical, sexual, psychological, controlling behaviors, economic). Proportions were presented by gender for the number of individual IPV acts experienced per IPV type, and the frequency of these acts (none, once, few times, or many times). A composite exposure score was developed to assess the number of acts and their frequency within types by comparing scores in tertiles and across types by correlations. Women reported greater overall prevalence of 20 of the 23 individual IPV acts assessed. Across all assessed acts, women comprised a substantially greater proportion of those who reported experiencing individual acts "many times." Women experienced more severe and more frequent IPV than men based on self-reported experience of IPV acts, and by the frequency with which acts were experienced. Significant differences between men and women's exposure scores were observed for all six assessed types, with greater proportions of women scoring in the upper tertiles. This study provides evidence of gender asymmetry in experiences of IPV at the population level. While men do experience IPV victimization, there remains need for directed and substantial resource allocation for intervention and therapeutic responses to women's exposure to IPV, and for primary prevention with men. Going forward, IPV measurement tools that consider frequency, severity, or co-occurring types of IPV are needed.

Development and Validation of a Prediction Tool for Reoffending Risk in Domestic Violence

Importance

Current risk assessment tools for domestic violence against family members were developed with small and selected samples, have low accuracy with few external validations, and do not report key performance measures.

Objective

To develop new tools to assess risk of reoffending among individuals who have perpetrated domestic violence.

Design, Setting, and Participants

This prognostic study investigated a national cohort of all individuals arrested for domestic violence between 1998 and 2013 in Sweden using information from multiple national registers, including National Crime Register, National Patient Register, Longitudinal Integrated Database for Health Insurance and Labour Market Studies Register, and Multi-Generation Register. Data were analyzed from August 2022 to June 2023.

Exposure

Arrest for domestic violence.

Main Outcomes and Measures

Prediction models were developed for 3 reoffending outcomes after arrest for domestic violence: conviction of a new violent crime (including domestic violence), conviction of any new crime, and rearrest for domestic violence at 1 year, 3 years, and 5 years. The prediction models were created using sociodemographic factors, criminological factors, and mental health status-related factors, linking data from multiple population-based longitudinal registers. Cox proportional hazard multivariable regression was used to develop prediction models and validate them in external samples. Key performance measures, including discrimination at prespecified cutoffs and calibration statistics, were investigated.

Results

The cohort included 27 456 individuals (mean [SD] age, 39.4 [11.6] years; 24 804 men [90.3%]) arrested for domestic violence, of whom 4222 (15.4%) reoffended and were convicted for a new violent crime during a mean (SD) follow-up of 26.5 (27.0) months, 9010 (32.8%) reoffended and were convicted for a new crime (mean [SD] follow-up, 22.4 [25.1] months), and 2080 (7.6%) were rearrested for domestic violence (mean [SD] follow-up, 25.7 [30.6] months). Prediction models were developed with sociodemographic, criminological, and mental health factors and showed good measures of discrimination and calibration for violent reoffending and any reoffending. The area under the receiver operating characteristic curve (AUC) for risk of violent reoffending was 0.75 (95% CI, 0.74-0.76) at 1 year, 0.76 (95% CI, 0.75-0.77) at 3 years, and 0.76 (95% CI, 0.75-0.77) 5 years. The AUC for risk of any reoffending was 0.76 (95% CI, 0.75-0.77) at 1 year and at 3 years and 0.76 (95% CI, 0.75-0.76) at 5 years. The model for domestic violence reoffending showed modest discrimination (C index, 0.63; 95% CI, 0.61-0.65) and good calibration. The validation models showed discrimination and calibration performance similar to those of derivation models for all 3 reoffending outcomes. The prediction models have been translated into 3 simple online risk calculators that are freely available to use.

Conclusions and Relevance

This prognostic study developed scalable, evidence-based prediction tools that could support decision-making in criminal justice systems, particularly at the arrest stage when identifying those at higher risk of reoffending and screening out individuals at low risk of reoffending. Furthermore, these tools can enhance treatment allocation by enabling criminal justice services to focus on modifiable risk factors identified in the tools for individuals at high risk of reoffending.