Risk-Informed Intervention: Using Intimate Partner Violence Risk Assessment within an Evidence-Based Practice Framework

The Temporal Pattern of Repeat Intimate Partner Violence Incidents Among High-Risk Survivors in Taiwan: A Survival Analysis

Intimate partner violence (IPV) is rarely an isolated incident, with survivors often experiencing repeat violence. Few studies, however, have been conducted to investigate the temporal pattern of IPV revictimization using a validated risk assessment instrument. In Taiwan, service professionals are mandated to report any known IPV incidents using the Taiwan Intimate Partner Violence Danger Assessment (TIPVDA), a validated risk assessment designed to assess the level of lethality faced by IPV survivors. The mandatory reporting policy and the universal use of the TIPVDA provide a unique opportunity to investigate the time course of repeat IPV victimization. This study analyzes high-risk IPV incidents (n = 18,740) reported in Taiwan from 2017 to 2019 using Cox regression analysis. Analysis results suggested three main findings: (a) The time interval between IPV victimizations shortened and the severity of violence increased; (b) the TIPVDA score was consistently associated with repeat victimization, unlike self-assessed dangerousness; (c) specific TIPVDA items, such as IPV history and financial stress, predicted the rate of repeat victimization. Those who reported ever being hurt by their partner during pregnancy, an escalation in physical violence during the past year, their partner threatening to kill them, and their partner being stressed about their financial situation were likely to have a faster rate of reporting the second and third high-risk victimization reports. These findings highlight the importance of using validated risk assessments in practice, not only for predicting reassault, severe reassault, or homicide but also for estimating the timing of revictimization. This can significantly inform intervention strategies and policy decisions.

Does Empowerment Mediate the Association Between Intimate Partner Violence (IPV) and Mental Health? An Analysis Across Multiple Forms of IPV

This study explores the extent to which self-reported empowerment mediates the association between intimate partner violence (IPV) victimization and mental health symptomatology. Four forms of IPV-severe, harassment, psychological, and technology-facilitated IPV-and two mental health symptomatologies-depression and posttraumatic stress disorder-are examined. Data were collected from women who sought help from domestic violence service agencies in a U.S. Southwestern state. Results showed that all forms of IPV had both significant direct and indirect effects on mental health symptoms through empowerment, indicating that IPV is associated with increased mental health symptoms by, in part, diminishing one's empowerment levels. The findings underscore the importance of empowering survivors in the practice process.

Building a Transdisciplinary Team to Prevent Intimate Partner Homicide: A Research Note

Intimate partner violence (IPV) and intimate partner homicide (IPH) are complex global problems. Transdisciplinary research approaches offer the potential to increase the understanding of these events and inform best practices for prevention. To encourage scholars to adopt transdisciplinary practices when investigating multifaceted problems, this note employs a case study approach to detail one such effort-The Preventing and Assessing Intimate Partner Homicide Risk (PAIR) Studies. The goal of the PAIR Studies is to improve the understanding of IPH to inform the development of best practices for prevention. The note concludes with a discussion of the benefits of transdisciplinary approaches.

Perceptions, Help-Seeking, and High-Risk Domestic Violence in Black Communities

One in four women report experiencing intimate partner violence. Yet, nearly 45% of Black women report experiencing this same crime. In addition, while Black women compose 14% of the U.S. population, they represent 31% of domestic violence fatalities and are three times more likely than White women to be killed by an intimate partner. This points to the continued need to better understand how the Black community perceives domestic violence and how their perception influences their help-seeking strategies. This paper reports on a project examining how Black communities perceive domestic violence, high-risk domestic violence, and how these perceptions impact their help-seeking strategies. The study was conducted between April 2020 and October 2020 with 128 participants that participated in focus groups in six geographically diverse U.S. cities including rural, urban, and suburban communities. The findings reaffirmed and presented new information about the perceptions of domestic violence, the impact of inadequate and negative systems' responses, the lack of cultural responsiveness and poor police interactions, and the calculated decision-making that survivors in the Black community use to determine who to tell, how to tell, and where to go in use of adapted help-seeking strategies. Implications are provided as to how to address these issues.

Black Communities' Perspectives on High-Risk Domestic Violence

Domestic violence homicide is a serious issue that is receiving increased attention in communities across the country. The Black community has been disproportionately impacted by domestic violence fatality. However, little information has been obtained as to how these communities understand and perceive high-risk domestic violence. This article provides information from 128 focus group participants from diverse Black communities on their perceptions of what constitutes high-risk domestic violence. The findings affirm some current high-risk indicators, such as stalking, strangulation, use of threats, access to a weapon, and isolation, and provide nuanced perspectives of each indicator. In addition, the findings provide new thoughts on what these communities identified as high-risk domestic violence, including public violence, repeated violence with no consequences, escalation of arguments, disconnection from the community, and being a member of a marginalized group. Implications for practice, policy, education, and protocol development are provided.

Accounting for Multiple Nonfatal Strangulation in Intimate Partner Violence Risk Assessment

Nonfatal strangulation is a prevalent, underreported, and dangerous form of intimate partner violence (IPV). It is particularly important to assess for strangulation among abused women as this form of violence may not leave visible injury. The most severe negative physical and mental health consequences of strangulation appear to be dose-related, with those strangled multiple times or to the point of altered consciousness at higher risk of negative sequelae. This research examines the relationship between multiple strangulation, loss of consciousness due to strangulation, and risk of future near-fatal violence to modify the Danger Assessment (DA) and the Danger Assessment for Immigrant women (DA-I), IPV risk assessments intended to predict near-fatal and fatal violence in intimate relationships. Data from one study (n = 619) were used to modify the DA to include an item on multiple strangulation or loss of consciousness due to strangulation. Data from an independent validation sample (n = 389) were then used to examine the predictive validity of the updated DA and DA-I. The updated version of the DA predicts near-fatal violence at 7-8 months follow-up significantly better than the original DA. Adding multiple strangulation or loss of consciousness to the DA-I increased the predictive validity slightly, but not significantly. The DA and DA-I are intended to be used as a collaboration between IPV survivors and advocates as tools for education and intervention. Whether or not an IPV survivor has been strangled, she should be educated about the dangerous nature of strangulation and the need for medical intervention should her partner use strangulation against her. This evidence-based adaptation of the DA and DA-I may assist practitioners to assess for and intervene in dangerous IPV cases.

Do You Believe Your Partner is Capable of Killing You? An Examination of Female IPV Survivors' Perceptions of Fatality Risk Indicators

Advocates in the field of intimate partner violence (IPV) have started to more actively engage survivors around their own perceptions of their lethality risk, as well as assist them in developing strategies for reducing and managing risk related to reassault and intimate partner homicide (IPH). Although research has examined the risk factors most associated with risk and utilized this information in the development and validation of risk assessment tools to be used with survivors, less is known about which indicators survivors most associate with lethality risk. This study aims to fill this gap by examining which risk indicators IPV survivors associate with fatality risk. Classification and regression tree analyses were used to differentiate between women who believed their partners were capable of killing them and those who did not. Data on a sample of 213 survivors of IPV used in this analysis were collected as part of a larger study in which a risk assessment instrument was piloted across four counties within New Jersey in 2016. More than three fourths of participants believed that their abuser was capable of killing them. Alhough the majority of survivors in the study felt as though their abusers were capable of killing them, there was variation in how survivors prioritized risk indicators. Factors associated with fatality risk included: (a) prior homicide threats; (b) whether the abusers had control over survivors' daily activities; (c) abusers' access to a gun; and (d) abusers' drug use. Findings suggest that IPV survivors need targeted intervention strategies around IPH, particularly those at higher perceived risk levels given the presence of risk indicators and their perceptions of lethality threat.

Can Justice System Interventions Prevent Intimate Partner Homicide? An Analysis of Rates of Help Seeking Prior to Fatality

When women are killed, they are more likely to be killed by an intimate partner than anyone else, and a substantial number of women who are killed by an intimate were abused by that intimate partner before their death. The proportion of men killed by an intimate partner is much lower and prior research indicates that male intimate partner homicide victims are likely to abuse their partners prior to their deaths. However, limited research has examined the criminal and civil justice help seeking of intimate partner homicide victims. This study examines administrative data from one large urban police jurisdiction to understand rates of help seeking by homicide victims in the 1 to 3 years prior to the homicide. Over 4 years (2010-2014), 197 women and 776 men were killed. The proportion of women killed by an intimate or ex-intimate partner was 39.6%, and the proportion of men killed by an intimate or ex-intimate partner was 3.9%. Police had been in contact with the victim of intimate partner femicides for a domestic violence complaint in 91% of cases in the 3 years prior to the femicide (44.9% resulted in arrest), with an average of 6.2 visits per contacted victim. Among male intimate partner homicide victims, 73.3% had been the complainant on a domestic violence case (38.1% resulted in arrest). Few (<10%) victims sought protection orders before the homicide. Over the 3 years prior to their deaths, 36.7% of male homicide victims and 9.0% of femicide victims had been the suspect in a domestic violence case. Results indicate high rates of engagement of police officers with intimate partner homicide victims before their deaths, and highlight the opportunity for homicide prevention through integration of risk assessment (to identify high-risk cases) and enhanced criminal justice and social service interventions in high-risk cases.

Women's Reproductive Coercion and Pregnancy Avoidance: Associations With Homicide Risk, Sexual Violence, and Religious Abuse

This survey study explores patterns of reproductive coercion (RC) and pregnancy avoidance (PA) among women recruited from domestic violence shelters in the southwestern United States (N = 661). Two logistic regression models assessed the demographic, relationships, and violence characteristics associated with RC and PA. Younger, African American, and Hispanic women were more likely to experience RC. Homicide risk, sexual intimate partner violence (IPV), and religious abuse were associated with RC, and RC and homicide risk were associated with PA. We discuss implications of the associations between RC and PA and their links to religious abuse, sexual IPV, and homicide risk.

Challenges in Risk Assessment with Rural Domestic Violence Victims: Implications for Practice

Through interviews the present study examined the perspectives of service providers (n = 14) in the violence against women (VAW) sector regarding risk factors and challenges in assessing risk for women experiencing domestic violence (DV) in rural locations. The present study also examined what promising practices VAW service providers are utilizing when working with women experiencing DV in rural locations. Interviews were coded and analyzed in a qualitative analysis computer program. Analysis indicated several risk factors including the location (i.e., geographic isolation, lack of transportation, and lack of community resources) and cultural factors (i.e., accepted and more available use of firearms, poverty, and no privacy/anonymity). Moreover, analyses indicated several challenges for VAW service providers assessing risk including barriers at the systemic (i.e., lack of agreement between services), organizational (i.e., lack of collaboration and risk assessment being underutilized/valued), and individual client (i.e., complexity of issues) level. However, participants outlined promising practices being implemented for rural locations such as interagency collaboration, public education, professional education, and outreach programs. The findings support other research in the field that highlight the increased vulnerability of women experiencing DV in rural locations and the added barriers and complexities in assessing risk for rural populations. Implications for future research and practice include further examination of the identified promising practices, a continued focus on collaborative approaches and innovative ways to prevent and manage risk in a rural context.

The Validity and Reliability of Available Intimate Partner Homicide and Reassault Risk Assessment Tools: A Systematic Review

At least one in seven homicides around the world is perpetrated by intimate partners. The danger of intimate partner homicide (IPH) associated with intimate partner violence (IPV) has led to the development of numerous IPV reassault and IPH risk assessment tools. Using 18 electronic databases and research repositories, we conducted a systematic review of IPH or IPV reassault risk assessment instruments. After review, 43 studies reported in 42 articles met inclusion criteria. We systematically extracted, analyzed, and synthesized data on tools studied, sample details, data collection location, study design, analysis methods, validity, reliability, and feasibility of use. Findings indicate that researchers in eight countries have tested 18 distinct IPH or IPV reassault risk assessment tools. The tools are designed for various professionals including law enforcement, first responders, and social workers. Twenty-six studies focused on assessing the risk of male perpetrators, although eight included female perpetrators. Eighteen studies tested tools with people in mixed-sex relationships, though many studies did not explicitly report the gender of both the perpetrators and victims/survivors. The majority of studies were administered or coded by researchers rather than administered in real-world settings. Reliable and valid instruments that accurately and feasibly assess the risk of IPH and IPV reassault in community settings are necessary for improving public safety and reducing violent deaths. Although researchers have developed several instruments assessing different risk factors, systematic research on the feasibility of using these instruments in practice settings is lacking.