The Danger Assessment: Assessing Risk of Intimate Partner Homicide - - PowerPoint PPT Presentation
The Danger Assessment: Assessing Risk of Intimate Partner Homicide Jacquelyn Campbell PhD RN FAAN Anna D. Wolf Endowed Chair & Professor Johns Hopkins University School of Nursing Multi City Intimate Partner Femicide Study Funded by:
The Danger Assessment: Assessing Risk of Intimate Partner Homicide
Jacquelyn Campbell PhD RN FAAN Anna D. Wolf Endowed Chair & Professor Johns Hopkins University School of Nursing
Multi City Intimate Partner Femicide Study Funded by: NIDA/NIAA, NIMH, CDC, NIJ VAWA R01 DA/AA1156
HOMICIDE IN BATTERING RELATIONSHIPS HOMICIDE IN BATTERING RELATIONSHIPS
Number one risk factor for intimate partner homicide – whether male or female is killed - prior intimate partner violence (at least 70% of cases) Often not known to criminal justice system – arrests
Purpose of Danger Assessment – first developed as a clinical instrument to help women accurately assess their own risk
Based on original IP homicide study – Dayton, Ohio – Campbell, ‘81
Number one risk factor for intimate partner homicide – whether male or female is killed - prior intimate partner violence (at least 70% of cases) Often not known to criminal justice system – arrests
Purpose of Danger Assessment – first developed as a clinical instrument to help women accurately assess their own risk
Based on original IP homicide study – Dayton, Ohio – Campbell, ‘81
DANGER ASSESSMENT (Campbell ‘86)
www.dangerassessment.org
Developed in 1985 to increase battered women’s ability to take care of themselves (Self Care Agency; Orem ‘81, 92) – original DA used with 10 samples of 2251 battered women to establish preliminary reliability & validity & refine items Interactive, uses calendar - aids recall plus women come to own conclusions - more persuasive & in adult learner/ strong woman/ survivor model Items added with further research with abused women (e.g. choking – Stuart & Campbell ‘89) Intended as lethality risk instrument versus re-assault (e.g.
SARA, DVSI-R) - risk factors may overlap but not exactly
the same
Overlapping Concerns
Similar; Not the same
Risk Assessment Safety Assessment Lethality Assessment
Danger Assessment – Independent Predictive Validity Studies - Re-assault – Before ‘03 Revision
(Goodman, Dutton & Bennett, 2001) N = 92; 53% returned; successful prediction of reabuse, DA stronger predictor than CTS2 (4.2 vs. 2.8 OR per 1 SD DA vs. CTS2) Women’s perception of danger stronger predictor than any of the 10 DA items available in criminal justice records – (Weisz, Tolman, & Saunders, 2000) Heckert & Gondolf (’02; ‘04) N = 499 – DA- 66% sensitivity but 33% false positives - Women’s perception of risk PLUS DA best model (over SARA & K-SID) but women’s perception of risk by itself not quite as good as DA
Femicide Risk Study – 12 US cities -
(Campbell et al ’03; NIH/CDC/NIJ VAWA R01 DA/AA1156) NIH/CDC/NIJ VAWA R01 DA/AA1156)
Purpose: Identify and establish risk factors for IP femicide – (over and above domestic violence) Significance: Determine strategies to prevent IP femicide – especially amongst battered women – Approximately half of victims (54% of actual femicides; 45% of attempteds) did not accurately perceive their risk – that perpetrator was capable of killing her &/or would kill her Case Control Design: Actual & Attempted femicides – police records – plus interviews with “proxy informants” for femicide victims – controls – other abused women
DA Revised & Weighted Scoring Developed with Cutoff Ranges - VISE
Based on sum of weighted scoring place into 1 of the following categories: Less than 8 - “variable danger” 8 to 13 - “increased danger” 14 to 17 - “severe danger” 18 or more - “extreme danger”
ROC Curve Analysis – 92% under the curve for Attempted Femicides; 90% for actuals -
Campbell et al JI PV ’09 Homicide -suicide – K-McL ‘06
Further testing with RAVE study
(Campbell, O’Sullivan & Roehl – NIJ #2000WTVX0011) N = 782 abused women in CA & NYC – prospective – random assignment to one of 4 risk assessment methods Areas under ROC curve with potential confounders Any & severe re-assault – all significant at <.01
DA - .67; .697 DV-MOSAIC .618; .647 DVSI - .60; .616 K-SID - .60; .62 Victim perception .62; .62
Instruments/method = to or improved on victim assessment DV MOSAIC most accurate for threats & stalking
New Projects with DA
Alberta Council of women’s shelters – qualitative data Glass testing with same sex couples Glass computerization with decision aide Webster visualization of results Testing of LAP in OK – NIJ funded project (Messing & Campbell) Shortened version – Snider – Academic Emergency Medicine 11/09 Lethality Assessment Project – adaptation in MD and other states – Dave Sargent www.mnadv.org
References
Snider, C., Webster, D. W., O’Sullivan, C. S. & Campbell, J. C. (2009). Intimate partner violence: Development of a Brief Risk Assessment for the Emergency Department, Academic Emergency Medicine. Campbell, J.C., Webster, D. W., & Glass, N. E. (2009). The Danger Assessment: Validation of a lethality risk assessment instrument for intimate partner femicide. Journal of Interpersonal Violence, 24, 653-74 Glass, N., Laughon, K., Campbell, JC, Block, C. R., Hanson, G., Sharps, P. W., Taliaferro, E. (2008). Non-fatal strangulation is an important risk factor for homicide
Koziol-McLain, J., Webster, D., McFarlane, J., Block, C. R., Ulrich, Y., Glass, N., & Campbell, J. C. (2006). Risk factors for femicide-suicide in abusive relationships: Results from a multi-site case control study. Violence & Victims, 21. 3-21. Campbell, J. C., Webster, D., Koziol-McLain, J., Block CR, Campbell, D., Curry, MA, Gary, F, Sachs, C. Sharps, PW, Wilt, S., Manganello, J., Xu, X. (2003). Risk factors for femicide in abusive relationships: Results from a multi-site case control study. American Journal of Public Health, 93, 1089-1097. Campbell, J. C. (1986). Nursing assessment for risk of homicide with battered
Campbell, J. C. (1981). Misogyny and homicide of women. Advances in Nursing Science 3(2) 67-85
U.S. INTIMATE PARTNER HOMICIDE RATE DECLINE 1976-02 FBI (SHR, 1976-02; BJS ’05, ‘07) U.S. INTIMATE PARTNER HOMICIDE RATE U.S. INTIMATE PARTNER HOMICIDE RATE DECLINE 1976 DECLINE 1976-
02 FBI (SHR, 1976
FBI (SHR, 1976-
02; BJS ’ ’05, 05, ‘ ‘07) 07)
200 400 600 800 1000 1200 1400 1600 1800 1 9 7 6 1 9 7 7 1 9 7 8 1 9 7 9 1 9 8 1 9 8 1 1 9 8 2 1 9 8 3 1 9 8 4 1 9 8 5 1 9 8 6 1 9 8 7 1 9 8 8 1 9 8 9 1 9 9 1 9 9 1 1 9 9 2 1 9 9 3 1 9 9 4 1 9 9 5 1 9 9 6 1 9 9 8 2 2 1 2 2 2 4 2 5
FEMALE MALE
DANGER ASSESSMENT ITEMS COMPARING ACTUAL & ATTEMPTED FEMICIDE SURVIVORS (N=493) & ABUSED (WITHIN PAST 24 MONTHS) CONTROLS (N=427) (*p < .05) DANGER ASSESSMENT ITEMS COMPARING ACTUAL & ATTEMPTED FEMICIDE SURVIVORS (N=493) & ABUSED (WITHIN PAST 24 MONTHS) CONTROLS (N=427) (*p < .05)
Physical violence increased in frequency* Physical violence increased in severity * Partner tried to choke victim * A gun is present in the house * Partner forced victim to have sex * Partner used street drugs * Partner threatened to kill victim * Victim believes partner is capable of killing her * Perpetrator AD Military History (ns.) Stalking score* Physical violence increased in frequency* Physical violence increased in severity * Partner tried to choke victim * A gun is present in the house * Partner forced victim to have sex * Partner used street drugs * Partner threatened to kill victim * Victim believes partner is capable of killing her * Perpetrator AD Military History (ns.) Stalking score* Att/Actual 56% 62% 50% 64% 39% 55% 57% 54% 16% 4.6 Att/Actual 56% 62% 50% 64% 39% 55% 57% 54% 16% 4.6 Control 24% 18% 10% 16% 12% 23% 14% 24% 22% 2.4 Control 24% 18% 10% 16% 12% 23% 14% 24% 22% 2.4
VICTIM & PERPETRATOR OWNERSHIP OF WEAPON IN FEMICIDE (N = 311), ATTEMPTED FEMICIDE (N = 182), ABUSED CONTROL (N=427) & NON-ABUSED CONTROL (N=418) CASES VICTIM & PERPETRATOR OWNERSHIP OF WEAPON VICTIM & PERPETRATOR OWNERSHIP OF WEAPON IN FEMICIDE (N = 311), ATTEMPTED FEMICIDE (N = IN FEMICIDE (N = 311), ATTEMPTED FEMICIDE (N = 182), ABUSED CONTROL (N=427) & NON 182), ABUSED CONTROL (N=427) & NON-
ABUSED CONTROL (N=418) CASES CONTROL (N=418) CASES
15.7 14.6 16.915.6 74.1 52.9 26.8 12.7 10 20 30 40 50 60 70 80 Victim Perpetrator Femicide Attempted Abused control Nonabused control
χ2=125.6, P< .0001
DANGER ASSESSMENT ITEMS COMPARING ACTUAL & ATTEMPTED FEMICIDE SURVIVORS (N=493) & ABUSED (WITHIN PAST 24 MONTHS) CONTROLS (N=427) (*p < .05) DANGER ASSESSMENT ITEMS COMPARING ACTUAL & ATTEMPTED FEMICIDE SURVIVORS (N=493) & ABUSED (WITHIN PAST 24 MONTHS) CONTROLS (N=427) (*p < .05)
Partner is drunk every day * Partner controls all victim’s activities * Partner beat victim while pregnant * Partner is violently jealous of victim (says things like “If I can’t have you,no one can”)* Victim threatened/tried to commit suicide Partner threatened/tried to commit suicide * Partner is violent toward victim’s children* Partner is violent outside house* Partner arrested for DV* (not criminality) Partner hurt a pet on purpose Partner is drunk every day * Partner controls all victim’s activities * Partner beat victim while pregnant * Partner is violently jealous of victim (says things like “If I can’t have you,no one can”)* Victim threatened/tried to commit suicide Partner threatened/tried to commit suicide * Partner is violent toward victim’s children* Partner is violent outside house* Partner arrested for DV* (not criminality) Partner hurt a pet on purpose Att/Actual 42% 60% 36% 79% 7% 39% 9% 49% 27% 10.1% Att/Actual 42% 60% 36% 79% 7% 39% 9% 49% 27% 10.1% Control 12% 32% 7.7% 32% 9% 19% 3% 38% 15% 8.5% Control 12% 32% 7.7% 32% 9% 19% 3% 38% 15% 8.5%
Significant (p<.05) Variables (Entered into Blocks) before Incident (overall fit = 85% correct classification) Perpetrator unemployed OR = 4.4 Perpetrator gun access OR = 5.4 Perpetrator Stepchild OR = 2.4 Couple Never Lived Together OR = .34 Highly controlling perpetrator OR = 2.1 Estranged X Low control (interaction) OR = 3.6 Estranged X Control (interaction) OR = 5.5 Threatened to kill her OR = 3.2 Threatened w/weapon prior OR = 3.8 Forced sex OR = 1.9 Prior Arrest for DV OR = .34
Femicide – Suicide Cases (32% of femicide cases in study – 29% US)
Significant explanatory power for same femicide – suicide risk factors.
Partner access to gun Threats with a weapon Step child in the home Estrangement
Unique to femicide – suicide:
Partner suicide threats – history of poor mental health Married Somewhat higher education levels (unemployment still a risk factor), more likely to be white
U f thi D A t S i
Danger Assessment Certification
_________________________________________________________________has completed the Danger Assessment Training Program and is certified to use the Danger Assessment and Levels of Danger Scoring System to evaluate the level of danger in domestic violence cases.
Jacquelyn C Campbell, PhD, RN, FAAN Anna D Wolf Chair Associate Dean for Faculty Affairs The Johns Hopkins University School of Nursing DateNAME OF VICTIM: Danger Assessment Scoring
Revised 2004Add total number of “Yes” responses, 1 through 19. Add 4 points for a “Yes” to question 2 Add 3 points for each “Yes” to questions 3 and 4. Add 2 points for each “Yes” to questions 5, 6 and 7. Add 1 point for each “Yes” to questions 8 & 9 Subtract 3 points if 3a is checked
Levels of Danger TOTAL Less than 8 Variable Danger 8 – 13 Increased Danger 14 -17 Severe Danger 18 or more Extreme Danger
Use of this Danger Assessment Scoring system is restricted to ____________________________ Danger Assessment Certified xx/xx/2005
Comparisons on Cutoffs – Sensitivity/Specificity
Femicides Attempteds Specificity
Variable Danger < 8 90% 92% 69% Increased Danger: 8 – 13 86% 90% 70% Severe Danger: 14 – 17 83% 86% 80% Extreme Danger: 18 + 57% 48% 98%
Gun Issues
Get the gun(s) out!!! Implementation of Brady Bill – judges need to order removal of all guns – specify in search warrants & PO’s MD law – No removal language at incident Only removal with both “permanent” not temporary protective
Judges can check “surrender” & can state removal PO information entered into federal data base (most states it is) Convictions for DV misdemeanors & felonies are entered & flagged – prohibits purchase (but only at licensed dealer, not gun shows) No removal/disarming language - (about 10 states) but judges can still order removal Firearm prohibition on face sheet of PO – (about ½ states)
Ideal Process Model
Women in Shelters Or Health Care System Danger Assessment & Safety Assessment Partners of Men in System Offenders in CJ, BIP, MH SA Tx &/or VA/DoD Judicial System Risk Assessment (Re-assault) System Safety Audit – CCR, Including Fatality Reviews & Court Watch/Monitoring (www.watchmn.org)
MD Lethality Assessment or B-SAFER