Accounting for Multiple Nonfatal Strangulation in Intimate Partner Violence Risk Assessment

Area of Science:

• Public Health
• Forensic Medicine
• Sociology

Background:

• Nonfatal strangulation is an underreported yet dangerous form of intimate partner violence (IPV).
• Strangulation may not leave visible injuries, making assessment critical for abused women.
• Negative health consequences are dose-related, increasing with multiple strangulation events or loss of consciousness.

Purpose of the Study:

• To examine the relationship between multiple strangulation, loss of consciousness, and the risk of future near-fatal violence.
• To modify the Danger Assessment (DA) and Danger Assessment for Immigrant women (DA-I) risk assessment tools to include strangulation history.
• To evaluate the predictive validity of the updated DA and DA-I for near-fatal IPV.

Main Methods:

• Data from 619 participants were used to adapt the DA by adding an item on multiple strangulation or loss of consciousness.
• An independent validation sample of 389 participants was used to test the predictive validity of the updated DA and DA-I.
• Follow-up assessments were conducted at 7-8 months to determine the occurrence of near-fatal violence.

Main Results:

• The updated DA, incorporating strangulation history, significantly improved the prediction of near-fatal violence compared to the original DA.
• Adding strangulation history to the DA-I showed a slight, though not statistically significant, increase in predictive validity.
• The study highlights the importance of strangulation as a predictor of escalating IPV severity.

Conclusions:

• The adapted DA and DA-I can enhance the assessment of near-fatal IPV risk.
• Practitioners should educate IPV survivors about the dangers of strangulation and the need for medical attention.
• These evidence-based adaptations can aid in assessing and intervening in high-risk IPV cases.