Accounting for Multiple Nonfatal Strangulation in Intimate Partner Violence Risk Assessment

Abstract

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.

Risk Assessment Instruments for Intimate Partner Femicide: A Systematic Review

“…The first study was published in 1986 in the United States (Campbell, 1986 ), and it has continued similarly in subsequent years. Twenty-seven studies were located in the United States to date, in each of the following years: Campbell ( 1986 ), McFarlane et al ( 1998 ), Glass et al ( 2008 ), Campbell et al ( 2009 ); Glass et al ( 2009 ); Snider et al ( 2009 ), Glass et al ( 2010 ), Messing et al ( 2013 ), Bianchi et al ( 2014 ); Messing et al ( 2014 ), Messing et al ( 2015a , b ), Messing and Campbell ( 2016 ); Messing et al ( 2016 ), Brignone and Gomez ( 2017 ); Grant and Cross-Denny ( 2017 ); Messing et al ( 2017 ), Dutton et al ( 2018 ); Ward-Lasher et al ( 2018 ), Dutton et al ( 2019 ); Richards et al ( 2019 ); Sabri et al ( 2019 ), Johnson et al ( 2020 ); Messing et al ( 2020a , b ) and Anderson et al ( 2021 ); Williams et al ( 2021 ). Other studies have been done, for the last years, in other countries such as Spain in and Echeburúa et al ( 2009 ), Canada in Storey and Hart ( 2014 ), China in Wang ( 2015 ), Portugal in Cunha and Goalves ( 2016 ), and Norway in Nesset et al ( 2017 ), Spain in López-Ossorio et al ( 2021 ) and Echeburúa et al ( 2009 ).…”

“…The sample size varied among the studies between 16 and 4,665 participants. This is constituted by a common sample of women victims of IPF, attempted IPF, and PVW by current or former male partners in heterosexual relationships (Campbell, 1986 ; McFarlane et al, 1998 ; Glass et al, 2008 , 2009 , 2010 ; Campbell et al, 2009 ; Snider et al, 2009 ; Messing et al, 2013 , 2014 , 2015a , b , 2016 , 2017 , 2020a , b ; Bianchi et al, 2014 ; Storey and Hart, 2014 ; Wang, 2015 ; Messing and Campbell, 2016 ; Brignone and Gomez, 2017 ; Nesset et al, 2017 ; Richards et al, 2019 ; Sabri et al, 2019 ; Johnson et al, 2020 ; López-Ossorio et al, 2021 ). These aggressors are also included (Echeburúa et al, 2009 ; Storey and Hart, 2014 ; Cunha and Goalves, 2016 ; Nesset et al, 2017 ; Anderson et al, 2021 ; López-Ossorio et al, 2021 ; Williams et al, 2021 ).…”

“…Most of the studies used similar data collection strategies from interviews and questionnaires directly from victims (Campbell, 1986 ; McFarlane et al, 1998 ; Glass et al, 2008 , 2009 , 2010 ; Campbell et al, 2009 ; Snider et al, 2009 ; Messing et al, 2013 , 2014 , 2015b , 2016 , 2017 , 2020a ; Bianchi et al, 2014 ; Wang, 2015 ; Brignone and Gomez, 2017 ; Richards et al, 2019 ; Sabri et al, 2019 ; Johnson et al, 2020 ), aggressors (Snider et al, 2009 ; Messing et al, 2015a ; Cunha and Goalves, 2016 ; Williams et al, 2021 ) and professionals (Dutton et al, 2018 , 2019 ; Ward-Lasher et al, 2018 ). One uses focus groups (Grant and Cross-Denny, 2017 ).…”

Preventing Intimate Partner Homicide: The Long Road Ahead

“…Therefore, the PAIR Studies are also examining risk factors of IPV-related homicides. Emerging risk factors such as technology-based abuse (Messing et al, 2020a) and strangulation, including multiple times and to unconsciousness (Messing et al, 2020b), will be examined for their contribution to IPH. In addition, potential risk factors that are population-specific will be examined, such as experiences of racial discrimination, partner’s use of homophobia or transphobia as coercive control, and partner threats of calling immigration authorities.…”

"These Questions Have Everything That Happens to me": Analysis of a Femicide Risk Assessment Tool for Abused Women in Brazil

“…The DA is used by women, law enforcement, courts and social service providers so that women and first responders may determine the need for protective action (Campbell, 2005). The DA has been periodically reviewed and updated according to specific needs, including adaptations for same-sex couples and immigrant populations in the US (Glass et al, 2008;Messing et al, 2013;Messing, Campbell, AbiNader, & Bolyard, 2020;Graham et al, 2021). The DA has been systematically translated for use in four languages.…”