Authors' objectives: To assess the research evidence on the inter-rater reliability and predictive validity of various risk assessment instruments in predicting male-to-female spousal violence recidivism and lethality in those males who had contact with the police system.

Authors' results and conclusions: No systematic review on this topic was located through a comprehensive literature search. Eight primary studies were found that evaluated the predictive validity of several currently used instruments, including the Ontario Domestic Assault Risk Assessment (ODARA), the Spousal Assault Risk Assessment (SARA), the Danger Assessment (DA), the Domestic Violence Screening Instrument (DVSI), the Violence Risk Appraisal Guide (VRAG), and the Level of Service Inventory-Revised (LSI-R). The ODARA was evaluated in only one Canadian study, whereas the SARA was evaluated in five studies. The characteristics of the population under study=male offenders=varied considerably across the included studies. Some male offenders were arrested, on probation, or in a maximum-security psychiatric facility, whereas others were referred to attend batterer treatment programs that were provided in Canada or the United States. Inter-rater reliability was tested for the SARA, the ODARA, and the VRAG, but not for the DA and other instruments. Limited research indicated good inter-rater reliability for the SARA, the ODARA, and the VRAG. In terms of predictive validity, five studies compared the predictive validity of one instrument with other instruments, whereas three studies reported the predictive validity of only one instrument. None of the studies reported any lethal assault during the follow up period. The reported area under the receiver operating characteristic curve (ROC AUC, a measure of predictive validity) was less than 0.80 (ranged from 0.59 to 0.77) for all instruments under evaluation, suggesting only marginal to moderate improvement over chance in predicting non-lethal recidivism. Only one study that was conducted in Canada compared predictive validity of the ODARA, the SARA, and the DA. On the basis of the ROC analysis, the predictive validity of the ODARA appeared to be lower in the cross-validation sample than that in the construction sample. In the construction sample, all three instruments yielded statistically significant predictive validity, but the ODARA predicted recidivism statistically significantly better than did the SARA or the DA. In the cross-validation sample, the ODARA significantly predicted recidivism, whereas the DA and the SARA did not. These findings need to be interpreted cautiously. First, instructions for the SARA were not completely followed; that is, no interview was performed, and no clinical judgment was made. Second, no lethal assault occurred during the follow up in this study; therefore, it could not be concluded that the ODARA was superior to the DA in predicting lethal assault.

Authors' recommendations: All instruments under evaluation demonstrated improvement over chance in predicting spousal violence recidivism; however, no conclusion could be made regarding the superiority of one tool over another at this time. Although lethal assault is of the greatest concern, the included studies failed to provide any information on how well these instruments (even the DA) predict lethal assault. Current research evidence on the predictive validity of these instruments has been exclusively based on measuring non-lethal reassault. The decision on selecting an appropriate risk assessment instrument needs to take into account factors such as the available research evidence, the population under assessment, the intended users of the instrument, and the Spousal Violence Against Women: Preventing Recurrence v purpose for conducting an assessment. The DA may be most appropriately used by clinicians, victim advocates, or social workers in women's shelters, hospitals, and women-s treatment programs. The ODARA, on the other hand, may be more appropriately applied by law enforcement personnel. The SARA may not be an optimal instrument for use by law enforcement personnel but it provides an immediate opportunity for the development of a comprehensive treatment plan for the assaulter. Because the research evidence available on the predictive validity of risk assessment instruments is very limited, it would be inappropriate to make any decision of an individual-s risk of recidivism based solely on the scores of the instruments being used. Information from all other sources, such as women-s perceptions of risk, and records in the justice system, should be gathered to make more accurate predictions. The Alberta Mental Health Board is in a unique situation where both the SARA and the ODARA are being applied to the target population of interest and within the local context. Data gathered during the implementation of the Provincial Family Violence Treatment Program using these risk assessment tools will provide valuable information regarding their predictive validity and the initiation of a classification system of recidivism severity. This implementation and evaluation process will allow a direct comparison of the predictive validity of the SARA, the ODARA, or a combination of both, in the subgroup of male abusers who were referred to the treatment program, to see whether the combination of the two tools would improve predictive validity. Findings from this process would be helpful to determine whether a composite tool that fits the Alberta context could be developed and used province-wide.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2008

URL for published report: http://www.ihe.ca/advanced-search/spousal-violence-against-women-preventing-recurrence

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 – Jasper Avenue, Edmonton, AB T5J 3N4, Canada. Tel: +1 780 448 4881 Fax: +1 780 448 0018

Contact Name: info@ihe.ca

Contact Email: info@ihe.ca

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