摘要：Objectives. We revised the Danger Assessment to predict reassault in abusive female same-sex relationships. Methods. We used focus groups and interviews to evaluate the assessment tool and identify new risk factors and telephone interviews at baseline and at 1-month follow-up to evaluate the revised assessment. Results. The new assessment tool comprised 8 original and 10 new items. Predictors included increase in physical violence (relative risk ratio [RRR]=1.95; 95% confidence interval [CI]=0.84, 4.54), constant jealousy or possessiveness of abuser (RRR = 4.07; 95% CI = 0.61, 27.00), cohabitation (RRR = 1.96; 95% CI = 0.54, 7.12), threats or use of gun by abuser (RRR=1.93; 95% CI=0.79, 4.75), alcoholism or problem drinking of abuser (RRR=1.47; 95% CI=0.79, 2.71), illegal drug use or abuse of prescription medications by abuser (RRR = 1.33; 95% CI = 0.72, 2.46), stalking by abuser (RRR=1.39; 95% CI=0.70, 2.76), failure of individuals to take victim seriously when she sought help (RRR=1.66; 95% CI=0.90, 3.05), victim’s fear of reinforcing negative stereotypes (RRR=1.42; 95% CI=0.73, 2.77), and secrecy of abuse (RRR=1.72; 95% CI=0.74, 3.99). Both unweighted ( P < .005) and weighted ( P < .004) versions of the revised assessment were significant predictors of reassault. Conclusions. The revised Danger Assessment accurately assesses risk of re-assault in abusive female relationships. Female same-sex intimate partner violence (IPV) is a serious public health issue. 1 – 3 Prevalence estimates have varied widely, because they are often based on small or convenience samples and use varying definitions of violence, time frames, and sampling procedures. 4 Turrell reported wide variation in rates of physical violence experienced by lesbians (8%–60%). 5 The National Violence Against Women Survey is the only population-based study to include female same-sex IPV. Tjaden et al. reported that of 79 women who reported cohabitation, 11.4% reported a lifetime prevalence of physical or sexual abuse or both perpetrated by a female partner. 6 Rose’s community-based study used a convenience sample of 229 lesbians and reported that 12.2% of participants had experienced at least 1 incident of IPV in the past year, 7 consistent with past-year IPV estimates in heterosexual relationships. 8 Despite the variation in prevalence estimates, even the lowest reported rate of 11.4% indicates that IPV in female same-sex relationships is an important issue deserving of attention from public health, social service, criminal justice, and domestic violence practitioners. Women who experience IPV in their relationships are at risk for reassault, increasing injuries, chronic health conditions, disabilities, and death. 9 Known risk factors include history of physical violence by an intimate partner (either a man or a woman), controlling behaviors, dependency on partner for resources and emotional support, alcohol and drug use by abusive partner and victim, depression, and termination of the relationship. 10 – 14 Existing risk models, risk assessment instruments, and prevention strategies were developed with heterosexual samples and then applied to women in same-sex relationships. It is only recently that factors such as internalized homophobia and discrimination have been examined as risk factors for IPV in same-sex relationships. 15 Identification of women who are at risk for reassault allows for preventive action. Among the identification methods most commonly used is the Danger Assessment (DA). 16 The DA is a clinical and research instrument designed to assist women in assessing their danger of being murdered or seriously injured by their male intimate partner. 17 – 22 Several predictive validity studies support the DA’s ability to predict IPV reassault, 23 – 26 but all have focused on reassault in heterosexual relationships, most often with women as victims and men as perpetrators. The extent to which this important tool can accurately assess risk of reassault in female same-sex abusive relationships, however, has not been examined. We reviewed and revised the DA to include risk factors for reassault in abusive female same-sex relationships and then evaluated the revised instrument (DA-R) with survivors.
