Intimate partner homicide risk assessment by police in Spain: the dual protocol VPR5.0-H

Psychosocial In e en ion Psychosocial In e en ion (2021) 30(1) 47-55 Ci e his a icle as: López-Osso io, J. J., González-Ál a ez, J. L., Loinaz, I., Ma ínez-Ma ínez, A., & Pineda, D. (2021). In ima e pa ne homicide isk assessmen by police in Spain: VPR5.0-H he dual p o ocol. Psychosocial In e en ion, 30 (1), 47-55. h ps://doi.o g/10.5093/pi2020a16 ISSN:1132-0559/© 2021 Colegio O icial de la Psicología de Mad id. This is an open access a icle unde he CC BY-NC-ND license (h p://c ea i ecommons.o g/licenses/by-nc-nd/4.0/). In ima e Pa ne Homicide Risk Assessmen by Police in Spain: The Dual P o ocol VPR5.0-H Juan J. López-Osso ioa, b, José L. González-Ál a eza, b, Ismael Loinazb, c , Ana Ma ínez-Ma ínezd , and Da id Pinedad, e a Gabine e de Coo dinación y Es udios, Sec e a ía de Es ado de Segu idad, Spain; b Ins i u o de Ciencias Fo enses y de la Segu idad (ICFS), Uni e sidad Au ónoma de Mad id, Spain; c G upo de Es udios A anzados en Violencia (GEAV), Uni e sidad de Ba celona, Spain; d Unidad de Psicología Fo ense, Uni e sidad Miguel He nández de Elche, Spain; e Facul ad de Psicología, Uni e sidad Nacional de Educación a Dis ancia, Mad id, Spain h ps://jou nals.copmad id.o g/pi Co espondence: [email p o ec ed] (D. Pineda). ARTICLE INFO Recei ed 20 Decembe 2019 Accep ed 17 June 2020 A ailable online 7 Sep embe 2020 Keywo ds: Homicide In ima e pa ne homicide Violence isk assessmen Police isk assessmen VioGén Sys em ABSTRACT Spanish police makes an ex ensi e use o in ima e pa ne iolence (IPV) isk assessmen on a daily basis. Imp o ed p edic ion p ocedu es ha e encou aged he sea ch o g ea e e inemen o IPV p edic o s by adjus ing o speci ic a ge s, such as le hal ou comes o po en ial ic imiza ion o child en. This pape desc ibes he e olu ion o he VPR5.0 ool (VioGén Sys em Police Risk Assessmen ) as an algo i hm aimed a imp o ing p edic abili y o in ima e pa ne homicides (IPH). A sample o 2,159 eco ds was used, 159 o whom we e IPH ic ims. The sample was di ided in o wo compa able g oups o cases (IPH) and con ols (N-IPH) o alida e he esul s. The esul s showed ha 13 ou o 35 isk ac o s we e signi ican ly ela ed o IPH wi h an e ec size di e en o ha o gene al N-IPH (wi h OR alues anging be ween 1.507 and 8.087). Bina y logis ic eg ession showed six signi ican ac o s ha co ec ly classi ied 86.3% o he IPH. The new H-Scale pe o mance pa ame e s we e compa able o hose ob ained in s udies wi h he same objec i e (sensi i i y 84%, speci ici y 60%, OR = 8.130, AUC = .80, PPV = .19 and NPV = .97). La alo ación policial del iesgo del homicidio de pa eja en España: el p o ocolo dual VPR5.0-H RESUMEN La policía española hace un uso dia io y ex enso de la e aluación del iesgo de iolencia en casos de iolencia de géne o (VCP). El pe eccionamien o de los sis emas de p edicción de VCP ha impulsado la búsqueda de p ocedimien os ajus ados a obje i os conc e os, como puede se el esul ado le al o la inclusión de meno es como posibles íc imas. En el p esen e abajo se desc ibe la e olución de la he amien a VPR5.0 (Valo ación Policial del Riesgo del Sis ema VioGén) a un algo i mo di e enciado cuyo obje i o es p edeci mejo los homicidios de muje es po su pa eja (HCP). Se analiza on 2,159 egis os, 159 de los cuales co espondían a HCP, di idiendo la mues a en dos g upos compa ables con casos (HCP) y con oles (N-HCP) pa a alida los análisis. Los esul ados pusie on de mani ies o que de los 35 ac o es de la he amien a 13 es aban asociados signi ica i amen e con el HCP, con un amaño del e ec o di e en e al de N-HCP (con alo es OR en e 1.507 y 8.087). La eg esión logís ica bina ia mos ó seis ac o es signi ica i os que clasi icaban co ec amen e el 86.3% de los HCP. Los pa áme os de endimien o de es a escala-H esul a on compa ables a los ob enidos en es udios con el mismo obje i o (sensibilidad 84%, especi icidad 60%, OR = 8.130, AUC = .80, VPP = .19 y VPN = .97). Palab as cla e: Homicidio Homicidio de pa eja E aluación del iesgo de iolencia E aluación policial del iesgo Sis ema VioGén In ima e pa ne iolence (IPV) is a complex phenomenon ha occu s o a ying deg ees in all coun ies, cul u es, and socie ies. An ex eme mani es a ion o his iolence is homicide. Violence a his le el c ea es g ea social ala m while also ha ing impo an epe cussions on he social en i onmen o ic im, pe pe a o , and socie y in gene al (López-Osso io e al., 2018). Homicides ha e mul i ace ed o igins. Figh agains homicides is ensh ined in he global goals o sus ainable de elopmen as highligh s how women and gi ls h oughou he wo ld a e a ec ed by i . The e we e app oxima ely 87,000 homicides o women in 2017 (UNODC, 2019). While his o al indica es a dec ease o e p e ious yea s, an ala ming ac is ha he numbe o homicides o women in he con ex o amily and couples inc eased om 47% in 2012 o 58% in 2017. Al hough app oxima ely 81% o all homicide ic ims a e men, his igu e changes subs an ially 48 J.J. López-Osso io e al. / Psychosocial In e en ion (2021) 30(1) 47-55 when in ima e pa ne homicide (IPH), whe e 82% o ic ims a e women, is eco ded (UNODC, 2019). These igu es con i m he indings o p e ious s udies by S öckl e al. (2013). I is es ima ed in he U.S. be ween 2003 o 2014 ha 55% o all homicides agains women we e IPV- ela ed. In addi ion, 7% o homicides had adolescen ic ims; only 18% o hem had a p io his o y o iolence being in lic ed agains hem (Adhia e al., 2019). In Eu ope, Spain, Holland, I aly, and Sco land a e among he coun ies and egions wi h he lowes IPH a es, less han 0.20 mu de s pe 100,000 inhabi an s. O he coun ies, such as Albania, Iceland, Hunga y, and C oa ia, ha e highe IPH a es, abo e 0.40 mu de s pe 100,000 inhabi an s (UNODC, 2019). These da a s and in con as o he highe p e alence o IPH in coun ies such as Sweden, Iceland, and Finland, which his o ically a e much mo e equal in e ms o women’s igh s and eedom. IPH a es in some o hese coun ies app oxima ely iple he Spanish a e, a phenomenon known as he “No dic pa adox” which has no ye been clea ly explained (G acia & Me lo, 2016). Complemen a ily, in Eu ope low IPH le els do no always co espond wi h low IPV le els (UNODC, 2019). Rega ding he numbe o women mu de ed in Spain by hei male pa ne s, o icial da a indica e educ ion om abou 70 cases pe yea du ing he 2003 o 2010 pe iod o less han 50 o e he pas wo yea s (Minis y o Heal h, Social Policy, and Equali y [MSPSI, 2018]). Al hough his phenomenon has a low p e alence in Spain, he pe sonal and social impac o his iolence is e y high, equi ing he in es men o e ec i e esou ces o i s p e en ion. In Spain, he epo ed ecidi ism o one yea in IPV is 15% (López-Osso io, Loinaz, e al., 2019), and he app oxima e IPH a e is 0.30 pe 100,000 women. The need o imp o e p edic ion and p e en ion sys ems is heigh ened when hese abs ac igu es a e ansla ed in o ac ual numbe s o ic ims o his iolence. One o he mos impo an app oaches in he ield o IPV ecidi ism p e en ion in ol es isk assessmen and managemen . Violence isk assessmen has a long his o y and has also been applied in nume ous c iminal ypologies (Bloom e al., 2005; Ha is e al., 2015; Loinaz, 2017; Singh e al., 2016). In he case o IPV, i s use is pa icula ly impo an o police, who a e usually in cha ge o case managemen . In daily p ac ice, he e o e, we would ha e a p edic i e in e es (i.e., di e en ia ing cases and an icipa ing and p edic ing ypes o iolence) ocused on p e en ion (i.e., implemen ing he necessa y measu es so ha he an icipa ed ou come does no occu , especially in he mos se ious cases). G aham e al. (2019) ha e ecen ly poin ed ou ha he e is a g ea a ie y o ools ha aim o assess IPV isk. Howe e , pa o he esea ch has ocused on analyzing applica ions as de e mined by esea che s wi h an academic p o ile and no by on line p o essionals, such as he police. The deg ee o homogenei y o samples (e.g., same-sex couples o emale pe pe a o s a e no aken in o accoun ), as well as hei p edic i e, a he han p e en i e, s udy aims a e among he limi a ions o ea lie s udies. The e a e also majo di e ences in he s a is ical alidi y indica o s o he ins umen s used in p e ious esea ch, which complica es compa ison be ween s udies. In o de o p e en bo h le hal and non-le hal iolence, co ec isk assessmen is essen ial. I homicide is unde s ood as he ul ima e exp ession o iolence, i could easonably be an icipa ed ha IPV ools would adequa ely p edic his phenomenon in he p esence o a high isk. Howe e , in he majo i y o p e iously epo ed IPH i was equen ly obse ed ha he la es police isk assessmen s had low p edic i e a es because he e we e no enough isk indica o s iden i ied o wa n o he possible IPH. This has o en been e oneously in e p e ed as a ailu e o hose assessmen s (MSPSI, 2018). This homicide phenomenon, a leas pa ially di e en and much mo e complex han ecidi ism in IPV, equi es complemen a y p e en i e s a egies (Cunha & Gonçal es, 2016; Dobash e al., 2009; He on, 2017; López-Osso io e al., 2018). The need o iden i y IPH isk ac o s ha make i possible o p edic he phenomenon and iden i y people wi h he g ea es po en ial o ha m has p e iously been highligh ed (Weil e al., 2018). Resea ch on IPV isk ac o s is ex ensi e and has allowed us o con ibu e in pa allel wi h ad ances in IPH. The e iew o cu en knowledge on couples’ homicides leads us o ques ion whe he p edic ion is possible when dealing wi h subjec s ha ing di e en p o iles, di e en mo i a ions, and di e en isk ac o s (López-Osso io e al., 2018). Among a ailable s udies on he opic a e desc ip ions o a se ies o IPH (Bel age & Rying, 2004; Caman, K is iansson, e al., 2017; González-Ál a ez, Ga ido, e al., 2018; Ki i uo i & Leh i, 2012); p o iles o IPH o ende s (Dobash & Dobash, 2011; Dobash e al., 2009); di e ences be ween ba e e s and IPH o ende s (Cunha & Gonçal es, 2019; Dobash e al., 2007; Jung & S ewa , 2019); compa ison o IPH o ende s and o he homicides (Caman, Howne , e al., 2017; Dobash e al., 2004; Juodis e al., 2014); and IPH and homicides o women ou side o in ima e ela ionships (Dobash & Dobash, 2015; Loinaz e al., 2018; Za a e al., 2019). B oadly speaking, esea ch could be summa ized as ollows: mos IPH cases a e pe pe a ed by cu en o o me in ima e pa ne s; IPH sha e many cha ac e is ics wi h o he homicides, al hough IPH o ende s a e mo e no malized (socially adap ed) han pe pe a o s o o he ypes o homicide; he e is no single IPH p o ile, and o ende ypologies mus always be es ablished; many cases do no ha e an o icial his o y o p e ious iolence; inally, p e alence o hese cases is e y low. As a consequence o hese ac o s, p edic i e abili y is e y complica ed. Con adic o y s udies poin o di e en ial p edic o s and less no malized p o iles in IPH (Eke e al., 2011; Juodis e al., 2014; Ki i uo i & Leh i, 2012). Because o his he e ogenei y and he dimensional na u e o iolence, IPV isk assessmen ools end o ha e a global p edic i e a ge – e.g., Spousal Assaul Risk Assessmen guide (SARA), B ie Spousal Assaul Fo m o he E alua ion o Risk (B-SAFER), P o ocolo de Valo ación del Riesgo de Violencia con a la Muje po pa e de su Pa eja o Expa eja (RVD-Bcn) –, al hough some ha e ocused in pa icula on p edic ing homicide – e.g., Dange Assessmen (DA) – o mo e se ious assaul s – e.g., Valo ación Policial del Riesgo (VPR), Escala de P edicción del Riesgo de Violencia G a e con a la pa eja- Re isada (EPV-R), On a io Domes ic Assaul Risk Assessmen (ODARA). Pe o mance pa ame e s o di e en ools ha e been e iewed and published in a a ie y o pape s (Nicholls e al., 2013). In summa y, indings ela ed o eliabili y and alidi y o hese isk assessmen ools a e simila o hose ob ained wi h Spanish ools (Echebu úa e al., 2010; Loinaz, 2014; López-Osso io e al., 2016; López-Osso io, González-Ál a ez, e al., 2019). In some cases, i has been poin ed ou ha he combined use o wo ools wi h di e en o ma s, such as SARA and ODARA, inc eases hei p edic i e capaci y (Ol e & Jung, 2017). A p oblem o IPH p edic ion a ises when he homicidal agg esso does no p esen isk ac o s and escapes assessmen sys ems (Dixon e al., 2008). In a ecen me a-analysis, Spence and S i h (2018) poin o ac o s wi h he g ea es po en ial o p edic ing IPH: di ec access o a gun, his o y o non- a al s angula ion, ape o he ic im, h ea s wi h a weapon, con olling beha io s, and p e ious h ea s o ha m. In addi ion, nume ous pape s poin o he impo ance o ob aining da a on suicide indica o s o p e en hese homicides (B idge e al., 2017). S udies such as hose by Campbell e al. (2003) also sugges he exis ence o isk ac o s ha p edic IPH: his o y o mis ea men , sepa a ion p ocesses, ha assmen , subs ance abuse, men al diso de , and access o i ea ms, gi ing ise o he de elopmen o he DA ool (Campbell, 2012; Campbell & Glass, 2009; Campbell e al., 2003; Campbell e al., 2009), which was designed o applied use as a ic im in e iew echnique. Policing ools end o ha e an easy- o-apply ac ua ial design ha seeks bo h o maximize esponse po en ial and o s eamline he implemen a ion p ocess (Messing, Campbell, Sulli an, e al., 2017). An in e na ional example is he On a io Domes ic Assaul Risk Assessmen (ODARA) (Hil on & Eke, 2016; Hil on e al., 2001; Hil on e 49 In ima e Pa ne Homicide Risk Assessmen by Police in Spain: The Dual P o ocol VPR 5.0 -H al., 2004), which con ains 13 unweigh ed isk ac o s ha link esul s o ecidi ism a es. This ool has been used in se e al ways: o analyze use ulness o online aining o use s (Hil on & Ham, 2015), as an indica o o emale pe pe a o s’ isk (Hil on e al., 2014), and o he assignmen o app op ia e ea men o di e en agg esso s (Rada z & Hil on, 2019). On he o he hand, adap a ions o s uc u ed judgmen ools o his con ex ha e ended o be b ie , such as he B-SAFER de i ed om SARA (K opp, 2008; Loinaz, 2014; S alin e al., 2018), o a b ie e sion o DA (Messing, Campbell, Sulli an, e al., 2017). The ield o police p edic ion has also unde gone no able de elopmen s wi h he c ea ion o new ools in he in e na ional en i onmen , such as SVRA-I (Dayan e al., 2013) o VP-SAF R (McEwan e al., 2019), o in he Spanish ield wi h Police Risk Assessmen (VPR) (López-Osso io e al., 2017; López-Osso io, González-Ál a ez, e al., 2019), and EPV-R (Echebu úa e al., 2010). In addi ion, analysis o police isk managemen has also been a ocus o a en ion (Bel age e al., 2012; McEwan e al., 2017; Pe ez T ujillo & Ross, 2008; S o ey e al., 2014; S alin e al., 2018; S alin e al., 2017). The e a e o he speci ic ools o assessing IPH isk, such as MOSAIC-20 o he Ma yland Ne wo k Agains Domes ic Violence h ough he Le hali y Sc een o Fi s Responde s ques ionnai e (Messing, Campbell, Sulli an, e al., 2017). In Spain, wo k on Fo m VPR4.0 obus ness allowed i s e olu ion o e sion 5.0 (López-Osso io, Loinaz, e al., 2019), s abilizing pe o mance pa ame e s o one yea , inco po a ing a new indica o linked o agg esso s unde he age o 24 and consolida ing i s 35 cu en isk indica o s (see Me hod sec ion o a mo e de ailed discussion). These adjus men s ha e educed he ma gin o e o ( alse posi i e) o he lowes le els o isk o be ween 8.3-13.7%, and he wo highes le els o isk p o ide a co ec classi ica ion o 54.1% o ecidi ism in hei ca ego ies. I also achie es some imp o emen s in i s pe o mance pa ame e s (Cabine o Coo dina ion and S udies, 2017: sensi i i y 82%, speci ici y 34%, AUC = .64 [.62, .66], PPV 17%, NPV 92%, OR = 2.4 [2.0, 2.8]). Despi e being an ac ua ial sys em, i s ocus is no only on isk assessmen , bu especially on isk managemen (which is mo e common in s uc u ed p o essional judgmen me hodologies han in ac ua ial sys ems), wi h di e en speci ic mechanisms managed and coo dina ed om he VioGén Sys em. Thus, one o he inhe en consequences o esea ch is ha isk managemen ends o a ec alse posi i es due o ic im p o ec ion ( isk subjec s who a e managed and who, he e o e, a e no expec ed o elapse despi e ha ing been gi en a high- isk de e mina ion). Since IPV and IPH p edic ion may s em om di e en ac o s, he aims o his s udy we e i s o de e mine speci ic IPH isk ac- o s, in con as o hose o gene al IPV in Spain and, second, o imp o e IPH p edic ion h ough he de elopmen and alida ion o a new scale o p o ide an es ima ion o homicide isk complemen- a y o he main algo i hm o he VPR5.0-H scale. Me hod Pa icipan s In 2007, he Spanish Minis y o he In e io implemen ed he VioGén Sys em (González-Ál a ez, López-Oso io, e al., 2018), which collec s and manages all na ional in o ma ion, mos ly om police epo s, on in ima e pa ne iolence agains women. The sys em co esponds wi h he ac ua ial ecidi ism isk assessmen ool used by specialis police o ice s (VPR5.0) o a icula e p o ec ion measu es based on he le el o isk. Cases a e pe iodically e-e alua ed using a complemen a y o m (Police Risk E olu ion Assessmen ) (VPER4.1; López-Osso io, González-Ál a ez, e al., 2019). A o al o 2,159 eco ds om he VioGén Sys em we e used in he cu en s udy. In all he eco ds, he pe pe a o was a man and he ic im a woman. O hese, 2,000 (92.6%) did no esul in dea h (con ol g oup; N-IPH) and 159 (7.4%) we e IPH (case g oup). The 2,000 eco ds o he N-IPH g oup co esponded o andom denuncia ions egis e ed in he VioGén Sys em in he las qua e o 2016. In his g oup, ic ims had an a e age age o 34.5 yea s ( SD = 13.03, ange = 13-68). Repo ed agg esso s’ mean age was 36.51 yea s ( SD = 14.57, ange = 14-68); 65.7% o he ic ims and 67.9% o hose epo ed we e o Spanish na ionali y; 65.0% o complain s we e iled in u ban a eas and 35.0% in u al a eas, es ima ed acco ding o e i o ial compe ences o police o ces. A o al o 159 homicides om he sample, o which isk assess- men in o ma ion was a ailable, occu ed be ween Feb ua y 2006 and Sep embe 2018 (only 14.5% o IPH occu ed be o e 2011, and 55.3% a e 2013), a pe iod in which 759 IPHs we e commi ed as con i med by he Go e nmen Delega ion o Gende Violence. Thus, he sample o homicides co esponds o 20.9% o he o al o ha pe iod. A e age age o women who died was 41.49 yea s old ( SD = 14.66, ange = 14-77) and 68.0% we e Spanish; 27.6% o he sample had p e iously denounced he agg esso o a leas one episode o iolence (pe cen age simila o he 25.9% o denuncia- ions p esen in he o al numbe o IPH cases o he men ioned pe iod). Rega ding homicides, a e age age was 46.38 yea s ( SD = 14.56, ange = 19-86) and 70.7% we e Spanish; 48.7% o IPH cases occu ed in u ban a eas and 51.3% in u al a eas. The pe cen age o suicide consumma ed a e he homicide o he analyzed sample was 22.0%, and in all homicides o he pe iod i was 20.2%. I is con- side ed ha samples a e ep esen a i e o hei s udy popula ions and compa able, excep o he ac ha o IPH cases do no main- ain he same empo al co espondence o simul anei y o N-IPH cases due o he ac ha he empo al ange had o be ex ended because o he low p e alence o homicides. Ins umen Fo m VPR5.0, composed o 35 dicho omously coded isk ac o s (p esen /absen ), p o ides i e le els o isk: unapp ecia ed, low, medium, high, and ex eme. Fac o s a e g ouped in o i e dimen- sions: 1) his o y o in ima e pa ne iolence; 2) ac o s ela ed o he o ende ; 3) indica o s ela ed o ic ims’ ulne abili y; 4) ci - cums ances ela ed o mino s; and 5) agg a a ing ci cums ances and subjec i e aspec s o a ic im’s own isk. Design and P ocedu es Fo he de elopmen o he s udy we used an epidemiological design, obse a ional analy ical cases (IPH) and con ols (N-IPH), which allows he cons uc ion o a p edic i e le el model based on bi a ia e s a is ics o know odds a io ( OR ) o ac o s p edic ing IPH, and mul i a ia e p ocedu es o analyze con usion o measu es. Fo he 159 homicides, e alua ions o cases wi h a p e ious epo we e used, and VPR5.0 in un epo ed cases we e comple ed by p o essionals wi h he same aining conside ing he in o ma ion g an ed by Spanish a ali y e iew eams (González-Ál a ez, Ga ido, e al., 2018). Six hund ed eco ds we e andomly selec ed om he 2000 N-IPH (non-le hal iolence) ha , oge he wi h he 159 IPH cases (600+159), o med a i s da a ma ix used o iden i y isk ac o s p obabilis ically associa ed wi h IPH e en s h ough con ingency ables and es ima ion o hei OR. The a io o IPH and N-IPH was e y close o 1:4, inc easing he numbe o “con ols” pe “case” o he maximum ad isable o epidemiological s udies, especially in he iden i ica ion o isk ac o s wi h ou comes o low p e alence o “ a e e en s”, as s a is ical powe inc eased (Fle che e al., 2014). Once he isk ac o s we e ob ained, he nex s ep was he de elopmen and alida ion o he H-Scale. In o de o maximize s abili y o measu es, a p ocedu e o c oss alida ion wi h wo o he ma ices was chosen, so ha o he de elopmen ma ix 60% o he andomized sample o IPHs and N-IPHs was used ( n = 936), and o ob aining alida ion pa ame e s ( alida ion ma ix) he emaining 40% ( n = 623), ollowing he same 50 J.J. López-Osso io e al. / Psychosocial In e en ion (2021) 30(1) 47-55 P edic o s Coe icien (χ²) % Valid OR 95% CI ( n = 759) Signi ican posi i e ela ionship Suicide h ea s om he agg esso 8.087*** [4.014, 16.295] 45.685 99.9 The pe pe a o shows exagge a ed jealousy o suspec ed in ideli y o his pa ne in he las six mon hs. 1.507* [1.057, 2.149] 5.175 93.9 The pe pe a o shows con olling beha io s in he las six mon hs. 1.725** [1.202, 2.478] 8.839 94.9 P esence o p oblems in his li e (s ess) in he las six mon hs. 3.338*** [2.298, 4.850] 42.153 85.5 The pe pe a o has economic o wo k- ela ed p oblems in he las six mon hs. 6.324*** [4.247, 9.419] 94.955 100 P esence o pas b eakings o sen ence condi ions 2.634** [1.384, 5.011] 9.292 96.7 P esence o physical o sexual agg ession eco ds 1.577* [1.031, 2.412] 4.455 97.1 The pe pe a o p esen s a men al o psychia ic diso de 3.384*** [2.003, 5.716] 22.659 88.0 P esence o suicidal ideas o a emp s 1.994** [1.300, 3.057] 10.262 92.0 P esence o any kind o disabili y in he ic im 2.020* [1.033, 3.952] 4.374 98.2 Men al o psychia ic diso de in he ic im 3.221*** [1.682, 6.168] 13.672 97.0 Any kind o addic ion o engages in subs ance abuse (alcohol and d ugs) in he ic im. 5.101*** [2.784, 9.346] 32.989 95.9 His o y o gende o domes ic iolence wi hin ic im’s amily. 4.063*** [1.941, 8.502] 15.919 100 Non-signi ican posi i e ela ionship Psychological iolence 0.525* [0.357, 0.774] 10.794 98.0 Physical iolence 0.340*** [0.237, 0.486] 36.430 99.3 Sexual iolence 1.539 [0.875, 2.706] 2.270 97.4 Th ea ened ic im wi h a cu ing weapon 1.082 [0.483, 2.423] 0.370 100 Th ea ened ic im wi h a i ea m 3.791 [0.236, 60.947] 1.022 100 Mino h ea s o ha m he ic im 0.448*** [0.301, 0.666] 16.129 72.3 An escala ion o agg ession in he las 6 mon hs 0.665* [0.456, 0.942] 5.261 95.1 In he las yea he agg esso has caused ma e ial damage 0.329*** [0.505, 0.230] 22.501 94.7 In he las yea hey ha e dis espec ed an au ho i y igu e 0.760 [0.385, 1.501] 0.627 92.0 In he las yea hey ha e commi ed an agg ession agains hi d pa ies o animals. 0.560 [0.302, 1.039] 3.459 93.0 In he las yea hey ha e made h ea s and sligh s owa ds hi d pa ies. 0.636 [0.402, 1.006] 3.791 91.3 P esence o a c iminal eco d 1.015 [0.713, 1.443] 0.007 100 P esence o eco ds o gende iolence agains o he in ima e pa ne s. 0.507* [0.285, 0.901] 5.537 96.7 P esence o any ype o addic ion o abuse o alcohol o d ugs. 0.875 [0.613 ,1.248] 0.545 92.6 The agg esso has a amily his o y o being abused 0.668 [0.377, 1.184] 1.928 73.4 Vic im has no social suppo 1.174 [0.750, 1.838] 0.491 96.4 Vic im o o eign o igin 1.386 [0.941, 2.041] 2.736 99.6 Vic im is economically dependen on he agg esso 1.318 [0.837, 1.992] 1.729 95.5 The ic im has mino s’ membe s unde hei ca e 0.463*** [0.322, 0.665] 17.776 98.0 The ic im has su e ed gende iolence by he hands o o he agg esso s in he pas . 0.487* [0.275, 0.863] 6.291 98.7 The ic im has communica ed o he agg esso hei desi e o end he ela ionship a leas 6 mon hs ago. 0.521*** [0.365, 0.745] 13.046 95.0 The ic im hinks ha he agg esso is capable o killing he . 0.131*** [0.076, 0.225] 67.242 87.7 Table 1. Risk P edic o s o In ima e Pa ne Homicide IPH ( N = 759) No e. OR = odds a io; 1CI 95%. signi ican alue ( ) o isk * p <. 05, ** p <. 01, *** p < .001. 51 In ima e Pa ne Homicide Risk Assessmen by Police in Spain: The Dual P o ocol VPR 5.0 -H p ocedu e o a oid duplici y and ha no con ol was eally a case o ha was epea ed in wo ma ices. Due o he ac ha he esea ch p ojec was o ien ed om he be- ginning o he cons uc ion and alida ion o a p ocedu e ha would allow o imp o e p edic ions o he IPH isk, h ee equi emen s we e es ablished: IPH isk ac o s had o demons a e hei associa ion wi h he mo al ou come, ob aining hei own ma hema ical weigh (OR), no ma e i i was di e en om he one used o he lowe in ensi y elapse; isk ac o s had o be sha ed wi h he base ins umen al eady in use (VPR5.0) o a oid agen s ha ing o make wo assessmen s; and, inally, he ul ima e p edic i e model should imp o e cu en VPR5.0 p edic ions o IPHs. Da a Analysis IBM S a is ical Package o Social Sciences (SPSS 20) was used. In- dependen a iables we e isk ac o s om VPR5.0, and he dependen a iable was a al ou come. To de e mine s a is ical signi icance, con- ingency ables we e used and Pea son and OR es χ2 was calcula ed. In o de o e i y ha esul s o con ingency ables a e no due o chance, i was con i med ha OR alue ange did no con ain he uni and he condi ional independence es χ2 o Man el-Haenszel was es ima ed. Raw OR esul s om he bi a ia e model we e also op imized h ou- gh bina y logis ic eg ession. Pe o mance pa ame e s we e es ima ed using he elemen s o es disc imina ion ( OR , sensi i i y, and speci i- ci y) and calib a ion wi h he posi i e p edic i e alue (PPV) and he nega i e p edic i e alue (NPV). The s a is ical analyses o p edic i e alidi y we e comple ed wi h ROC cu es o ob ain he a ea unde he cu e (AUC). Resul s IPH Risk Fac o s The analysis o IPH p edic o s wi h he i s ma ix (600 + 159) showed ha 13 o he 35 indica o s p esen in VPR5.0 we e signi ican ly associa ed wi h a al ou comes (see Table 1). OR ob ained anged om 1.507 o he agg esso ’s jealousy o 8.087 o his suicide h ea s. A hi d o indica- o s belonged o ci cums ances o he ic im, and mos o pe pe a o ’s sphe e. The esul s o he bina y logis ic eg ession analysis showed ha six ac o s could co ec ly classi y 86.3% o cases (Table 2). H-Scale De elopmen and Pe o mance Pa ame e s One o he aims o he s udy was o de elop an IPH isk assessmen ool ha could be used by he compu e sys em a he same ime ha he global ool (VPR5.0) is applied by police o ice s/clinicians, and a ious es s we e ca ied ou o assess he bes op ion and p edic o s. The i s echnical ini ia i e was aimed a imp o ing p edic ion o IPH wi h he VPR5.0, including new weigh s ob ained o he 13 signi ican ac o s (Table 1). Howe e , he di e en combina ions did no show any op imal esul s, because i he p edic ion o IPH was imp o ed ha o ecidi ism would dec ease, and ice e sa. The p edic i e model de i ed om he six isk ac o s o he logis ic eg ession o e ed simila esul s o ha o he 13 ac o s. Gi en hese esul s, i was decided ha he H-Scale be cons uc ed using he 13 isk ac o s. Once he esul s o he ROC cu e we e ob ained, he bes cu -o poin s we e op imized o h ee isk le els classi ied by he H-Scale: low le el up o 3.232, medium le el up o 12.883, and high le el wi h sco es abo e 12.883. The cons uc ion me hod was o an ac ua ial weigh ed addi i e ype, adding he speci ic OR alue wi h he IPH o each p esen i em. As a sc eening mode, he aim was o educe he a e o alse nega i es (FN), aluing sensi i i y o e speci ici y. In he alida ion ma ix, low isk le el comp ised 56.0% o he sample and 15.9% o he IPH (FN); medium isk le el comp ised 31.3% o he sample and 36.5% o he IPH; and high isk le el comp ised 12.7% o he sample and 47.6% o he co ec classi ica ion o IPH, wi h a ue posi i e a e o 84.1% (TP). Pe o mance pa ame e s wi h espec o p edic i e alidi y, calcula ed wi h a de elopmen ma ix and a alida ion ma ix, showed high consis ency (Table 3), wi h g ea simila i y o AUC alues con idence in e als. Es ima o s ound in bo h ma ices we e e y simila . OR as indica o s o measu e o e ec and inc ease o isk anged om 6.70 o 8.13. OR o high- isk le el was 9.481 (5.336, 16.844, p < .001); hus, a isk assessmen o his classi ica ion inc eases almos 10 imes he p obabili y o an ex emely se ious e en . Sensi i i y anged om 81% o 84% and speci ici y om 61% o 60%. PPV, which indica es he p opo ion o pe cen age o indi iduals co ec ly classi ied as a isk, s ood a 19%, despi e he ac ha he pe cen age o alse posi i es emained high. NPV, which indica es he p opo ion o indi iduals co ec ly classi ied as low isk, eached 97%. O he o al numbe o cases classi ied as low isk (56.0%), only 2.9% we e inco ec ly classi ied. The cu -o poin a low isk le el was used o make hese calcula ions. P edic o s B SE Wald χ2 p exp( B ) 95% CI [lowe -uppe ] Suicide h ea s om he agg esso 1.743 0.552 9.978 .002 5.714 [1.938, 16.849] The pe pe a o shows con olling beha io s in he las six mon hs 0.700 0.309 5.132 .023 2.015 [1.099, 3.693] The pe pe a o has economic o wo k- ela ed p oblems in he las six mon hs 1.562 0.321 23.707 .000 4.768 [2.543, 8.941] P esence o physical o sexual agg ession eco ds 0.956 0.392 5.937 .015 2.602 [1.206 ,5.614] The pe pe a o p esen s a men al o psychia ic diso de 1.492 0.402 13.782 .000 4.446 [2.022, 9.773] P esence o any kind o disabili y in he ic im 1.286 0.636 4.091 .043 3.617 [1.041, 12.571] Table 2. Logis ic Reg ession Coe icien s o Bina y Ou comes No e . EXP( B ) = haza d a ios; CI = con idence in e al; SE = s anda d e o . Model summa y. Cox & Sell’s chi-squa e R2 = .153; Nagelke ke’s chi-squa e R2 = .279; Hosme & Lemeshow’s χ2 (4, n = 623) = 5.00. p = .287. 52 J.J. López-Osso io e al. / Psychosocial In e en ion (2021) 30(1) 47-55 Pe o mance pa ame e s De elopmen ma ix ( n = 936) H-Scale Valida ion ma ix ( n = 623) H-Scale OR 6.70 [3.94, 11.39] 8.13 [4.05, 16.32] Sensi i i y .81 .84 Speci ici y .61 .60 AUC .81 [ .76, .86] .80 [.74, .86] PPV1 .19 .19 NPV .97 .97 Table 3. E icacy and Gene al P edic i e Validi y o To al Sco es in De elopmen and Valida ion Samples o he H Scale No e . CI = 95%; OR = odds a io; AUC = a ea unde he ecei e ope a ing cha ac- e is ic cu e; PPV= posi i e p edic i e alue; NPV= nega i e p edic i e alue. 2Base a e (%) de elopmen ma ix = 10.25% and alida ion ma ix= 10.11%. The AUC ob ained om he H-Scale was .80 (IC .74 - .86), he s anda d e o was low o a iance es ima ion o he a ea and he p - alue was e y signi ican , being able o de e mine ha his es- ima o o e s good disc iminan capaci y. Figu e 1 illus a es di e- ences in p edic i e capabili y o he H-Scale and non-dual Fo m VPR5.0 o es ima ing IPH isk. Discussion The aim o he s udy was o es whe he ac o s in he VPR5.0, he Police Risk Assessmen Fo m o IPV ecidi ism used by mos law en o cemen agencies in Spain, we e capable o disc imina ing IPH cases. In addi ion, he idea was o de elop a speci ic ool o he p edic ion o homicide ha could be co ec ed by he sys em a he same ime as VPR5.0 was applied (same applica ion o VPR allows o co ec a pa allel algo i hm speci ic o homicide wi h speci ic signi ican ac o s). O he 35 isk ac o s p esen in he ool, 13 we e signi ican ly associa ed wi h IPH, wi h e ec sizes di e en om p edic ion o non-le hal IPV. Fou ac o s om a ic im’s sphe e we e ele an , which had no been obse ed in p e ious s udies ega ding p edic ion o isk o non-le hal ecidi ism (López-Osso io e al., 2017). This aspec would con i m di e ences poin ed ou be ween IPV and IPH, al hough he e a e also common isk ac o s in bo h o ms o iolence (Cunha & Gonçal es, 2019). On he o he hand, i should be no ed ha he agg esso ’s suicide h ea s, iola ion o es aining o de s, suicide idea ion and a emp s, he ic im’s su e ing om some o m o men al illness, and he expe ience o IPH in he ic im’s amily en i onmen had no appea ed as ele an o IPH p edic ion in p e ious s udies, as shown by he me a-analysis by Spence and S i h (2018). Clinical ci cums ances o he agg esso and he ic im appea o be impo an in IPH e en s, especially in he agg eso ’s pa asuicidal sphe e, elemen s ha a e no so p ominen in IPV iolence isk assessmen (Loinaz, 2017). Con a y o wha migh be expec ed (Campbell e al., 2003), ac o s such as a his o y o complain s ega ding p e ious episodes o iolence, p esence o physical o sexual iolence, and use o weapons did no p o e o be a di e en ia ing ac o be ween a non-le hal epea episode and an IPH. The possible explana ion is ha he IPH sample used in his s udy is de i ed no only om cases wi h p e iously epo ed iolence (27.6%), bu also om o he s ha p esen di e en cha ac e is ics, including 22% o homicide cases ollowed by suicide (López-Osso io e al., 2018). The esul s in his sense would be simila o hose ound in he compa ison o IPH and IPH in Po ugal (Cunha & Gonçal es, 2019). The H-Scale, composed o 13 ac o s, p esen s a sensi i i y o 84% and a speci ici y o 60%, alues sui able o his con ex o applica ion. These alues a e simila o hose ob ained wi h he DA-5 o he same objec i e: sensi i i y 86% and speci ici y 56% (Messing, Campbell, & Snide , 2017; Snide e al., 2009). The balance be ween sensi i i y and speci ici y alues is always a complica ed decision ha mus be made on he basis o da a ob ained and conside ing he con ex o applica ion (Messing & Campbell, 2016). The speci ici y should no be o e y low alue in o de o a oid o e s e ching police esou ces o he p o ec ion o ic ims. On he o he hand, on line p o essionals need pa icula ly sensi i e sc eening ools o de ec as many cases o in e es as possible, e en hough alse posi i es a e inc easing mode a ely (Messing, Campbell, & Snide , 2017). In subsequen assessmen s in he ield o c iminal jus ice, whe e judicial decisions a e o g ea signi icance o de endan s, g ea e ca e should be aken o ensu e ha he alue o speci ici y is conside ed. The e ec size and p edic i e capabili y ( OR = 8.13 and AUC = .80), oge he wi h he es o disc imina ion and calib a ion pa ame e s ob ained (PPV = .19 and NPV = .97), a e also compa able o hose o le hal IPV p edic ion in he ew s udies ha epo hem, such as he applica ion o Le hali y Sc een (Messing, Campbell, Sulli an, e al., 2017). These esul s con i m hose ob ained in o he esea ch (G aham e al., 2019) and show ha he specializa ion o iolence isk assessmen ins umen s achie es highe pe o mance pa ame e s (McEwan e al., 2019). I is impo an o no e ha , unlike simila s udies such as hose de eloped o VPR by es ima ing ecidi ism, in he cu en wo k mos cases we e no unde police p o ec ion o o he ci cums ances ha may modi y p edic i e alidi y esul s o he ins umen . The impo an indings o his s udy ha e salien p ac ical implica ions. Al hough he H-Scale can be used by di e en p o essionals o es ima e he speci ic isk o IPH, in con ex s whe e subsequen isk managemen is equi ed (such as policing), he esul s ob ained show ha o imp o e combined es ima es o ecidi ism and homicide, a dual mechanism o measu emen is ecommended. The e o e, a i s esul is ob ained o isk o ecidi ism in IPV wi h VPR5.0 and ano he speci ic esul o Figu e 1. ROC Cu e o he H-Scale and Non-dual Fo m VPR5.0 o Es ima ing IPH Risk. Valida ion Sample ( n = 623). 1 - Speci ici y Sensi i i y AUC SD p 95% CI H-Scale .802 .032 .000 [.739, .865] VPR5.0 .540 .039 .292 [.466, .616] 1.0 .8 .6 .4 .2 00.2 .4 .6 .8 1.0 H-Scale VPR5.0 53 In ima e Pa ne Homicide Risk Assessmen by Police in Spain: The Dual P o ocol VPR 5.0 -H isk o homicide using he H-Scale, which allows he le el o isk o be au oma ically adjus ed om he wo es ima es: ecidi ism and homicide. This en ails a special deg ee o p o ec ion o cases iden i ied as mo e se ious (speci ically, in cases ini ially classi ied as unapp ecia ed isk, low, and medium isk). This new combined p ocedu e is called VPR5.0-H and p o ides in o ma ion on bo h isks (IPV and IPH) independen ly and in eg a ed in o a single isk epo (Sec e a ía de Es ado de Segu idad [SES, 2019]). Thus, a e he agen assesses cu en VPR5.0 isk ac o s he VioGén Sys em p o ides a le el o ecidi ism isk ha is e-e alua ed by he H-Scale. This second au oma ic analysis makes i possible o iden i y he isk o IPH a unapp ecia ed, low, and medium le els o VPR5.0 and o eclassi y cases wi h he highes isk o IPH a le els highe han hose ini ially ob ained, hus inc easing hei p o ec ion. The di e en i ine a ies ha can lead o an ou come as iolen as IPH lead us o conside he unknowns aised by many cases and which may be in isible o adi ional p e en ion mechanisms employed in he ace o non-le hal IPV agg essions. The esul s o his s udy sugges ha calib a ion o alida ed ins umen s o p edic IPV may be inadequa e o many po en ial cases o le hal iolence, especially conside ing he possibili y ha he e had no been a p e ious complain . While i canno be de ini i ely s a ed ha he e a e many isk ac o s speci ic o IPH, his esea ch highligh s ha main axis o analysis is o know as igo ously as possible hei ele ance, which has been p esen ed in his s udy h ough he size o he speci ic e ec o IPH isk ac o s. We unde s and ha he new VPR5.0-H dual p ocedu e app oaches his objec i e and also p o ides quali y in o ma ion o isk managemen by epo ing mo e accu a e in o ma ion o he Jus ice Sys em o addi ional isk assessmen s (Messing & Thalle , 2013). The e alua ing agen will ob ain he inal esul in a compu e ized o m and, in hose alua ions iden i ied as highe isk, he VioGén Sys em quali a i ely complemen s he epo ha is usually sen o he Jus ice Sys em on police isk assessmen . A u he pu pose is o p opose a complemen a y isk assessmen by o ensic eam p o essionals while he isk is managed by police o ice s. The new ool is p esen ly calib a ed o use in he police ield, whe e isk managemen assessmen akes p ecedence. Howe e , in o he p o essional ields, such as he Jus ice Sys em, i s usage migh bene i om ecalib a ion (Muñoz & López-Osso io, 2016). Following in e na ional p e en i e ecommenda ions, wi hin he amewo k o he ecological model, which con ibu es o “mo e e icien and e ec i e isk assessmen s” (UNODC, 2018); Weil e al., 2018), IPH isk p e en ion should no conclude wi h police ac ions bu should be in eg a ed in a coo dina ed and syne gis ic manne wi h o he ins i u ions. The s udy p esen s some limi a ions ha should be conside ed. Despi e homicide cases accoun ing o 20.9% o he o al numbe o cases in he pe iod, which was a ep esen a i e pe cen age, hey may no ha e included all o he casuis y o a phenomenon as complex as IPH. The in o ma ion used o he analysis o isk ac o s comes only om VPR5.0 indica o s and, as p e ious s udies ha e indica ed, he e a e ce ainly o he ypes o impo an indica- o s associa ed wi h IPHs ha ha e no been conside ed in his e- sea ch because hey a e no accessible o police o ice s (Spence & S i h, 2018). Fu u e esea ch should s udy hese aspec s in o de o de e mine whe he he e a e o he ypes o isk ac o s ha make i possible o de ec and p e en hese e en s, especially in heal h o social con ex s, ha make i easie o p o ec women who do no epo o he police. VPR5.0-H is a compu e ized ool used by police o ces in Spain, a ac ha limi s he eplicabili y o he esul s by eams ou side he VioGén Sys em. The use ulness o he a iables ha comp ise he p edic ion sys em in applica ions dis inc om he cu en one is a challenge ha would allow us o deepen ou knowledge o ypes o agg esso samples in he u u e. Con lic o In e es The au ho s o his a icle decla e no con lic o in e es . Re e ences Adhia, A., Ke nic, M. A., Hemenway, D., Va ilala, M. S., & Ri a a, F. P. (2019). In ima e pa ne homicide o adolescen s. JAMA Pedia ics . h ps:// doi.o g/10.1001/jamapedia ics.2019.0621 Bel age, H., & Rying, M. (2004). Cha ac e is ics o spousal homicide pe pe a o s: A s udy o all cases o spousal homicide in Sweden 1990- 1999. 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