Elbogen et al developed teh Violence Screening and Assessment of Needs (VIO-SCAN) to screen a military veteran for risk of violence. The authors are from the University of North Carolina, Duke University, University of Southern California, Oregon Health & Sciences University and the Veterans Administration.
Patient selection: military veteran
Outcome: risk of severe violent behavior in the next year
Parameters:
(1) financial instability (able to cover food, clothing, housing, social activities, etc each month)
(2) combat experience (witness someone being seriously wounded or killed)
(3) alcohol misuse (asked to cut down use, or someone expressed concern)
(4) history of violence towards others and/or arrests
(5) post-traumatic stress disorder (PTSD) AND number of episodes of anger or irritation during the past week
|
Parameter
|
Finding
|
Points
|
|
financial instability
|
no
|
0
|
|
|
yes
|
1
|
|
combat experience
|
no
|
0
|
|
|
yes
|
1
|
|
alcohol misuse
|
no
|
0
|
|
|
yes
|
1
|
|
history of violence
|
no
|
0
|
|
|
yes
|
1
|
|
PTSD and violence
|
probable PTSD AND >= 4 episodes in past week
|
1
|
|
|
other
|
0
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk of violent behavior.
|
Total Score
|
Violence in Next Year
|
|
0
|
3%
|
|
1
|
5-7%
|
|
2
|
11-12%
|
|
3
|
19-21%
|
|
4
|
32-37%
|
|
5
|
41 to 54%
|
Limitations:
• The instrument is not an actuarial tool.
• It is a screening instrument and not a comprehensive risk assessment for violent behavior.
Performance:
• The area under the ROC curve was 0.74 to 0.78 for a national survey of military veterans.
