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Domestic Violence: The Perpetrators Are Our Patients Too-Reply

Terrence Conway, MD
Arch Intern Med. 1996;156(22):2626. doi:10.1001/archinte.1996.00440210158017.
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Perpetrators and victims of violence share similar profiles.1 Platt suggests that violence might be prevented by identifying violent offenders and those with a propensity to commit violent acts. In our previous study of the prevalence of violence in an urban public hospital walk-in clinic, 1 in 10 respondents admitted to having committed acts of serious physical violence.2 I appreciated Platt's thoughtful comments. However, it is unclear whether screening for violent perpetration or unusual anger adds value to the screening and intervention of violence. In addition, there are, to my knowledge, no clear and authoritative recommendations to screen for either anger or potential perpetrators at the present time. Programs to decrease violence in schools through conflict resolution training have not shown evidence of long-term changes in behavior or risk of victimization in enrolled youth.3 It is difficult to recommend this screening if interventions to decrease risk are unavailable.


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