A Screen to Predict Violence in Military Veterans

Predicting violence in individuals is challenging and important, particularly in returning military veterans. Federally funded investigators developed the Violence Screening and Assessment of Needs instrument (VIO-SCAN) and applied it in two samples of post-9/11 veterans. Its five questions, in “yes” or “no” format, address financial instability (insufficient money to pay for ordinary needs), combat experience (witnessing serious injury or death), alcohol misuse, history of lifetime noncombat violence or arrest for crime, and probable post-traumatic stress disorder plus past-week irritability or angry outbursts. Severe violence was defined as using a knife or gun against someone, threatening to use a lethal weapon, beating up someone, or physically forcing a person to have sex.

In a national survey of 1090 veterans who completed self-reports and had 1-year follow-up, the predicted probability for severe violence during follow-up was 0.025 for a VIO-SCAN score of zero, compared with 0.539 for a score of 5. In a self-selected sample of 197 veterans with in-depth assessments (interviews, self-reports, and collateral informants' reports), the predicted probability for severe violence during 1-year follow-up was around 0.40 for a score of 5. In both samples, VIO-SCAN scores were linearly related to risk for subsequent violence; the predicted probability for severe violence at follow-up started at roughly 0.2 for scores ≥3.