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The Quantification of Violence Scale: a Simple Method of Recording Significant Violence

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London, p.tyrer{at}imperial.ac.uk

Sylvia Cooper

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Elizabeth Herbert

Imperial College Medical School, Exhibition Road, London

Conor Duggan

Department of Forensic Mental Health, University of Nottingham, Nottingham

Mike Crawford

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Eileen Joyce

Institute of Neurology, University College London, Box 19, The National Hospital for Neurology and Neurosurgery, London

Deborah Rutter

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Helen Seivewright

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Sandra O'Sullivan

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Bharti Rao

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Domenic Cicchetti

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Tony Maden

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London

Background: Although there are many rating scales recording the incidence and intensity of violence there are none that are specifically concerned with the measurement and assessment of severe violence.

Aims: To develop a scale sensitive to variation centred on severe violence, establish its normative values, test its feasibility, and assess its reliability and validity in different populations.

Method: The Quantification of Violence Scale (QOVS) was developed in two stages. First, a list of 30 commonly eXperienced violent episodes in clinical psychiatric practice were evaluated and tested by weighting each episode by severity. Second, a numerical scale used to record the severity of the episode according to its degree of planning, intent and consequences. Violent episodes in two clinical populations were compared using the Modified Overt Aggression Scale (MOAS) and the preliminary version of the QOVS over periods up to 18 months, following which the numerical scale was developed.

Results: Good (0.60—0.74) to EXcellent (> 0.75) test—retest and inter-rater reliability agreement was obtained with both forms of the scale (intra-class correlations of 0.75 and 0.69 respectively), and similar agreement with MOAS scores was reached (0.67) in clinical populations. The scale was quick and easy to use in practice, and a score defining severe violence (9 on the numerical scale and 16 on the matched scale) was determined.

Conclusions: The QOVS, in its two forms, is a useful measure of recording significant violence in clinical and forensic practice.

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