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Avaliao do risco
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75
INTRODUO
A violncia nas relaes de intimidade (VRI) inclui atos de agresso fsica,
sexual, abuso emocional e outros comportamentos controladores perpetrados
por cnjuge, parceiro(a), namorado(a) da vtima ou progenitor(a) de filho
comum (Heise & Garcia-Moreno, 2002). Pode ocorrer durante uma relao,
independentemente da sua durao, ou aps o seu trmino (Harvey, Garcia-Moreno & Butchart, 2007).
Esta forma de violncia acontece escala mundial, abrangendo uma
grande variedade de pases e culturas (Archer, 2006; Garcia-Moreno e col.,
2006; Straus, 2008). Uma pesquisa multinacional realizada pela Organizao Mundial de Sade (OMS), atravs de uma entrevista efetuada a 24,097
mulheres em dez pases diferentes, incluindo Bangladesh, Brasil, Etipia,
Japo, Nambia, Per, Samoa, Srvia, Montenegro, Tailndia e Tanznia,
evidenciou taxas de prevalncia de vitimizao de mulheres entre 15% e 71%
(Garcia-Moreno e col., 2006).
Nas ltimas duas dcadas, tm-se verificado grandes mudanas na
resposta VRI, quer pelo pblico em geral, quer a nvel dos servios
judicirios, judiciais, sociais e de cuidados de sade (Campbell, 2005;
Kline e col, 1997). O aumento da utilizao destes servios pelas vtimas
de VRI levou ao desenvolvimento de estratgias para identificar os casos
que necessitam de maior ateno e de intervenes dirigidas, dado que
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4
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77
A NATUREZA DO RISCO
O conceito de risco no consensual na literatura terica e emprica
sobre o que se pretende concretizar quando feita referncia ao risco de
VRI (Kropp, 2004).
Mais comumente, os estudos que analisam o risco de recidiva de VRI
definem risco como a probabilidade de um incidente de violncia ocorrer no
futuro, embora os estudos variem consideravelmente na sua operacionalizao
quanto ao significado de "futuro", incluindo perodos de acompanhamento
que vo de meses a anos. Esta concetualizao do risco coloca a tnica na
previso de comportamentos sem considerar o contexto individual envolvido.
Na prtica, o conceito de risco multifacetado e no inclui apenas a
probabilidade de que um indivduo seja ou no violento no futuro mas,
tambm, considera a natureza do risco em questo (por exemplo, o tipo de
A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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79
Avaliao atuarial
A abordagem atuarial, ou de"segunda gerao"da avaliao de risco,
depende da utilizaode mtodos estatsticospara prever o comportamentofuturo (Douglas e col., 1999). O foco situa-se napreviso deum
comportamentoespecfico dentro de umdado perodo de tempo (Kropp,
2004). Na avaliaoatuarial dorisco de violncia, os itenspreditores(fatores
de risco)baseiam-se emestudos de follow-up bem concebidos,que permitem
identificaros itens que estoprospetivamenteassociadosao resultado (Hilton e col., 2010). Ao adotareste mtodo, a seleoideal deitensconsidera
a validade incremental- ou seja,os preditores mais fortesso escolhidos
masapenas os fatores queaumentam significativamentea capacidade preditiva
do modeloso includos.Tais abordagenspodem usarequaesestatsticas
(previso estatstica),tabelas atuariaise/ou programasalgortmicos (Grove
e col., 2000).
O termo atuarial tambm usado para referira seleo de variveispreditoras
com
A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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Mas a incluso nestas avaliaes de dadosrelativos vtimanas avaliaesde risco e perigosidadedevem ser tambmregularmente colhidas na
avaliao de agressores nas relaes de intimidade, tendo em vistaobter uma
estimativa maisvlidado risco (Kropp, 2007). De facto, alguns estudos que tm
investigado sobre a capacidade das mulheres vtimas de VRI preverem com
preciso a probabilidade da sua prpria vitimizao futura, em comparao
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A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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A avaliao mdico-legal
O diagnstico mdico-legal de uma situao de VRI complexo e delicado,
pelo que deve ser promovido no mais curto espao de tempo possvel aps o
episdio de abuso. No entanto, sabemos que a maior parte das vtimas oculta
este tipo de violncia durante um logo perodo (geralmente vrios anos), e s
algumas vezes, e muito tardiamente, procede sua denncia. Assim, a suspeita
e deteo destes casos pelos profissionais que com estas vtimas trabalham, pode
constituir o primeiro e mais relevante passo, tendente a garantir a sua proteo,
estabelecido que seja, com segurana, o diagnstico mdico-legal do caso.
91
CONSIDERAES FINAIS
De um modo geral,todos os instrumentosde avaliao do risco de VRI,
aqui discutidos, apresentamalgum grau depreciso (pelo menos moderado)
quanto sua capacidade de previso desse risco.
Revista Portuguesa do Dano Corporal (22), 2011
[p. 75-98]
A n a C l a r a G r a m s, Te r e s a M a g a l h e s
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Os dados analisadosso mais favorveis utilizao dosinstrumentosatuariais por garantirem resultados mais vlidos e fiveis do que a avaliao
clnica estruturada. Mas na prtica as diferenas de desempenho dos diferentes
instrumentos no parece ser grande, apesar do escasso nmero de estudos
prospetivos de validaoem larga escala publicados e do restrito nmero
depases de onde eles foram efetuados.
Acresce que so evidentes as vantagens da integrao das percees
fornecidaspelas vtimasnoprocesso de avaliaode risco,embora seja
necessria tambm mais investigao nesta matria, a fim dese entender
quaisos fatores que devem ser mais claramenteatendidos.O que evidente,
que as vtimas tm acesso a umagamade informaes relevantes para a
avaliao doseu risco pessoal, pelo que os profissionaisdevem prestar toda
a atenos suas alegaes, tendo em vista a reduo da recidiva de VRI.
Por tudo isto, ser aindaprematuro recomendarumdeterminado instrumento de avaliaode riscoem detrimento dos restantes, sendo que o
importante na decisosobre o instrumento a utilizar ocontexto daavaliao
de risco e as exignciascolocadas ao avaliador (Bowen, 2011).
De qualquer forma, s uma articulao adequada poder permitir colaborar, efetivamente, na proteo da vtima (atravs do diagnstico da VRI,
diagnstico do risco associado, orientao do caso, preveno da revitimizao e promoo da reabilitao) e na investigao criminal (atravs da
denncia do caso e preservao de evidncias), bem como evitar a vitimao
secundria (atravs de abordagens corretas e sem repeties desnecessrias).
Para que esta articulao funcione, importa que cada profissional envolvido
conhea o processo de vitimao nas relaes de intimidade, as tcnicas de
abordagem das vtimas, o papel e competncias de cada ator neste processo
e os recursos disponveis na sua comunidade para a interveno nestes casos,
designadamente para a avaliao do risco.
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Pedido de separatas:
ANA CLARA GRAMS
acgrams@dpinml.mj.pt