Injuries due to deliberate violence in areas of Denmark. I. The extent of violence

As part of a transcultural investigation of violent behavior in Denmark and South America an analysis was made during a one year period of the incidents involving deliberate violence as registered at 3 Danish emergency wards, and at the Institute of Forensic Medicine in Copenhagen. In the three emergency wards a total of 1316 victims of deliberate violence were observed corresponding to a rate of about 3.3/1000 per year in a provincial/rural district, the catchment region of Holbaek County Hospital, 5.5/1000 per year in a mainly middle income area of the metropolis Copenhagen, the catchment region of Frederiksberg Hospital, and 7.6/1000 per year in a mainly low income area of Copenhagen, the catchment region of the Rigshospital. The highest risk, 28/1000 per year, was found for young men between 15 and 19 years of age living in the low income area of Copenhagen. The risk was low for people greater than or equal to 60 years of age in all three areas investigated, ranging from 0 (men) to 1.3/1000 per year (women). Skilled and unskilled workers were greatly over represented as victims of violence, considering their share of the background population. Seventy percent of the victims were men. At least 44% of the men and 32% of the women were alcohol intoxicated when arriving in the emergency ward. The incidents took place in restaurants or in the vicinity of restaurants for 30% of the male and 11% of female victims respectively, while 45% of the women had been subject to deliberate violence at home. The rate of fatal cases of deliberate violence in the Eastern part of Denmark, the catchment area for the Institute of Forensic Medicine in Copenhagen, was found to be 0.02/1000 per year. The risk of becoming a victim of deliberate violence has not increased during the last 4 years comparing with similar investigations from other parts of Denmark. However, the rate of homicide seems to have increased, and so has the severity of the injuries caused by deliberate violence. The pattern of deliberate violence appears to be associated with socio-economic and cultural factors, and to be closely linked with alcohol intoxication.     

Injuries due to deliberate violence in areas of Argentina. I. The extent of violence. Copenhagen Study Group

As part of a transcultural investigation of violent behaviour in Argentina and Denmark an analysis was made of the incidents involving deliberate violence as registered in the emergency wards of Hospital Fernandez and Hospital Pinero in Capital Federal Buenos Aires over a period of 13 and 17 months, respectively. In the two emergency wards a total of 281 victims of deliberate violence were observed corresponding to a rate of approximately 0.2/1000 per year in a mainly middle income area of the metropolis Buenos Aires, the catchment region of Hospital Fernandez, and 0.6/1000 per year in a mainly low income area of Buenos Aires, the catchment region of Hospital Pinero. Men aged 20-24 years and 40-49 years were found to be the most frequent victims of deliberate violence, 13% and 11%, respectively. Elderly women greater than or equal to 60 years of age were rarely found to be victims of deliberate violence (2%). Skilled and unskilled male workers were over-represented as victims of violence. Sixty-four percent of the victims were men and 29% women, 6% were boys and 0.7% girls less than or equal to 14 years of age. Twenty-one percent of the male victims and 5% of the female victims were alcohol intoxicated when arriving in the emergency ward. The incidents took place in restaurants or in the vicinity of restaurants for only 7% of the male victims, while 55% of male victims and 34% of female victims had been injured in the street, most often by non-acquainted men. Fifty-eight percent of the female victims had been subject to deliberate violence at home, in the majority of the cases beaten by their spouse. Twelve percent of the male victims and 8% of the female victims were estimated to be under the influence of drugs. The incidence of deliberate violence seems to be lower in Argentina than in Denmark. However, serious lesions appear to be considerably more frequent in male Argentinian victims compared to male Danish victims, maybe because the practice of seeking medical assistance is different in the two countries. The pattern of deliberate violence appears to be associated with socio-economic and cultural factors. Influence of alcohol does not appear to play a role that is comparable to the situation observed in Denmark. A considerably larger percentage of victims in Argentina than in Denmark had been injured in the street.     

Alcohol involvement in violence. A study from a Danish community

All cases of assaults with violence (n = 1639) from a well defined area were registered for 1 year. A positive alcolmeter test (% greater than 0.2) was registered in 488 cases (29%). A further 216 patients (13%) were found under the influence of alcohol according to a simple clinical judgement. In nine of ten manslaughter and murder cases alcohol was involved. Young men, 19-29 years of age, comprised the majority of victims. Of the episodes of violence 66% took place during the weekend. In 250 cases the alcohol concentration surpassed 1.5%. Almost 50% of the violence episoded took place in or around restaurants. Blunt violence was concerned in 73% of the episodes. Gunshot was registered in five cases, stabbings in two cases.     

Injuries due to deliberate violence in areas of Denmark. V. Violence against women and children. Copenhagen Study Group

As part of an European-South American study of deliberate violence cases of violence against women greater than or equal to 15 years of age and violence against and among children under the age of 15 years were registered at 3 Danish emergency wards and at the Institute of Forensic Medicine in Copenhagen. 352 cases of violence against women and 46 cases of violence against children were registered in the three emergency wards corresponding to rates of about 1.6/1000 per year for women, 0.6/1000 per year for boys and 0.7/1000 per year for girls in a provincial/rural district, the catchment region of Holbaek County Hospital, 3.4/1000 per year for women, 2.8/1000 per year for boys and 0.6/1000 per year for girls in a mainly middle income area of the metropolis Copenhagen, the catchment region of Frederiksberg Hospital, and 4.0/1000 per year for women, 4.0/1000 per year for boys and 0.9/1000 per year for girls in a mainly low income area of Copenhagen, the catchment region of the Rigshospital. Nineteen live adult female victims and 17 dead adult female victims of violence were registered in the Institute of Forensic Medicine in Copenhagen, where also one was registered as a victim of homicide. Nearly half of the adult live female victims of violence had been injured at home while this was the case for approximately three fourth of the dead victims. In 35% of the live cases the husband was the aggressor and in 12% a former cohabitant. In 71% of the homicide cases the husband was the aggressor. The live women appeared to have fewer but more serious lesions than men. The pattern of deliberate violence against women appears to be associated with socio-economic and cultural factors. In cases with a preceding quarrel there is statistically a link to alcohol intoxication. In half of the cases of violence against children the aggressor was known to the victim, in 15% the aggressor was one of the parents, while 42% of the cases were violence among children. The pattern of violence according to sex, and the distribution and severity of lesions for 10-14 years old children showed resemblance to the situation for adults. The lesions were more serious in young infant victims, especially boys, than in adult victims.     

Injuries due to deliberate violence in Chile

An analysis was made over a period of 6 months of the incidents involving deliberate violence as registered in 'Vicaria', the clinic for out-patients within the Cathedral of Santiago de Chile. A total of 236 victims of deliberate violence were observed. Men aged 15-24 years were found to be victims of deliberate violence most frequently. 'Under education' was the most frequently registered occupation for both sexes, and a large group of male victims were 'Unemployed'. 82% of the victims were men and 14% women, 1.5% were boys and 1.5% girls less than or equal to 14 years of age. None of the victims were alcohol intoxicated when arriving in the clinic. The incidents took place in streets for 81% of the male victims and 79% of the female victims, and in the majority of the cases the aggressor(s) was one (or several) police officer(s). Six percent of the female victims had been injured at home. There was no reporting of the aggressor being a relative or acquaintance. The most frequent type of violence was blunt violence from baton(s) (44%), while blunt violence without the use of instruments was reported less frequently (33%). The use of firearms was registered in 18% of the cases, and of sharp instruments, combustion, electro-shock and chain in 1.4%, 1.4%, 1.1% and 0.4% of the cases respectively. A total of 517 primary and secondary diagnoses were applied to the patients. Most of the victims (99%) had moderate or less serious lesions according to the Abbreviated Injury Scale (AIS) (score less than or equal to 2). Twenty-four percent of the victims had more than 4 lesions, and 7% more than 10 lesions. The head/neck region and the trunk were affected with equal frequency, the frequency of injuries of the head/neck region being comparable with that observed among torture victims and in contrast to the pronounced predominance of injuries of the head/neck region observed in a Danish emergency ward study of deliberate violence.     

Injuries due to deliberate violence in areas of Denmark. II. Victims of homicide in the Copenhagen area

As part of a transcultural investigation of injuries due to deliberate violence in Denmark and South America, homicides in the Copenhagen area were studied for a 1-year period. Forty-five cases corresponding to a rate of approximately 2/10(5) per year were recorded. The rate seems to be increasing and the pattern changing with a higher frequency of stabbing and with an increasing frequency of high blood-alcohol concentrations in the victims. The highest number were killed at home. In the majority of cases the aggressor and the victim knew each other. A reduction in alcohol consumption is indicated as a possible preventive measure.     

Alcohol intoxicated eyewitnesses' memory of intimate partner violence

Alcohol affects memory in many, and mostly negative, ways. This is a problem in legal contexts as many witnesses are alcohol intoxicated when taking part of the critical event. However, research is sparse regarding how, and under what circumstances, the reports of alcohol intoxicated witnesses differ from those of sober witnesses. This study investigated whether alcohol intoxicated and sober eyewitnesses differ regarding completeness, accuracy, and type of information reported, as well as whether gender influenced these variables. Eighty-seven healthy men (n = 44) and women (n = 43) received either an alcoholic beverage (0.7 g/kg) or a control (juice) in a laboratory setting before viewing a film picturing intimate partner violence. Ten minutes after viewing the film, they were interviewed. Reports by alcohol intoxicated women were less complete, but as accurate, as sober women's. In contrast, intoxicated and sober men did not differ regarding completeness or accuracy. Furthermore, compared with sober women, intoxicated women reported fewer actions but no difference was found between the groups regarding reported objects. At this moderate dose, alcohol affected women's reports more than men's, which may be because alcohol affects attention and memory consolidation more clearly at a lower dose for women than for men.     

The relationship between the quantity of alcohol consumed and the severity of sexual assaults committed by college men

Researchers have suggested that intoxicated perpetrators may act more violently than other perpetrators, although empirical findings have been mixed. Past research has focused on whether or not alcohol was consumed, rather than the quantity consumed, and this may explain these inconsistent findings. The authors hypothesized that the quantity of alcohol consumed would have a curvilinear relationship to the severity of the assault. Data were collected from 113 college men who reported that they had committed a sexual assault since the age of 14. The quantity of alcohol that perpetrators consumed during the assault was linearly related to how much aggression they used and was curvilinearly related to the type of sexual assault committed. The quantity of alcohol that victims consumed during the assault was linearly related to the type of sexual assault committed. Strategies for improving assessment of alcohol consumption in sexual assault research are discussed.     

Deaths associated with choking in San Diego county

Death from choking is the fourth most common cause of unintentional-injury mortality, but little data are published on causes or locations of these episodes. These deaths typically are peaked at the extremes of age, with young children and the elderly having the greatest rate of fatal choking. Our objective was to characterize the causes of fatal airway obstruction in adults. The San Diego County Medical Examiner's database was searched for deaths attributed to choking in decedents 18 years and older during the 10-year period from 1994 to 2004. Data were abstracted regarding the underlying medical conditions, items choked on, location of the choking, and treatments involved in the individual cases. We found 133 victims who died from choking, with 14% having using alcohol or other sedatives and 55% having a documented neurological deficit or anatomic difficulty with swallowing. The most common specified food objects that victims choked on were meat products, and 45% occurred at home, followed by 26% at supervised facilities, and 14% at restaurants. Of the 19 choking episodes occurring in restaurants, only one employee was documented to attempt a resuscitative effort. Most victims who choked to death had an underlying neurological deficit, and occurred at home or supervised facilities appear to have an appropriate initial-response intervention.     

Characteristics of victims coarrested for intimate partner violence

This study evaluated the frequency of coarrest in female victims who utilized 911 for intimate partner violence (IPV) and any patterns or circumstances that increased the likelihood of coarrest. All cases of police-documented IPV where a female IPV victim was arrested in conjunction with the perpetrator were included. Each incident report was reviewed to determine demographic characteristics of the victim, weapon and substance involvement, presence of children, and violence severity. Of IPV victims, 9% (131 of 1,489) were arrested. Having a weapon, alcohol use, not being married, and older age were associated with increased likelihood of arrest (p < .001). The presence of a child decreased the likelihood of victim arrest (p < .001). Race, prior incidents of IPV, offender restraining order, and incident severity were not significantly associated with coarrest. Although coarrest occurred in a minority of cases, it may deter victims from contacting police for future incidents of police.     

Analysis of 1989-1999 homicide crimes in the catchment area of the Bonn Institute of Forensic Medicine with reference to selected aspects

195 cases of homicide, grouped according to juridical assessment, were retrospectively analysed with regard to individual characteristics of perpetrators and victims, circumstances, and mode of commitment. The involvement of underage victims and perpetrators as well as differences between the urban and rural areas studied were taken into special consideration. To summarise, the majority of the offences studied was carried out by a male perpetrator with a mean age of 35 years driven by personal motives or greed in his immediate vicinity and affected family members or close acquaintances. The fatal injuries were mainly attributable to sharp or blunt force. With regard to killings of children, a higher prevalence of female victims and male assailants, emotional motives and an even higher importance of the social vicinity were found. Particularly in victims younger 12 years of age, manual modes of commitment without application of any tools were predominantly encountered. The comparison of urban and rural areas revealed a higher homicide rate in municipal areas especially of offences with a loose relationship between victims and assailants (greed, sexual assault). In contrast, rural areas exhibited higher rates of bodily harm with fatal consequences as well as offences by highly intoxicated assailants.     

Injuries due to deliberate violence in areas of Argentina. II. Lesions. Copenhagen Study Group

As part of a transcultural investigation of violent behavior in Argentina and Denmark, the lesions from accidents involving deliberate violence registered in the emergency wards of Hospital Fernandez and Hospital Pinero in Capital Federal Buenos Aires over a period of 13 and 17 months, respectively, were studied. Among the 281 victims entering the two emergency wards blunt violence without use of instruments was most often reported to be the violation method. Frequently indicated violation instruments against the male victims were batons (18.7%), sharp instruments (17.7%), and firearms (17.7%), the corresponding figures for female victims being 9.6%, 8.4% and 4.8%. The use of firearms and batons was considerably more pronounced in Argentina than in Denmark, particularly against male victims. A total of 373 primary and secondary diagnoses were reported from the patients, the most frequent diagnoses being contusions and open wounds in the head/neck region. Forty-three percent of the diagnoses were related to the head/neck region, being the most frequently injured region and the trunk the second most frequently injured region (30%). The degree of predominance of lesions in the head/neck region was much less than in the Danish material. Injuries of internal organs of the trunk were considerably more frequent in Argentina than in Denmark. Eighty-five percent of the victims had moderate or less serious lesions when assessed on the basis of the scores in the Abbreviated Injury Scale (AIS), (score less than or equal to 2). The AIS scores of the lesions in female victims were on average only slightly higher than those recorded in the Danish study, while 16.1% of the male Argentinian victims had lesions scored greater than or equal to 3 compared to 1.8% in male Danish victims. The need for treatment and hospitalization was more pronounced than in the Danish study. It may be concluded that the frequency of serious cases of deliberate violence probably would decrease if more restrictive rules for the possessing of firearms were enacted and enforced.     

Rape-myth congruent beliefs in women resulting from exposure to violent pornography: effects of alcohol and sexual arousal

Previous research findings indicate that women suffer a variety of detrimental effects from exposure to violent pornography. This study used an experimental paradigm to examine the effects of a moderate alcohol dose and alcohol expectancies on women's acute reactions to a violent pornographic stimulus. A community sample of female social drinkers (N = 134) read an eroticized rape depiction after completing an alcohol administration protocol. As predicted, intoxicated participants were less likely to label the depicted events as rape than their sober counterparts. A path analytic model illustrated that participants' self-reported sexual arousal to the stimulus, as influenced by alcohol consumption and expectancies, resulted in increased rape myth congruent perceptions of the victim and decreased labeling of the incident as rape. Findings suggest that acute alcohol intoxication during violent pornography exposure may ultimately result in women developing more calloused attitudes toward rape and rape victims.     

Fatal accidents and blood ethanol levels in adolescents and adults. The Wayne County experience, 1978-1988

The files of 874 fatal traumatic accident victims, aged 12-25 years, examined at the Wayne County Medical Examiner's Office during the period 1978-1988 were reviewed. Postmortem blood alcohol results of individuals who died after less than 15 min of hospitalization were utilized to approximate alcohol levels at the time of the fatal injury. Relationships between types of accidents, sex, age, race, and time of accident were examined. White victims were far more likely to have been drinking than blacks, and the data indicated that underaged drinkers were involved in fatal accidents at lower levels of blood alcohol than their counterparts of legal drinking age. Consistent racial differences in average alcohol levels were not observed, however. Unlike female and black victims, who much less frequently tested positive for alcohol when underage, white male victims 16-21 years of age were just as likely to have been drinking as those aged 21-25. The results of the study show that postmortem blood alcohol level can be used to identify differences in alcohol consumption among groups of accident victims in a major metropolitan area.     

The emotional witness effect: story content,emotional valence and credibility of a male suspect

Abstract

Building on previous research which identified alcohol as the drug of choice for facilitating sexual assaults, this paper analysed 93 rape cases reported to the police in which the victim was under the influence of drugs/alcohol when the assault occurred. The aim was to explore what substances victims consumed to become incapacitated and who induced the state of incapacity. The degree of pre-planning suggests that the offender could be described as opportunistic or predatory. Findings demonstrated that the majority of rapes (coming to police notice) in which alcohol or drugs are implicated, are circumstances where the victim has self-intoxicated through alcohol consumption. There were relatively few cases in which drugs had been administered surreptitiously. The analyses successfully identified differences between rapes that occur when the victim is intoxicated or drugged according to how she consumed that alcohol/drug and what kind of alcohol/drugs she had consumed. The concept of negotiative space is offered as a potential theoretical explanation. The findings are discussed in the light of this and recommendations for crime prevention are made.     

Morphology and phenomenology of death by kicking (II)

In the years from 1982 to 1995, 20,504 autopsy cases were examined at the Departments of Forensic Medicine in Hamburg and Greifswald. In 103 cases death was caused by kicking. In the Greifswald area, the occurrence of kicking as the cause of death could be demonstrated in 68 cases (30% of all homicides), which is in contrast to the observations in Hamburg, were kicking amounted to only 2.5% of the homicides. Most of the victims (average age 44 years) were under the influence of alcohol (mean blood alcohol concentration 1.75/1000), and most were on social support. The victims often showed other signs of blunt trauma such as blows with the fist and strangulation. In a few cases, cutting and stabbing wounds were also found. In the majority of cases death was due to severe haemorrhages and aspiration of blood in addition to the direct effects of the head injuries. The crimes were committed by one person in 46 cases, two in 20 and three in 4 cases. The perpetrators (average age 27.6 years) were always younger than the victims. Case reports show that fatal kicking was mostly triggered by relatively trivial arguments. None of the incidents were preplanned by the perpetrators. In contrast to an expected higher incidence of kicking deaths in the urban area of Hamburg, these crimes occurred ten times more frequently in the rural area of Greifswald.     

Alcohol and Domestic Violence: A Cross-Over Study in Residences of Individuals in Brazil

The objective of this study was to investigate psychological or physical violence associated with the use of alcohol, in residences of individuals in Brazil and, also describe the social characteristics of aggressors and victims. Therefore, this study expects to contribute to studies in Brazil that seek to clarify the relations between alcohol and violence in residences. A total of 454 respondents, 12–65 years old, were assessed, they were sorted by the Kish method, and the residences randomly. The SAMHSA questionnaire was utilized after translated and adapted to Brazilian conditions. 26% of the individuals reported psychological violence, and 16% reported physical violence. The study’s main results set the differences in the reports for physical violence (OR 7, 95% CI: 4–13) and psychological violence (OR 5, 95% CI: 3–8) in residences where someone arrived or became intoxicated with alcohol (P < 0.05). 50% of the aggressors were under the effects of alcohol, and 77% of the victims were relatives of their aggressors. Acts of violence are not necessarily associated with alcohol consumption. Men and women reported acts of domestic violence; psychological violence was the most prevalent form. Men are currently the primary aggressors, while women are primarily the victims     

Injuries due to deliberate violence in areas of Denmark. III. Lesions. The Copenhagen Study Group

As part of a transcultural investigation of violent behavior in Denmark and South America, the lesions from accidents involving deliberate violence registered in three Danish emergency wards during a 1-year period were studied. A quantity of 2211 lesions were diagnosed in 1316 patients (953 male and 363 female patients). Sixty-five percent of the lesions were in the head/neck region, 13% in truncus, 18% in the upper extremities and 5% in the lower extremities. The most frequent diagnosis was an open wound in the head/neck region. Adding contusions and fractures in the same region this amounted to more than half of the total number of lesions. In the upper extremities 62% of the lesions were contusions or open wounds. Serious lesions of internal arteries were few, however always caused by sharp instruments (knives). Serious lesions due to firearms were not recorded/reported. Strangulation had been used against 1.1% of the victims, the male/female ratio being 1:6. The main part of the lesions were of minor severity when assessed on the basis of the scores in the Abbreviated Injury Scale (AIS). The lesions were, however, more serious compared to other recent studies, and it appeared that the female victims had fewer but more serious lesions than the male victims. The need for treatment and hospitalization was in the range of other recent studies.     

Gender differences in risk for intimate partner violence among South African adults

Despite a high prevalence of intimate partner violence in South Africa, few epidemiological studies have assessed individual risk factors and differential vulnerability by gender. This study seeks to analyze gender differences in risk for intimate partner violence victimization and perpetration according to childhood and adult risk factors in a national sample of South African men and women. Using data from the cross-sectional, nationally representative South Africa Stress and Health Study, the authors examine data from 1,715 currently married or cohabiting adults on reporting of intimate partner violence. Our analysis include (a) demographic factors, (b) early life risk factors (including exposure to childhood physical abuse, witnessing parental violence, parental closeness, and early onset DSM-IV disorders), and (c) adult risk factors (including experiencing the death of a child and episodes of DSM-IV disorders after age 20). Although prevalence rates of intimate partner violence are high among both genders, women are significantly more likely than men to report being victimized (29.3% vs. 20.9%). Rates of perpetrating violence are similar for women and men (25.2% and 26.5%, respectively). Men are more likely to report predictive factors for perpetration, whereas women are more likely to report predictors for victimization. Common risk factors among men and women reporting perpetration include exposure to childhood physical abuse, witnessing parental violence, and adult onset alcohol abuse/dependence. However, risk factors in male perpetrators are more likely to include cohabitation, low income, and early and adult-onset mood disorders, whereas risk factors in female perpetrators include low educational attainment and early onset alcohol abuse/dependence. The single common risk factor for male and female victims of partner violence is witnessing parental violence. Additional risk factors for male victims are low income and lack of closeness to a primary female caregiver, whereas additional risk factors for female victims are low educational attainment, childhood physical abuse, and adult onset alcohol abuse/dependence and intermittent explosive disorder. Intimate partner violence is a significant public health issue in South Africa, strongly linked to intergenerational cycling of violence and risk exposure across the life course. These findings indicate that gender differences in risk and common predictive factors, such as alcohol abuse and exposure to childhood violence, should inform the design of future violence-prevention programs and policies.     

Predicting the occurrence of stalking in relationships characterized by domestic violence

A high correlation has been found between domestic violence and stalking. However, very few studies have examined what factors predict the occurrence of stalking in relationships characterized by domestic violence. Using in-depth interviews with victims of domestic violence whose cases have gone through the criminal justice system, this article explores this issue. It was found that experiences of stalking by their abusers were very prevalent in this group of domestic violence victims. In terms of predicting stalking, domestic violence victims who were not in a relationship with their abuser, whose abusers had an alcohol or drug problem, who experienced more controlling behaviors by their abusers, and who had experienced prior stalking by their abusers were at the greatest risk of experiencing more severe stalking. Implications for intervention are discussed.