Social support among releasing men prisoners with lifetime trauma experiences

High rates of lifetime trauma experiences exist among men incarcerated in US state and federal prisons. Because lifetime trauma experiences have been linked to problematic behavioral and psychiatric outcomes for incarcerated populations, trauma-informed interventions could improve post-release well-being of releasing men prisoners with trauma histories. Social support has consistently been found to have a positive impact on trauma-related outcomes in non-incarcerated populations. Therefore, it is reasonable to hypothesize that social support may be an important intervention component for releasing men prisoners with trauma experiences; yet, the relationship between trauma experiences, psychiatric and behavioral factors, and social support has received almost no attention in research with men prisoners. Using a probability sample of 165 soon-to-be-released men, the present study examined differences in certain demographic, criminal justice history, mental health, substance abuse, and social support (type, quality, amount, and source) variables between releasing men prisoners with and without lifetime trauma experiences. Results indicate that men with trauma histories had more negative social support experiences and fewer positive social support resources before prison than their counterparts. Men with trauma histories also had more lifetime experiences with mental health and substance use problems. On further investigation of the subsample of men with trauma histories, those who were older, had substance use disorders, and histories of mental health problems anticipated fewer post-release social support resources. Study findings underscore the nuances of social support for men prisoners with trauma experiences and point to implications for future directions in targeted trauma-informed intervention development for releasing men prisoners.     

迟发性外伤性脑内血肿脑组织GFAP、S-100和NSE的免疫组织化学研究

应用免疫组织化学ABC法和S－P法，对6例伤后1．5天至2年发生的迟发性外伤性脑内血肿（DTICH）脑组织标本进行神经胶质细胞内胶质纤维酸性蛋白（GFAP）、S－100蛋白（S－100）和神经元细胞内特异性烯醇化酶（NSE）变化和应用价值的研究。尸检和组织学检查发现有脑挫伤等病变。6例DTICH脑组织挫伤及周围区均有明显的GFAP、S－100阳性的细胞变化，细胞数目增多，胞体肥大、增生，免疫组化反应产物增多、深染；神经元细胞NSE免疫组化染色均呈阴性改变。结果表明：6例DTICH脑组织中GFAP、S－100的NSE的免疫组织化学变化是有一定时间间隔的外伤性陈旧性改变，在DTICH的病理诊断上具有重要价值，可作为DTICH法医学鉴定的一个辅助手段。     

The role of trauma in postmortem blood alcohol determination

In postmortem cases, a blood sample is frequently obtained by transthoracic (TT) puncture. The purpose of this study was to determine if, in traumatic death, blood samples collected by TT provided a valid sample for blood alcohol analysis. A retrospective study (1980–1986) was conducted to evaluate possible contamination of blood by GI alcohol in traumatic death cases. Out of 6000 cases reviewed, 19 cses with BACs >500 mg/dl were found and 8 of these cases involved traumatic death with GI laceration and/or transection. The results of this study support the hypothesis that blood samples from the 8 cases had been contaminated, resulting in a falsely elevated BAC. A transthoracic study (1987–1989) was conducted under controlled conditions, where blood alcohol content of TT blood samples was compared with samples collected from the intact heart chamber. Seven out of 28 cases of traumatic injury revealed trauma to the GI tract. The results showed that when GI traumatic injury occurs and unabsorbed ethanol is present in the stomach, contamination of TT blood samples occurs and artificially elevated BACs are obtained. It is recommended that, in cases of traumatic injury, heart blood samples from the intact heart chamber, as well as samples of additional biological fluids, be collected to rule out the possibility of contamination and to ensure that the BAC used for forensic interpretation is accurate.     

Death caused by a signal rocket--not an isolated case*

Fatalities related to sporting events are predominantly caused by blunt force injuries especially due to the emotional involvement of crowd, but occasionally other types of trauma are reported as well. A case of very rare trauma caused by shooting with a hand-held parachute signal rocket during a football match is presented. A 17-year-old football fan sustained fatal injuries, a combination of mechanical trauma caused by rocket penetration, as well as extensive thermal burning of the thoracic viscera. Analysis of the event was based on autopsy findings and evidence produced by medicolegal and ballistic experts. Improper use of a hand-held signal rocket, designed for marine distress signals, may cause serious injuries either mechanically, due to explosion, or as a result of thermal discharge. In the reported case, pattern of injuries is discussed, and medical finding corroborated to other available evidence. The presented case is a reminder that the forensic pathologist should be informed accordingly on the type and features of weapon suspected to produce injury, to be able to understand traumatic changes, and look for potential presence of foreign bodies at postmortem examination.     

Subjective effect of September 11, 2001 among pregnant women: is cumulative history of interpersonal violence important?

Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and subjective impact of the September 11, 2001 (9/11) terrorists attacks. Using hierarchical linear regression, cumulative risk theory was partially supported. Women with a history of only one type of interpfersonal violence reported greater effect of 9/11 than did women without a history, but women with both types of violence did not report a greater effect of 9/11 compared to women endorsing history of one type. These data corroborate the literature in that level of exposure to terrorist-related trauma predicts subjective reaction to the attacks. Future research with a larger sample and standardized instruments is warranted.     

The forensic medical expertise in trauma of male genitals

A damage inflicted to genitals organs (GO) affects the copulative functions, the sperm fertilizing ability and, as a whole, the reproductive function. Injuries to the external genital organs (EGO) due to immediate trauma are more often the case in the forensic medical practice; they are less often encountered in operative interventions in organs, which are close to the prostate or those having immediate direct links with the testicles or with the cavernous bodies of the penis, i.e. in case of an indirect trauma or an mediated effect on the functions of GO. Even if there is a smallest damage to the EGO region, the man needs to consult the urologist in the out-patient or in-patient medical institution. It is always necessary to asses a degree of severity to the health both by signs of duration to health disorders and by an outcome of injury with regard for trauma severity and possible impact on the reproductive function.     

Interpreting perimortem blast trauma from skeletal remains: Complications and considerations

Blast trauma results from highly variable events that can lead to similar effects in the skeleton. Clinical literature, which largely focuses on soft tissue, provides limited efficacy for interpreting fully skeletonized cases. Interpretation of skeletal blast trauma is hampered by the low number of fully skeletonized case studies and experimental replication studies, which mainly use nonhuman proxies. The purpose of this study is to discuss fracture patterns on two individuals from WWII as a means to better understand and identify fracture patterns associated with blast trauma. Existing clinical and anthropological criteria are reviewed and applied to two World War II cases, both presumed to exhibit blast trauma based on historical contexts. These case studies exhibit combinations of complicated and extensive signs of blunt-force and projectile trauma, reflecting the diversity of skeletal trauma resulting from blast-related events. This analysis emphasizes the arguably impossible task of establishing a diagnosis based on the available literature and lack of prior knowledge about specific losses. Ultimately, analysts must consider the totality of skeletal trauma, combining biomechanical theory and relevant clinical and anthropological literature to arrive at useful yet defensible assessments of trauma. However, refined criteria and additional studies are needed to assess complicated trauma from blast-related events in anthropological contexts.     

头部外伤后精神损伤的法医学鉴定(附204例分析)

目的　研究颅脑外伤所致精神障碍的损伤程度评定标准。方法　通过对２０４ 例由司法部门委托进行法医学精神损伤程度鉴定实践,重点对颅脑外伤所致神经症的损伤程度评定标准及其他相关问题进行了讨论。结果　２０４ 例中,男、女比例无差异。年龄组以２１ ～３０ 岁（６３ 例） 、３１～４０ 岁（５３ 例） 居多。表明上述年龄组的社会活动多,受到伤害的可能性大;职业以工人、农民为多,文化程度相对较低。损伤原因以伤害（１０７ 例） 、交通事故（４９ 例） 为多。损伤与精神障碍间隔时间,半年以内１５２ 例,半年至１ 年为２３ 例,表明鉴定时间选择在１ 年内为佳。精神障碍的种类与性质：器质性精神障碍１０８ 例,占５２－８％ ;功能性精神障碍８４ 例,占４１－４％ ,其中外伤后神经症（ 含癔症３５ 例）６６ 例,占３２－３ ％ 。社会功能评定：无社会功能受损７７ 例,轻度受损４１ 例,明显受损８６ 例。神经系统检查：２０４ 例中有一过性神经体征３８ 例,有明显阳性体征６２ 例。损伤与精神障碍的关系：直接因果关系１０４ 例、间接因果关系６１ 例;条件相关３４ 例、无相关５ 例。损伤程度评定结果：重伤８５ 例,轻伤６７ 例,伤病关系评定４７ 例。结论　通过对２０４ 例头部外伤     

Biomechanical features of spinal trauma depending on conditions of the trauma

The aim of the study was to investigate biomechanical features of spinal trauma (fractures) depending on external impact, position of a human body or its parts in the moment of the trauma and before it; to reveal morphological signs of fractures characterizing specific trauma mechanisms. From a position of theoretical mechanics, the vertebral column is an elastic stem the strength of which depends on elastic properties of the pulpous nuclei and intervertebral disks, the column length and curvature. To determine the mechanism of the trauma, it is recommended to make the following measurements: the length of the body, the length of the vertebral column, the length of the cervical, thoracic, lumbar parts, size of the chest kyphosis.     

Multiple traumatic experiences and the development of posttraumatic stress disorder

This study assesses the differential and combined impacts of multiple lifetime stressors in the development and severity of posttraumatic stress disorder (PTSD) symptoms. One hundred and four clinical and 64 nonclinical participants were assessed for their exposure to four types of interpersonal trauma: physical and sexual abuse in childhood, lifetime community violence, and domestic violence in adulthood. PTSD symptomatology was assessed using the Los Angeles Symptom Checklist (LASC). Results indicated that exposure to lifetime multiple traumatic experiences was positively correlated with severity of PTSD symptoms. Clinical participants had experienced significantly more multiple traumas and had a higher rate of PTSD than the nonclinical participants. Results also suggested that adults who had experienced childhood sexual abuse were at higher risk for the development of PTSD related to interpersonal violence than adults who were not sexually abused as children.     

The diagnosis of intravital mechanical trauma by the blood EPR-spectral parameters

The author studied the possibility of diagnosing the lifetime occurrence of mechanical trauma by electron paramagnetic resonance on the basis of values of a constant related to the rate of reaction of spin probe recovery by blood in different time periods up to 28 days of postmortem interval.     

Gas at postmortem computed tomography - An evaluation of 73 non-putrefied trauma and non-trauma cases

Postmortem computed tomography (PMCT) has become an important complement in investigating forensic cases allowing an accurate detection of gas accumulations. The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. Furthermore, in the gunshot group gas was frequently seen in the intracranial cavity. Pneumobilia occurred in one case of the blunt trauma group; in that control group gas was also seen, but less frequently. Gas accumulation showed a strong association with traumatic events, but even the majority of non-trauma cases showed gas accumulations. Despite the exclusion of cases with visible decomposition signs, a putrefactive origin of gas was assumed in some cases. Gas accumulations are a frequent finding in PMCT with a higher incidence in (open) trauma cases. Even though a differentiation between putrefactive and traumatic gas accumulations is still difficult, knowledge of the circumstance surrounding the case may help identify the origin of gas.     

Polytraumatization and trauma symptoms in adolescent boys and girls: interpersonal and noninterpersonal events and moderating effects of adverse family circumstances

The objective of this study was to investigate the cumulative effect of interpersonal and noninterpersonal traumatic life events (IPEs and nIPEs, respectively) on the mental health of adolescents and to determine if the adverse impacts of trauma were moderated by adverse family circumstances (AFC). Adolescents (mean age 16.7 years) from the normative population (n = 462) completed the questionnaire, the Link?ping Youth Life Experience Scale (LYLES), together with Trauma Symptom Checklist for Children (TSCC). The lifetime accumulation of interpersonal, noninterpersonal, and AFC was independently related to trauma-related symptoms in both boys and girls. The number of AFCs moderated the mental health impact of both IPEs and nIPEs in boys but not in girls. Cumulative exposure to both interpersonal and noninterpersonal traumatic events is important for the mental health of adolescents, and, at least for boys, family circumstances seem to be relevant for the impact of trauma. Our results suggest that broader approaches to the study, prevention, and treatment of trauma, including consideration of cumulative exposure, different types of trauma, and additional social risk factors, could be fruitful.     

Traumatic testicular displacement in motorcycle drivers

Testicular displacement is a rare clinical presentation of blunt scrotal injury that may take place in road traffic accidents involving motorcycle occupants. We are presenting two cases of motorcycle occupant fatalities, 21 and 24 years of age, where testicular displacement and other signs of groin trauma have been determined. In both cases, discrete external signs of scrotal trauma were noted on examination, while unilateral and bilateral traumatic testicular displacement, respectively, have been documented at autopsy. For motorcycle occupants involved in collision, it is necessary to perform a thorough analysis of injuries, in particular to look for specific trauma arising from fuel-tank impact to genitalia and/or groin. These injuries are of great medico-legal importance both at postmortem and in clinical cases involving motorcycle occupants involved in collision.     

Temperature fluctuations at sympathetic preganglionic neuron sites in the thoracolumbar section of the spinal column as cues to deception: a preliminary study

In this experiment, both thermal imaging and the Concealed Information Test (CIT) methodologies were adopted, for the first time, to explore the efficacy of the thermal imaging of the thoracolumbar (T1–L3) region of the spinal column within the context of deception detection. Thirty-one participants followed a CIT-based structured interview process in a low-stakes laboratory setting whereby temperature fluctuations induced by the preganglionic neurons in the spinal column were measured with a thermal imaging camera during verbal responses to interview questions. The degree of temperature changes was then analyzed in order to determine truthfulness and deceit. Thermal imaging of the thoracolumbar region of the spinal column during sympathetic activation was effective in determining truthful responses with an accuracy rate of 91.9% and deceitful responses with an accuracy rate of 71.0%. Current findings support the potential use of temperature fluctuations of preganglionic neuron sites in the thoracolumbar section for lie-detection purposes.     

Fractography of the long tubular bones of the lower extremities in trauma by blunt objects

New data on micromorphological signs of fracture of long tubular bones in normal distribution and transformation of deforming forces are presented. Fractographic signs of bone for each destructive stage, signs of repeated trauma are singled out. Interrelationship between bone microstructure and conditions of its destruction is stated.     

Identification of traumatic injury in burned cranial bone: an experimental approach.

Interpreting patterns of injury in victims of fire-related deaths poses challenges for forensic investigators. Determining manner of death (accident, suicide or homicide) using charred remains is compounded by the thermal distortion and fragmentation of soft and skeletal tissues. Heat degrades thin cranial structures and obscures the characteristic signatures of perimortem ballistic, blunt, and sharp force trauma in bone, making differentiation from thermal trauma difficult. This study documents the survivability and features of traumatic injury through all stages of burning for soft tissue reduction and organic degradation of cranial bone. Forty cadaver heads were burned in environments simulating forensic fires. Progression of thermal degradation was photographically documented throughout the destructive stages for soft tissues and bone to establish expected burn sequence patterns for the head. In addition to testing intact vaults, a percentage were selectively traumatized to introduce the variables of soft tissue disruption, fractures, impact marks, and incisions throughout the cremation process. Skeletal materials were recovered, reconstructed, and correlated with photographs to discern burn patterns and survivability of traumatic features. This study produced two important results: (1) Identification of preexistent trauma is possible in reconstructed burned cranial bone. Signatures of ballistic (internal and external bevel, secondary fractures), blunt force (impact site, radiating fractures), and sharp force (incisions, stabs, sectioning) survive the cremation process. (2) In non-traumatized specimens, the skull does not explode from steam pressure but does fragment as a result of external forces (collapsed debris, extinguishment methods) and handling. The features of both results are sequentially described throughout the progression of thermal destruction.     

Identification of traumatic injury in burned cranial bone: an experimental approach.

Interpreting patterns of injury in victims of fire-related deaths poses challenges for forensic investigators. Determining manner of death (accident, suicide or homicide) using charred remains is compounded by the thermal distortion and fragmentation of soft and skeletal tissues. Heat degrades thin cranial structures and obscures the characteristic signatures of perimortem ballistic, blunt, and sharp force trauma in bone, making differentiation from thermal trauma difficult. This study documents the survivability and features of traumatic injury through all stages of burning for soft tissue reduction and organic degradation of cranial bone. Forty cadaver heads were burned in environments simulating forensic fires. Progression of thermal degradation was photographically documented throughout the destructive stages for soft tissues and bone to establish expected burn sequence patterns for the head. In addition to testing intact vaults, a percentage were selectively traumatized to introduce the variables of soft tissue disruption, fractures, impact marks, and incisions throughout the cremation process. Skeletal materials were recovered, reconstructed, and correlated with photographs to discern burn patterns and survivability of traumatic features. This study produced two important results: (1) Identification of preexistent trauma is possible in reconstructed burned cranial bone. Signatures of ballistic (internal and external bevel, secondary fractures), blunt force (impact site, radiating fractures), and sharp force (incisions, stabs, sectioning) survive the cremation process. (2) In non-traumatized specimens, the skull does not explode from steam pressure but does fragment as a result of external forces (collapsed debris, extinguishment methods) and handling. The features of both results are sequentially described throughout the progression of thermal destruction.     

The Impact of Psychological Consequences of Rape on Rape Case Attrition: The Police Perspective

This paper examines whether the psychological sequelae of rape relate to rape case attrition by leading police to see the victim as less reliable. A mixed methods approach with two linked studies, one qualitative and one quantitative, was used. In Study 1, the qualitative study, interviews with 12 specialist police officers were analysed using Framework Analysis. In Study 2, the quantitative study, 76 specialist officers completed an online questionnaire to assess the generalisability of Study 1’s findings. In Study 1, officers’ perceptions of victims clustered into three stereotypes, which we label “the real victim”, “the mad discloser”, and “the bad discloser”. Victims who exhibited signs of shame, self-blame, and post-traumatic stress reactions which impeded their ability to give a coherent account of the rape were perceived as less reliable “mad” or “bad” victims. The findings of Study 2 supported these results. Although police interview strategies have improved in recent years, there is evidence that signs of trauma and shame in the victim are sometimes misinterpreted as signs of lying. This may affect attrition by impacting on victim-officer relationships. Further training on recognising trauma and understanding its consequences is recommended both for specialist officers and front-line staff.