Triggers for alcohol‐related violence in young male offenders

Purpose. Improving the effectiveness of offender treatment programmes is important and one approach is to attend to their content. The aim here was to identify triggers to alcohol‐related violence to inform the development of programmes to treat this problem. Method. Information from 149 young male offenders’ accounts of incidents of alcohol‐related violence was studied using thematic analysis. Results. Sixteen triggers for violence were identified and these were organized into six themes: (1) being offended by someone, (2) seeing an opportunity for material gain, (3) seeing others in need of help, (4) perception of threat, (5) distress, and (6) wanting a fight. Discussion. The implications of the results for developing treatments for alcohol‐related violence are presented. First, identifying triggers should be part of the treatment programme and ways of avoiding triggers should be addressed. Second, changing values, specifically hypermasculine and antisocial values, could attenuate the rewards signalled by the triggers. Third, methods of reducing the potency of triggers would be of value and would include addressing issues of need for respect and responses to perceived disrespect. Fourth, non‐violent ways of helping people who are in trouble need to be introduced. Fifth, coping with threat cues through distraction and increasing self‐awareness would reduce the effects of ‘alcohol myopia’. Sixth, seeking fights for excitement could be reduced by examining the costs through motivational procedures. Finally, and self‐evidently, a primary target of treatment programmes to reduce alcohol‐related violence should be to reduce the level and frequency of alcohol intoxication.     

Sexual violence and reproductive health among young people in three communities in Jamaica

A secondary analysis of data collected from 1,130 young people ages 15 to 24 in a population-based household survey to assess the reproductive health needs of young people in three communities in Jamaica was conducted to determine the relationships among three measures of sexual violence, background variables, three measures of sexual risk taking (early sexual debut, multiple partners, and no condom at last sex), and two reproductive health outcomes (genital discharge within the past 12 months and pregnancy). In the multivariate analyses, forced first sex increased the likelihood of genital discharge among males (odds ratio, OR = 5.33) and females (OR = 2.02) and pregnancy among females (OR = 2.05), controlling for background characteristics and sexual risk taking. Associations between sexual violence and reported genital discharge and pregnancy that were not mediated by our measures of sexual risk taking were found. More research into the causal mechanisms for this association is needed.     

Advances in violence and trauma: toward comprehensive ecological models

The most important things learned about violence and trauma in the past 20 years are that interpersonal violence is prevalent, with different forms co-occurring, and that victims' reactions are complex. Researchers are called to consider models that include the ecological context within which victims experience violence and trauma to gain a better understanding of the variation seen in psychological outcomes. Multivariate data-analytic techniques such as structural equation modeling and cluster analysis are suggested as promising ways to explore questions framed by comprehensive models. These recommendations are predicted to provide comprehensive and individualized ways to intervene and prevent interpersonal violence.     

Issues related to defining and measuring violence against women: response to Kilpatrick

This paper asserts that although there is considerable agreement in the U.S. and internationally about the importance of uniform terminology and measurement related to violence against women, we need a strategy for choosing standardized definitions and measures. Responding to Kilpatrick's comments at the October 2003 national research conference on violence against women, the author stresses the importance of developing and using uniform terminology related to violence against women, and discusses the lack of a formal mechanism to achieve uniformity of definitions and measurement. Uncertainty about the impact of context on survey findings and the lack of agreement about the optimal scope of measurement are discussed. The author also comments on some difficulties associated with implementing Kilpatrick's proposed modifications to existing measures of rape and sexual assault.     

Betrayal trauma: associations with psychological and physical symptoms in young adults

Betrayal trauma, or trauma perpetrated by someone with whom a victim is close, is strongly associated with a range of negative psychological and physical health outcomes. However, few studies have examined associations between different forms of trauma and emotional and physical symptoms. The present study compared betrayal trauma to other forms of trauma as predictors of young adults' psychological and physical symptoms, and explored potential mediators. A total of 185 university undergraduate students completed the Brief Betrayal Trauma Survey, the Trauma Symptom Checklist, the Toronto Alexithymia Scale, and the Pennebaker Inventory of Limbic Languidness. For each set of symptoms, simultaneous multiple regressions assessed the relative contributions of low versus high betrayal trauma to psychological and physical health reports. Structural equation models examined traumatic stress symptoms and alexithymia as mediators of the relationship between betrayal trauma and physical health symptoms. A total of 151 participants (82%) reported exposure to at least 1 of 11 forms of trauma queried (M = 2.08, SD = 1.94); 96 participants (51.9%) reported at least 1 betrayal trauma. Traumas characterized by high betrayal predicted alexithymia, anxiety, depression, dissociation, physical health complaints, and the number of days students reported being sick during the past month, whereas other traumas did not. Structural equation modeling revealed that traumatic stress symptoms and alexithymia mediated the association between betrayal trauma and physical health complaints. These results indicate that betrayal trauma is associated with young adults' physical and mental health difficulties to a greater extent than are other forms of trauma. Results may inform assessment, intervention, and prevention efforts.     

Mental disorder in violent women in secure settings: Potential relevance to risk for future violence

The relevance to women of common violence risk factors identified in men has in many instances yet to be established. Consequently, there is a reluctance to accept without question the application to women of practices relating to violence risk assessment and management developed from research into men. This study examines mental disorder in women who are violent in order comment on its relevance to the practice of violence risk assessment and management. A sample of 95 violent women in high secure prison and forensic psychiatric care were assessed. Structured assessments of Axis I and II mental disorders and psychopathy were undertaken on all women and conviction histories were recorded. Very high levels of psychiatric morbidity were noted and patterns in comorbidity were detected. Among Axis I conditions, psychotic disorders and disorders of mood co-occurred at a very high rate. Among the Axis II conditions, dimensional ratings of borderline personality disorder (PD) correlated with dimensional ratings of avoidant, dependent and paranoid PDs while ratings of antisocial PD correlated with those of narcissistic, histrionic and obsessive–compulsive PDs. Women who had been incarcerated for a major violent offence were four times more likely to have a diagnosis of borderline PD than women whose index offence was one of minor violence. A number of the findings reported are in contrast to those reported in similar studies of men. Findings suggest that practitioners are right to question the application to women of knowledge derived from research into men. The practice of violence risk assessment and management with women should emphasise the development of individual risk formulations and responding to psychiatric comorbidity should be the rule rather than the exception with this population.     

A preliminary study of the factors related to trauma in childhood sexual abuse

This study examined levels of depression, anxiety, and self worth in a sample of 75 sexually abused girls. The subjects had higher levels of anxiety and depression and lower levels of self worth than normal samples. Although multivariate analysis failed to find a relationship between abuse-specific variables and outcome when the variables were examined alone, significant interactions emerged. The interaction between the identity of the perpetrator and force was significantly related to levels of depression and self worth. Force was related to a less serious impact when the father was a perpetrator and more serious with a non-father perpetrator. The interaction of the perpetrator and whether the child was removed from the home was related to anxiety. When abused by a perpetrator who was not a father figure, those removed from the home had higher levels of anxiety. Trends in the data and significance of the research to intervention are discussed.     

Nature-nurture interplay: genetically informative designs contribute to understanding the effects of trauma and interpersonal violence

The past two decades have seen an explosion in research in the fields of violence and trauma and behavior genetics. These two fields came into direct conflict when Lisabeth Fisher DiLalla and Irving I. Gottesman outlined a fundamental conceptual limitation of trauma and violence research: that rather than being causal, the well-documented relationship between exposure to trauma or violence and later negative outcomes could be explained by gene-environment correlation. In the past decade, researchers have addressed this limitation by studying the effects of trauma and violence using genetically informative designs. This report briefly discusses the gains made from this research approach and the promising future for genetically informative trauma and violence research.     

Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women

Childhood abuse and other developmentally adverse interpersonal traumas may put young adults at risk not only for posttraumatic stress disorder (PTSD) but also for impairment in affective, cognitive, biological, and relational self-regulation ("disorders of extreme stress not otherwise specified"; DESNOS). Structured clinical interviews with 345 sophomore college women, most of whom (84%) had experienced at least one traumatic event, indicated that the DESNOS syndrome was rare (1% prevalence), but DESNOS symptoms were reported by a majority of respondents. Controlling for PTSD and other anxiety or affective disorders, DESNOS symptom severity was associated with a history of single-incident interpersonal trauma and with more severe interpersonal trauma in a dose-response manner. Noninterpersonal trauma was associated with elevated prevalence of PTSD and dissociation but not with DESNOS severity. Study findings indicate that persistent posttraumatic problems with self-regulation warrant attention, even in relatively healthy young adult populations.     

Advances and future directions in the study of children's neurobiological responses to trauma and violence exposure

One of the most exciting developments to emerge from the field in the past 20 years is the increasing attention to neurobiological responses to violence and trauma exposure. Although researchers have yet to identify a consensual pattern of neurobiological response to violence and trauma exposure, it does appear that some type of alteration in the hypothalamic pituitary adrenal (HPA) axis is likely. This article briefly reviews the multiple moderating factors that help account for the divergent patterns in HPA function as well as methodological advances that will continue to improve the assessment of HPA function in youth exposed to violence and trauma.     

Do court‐ and self‐referred domestic violence offenders share the same characteristics? A preliminary comparison of motivation to change,locus of control and anger

Objectives. The purpose of this research was to assess whether court‐ and self‐referred domestic violence offenders differ on levels of motivation to change, personal control and anger, and hence whether these two offender groups are distinct. Method. Thirty‐eight court‐referred and 14 self‐referred male domestic violence offenders completed three scales: URICA‐DV, Levenson Locus of Control and Novaco Anger Scale. Results. It was found that self‐referred men exhibited significantly higher levels of motivation to change, internal locus of control and anger in response to anger‐provoking situations than did court‐referred men. Conclusions. The results indicate that there may be fundamental differences between these two offender groups and question the suitability of combining these groups in offender treatment. Results are discussed in the context of treatment efficacy and outcome.     

Poor parenting and antisocial behavior among homeless young adults: links to dating violence perpetration and victimization

Though research has examined risk factors associated with street victimization among homeless young people, little is known about dating violence experiences among this group. Given homeless youths' elevated rates of child maltreatment, it is likely that they are at high risk for dating violence. As such, the current study examined the association between child maltreatment and parental warmth with dating violence perpetration and victimization through substance use and delinquency among a sample of 172 homeless males and females. Results from path analysis revealed that physical abuse, sexual abuse, and neglect were all significant correlates of both substance use and delinquency, whereas lack of parental warmth was only associated with substance use. Neglect and substance use had direct effects on dating violence and substance use and was found to mediate the relationship between physical abuse and dating violence. Finally, females, older youth, and non-Whites had significantly higher levels of dating violence compared with their counterparts.     

Death related to nasal surgery: case report with review of therapy-related deaths

The investigation of deaths that are suspected to be related to medical therapy present several challenges for the forensic pathologist. In all such cases, it is important for the pathologist to understand the therapy/procedure that may have played a role in death. As such, review of medical records and possible consultation with various medical specialists before autopsy can provide valuable information to ensure proper evaluation in any given case.Herein, we describe a rare death occurring as a complication of septoplasty, nasal polypectomy, and intranasal endoscopic ethmoidectomy, which are common surgical procedures performed by otolaryngology/head and neck surgeons. An otherwise healthy 58-year-old woman underwent the elective surgical procedures for a deviated nasal septum, multiple nasal polyps, and chronic ethmoid sinusitis. Following surgery, the patient never awoke from general anesthesia, and further evaluation before death revealed a basilar subarachnoid hemorrhage. Autopsy disclosed basilar subarachnoid hemorrhage, a traumatic defect of the right cribiform plate, and associated anterior cerebral artery injury with frontal lobe damage. No vascular anomalies were present. The cause of death was attributed to complications related to nasal surgery, and the manner of death was ruled "accident."Following the presentation of this case, the authors discuss these common nasal surgical procedures, including a summary of their known complications. In addition, the authors address and review the topic of deaths related to medical therapy.     

Child witness research and forensic interviews of young children: A review

In this article, we provide an introduction to child eyewitness memory issues that are frequently discussed and debated, both within the research and practice communities. We review several of the central areas of research on child eyewitness memory and some of the most promising protocols aimed at standardizing and improving child forensic interviews. We focus primarily on memory in young children, because they pose particular challenges. Research on the use of props and external cues to prompt young children's memory is discussed. We also review research on professionals' knowledge and attitudes about children as witnesses. It is concluded that we must guard against overly negative or overly optimistic views of children's abilities.     

Children and young people accused of child sexual abuse: A study within a community

This paper reports on a study of 227 children and young people, all living in a West Midlands city in the UK, who between November 1993 and December 1999 were accused of having sexually abused a child. The study had two main objectives: first to examine the alleged behaviours, family backgrounds and personal characteristics of the young people; and second to discover what factors, if any, may be associated with recidivism later in adulthood. It is still too early to draw firm conclusions regarding recidivism, because half of the sample has not yet reached adulthood. However, preliminary findings contradict the notion that many young people who display sexually abusive behaviour will grow into adult sex offenders.