Ophthalmologic Concerns in Abusive Head Trauma

When Abusive Head Trauma (AHT) is suspected in a child, a dilated eye examination by an ophthalmologist is an essential part of the medical workup, as the presence and pattern of retinal hemorrhages can have a high positive predictive rate for abusive head injury. This article proposes to review the clinical presentation, pathophysiology, natural history, sequelae, and differential diagnosis of retinal hemorrhages and other ocular lesions associated with AHT.     

Skin Lesions and Other Associated Findings in Children with Abusive Head Trauma

When Abusive Head Trauma (AHT) is suspected, the presence of extracranial lesions can be a decisive factor in confirming the diagnosis. In this article, we briefly review and illustrate some of the skin lesions and other extracranial injuries frequently associated with AHT.     

急性闭合性颅脑损伤临床分型与伤情鉴定30例分析

目的 探讨急性闭合性颅脑损伤的临床分型与损伤程度鉴定结果 的相关性,以提高法医学鉴定结果 的准确性,为今后损伤程度鉴定标准的修订提供科学、合理的参考依据. 方法 选取急性闭合性颅脑损伤的鉴定案件30例,分别做出临床分型与损伤程度鉴定,比较两者结果 及相关依据的异同. 结果 轻型颅脑损伤相当于轻微伤或轻伤,中型颅脑损伤相当于轻伤或重伤,重型或特重型颅脑损伤多相当于重伤.结论 急性闭合性颅脑损伤的临床分型与损伤程度鉴定结果 有一定的相关性,在修订人体损伤程度鉴定标准时有必要参考临床分型标准,以提高鉴定标准的科学性和合理性.     

African American Women’s Readiness to Change Abusive Relationships

This study explores 178 low-income, abused African American women’s readiness to change abusive relationships and achieve safety. We explore stages of change using Prochaska and DiClemente’s transtheoretical model (TM; Precontemplation, Contemplation, Action, Preparation, and Maintenance). Results reveal that: for abused women, the stages fall along a continuum (versus discreet and linear stages); abused women are primarily in the Contemplation stage; and multiple factors (perception of current abuse, number of children in her home, symptoms of general anxiety and posttraumatic stress disorder [PTSD], substance use, spiritual well-being, self-esteem, and social support) affect women’s total readiness to change intimate partner violence (IPV). Current IPV, anxiety, PTSD, substance abuse, and spirituality were positively correlated with readiness to change, and children in the home and self-esteem were negatively correlated with readiness to change. Multiple regression analysis revealed that PTSD and spiritual well-being are positive predictors of readiness to change. Findings contribute to the growing body of literature supporting the TM as applied to IPV. Results are discussed in terms of applicability to interventionists, policy makers, and community leaders as they consider the plight of abused women and their efforts towards violence-free relationships.     

Using the Investment Model to Understand Battered Women's Commitment to Abusive Relationships

We replicate and extend research using the Investment Model (Rusbult, 1980, J. Exp. Social Psychol., 45, 101–117) to understand battered women's commitment to abusive relationships. The Investment Model is a nonpathologizing theory that views commitment as a function of one's satisfaction with, alternatives to, and investments in the relationship. These factors were examined in a shelter-based sample of battered women. Investment model variables, particularly satisfaction, were also examined as mediators of the relationship between abuse exposure and commitment. Both Investment Model and abuse exposure constructs were assessed using instruments more fully developed than in previous research. Results indicated that each of the Investment Model factors contributed uniquely to women's commitment, and that relationship satisfaction mediated the relationship between psychological (but not physical) abuse and commitment. Implications for future research and intervention are discussed.

Shame and Guilt and its Relation to Direct and Indirect Experience of Trauma in Adolescence,a Brief Report

Exposure to different kinds of traumatic events is common among adolescents. This brief report study examined whether shame proneness and guilt proneness were associated with direct and indirect experience of potentially traumatic events (PTEs). We investigated the relationship between gender, PTEs, shame, and guilt among adolescents (n?=?314, age?=?15–20 years). We hypothesized that shame proneness and guilt proneness would be associated with direct experience of interpersonal and sexual PTEs, that both direct and indirect experience of potentially traumatic sexual event/s would correlate with female gender, and that potentially traumatic direct and indirect interpersonal event/s would correlate with male gender. Shame was positively associated with having experienced direct sexual trauma and with female gender. Girls had more often experienced potentially traumatic direct sexual events and boys had more often experienced potentially traumatic direct interpersonal events. Indirect experiences of traumatic events were not related to either gender or shame. We conclude that the relation between shame, PTEs, and gender is complex with both types of traumas and gender interact with shame. This study found that shame and direct experience of sexual traumatic events were associated among adolescent girls. Gender and what type of traumatic events adolescents’ direct experience is most likely related but not gender and what type of indirect experienced trauma.

     

Discrimination of Falls and Blows in Blunt Head Trauma: A Multi‐Criteria Approach

Abstract: In the discrimination of falls versus blows, the hat brim line (HBL) rule is mentioned in several textbooks as the most useful single criterion. Recent studies, however, have found that the HBL rule is only moderately valid and that its use on its own is not recommended. The purpose of this 6‐year retrospective study was to find additional individually useful criteria in the distinction of falls from blows. Overall, the following criteria were found to point toward blows: more than three lacerations, laceration length of 7 cm or more, comminuted or depressed calvarial fractures, lacerations or fractures located above the HBL, left‐side lateralization of lacerations or fractures, more than four facial contusions or lacerations, presence of ear lacerations, presence of facial fractures, and presence of postcranial osseous and/or visceral trauma. Based on the most discriminating criteria, a decision tree was constructed to be potentially applicable to future cases.     

Reasons for Returning to Abusive Relationships: Effects of Prior Victimization

Studies have demonstrated that women with a history of childhood sexual abuse (CSA) are at increased risk of revictimization, but research has not yet examined whether a history of CSA may affect patterns of remaining in or returning to abusive relationships in adulthood. This study examines the impact of a CSA history on decisions to return to abusive relationships in a sample of 104 adult domestic violence survivors. Participants were interviewed about the number of times that they had previously separated from and returned to their abusive partner, the factors that influenced their decision to return (both psychological/internal and environmental/external factors), and their perceived likelihood of returning in the future. As predicted, CSA survivors (n = 34) reported a significantly greater number of past separations than non-CSA survivors (n = 70). CSA survivors were also significantly more likely to report that their decisions to return were influenced by emotional attachment to the batterer. CSA survivors did not perceive themselves to be at greater risk of returning in the future, suggesting that they may be more likely to underestimate their vulnerability to returning to the battering relationship. Clinical implications of the findings are discussed.     

Personality Profiles of Women in Multiple Abusive Relationships

Personality profiles of women with multiple abusive relationship histories (N = 42) were compared to either abused women with 1 abusive relationship (N = 33) or a control group (N = 52) on the Coolidge Axis II Inventory (Coolidge & Merwin, 1992, J. Pers. Assess. 59: 223–238), a self-report measure based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). Women with multiple abusive relationships had higher rates and greater levels of dependent, paranoid, and self-defeating personality disorders than women in the other 2 groups. Women in multiple abusive relationships had significantly more depression, and women in this group with posttraumatic stress disorder (PTSD) had significantly more personality disorders than women with single abusive relationships with PTSD. Women in single abusive relationships did not exhibit more psychopathology than women in the control group with matched marital status. Theoretical and methodological issues, and treatment recommendations are discussed.     

Discrimination of Falls and Blows in Blunt Head Trauma: Assessment of Predictability Through Combined Criteria*

Abstract: The discrimination of falls from homicidal blows in blunt head injuries is a common but difficult problem in both forensic anthropology and pathology. Three criteria have been previously proposed for this distinction: the hat brim line rule, side lateralization of fractures, and number of lacerations. The aim of the present study was to achieve a better distinction rate by combining those criteria and assess the predictability of these combined criteria tools. Over a 6‐year period, a total of 114 cases (92 males and 22 females) were studied: 21 cases of downstairs falls, 29 cases of falls from one’s own height, and 64 cases of head trauma by a blunt weapon. The results revealed predictability rates varying from 62.5 to 83.3% for criteria pointing towards a fall. As for combined criteria in favor of a blow, the assumption was accurate in all cases (100%).     

Women Who Kill Their Abusive Partners: from Sameness to Gender Construction

Since the early 1990s there has been a plethora of academic commentary on the criminal law’s treatment of women who kill their abusive partners. More recently, the debate has been re-opened due to the Law Commission’s proposals on Partial Defences to Murder. This article aims to critically analyse the approach adopted by the academic commentary and to place in within a feminist theory framework. In addition the article argues that the work of queer theorist Judith Butler enables the analysis of the law’s treatment to be developed further.Law Lecturer, Liverpool John Moores University. I would like to thank Dr Jamie Murray and Dr Lorie Charlesworth for their help and support in the writing of this article.     

德国法中的滥用市场支配地位行为

一　德国竞争法的主要内容自从 1 95 8年《反对限制竞争法》开始生效以来 ,德国关于对滥用市场支配地位行为的管制便体现在法律中。顺便提出 ,欧共体竞争法也是在同一年生效的。对滥用行为的管制和与其同时首次实施的全面禁止卡特尔的法律一并构成德国竞争法的两大基石。另一方面 ,关于企业合并控制的规定在德国是《反对限制竞争法》颁布 5年后实施的 ,而欧盟则是在 1 990年。目前 ,禁止卡特尔、控制企业合并和管制占市场支配地位的企业构成德国竞争法中保护竞争的三根主要支柱。鉴于德国竞争政策和经济结构的发展 ,禁止卡特尔变得至关重要…     

Perpetrator Personality Effects on Post-Separation Victim Reactions in Abusive Relationships

Previous research has examined the influence of the abusive personality (Dutton, 1994a,b) on relationship dynamics. Men with high scores of abusive personality (borderline personality organization, anger and MCMI8: Negativity) generate more frequent and extreme forms of physical and emotional abuse in intimate relationships. Other lines of research have examined the role of these relationship features in influencing post-separation adjustment in women. The current study combines two data sets; one bearing on the first of these issues, the other on the second issue, in order to connect characteristics of the perpetrator's personality to post separation aspects of victim reaction. Substantial associations are found between abusive personality and relationship dynamics and between the latter and persistent attachment, trauma symptoms, and lowered self esteem in battered women.     

Race and Demographic Factors in Treatment Attendance for Domestically Abusive Men

This study examined the influence of race and other demographic characteristics on session attendance and dropout from a cognitive-behavioral treatment program for male domestic abusers (N = 101). Multiple regression analyses revealed that lower session attendance was significantly predicted by unemployed status and African American (versus Caucasian) race. Other demographic factors could not account for the race differences in session attendance. Race was the strongest predictor of dropout and session attendance in all analyses. Racial composition of treatment groups was not significantly related to number of sessions attended for Caucasian or African American clients. Although the combined (interactive) effect of race and referral source on number of sessions was not statistically significant, the pattern of means suggested that self-referred African Americans were at the greatest risk for dropout. Results suggest that race differences in dropout, and the mechanisms that account for these differences, deserve more clinical and research attention in treatment for domestic abusers.     

Causal Attributions and Affective Responses to Provocative Female Partner Behavior by Abusive and Nonabusive Males

The present study examined the effects of the degree of female partner provocation on cognitive attributions and affective responses in verbally abusive and nonabusive college males. In Phase 1 (N = 116), subjects listened to audiotapes of hypothetical dating situations in which the female partner's behavior was nonprovocative or moderately provocative; in Phase 2 (N = 105), the female partner's behavior was nonprovocative or highly provocative. The major hypothesis was that abusive males would make greater negative intent and responsibility attributions and report more powerful feelings of jealousy, rejection, and abandonment in response to moderately and highly provocative partner behavior but not in response to nonprovocative partner behavior than would nonabusive males. Results from Phase 1 showed that abusive males reported reliably greater negative attributions and feelings of jealousy, rejection, and abandonment in response to moderately provocative partner behavior than did nonabusive males. No group differences were associated with nonprovocative partner behavior. Results from Phase 2 showed that abusive males attributed greater negative intent and feelings of rejection and abandonment to both highly provocative and nonprovocative partner behavior than did nonabusive males. Negative attributions and feelings of jealousy, rejection, and abandonment increased reliably from moderately provocative to highly provocative female behavior for abusive and nonabusive males, who differed reliably from each other. Implications for the assessment and treatment of abusive men were discussed.     

Intervention for Abusive Fathers: Promising Practices in Court and Community Responses

Fathers who have abused their children or their children's mothers constitute a significant challenge to court and community service providers. Although legislation offers direction for court dispositions, resulting court orders are only the starting point for ensuring children's safety. This article begins with a rationale for expanding services to include intervention for abusive fathers. Using the Caring Dads program as an example, we identify four principles to guide appropriate intervention with abusive fathers and discuss their theoretical and practical implications. Throughout the article we contrast the model we are proposing with more traditional court and intervention program responses to abusive fathers.     

Teaching Young Children to Discriminate Abusive From Nonabusive Situations Using Multiple Exemplars in a Modified Discrete Trial Teaching Format

Personal safety programs can teach young children knowledge and skills they can utilize to avoid or escape abduction and sexual abuse (Wurtele, 1990). An appropriate escape response will not occur, however, if the child is unable to discriminate an innocuous situation from a potentially abusive one. This study examines the crucial elements involved in training the recognition or discrimination phase in personal safety programs. A multiple probe design across three typically developing children, ages 5-years 7-months through 6-years 7-months, was used to determine whether rules and discrete trial training of discriminations of appropriate and inappropriate touch and situations generalized to puppet role-play scenarios. All participants showed increases in correct responding on generalization role-play probes and maintained these increases over a 3-and 6-week follow-up.     

Development of a Marketing Campaign to Recruit Non-adjudicated and Untreated Abusive Men for a Brief Telephone Intervention

Although voluntary enrollment by abusive men in domestic violence perpetrator treatment programs occurs, most men enter treatment only after they have injured a partner or family member and have been arrested, convicted and sentenced. This leaves a serious gap for those who engage in abusive behavior but who have not been served by the legal or social service systems. To address this gap, the researchers applied social marketing principles to recruit abusive men to a telephone-delivered pre-treatment intervention (the Men’s Domestic Abuse Check-Up—MDACU), designed to motivate non-adjudicated and untreated abusive men who are concurrently using alcohol and drugs to enter treatment voluntarily. This article discusses recruitment efforts in reaching perpetrators of intimate partner violence, an underserved population. Informed by McGuire’s communication and persuasion matrix, the researchers describe three phases of the MDACU’s marketing campaign: (1) planning, (2) early implementation, and (3) revision of marketing strategies based on initial results. The researchers’ “lessons learned” conclude the paper. This project is supported by a grant from the National Institute on Drug Abuse, 1 RO1 DA017873.     

How to Maintain Emotional Health When Working with Trauma

Vicarious traumatization, compassion fatigue, or secondary traumatization refers to the cumulative effect of working with survivors of traumatic life events as part of everyday work. Although this issue has been acknowledged and addressed among professionals such as police officers and medical professionals, it has been discussed less among juvenile and family court judges who also experience secondary traumatic stress. In fact, in one recent study, a majority of judges reported one or more symptoms of secondary traumatization. This article describes the common signs and symptoms of secondary trauma, job‐related factors that contribute to secondary trauma among judges, and the potential negative impact on organizational performance. The authors conclude with specific recommendations tailored for juvenile and family court judges.