A forensic medicine perspective on recurring episodes of intimate partner violence

During a three year period, 418 victims of intimate partner violence (IPV) were examined and their injuries documented at the Center for Victims of Violence (CVV) in Hamburg, Germany. All victims were questioned if their acute injuries were attributable to recurring acts of violence by the same intimate partner. The victims' experiences with recurring IPV were analyzed and associated risk factors as well as findings of acute physical injuries were integrated into the assesment. Overall, women were significantly more often victims of recurring episodes of IPV than men. In 35.4% of cases, victims of recurring IPV sustained injuries to three or more body regions. However, women who were victimized during a single act of violence, presented with the same distribution of injuries in only 21.1% of cases (p = 0.01). The results emphasize the fact that IPV often manifests itself in a spiraling escalation of physical violence. Furthermore, blunt force trauma to the head was diagnosed significantly more often (p = 0.05). The risk of sustaining a head injury was equally high for women who experienced a first-time violent episode by their ex-partner as it was for married women or women living in a non-marital partnership during recurring episodes of IPV. In an effort to reduce the increased risk for victims of IPV, health care personnel are highly encouraged to partake in forensic medicine based continuing education. This preventative measure may prepare clinicians to recognize IPV earlier as well as to treat and advise clients appropriately.     

Patients’ views of the quality of Danish forensic psychiatric inpatient care

The present study describes the quality of psychiatric care among forensic inpatients in Denmark who answered the Danish version of the Quality in Psychiatric Care–Forensic In-Patient (QPC–FIP) instrument. A sample of 143 patients (response rate 53%) from 25 of the 27 specialized forensic units in Denmark participated in the study. The patients’ ratings of the quality of care were generally high. The highest rating was found for the quality of the secluded environment and the lowest for patient participation in the care. The results showed that several factors influenced the patients’ ratings. Women rated the quality of care lower in comparison to men. Patients living together with someone before admission, patients with a lower level of education, and patients who were better informed regarding their diagnosis, who was the responsible physician, and where to complain rated the quality of care higher. We can recommend the use of the Danish version of the QPC–FIP instrument for measuring and improving the quality of care in forensic inpatient care.     

Observer Sensitivity and Early Radicalization to Violence Among Young People in Germany

Social Justice Research - Personal sensitivity to injustice from either a victim or an observer perspective shapes political attitudes and actions. Yet, little is known about the link between...     

Fatal child neglect in East Germany 1 January 1985 to 2 October 1990. Results of a multicenter study

No reliable data are available on cases of lethal child neglect in the area of the former German Democratic Republic. In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in the entire area of the former German Democratic Republic. RESULTS: A total of 9 cases were reported to the study center. This does not include undetected cases, whose number, though indeterminate, is probably small due to the general obligation to perform autopsies on all children dying before their 16 birthday. Just over half of all victims were less than one year old, the oldest was 3 1/2 years old. Starvation and severe dehydration were by far the most common causes of death; in half of cases these occurred in combination with hypothermia. Most often mother killed their children by neglect, either alone or together with the victim's father. In the majority of cases no close bond existed between the parents and the child. Seventy percent of the perpetrators were chronic alcoholics. All 10 of the perpetrators were sentenced to imprisonment for periods ranging from one year to life long. Mitigating circumstances were presented at the sentencing phase of the trial on behalf of 20% of those convicted. The experience of legal medical and pathological institutes in the former German Democratic Republic underscores the need to perform an autopsy on all deceased infants and young children. Only this can ensure that no cases of lethal child neglect are overlooked.     

Swollen Lips After a Night of Partying—An Allergic Reaction to Ecstasy?

Ecstasy (MDMA) is a mood‐lifting drug with numerous somatic side effects, for example, dehydration or continuous chewing and biting. We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claimed to have suffered from a memory lapse, and she had a painful swelling of her lips with a plaque‐like coating on her lips and buccal mucosa. The attending physician suspected that these findings might have been caused by strong sucking pressure on her lips within the context of a sexual assault. A toxicological examination of a blood specimen verified that she had been under the influence of an extremely high dose of ecstasy (1.456 mg/L MDMA and 0.0213 mg/L MDA). Pursuant to the forensic medical assessment, the described findings on her lips, and buccal mucosa were interpreted as an allergic and mechanical reaction (through continuous chewing and biting) to ecstasy.     

Self-mutilation in men--injury pattern and motivation

6 cases of self-inflicted injuries in male individuals are reported. The age of the affected men was between 15 and 46 years whereas the younger age predominated. Alleged incidents were robberies in 3 cases, rape in one case, violation in custody in one case and an assault originating in personal motives in one case. In 4 cases, the typical injury pattern of self-infliction was present showing parallel course and superficiality of the wounds in areas accessable by the persons's own hands. In 2 cases, atypical injuries (i.e. deep cuts and massive signs of strangulation respectively) were found. However, in most cases, the underlying motive was to gain affection. An autoerotic accident was tried to be disguised in one case. Profit was the leading motive in another case.