Thurston High School

Abstract

On May 21, 1998 Kipland Kinkel entered Thurston High School in Springfield, Oregon, gunned down two students and injured scores more, after murdering his parents the night before. There is a dearth of research focused on the effects of such violence in school settings where the perpetrator is a peer of his victims. We do not know if, how, or under what circumstances adolescents exposed to this violence are psychologically changed, or if the changes are temporary or long-lasting. This study explores the incidence of post-traumatic effects of such an incident. These effects are hypothesized to be influenced by both distal (physical) (Pynoos & Nader, 1986) and emotional proximity (Terr, 1990). Emotional proximity is, in this study, measured by connectedness to the school. Effects of peritrauma dissociative responses in the immediate aftermath of the incident on longitudinal effects are also explored. Participants include 80 respondents who completed a lengthy survey at two to three years post incident. The sample was predominantly recruited from three Oregon institutes of higher learning. It includes adolescents who were enrolled at Thurston High School at the time, young adults who had graduated from Thurston in the five years prior to the incident and a control group from another college town 40 miles away. Findings support the hypotheses that distal proximity at the time of the event predicts the longitudinal direct effects of distress from hyper arousal, intrusions, and avoidance. Controlling for distal proximity, emotional proximity to Thurston High School predicts peritrauma dissociative response and alexithymia. Further, elevated peritrauma scores predicts distress from intrusions at two to three years. These results suggest there can be long-lasting effects from one instance of acute school violence. Limitations of the study and future research are discussed.     

Asylum Seekers Along the U.S.-Canada Border

Abstract

Given the large numbers of people fleeing their homelands, social workers are likely to encounter refugees from all over the world. Although the social work profession has a mandate to work with disenfranchised populations, limited attention has been paid to providing services to refugees. Residents of the largest refugee shelter in the U.S. were interviewed about their claims. These findings can help social workers understand the situations refugees come from as well as processes they go through in applying for legal status. With this information, it is possible to identify roles social workers can play with this vulnerable population.     

Chapter 10. Central American Survivors of Political Violence

Abstract

Despite compelling, well-documented findings on the levels of stress and trauma among Central American refugees, this group continues to be underserved. A host of issues contributes to this underservice, ranging from macro-level imposed obstacles, such as citizenship and health insurance as determining factors for accessing social and health services, to institutional factors that impede service utilization, such as an insufficient number of translators or a cumbersome and confusing bureaucracy. This chapter adopts a human rights framework as a strategy for working with groups of Central Americans who have experienced political violence. The ongoing effects of political violence on Central Americans, as they relate to mental and physical health problems, are reviewed and a case vignette is used to illustrate how political violence affects individuals and how macro-level forces and institutions create barriers to access and use of health care and social services. Treatment approaches for helping survivors of political violence in the context of a human rights framework are suggested.     

Sudden Unexpected Death due to Chiari Type I Malformation in a Road Accident Case

This case concerns a sudden death of a patient with Chiari I malformation. A 17‐year‐old female was seen unconscious then fell off a motorbike during the vehicle acceleration. The girl was confirmed dead on the way to hospital, being previously asymptomatic and with a clean medical record. Autopsy findings showed an extremely extra‐long cerebellar tonsillar herniation in the left side and unexplained multiple small cavities in cerebral hemispheres. Microscopic findings revealed loss and abnormal migration of the Purkinje cells, as well as capillary congestion in the herniated tonsil. The cause and mechanisms of this sudden death are considered as the cardiopulmonary dysfunction and arrest resulted from compression of the medulla and cervical cord, which was induced by both the positional insult and minor head trauma. In addition, this study stresses the importance of cervical cord examination in the case of unexpected sudden death following road accidents.     

Spaced cognitive interviewing: Facilitating therapeutic and forensic narration of traumatic memories

Abstract

The evolution of the cognitive interview (CI) is reviewed from the original package of memory-enhancing techniques through to the revised (or enhanced) CI, and the cognitive approach now taught to police officers in UK. Many officers are reluctant to apply CI, particularly to traumatised victims. The traumatising effects of crime are examined in terms of immediate response and the potential for an acute stress response and post-traumatic stress disorder, with subsequent re-experiencing of dissociated traumatic memories in the form of intrusive, unwanted imagery. Traumatic memories are described, particularly their accuracy, detail and persistence. The therapeutic potential of prolonged experience of distress while narrating the content of traumatic imagery is explained. An approach to maximising the disclosure of dissociated detail - spaced cognitive interviewing (SCI) - is described and case material presented illustrating its forensic and therapeutic application. The practice and practical implications of SCI are summarised.     

Scanning Electron Microscope Analysis of Gunshot Defects to Bone: An Underutilized Source of Information on Ballistic Trauma

Recent years have seen increasing involvement by forensic anthropologists in the interpretation of skeletal trauma. With regard to ballistic injuries, there is now a large literature detailing gross features of such trauma; however, less attention has been given to microscopic characteristics. This article presents analysis of experimentally induced gunshot trauma in animal bone (Bos taurus scapulae) using full metal jacket (FMJ), soft point (SP), and captive bolt projectiles. The results were examined using scanning electron microscopy (SEM). Additional analysis was conducted on a purported parietal gunshot lesion in a human cranial specimen. A range of features was observed in these samples suggesting that fibrolamellar bone response to projectile impact is analogous to that observed in synthetic composite laminates. The results indicate that direction of bullet travel can be discerned microscopically even when it is ambiguous on gross examination. It was also possible to distinguish SP from FMJ lesions. SEM analysis is therefore recommended as a previously underexploited tool in the analysis of ballistic trauma.     

Death Due to Isolated Jejunal Tear Following Blunt Abdominal Trauma

Small intestinal injury following blunt abdominal trauma has been widely reported. Isolated jejunal tear which is caused by blunt abdominal trauma is rare and is most often seen in road traffic accidents. Here, we report a case of isolated jejunal tear in a 24‐year‐old male truck driver. He was admitted to a tertiary care hospital in a South Indian Metropolitan city with complaints of acute abdominal pain and tiredness following alleged accidental blunt trauma sustained to abdomen due to steering wheel impact. An isolated jejunal tear and adjacent mesenteric contusion and tear were missed by the treating physician even after preliminary investigations, and thus, the conservative management was instituted. The condition deteriorated gradually, and he succumbed to death. The autopsy revealed transverse tear of jejunum almost involving whole of its circumference on the antimesenteric border and peritonitis. Proper use of radio‐diagnostic techniques and timely undertaken explorative laparotomy would have saved the life.     

Reverse engineering--rapid prototyping of the skull in forensic trauma analysis

Rapid prototyping (RP) comprises a variety of automated manufacturing techniques such as selective laser sintering (SLS), stereolithography, and three-dimensional printing (3DP), which use virtual 3D data sets to fabricate solid forms in a layer-by-layer technique. Despite a growing demand for (virtual) reconstruction models in daily forensic casework, maceration of the skull is frequently assigned to ensure haptic evidence presentation in the courtroom. Owing to the progress in the field of forensic radiology, 3D data sets of relevant cases are usually available to the forensic expert. Here, we present a first application of RP in forensic medicine using computed tomography scans for the fabrication of an SLS skull model in a case of fatal hammer impacts to the head. The report is intended to show that this method fully respects the dignity of the deceased and is consistent with medical ethics but nevertheless provides an excellent 3D impression of anatomical structures and injuries.     

A method for studying knife tool marks on bone

The characteristics of knife tool marks retained on hard tissues can be used to outline the shape and angle of a knife. The purpose of this study was to describe such marks on bone tissues that had been chopped with knives. A chopping stage with a gravity accelerator and a fixed bone platform was designed to reconstruct the chopping action. A digital microscope was also used to measure the knife angle (θ) and retained V-shape tool mark angle (ψ) in a pig skull. The κ value (elasticity coefficient; θ/ψ) was derived and recorded after the knife angle (θ) and the accompanied velocity were compared with the proportional impulsive force of the knife and ψ on the bone. The constant impulsive force revealed a correlation between the V-shape tool mark angle (ψ) and the elasticity coefficient (κ). These results describe the tool marks--crucial in the medicolegal investigation--of a knife on hard tissues.