Unveiling the shadows: Investigating the interplay of stalking and sexual homicide-A case study.

Stalking can be defined as a pattern of fixated, repeated, and unwanted behaviours. Stalking is not an isolated incident and was associated to sexual violence. While the relationship between sexual violence and stalking is scarcely explored, no studies have tested the relationship between stalking and sexual homicide, which both involves elements of obsession. The aim of this paper was to study the relationship between stalking and sexual homicide using an exploratory case study analysis of 7 males convicted for sexual homicide. Results revealed: (1) The presence of obsession prior to the homicide; (2) The victims were ex-intimate partners or acquaintances; (3) The victims were followed several times prior to the index offence; (4) Stalking elements were not always considered by the authorities, which has led to an escalation of behaviours. This study expands our understanding between stalking and sexual violence, supporting the design of prevention and treatments.

The temporal relationship between mental health service use and stalking perpetration.

OBJECTIVE: Mental disorder is common among people who stalk. However, the nature of this association is unclear and it is not known whether the commencement of stalking is associated with symptoms of disorder. This study used a longitudinal design to examine the association between the onset and cessation of stalking behavior and indicators of mental disorder in the form of mental health service use. METHOD: Data linkage was used to explore public mental health service use among 157 people who engaged in stalking in Melbourne, Australia. Mental health service use across the lifetime, 5 months prior to stalking onset, between the onset and cessation of stalking (during stalking) and 5 months post-stalking was identified. Mixed regression models tested temporal associations between types of mental health service use (acute vs continuing care) and onset and cessation of stalking in a subsample of 130 participants where dates of the stalking episode were available. RESULTS: A total of 105 (67%) participants had lifetime use of public mental health services, while 15% accessed mental health services in the 5 months prior to (N = 19) or during the stalking (N = 20) and 22% (N = 29) used services in the 5 months after the stalking ceased. Odds of using acute mental health services and average monthly rate of use were highest during the stalking. Odds and average monthly rate of using continuing care were highest after the episode ceased. CONCLUSIONS: Most people who stalk have used public mental health services, but a minority access services immediately prior to or during the stalking episode. Acute service use was more common during the stalking, while use of continuing care services was more common after the stalking ceased. These findings provide preliminary support for a temporal relationship between acute mental disorder and stalking behavior.

A critical analysis of stalking theory and implications for research and practice.

This article comprehensively reviews and critiques theories providing an aetiological account of stalking. We evaluate applications of preexisting psychological theories to stalking (attachment theory, evolutionary theory, social learning theory, information processing models of aggression, coercive control theory, and behavioural theory) as well as the only novel theory of stalking to date: Relational goal pursuit theory. Our aim was to identify which are supported by research, identify gaps in theoretical scope and explanatory depth and examine how current theories might inform clinical practice. This evaluation suggests that theories of stalking are underdeveloped relative to other areas of forensic clinical psychology and the theoretical literature is relatively stagnant. Consequently, there is limited research into clinically meaningful constructs that can guide the assessment, formulation and treatment of this client group. We identify similarities across existing theories, discussing implications for future research and clinical practice with people who stalk.

Victim reactions to being stalked: Examining the effects of perceived offender characteristics and motivations.

The current research utilized the National Crime Victimization Survey Supplemental Victimization Survey to investigate stalking in the United States. These data, collected from stalking victims, address the relationship between victims' perceptions of the stalker's motives on two post-victimization outcomes. Specifically, we examined the relationship between the victim's assessment of motive and the degree of harm they reported, along with exploring the relationship between harm and the likelihoods of engaging in self-protective behaviors. Here, harm was measured through an index of specific fears, concerns, and emotional distresses. We found that the frequency of stalking behaviors, the duration of the stalking experience, and the overall invasiveness of the victimization, in addition to certain motives, were positively correlated with harm. Furthermore, we found that harm was positively correlated with a number of protective actions. For researchers, this work may serve to provide entry points in the development of new grounded theory. For practitioners in law enforcement, this work may provide insights into the invasive nature of stalking and the fear and harm caused to the victim.

The Assessment and Management of Stalking Perpetrated by Clients Against Their Counselors.

Mental health professionals are at heightened risk of stalking victimization, however minimal research has examined empirically supported risk factors for stalking and the efficacy of risk management strategies. Three hundred and six counselors were surveyed, and the present study focuses on the 7% (n = 23) who had been stalked by clients. Results describe the characteristics of stalking, perpetrators, and victims and the perceived efficacy of management strategies employed. Stalking behaviors tended to be of lower severity. Common perpetrator risk factors included relationship problems, anger, and obsession. Victim vulnerabilities were identified, where many victims engaged in behavior considered ineffective in response to stalking. Victims often encountered problems coping with victimization due to inadequate access to resources. Results indicate that risk management plans must be individualized and highlight ways that mental health professionals can and would like to be protected from stalking.

Health Care Professionals' Knowledge of Stalking Perpetrators, Victims, Behaviors, and Coping Strategies: A Preliminary Study among Italian Hospitals.

The aim of this study was to investigate health care professionals' level of in-depth understanding about the various types and characteristics of stalking. In particular, the study examines knowledge on the characteristics of stalkers and their victims, acted behaviors, and coping strategies used to stop the harassment. The data were collected by means of an ad hoc questionnaire. The sample comprised 210 participants working in local health units in Turin, a large city located in the northern part of Italy. The majority were women (160, 76.2%). The participants were aged 20-64 years, and the mean age was 41.63 years (SD = 11.18). The majority of participants were psychologists (99, 47.1%), 31 (14.8%) were nurses, 31 (14.8%) had an unspecified medical profession, 29 (13.8%) were psychiatrists, and 20 (9.5%) were general practitioners. According to the findings, interventions with male victims of stalking, especially when the stalker is a woman, require attention in particular. Underestimating the stalking experience is a risk, so health care professionals in their interventions must explain to the men the emotive and physical consequences of the victimization. Moreover, in suggesting coping strategies, health care professionals must consider the victim's fear of reporting the incident not only to law enforcement authorities but also to family and friends. The findings showed that health care professionals need a better understanding of the stalking phenomenon. Education courses are a valuable tool to identify characteristics of the phenomenon, validate existing knowledge, and decrease the level of missing information to develop the skills needed to take appropriate action in cases of stalking.

Prevalence rates, reporting, and psychosocial correlates of stalking victimization: results from a three-sample cross-sectional study.

PURPOSE: Public health and criminal justice stalking victimization data collection efforts are plagued by subjective definitions and lack of known psychosocial correlates. The present study assesses the question of stalking victimization prevalence among three groups. Psychosocial risk and protective factors associated with stalking victimization experiences were assessed. METHODS: Archival data (n = 2159) were drawn from a three-sample (i.e., U.S. nationwide sexual diversity special interest group, college student, and general population adult) cross-sectional survey of victimization, sexuality, and health. RESULTS: The range of endorsement of stalking-related victimization experiences was 13.0-47.9%. Reported perpetrators were both commonly known and unknown persons to the victim. Participants disclosed the victimization primarily to nobody or a family member/friend. Bivariate correlates of stalking victimization were female gender, Associates/Bachelor-level education, bisexual or other sexual orientation minority status, hypertension, diabetes, older age, higher weekly drug use, elevated trait aggression, higher cognitive reappraisal skills, lower rape myth acceptance, and elevated psychiatric symptoms. Logistic regression results showed the strongest factors in identifying elevated stalking victimization risk were: older age, elevated aggression, higher cognitive reappraisal skills, lesser low self-control, increased symptoms of suicidality and PTSD re-experiencing, and female and other gender minority status. CONCLUSIONS: Behavioral approaches to epidemiological and criminal justice stalking victimization are recommended. Victimization under reporting to healthcare and legal professionals were observed. Further research and prevention programming is needed to capitalize on data concerning personality and coping skills, sexual diversity, and trauma-related psychiatric symptoms.

Correlates of Cyberstalking Victimization and Perpetration Among College Students.

Few studies have examined theoretical predictors of cyberstalking victimization and offending. The current study, guided by self-control theory and a feminist framework, analyzed predictors of cyberstalking victimization and offending among undergraduate college students (N = 662). College women were at increased risk of cyberstalking victimization, but were also more likely to report having engaged in cyberstalking perpetration. Higher levels of self-control reduced the likelihood of cyberstalking victimization and offending. While Greek life membership and holding adversarial heterosexual beliefs did not affect cyberstalking victimization and offending, gender stereotyping decreased the odds of experiencing cyberstalking victimization. Implications for future research and practice are discussed.

[Stalking of psychiatrists and psychotherapists : Results of an online survey]. / Stalking von Psychiatern und Psychotherapeuten : Ergebnisse einer Onlinestudie.

BACKGROUND: Currently, there are clear indications that due to their exposed occupational position psychiatrists and psychotherapists are at a higher risk than the general public to become the victim of stalking by patients. OBJECTIVES: This study investigated the frequency of stalking and its psychosocial impact among psychiatrists and psychotherapists in the Federal Republic of Germany. METHODS: Analysis of an online survey among members of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) from 23 September 2015 until 22 October 2015. RESULTS: Of the respondents 26.5% reported having been the victim of stalking. In more than a third of the reported cases the stalking was described as severely or very severely debilitating. The majority of the perpetrators suffered from psychotic or personality disorders. Male victims were significantly more frequently stalked by a female perpetrator. Approximately 1 in 10 stalking victims continued the treatment of the perpetrator. The majority of the stalking victims did not obtain substantial support from their employer. CONSLUSION: The phenomenon of stalking within therapeutic relationships needs to be incorporated into the medical and psychotherapeutic professional training, e. g. by implementing specialized training courses and the systematic integration of this topic into clinical supervision. The institutional dealing with stalking by patients needs to optimized, e. g. by promptly transferring treatment of patients who stalk to other professionals and, where required, providing assistance in reporting stalking incidents to the police.

Risk Management with Clients Who Stalk, Threaten, and Harass Mental Health Professionals.

Although most psychologists will at some point be confronted with a client who engages in stalking, threatening, or harassing behavior (STHB), few feel prepared to manage these situations. In this article, the results of a survey of 112 psychologists who endorsed experiencing STHB are reported. Psychologists were asked about their perceptions of client motivations and personality pathology, frequency of use of 18 risk management responses, and perceived effectiveness of these responses. The effectiveness of risk management strategies differed by client level of personality organization and motivation for STHB. Some of the most commonly used risk management responses were among those most likely to result in adverse outcomes, particularly with certain types of clients. Efforts to develop empirically derived risk management strategies for clinicians confronted with STHB should integrate contextual variables, such as client personality and motivation.

Perceptions of Stalking: The Impact of Threat Level and Victim Response.

Because of varying legal definitions across jurisdictions, factors that influence judgments of what constitutes stalking are important to identify. In this study, participants (N = 147) were randomly assigned to read 1 of 4 vignettes involving a hypothetical case of stalking, stemming from a 2 (threat level: explicit vs. implicit) × 2 (victim response: fear vs. anger) between-subjects factorial design. Overall, when the threat was implicit or the victim responded with anger, participants were less inclined to view the scenario as representative of stalking. An interaction further revealed that when the threat was explicit, participants were more likely to rate the perpetrator's behavior as severe when the victim responded with fear, as opposed to anger. Implications are discussed.

Young women's experiences of intrusive behavior in 12 countries.

The present study provides international comparisons of young women's (N = 1,734) self-reported experiences of intrusive activities enacted by men. Undergraduate psychology students from 12 countries (Armenia, Australia, England, Egypt, Finland, India, Indonesia, Italy, Japan, Portugal, Scotland, and Trinidad) indicated which of 47 intrusive activities they had personally experienced. Intrusive behavior was not uncommon overall, although large differences were apparent between countries when women's personal experiences of specific intrusive activities were compared. Correlations were carried out between self-reported intrusive experiences, the Gender Empowerment Measure (GEM), and Hofstede's dimensions of national cultures. The primary associations were between women's experiences of intrusive behavior and the level of power they are afforded within the 12 countries. Women from countries with higher GEM scores reported experiencing more intrusive activities relating to courtship and requests for sex, while the experiences of women from countries with lower GEM scores related more to monitoring and ownership. Intrusive activities, many of them constituent of harassment and stalking, would appear to be widespread and universal, and their incidence and particular form reflect national level gender inequalities.

Adolescent stalking and risk of violence.

Stalking perpetration and the associated risk for violence among adolescents has generally been neglected. In the present study, 1236 youth completed surveys assessing empirically established stalking indicators, threats and aggression toward stalking victims, dating violence, and violent delinquency. Latent Profile Analysis identified 3 latent classes of boys: non-perpetrators (NP), hyper-intimate pursuit (HIP), and comprehensive stalking perpetrators (CSP) and, and 2 classes for girls: NP and HIP. Boys in the CSP class were the most violent youth on nearly all indices with boys in the HIP class demonstrating an intermediate level of violence compared to NP boys. Girls in the HIP class were more violent than NP girls on all indices. These findings suggest stalking in adolescence merits attention by violence prevention experts. In particular, juvenile stalking may signify youth at risk for multiple forms of violence perpetrated against multiple types of victims, not just the object of their infatuation.

Public Figure Fixation: Cautionary Findings for Mental Health Practitioners.

Research in western nations has found that pathologically fixated individuals pose a risk of serious harm to public figures, and that many of these fixated persons are mentally ill and require treatment. Over the past decade, integrated fixated threat assessment agencies have been established in western Europe and Australia to specifically assess and manage this group. The current study examines 400 consecutive referrals to a fixated threat assessment center in Queensland, Australia, with a particular focus on the mental health and risk profile of those who engage in inappropriate contact with public office holders. It considers the high proportion of delusional disorders in this cohort, and their identification and management by psychiatric services. The authors conclude with a discussion of the mental health response to this group and impediments to mitigating the risks posed by fixated persons. Copyright © 2016 John Wiley & Sons, Ltd.

Medical Boards and Fitness to Practice: The Case of Teleka Patrick, MD.

BACKGROUND: Medical boards and fitness-to-practice committees aim to ensure that medical students and physicians have "good moral character" and are not impaired in their practice of medicine. METHOD: Presented here is an ethical analysis of stalking behavior by physicians and medical students, with focus on the case of Teleka Patrick, MD (a psychiatry resident practicing medicine while under a restraining order due to her alleged stalking behavior). CONCLUSIONS: While a restraining order is not generally considered a criminal conviction, stalking behavior is clearly unprofessional and a marker of inappropriate character and fitness, yet the reporting obligations for such matters are complex. Medical schools and training programs that fail to assess, record, and report matters of moral conduct such as this potentially allow impaired students to graduate and enter the work force (unless a robust licensing process identifies them). Patrick's case should be a wake-up call for medical schools and medical boards to better integrate the professionalism domain into their operations. Further, the professionalism of students and doctors need to be integrated into the legal domain, so that those who are unfit to practice are, in fact, prevented from doing so. Guidance for integration is provided.

Harassment, stalking, threats and attacks targeting New Zealand politicians: A mental health issue.

OBJECTIVE: Due to the nature of their work, politicians are at greater risk of stalking, harassment and attack than the general population. The small, but significantly elevated risk of violence to politicians is predominantly due not to organised terrorism or politically motivated extremists but to fixated individuals with untreated serious mental disorders, usually psychosis. Our objective was to ascertain the frequency, nature and effects of unwanted harassment of politicians in New Zealand and the possible role of mental illness in this harassment. METHODS: New Zealand Members of Parliament were surveyed, with an 84% response rate (n = 102). Quantitative and qualitative data were collected on Parliamentarians' experiences of harassment and stalking. RESULTS: Eighty-seven percent of politicians reported unwanted harassment ranging from disturbing communications to physical violence, with most experiencing harassment in multiple modalities and on multiple occasions. Cyberstalking and other forms of online harassment were common, and politicians felt they (and their families) had become more exposed as a result of the Internet. Half of MPs had been personally approached by their harassers, 48% had been directly threatened and 15% had been attacked. Some of these incidents were serious, involving weapons such as guns, Molotov cocktails and blunt instruments. One in three politicians had been targeted at their homes. Respondents believed the majority of those responsible for the harassment exhibited signs of mental illness. CONCLUSION: The harassment of politicians in New Zealand is common and concerning. Many of those responsible were thought to be mentally ill by their victims. This harassment has significant psychosocial costs for both the victim and the perpetrator and represents an opportunity for mental health intervention.

The impact of frequency of behavior and type of contact on judgments involving a criminal stalking case.

We investigated mock juror perceptions of the frequency of behavior and type of contact in an ex-intimate stalking case. We used a mock-juror methodology, in which 204 community members (129 women) read a stalking trial summary, rendered a verdict, and evaluated the intent of the defendant to cause the victim fear and distress, as well as the victim's experience with these emotions. The trial varied as to whether there were 5 or 30 stalking incidents and whether the stalking involved personal contact or stalking via text message. Results showed that females were more likely to render a guilty verdict when the victim had been stalked 30 times rather than 5 times while males were equally likely to render a guilty verdict regardless of the frequency. Mock jurors were significantly more likely to render guilty verdicts in the personal contact condition than in the text message condition. Females' perceptions of the victim's fear and distress mediated the frequency of incidents x gender interaction. The victim's fear and the defendant's intentions mediated the main effect of type of contact on verdict. Cognitive network analyses showed that victim fear and the defendant's intent to cause fear were central to participant verdict decision making. We discuss these results in terms of the implications, specifically that victim fear should be a primary focus in stalking legislation.

Children's Everyday Lives Shadowed by Stalking: Post separation Stalking Narratives of Finnish Children and Women.

This qualitative study discusses post separation stalking and its implications in children's everyday lives. Based on narratives of 13 Finnish children and 20 women, the research fills a gap in the knowledge regarding the psychosocial, emotional, and physical impacts of stalking on children when their mothers are stalked by a former partner. It identifies four forms of impact: (a) an atmosphere of fear and feelings of insecurity; (b) disguised acts of stalking and the father's performance of care, love, and longing; (c) exploitation of children in stalking; and (d) physical abuse, acts of violence, and threats of death. The findings indicate that stalking severely constrains children's everyday lives and strengthens, yet often distorts, the mother-child bond. The study concludes that in cases where mothers are stalked, professionals in the social and health services, law enforcement, and criminal justice should view the children, too, as victims and construct supportive social relationships for women and children facing threatening life situations.

My Patient, My Stalker Empathy as a Dual-Edged Sword: A Cautionary Tale.

Success in psychotherapy is correlated with the "fit" between patient and therapist, a factor related to attachment. For psychotherapists of any orientation, empathy and building the bond of attachment is our stock-in-trade. When empathy builds the bond of attachment with someone starved for connection, a therapist may inadvertently set him- or herself up to become a victim of a stalker. Because individuals who stalk others suffer from severe attachment disorders, their hunger for attachment motivates them to shadow psychotherapists, which makes being stalked a very real occupational hazard for psychotherapists. This was a painful discovery for me. I was stalked for 11 months, leaving me with post-traumatic stress disorder. After recovering, I deconstructed the experience to understand how and why it happened, and discovered that it was my empathy and compassion that contributed to and maintained the stalking. What I learned from the forensic literature provided the knowledge and confidence needed to end the stalking. In this paper recommendations are made about how to prevent stalking and to halt it if it does happens.

Stalking experiences and associated factors--a controlled population-based study from Norway.

BACKGROUND: Stalking is a considerable health problem. In order to develop interventions for victims, more knowledge is needed concerning prevalence, stress and coping related to stalking as well as associated symptomatology in the victims. This is the first population-based study of stalking in Norway. AIMS: To examine the prevalence of stalking in relation to gender and time, and the association with indicators of socio-demographic status and mental health. METHODS: A cross-sectional case-control questionnaire design. The sample, 5000 Norwegians aged 20-59 years, was nationally representative according to gender, 10-year age groups and county of living. A total of 248 (5%) of the mailed envelops were returned due to wrong address, leaving 4752 individuals as possible respondents. Among them 1520 (32%) returned the questionnaire, but 98 of them had to be discarded due to lack of completion, giving a sample of 1422 valid questionnaires (30%). RESULTS: The total weighted lifetime prevalence of stalking was 8.1% (95% CI 6.6-9.4%), for females 11.8% (95% CI 10.2-13.5%) and for males 4.3% (95% CI 3.2-5.3%) [corrected]. The point prevalence of current stalking was 2.8% (95% CI 2.0-3.7%). The stalked individuals had a significantly poorer social situation and mental health than the controls. Few significant group differences were observed between males and females exposed to stalking. CONCLUSIONS: The prevalence of stalking was within the range observed by questionnaire studies in other cultures.