Experiences and perspectives of women who have committed neonaticide, infanticide and filicide: A systematic review and qualitative evidence synthesis.

WHAT IS KNOWN ON THE SUBJECT?: The phenomenon of child killing (neonaticide, infanticide or filicide) is a rare event that cannot be fully explained by a single construct as each case involves the unique life circumstances of each woman who committed the act(s). WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of women who committed neonaticide, infanticide or filicide regretted the act and regretted not seeking help from family and healthcare professionals. Women who committed neonaticide, infanticide or filicide in the main had complex circumstances characterised by poverty, abusive relationships, poor family and social support or over reliance on family supports and mental health issues. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Women require a clear plan of what to do if they feel overwhelmed with caring for a baby or child. Healthcare professionals involved with women in the perinatal period need to explore further women's expressions of "not being ready to be a mother" which for some women may be pathological and require further assessment. Women need to be made aware of the support service pathways available to them during the perinatal period and beyond. Further research is needed to explore and learn from women's experiences to reduce child homicide mortality and support women and their families. ABSTRACT: INTRODUCTION: Meaning and personal experiences of the acts of neonaticide, infanticide and filicide have rarely been investigated from the perspectives of the women who committed those acts. AIMS: To identify and synthesise evidence on the perspectives of women directly involved in the complex phenomena of neonaticide, infanticide or filicide from the evidence available on their unique point of view and how these experiences have affected women's lives. To understand how the experiences and perceptions of women who engaged in child killing present similarities or differences according to the child's age at time of death. METHODS: Qualitative primary studies published in English were included if they explored the experiences of women who engaged in neonaticide, infanticide or filicide. Methodological quality was assessed using the qualitative Critical Appraisal Skills Programme (CASP) checklist. A thematic analysis framework guided the synthesis. RESULTS: Seven papers reporting on five studies met the inclusion criteria for the review. Three analytical themes were identified: Not ready to be a mother; Intentionality and premeditation in the context of trauma and mental health issues; Sorrow of regret. DISCUSSION: The majority of women who committed neonaticide, infanticide or filicide had complex psychological, social and personal circumstances and in the main regretted the act and regretted not seeking help from family and healthcare professionals. Healthcare professionals in contact with women during the perinatal period and beyond need to be aware of the profiles of vulnerable women and undertake holistic integrated assessments to identify the woman's personal context, changes in interpersonal relationships, social isolation or over reliance on family supports and changes in mental health status or new onset of mental health conditions. IMPLICATIONS FOR PRACTICE: Women require a clear plan of what to do if they feel overwhelmed with caring for a baby or child. Healthcare professionals involved with women in the perinatal period need to explore further women's expressions of "not being ready to be a mother" which for some women might be pathological and require further assessment. Women need to be made aware of the support services pathways available to them during the perinatal period and beyond. Further research is needed to explore and learn from women's experiences of each of the phenomena separately to reduce child homicide mortality and support women and their families.

Compassion meditation increases optimism towards a transgressor.

Past research reveals important connections between meditative practices and compassion. Most studies, however, focus on the effects of one type of meditation (vs. a no-intervention control) on a single expression of compassion (e.g. offering a seat) towards a relatable target (e.g. a person on crutches), without exploring possible mechanisms. Hence, few studies include different types of meditation, active controls, multiple ways to express compassion, unrelatable targets, and potential mediators. To this end, the present study compared the effects of mindfulness meditation with those of compassion meditation on different expressions of compassion towards a convicted murderer. Seventy-four participants were randomly assigned to a mindfulness meditation, compassion meditation, or active control class, or a no-class control. After an 8-week programme, we assessed compassion by giving participants the option of fulfilling a murderer's request that they write him and then coding those letters for empathy, sympathy, forgiveness, and optimism. Participants in the compassion meditation class wrote more optimistic letters compared to participants in the other three conditions, in part because they valued positivity more. No statistically significant differences emerged for the other expressions of compassion. We discuss the implications of these findings for our understanding of how meditation increases compassion towards unrelatable targets.

Performative retelling: Healing community stories of loss through Playback Theatre.

Restorative retelling (RR) is an evidence-based procedure for facilitating adaptation following traumatic bereavement. In this paper, we introduce performative retelling (PR), a variation on RR, which fosters healing from personal losses and portrays personal reactions to collective tragedy. We describe our collaboration with an ex-offender reentry program, the Memphis Police Department, and Playback Theatre to use improvisational community theatre to bridge the gap between law enforcement and the citizens they serve. We review program outcomes to-date and illustrate its impact using participant stories. We argue that training police and citizens in PR can potentially transform broken narratives of police-community relations.

Feasibility and Acceptability of Mindfulness for Survivors of Homicide and Their Providers.

PURPOSE: This study uses participatory research methods with survivors of homicide and their service providers to explore the feasibility and acceptability of a culturally adapted mindfulness intervention for stress reduction and resilience in homicide survivors. PROCEDURES: Our mixed methods approach included: (a) previewing a Mindfulness-Based Stress Reduction program with providers and survivors; (b) using their iterative feedback during focus groups to revise the curriculum; and (c) studying the acceptability of the adapted curriculum for survivors through focus group and standardized data collection. FINDINGS: We learned that providers use mindfulness for self-care and both providers and survivors view the approach for survivors as promising. Based on attendance, participation, and focus group data, the adapted curriculum was both feasible and acceptable. Survivors' reports suggested most experienced improved emotion regulation, feelings of empowerment, and better coping. CONCLUSIONS: Culturally adapted mindfulness programs may support healing for homicide survivors and possibly other low-income people of color with significant trauma backgrounds. Further investigation is needed to rigorously assess outcomes and specific effects, both positive and negative, of mindfulness in this and other more diversified populations.

Intentional or Negligent Homicide? Evidence for Juror Decision Making.

The present study examined the influence of specific evidence and testimonies on a juror's decision to make a verdict of intentional or negligent homicide in a Civil law country. Italian students (N = 280; M age = 25.0 years, SD = 2.9) read different affidavits characterized by the presence or absence of three elements against the defendant: motive, skill in use of weapons, and previous violence toward the victim. Participants then decided a verdict and provided a confidence judgment on their decision. Results showed that the presence of motive, skill, and previous violence influenced the jurors' decision, significantly changing the verdict from negligent to intentional homicide. The findings were discussed in terms of the folk-concept approach of intentionality.

The role of forensic death investigators interacting with the survivors of death by homicide and suicide.

When sudden unexpected death occurs, an investigation ensues in an attempt to discover the cause and manner of death. Autopsies are performed when reasons for death are not obvious. They are used to provide information, confirm the cause of death, and/or reveal conditions not recognized before death (Hendricks, 2011). One important reason for performing an autopsy is to help families to understand what happened to their loved one so that they can begin the process of grieving. The way that the initial notification and investigation is handled can have a bearing on how a family's grief progresses. Forensic nurses are in a unique position to bring a holistic approach to death investigation with a focus of care that includes not only the decedent but the surviving loved ones as well (Koehler, 2008). Forensic nurse death investigators can assist families through initial stages of grief in the investigation of death.

Death thoughts and images in treatment-seekers after violent loss.

Violent loss survivors often describe experiencing recurrent imagery about their loved one's death. The Death Imagery Scale assesses 5 kinds of imagery: reenactment, rescue, revenge, reunion, and remorse. We explored the frequency of these forms of imagery and their associations with PTSD, depression, and/or complicated grief (CG) among 130 treatment-seeking survivors who were, on average, 3.5 years postloss. Reenactment, rescue, and remorse imagery were most frequently endorsed, and all forms of imagery were associated with PTSD, depression, and CG. Bereaved parents reported more remorse and reunion imagery than others. Homicide survivors reported more revenge imagery than suicide and accident survivors.

Fatal torment--from psychosis-driven index offence to trauma: a case study in forensic psychotherapy, trauma therapy and matricide.

OBJECTIVE: This paper presents the case of a forensic inpatient who was found 'Not Guilty by Reason of Mental Illness' for the murder of his mother and illustrates how psychotic symptoms can mask trauma symptoms, leading to neglect in the treatment of trauma in psychotherapy with forensic inpatients. METHOD: A case study of a forensic inpatient diagnosed with schizophrenia that as part of his rehabilitation program received 19 sessions of therapy (i.e. grief counselling, Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and imagery rescripting). The following measures were administered pre- and post-treatment: (a) The Depression Anxiety Stress Scale (DASS), to measure symptoms of depression, anxiety and stress; (b) The Impact of Events Scale-Revised (IES-R), to measure post-traumatic stress symptoms; and (c) The Trauma Attachment and Beliefs Scale (TABS), to measure disruption in beliefs about self and others. RESULTS: At completion of therapy, he showed a reduction in Post-Traumatic Stress Disorder (PTSD), depression, anxiety and stress symptoms. CONCLUSIONS: Trauma and PTSD-related symptoms in the forensic inpatient population must be assessed and treated alongside psychotic symptoms, where relevant. TF-CBT was effective in reducing PTSD symptoms in this current case study and should be considered as an intervention in forensic inpatient populations.

Influence of Music Therapy on Coping Skills and Anger Management in Forensic Psychiatric Patients: An Exploratory Study.

The effect of music therapy on anger management and coping skills is an innovative subject in the field of forensic psychiatry. This study explores the following research question: Can music therapy treatment contribute to positive changes in coping skills, anger management, and dysfunctional behavior of forensic psychiatric patients? To investigate this question, first a literature review is offered on music therapy and anger management in forensic psychiatry. Then, an explorative study is presented. In the study, a pre- and post-test design was used with a random assignment of patients to either treatment or control condition. Fourteen participants' complete datasets were collected. All participants received "treatment as usual." Nine of the participants received a standardized, music therapy anger management program; the five controls received, unplanned, an aggression management program. Results suggested that anger management skills improved for all participants. The improvement of positive coping skills and diminishing of avoidance as a coping skill were measured to show greater changes in music therapy participants. When controlling for the exact number of treatment hours, the outcomes suggested that music therapy might accelerate the process of behavioral changes.

Faith without answers: the use of religion among cold case homicide survivors.

Through data gathered from interviews with cold case homicide survivors, this article reveals the important role of religion and faith in the aftermath of an unsolved murder. Using qualitative methodology, the author highlights the lived experiences and personal journeys of cold case homicide surviving family members, who are often a forgotten and an overlooked segment of victims. Qualitative data suggests that these cold case homicide survivors found religion to be critical in the aftermath of their loved one's murder. Specifically, survivors indicated their faith was fundamental in coping with the homicide and provided hope for anticipating a resolution in their cases. From these intimate, personal survivor accounts, scholars and practitioners can begin to develop future research and programs that are specifically designed to highlight the role of religion in moving forward after an unsolved murder.

Religion in the lives of older women serving life in prison.

This exploratory qualitative study examined the roles of religiousness in the lives of 21 older women (mean age = 63) serving life sentences in one southern state. Based on survey and focus group methodology, several themes emerged as important focal points, including early religious experiences prior to incarceration, imprisonment and religious doubt, participation in formal and informal religious activities, and use of religion in coping with stressors such as interpersonal relationships, trauma, and health statuses. Irrespective of their religious upbringing, all participants agreed that religiosity/spirituality played a key role in their ability to cope with their prison experience as well as for maintaining hope and the opportunity for release.

Adult eyewitness memory and compliance: effects of post-event misinformation on memory for a negative event.

This study investigated effects of misleading post-event information, delay, and centrality definition on eyewitness memory and suggestibility for a negative event (a vividly filmed murder). Either immediately or 2 weeks after viewing the film, 93 adults read a (misleading or control) narrative about the event and then completed a recognition memory test. Misinformation acceptance was operative, but strong evidence for memory malleability was lacking. Compliance predicted misinformation effects, especially on the delayed test. Although accuracy was generally higher for central than peripheral information, centrality criteria influenced the pattern of results. Self-report of greater distress was associated with better recognition accuracy. The results suggest that use of different centrality definitions may partly explain inconsistencies across studies of memory and suggestibility for central and peripheral information. Moreover, social factors appeared, at least in part, to influence misinformation effects for the highly negative event, especially as memory faded. Implications for eyewitness memory and suggestibility are discussed.

The narrative dynamics of grief after homicide.

The homicidal death of a loved one is horrific. Dying from homicide can be more sudden, frightening, and stigmatizing than natural dying and may be followed by a sub-type of prolonged grief complicated by vivid narrative reenactment of the dying, intense feelings of remorse, and nihilistic despair. After a literature review of grief after homicide, the author clarifies the salient narrative themes of homicidal dying and their specific effects on trauma and separation distress. A preliminary model is then developed and illustrated in a therapy case outlining a technique (imaginative exposure) to diminish the disabling fixation of reenactment imagery, remorse, and despair.

When tragedy is our own.

How do members of a nursing uint and a healthcare center find their way through the tragic loss of a friend and colleague? This article shares how the hospital "family" came together to offer support and empathy to one another, and how God revealed himself amidst the loss.

Developing a trauma-informed, emergency department-based intervention for victims of urban violence.

The Surgeon General's report on youth violence, the Centers for Disease Control and Prevention, and other national organizations are calling for public health approaches to the issue of youth violence. Hospital-based violence intervention programs have shown promise in reducing recurrent violence and decreasing future involvement in the criminal justice system. These programs seldom address trauma-related symptoms. We describe a conceptual framework for emergency department-based and hospital-based violence intervention programs that intentionally addresses trauma. The intervention described--Healing Hurt People--is a trauma-informed program designed to intervene in the lives of injured patients at the life-changing moment of violent injury. This community-focused program seeks to reduce recurrent violence among 8- to 30-year-olds through opportunities for healing and connection. Healing Hurt People considers the adversity that patients have experienced during their lives and seeks to break the cycle of violence by addressing this trauma.

Forensic psychiatry in France: the Outreau case and false allegations of child sexual abuse.

During the Outreau case in France, 13 individuals were falsely accused of child sexual abuse and incarcerated. The author of this article testified as a psychiatric expert when the convictions were appealed. He explains how purposeful false statements by adults, inept expert witnesses, and the judicial assumption that children do not lie converged to create a tragic legal outcome. This article explains how psychiatric experts should conduct evaluations in cases of alleged child sexual abuse.