Homicide-suicide across the lifespan: a mixed methods examination of factors contributing to older adult perpetration.

OBJECTIVES: The purpose of this study is to determine how individual and contextual factors that contribute to homicide-suicide (HS) differ between young adults, middle-aged adults, and older adults, and to describe, in detail, the circumstances that lead to HS by older adults. METHODS: Data were obtained from the Center for Disease Control and Prevention (CDC) National Violent Death Reporting System. We used a sequential mixed methods approach to the analysis. Guided by the Marzuk HS framework, we conducted quantitative analyses to identify characteristics distinguishing older adult HS perpetrators from younger HS perpetrators. These results guided the qualitative content analysis, which further described the circumstances surrounding HS incidents perpetrated by older adults. RESULTS: While HS perpetrated by young and middle-aged adults were quite similar, the demographic characteristics, victim-perpetrator relationship, and contributing factors in HS incidents perpetrated by older adults were substantially different. Mental health and depressed mood were more common among older adult perpetrators, and jealousy, fights, and substance use issues were less common, relative to younger perpetrators. Escalating intimate partner violence and caregiving/health-related issues, including caregiving strain, housing transitions, and financial problems, were the primary contributors to older adult HS. CONCLUSION: HS perpetrated by older adults was both similar and different from incidents perpetrated by younger adults. Programs that prevent or de-escalate intimate partner violence would likely prevent many HS incidents perpetrated by older adults, but health and aging-related issues must also be considered.

Factors contributing to filicide-suicide: Differences between male and female perpetrators.

BACKGROUND: One-quarter of homicide-suicide deaths in the U.S. are children. Filicide-suicide, a subset of homicide-suicide involving parent or caregiver perpetrators, is the most common form of homicide-suicide involving children. While these incidents have significant impacts, relatively few studies examine modifiable factors that contribute to these incidents. OBJECTIVES: The purpose of this study was to identify patterns of circumstances and contributing factors for filicide-suicide deaths, focusing on the individual and interpersonal differences between male and female perpetrators. PARTICIPANTS: This study utilized data from the National Violent Deaths Reporting System (NVDRS), which included 76 filicide-suicide incidents reported to NVDRS in 32 U.S. states between 2013 and 2015. METHODS: We conducted a qualitative content analysis, which was grounded in the Marzuk, Tardiff, and Hirsch (1992) framework. We reviewed the filicide-suicide narratives and engaged in conversations about codes or themes that emerged for the filicide-suicide narratives. Additional codes were added as needed, and narratives were retroactively coded to ensure codes were consistently applied. RESULTS: Relationship conflict and mental health issues were common among male and female perpetrators, but the manifestation of these factors differed greatly. For female perpetrators, relationship conflict, mental health issues, and children's chronic health issues commonly co-occurred. In contrast, relationship conflict, history of violence, and consequences of violence (e.g., legal issues, job problems) more commonly co-occurred among male perpetrators. CONCLUSION: Filicide-suicides are preventable acts of violence with numerous contributing factors. Our findings highlight the need for prevention efforts to recognize interpersonal experiences, particularly differences between male and female perpetrators.

"I'm here to listen and want you to know I am a mandated reporter": Understanding how text message-based crisis counselors facilitate child maltreatment disclosures.

BACKGROUND: Emerging research suggests technology-facilitated crisis services are a promising method to support young people during child maltreatment disclosure. Little is known about how employees/volunteers respond to child maltreatment disclosure in these platforms and how they may support young victims through the disclosure process. OBJECTIVES: We sought to determine how crisis counselors respond to child maltreatment disclosures using a content analysis of all conversations within a text-based crisis organization that resulted in a mandatory report. METHODS: We conducted an iterative team-based content analysis of 244 conversations (24,730 text messages) between a young person and a crisis counselor from an anonymous text-based crisis service. All conversations included in the sample resulted in a mandatory report to child protective services. RESULTS: There were two crucial points in maltreatment disclosure conversations. The first occurred immediately after the disclosure. At this point, crisis counselors most often provided sympathy and affirmation. The second crucial point after disclosure was the discussion of mandatory reporting. In many cases, crisis counselors confirmed both parties understood mandatory reporting and encouraged young people to consider the repercussions of their decision to share identifiable information that would permit a mandatory report. CONCLUSION: Understanding how crisis counselors responded to young people in one text-based crisis service, particularly characteristics of well-received conversations, may inform the policies and processes for other organizations. Continued exploration of crisis text-based services may improve the disclosure process for young victims.

Adverse Childhood Experiences Associated with Children's Patterns of Out of Home Placement Over Time and Subsequent Negative Outcomes During Adolescence.

BACKGROUND: Out of home placement (OOHP) of welfare involved children is a critical problem associated with child abuse and neglect and household dysfunction. Few studies have also implicated greater instability in OOHP with more negative outcomes. However, several gaps remain. OBJECTIVES: Objectives were twofold. To identify combinations of adverse childhood experiences that are associated with OOHP - based on both duration of OOHP and change in actual placement during each time point, among welfare involved youth. The second objective was to understand long-term negative outcomes during adolescence that are associated with greater placement instability. METHODS: Data come from the National Survey of Child and Adolescent Wellbeing (n = 1,657). Multinomial logistic regression was used to evaluate adverse childhood experiences that were associated with specific patterns of OOHP. Multivariate regression models were estimated to evaluate delinquency, aggression as well as depressive and trauma symptoms during adolescence that were associated with specific patterns of OOHP. RESULTS: There were six categories of OOHP found in the sample: 1) no OOHP, 2) OOHP one time, 3) OOHP two times, 4) OOHP two times with change in placements, 5) OOHP three times, and 6) OOHP three times with change in placement. Longer duration of OOHP was associated with more adversity exposure. Longer duration and more change in placement were associated with the most negative outcomes. CONCLUSIONS: Findings demonstrate the need for future testing of these findings in prevention trials.