The Impact of Stalking and Its Predictors: Characterizing the Needs of Stalking Victims.

Victims of stalking suffer severe and varied impacts requiring assessment and treatment. Research to inform support is limited. This study examines a national sample of stalking victims to identify the types and prevalence of impact reported and the predictors of impact. A secondary analysis of 258 stalking cases reported to a stalking charity was conducted. Four categories of victim reported impact were coded; psychological and substance abuse, physical health, practical impact on life, and impact on others. Stalking duration, severity, the diversity of stalking behaviors, and the relationship between the victim and perpetrator were investigated as predictors of impact. In all, 48 types of impact were identified with victims experiencing an average of four types. Psychological impact was the most prevalent (91.5%). Several new forms of impact were identified including a variety of impacts on persons known to the victim (e.g., children, friends) in 35.3% of the sample. Increased diversity of stalking behavior was predictive of impact in all models (explaining 11% of the variance in total impact scores), except for physical impact which was not analyzed due to low prevalence. Stalking impact was prevalent and varied, suggesting that victims (and potentially those close to them) require trauma-informed support from clinicians. Future research should include the development of a stalking impact index to improve the consistency of research and clinical assessment of need.

Elder Mistreatment and Dementia: A Comparison of People with and without Dementia across the Prevalence of Abuse.

This paper examines the prevalence of different types of elder mistreatment, care needs, and risk factors amongst older adults living with and without dementia in any setting (community or institution). Three years (2014-2017) of anonymized reported incidents of elder mistreatment to a national UK helpline were examined in an exploratory study, using a matched sample design (N = 598) comparing adults with dementia (n = 299) to those without (n = 299) on mistreatment type, care needs, and risk factors for abuse. Financial exploitation was more common among older adults with dementia who required more daily care than those without. Risk factors for elder mistreatment among older adults without dementia were often chronic in nature (such as poor physical health) whereas risk factors for people with dementia were associated with a dementia diagnosis. Raising implications for health and social care, results show that older adults diagnosed with dementia had increased care needs and vulnerability to abuse.

Forecasting Stalking Recidivism Using the Guidelines for Stalking Assessment and Management (SAM).

We examined the long-term risk for stalking recidivism and the predictive validity of ratings made using the Guidelines for Stalking Assessment and Management (SAM) in 100 stalking offenders from a forensic clinic. Overall, 45 offenders were convicted of, charged with, or the subject of police investigation for stalking-related offenses during a potential time at risk that averaged 13.47 years. Survival analyses using the Cox proportional hazards model indicated that a composite score of the presence of SAM risk factors was significantly predictive of recidivism and had significant incremental validity relative to total scores on two scales commonly used in violence risk assessment, the Screening Version of the Hare Psychopathy Checklist-Revised (PCL:SV) and the Violence Risk Appraisal Guide (VRAG). Overall ratings of risk made using the SAM, however, were not significantly predictive of recidivism. We discuss the potential uses of the SAM in stalking risk assessment and provide recommendations for future research.

Characterizing Elder Abuse in the UK: A Description of Cases Reported to a National Helpline.

The abuse of older adults by someone in a position of trust-also known as elder abuse (EA)-has a severe impact on victims and society. However, knowledge about EA in the UK is limited in comparison to other types of interpersonal violence and international knowledge. The present study utilized secondary data from a UK national EA helpline to investigate the characteristics of reported cases. Over a one-year period between 2017 and 2018, 1,623 records met inclusion criteria. Descriptive statistics are provided to describe this sample. Most cases reported to the helpline pertained to female victims, suffering from financial or psychological abuse. Co-occurrence of different abuse types was common. Findings provide updated knowledge about the phenomenology of EA cases in the UK. Recommendations are provided for advancing research in this area, including the need for examining cases across longer periods of time with a view to informing practice and policy.

Elder Abuse Vulnerability and Risk Factors: Is Financial Abuse Different From Other Subtypes?

Elder abuse (EA) affects one in six older adults, and financial EA, a common subtype, severely impacts victims and society. Understanding victim vulnerability and perpetrator risk factors is essential to EA prevention and management. The limited existing evidence about these factors in relation to EA types suggests that financial EA is different. In a cross-sectional quantitative analysis of secondary data (N = 1,238), we investigated EA vulnerability and risk factors, and victim-perpetrator family relationship, with respect to different EA types (financial only, financial co-occurring with other types, and nonfinancial abuse). Financial abuse-only cases had the lowest prevalence of vulnerability and risk factors. Most of these factors, and a familial relationship, were significantly more common in cases involving other EA types. Findings indicate that financial abuse, occurring in isolation, is distinct from other EA types. Risk assessment and future research should consider financial abuse separately to other EA forms.

Identifying Interventions and Their Efficacy as Used by a Community Agency Managing and Responding to Elder Abuse.

Limited research has been conducted to identify how elder abuse (EA) can be managed and prevented. Interventions employed by a community agency multidisciplinary team across 164 EA cases were examined. Results identified the largest number (N = 369) and widest variety of EA interventions to date. Using content analysis, interventions with similar proximal goals were grouped into 30 intervention strategies to evaluate efficacy and 12 higher-order intervention categories to guide practice. Intervention outcomes were rated as positive, negative, neutral, could not implement, or unknown. Positive outcomes were the most common (35%), and also included novel and/or effective interventions aimed at perpetrators such as physical treatment, social support, and communication. Few (1%) interventions had negative outcomes. Many interventions could not be implemented (21%), often due to a lack of funding or victim refusal. Results suggest changes to policy, practice, and research methodology, which could increase positive outcomes through facilitation of intervention implementation and improved data access.

PROTOCOL: Global elder abuse: A mega-map of systematic reviews on prevalence, consequences, risk and protective factors and interventions.

This is the protocol for a Campbell systematic review. The objectives are as follows: to produce a mega-map which identifies, maps and provides a visual interactive display, based on systematic reviews on all the main aspects of elder abuse in both the community and in institutions, such as residential and long-term care institutions.

Help-Seeking Behavior in Victims of Elder Abuse: A Systematic Review.

Elder abuse has become increasingly relevant for intervention and study in the context of an aging population. One of the major barriers to progress in the field is underreporting of elder abuse by victims. This systematic literature review aimed to synthesize the available findings regarding victims' help-seeking behavior to inform practice, understand the limits of the evidence, and identify research gaps. A comprehensive search of published and unpublished literature was undertaken, and studies were included if they addressed help-seeking behavior from the perspective of elder abuse victims aged 60 and older. A total of 19 studies met inclusion criteria for review. Findings are presented as a narrative synthesis organized according to help-seeking barriers, facilitators, sources of help, the responses of others, and the characteristics of victims more likely to seek help. Although barriers and sources of help received detailed attention across all studies, findings regarding victim characteristics and facilitators for and responses to help-seeking were limited. The results suggest that there are many barriers to help-seeking and that some victims only seek help when the abuse is perceived as unbearable or they fear for their safety. Results are discussed in relation to implications for intervention, including suggestions to enhance help-seeking behavior. Future research should identify facilitators of help-seeking among victims of elder abuse and victim characteristics associated with early disclosure. Research efforts should frame help-seeking as a continuing process and study ways in which the responses of others may impact future help-seeking or service engagement.

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.

Elder Abuse Detection and Intervention: Challenges for Professionals and Strategies for Engagement From a Canadian Specialist Service.

Elder abuse (EA) is of increasing relevance in the context of an aging society, and this has implications for detection and intervention for several types of healthcare providers, including forensic nurses. Knowledge related to EA is important as victims are likely to interact with providers, because of either existing health problems or the consequences of abuse. This article provides a brief overview of EA, followed by an outline of current detection and intervention efforts used by healthcare providers in community and hospital settings. In addition, knowledge about help-seeking and barriers to disclosure are discussed to inform healthcare provider interactions with older adults where EA is suspected or disclosed. To illustrate challenges faced by healthcare providers in this area, two cases of EA involving case management by a forensic nurse in a specialist service in Canada are presented.

Intimate Partner Violence in Urban, Rural, and Remote Areas: An Investigation of Offense Severity and Risk Factors.

This study compared the severity of intimate partner violence (IPV) and the relationship between risk factors for IPV and overall risk judgments of future IPV in urban, rural, and remote areas. IPV risk assessments conducted by the Swedish police between 2010 and 2014 in urban ( n = 564), rural ( n = 456), and remote ( n = 196) areas were examined. Rurality was associated with the severity of IPV reported, as well as the presence of risk factors and their relationship to overall risk judgments. Cases in remote areas included more severe IPV as well as more risk factors.

Recognizing, reporting, and responding to abuse, neglect, and self-neglect of vulnerable adults: an evaluation of the re:act adult protection worker basic curriculum.

Abuse and neglect of vulnerable adults are significant problems, the identification and management of which is increasingly being made the legal responsibility of healthcare professionals. In response, some jurisdictions have developed training to assist professionals in these duties. This study evaluates the re:act Adult Protection Worker Basic Curriculum training from British Columbia, Canada. One hundred and fifty-seven participants, 109 training completers and 48 non-completers, answered a survey evaluating their confidence, knowledge, and applied knowledge in identifying, reporting, and investigating cases of suspected abuse, neglect, and self-neglect of vulnerable adults. Comparisons of training completers to non-completers showed significant gains in completers' perceived confidence and knowledge, but no improvement in applied knowledge. The type of healthcare professional being trained and the length of training did not impact learner improvement. The results suggest ways in which both training and evaluation can be improved (e.g., supervised practice) to increase and detect gains in knowledge and practice.

The Influence of Victim Vulnerability and Gender on Police Officers' Assessment of Intimate Partner Violence Risk.

This study investigated the influence of victim vulnerability factors and gender on risk assessment for intimate partner violence (IPV). 867 cases of male and female perpetrated IPV investigated by Swedish police officers using the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER) were examined. For male-to-female IPV, victim vulnerability factors were associated with summary risk judgments and risk management recommendations. For female-to-male IPV, vulnerability factors were more often omitted, and consistent associations were not found between vulnerability factors, summary risk judgments, and risk management. Results indicate that B-SAFER victim vulnerability factors can assist in assessing male-to-female IPV risk. Further research is necessary to examine the use of B-SAFER victim vulnerability factors for female-to-male IPV, as results showed victim vulnerability factors to be less relevant to officers' decision making, particularly their management recommendations. However, several variables external to the B-SAFER, such as the availability of management strategies may account for these findings.

Psychometric properties of the Hare Psychopathy Checklist-Revised (PCL-R) in a representative sample of Canadian federal offenders.

The Hare Psychopathy Checklist-Revised (PCL-R; Hare, 2003) is a commonly used psychological test for assessing traits of psychopathic personality disorder. Despite the abundance of research using the PCL-R, the vast majority of research used samples of convenience rather than systematic methods to minimize sampling bias and maximize the generalizability of findings. This potentially complicates the interpretation of test scores and research findings, including the "norms" for offenders from the United States and Canada included in the PCL-R manual. In the current study, we evaluated the psychometric properties of PCL-R scores for all male offenders admitted to a regional reception center of the Correctional Service of Canada during a 1-year period (n = 375). Because offenders were admitted for assessment prior to institutional classification, they comprise a sample that was heterogeneous with respect to correctional risks and needs yet representative of all offenders in that region of the service. We examined the distribution of PCL-R scores, classical test theory indices of its structural reliability, the factor structure of test items, and the external correlates of test scores. The findings were highly consistent with those typically reported in previous studies. We interpret these results as indicating it is unlikely any sampling limitations of past research using the PCL-R resulted in findings that were, overall, strongly biased or unrepresentative.

An examination of violence risk communication in practice using a structured professional judgment framework.

The increased use of violence risk assessment tools in professional practice has sparked the development of best-practice guidelines for communicating about violence risk. The present study examined 166 pre-sentence reports, authored by clinicians and probation officers, to determine the extent to which they are consistent with those guidelines. We examined the frequency with which reports contained information about five topics: the presence of risk factors; the relevance of risk factors; scenarios of future violence; recommended management strategies; and summary risk judgments. Analyses revealed that the topics addressed most frequently in reports were the presence of risk factors and recommended management strategies, but none of the five topics was addressed consistently, completely, or clearly in reports. This was especially the case for probation reports. The findings highlight the need to improve practice through better implementation of guidelines for risk communication. Also needed is research on the extent to which information in risk communications is comprehended, accepted, and used by various stakeholder groups.

Assessment and management of risk for intimate partner violence by police officers using the Spousal Assault Risk Assessment Guide.

Intimate partner violence (IPV) is a crime that is present in all countries, seriously impacts victims, and demands a great deal of time and resources from the criminal justice system. The current study examined the use of the Spousal Assault Risk Assessment Guide, 2nd ed. (SARA; Kropp, Hart, Webster, & Eaves, 1995), a structured professional judgment risk assessment and management tool for IPV, by police officers in Sweden over a follow-up of 18 months. SARA risk assessments had significant predictive validity with respect to risk management recommendations made by police, as well as with recidivism as indexed by subsequent contacts with police. Risk management mediated the association between risk assessment and recidivism: High levels of intervention were associated with decreased recidivism in high risk cases, but with increased recidivism in low risk cases. The findings support the potential utility of police-based risk assessment and management of IPV, and in particular the belief that appropriately structured risk assessment and management decisions can prevent violence.

Utilization and implications of the Static-99 in practice.

The Static-99 is the most commonly used risk assessment instrument for sexual violence in North America and its results can affect highly consequential decisions made in the criminal and civil justice systems. Despite its influence, few studies have systematically examined how the Static-99 is used by clinicians in practice. The current study compares the Static-99 ratings of clinicians to those of researchers for 100 adult males who completed an outpatient sex offender treatment program and were followed up over an average of about 4 years. Results showed good agreement between the ratings of clinicians and researchers for total scores on the Static-99, as well as for most individual items. Ratings by clinicians tended to be slightly lower than those made by researchers. The predictive validity of ratings made by clinicians and researchers was very similar and moderate in terms of effect size. In 30 cases, clinicians used discretion to "override" or adjust the Static-99 ratings when making final risk judgments, but the predictive validity of the clinical adjusted ratings was worse than that of the original Static-99 ratings made by clinicians. The need for quality assurance and training are discussed along with the need for clear empirically supported guidelines regarding overrides.

The development and validation of the guidelines for stalking assessment and management.

International research has established that stalking is a prevalent problem with serious and often life-threatening consequences for victims. Stalking is also a unique form of violence due to its nature and diversity, making it difficult for criminal justice and health professionals to establish which perpetrators and victims have the greatest need for services and protection. Risk assessment is one way to address these problems but few tools exist. This article describes the development of the Guidelines for Stalking Assessment and Management (SAM), the first risk assessment instrument designed specifically for the stalking situation. Preliminary data are presented, indicating that the SAM has promise for use by professionals working with stalkers and their victims. Results indicated that interrater reliabilities for the SAM risk factors and total scores range from fair to good, and the structural reliability of the SAM is sound. Moreover, the SAM showed good concurrent validity when compared with two other measures of violence propensity: the Psychopathy Checklist Screening Version (PCL:SV) and the Violence Risk Appraisal Guide (VRAG). Limitations of the study are discussed, especially those related to the difficulties inherent in file-based research, and suggestions for future research are offered.

Psychopathy and stalking.

We examined the association between psychopathy, assessed using the Hare Psychopathy Checklist-Revised: Screening Version (Hart et al., Manual for the psychopathy checklist screening version (PCL:SV), 1995), and stalking in 61 men convicted of stalking-related offenses. Psychopathic symptoms were rare, but their presence-especially that of affective deficit symptoms-was associated with victimization of casual acquaintances and with several risk factors from the Guidelines for Stalking Assessment and Management (SAM) (Kropp et al., Guidelines for stalking assessment and management, 2008a), including stalking in violation of supervision orders, degree of preoccupation with victims, and targeting of victims with limited access to external resources. The findings suggest that in spite of their rarity, psychopathic traits may be important in the assessment and management of stalking risk.