Stalking behaviour by patients towards psychiatrists in a large mental health organization

Exploring the impact of work-related potential traumatic events among Dutch psychiatrists

Psychiatrists are frequently exposed to work-related potential traumatic events (PTEs). A survey was sent to the members of the Dutch Society of Psychiatrists of which 250 questionnaires were eligible for analysis. At least one work-related PTE was reported by 196 (78.4%) of the respondents, of which 177 described the PTE. Witnessing or experiencing verbal aggression (29.2%), physical violence (29.2%) or completed suicide (26.8%) were the most common PTEs. This survey implies that psychiatrists frequently experience work-related PTEs, often with a significant emotional impact. The majority of respondents considered current support as insufficient.

Psychological Impact of Stalking on Male and Female Health Care Professional Victims of Stalking and Domestic Violence

The aim of this work was to investigate stalking experiences in a sample of Health Care Professionals, or HCPs, who experienced domestic violence in their previous relationships with an intimate romantic or non-romantic who had become their stalkers. A comparison between males and females was made to highlight the differences among the genders. The findings showed that, for the most part, the victims experienced stalking by a stalker that was not of the same gender. Moreover, the nature of the relationship was romantic, for the most part, for both female and male subjects, suggesting that the principal motivation of stalking is the disruption of an intimate relationship. Regarding domestic violence, females described the phenomenon from a different perspective, indicating verbal, physical, and sexual abuse, while males indicated only verbal abuse. Females tended to amplify, more than the males, depression, and state and trait anxiety. Even if all symptoms were expressed in both females and males, the males exhibited a lack of confidence in their bodies, and the emotional literacy made the expression of distress more difficult. At the same time, the expression of anxiety presented in the women permitted them to become progressively less victimized over time; depression and anxiety allow the recognition of these symptoms as signs of distress and to intervene to reduce them.

Health Care Professionals as Victims of Stalking: Characteristics of the Stalking Campaign, Consequences, and Motivation in Italy

Stalking is a phenomenon characterized by a set of repetitive behaviors, intrusive surveillance, control, communication, and search of contact with a victim who is afraid and/or worried and/or annoyed by such unwanted attention. Literature analysis shows that Health Care Professionals (HCPs) are at greater risk of being stalked than the general population. As described by Mullen, Pathé, Purcell, and Stuart, stalkers may have different motives: relational rejection, an infatuation, an inability to express their own emotions and recognize those of others, or a desire for revenge. The aim of this study was to explore stalkers' motivation as perceived by their victims, characteristics of stalking campaigns, and consequences. A copy of the Italian modified version of The Network for Surviving Stalking (NSS) Questionnaire on Stalking, the Beck Depression Inventory (BDI) and the State Trait Inventory (STAI) Y1-Y2 scales were distributed in six Italian state hospitals. Participants included 1,842 HCPs, 256 (13.9%) of which had been victims. The majority of victims reported that stalkers were Rejected (96, 37.5%), Intimacy seekers (41, 16%), Incompetent suitors (60, 23.4%), and/or Resentful (43, 16.8%; χ² = 163.3, p = .001). Stalking campaigns were characterized by several behaviors, principally contact (by telephone calls, text message) and following. The stalking campaign caused in victims both physical and emotional consequences, the most frequent being weight changes, sleep disorders, weakness, apprehension, anger, and fear. The most used coping strategies were moving away and moving toward, the less used was moving inward. Intervention programs and preventive measures (both individual and organizational) for HCP victims and those who could be considered at risk are also discussed.

[Stalking of psychiatrists and psychotherapists : Results of an online survey]

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.

Stalking and Violence

The three widely known stalker classifications assist in categorizing stalkers, which allows for better management of violence risk. Although 80% of stalking is done by men, women also engage in stalking, and their violence risk should not be underestimated. Juvenile stalkers do exist and juvenile stalking is also associated with violence. Clinicians can become a victim of stalking and may become victims of stalking by proxy, a special type of stalking behavior where the stalker involves other people or agencies to communicate with or track their victim. A careful stalking violence risk assessment is essential in the intervention and risk management process.

Italian nurses' experience of stalking: a questionnaire survey

A literature analysis shows that nurses are at greater risk of being stalked both by ex-partners and acquaintances (such as colleagues and patients) and by unknown stalkers. The aim of this study was to explore Italian nurses' experience of stalking. A copy of the Italian modified version of the Networking for Surviving Stalking (NSS) Questionnaire on Stalking, Beck Depression Inventory (BDI), and State Trait Inventory (STAI) Y1-Y2 scales were distributed to 2,000 nurses working in 4 Italian state hospitals. There were 765 nurses who returned the questionnaire (38.4%), 107 of whom had been victims (14.0%). On average, victims had been stalked for more than 12 months by an acquaintance (41.1%), whose behavior included unwanted communications, following, control, and threatening behavior. The coping strategies used most involved offensive and interactional tactics. Stalking has both emotional and physical consequences for victims, although depression levels were not as high as we expected (BDI M = 11.05, SD = 8.84; STAI Y1 M = 42.11, SD = 11.75; STAIY2 M = 44.04, SD = 12.90). The need to adopt legal, organizational, and individual strategies is also discussed.

Stalking by patients: doctors' experiences in a Canadian urban area (Part II)--physician responses

Stalking involves recurrent unwanted communication, harassment, and intrusive behaviors. The aim of this study was to examine physicians' experiences of being stalked by their patients, with particular attention to the emotional impact on the physicians and their actions taken. A questionnaire designed to study the nature and the impact of stalking experiences among physicians was sent to 3159 randomly chosen physicians in the Greater Toronto Area. Approximately 15% (14.9%) of the 1190 physicians who responded reported having been stalked. The physicians reported feeling angry, frustrated, anxious, frightened, lacking control, and helpless. The physicians coped in a number of ways including terminating the physician-patient relationship, but many just ignored the problem. Most had no previous knowledge about stalking. Physicians experience a range of emotions as a result of being a victim of stalking. In view of the prevalence and the impact, physicians may benefit from education to help prepare them for the possibility of being stalked.

The role of psychopathology in stalking by adult strangers and acquaintances

OBJECTIVE

Individuals who stalk strangers and acquaintances are under-studied, although there is some evidence suggesting a greater prevalence of psychopathology than is present in those who stalk former partners. This study investigated the nature and prevalence of psychopathology in a sample of stranger and acquaintance stalkers and whether psychopathology was associated with increased duration or serial stalking in this group. It was hypothesised that mental illness, and specifically psychosis, would be more prevalent among strangers and acquaintances than among ex-intimate stalkers.

METHOD

Two hundred and eleven stalkers (10% female; mean age = 35, SD = 10.8; 71 ex-intimates) were recruited between 2002 and 2007 from a specialist service in Melbourne, Australia. Each underwent psychiatric and psychological assessment and disorders were diagnosed according to DMS-IV-TR criteria. Non-parametric independent sample tests were used to examine associations between relationship type and psychopathology, and to identify individual and stalking-related characteristics associated with increased duration and serial stalking.

RESULTS

Axis I disorders were significantly more prevalent among strangers and acquaintances than ex-intimates (71% vs 48%, OR = 2.6, 95% CI = 1.4 to 4.7), as were psychotic disorders (29% vs 9%, OR = 4.4, 95% CI = 1.8 to 10.9). Psychosis was significantly associated with increased duration of stalking behaviour (U = 3043, p < 0.001). Those with a personality disorder were twice as likely to have stalked multiple times (OR = 2.4, 95% CI = 1.2 to 5.0).

CONCLUSIONS

Those who stalk strangers and acquaintances are often mentally ill and psychopathology is associated with more persistent and recurrent stalking behaviour. Although limited by the use of clinical interview rather than structured assessment, these findings strongly support the argument for routine mental health assessment of stranger and acquaintance stalkers who become involved with the criminal justice system.

Stalking by patients: doctors' experiences in a Canadian urban area

Stalking involves recurrent unwanted communication, harassment, and intrusive behaviors. The aim of this study was to examine doctors' experiences of being stalked by their patients in a Canadian urban area. A questionnaire designed to study the nature and prevalence of stalking experiences among physicians was sent to 3159 randomly chosen physicians in the Greater Toronto Area. Of the 1190 physicians who responded, 14.9% reported having been stalked. Although both male and female patients were stalkers, their motives and stalking behaviors were dissimilar. Psychiatrists, surgeons, and OB/GYNs reported the highest rates of being stalked. Both male and female physicians are at an increased risk of being stalked by patients who may feel loving feelings or anger and resentment. Varying reasons behind the stalking may account for the differing rates between specialties. Physicians may benefit from recognition of behaviors that tended to precede the onset of stalking behavior.