[Experiences of Violence During Inpatient Child and Adolescent Psychiatric Treatment: An Explorative Study with Implications for Child Protection]

Experiences of Violence During Inpatient Child and Adolescent Psychiatric Treatment: An Explorative Study with Implications for Child Protection Abstract. Objective: Educational and medical institutions care for children and adolescents by providing supervision, schooling, education, therapy, and protection. Nevertheless, children in institutional care are exposed to potential danger through maltreatment and abuse. Method: As part of the establishment of the protection concept at the University Hospital for Child and Adolescent Psychiatry in Würzburg, a retrospective patient survey was conducted. The study population consisted of former inpatient clients from 2006 and 2007, who at the time of the catamnesis were of legal age. The survey was conducted by mail. In addition to items on their experiences of violence, the questionnaire included established scales to assess treatment satisfaction and quality of life (FBB-K, WHO-BREF). Results: Of 568 former patients, 87 (15.3 %) provided valid responses (59 female, mean age at the time of the survey: 24.5 years): 35 former patients (40.2 % of the participants) reported experiences of violence during their inpatient treatment (26 victims only, 7 experiences as victims and perpetrators, and 2 perpetrators only). Experiences as victims mainly included emotional violence (34.5 %), but also physical (5.7 %) and sexual violence (10.3 %). Conclusion: We found a significant correlation between experiences of violence, on the one hand, and retrospective treatment satisfaction and current quality of life, on the other hand. The results of the survey underline the importance of establishing protection concepts in clinics and other institutions.

The 'Oscar curse' or the price of women's development

This article aims to reflect on the unconscious dynamics that sustain the shocking increase in feminicide in the world. It is observed that psychological and physical violence by the intimate partner has numerous facets, especially when the woman gains more or has more professional success than her partner. This violence can take a subtle form as rejection and betrayal in order to hurt the woman and destroy her self-esteem and success. Based on numerous studies and bibliography it is demonstrated that the main cause of violence by the intimate partner is the fear of the power of the feminine that has been present throughout history. Despite the evolution of women, historical violence reverberates in the 21st century as an intergenerational trauma causing great suffering in families and disturbances in interpersonal relationships.

Gewalt und Gewaltprävention in der stationären Altenpflege während der COVID-19-Pandemie

Violence and Violence Prevention in Nursing Homes during the COVID-19 Pandemic - A partial analysis of Interviews with Managers or Team Leaders Abstract. Background: During the first wave of the COVID-19 pandemic, strict infection control measures were in force in long-term residential care in Germany that burdened staff and isolated residents socially. Both are considered risk factors for violence in long-term residential care. Questions: How does violence develop in nursing homes under pandemic conditions from the point of view of managers and how do strategies for preventing violence change? Methods: Semi-structured telephone interviews were conducted with staff in 43 nursing homes: 25 with service managers, 15 with nurse managers, 28 with nursing team leaders and 10 with registered nurses with extended tasks. The interviews were recorded as audio, transcribed and analysed in five steps following the "Thematic Framework Analysis". Results: The infection control measures were partly perceived as deprivation of freedom. Residents, relatives and staff partly reacted most with verbal violence. Nevertheless, the issue of violence was not a major concern for management and preventive measures were not carried out. Conclusions: The results show that strategies to prevent violence might not be sufficiently established in the institutions involved and would have to be adapted to the conditions of the pandemic. Further research is needed to evaluate infection control measures in their potential to increase the incidence of violence.

[Paternal Risk and Protective Factors for Endangerment of Child Well-Being and their Consideration in the Risk Inventories Used Throughout Germany]

Paternal Risk and Protective Factors for Endangerment of Child Well-Being and their Consideration in the Risk Inventories Used Throughout Germany In view of the current family and role models, paternal risk and protective factors can have a significant impact on the risk of violence within a family and should therefore - in addition to the factors on the part of the mother, the child and the closer or other family systems - be taken into consideration when estimating the endangerment of child well-being. In this article we explore which empirical findings on paternal risk and protective factors for abuse, neglect and sexual abuse (sexual violence) in childhood and adolescence were published in international research literature from 1980 to 2019. Seventeen risk factors and four protective factors could be identified, which in 33 quantitative original studies showed a risk-increasing or a buffering influence on violence experiences in families on the part of the father. In addition, the risk inventories used in practice in Germany were analyzed with regard to the paternal risk and protective factors, in order to be able to illustrate the application of the empirically identified factors in early intervention, youth welfare and health care. The article used results from a benchmark survey on risk inventories from 2009. These results were compared with current findings from 2018 as part of a research update. In 2009, 67 % of the instruments "often" contained items on the father, while this was found for 12 % of the instruments in 2018. At the same time, in 2018, 53 % of the risk inventories were "often" asked about custodians, parents or main caregivers. The article thus reflects developments in research and practice in risk assessment for child well-being, in which especially the fathers, who unlike the mothers are often not explicitly addressed during screenings and interventions for families with psychosocial problems, are taken into consideration. The knowledge about the influence of the fathers can feed into the preventive interventions in early interventions and complement them meaningfully.

[Depression and Violence: A Contradiction?]

Depression and Violence: A Contradiction? Abstract. Depression is one of the leading diseases worldwide. Its symptoms are of great importance for a variety of areas within internal medicine, as patients often pay a visit to their general practitioners first. Although symptoms of depression are observed in both genders, existing peculiarities of the symptoms in men are only insufficiently known or acknowledged. Therefore, we dedicate this article to the concept of male depression, which can be characterized by social withdrawal, irritability or substance abuse. Here, we present practice-related associations between depression and violent behavior, which will be illustrated by two case studies. Of particular relevance is the so-called suicidal-homicidal syndrome, which should make further psychiatric, if not forensic-psychiatric evaluation mandatory.

A developmental origins perspective on the emergence of violent behavior in males with prenatal substance exposure

Children with prenatal substance exposure are at increased risk for externalizing behavior problems and violence. However, the contribution of early life experiences for placing these individuals at risk is not well understood. Utilizing a sample of 1,388 children with prenatal substance exposure from the Maternal Lifestyle Study, we attempt to shed light on these contributing factors by examining the impact of infant temperament, maternal sensitivity, and early life stress on the expression of violent behavior at ages 12 through 14 years. Males may be more at risk for increases in violent behavior in early adolescence through a number of early life experiences, such as variability in responses to maternal flexibility and engagement related to individual differences in temperament, as well as exposure to early adversity. Comparing two prevailing developmental theoretical frameworks, deficit models and differential susceptibility, we aim to understand the developmental origins of violent behavior in males by identifying children who may be most susceptible to early caregiving experiences.

Age and gender as independent predictors of violence under the influence of alcohol in Zurich, Switzerland

Violent behaviour associated with alcohol consumption is frequently reported by different media. Clinical data analysing the correlation between alcohol intoxication, age, gender and violence are scarce. The aim of this study was to evaluate the influence of age, gender and blood alcohol content on violent behaviour under the influence of alcohol under central European conditions. Three hundred patients admitted to the emergency department were included into this study in the time period from January 01. to December 31. 2009. The inclusion criteria were a blood alcohol content (BAC) of ≥10 mmol/l, any traumatic injury and an age ≥16 years. Violence was defined as an evitable act committed by others leading to patient's hospitalisation. The data were compared with Wilcoxon and χ2-test for proportions. The data were considered as significant if p<0,05. Predictive quality was evaluated by using receiver operating characteristic (ROC) curve. Independent predictors were analyzed by logistic regression analysis. The average age was 36,9±16,9 years (range: 16-84 years), 259 (86%) males and 41 (24%) females. There was a significant difference in gender (odds ratio for gender male 2,88; CI 95%: 1,24-6,67; p<0,001) and age dependent (odds ratio for each year of age 0,94; CI 95%: 0,93-0,96; p<0,0001) violence with no correlation to blood alcohol content found. Logistic regression analysis revealed male gender and young age as an independent predictor for violence. These results clarify the relationship between alcohol, age, gender and violence and have important implications for municipal-level alcohol policies.

[Examining victims of interpersonal violence]

Interpersonal violence represents a widespread phenomenon with a high prevalence. Consequences of these acts of violence are serious and extensive to the victims and from a socio-economic point of view. Physical examination of the victims is a key aspect in the medic-legal expertise. This article describes the basic principles and the standard procedures in conjunction with the examination of violent crime victims.

[Schizophrenia and violence]

As compared to the general population schizophrenic patients are at increased risk of becoming delinquent. The majority of schizophrenic patients do not commit any crime, and the risk of the general population to be a target of a violent act by a person with schizophrenia is low. The causes of delinquency in schizophrenia are complex, but certain risk characteristics (e. g. an accompanying substance abuse) have been identified. The treatability and legal prognosis of schizophrenic offenders are good, which suggests that establishing a suitable helpers network could also be used for violence prevention in patients at risk.

[Violence-related injuries in an urban environment-view from an accident and emergency department]

Violence is a growing problem worldwide. In Switzerland, interpersonal violence seems to be an increasing problem as well. The aim of the current study was to describe a comprehensive picture of violence in a swiss city with regard to medical and social aspects. A total of 1740 patients injured by violent crimes between April 2004 and January 2011 were enrolled into this study. Most of them were male. There were no relevant changes regarding the number of within the observation period. However, the proportion of affected females increased. Especially at the weekend, there is a need for preventive measures to reduce the high number of affected patients and the associated costs.