Murdered Native and Indigenous Women: A Comparison Study of Victim and Perpetrator Patterns and Characteristics.

INTRODUCTION: The rate of violent crimes against Indigenous people, including murder and rape, is significantly higher than national averages. Even more concerning, Indigenous women and girls represent a large proportion of murdered and missing individuals in the United States. In addition to the murder rate of Indigenous women being higher than the national average, they are significantly more likely to experience rape or other types of sexual violence. The main goal of this study was to gain a better understanding of cases involving the homicide of Indigenous women and identify patterns associated with the violence committed against them. METHODS: Cases of Indigenous women between the ages of 18 and 55 years were pulled from the database. Cases were coded and analyzed for information pertaining to victim, perpetrator, and crime characteristics. Descriptive analysis and test of association were performed. RESULTS/FINDINGS: There was a statistical association between the nature of the relationship between perpetrators and victims and whether the crime occurred on a reservation, the race/ethnicity of the perpetrator, a victim's history of domestic violence, and the method and motive of murder. DISCUSSION/CONCLUSION: Indigenous women are at an increased risk of victimization, including intimate partner violence and homicide. They also represent a group that has been marginalized, receiving little attention from the media, clinicians, researchers, and policy makers. The findings in this study highlight specific factors that may help to mitigate risk factors and/or enhance culturally competent clinical and forensic nursing practice.

Long-Term Psychological and Physiological Effects of Male Sexual Trauma.

Male sexual trauma presents multiple clinical challenges. Although the topic has received increased attention in the last couple decades, male sexual trauma continues to be underreported and underrecognized. This study aimed to investigate the long-term effects of sexual trauma for men who were victimized within an institutional environment by a person in a position of power. This study included data from 47 adult men who were victims of sexual abuse or misconduct by an assigned physician at a higher education academic institution between 1966 and 2003. A primary finding was elevated rates of intimacy and sexual problems and erectile dysfunction, which started shortly after the abuse and persisted over time. We found that there was an association between intimacy and sexual problems and difficulty maintaining employment, drug addiction, erectile dysfunction, and loss of meaningful and romantic relationships. Levels of potential psychopathology were prominently linked to loss of sexual interest or pleasure, intimacy concerns, and loss of intimate and other personal relationships. Men who experienced sexual abuse as adults within an institutional environment developed long-standing patterns of interpersonal and professional problems. This study emphasizes the need for nuanced screening, evaluation, and treatment for male sexual trauma.

The Nurse-Police Assistance Crisis Team (N-PACT): A new role for nursing.

AIM: This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response. DESIGN: This study used a descriptive, qualitative exploratory design and was informed by Systems Theory. METHODS: The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed. REPORTING METHOD: The Standards for Reporting Qualitative Research (SRQR) guidelines were used. RESULTS: Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation. CONCLUSION: This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response-the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents. IMPLICATIONS: Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system. IMPACT: The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Manual and instrument asphyxiation/strangulation: Examining perpetrator and victim characteristics.

Asphyxiation and strangulation are predominant murder methods, with ligature and hands being common weapons in such attacks. This study examines a broad sample with the goal of establishing statistical significance between manual and instrument asphyxiation/strangulation and both victim and offender characteristics. Two hundred cases of perpetrators who strangled or asphyxiated at least one victim on or after 1970 were randomly selected from the Radford-FGCU Serial Killer Database. Descriptive analysis and association tests were performed for characteristics of the perpetrators, victims and crimes. In 68% of the cases, perpetrators only targeted women. The primary murder motives were sadism (36%) and intense emotions (22%), which were statistically associated with the perpetrators' relationship with their victims, serial killing and motive of asphyxiation. There was a relationship between the perpetrators' favoring the use of manual or ligature strangulation/asphyxiation and their ethnicity, prior history of abuse and the victims' racial/ethnic group. Findings highlight the variety of contexts in which strangulation takes place, ranging from sexually or sadism motivated homicide and intimate partner violence. Moreover, the predominance of manual or ligature asphyxiation/strangulation among different racial/ethnic groups may have implications in legal processes, as well as in risk and threat assessments.

Female murderers who mutilate or dismember their victims: An exploration of patterns and sex differences.

Attributes and behavioral patterns of female homicide offenders have been less explored than those of males, particularly in crimes that involve aggravating factors such as dismemberment and mutilation. This study explored the patterns of female murderers who engage in postmortem dismemberment and/or mutilation of victims, contrasting these with the patterns of males who display these same behaviors. Cases were obtained from Radford-Florida Gulf Coast University Database and public sources, and then analyzed for specific characteristics of the crimes. An informational form was used to derive quantitative parameters. Statistical significance between sex and variables such as motive, dismemberment/mutilation style, and level of organization during the crime were examined. The majority of the cases were consistent with a defensive style. However, 23% of the cases involving females followed an offensive style compared to 33% among males. The nature of prior relationships between offenders and their victims was noteworthy, with the victims of males being largely strangers and the victims of females being primarily known to them. In comparison to males, females were markedly organized. These differences may emphasize aspects of psychological drives and pleasure-seeking that was more commonly seen among men, who often targeted strangers and were motivated by sadism in 25% of the cases. Dismemberment perpetrated by women primarily followed a defensive style that aimed to dispose of evidence, which would be congruent with the assumption that the murder occurred within a prior background of interpersonal partner violence toward the female perpetrator or other family members.

Dismemberment and Mutilation: A Data-Driven Exploration of Patterns, Motives, and Styles.

Classification of violent behavior, including dismemberment and mutilation, has become increasingly more significant. This study uses a data-driven classification system based upon knowledge drawn from the pertinent literature, and examination of cases of offenders who have dismembered or mutilated their victims. The latter were extracted from the Serial Killer Database, as well as media sources, and assessed for characteristics of the perpetrators and victim(s). An informational form was developed and used to establish quantitative parameters and objectively extract pertinent information that could be used for comparison and pattern analysis. Motives and styles, as well as the organized/disorganized dichotomy for murder and dismemberment/mutilation, were examined for each case. The majority of cases demonstrated defensive styles (60%), with the second most common being offensive styles (26%), which differs from previous studies that do not exclude older cases. Additionally, 68% of cases reflected organized patterns for both murder and the acts of dismemberment or mutilation. The results support a data-driven classification system that may serve as a foundational model for the investigation of specific motives of this type of deviant behavior in future research.

College Warrior Athlete Initiative and academic nursing.

OBJECTIVE: The College Warrior Athlete Initiative (CWAI) determined if a key element of military occupational culture, referred to as the "battle-buddy" concept of pairing college athletes with veterans, could be applied to Student Service Members/Veterans (SSM/V) health promotion. Participants: Fifty veterans of fifty-seven enrolled completed the program in seven separate cohorts between 2016 and 2017. Methods: The veteran-student athlete pairs or small groups exercised twice a week for 75 min under the supervision of a certified athletic trainer and attended wellness classes. Results: Of the data from 50 veterans, over 2/3rd of veterans lost weight during their 12-week program and reported increased overall health, mood, energy levels and social engagement. Conclusions: This exercise intervention program implemented at two university campuses indicates the benefits of engaging SSM/Vs and college students for physical exercise to improve health. Results provide a foundation for academic nursing in conjunction with other university departments to increase peer cohesion and a sense of community for SSM/Vs.

Student views on campus sexual assault.

Objective: To report on college student opinions about the scope of college sexual misconduct (CSM), suggested university sanctions, and treatment of students found responsible of CSM. Participants: In all, 23 US undergraduate students (14 females and 9 males) with a mean age of 20 years. Methods: Students participated either in female, male, or mixed-sex focus groups that facilitated the discussion of factors related to CSM. Results: Students provided in-depth feedback on the climate on US college campuses and factors related to CSM. They agreed upon CSM risk factors and context characteristics, but raised different male and female issues across sex groups. They further provided resolute suggestions for the solution of CSM, experienced treatment barriers, and limited victim reporting. Conclusion: Student focus groups provide important information about the scope of CSM and offer valuable suggestions for the solution of the problem that may be crucial for the development of successful sexual assault interventions.

Fetal Abduction: Comparison of Two Cases.

The current article compares two cases involving the murders of two pregnant mothers for the kidnapping of their fetuses. The structure of the crimes includes seven steps. Both mothers were befriended by their killers (one before and one on the day of the murder and abduction), rendered unconscious by blunt force trauma, and then killed (one by strangulation and one by gunshot). Both bodies were moved after the murders and hidden, and later discovered by the circumstances of the babies' births: crude cesarean section operations. One killer, Winifred Ransom, was diagnosed in 1975 with schizophrenia, acquitted as insane, sentenced to Byberry State Hospital and, on appeal, was released as "cured" 20 months later. The other killer, Julie Corey, was found guilty in 2014 and sentenced to life in prison. The cases illustrate two different eras in psychiatric nursing. [Journal of Psychosocial Nursing and Mental Health Services, 54(11), 37-43.].

Online Reporting of Military Sexual Trauma.

Case finding and treatment of military sexual trauma (MST) remains a serious problem in military and veteran populations as well as in the civilian population. This report provides descriptive examples, with statistics, of persons serving in the military or while living/working on a military base when they experienced unwanted sex. Males, more than females, never disclosed MST before online survey, had more physical injuries as a result and reported chronic disturbing thoughts of the experience. Undisclosed and unreported intrafamilial childhood sexual experiences were cited before an MST by some respondents. Interprofessional collaboration is recommended between military nurse practitioners and behavioral health clinicians as well as innovative strategies using telecommunication and online counseling.

To Tell or Not to Tell.

The underreporting of rape is well known; however, there is less information on women who fail to disclose to anyone. This online study suggests that 24% of 242 women who were non-disclosing compared with those who had disclosed were significantly less likely to seek treatment for emotional injuries. Also, almost two thirds of non-disclosing women believed the abuse was their fault versus 39.1% of women with prior disclosure. Of clinical interest is that regardless of disclosure pattern, there was no significant difference in reports of depression, anxiety, or posttraumatic stress disorder, and the majority of respondents endorsed support for online counseling over telephone or individual contact.

Gaps in Crisis Mental Health: Suicide and Homicide-Suicide.

Gaps in crises of mental health emerge from poor distinction between the qualities of people who suicide and those who murder and then kill themselves. The role, if any, that substance use has in such lethal violence is an example of such a lack of distinction. In this study, a sample of medical examiner investigative and toxicology reports from Los Angeles and Orange counties in California were available for analysis for 432 suicide cases and 193 homicide-suicide cases. This informed clearer toxicological and pharmacological distinction of suicide from homicide-suicide. Blood alcohol levels were higher in persons committing suicide than in homicide-suicide perpetrators (p=.004). Homicide-suicide perpetrators had almost twice the level of stimulants in their system than people who suicide (p=.022) but did not have comparatively elevated levels of drugs or alcohol. Predictors of suicide included the following: substance abuse history, high number of drugs in system, death inside a house, and legal impairment by alcohol. Predictors of homicide-suicide included gunshot as the cause of death, female gender, domestic conflict, children living in the home, and prior arrest for substance abuse.

To Tell or Not to Tell.

The underreporting of rape is well known; however, there is less information on women who fail to disclose to anyone. This online study suggests that 24% of 242 women who were non-disclosing compared with those who had disclosed were significantly less likely to seek treatment for emotional injuries. Also, almost two thirds of non-disclosing women believed that the abuse was their fault versus 39.1% of women with prior disclosure. Of clinical interest is that regardless of disclosure pattern, there was no significant difference in reports of depression, anxiety, or posttraumatic stress disorder (PTSD), and the majority of respondents endorsed support for online counseling over telephone or individual contact.

Homicide-suicide and duty to warn.

This retrospective study of medical examiner records from three counties reported on 252 persons who killed 302 victims before killing themselves and reviews the Tarasoff ruling that set the standard for duty to warn and/or protect third parties whose lives are threatened by a patient. The three sites varied significantly for the perpetrator in terms of race, employment, cause of death, and motive. Female offenders killed more children under the age of 10 and adolescents than did male offenders. Evidence of premeditation included suicide notes and weapon brought to the crime scene, while strangulation indicated a spontaneous domestic homicide. Implications for practice are discussed including the importance of evaluating violent thoughts, fantasies, and behaviors in acute emergency settings and recommendations include second opinion consultation for Tarasoff-type cases and psychological autopsy review for completed homicide-suicide cases.

Symptom responses to a continuum of sexual trauma.

This study reports the findings of an anonymous web-based survey to test differences in symptom presentation (depression, anxiety, posttraumatic stress disorder [PTSD]) among women who experienced different types of sexual trauma (forcible, pressured, sex stress). The study used a descriptive cross-sectional design with an online convenience sample of 243 adult females living primarily in the United States. The findings revealed that there was a statistically significant difference among type of sexual trauma groups for depression (p = .013) and PTSD (p = .044) but not for anxiety (p = .183). Post hoc analysis of the overall difference in depression revealed that the multiple rape type group (p = .010) and the forcible sex group (p = .016) had higher levels of depression.

Military sexual trauma: a silent syndrome.

This article examines an age-old problem-sexual assault-through the lens of its occurrence within the military culture. Specific cases as well as U.S. Department of Defense responses to better handle these issues are offered to educate psychiatric-mental health nurses of the potential differences in symptomatology and presentation of military sexual trauma (MST). This appears to be an increasing problem with the predicted cohort of returning veterans appearing both in the U.S. Department of Veterans Affairs system as well as in civilian locations, hospitals, community centers, and especially the workplace. It will be critical to develop training materials and pursue further research to identify this silent syndrome of MST to better meet the needs of our returning veterans.

Patterns of federal Internet offenders: a pilot study.

Internet-facilitated sexual offending is receiving increased forensic and clinical attention. Two issues confront this field. First, studies are equivocal as to whether (or not) the possession of Internet pornography can escalate to contact sexual offenses against a child, and second, federal judges have been questioning the length of sentences for users only of child pornography. The findings of this pilot study of 101 federal Internet offenders revealed over half of the men at the time of arrest were employed, educated, were in (or had been in) a relationship, had children, and did not have a prior criminal offense, suggesting a changing profile of a convicted sex offender. Forensic and psychiatric nurses who evaluate users of child pornography contraband need to be knowledgeable of Internet file transfer technology and the various types of contraband viewed specifically for the age of the preferred child, extreme acts to the child (e.g., bondage, S&M), and whether the user prefers images of adults with children or images of children only.

Using a trauma-informed framework to care for incarcerated women.

Available health and social services in women's correctional facilities often do not consider the interrelationship of gender, trauma, and mental illness. As a result, preexisting health issues are often exacerbated, leaving women to reenter their communities with more complex health needs. We propose that a trauma-informed framework can be used to guide clinical interactions with female inmates. A case study is presented as an example of proposed best clinical practice. Future trauma-related practice implications are provided.

Original research: online social networking patterns among adolescents, young adults, and sexual offenders.

OBJECTIVE: The use of online social networks like Facebook continues to increase rapidly among all age groups and segments of our society, presenting new opportunities for the exchange of sexual information as well as for potentially unsafe encounters between predators and the vulnerable or young. This study surveyed middle school, high school, and college-age students, as well as sexual offenders, regarding their use of social networking sites in order to provide information to better focus education and prevention efforts from nurses and other health care providers. METHODS: Written questionnaires asking about various characteristics of participants' use of social networking sites were distributed to each group and filled out by 404 middle school students, 2,077 high school students, 1,284 students drawn from five traditional four-year colleges, and 466 adults who had committed either an Internet sexual offense or a hands-on sexual offense (in some cases both). RESULTS: Notable findings emerging from our analysis of the questionnaire responses included the following: offenders and students both frequent social networking sites, although at the time of the study offenders reported that they preferred Myspace and students that they preferred Facebook; nearly two-thirds of the Internet offenders said they'd initiated the topic of sex in their first chat session; more than half of the Internet offenders disguised their identity when online; most Internet offenders we surveyed said they preferred communicating with teenage girls rather than teenage boys; high school students' experience with "sexting" (sharing nude photos of themselves or others on cell phones or online) differed significantly according to their sex; a small number of students are being threatened and assaulted by people they meet online; avatar sites such as Second Life were used both by students and offenders, with both child molesters and Internet offenders expressing interest in Second Life. CONCLUSIONS: The use of the Internet presents relatively new and complex issues related to the safety and privacy of adolescents and young adults, and it's crucial that our understanding keep pace with these changes. Possible nurse-initiated policy recommendations include designing technologies and educational programs to help in the identification of suspicious online behaviors; strengthening Internet filters and privacy options for protecting students online; and school outreach for students who are harassed, threatened, or assaulted as a consequence of meeting someone online.

Clustering of Internet risk behaviors in a middle school student population.

BACKGROUND: Internet safety is a growing public concern especially among adults and youth who live in an "instant messaging" world of technological communication. To better understand how early adolescents are using the Internet, a study was undertaken to more clearly identify the online general use, safety knowledge, and risk behaviors of middle school students. METHODS: This exploratory study adapted from Finkelhor et al's (2000) Youth Internet Safety Survey to identify the usage and characteristics of online youth, solicitation of youth, and searching for pornography or delinquent behaviors. The 404 students who were recruited from public and parochial schools consisted of both boys and girls with a mean age 12 years. RESULTS: These students reported the beginnings of high-risk Internet behavior, specifically, giving out personal information, using the Internet to harass or embarrass another person, and for a small number of students, chatting with strangers and starting relationships. The students who posted their picture online were more likely to have sent their picture to someone, made rude comments to others, played online jokes, harassed or embarrassed someone, and sought out pornographic sites. CONCLUSIONS: Findings suggest that middle school students who are early adolescents are beginning risky behaviors on the Internet. Risk-taking behavior is not unique to adolescents, but the consequences can be detrimental to their development. Educators, clinicians, health care providers, and other professionals need to be informed of Internet behaviors in order to assess for children at risk, to make referrals, intervene, and to educate parents.