Traumatic distress among support-seeking female victims of stalking

The psychological consequences of stalking: cross-sectional findings in a sample of Danish help-seeking stalking victims

Background: The experience of stalking presents a threat to the mental and physical health and wellbeing of victims. Although some studies have explored the impact of stalking on victims, few have gone into detail about specific mental health outcomes and their association with various types of stalking behaviour.Objective: To investigate the psychological consequences among Danish help-seeking victims of stalking who have contacted and received help through the Danish Stalking Center (DSC).Methods: We used survey-data from stalking victims who sought and received help from the DSC during 2015-2020 (N = 591). Descriptive statistics, correlation analysis, T-tests, and hierarchical logistic regression analysis were used to examine psychological distress symptoms and the relationship between psychopathological symptoms and stalking behaviour characteristics.Results: Victims reported considerable levels of stalking and psychological distress. Almost 80% of victims reported symptom levels indicative of a diagnosable disorder of PTSD, depression, or anxiety. T-test shoved that following behaviour had the greatest effect size for PTSD-symptoms (t(575) = -5.81, p < .01, d = -.58), anxiety (t(576) = -4.21, p < .01, d = -.42), and somatization (t(572) = -4.29, p < .01, d = -.43). Hierarchical logistic regression analysis showed that stalking victims who experienced following had significantly higher odds of experiencing symptoms of PTSD (OR 2.869; 95% CI, [1.641-5.016]) and anxiety (OR 2.274; 95% CI [1.265; 4.090]).Conclusion: Being stalked is associated with substantial PTSD-, affective and trauma-related symptoms and psychological distress in general. Together with the strikingly high levels of psychopathology and the particularly grave effects of being followed, it is indicated that stalking is a special type of trauma with many negative and harmful effects. Hence, further research into how to properly help stalking victims through preventive interventions and treatment is needed.

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.

Stalking im Jugendalter

Zusammenfassung. Theoretischer Hintergrund: Die Folgen für Betroffene von Stalking reichen von der Beeinträchtigung des sozialen Wohlbefindens über negative wirtschaftliche Folgen bis hin zu gesundheitlichen und psychischen Problemen. Fragestellung: Diese Studie präsentiert erstmalig die Lebenszeitprävalenz für die Opferwerdung von Stalking unter deutschen Jugendlichen und berichtet Zusammenhänge mit der psychischen Befindlichkeit. Methode: Daten einer repräsentativen Schüler_innenbefragung in Niedersachsen werden mittels T-Tests und χ2-Test überprüft. Ergebnisse: Die Ergebnisse weisen auf eine Prävalenz von 22.6 % von Stalking hin, die bei Mädchen und Jugendlichen höher ausfällt als bei Jungen und Erwachsenen. Betroffene leiden häufiger unter psychischen Problemen und problematischem Substanzkonsum als Nicht-Betroffene. Diskussion und Schlussfolgerung: Folglich sollten Schüler_innen über Stalking sowie dessen strafrechtliche Konsequenzen und gezielte Unterstützung der Betroffenen aufgeklärt werden.

Psychological Distress and Attachment Insecurity of Stalked Mothers

There is a lack of research about intimate partner stalking when victim and stalker have children together. The aim of the current study was to provide knowledge about the mental health status and attachment patterns of mothers stalked by the father of one or more of their children. One hundred ninety six Danish women, recruited via a closed social network for stalked mothers, completed an anonymous online questionnaire concerning their experiences of violence during and after the relationship with the stalker, relationship characteristics, attachment patterns, and psychological distress. Results indicated high exposure to psychological maltreatment during the victim-stalker relationship, harassing and violent stalking behaviors after relationship termination, and high levels of functional disabilities, PTSD (posttraumatic stress disorder), other trauma-related, affective, and somatization symptoms. Furthermore, the women retrospectively reported an increase in attachment insecurity from the time before their relationship with the stalker to the time of study participation (after they experienced relationship violence and/or stalking). Stalking behaviors uniquely contributed to the explanation of the mothers' psychological distress above the effects of relationship violence. Moreover, attachment insecurity appeared to be the strongest predictor of psychological distress. Having children together with their stalker captures women in an ongoing situation of threat and interpersonal traumatization that differs from other forms of stalking in many respects. The present study is the first drawing attention to the experiences and suffering of stalked mothers, a particularly vulnerable group of stalking victims.

Longitudinal Associations Among Negative Cognitions and Depressive and Posttraumatic Stress Symptoms in Women Recently Exposed to Stalking

Being stalked is a potentially traumatic experience associated with a threat to personal safety. Although major depression and posttraumatic stress (PTS) disorder are highly prevalent among stalking victims, little is known about factors associated with risk for the onset and maintenance of depressive and PTS symptoms in individuals with recent stalking exposure. The aim of this study was to determine the role of cognitive appraisals (negative views about the self, negative views about the world, self-blame) in the development of depressive and PTS symptoms in young adult women who had experienced stalking within 1 month of their baseline assessment. Participants (n = 82) completed self-report online surveys of posttraumatic cognitions and symptoms four times over the course of 3 months. Levels of posttraumatic cognitions among female stalking victims were comparable to those in other studies of trauma-exposed individuals. Multilevel models (MLMs) revealed that within-person changes in cognitions were differentially associated with concurrent changes in depressive and PTS symptoms over time, controlling for the influence of time, age, race, ethnicity, lifetime stalking victimization, childhood trauma exposure, and symptoms of the other disorder. Whereas more negative cognitions about the world were associated with higher levels of concurrent depressive and PTS symptoms, negative cognitions about the self were uniquely associated with higher concurrent depressive symptoms. Contrary to expectation, self-blame was not significantly associated with depressive or PTS symptoms. Results provided support for the potential utility of negative cognitions as risk markers for depressive and PTS symptoms in young adult female stalking victims. The present findings suggest that interventions targeting symptom-specific thinking patterns could help reduce risk for negative mental health outcomes associated with stalking victimization.

Increased risk of mental disorders among lifetime victims of stalking – Findings from a community study

Purpose

Population-based studies on the relationship between stalking and mental health outcomes in victims are scarce. The aim of the present study was to assess associations between stalking victimization and specific DSM-IV mental disorders in a community sample.

Method

A postal survey was conducted in a middle-sized German city (sample size = 675). Lifetime stalking victims and non-victims were compared regarding rates of any mental disorder, comorbid mental disorders, and specific disorders assessed by the Patient Health Questionnaire (PHQ).

Results

Victims had a higher incidence of mental disorders and comorbid mental disorders. Sex- and age-adjusted rates of specific disorders were increased, with the most robust associations identified for major depression (OR 4.8, 95% CI 1.8–12.8) and panic disorder (OR 4.1, 95% CI 1.1–14.9). Victims also reported higher current use of psychotropic medication (20.8% versus 5.6%).

Conclusions

Our study indicates substantial associations between stalking victimization and impaired mental health that can be quantified at diagnostic levels in the general population. To confirm these findings, larger community studies are needed, which also include an assessment of lifetime psychopathology and of factors potentially mediating the associations between stalking victimization and mental health.

The Impact on Informal Supporters of Domestic Violence Survivors: A Systematic Literature Review

Domestic violence (DV) is experienced by 1 in 4 women in the United Kingdom during their lifetime, and most survivors will seek informal support from the people around them, even if they choose not to access help from professionals. Support from these relatives, friends, neighbors, and colleagues can provide a buffer against effects on the survivor's physical health, mental health, and quality of life, and has been shown to be protective against future abuse. There has been an absence of research studying members of survivors' networks and, in particular, investigating how the impact of DV might diffuse to affect them. A systematic literature review of reported research (either in peer-reviewed journals or in gray literature) was undertaken to explore the impacts of DV on survivor networks. Of the articles found, 24 had data relating to the topic area, though no study addressed the question directly. Framework analysis and meta-ethnography generated the following themes: physical health impacts, negative impacts on psychological well-being, direct impacts from the perpetrator, and beneficial impacts on psychological well-being. The studies in this review indicated that informal supporters may be experiencing substantial impact, including vicarious trauma and the risk of physical harm. Currently, there is little support available which is directly aimed at informal supporters of DV survivors, thus these findings have practical and policy implications, in order to acknowledge and meet their needs.

A comprehensive approach to managing threats of violence on a university or college campus

Horrifying, high profile acts of violence on campuses remain relatively rare, nevertheless, academic administrators are required to manage threats of violence on campus on an increasingly regular basis. These threats take two primary forms, those in which the perpetrator and the intended victim(s) are clearly identified, often involving repeated threats and threatening behaviour towards an individual; and those involving anonymous threats to commit acts of larger scale violence. Complicating factors in managing these threats include: fear contagion; mass media and social media attention; responsibilities to all members of the university community sometimes including individuals issuing the threat and the intended victims; demands for safety and security measures that are often at odds with professional advice; and permeable campus boundaries that cause security challenges. This paper considers the changing landscape of threat assessment and risk assessment on university and college campuses and suggests opportunities for partnerships between forensic mental health professionals and academic administrators.

Cyberstalking in a large sample of social network users: prevalence, characteristics, and impact upon victims

The aim of this study was to determine the prevalence of cyberstalking victimization, characteristics of victims and offenders, and the impact of cyberstalking on the victims' well-being and mental health. An online survey of 6,379 participants was carried out, involving users of the German social network StudiVZ. Subjective mental health status was assessed with the WHO-5 well-being index. The prevalence of cyberstalking was estimated at 6.3%. In various aspects, cyberstalking was comparable to offline stalking: cyberstalking occurred most often in the context of ex-partner relationships; most of the victims were female and the majority of the perpetrators were male. Compared to non-victims, victims of cyberstalking scored significantly poorer on the WHO-5 well-being index. The prevalence of cyberstalking is considerable. However, if stringent definition criteria comparable to those of offline stalking are applied, it is not a mass phenomenon. The negative impact of cyberstalking on the victims' well-being appears similar to that of offline stalking. Hence, cyberstalking should be taken as seriously as offline variants of stalking by legal authorities and victim assistance professionals.

Assessment and psychotherapy with women experiencing intimate partner violence: integrating research and practice

Intimate partner violence (IPV) is a serious, pervasive problem; however, professional literature focused on psychotherapy for women experiencing IPV is limited. This article delineates reasons why there is a dearth of literature on this topic. It then provides guidelines for assessment and practice, focusing on issues and approaches unique to women experiencing IPV. For assessment, the therapist should gather information on the type of IPV the client experiences, the relationship dynamics involved, and the availability of the client's social support network. Discussion of the client's developmental history, including any history of child maltreatment and violence in early dating relationships is also relevant. Assessment of the client's current mental health functioning is essential and will include a consideration of common psychological sequelae that can result from IPV. Treatment should include safety planning as well as reducing minimization of the abuse. In addition, treatment should address potential IPV-related emotion dysregulation and splitting.

Mediating effects of stalking victimization on gender differences in mental health

Studies suggest that stalking victimization may have a serious mental health impact. The present article investigates gender differences in mental health and possible mediating effects of stalking victimization in a community sample. The study includes a postal survey of 665 German community residents on the experience of stalking and various mental health indicators. In a majority of mental health scales, women score poorer than men, and a higher percentage of women fulfill criteria for a current mental disorder and used psychotropic medication. However, effects of gender decrease to a nonsignificant level when stalking victimization is entered into the respective models. Furthermore, associations of stalking victimization with poor mental health, psychosocial functioning, and use of medication are largely comparable across gender.

Describing intimate partner stalking over time: an effort to inform victim-centered service provision

Stalking has increasingly been the subject of legislation and research in the past 20 years. Within intimate partner violence, the context where it is most likely to occur, stalking predicts both greater danger and greater distress for the victim. However, research shows that practitioners are often unsure how to address stalking, and that the remedies available may not be effective. This longitudinal exploration of stalking focused on the experience of victims of intimate partner stalking and was conducted by Safe Horizon, an organization providing assistance to victims of violence and abuse in New York City. The sample of 82 women was interviewed monthly over 7 months, and the data were analyzed using growth curve models. We found that stalking decreased over time at a marginally significant level, and that change in stalking varied among participants. Perceived safety followed a similar pattern, increasing but not significantly, while stalking-related distress decreased significantly. The slopes of these variables were correlated, such that as stalking frequency decreased, perceived safety increased and distress decreased. Help-seeking was greater from court sources than victim services over the course of the study, but neither help source was related to a significant decrease in the stalking trajectory. According to victim report, orders of protection (OP) were helpful at some points and not at others. Implications of these results for offering victim-centered services are discussed.

Advances in stalking risk assessment

Over the past 15 years, forensic mental health has become more concerned with the concepts of violence prevention, management, and treatment. The development of specialist tools to aid in the assessment of a range of risks reflects this concern. This article explores contemporary thinking on violence risk assessment and how this knowledge can be applied to the relatively newer field of stalking risk assessment. The role of risk state and risk status are discussed, in addition to the way that standard structured professional judgment procedures need to be adapted to reflect the variety of risks present in stalking situations. The authors go on to describe the development and format of the Stalking Risk Profile, a set of structured professional judgment guidelines for assessing risk in stalkers. Suggestions are made for future research to enhance knowledge and improve practice in the field of stalking risk assessment.

Management and treatment of stalkers: problems, options, and solutions

Legal sanctions alone are often ineffective in preventing stalking because, in the absence of treatment, the fundamental problems driving the stalker remain unresolved. Criminal justice interventions can be problematic because of difficulties in framing anti-stalking legislation and inconsistencies in their application. Civil remedies in the form of restraining orders may be ineffective or counterproductive. Treatment of stalkers involves pharmacotherapy when mental illness is present, but the mainstays of treatment for non-psychotic stalkers are programmes of psychological intervention. These depend on accurate assessment of the risks inherent in stalking and on the identification of psychological deficits, needs, and responsivity factors specific to the individual. Treatment can then be tailored to suit the stalker, thereby enhancing therapeutic efficacy. Developing a framework for identifying the risk factors and shaping the delivery of treatment is crucial. Two service innovations developed specifically to work with stalkers are presented as options to overcome current management deficiencies.

A Meta-Analysis of Coefficient Alpha for the Impact of Event Scales: A Reliability Generalization Study

We conducted a score reliability meta-analysis across studies using the Impact of Event Scales. Five hundred and ninety-four studies using the measure were located through electronic database searches and then separated to identify studies that had calculated and reported reliability coefficients from their own data. The 66 articles that remained were then coded to identify potential study characteristics that might influence the variation in reliability estimates. Results indicate adequate internal consistency estimates for all subscales across both scale versions. Furthermore, coefficient alpha was positively correlated with studies involving war and abuse victims for the IES Avoidance subscale. The alpha coefficient was also positively correlated with the percentage of female participants for the Intrusion subscale and negatively correlated to journal type for the composite reliability estimate. Results from this study provide useful information, in terms of scale performance, for researchers interested in using the scale for future academic pursuits and for school psychologists. In particular, implications for school psychologists are considered.

Cumulative victimization, psychological distress, and high-risk behavior among substance-involved women

This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women's engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.

Coping with stalking

Stalking is a serious public health and societal concern affecting the college population. Although numerous studies illustrate the physical and mental effects of stalking, literature addressing how individuals cope with this phenomenon is lacking. The purpose of this study was to describe stalking experiences of college students and the coping strategies used to manage stalking. In this descriptive study, 262 college students completed an online survey that included a stalking questionnaire and coping survey. Slightly more than one-fourth of the sample (n = 69) reported experiencing stalking victimization. Results indicated that the most common coping strategies employed were: ignoring the problem, minimizing the problem, distancing, detaching or depersonalizing, using verbal escape tactics, attempting to end the relationship, controlling the interaction, and restricting accessibility. Implications for refining current practice and research on coping strategies and stalking are suggested.

Partner stalking: psychological dominance or "business as usual"?

Partner stalking may remain one of the least clearly understood forms of intimate violence. This review examines the literature guided by two main goals: (a) to examine how partner stalking is distinct from nonpartner forms of stalking and (b) to describe areas of research on partner stalking that need to be systematically addressed to deepen the understanding of partner stalking and to craft more effective mental health and criminal justice responses. These areas of research include three overarching questions: (a) Is partner stalking a unique form of psychological dominance or is it just "business as usual"? (b) What components characterize stalking differently from business as usual for women? and (c) How is psychological distress within the context of partner stalking best characterized?

Stalking among juveniles

BACKGROUND

There is an almost total lack of empirical research on stalking among juveniles.

AIMS

To examine the characteristics, nature and impacts of stalking by juveniles.

METHOD

Analysis of consecutive court applications for a restraining order against a juvenile because of stalking behaviours.

RESULTS

A total of 299 juvenile stalkers were identified. The majority were male (64%) and their victims predominantly female (69%). Most pursued a previously known victim (98%), favouring direct means of contact via unwanted approaches (76%) and telephone calls or text messaging (67%). Threats (75%) and physical and sexual assaults (54%) were common. The contexts for juvenile stalking involved an extension of bullying (28%), retaliation for a perceived harm (22%), a reaction to rejection (22%), sexual predation (5%) and infatuation (2%).

CONCLUSIONS

Juvenile stalking is characterised by direct, intense, overtly threatening and all too often violent forms of pursuit. The seriousness that is afforded to adult forms of stalking should similarly apply to this behaviour among juveniles given the even greater rates of disruption to the victim's life and risks of being attacked.

Sampling in research on interpersonal aggression

The aim of this study was to investigate the usefulness of convenience samples in research on interpersonal aggression among adults. It was hypothesised that convenience sampled targets of aggression differs from targets in general with regards to both demographic characteristics and degree of aggression exposed to. A convenience sample comprising support-seeking targets of workplace bullying was compared with a representative sample of Norwegian targets of bullying. The results showed that the two samples differed significantly on all demographic variables investigated, except gender. A far higher percentage of the convenience sample had blown the whistle on illegal, immoral or illegitimate practice at their workplace, whereas they also reported significantly more frequent and more intense exposure to aggression. The findings confirm that convenience samples have low external validity when generalising to the general population. Such samples should therefore mainly be used to investigate tendencies in, and the phenomenology of, interpersonal aggression, in studies where generalisability is not the principal objective.

What can we learn from the first community-based epidemiological study on stalking in Germany?

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.

The epidemiology and characteristics of stalking

PURPOSE OF REVIEW

This article summarizes major results in the field of epidemiology and characteristics of stalking, as published in literature between 2003 and October 2005.

RECENT FINDINGS

Although stalking had been only recently conceptualized, it soon became evident that it represents a significant social and medical problem. Community-based studies on the prevalence of stalking are scarce and predominantly from English-speaking countries. All epidemiological studies, however, revealed that stalking is a widespread phenomenon with lifetime prevalence rates of stalking victimization ranging 12-16% among women and 4-7% among men. With regard to the impact of stalking, studies suggest that stalking can cause serious economic, social, medical and psychiatric consequences. Growing evidence suggests that serious violence and even homicide may occur in the context of stalking, and research on risk assessment has yielded an improved understanding of risk factors. Research on therapy of stalkers and stalking victims is still at its beginning; however, there are some preliminary reports with encouraging results.

SUMMARY

Although there are research activities in the main fields, many basic questions still remain to be adequately addressed. Increased social and political awareness and expanded research funding are obligatory prerequisites to realize sound and well designed studies.

College women's experience of stalking: mental health symptoms and changes in routines

BACKGROUND

Stalking is a serious public health and societal concern affecting many college women.

PURPOSE

The purpose of this study was to explore college women's experiences of stalking. The specific aims were to compare victims and nonvictims on physical and mental health indicators and to identify lifestyle changes made in response to being stalked.

METHODS

In this cross-sectional design, 601 women from two universities completed a stalking questionnaire, a mental health screening tool, and an injury checklist. Data analysis included frequencies, multivariate analysis of variance, analysis of variance, and chi(2) analysis.

RESULTS

A quarter of the sample reported experiencing stalking, most often by an intimate or dating partner. Individuals who reported experiencing stalking reported significantly more mental health symptoms and lower perceived physical health status than individuals who did not. Victims reported changing routines, behaviors, and activities.

CONCLUSIONS

Psychiatric nurses must be knowledgeable about stalking and its impact on health. Nurses can provide support, services, and community referrals.

Interapy: treatment of post-traumatic stress via the internet

This paper describes the theoretical background and procedures (including psycho-education, screening, treatment protocol and outcome measurement) involved in a protocol-driven internet treatment of post-traumatic stress and grief in a group of people who have suffered from mild to relatively severe trauma. The paper examines the results of 3 outcome and process studies, which were carried out initially in a student population and subsequently in the general population of highly traumatized people. In the latter study, participants in the experimental condition (n = 69) improved significantly more than participants in the waiting list control condition (n = 32), with respect to trauma-related symptoms and general psychopathology. The effect sizes were large. More than 50% of the participants treated showed reliable change and clinically significant improvement after treatment for avoidance and depression. Treatment proved most beneficial for participants who had suffered from intentional trauma and those who had not previously discussed the traumatic events with significant others. Content analysis of the publications indicates a remarkable increase in cognitive coping during treatment. The possibilities for future research into internet-driven treatment of post-traumatic stress symptomatology are discussed, including the proposal to study the effects of sending a final written letter to a significant other person.

Association between stalking victimisation and psychiatric morbidity in a random community sample

BACKGROUND

No studies have assessed psychopathology among victims of stalking who have not sought specialist help.

AIMS

To examine the associations between stalking victimisation and psychiatric morbidity in a representative community sample.

METHOD

A random community sample (n=1844) completed surveys examining the experience of harassment and current mental health. The 28-item General Health Questionnaire (GHQ-28) and the Impact of Event Scale were used to assess symptomatology in those reporting brief harassment (n=196) or protracted stalking (n=236) and a matched control group reporting no harassment (n=432).

RESULTS

Rates of caseness on the GHQ-28 were higher among stalking victims (36.4%) than among controls (19.3%) and victims of brief harassment (21.9%). Psychiatric morbidity did not differ according to the recency of victimisation, with 34.1% of victims meeting caseness criteria 1 year after stalking had ended.

CONCLUSIONS

In a significant minority of victims, stalking victimisation is associated with psychiatric morbidity that may persist long after it has ceased. Recognition of the immediate and long-term impacts of stalking is necessary to assist victims and help alleviate distress and long-term disability.

Lifetime prevalence and impact of stalking in a European population: epidemiological data from a middle-sized German city

BACKGROUND

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in European countries.

AIMS

To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims, and the impact of stalking on current psychological well-being in a German community sample.

METHOD

A postal survey was conducted with a sample randomly selected from the population of a middle-sized German city; 679 people (400 women, 279 men) responded. The survey included a stalking questionnaire and the WHO-5 well-being scale.

RESULTS

Almost 12% of the respondents (n=78, 68 women, 10 men) reported having been stalked. A multiple regression analysis revealed a significant effect of victimisation on psychological well-being.

CONCLUSIONS

This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health are significant, suggesting that the phenomenon deserves more attention in future community mental health research.

20 years of research into violence and trauma: past and future developments

This reflection on major developments in the past, present, and future of the wider field of violence and trauma is a personal (and probably biased) sampling of what the authors hold to be important. The authors reviewed advances for victims and perpetrators of violence separately. For victims, the authors note that empirical research has established the potential traumatic impact of violence as well as various predictors of what makes persons vulnerable to adverse psychological consequences. The authors also note that the definitions of violence and trauma have evolved to include such behavioral patterns as stalking. Finally, encouraging evidence regarding the efficacy of exposure-based treatments for victims of violence is reviewed, as well as discouraging evidence regarding the efficacy of single-session debriefing following trauma. For the perpetrators, the importance of individual assessment in planning interventions is underscored, and advances in explicit and implicit assessment techniques are discussed.

Informant Personality Descriptions of Postintimate Stalkers Using the Five Factor Profile

Psychological descriptions of stalkers are few, especially nonforensic cases. As direct assessment is often hindered by lack of cooperation, assessment by informants may be a next-best approach. Indirect assessment may be most fruitfully applied among postintimate stalkers using instruments that are specifically validated for this purpose. Accordingly, in this study, we documented the psychological profile of 112 male postintimate stalkers as judged by ex-partners and/or subsequent victims using the Five Factor Personality Inventory (Hendriks, Hofstee, & de Raad, 1999b) and indexes of attachment and psychopathology. As compared to the Dutch norms, postintimate stalkers were described as extremely low on Agreeableness and moderately low on Conscientiousness and Emotional Stability. Most often insecurely attached with underlying negative self-representations, they were characterized as relatively functional people with strong sensitivities to rejection, abandonment, and loss.

Stalking: knowns and unknowns

The current work reviews literature on the nature of stalking. Despite its nebulous nature and differing legal and clinical definitions of stalking, researchers and practitioners are referring to the same phenomenon. Stalking is chronic, consisting of a number of nuisance behaviors that appear consistent over countries and samples. Different categorizations of stalkers and their victims exist, but ex-partner stalkers are a distinctive category with respect to their prevalence, violence risk, and attrition rate. Different samples and definitions and false victimization reports obscure reliable lifetime prevalence estimates, but these appear to be around 12%-16% among women and 4%-7% among men. Stalking has deleterious effects on victims but some of the effects may be the result of stalking's exacerbating of existing vulnerabilities. Future research should focus on subgroups of stalkers and their victims, on cross-cultural investigations, and on the co-occurrence of stalking with other crimes.

Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the internet

Online therapy offers many advantages over face-to-face therapy. Interapy includes psychoeducation, screening, effect measures, and a protocol-driven treatment via the Internet for people suffering from posttraumatic stress. The present article reports the results of a controlled trial on the Internet-driven treatment of posttraumatic stress and grief in a group of people who manifested mild to relatively severe trauma symptoms. Participants in the treatment condition (n=69) improved significantly more than participants in the waiting-list control condition (n=32) on trauma-related symptoms and general psychopathology. The effect sizes were large. On most subscales, more than 50% of the treated participants showed reliable change and clinically significant improvement, with the highest percentages being found for depression and avoidance.

Stalking behavior - an overview of the problem and a case report of male-to-male stalking during delusional disorder

Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behavior leading to the victim's perception of being harassed and rendered fearful. This paper outlines relevant aspects of the stalking concept and reviews the historical development of this categorization, different typologies of stalking behavior, associated psychiatric diagnoses, frequency and demographic data, psychomedical impact on the victims and therapeutic approaches. Special gender aspects are discussed by presenting a case history of male-to-male stalking.