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REDUCINGINTERPERSONAL VIOLENCE Therearemanytypesofinterpersonalviolencethatcanleadtoshort-and long-termphysicalandpsychologicaleffectsonthoseinvolved. Reducing InterpersonalViolence reflectsontheWorldHealthOrganization’sstancethat interpersonalviolenceisapublichealthproblemandconsiderswhatsteps canrealisticallybetakentowardsitsreduction.
CliveHollinexaminesinterpersonalviolenceacrossarangeofsettings,from bullyingatschoolandintheworkplace,smackingchildrenandpartnerviolence inthehome,tosexualandotherformsofcriminalviolenceinthecommunity. Thisbooksummarisestheresearchonevidence-basedstrategiestoreduce violenceandshowsthatreducinginterpersonalviolencecanhaveapositive effectonpeople’swellbeingandmaysaveagreatdealofpublicexpenditure.
Thisbookisaninvaluableresource forstudentsandresearchersinthe fieldsof psychology,criminology,law,andpolicestudies,aswellasprofessionalssuchas probationstaff andforensicpsychologists.
CliveR.Hollin isEmeritusProfessorattheUniversityofLeicester.Hehas writtenandeditedover20books,andover300academicpapersandbook chapters,relatingtopsychologyandcrime.Heeditedthejournal Psychology, Crime,&Law from1992to2012.Hehasworkedatthreeuniversities,fortwo governmentsdepartments(HomeOfficeandDepartmentofHealth),andin prisons,specialhospitals,andregional secureunits.In1998Clivewaspresented withtheBritishPsychologicalSociety,DivisionofCriminologicalandLegal Psychology,SeniorAwardforDistinguishedContributiontotheFieldofLegal, CriminologicalandForensicPsychology.
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REDUCING INTERPERSONAL VIOLENCE APsychologicalPerspective CliveR.Hollin
Firstpublished2019
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Names:Hollin,CliveR.,author.
Title:Reducinginterpersonalviolence:apsychologicalperspective/ CliveR.Hollin.
Description:MiltonPark,Abingdon,Oxon;NewYork,NY: Routledge,[2019]|Includesbibliographicalreferences. Identifiers:LCCN2018020270|ISBN9781138632493(hardback:alk. paper)|ISBN9781138632509(pbk.:alk.paper)| ISBN9781315208220(ebook)
Subjects:LCSH:Violence--Prevention.|Interpersonal conflict--Prevention.|Violence--Psychologicalaspects. Classification:LCCHM1116.H662018|DDC303.6--dc23LCrecord availableathttps://lccn.loc.gov/2018020270
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TABLES 1.1.SummaryofDSM-5DiagnosticCriteriaforAPD7
3.1.IllustrativeitemsfromtheChildrenandAnimals AssessmentInstrument(CAAI;Ascione,Thompson,& Black,1997)andtheCrueltytoAnimalsInventory (CAI;Daddsetal.,2004)21
5.1.Organisationalschemeforpreventativestrategiesfor reductionofchildsexualabuse(afterMendelson& Letourneau,2015)60
5.2.MAPPAcategoriesandlevelsofmanagement(after MinistryofJustice,2016)62
5.3.Strategiestoreducethelikelihoodofsexualassault76
6.1.Principlesofeffectivepracticetoreducereoffending93
6.2.AssessmentDomainsintheLSI-R94
7.1.ProsandconsinthepressregardingtheMinimumPrice perUnit(MPU)debate;afterKatikireddiandHilton (2015)116
ACKNOWLEDGEMENTS IdotrynottobutIknowthatIcanmoanjustalittlebit,wellquitealot actually,whentheday’swritingisnotgoingaswellasI’dlike.Mypartner inlife,FlickSchofield,hasaftermanyyearshabituatedtomygroaningand pacingaboutandtellsmejusttogetonwithit.Soundadviceforany writer.I’vealsonoticedthatinmynot-too-happyphasesourlatestdog, Toby,relinquisheshischairinmystudyandheadsforthelessfraught environmentofhisbedinthekitchen.AtwhichpointIfeelreally,really guiltyandresolveinfuturetobehaveinabetterfashion.Anyway,Ican revealthateveryoneispleasedthatthisbookis finallywrittenandpeace nowreignsinourhousehold.
PREFACE Ithinkofthisbookasacompaniontomypreviousbook ThePsychologyof InterpersonalViolence .Indeed,thisbookstartedlifeasChapter8of The PsychologyofInterpersonalViolence beforeIrealiseditwasexpandingexponentiallyandtakingonalife,nowrealised,ofitsown.Inagreementwith others,itismyviewthatinterpersonalviolenceisoneofthegreatpublic healthissuesofourtimes,bringingaboutharmanddistressonaglobalscale. Ihopethattheideasandresearchcoveredinthesepageswillactasa resourceforbothstudentsandpractitioners.
1 INTERPERSONALVIOLENCE Apsychologicalperspective The WorldReportonViolenceandHealth publishedbytheWorldHealth Organization(Krugetal.,2002)wasunequivocalin “Declaringviolencea majorandgrowinghealthproblemacrosstheworld” (p.ix).However, despitetheseriousnessofthematter,thereissomedebateintheliterature regardingasatisfactorydefinitionofviolence.Lee(2015)suggestsawiderangingdefinition:
Theintentionalreductionoflifeorthrivingoflifeinhumanbeing(s)by humanbeing(s),throughphysical,structural,orothermeansofforce,that eitherresultsinorhasahighlikelihoodofresultingindeprivation,maldevelopment,psychologicalharm,injury,death,orextinctionofthespecies. (p.202)
Lee’sdefinitionspeakstothewidespreadnatureofviolenceanditsmany adversephysical,sometimefatal,andpsychologicalconsequencesforthe victim.TheWHOreportattemptedtomanagethediversityofactsthatfall undertherubricofviolencebyformingthethreecategoriesof self-directed violence,interpersonalviolence,and collectiveviolence .Theterm interpersonalviolence isusedhereinthesamesenseasinthe WorldReportonViolenceand Health.Thus,interpersonalviolencecoversofactsofprincipallyface-to-face violence,excludingviolenceinthewidercontextofwarandterrorism, betweenpeopleeitherwithinthesamefamilyorwidercommunity.In
2 Interpersonalviolence addition,manyformsofinterpersonalviolencearepunishablebylawand maythereforebedescribedas criminalviolence
Kazdin(2011)makesthepointthatinterpersonalviolencecanbeconsidered intwoways.The molecularview,touseKazdin’sterminology,conceivesof interpersonalviolenceasasetofdifferenttypesofviolentact,categorisedby setting,typeofperpetrator,thenatureoftheactandsoon.Thus,forexample,a meaningfuldistinctioncanbedrawnbetweenphysicalchildabuseandthe sexualassaultofanadult.Incontrast,Kazdin’ s molarview takesinterpersonal violenceasacomplexphenomenon,withnoneatdivisionsbetweenitsmany forms,whichisembeddedinanestofothersocial,political,andeconomic problemssuchasinequalityandpoverty.
Thesheercomplexityofthemolarview,Kazdinargues,meanstherecan beno “silverbullet” thatwillmakeinterpersonalviolencedisappear.This viewresonateswiththeviewofarchaeologistssuchasLeBlanc(2003)who seewarfareasanintractableaspectofhumanexistence.Therehavebeen warsbetweennationsandwithinnationssincetimeimmemorial,thereare warsbeingfoughtasyoureadthissentence,andtherewillundoubtedlybe warstobefoughtinthefuture.Warsmaystartandwarsmayend;warfare isforever.Incontrasttotheenormityofconflictbetweennations,some formsofinterpersonalviolence,suchasviolenceinthecontextofsport,are generallyacceptedascommonplace “everyday” violence.
Thescaleoftheproblemofviolence,alongsideitsdynamic,shiftingand changing,complexnaturemeansthattheevidencebasewillalwaysbe incomplete.AWorldHealthOrganizationReport(WHO,2014)laments thegapsinthedatawhichacttohinderprogressindevelopingevidencebasedviolencepreventionstrategies.Thelackofcontemporaneousevidence actstocompoundthedifficultiesofknowingwhichstrategiestoapplyto reduceviolencemosteffectively.
Thebroadunderstandingofinterpersonalviolenceusedhere,whichwillbe usedasaspringboardforconsideringstrategiestoreduceviolence,isthat interpersonalviolenceisa social act.Thisisnottodiscountnon-socialinfluencesonbehaviour(Fox,2017),rathertosaythattheactionsofthoseengaged intheviolencearetobeconsideredintheirsocialandsituationalcontext.The notionofaperson–situationinteractionis,ofcourse,highlyfamiliarwithin mainstreampsychology(e.g.,Bandura,1977)andhasbeenappliedspecifically toviolentbehaviour(e.g.,Allen,Anderson,&Bushman,2018;Anderson& Bushman,2002;Bandura,1978;Nietzel,Hasemann,&Lynam,1999).
Aperson–situationapproachhasthreecomponentparts.Thus,asappliedto interpersonalviolence,the firstpartisthesettinginwhichtheviolencetakes
place.Thesettinghasseveralcharacteristics,anyandallofwhichmaybepresent inagivenincident,whichincludethetypeofplace(home,publicbar,street, etc.),thepresenceandnumbersofotherpeople,thephysicaltemperature,and whetherweaponsarepresent(seeHollin,2016;Krahé,2013).
Thesecondpartliesinqualitiesoftheindividualinthegivensetting; thesequalitieswillbeacombinationofstaticanddynamicfactors.Static factorsincludetheperson’sage,gender,andwhethertheyhaveahistoryof violence.Dynamicfactorsrelatetotheindividual’sfunctioningduringthe incidentwhichmay fluctuateandchangeaseventsunfold.Thus,dynamic factorsincludetheindividual’scognitionandemotionaswellastheir mentalhealthanduseofdrugsandalcohol.Finally,thethirdpartconcerns thenatureoftheinteractionsbetweenthoseinvolvedintheincident.
Inmanycasesanactofinterpersonalviolenceistheproductofaseriesof exchangesbetweenthoseinvolved.Luckenbill(1977)calledtheseexchangesa situatedtransaction.Inananalysisofincidentswhichhadculminatedinmurder, althoughthesequenceappliesequallywelltoothertypesofinterpersonal violence,Luckenbilldescribedsixstagesinthebuild-uptothe finalact.
Inthe firststagetheeventualvictimmakesthe firstmoveintheformof spokenwords,anact,orarefusaltocomplywitharequestfromtheother person.Atstagetwotheeventualoffenderseesapersonalinsultintheother person ’swordsoractionsleading,atstagethree,totheoffenderseeking confirmationoftheperceivedinsultandreactingwithaninsultoftheirown. Thisinsultoffersachallengetothevictimtocontinuetheexchangesthereby placingthevictim,atstagefour,inthesamepositionastheoffenderinstage two:theiroptionsaretorespondtothechallenge,toapologise,ortoleave and “loseface”.Ifthevictimresponds,soacceptingthechallenge,a “workingagreement” isinplacesuchthatviolencebecomeshighlylikely.
Atstage fivethephysicalbattlecommenceswith,insomeinstances,the useofweapons;Luckenbillreportsthatinjustoverone-thirdofcasesthe offenderwascarryingagunoraknifewhileinothercasestheoffender eitherleftandreturnedwithagunorknifeortheyseizedwhateverwasat hand,suchasabrokenglass,touseasaweapon.Theuseofweaponsis culturallybound:Luckenbill’sanalysiswasbasedoncasesinCalifornia, USA.Inaboutone-halfoftheincidentsthevictimwaskilledquicklywith asingleshotorstab;intheothercasesthe fightwastwo-sided,withboth protagonistsarmed,anditwasafteranexchangeofblowsthatthevictim waskilled.Inthe finalstageaboutone-halfofoffendersranfromthescene, aboutone-thirdvoluntarilywaitedforthepolice,andtheremainderwere preventedfromleavingbybystandersuntilthepolicearrived.
4 Interpersonalviolence Itisimplicitinthedescriptionofthesocialexchangesthat,forboth offenderandvictim,theperceptionsoftheotherperson’sactionsand intentionsaredrivingthesequenceofinteractions.However,asLuckenbill notes,theseperceptionsarenotnecessarilyaccurateand,giventhecontext, situationalfactorsmayleadtomisperceptions.Theexchangesmaytake placeinfrontofotherpeople,bothacquaintancesandstrangers,whomay encouragetheprotagonists’ increasinglyaggressivebehaviour.Inaddition,as thetransactionprogressessoemotionsarelikelytobecomeheightenedwith oneorbothofthoseinvolvedbecomingangry,excited,oranxiousasviolencedrawsclose.
Amyriadoffactorsmayinfluencetheoutcomeofthesesocialexchanges. Individualswillactdifferentlybecauseofvariationsintheirperceptionand appraisalofthesituationandthoseinvolved.Therewillalsobevariationsin eachindividual’svalues,morals,socialproblem-solvingskills,andexperienceofviolence.Inaddition,factorssuchastheeffectsofalcohol,theuse ofweapons,thepresenceofmentaldisorder,andhighlevelsofemotionality mayinfluenceinterpersonalexchanges,makingviolencemoreorlesslikely tooccur.Asthesefactorsarepotentiallyactiveacrossdifferenttypesof interpersonalviolenceabriefoverviewofeachisgivenbelow.
Theeffectsofalcohol Theassociationbetweenalcoholandviolenceis firmlyestablishedintheresearch literature(e.g.,Boden,Fergusson,&Horwood,2013;Parrott&Eckhardt,2018) andisrecognisedaroundtheglobe(WorldHealthOrganization,2008).The InstituteofAlcoholStudies(2010)havesummarisedsomekeystatisticsaboutthe alcohol–crimerelationship:(1)approximatelyone-thirdofviolentoffenders haveadrinkproblem,includingbinge-drinking;(2)alcoholuseisprevalentin closetoone-halfofconvicteddomesticviolenceoffenders;(3)about20percent ofthosearrestedbythepolicetestpositiveforalcohol;(4)alcoholiscommonin manydifferenttypesofviolentcrimesagainsttheperson,includinghomicide, wounding,affray,anddomesticviolence,aswellaspropertycrime(Cordilia, 1985);(5)ahighproportionofbothoffendersandvictimsofviolentcrimeare undertheinfluenceatthetimetheoffenceoccurs.
Ofcourse,thesettinginwhichtheviolencetakesplaceisalsoimportant: violentincidentsclusteraroundtheimmediatevicinityofbarsandclubs,soit ishighlylikelythatallthoseinvolved,offender,victim,andbystanders,will haveconsumedalcohol(Ratcliffe,2012).Itfollowsthatalcoholproblemsare widespreadamongconvictedviolentoffenders(MacAskilletal.,2011)and
victimsofviolentcrime(Branasetal.,2009).Yetfurther,thealcohol-crime relationshipisfoundformalesandfemales,adolescentsandyoungadults (Popovici,etal.,2012).
Theuseofweapons Thepresenceofaweaponinapotentially violentsituationactstoprimehostile thoughtsamongthoseinvolved,inturnmakingitmorelikelythattheweapon willbeused(Bartholow,etal.,2005;Benjamin&Bushman,2018;Cukier& Eagen,2018).Ifaweaponisused,withsomeweaponsmorelethalthanothers, theriskofseriousinjuryanddeathissubstantiallyincreased.Brennanand Moore(2009)notethatinbothAmericaandtheUKweaponsareusedin aboutone-quarterofviolentincidents.Apersonmayhaveaweaponforseveral reasons:(i)theweaponmaybeforself-protection;(ii)tothreatenotherpeople; (iii)deliberatelytoharmanotherperson;(iv)toactasastatussymbol;(v)to bolsterself-image.
Mentaldisorder Anotherfactortoconsiderliesinthequalityoftheviolentindividual’ s mentalhealth.Therelationshipbetweenmentalhealthandviolence,mainly criminalviolence,hasconcentrateduponthedisordersofpsychosis,mainly schizophrenia,andpersonalitydisorder.
Thereisresearchevidencetoindicatethat,comparedwiththegeneral population,menandwomenwithpsychosishaveanelevatedriskof convictionforviolentoffences(e.g.,Bonta,Blais,&Wilson,2014;Douglas, Guy,&Hart,2009;Fazel&Yu,2009;Hodgins,2008;Witt,vanDorn,& Fazel,2013).Itappearsthatpeoplewithamentaldisorderareoverly representedamongperpetratorsofhomicide.Inatypicalstudy,Meehanet al.(2006)reviewed1,594casesofhomicideinEnglandandWalescommittedbetween1996and1999.Theyreportedthat85(5%)ofthesample hadaformaldiagnosisofschizophrenia:this figurestandsincontrasttoan incidenceofschizophreniaof1percentinthegeneralpopulation.
Violenceandschizophrenia Schizophreniaischaracterisedbydelusions,hallucinations,andconfused speechwhichcanbeofsufficientseveritytobringaboutchangesinbehaviourwhichprecipitatesocialoroccupationaldifficulties.Boetal.(2011)
6 Interpersonalviolence describedtwotrajectoriestoexplaintheassociationbetweenschizophrenia andviolence.Inthe firsttrajectory,theprimaryexplanationliesinthe presenceofpsychopathicandantisocialpersonalitydisorderwiththe psychoticsymptomsofsecondaryconcern.Thoseindividualsinthistrajectoryhadahistoryofantisocialbehaviourwhichprecededtheonsetof schizophrenia.Inthesecondtrajectory,theprimaryexplanationisahigh occurrenceofsymptoms – includingpersecutorydelusions, “threatcontrol override” symptoms,andcommandhallucinations – oftenwithoutahistory ofantisocialbehaviour.Threatcontroloverridesymptoms,oftenimplicated inviolence(Braham,Trower,&Birchwood,2004;Buccietal.,2013),may beexperiencedasadelusionthatotherpeoplearetryingtocausepersonal harmorcontrolone’sthoughtsandactions.Thesespecificaspectsof schizophreniaassociatedwithviolenceshouldbeseeninthelargercontext ofsocialconditionsandotherphysiologicalandpsychologicalaspectsofthe disorder(Steinert&Whittington,2013).
Anindividualmayhaveconcurrent,or comorbid,mentalhealthproblems. Alargeproportion,perhapshalf,ofpeoplewithschizophreniahavea comorbidsubstanceusedisorder(Volkow,2009).Giventheassociation betweenalcoholandviolence,acombinationofschizophreniaandalcohol misusepotentiallyraisestheriskofviolence(Fazeletal.,2009).
Violenceandpersonalitydisorder Thereareseveraltypesofpersonalitydisorder(PD)definedbydiagnosticsystems suchasthe DiagnosticandStatisticalManualofMentalDisorders (DSM-5;American PsychiatricAssociation,2013).Yu,Geddes,andFazel(2012)conductedasystematicreviewoftheevidenceandconcludedthatascomparedtothegeneral populationPDwasassociatedwithathreefoldhigherriskofviolence.Theriskof violenceassociatedwithPDwassimilartotherisklevelsforthosewithother mentaldisorderssuchasbipolardisorderandschizophrenia.However,ifthePD wasspecificallyAntisocialPersonalityDisorder(APD)theriskofviolencerose significantlytolevelscomparabletotherisksassociatedwithdrugandalcohol abuse.Inaddition,APDincreasedtheprobabilityofreoffendingtoahigherlevel thanotherpsychiatricconditions.Ina BritishsurveyusingDSM-IV,Coidetal. (2017)foundthatAPDwasthe personalitydisordermoststronglyassociatedwith violenceandwasthreetimesmoreprevalentinmenthaninwomen.
DSM-5specifiesfourdiagnosticcriteriaforAPD(seeTable1.1):(1)a disregardfortherightsofotherpeoplewhichislongstandingandmayhavebeen evidentfromchildhood;(2)theindividualhasreached18yearsofage;(3)thereis
TABLE1.1. SummaryofDSM-5DiagnosticCriteriaforAPD
A.Disregardforandviolationoftherightsofotherpeoplesince15yearsofage asseenby:
(i)Breakingthelaw;
(ii)Lyingandmanipulationforprofitorfun;
(iii)Impulsivebehaviour;
(iv)Highlevelsofaggressionevincedbyfrequentinvolvement in fightsandassaults;
(v)Deliberatedisregardforownandotherpeople’ssafety;
(vi)Apatternofirresponsibility;
(vii)Anabsenceofremorse.
B.Theindividualisatleast18yearsofage.
C.Conductdisorderwaspresentbefore15yearsofage.
D.Theindividualwasnotdiagnosedwithschizophreniaorbipolardisorderwhen theantisocialbehaviouroccurred.
evidenceofConductDisorderbeforetheageof15years;(4)theantisocial behaviourisevidentnotonlyduringanepisodeofschizophreniaormania.
DSM-5presentsseveralspecificinstancesbywhichthe firstcriterion,a callousdisregardfortherightsofothers,maybeseenwhichillustratethe essenceofAPD.Theseinstancesare:(a)failingtofollowacceptedsocial normsasseenbyarepetitionofbehavioursthatgivegroundsforcriminal arrest;(b)deceitforgainorpersonalpleasurethroughconsistentlyingor cheating;(c)impulsivebehaviour;(d)belligerenceleadingtoinvolvement innumerous fightsorassaults;(e)anirresponsibledisregardforthesafetyof selforothers;(f)repeatedlylosingemploymentandfailuretomaintain financialresponsibilities;(g)failuretoshowremorseforvictims.
ItisevidentthatAPDisstronglyassociatedwithcriminalbehaviour, particularlywhenitiscomorbidwithsubstanceusedisorders(Roberts&Coid, 2010;Walteretal.,2010).Thisassociationappliestooffendersinboththe criminaljusticeandmentalhealthcaresystems.Similarly,psychopathicdisorder,whichhasfeaturesincommonwithpersonalitydisorder,isalsostrongly associatedwiththelikelihoodofviolentconduct(Lesticoetal.,2008).
Emotionalarousal Angeristheemotionmostreadilyassociatedwithinterpersonalviolence.A persontypicallybecomesangrywhencuesfromtheirimmediateenvironment,
suchasthewordsoractionsofotherpeople,provokephysicalfeelingsand thoughtswhich,influencedbyexperience,theylabelas “ anger ”.This emotionalstatemayleadtoanexpressionofangerintheformofverbalor physicalviolencedirectedatanotherperson(Novaco&Welsh,1989).The wayinwhichanindividualexpressestheirangerdependsuponfactorssuchas attributionofhostilityandperceptionofprovocation(bothofwhichmaybe inaccurate),experienceandmemoriesofsimilarsituations,andabilitytocope withthesituationandwithfeelingsofanger.Whenitisundercontrol,anger canhaveapositiveaspectinthatitsignalstootherstheeffectoftheiractions anditcanprompttheindividualintopositiveactiontoprotectthemselvesor others.However,afailuretoregulateangereffectivelycanleadtotheemotion becomingdysfunctionalinnature.
Angerregulationreferstotheabilitytoremaininacalmstatewhenone perceivesprovocation.Thelevelofangercontrolofwhichanindividualis capablemaybedependentuponfactorssuchasthewayinwhichtheylabel theirinternalstate,fromirritationthroughtorage,andtheappraisaloflevel ofemotionalcontrol,fromkeepingcontrolto “losingit”
Whilemostpeoplewilloccasionallyhavebeenrousedtoanger,for othersangerandaggressioncanbecomeanestablishedbehaviouralpattern fromanearlyage(Lemerise&Dodge,2008).Whenangerishabitualitmay becomedysfunctionalwithadverseconsequencesfortheindividualand otherpeopletheyencounter.Dysfunctionalangermaytaketheformof intermittentexplosivedisorder(Coccaro,2000)andalongsideanincreased likelihoodofactsofinterpersonalviolence,chroniclevelsofangercan precipitateseriouspsychologicalandhealthproblems(Milleretal.,1996).
Thehostileprocessingofsocialinformationleadingtoangermaybe exacerbatedbyqualitiesofthephysicalenvironmentsuchashightemperatureandover-crowding.Inaddition,angerarousalcanbeintensified throughinteractionswithotherconditions,suchasalcoholuseandmental healthproblems,whichservetoheightentheriskofhostileperceptionand appraisalofotherpeople.
Payoffsfromreducinginterpersonalviolence Whyisitimportanttoreduceinterpersonalviolence?Whatpayoffswould therebeifthelevelsofinterpersonalviolencecouldbereduced?
The firstpayoff wouldbeareductioninthehumancostsofvictimisation. Theexacteffectsofviolentvictimisationvaryacrossseveralfactorssuchasthe victim’sageandgender,thenatureoftheassaultintermsofthedegreeofforce
usedandsexualintent,andthevictim’srelationshipwiththeperpetrator. Giventhesevariations,victimsurveys(e.g.,Tan&Haining,2016)showthe fourfoldeffectsofvictimisation.First,thereisahighprobabilityofphysical harmrangingfromtheeffectsofslaps,bites,andpunches,throughseveretissue damage,brokenbones,andinternalinjuries,tolife-threateningconditions. Theseinjuriesmayrequiremedicalattention.Second,thepsychological sequelaeofvictimisationincludelossofself-confidence,fearandanxietyfor selfandothers,panicattacks,post-traumaticstressdisorder,depression,and thoughtsofsuicide.Third,thevictimisationmayprecipitatebehavioural changeasseenwithalcoholanddruguse,smoking,disruptedsleeppatterns, relianceonprescriptionmedication,andappetitechange.Finally,thesocial consequencescanincludewithdrawalfromsocialactivitiesresultingin diminishedqualityoflifeandlossoffriendships,absencesfromworkcausing financialproblems,andstrainsonfamilylifethreateningthequalityand stabilityofrelationshipswithrelativesincludingpartnerandchildren.
Whilesomeoftheseconsequencesmaybeshort-term,inthatcutsand bruisesheal,theyallhavethepotentialtohavelong-termeffectsfrom physicalscarringto financialinstabilityandbreakdownofthefamilyhome. AsKazdin(2011)comments,whiletheadverseconsequencesof interpersonalviolencecanbecategorisedasphysical,psychological,andso on,itislikelythatthesewilloccurconcurrentlybringingmiseryanddespair potentiallyoveraperiodofyears.Areductioninthelevelsofvictimisation frominterpersonalviolencehasthepotentialtoalleviatetheseconsequences forthebenefitofnotjustthevictimbutalsotheirfamilyandfriends,aswell ashelpingtomaintaintheirwidersocialandeconomiccontributionto society.
Asecondpayoff liesinthelong-termbenefitsrealisedbydiminishingthe perpetuationofviolenceacrossgenerations.Widomdescribedthecontinuity ofviolenceacrossgenerationswithinafamilyasa “cycleofviolence” (Widom, 1989a,1989b).Ifthefamilialinfluenceswhichreinforceandperpetuatesuch cyclescanbeameliorated,thereisthepossibilityofasignificantreductionin interpersonalviolence.
Thethirdpayoff ofareductionininterpersonalviolenceisareductionin the financialburdencausedbytheconsequencesofinterpersonalviolence.It isnotasimpletasktoestimatethe financialcostsofcrime: first,asnotall crimes,perhapsaminority,arereported,estimatesbasedonrecordedcrime canonlybeasampleofthetruecosts;second,estimatingcostsforallthe agenciesimmediatelyinvolvedinthecrime – police,courts,medicalservices, probation,andprison – isnotstraightforward;third,therearemoredistal
costssuchaslossofproductivityfromaninjuredemployeeandshortfallsin publicservicefrominjuriesto,forexample,medicalpersonnel;fourth,costs willvaryfromcrimetocrimeandwill fluctuateovertime.
Whileitisimpossibletoprovideprecise figuresforthe financialcostsof crime,theavailableestimationsshowthatthecostsareconsiderable.Thus, forexample,McCollister,French,andFang(2010)statethat “IntheUnited States,morethan23millioncriminaloffenseswerecommittedin2007, resultinginapproximately$15billionineconomiclossestothevictimsand $179billioningovernmentexpendituresonpoliceprotection,judicialand legalactivities,andcorrections” (p.98).Inthesameway,thecostsof compensationtovictimsofviolentcrimecanrunintothousandsofdollars (Johnston,Shields,&Suziedelyte,inpress).Whilethesumsinvolvedare notashighasthoseintheUnitedStates,intheUKasimilarsituationmay befoundwithcrimebringingabouthighcoststothepublicpurse(e.g., Welsh&Farrington,2015;Piquero,Jennings,&Farrington,2013).
Oneoftheadvantagesofareliableestimateofthecostofcrimeisthatit allowsthemonetarybenefitsofcrimereductionprogrammestobe calculated.Thesebenefitsaresometimesexpressedas “£x poundssavedfor every£1invested”.Asmaybeanticipated,such financialcalculationsareof interesttopolicy-makerswhofundcrimereductionindicatives(Welsh, Farrington,&RaffanGowar,2015).
Conclusion Interpersonalviolenceisnestedwithinabroaderspectrumofmanytypesof violentacts.Evenso,thereareseveralwaysinwhichinterpersonalviolence canbecomemanifestacrossavarietyofsettingsinvolvingmen,women,and childrenasbothperpetratorsandvictims.Thereareseveralfactorsreliably relatedtointerpersonalviolenceincludingthepresenceofaweapon, mentalhealthproblems,personalitydisorder,anddysfunctionalanger.The costsofinterpersonalanger,bothhumanand financial,arehighanditis evidentthatthereismuchtobegainedfromreducingtheharmweinflict uponotherpeople.
2 PRINCIPLESOFREDUCING BEHAVIOUR GiventhatviolencehasbeenreferredtobytheWHOasapublichealth problemitisanaturalsteptolooktopublichealthandmedicinefor strategiestoreduceviolence(Lee,2017a,2017b).Intermsofphysical health,therearethreebroadapproachestodiseasecontrol:(1)eliminatethe disease(Dowdle,1998);(2)preventthespreadofthedisease(Gordon, 1983);and(3)treatthoseindividualswhohavethedisease.
The firstapproachtodiseasecontrol, elimination,canbeachievedthrough vaccination.TheWHOhascertifiedtheglobaleradicationoftwo infectiousdiseases:in1979smallpoxwasdeclarederadicated,followedin 2011byrinderpest(cattleplague),aninfectiousviraldiseasewhichaffected cattle,domesticbuffalo,andvariousotherspecies.Thesecondapproach, prevention,isconcernedwithhelpingpeopletoavoiddisease.Apreventative approachmayseektochangeculturalpractices,suchastobaccosmokingor unprotectedsexualactivitythroughwhichdiseasessuchaslungcancerand sexuallytransmitteddiseasesoccur.Thegoalofpreventionmayalsobe achievedbydirectingresourcesatbasicssuchassanitisingdrinkingwateror promotingwidespreadvaccinationprogrammes.Finally, treatment is concernedwithmedicalinterventionforthesickindividualtoenablethem torecoverfromthedisease.
Ifthesethreestrategiesfordiseasecontrolareappliedtoreducinginterpersonalviolence,thenthefollowingoptionsemerge:(1)totally eradicate thecausesofinterpersonalviolencethroughlegalandsocietalchange;(2)
12 Principlesofreducingbehaviour prevent thelikelihoodofinterpersonalviolencethroughlegalmeasuresand environmentalcontroltoreducethelikelihoodofviolenceforhigh-risk groups;(3) treat theviolentpersontoreducethelikelihoodoffutureviolent behaviour.
InsimilarmannertotheWHO,theInstituteofMedicineidentified threewaystoreducemental,ratherthanphysical,illness:(1) universal, targetedatawholepopulation;(2) selective,targetedat “atrisk” groups; (3) indicated,targetedatthosewiththespecificproblem(Mrazek& Haggerty,1994).
Eradication/prohibition Isitpossibletotakestepstotallytoeradicatethecausesofinterpersonal violence?Thisoptionborrowedfromhealthdoesnottranslateeasilyto reducingviolence.Whileitmayliterallybepossibletoeradicatethebiologicalcausesofadiseasethesameisplainlynottrueofhumanbehaviour. Thebehaviouralanalogytoeradicationisto prohibit behaviourandsothis termwillbepreferredhere.Anexampleofaprohibitiveapproachto changingbehaviouronalargescaleliesintheeffortmadeinthemid-2000s toimprovepublichealthbysigni ficantlyrestrictingthesmokingoftobacco. Thus,lawswereintroducedtoprohibitsmokinginpublicplacessynonymouswithsmokingsuchasbarsandrestaurants;massadvertisingonthe perilsofsmoking,somespecificallyaimedatchildrenandadolescents;and financialmeasuresinraisingthecostoftobacco.Thenumberofpeople whohavestoppedsmokingsincethebancameintoforceisdifficultto estimate.Itisthecasehoweverthattobaccosaleshavefallenandsurveys suggestthattherearefewerpeoplesmoking.Aspecificeffectofthebanis thatithasbeeneffectiveinreducingsecondarysmoking,asforexample withbarstaff inasmoke-filledpub.
Anyattempttointroducewidespreadsocietalchangewill,perhapsrightly insomeinstances,provokeoppositionandevenabacklashagainstthenew legalmeasures.Theseattemptsatsocietalchangearebestunderstoodwithin theirhistoricalcontext:whatwetaketodayasbeingself-evidentlycorrect maynothavebeenthecaseatthetimethechangeswereintroduced.This pointisillustratedbytheattemptsinthe19th centurytoprohibittheilltreatmentofchildren.
InVictoriantimeschildrenwereareadysourceofcheaplabourinthe fermentofindustrialactivitystokedbytheindustrialrevolution.Children werereadilyputtoworkincoal,tin,andleadminesas putters,pushing
trucksofcoalalongthenarrowminetunnels,andas trappers responsiblefor openingandshuttingwoodendoorstoallowairtopassthroughthetunnels.Atrapperboyorgirlwouldsitaloneforhourseachdaywithjusta smallcandleforlight.Childrenworkinginminescouldstartworkat2a.m. andremainbelowgroundfor18hours.Aswellaslabouringinthemines childrenwerealsoputtoworksweepingchimneysortoiledindangerous factoryconditions.Childrenwereindemandbyindustrybecausetheirsize meanttheycouldaccesssmallspacesinfactoriesormines,theywereeasyto control,and,ofcourse,astheywerepaidlessthanadultstheywereacheap sourceoflabour.
Thewageschildrenearnedaslabo urerscouldhelptosupporttheir familiesbutatthecostoftheiredu cation.Inthe1830sParliamentbecame concernedabouttheexploitationofchildlabourandpassedaseriesof Actsintendedtoimprovethelotofyoungchildren.The1833Factory Actwasintendedtoimproveconditionsforchildrenworkinginfactories. TheActstatedthereshouldbenochildworkersunder9yearsofage, childrenagedfrom9to13yearsweretoworknomorethan9hoursa day,andthoseaged13to18yearsnomorethan12hoursaday.Further, childrenwouldnotbeallowedtoworkatnightandtheyshouldreceivea mandatory2hoursschoolingeachday.Inasimilarfashionthe1834 ChimneySweepsActmadeitillegaltoemployachildbelow10yearsof age,whilenochildunder14yearsofagecouldbeengagedincleaning chimneys.
Theintroductionoflegislationstronglyfavourabletowardschildwelfare metwithstrongopposition,mainlyonthegroundsofitseffectsonprofits. ThereweremanyattemptstorepealthelawsinParliamentandsome employerssoughtto floutthenewlegislation.Toenforcethelaw,the governmentsetupvariousinspectorates – theFactoriesInspectorate,followedbytheMinesInspectorateandthentheQuarryInspectorate – to scrutinisetheseplacesofworkandensurethatthelawwasfollowed.
Fromamodernstandpoint,wemaythinkthatthestepsourforbearstook tosafeguardchildrenaretobecommendedandweexpressdisapprovalof countrieswherechildrenarestillputtowork.However,thedebateabout childwelfarecontinuesinotherarenas:forexample,intheUKtheChildren Act1989strengthenedtherightsofchildrenwithrespecttothosewhoheld parentalresponsibilityfortheirsafetyandwellbeing.Aswillbediscussedin thefollowingchapter,legislationintendedtoeradicatethecorporal punishmentofchildrenhasledtodisputeslikethoseseenwithchangesin childlabourlaws.
Inthefollowingchaptersprohibitionwillbeconsideredbylookingat howtherelevantlegislationisenforcedandbyreviewing,wherepossible, theeffectivenessofthelegislation.
Prevention Whilethenotionofpreventionmakessenseinamedicalcontextthereare difficultiesintransposingittoabehaviouralframework.First,amajorproblemwithpreventionofbehaviourliesinknowingexactlywhichhighrisk individualswillactuallycarryoutthespecificbehaviourandsowhereto focusresources.Ariskisanestimationofthe likelihood thatanindividual willactinacertainway:forexample,ratherlikea100–1shotwinningthe Derbywhiletheodds-onfavouriteloses,someadultsat low riskfor,say, hittingchildrenwillhitwhileothersat high riskdonot.Thus,directing preventativemeasurestothoseatahighriskofhittingchildrenmayreduce behaviourbythosewhowouldhitbutiswastedonthosewhowouldnot. Inaddition,afocusjustonhigh-riskgroupsalonewillmissthoseatlowrisk whononethelesswillhitchildren.
Anotherproblemwithpreventionisthatitrunstheriskof netwidening (Ezell,1989).AsSmyth(2011)explains:
Netwideningisatermmostcommonlyusedtodescribeaphenomenon wherebyaprogramissetuptodivertyouthawayfromaninstitutional placementorsomeothertypeofjuvenilecourtdispositionbut,instead, merelybringsmoreyouthintothejuvenilejusticesystemwhopreviouslywouldneverhaveentered.Insteadofshrinkingthe “net” of socialcontrol,oneactually “widens” ittobringmorein.
(p.159)
Theissuessurroundingprevention – includingmeasurementofrisk, unnecessaryinterventionwithsomehigh-riskindividualswhilemissing somelowriskindividuals,andthepotentialofnet-widening – suggestthat prohibitionandtreatmentaremorelikelytobeusedtoreduceinterpersonal violence.Thus,fromaconceptualpointofview,thereisacleardistinction betweenthelegallydrivenprocessofprohibitionofinterpersonalviolence andthepsychologicaltreatmentoftheviolentindividual.However, preventionisintertwinedwithprohibitionandtreatment.Asprohibitionis manifestacrosssocietyitmayinfluencethebehaviourofhigh-riskgroups andsohasthepotentialtopreventinterpersonalviolence.Atthelevelof
theindividual,treatmentaimstopreventfurtherinstancesofviolenceby thosewhohaveactedviolentlyandsoalsoservesapreventativefunction. Whiletherearedifficultiesinthiscontextinclearlydelineatingprevention, therearesomeclearexamplesofstrategiesthatareadditionaltolegal sanctionsandwhichareintendedtopreventinterpersonalviolence.Asthese instancesarisetheywillbeconsideredasappropriatewithinagivencontext.
Psychologicaltreatment Theuseofpsychologicaltheoryandpracticetochangeantisocialandcriminal behaviour,includinginterpersonalviolence,hasbeenevidentsinceFreudand theadventofpsychoanalysis(Hollin,2012;Marshall&Hollin,2015).A gamutofpsychologicaltheories – fromGestalttoradicalbehaviourism, transactionalanalysistocognitivetherapy,educationandvocationaltraining tofamilytherapy,andtherapeuticcommunitiestocognitive-behavioural programmes – haveallbeenemployedwithoffenders(Hollin,2001a).The treatmentoptionofworkingconstructivelywiththosewhohavecommitted violentactstobringaboutpsychologicalandbehaviouralchangetoreduce theirfutureinvolvementinviolenceisawell-troddenpath(McGuire,2008a; Polaschek&Reynolds,2011).
Treatmentandrisk Thedecisiontodeliverpsychologicaltreatmentwillnecessarilybe influencedbytheriskposedbytheindividual.Whenthetreatmentis effectiveitwillreduceriskandthereforethelikelihoodofrecurrencesof thebehaviour.Thus,theaimofreducinginterpersonalviolencemaybe achievedbytargetingthosedeemedtobeathighriskofrepeatedviolence. AstudybyCastellanos-Ryanetal.(2013)providesaperfectexampleof focusingtreatmentonhighriskgroupstoreducelaterbehaviour. Castellanos-Ryanandcolleaguestargetedtheirinterventionatagroupof six-year-olddisruptivekindergartenboys.Asdisruptivebehaviouratan earlyageisariskfactorforsubstanceuseinadolescence,thetargeted interventionshouldacttoprevent,oratleastreduce,thechildren ’suseof substancesinlaterlife.Atfollow-uptheinterventionwassuccessfulin reducingthechildren’ssubstanceuseintheiradolescentyears.
TheCastellanos-Ryanandcolleaguesstudyisanexampleofearlyinterventionintendedtohaveabeneficialeffectinlateryears.Whilethisstudy couldfocusonaknownchildhoodriskfactorforsubstanceuse,anissuefor
16 Principlesofreducingbehaviour interpersonalviolenceliesinthepreciseidentificationofriskfactorsusedto indicatewhoismost “atrisk”.Ifriskisunderstoodasthelikelihoodof somefutureeventtherearetworelatedelementstoconsider: firstthe identificationofthefactorswhichcontributetotherisk;second,howthe levelofriskisestablishedineachindividualcase.
Inpractice,anindividual’slevelofriskmaybegaugedinoneoftwoways, eitherthroughpractitionerexperienceorbyuseofanempiricallydeveloped assessmentmeasure.Intheformer,estimationofthelevelofriskisbasedon clinicaljudgement;inthelatter,risklevelisbaseduponmeasurementusing evidence-basedscales.Therelativemeritsofthesetwoapproachestoassessing riskhavebeenmuchdiscussedintheliterature(e.g.,Dawes,Faust,&Meehl, 1989;Meehl,1954).
Theempiricalapproachtoriskassessmenttypicallyestablishestheidentityof therelevantriskfactorsforthespecificbehaviour,thenusesactuarialmethods toproduceascaleoraninventorytomeasurerisk.Therearemanyactuarial riskassessmentinstrumentsforviolentbehaviour:forexample,theRiskMatrix 2000assessestheriskofsexualreoffending(Barnett,Wakeling,&Howard, 2010;Thorntonetal.,2003);theSpousalAssaultRiskAssessment(SARA) Guidemaybeusedtoinformassessmentsoftheriskofinter-partnerviolence (Kropp&Hart,2000);andtheViolenceRiskAppraisalGuide(VRAG)for usewithmaleviolentoffenders(Quinseyetal.,2006).
Theriskfactorsusedintheseactuarialscalesmaybeclassifiedas dynamicrisk factors,suchasproblemdrinking,which,bydefinition,canbechanged;and staticriskfactors,suchasnumberofpreviousconvictionswhich,againby definition,cannotbechanged.(Thereisathirdtypeofcriterion,suchasage, whichnaturallychangesslowly:inpracticeageisgenerallytakentobestatic innature.)Ofcourse,riskfactorsdonotalwaysoccurinisolation,thegeneral ruleisthatthegreaterthenumberofriskfactorsinagivencasesothegreater theoverallcumulativeriskbecomes(Andershed,Gibson,&Andershed, 2016).Thereisasubstantialbodyofresearchgiventoconsiderationofthe useofriskinstrumentswithviolentpopulations(Prell,Vitacco,&Zavodny, 2016;Singhetal.,2014;Singh,Grann,&Fazel,2011),theirrelativeaccuracy (Campbell,French,&Gendreau,2009;Yang,Wong,&Coid,2010)and theiruseinpractice(Buchanan,2013).
AsCookehaspointedout(Cooke,2016;Hart&Cooke,2013),the effortstorefineactuarialmeasuresofriskhaveledtoresearchwhichis dominatedbystatistical,ratherthanpsychological,thinking.Theneteffect ofthisfocusonmethodology,Cookeargues,hasbeentoneglectthefact thatwhileactuarialmeasuresmaysaywhetherapersonisamemberofan
at-riskgroup,theycannotsaythataspecificindividualwithinthatgroup willbeoneofthosewhoreoffends.Thepsychologicalreasoningthat shouldinformdecision-makingattheindividuallevelhasbecomelostin themistsof “statisticalritual” (Cooke,2016,p.84).Themiddleroadof structuredprofessionaljudgement offersablendoftheapplicationofempirical researchonknownriskfactorswithtraditionalclinicalskillstofocusonthe likelihoodthatanindividualwillbehaveviolently.Thisapproach,usedby scalessuchastheHCR-20(K.S.Douglasetal.,2013),hasprompteda freshwaveofthinkingaboutpractice(Falzer,2013).
Protectivefactors Ariskfactorincreasesthelikelihoodofagivenbehaviour,howeverthere areotherfactorsthatappeartocounterrisk.Klepfisz,Daffern,andDay (2017)notethatthesemitigatingfactors “Areincreasinglybeingreferredto as ‘protective’ factors,butaredenotedbyvariousothertermsincluding ‘strengths’ , ‘promotivefactors’ , ‘stabilizers’,and ‘desistancefactors’” (p.80). Abodyofresearchhasrevealedthecomplexityofprotectivefactors:for example,thereareprotectivefactorsforchildreninthecommunity(Li, Godinet,&Arnsberger,2011);foryoungoffenderstheymayvarybyage (Fontaineetal.,2016);foradultprisonerssomeprotectivefactorsmay provetobestrongerthanothers(Ullrich&Coid,2011);protectivefactors mayvaryaccordingtothenatureoftheireffectonbehaviourandintheir relationshipwithriskfactors(Hemphill,Heerde,&Scholes-Balog,2016; Lösel&Farrington,2012).
Therehasbeeninterestinprotectivefactorsfromtheperspectiveof reducingcriminalbehaviour(Kewley,2017).Thebasicpremiseholdsthatif offenderscanbeencouragedtoapplytheirpersonalstrengthsinaconstructivemannertheywillbeabletogainlegitimatelywhattheywantin life.TheStructuredAssessmentofProtectiveFactorsforViolenceRisk (SAPROF;deVriesRobbéetal.,2011)isintendedtoassessprotective factorsforviolenceinadultoffenders.The17-itemSAPROFconsiders bothindividualfactors,suchasempathy,coping,andself-control,alongside environmentalsupportfactorssuchasastableintimaterelationshipand socialsupportwhichisnegativetowardscriminalbehaviour.Inaddition, thereisevidencetoshowthatfromearlyadolescencetoadulthoodhigher intelligencecanfunctionasaprotectivefactor(Tto fi etal.,2016).
Strongassessmentprotocolshelptoidentifyhighriskindividualsandgroups sothatstepscanbetakentowardsprevention.Thepreventativemeasuresmay
18 Principlesofreducingbehaviour involve,forexample,welfareservices,education,orpsychologicaltreatment.A contemporarytreatmentapproachtoreducinginterpersonalviolenceis informedbyunderstandingtheindividual’sactionsinasocialcontext,a situated transaction inLuckenbill’sterms.Thus,inapotentiallyviolentsituationhow doestheindividual’ssocialcognitionfunction?Whatdistinguishestheir perceptionofthesituationandtheirappraisaloftheotherpeoplepresent? Howdotheirsocialproblem-solvingskills,alongsidetheirmoralvaluesand beliefs,influencetheirbehaviour?Inaddition,isthereaneedtoconsiderthe influencesofalcohol,mentaldisorder,andhighemotionality?Thesevarious factorswillappearasstrategiestoreducearangeoftypesofinterpersonalviolencewithdifferentpopulationsareconsideredinthefollowingchapters.
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LIVRE IX.