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Purpose Intimate Partner Violence and Abuse (IPVA) is as a major health concern globally. The prevalence of IPVA perpetration and victimisation has been found to be higher in military compared to civilian populations. Of concern, help-seeking for other psychosocial difficulties among military communities has been shown to be both limited and challenging, and military personnel could face additional or amplified barriers to help-seeking for IPVA than their civilian counterparts. This study aimed to use qualitative methods to explore the experiences of, and barriers to, help-seeking for IPVA victimisation and perpetration among UK military personnel. Methods Thematic analysis was conducted on 40 one-to-one semi-structured interviews with military personnel (29 male, 11 female). Results Four superordinate themes were derived, thematically organised according to different levels of the social ecological model: Military cultural factors; Support service factors; Interpersonal factors; and Individual factors. At a military cultural level, participants described difficulties in help-seeking for IPVA resulting from widespread stigma and hypermasculine attitudes in military communities, minimisation of violence, perceived pressure from chain of command, and fear of consequences of reporting. At a support-service level, participants’ negative views or experiences and lack of awareness of services were also significant in deterring help-seeking. At an interpersonal level, participants recounted how relationships with military colleagues, their partner and their family could be both instrumental or a hindrance to help-seeking for IPVA. At an individual level, lack of insight into IPVA and different forms of abuse were suggested through minimisation of violence and described to contribute to delay in help-seeking. Shame, compounded by multi-layered stigma present at each social ecological model level, was a key reason for delaying or avoiding help-seeking. Conclusions The findings indicate the added challenges in help-seeking for IPVA experienced by military personnel and highlight a need for a whole systems approach to improve the provision of support for IPVA in the military serving and ex-serving community to instil meaningful change.

Readmission from secure forensic services has significant implications for individuals and providers. Whilst there is research on readmission for forensic services internationally and for medium se...

Purpose The prevalence of Intimate Partner Violence and Abuse (IPVA) perpetration and victimisation has been found to be higher in serving and ex-serving military samples compared to civilians. Despite this, there is a lack of qualitative research exploring the IPVA experiences of couples in which one or both partners are serving or have served in the military. This qualitative study aimed to explore IPVA experiences within the UK military community from the perspective of serving and ex-serving military personnel and civilian partners of UK military personnel. Method One-to-one telephone interviews were conducted with 40 serving and ex-serving military personnel (29 male, 11 female) and 25 female civilian partners. Data was analysed using thematic analysis. Results Four superordinate themes were derived: (1) patterns and directions of IPVA, (2) types of IPVA, (3) perceived drivers of IPVA and (4) perceived impact of IPVA. The findings point to frequent bidirectional abuse in part driven by poor communication and emotion regulation, whilst also highlighting the experiences of severe IPVA victimisation of civilian partners by military personnel motivated by power and control. Perceived drivers of both IPVA perpetration and victimisation include military factors borne of military culture or training, alcohol and mental health difficulties. Conclusion These results highlight the role of cultural norms, as well as the role of emotion dysregulation, poor communication skills and mental health difficulties in explaining and perpetuating abuse within ecological theoretical frameworks of violence among couples within which one or both partners are serving or ex-serving military personnel.

Little is known about the functioning of children in veteran-connected families, who may experience a unique constellation of stressors including exposure to parental mental health symptoms and unemployment. Further, research has not previously considered the role of school climate in counteracting these stressors for veteran-connected students. This preliminary study examines the relationship between veteran parent’s mental health and employment with adverse outcomes for their school-age children, as well as the potential moderating effect of safe school climate. Participants were 218 veteran parents of children in K-12 schools, who completed the Chicago Veterans Survey, including measures of PTSD and depression, unemployment, a school safety scale drawn from the California School Parent Survey, and an adverse child functioning screening tool. Regression models suggest that depression symptomatology and perceptions of less safe school climate were significantly associated with adverse outcomes among veteran-connected students. Safe school climate buffered against the negative effects of parents’ depression symptoms, particularly at lower levels of depression severity. Findings suggest the need for future research to explore the potentially crucial role for schools, including teachers, administrators, and particularly school-based mental health providers, in supporting the healthy functioning of veteran-connected students and their families.

There is evidence that Intimate Partner Violence and Abuse (IPVA) is more prevalent among military populations compared with civilian populations. However, there has been limited research into the help-seeking experiences of civilian victim-survivors who have experienced IPVA within relationships with military personnel. This qualitative study aimed to explore the experiences of, and barriers to, help-seeking for IPVA victimisation among civilian partners of military personnel in order to identify strategies to improve the management of IPVA both within the military and civilian sectors. The study adopted a descriptive cross-sectional study design and used qualitative research methods. One-to-one telephone interviews were conducted with civilian victim-survivors (n = 25) between January and August 2018. Interview transcripts were analysed using thematic analysis. Three superordinate themes were derived: (1) Drivers to help-seeking; (2) Barriers to help-seeking; and (3) Experiences of services. The findings indicate difficulties in help-seeking for IPVA among civilian partners of military personnel due to stigma, fear, dependency, poor understanding of IPVA, lack of appropriate and timely support, and a perceived lack of victim support. Difficulties in help-seeking were perceived by participants to be amplified by military culture, public perceptions of the military, military protection of personnel and the lack of coordination between civilian and military judicial services. This study reinforces the need for a military specific Domestic Abuse strategy, identifies vulnerable groups and highlights a need for both increased awareness and understanding of IPVA within civilian and military services in order to provide adequate victim protection.

Background Despite the rise in ‘online’/technology-assisted child sexual abuse (TA-CSA), little research has been conducted on professionals’ perceptions beyond reporting on young people’s experiences. Objectives This novel study aimed to understand how professionals who work with victims perceive online CSA (i.e., dynamics and impact), and organizational responses to it. Participants and settings Seven child protection professionals completed a paper-based pilot questionnaire; another 45 professionals (from child protection, policing, education and therapy) completed a shorter, online survey. Methods Recruitment occurred via a child protection conference, relevant law enforcement/child protection organizations, and advertised via BASPCAN (a national organization for child protection professionals). Results Professionals often demonstrated a limited understanding of the wide range of ‘online’ CSA. Online CSA was often seen by organizations and some professionals as less serious than offline CSA, with offline victims’ prioritized as higher risk, even though respondents noted the impact may be the same. Organizations rarely had clearly outlined assessment/intervention pathways, and some professionals noted that organizations are more likely to perceive victims as ‘active’ participants or to blame for their abuse. Conclusions There is often a limited understanding of the risks and severity of TA-CSA, and this can lead to victims remaining at risk, a systemic failure to protect, and a decreased chance of accessing appropriate interventions. Drawing on our findings, we make a number of recommendations, including adoption of the term ‘technology-assisted abuse’, adapted assessment tools and interventions, and widespread training. Policies should be reviewed to ensure they are not implicitly minimizing this serious form of abuse.

Rationale Research suggests that parenting behaviours are negatively affected by parental trauma. However, thus far, the evidence base has provided limited insight into why this occurs. Further, the available evidence has focused largely on high income contexts (HICs), and we know much less about the experiences of parents in low- and middle-income countries (LMICs) who are frequently coping with multiple adversities. Objective The current qualitative study aimed to gain a more in-depth understanding from the parent's perspective about whether and how their trauma impacted themselves and their parenting behaviours. Method We conducted interviews with 30 trauma-exposed, Xhosa speaking parents (28 mothers) from Khayelitsha, a township outside Cape Town in South Africa, 66% of whom reported experiencing moderate to severe posttraumatic stress symptoms. Results Five key themes were identified: consequences for parents as individuals (in terms of mental and physical health); the centrality of community and cultural context to parental experiences; consequences in terms of parenting capacity; trauma related effects on the child and how these may influence parental coping; and mechanisms of coping and achieving recovery. Conclusion Findings highlight the difficult nature of parenting following trauma due to impacts on multiple areas of life, and suggest potential avenues for the development of parenting interventions in order to support parents and families more effectively following trauma.

This study sought to understand how individuals bereaved through homicide (murder or manslaughter) describe their postevent experiences to inform clinical needs and promote mechanisms for change. A total of 21 participants (18 females) between the ages of 29 and 66 ( M age = 47.81 years, SD = 8.99) took part in this study. They were all participating in a residential program for homicidally bereaved individuals and were all residents in the United Kingdom. The sample comprised of 12 parents, five siblings, one partner, one daughter, one friend, and one grandmother of the deceased. The length of time since the bereavement varied from 12 months to 18 years ( M = 2.48, SD = 1.80). Thematic analysis was used to analyze the narratives collected. Three central themes emerged, namely (a) uniqueness of the experience, (b) changed self and world, and (c) mixed experiences of support. The uniqueness of the individuals’ experiences was associated with the nature of the homicide event and the consequences that are unlikely to occur in “normal” deaths (e.g., judiciary). A sense of a changed self (e.g., ongoing emotional/mental and physical responses, coping) and world (e.g., changed beliefs regarding safety and criminal activity) seemed to be contributing to different shades of (mal)adjustment. Adaptive and protective strategies were identified. The current study with a large qualitative sample generated a unique, rich description/integration about individuals’ journeys following an experience of homicidal bereavement. Findings are likely to inform policy and clinical practice by considering individuals’ voices.

Research has demonstrated that approximately 45–50% of individuals show healthy levels of psychological and physical functioning in the first 12 months post-loss. Homicidal bereavement (loss due to murder or manslaughter) does not appear to follow this pattern. Homicide-related mental health difficulties are a serious problem worldwide, displaying high rates of lifetime incidence, high chronicity, and role impairment. Individuals are at increased risk to develop symptoms of post-traumatic stress disorder (PTSD), complicated grief (CG), and depression. Nevertheless, a systematic review specifically on the efficacy of psychological interventions following homicidal loss has not yet been conducted. The current systematic review (registered via PROSPERO) aimed to review the psychological interventions available and report their effectiveness. Of 77 records, 7 met predefined inclusion criteria. Studies presented different methodologies, tested different clinical models, and treatment conditions. Thus, a narrative systematic review was conducted. Studies included manualized interventions to deliver 1:1 and group sessions. Cognitive behavioral therapy, restorative retelling, and eye movement desensitization and reprocessing were the main models used together with psychoeducational elements about trauma and grief responses. Overall, symptoms of PTSD, CG, and depression decreased significantly postintervention. Sustained improvements were reported for PTSD and depressive symptoms at the follow-up measurements. Mixed results were found regarding how individual (age, gender) and external factors (time since loss, relationship with the deceased) impact on symptom progression. As a result of differences in methodologies, categorization of therapies, methodological differences, and small sample sizes, important questions remain unanswered. Further randomized controlled trials and expert consensus could be considered.

Background: There is little research exploring the impact of technology assisted child sexual abuse (TA-CSA) and how this is similar to/differs from offline. Objectives: This novel study aimed to understand the impact following TA-CSA from the perspective of young people, including identifying additional elements or complexities arising from the digital element. Participants and settings: Quantitative data was collected in the UK from 30 young people, 16 completed qualitative interviews, and screening data was collected from another 230 young people. All were recruited via a children’s helpline, a children’s charity or a law enforcement agency. Interviews were conducted face-to-face, by telephone or online; questionnaires were completed online. Methods: A mixed methods approach was employed to enable a fuller, richer understanding of TA-CSA using triangulation of data from different sources.Results: TA-CSA occurred in 46.4% to 62.5% of cases. No statistically significant differences were found between TA-CSA and offline for impact of abuse; although the study was somewhat underpowered. Qualitative analysis identified similar impacts to offline CSA, but also six ways in which technology facilitated the initiation, escalation and maintenance of abuse (e.g., ease of access, control of the night time space, blackmail using images) and complicated the impact in five ways (e.g., permanence and loss of control of images, revictimisation).Conclusions: This study showed that although TA-CSA is sometimes viewed as less serious than offline CSA, the emotional, psychological and behavioural outcomes appear to be the same. Furthermore, the role of technology as a facilitator of abuse and the additional complexities in impact need to be accounted for in practice guidelines and policies. Keywords: technology-assisted; digital; child sexual abuse; online; impact

Background Awareness of domestic violence and abuse (DVA) as a problem among military personnel (serving and veterans) has grown in recent years, and there is a need for research to inform improvements in the identification of and response to DVA in this population. This study aimed to explore the experience of health and welfare professionals in identifying and responding to DVA among the UK military population (serving personnel and veterans). Methods Thirty-five semi-structured telephone interviews were conducted with health and welfare staff who work with serving UK military personnel and veterans. Interviews were analysed using thematic analysis. Results Three superordinate themes were identified: i) patterns of DVA observed by health and welfare workers (perceived gender differences in DVA experiences and role of mental health and alcohol); (ii) barriers to identification of and response to DVA (attitudinal/knowledge-based barriers and practical barriers), and iii) resource issues (training needs and access to services). Participants discussed how factors such as a culture of hypermasculinity, under-reporting of DVA, the perception of DVA as a “private matter” among military personnel, and lack of knowledge and awareness of emotional abuse and coercive controlling behaviour as abuse constitute barriers to identification and management of DVA. Healthcare providers highlighted the need for more integrated working between civilian and military services, to increase access to support and provide effective care to both victims and perpetrators. Furthermore, healthcare and welfare staff reflected on their training needs in the screening and management of DVA to improve practice. Conclusions There is a need for increased awareness of DVA, particularly of non-physical forms of abuse, and of male victimisation in the military. Standardised protocols for DVA management and systematic training are required to promote a consistent and appropriate response to DVA. There is a particular training need among healthcare and first-line welfare staff, who are largely relied upon to identify cases of DVA in the military. Employing DVA advocates within military and civilian healthcare settings may be useful in improving DVA awareness, management and access to specialist support.

ObjectiveResearch on homicidal bereavement has focused on postloss impact and coping. Less is known about how individuals perceive their adjustment posthomicide. Adverse experiences are likely to leave individuals with an increased risk of developing severe psychological difficulties, such as depression, Post-traumatic stress(PTSD), anxiety and complicated grief. This study aimed to explore how individuals perceive their change and progression posthomicide and post-psychoeducational intervention.DesignSemistructured qualitative interviews were conducted both as part of a prospective study and retrospectively to allow for a longer follow-up period.SettingHomicidally bereaved individuals who participated in a residential psychoeducational intervention offered by a national charity (Escaping Victimhood (EV)).ParticipantsTwenty-nine individuals (mainly females) took part: 14 as part of a 6–9-month follow-up (short-term trajectory group (STG) individuals—mean age 45.25) and 15 individuals (long-term trajectory group (LTG) individuals—mean age 48.50), retrospectively, 2 to 5 years postintervention.ResultsInterviews were analysed using an inductive Thematic Analysis method. Three main themes and nine subthemes emerged, and applied to both groups, as follows: (1) actual changes perceived by the participants (increased understanding, improved coping strategies and positive self-change), (2) barriers to recovery (severe psychological difficulties over time, need for further support, reminders and close relationships with both victim and perpetrator), and finally perceived future progression (living day by day, hope and hopelessness). The only significant differences between the two groups related to the reported self-growth among LTG individuals and the perceived increased informal support among STG individuals by keeping in touch in other EV participants.ConclusionThis unique study provides insight into how homicidally bereaved individuals perceive their bereavement paths and helped to identify elements that appear to contribute for their adjustment. Importantly, it has highlighted that positive changes can also be an outcome.

Although some studies point to cognitive stimulation as a beneficial therapy for older adults with cognitive impairments, this area of research and practice is still lacking dissemination and is underrepresented in many countries. Moreover, the comparative effects of different intervention durations remain to be established and, besides cognitive effects, pragmatic parameters, such as cost-effectiveness and experiential relevance to participants, are seldom explored. In this work, we present a randomized con- trolled wait-list trial evaluating 2 different intervention durations (standard 1⁄4 17 vs brief 1⁄4 11 sessions) of a cognitive stimulation program developed for older adults with cognitive impairments with or without dementia. 20 participants were randomly assigned to the standard duration intervention program (17 sessions, 1.5 months) or to a wait-list group. At postintervention of the standard intervention group, the wait-list group crossed over to receive the brief intervention program (11 sessions, 1 month). Changes in neuropsychological, functionality, quality of life, and caregiver outcomes were evaluated. Experience during intervention and costs and feasibility were also evaluated. The current cognitive stimulation programs (ie, standard and brief) showed high values of experiential relevance for both intervention durations. High adherence, completion rates, and reasonable costs were found for both formats. Further studies are needed to definitively establish the potential efficacy, optimal duration, cost-effectiveness, and experiential relevance for participants of cognitive intervention approaches., The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by the Portuguese Foundation for Science and Technology, with individual grants (SFRH/BD/64457/2009 and SFRH/BD/65213/2009, co-funded by FSE/POPH) and project grant PIC/IC/83290/2007, supported by FEDER (POFC-COMPETE).

RESUMO: Este trabalho é realizado com o objectivo de contribuir para uma melhor compreensão da Esquizofrenia e a sua relação com a criminalidade e a melhor forma de intervir psicológica e socialmente com o intuito de reabilitar o doente mental e reinseri-lo na sociedade, evitando fenómenos de estigma e exclusão social. Sendo este tema muito abrangente e complexo, o que se pretende, de forma descritiva, é abordar noções, segundo uma perspectiva psicológica forense, que permitam a reflexão sobre o estatuto de inimputável e a medida a aplicar a estes sujeitos (criminosos ou doentes mentais?) com características muito peculiares. Torna-se evidente a necessidade de desenvolver esforços no sentido de prevenir e reabilitar clínica e socialmente os indivíduos que sofrem de doença mental e que por razão desta cometeram um crime, nomeadamente através da criação de programas de intervenção adequados à casuística. Nesse sentido, neste trabalho é proposto um modelo de intervenção psicossocial, aqui elaborado sob a forma de programa de intervenção comunitário, tendo como principais objectivos, a reabilitação clínica e a reinserção social do utente na comunidade local, a prevenção da recidiva da doença e a reincidência no crime, a redução do estigma e exclusão social associado à doença mental e a promoção do acesso aos direitos e à igualdade de oportunidades., Orientador: Carlos Poiares