The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder

Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

A pilot feasibility trial of alcohol screening and brief intervention in the police custody setting (ACCEPT): study protocol for a cluster randomised controlled trial

BACKGROUND: There is evidence of an association between alcohol use and offending behaviour and around a quarter of police time is spent on alcohol-related incidents. Police custody, therefore, provides an important opportunity to intervene. This pilot trial aims to investigate whether a definitive evaluation of screening and brief interventions aimed at reducing risky drinking in arrestees is acceptable and feasible in the custody suite setting. METHODS: Screening will be carried out by trained detention officers or drug and alcohol workers in four police forces across two geographical areas (North East and South West England). Detention officers (or drug and alcohol workers) will be cluster randomised to one of three conditions: screening only (control group), screening followed immediately by 10 min of manualised brief structured advice delivered by the individual responsible for screening (intervention 1) or screening followed by 10 min of manualised brief structured advice delivered by the individual responsible for screening plus the offer of a subsequent 20-min session of behaviour change counselling delivered by a trained alcohol health worker (intervention 2). Participants will be arrestees aged 18+ who screen positive on the Alcohol Use Disorders Identification Test. Participants will be followed up at 6 and 12 months post-intervention. An embedded qualitative process evaluation will explore acceptability of alcohol screening and brief intervention to staff and arrestees as well as facilitators and barriers to the delivery of such approaches in this setting. RESULTS: Recruitment is currently underway and due to end May 2015. CONCLUSION: Results from this pilot trial will determine if a definitive evaluation is possible in the future and will provide stakeholder input to its design. TRIAL REGISTRATION: Reference number: ISRCTN89291046

Violence witnessing, perpetrating and victimization in medellin, Colombia: a random population survey

<p>Abstract</p> <p>Background</p> <p>The burden of injury from violence and the costs attributable to violence are extremely high in Colombia. Despite a dramatic decline in homicides over the last ten years, homicide rate in Medellin, Colombia second largest city continues to rank among the highest of cities in Latin America. This study aims to estimate the prevalence and distribution of witnesses, victims and perpetrators of different forms of interpersonal violence in a representative sample of the general population in Medellin in 2007.</p> <p>Methods</p> <p>A face-to-face survey was carried out on a random selected, non-institutionalized population aged 12 to 60 years, with a response rate of 91% yielding 2,095 interview responses.</p> <p>Results</p> <p>We present the rates of prevalence for having been a witness, victim, or perpetrator for different forms of violence standardized using the WHO truncated population pyramid to allow for cross-national comparison. We also present data on verbal aggression, fraud and deception, yelling and heavy pranks, unarmed aggression during last year, and armed threat, other severe threats, robbery, armed physical aggression, and sexual aggression during the lifetime, by age, sex, marital and socioeconomic status, and education. Men reported the highest prevalence of being victims, perpetrators and witnesses in all forms of violence, except for robbery and sexual violence. The number of victims per perpetrator was positively correlated with the severity of the type of violence. The highest victimization proportions over the previous twelve months occurred among minors. Perpetrators are typically young unmarried males from lower socio-economic strata.</p> <p>Conclusions</p> <p>Due to very low proportion of victimization report to authorities, periodic surveys should be included in systems for epidemiological monitoring of violence, not only of victimization but also for perpetrators. Victimization information allows quantifying the magnitude of different forms of violence, while data on factors associated with aggression and perpetrators are necessary to estimate risk and protective factors that are essential to sound policies for violence prevention formulation.</p