“Ask for Bread, not Peace”

Anger management programmes for offenders typically aim to improve the management of emotion associated with aggressive and antisocial behaviour. Such programmes have been quite extensively evaluated in prison and probation settings, but there is less published research in forensic mental health settings. This study aimed to evaluate anger management groups in a high-security hospital. Eighty-six patients were referred for a 20-session anger management intervention. Outcomes were self-reported experiences of anger and changes in institutionally documented incidents of aggression. Incident rates were retrospectively reviewed for all group graduates, where data were available, including a comparison group of graduates who acted as their own controls. Group graduates reported sustained reductions in feelings of anger and positive changes in their use of aggression in reaction to provocation. Some reduction in incidents of physical aggression was noted when group completers were compared with non-completers. Incidents of verbal aggression were observed to increase for graduates. There was also a trend towards improvement when treated men were compared with men on the waiting list. Our findings contribute to the growing evidence for anger management groups for aggressive men, although the low-base rate of incidents, typical of such a containing and therapeutic hospital setting, rendered the analysis of behavioural outcomes difficult. Anger management sessions for male forensic psychiatric patients can be effective in reducing incidents of physical aggression in response to provocation. Evaluation of treatments for anger is particularly difficult in secure and protective settings, where the aim is to keep incidents of actual physical aggression to a minimum. Further research of this kind is needed to test the value of self-reported reduction in angry feelings as an indicator of clinically useful progress.

Reports of violence and injuries to staff and patients in acute psychiatric inpatient settings have led to the development and implementation of training courses in the Prevention and Management of Violence and Aggression (PMVA). The purpose of this study was to explore the relationship between PMVA training of acute psychiatric ward nursing staff and officially reported violent incident rates. A retrospective analysis was conducted of training records (312 course attendances) and violent incident rates (684 incidents) over two-and-a-half years on 14 acute admission psychiatric wards (5,384 admissions) at three inner-city hospitals in the United Kingdom as part of the Tompkins Acute Ward Study. A positive association was found between training and rates of violent incidents. There was weak evidence that increased rates of aggressive incidents prompted course attendance, no evidence that course attendance reduced violence, and some evidence that attendance of briefer update courses triggered small short-term rises in rates of physical aggression. Course attendance was associated with a rise in physical and verbal aggression while staff were away from the ward. The failure to find a drop in incident rates after training, coupled with the small increases in incidents detected, raises concerns about the training course's efficacy as a preventive strategy. Alternatively, the results are consistent with a threshold effect, indicating that once adequate numbers of staff have been trained, further training keeps incidents at a low rate.

The events of 1956 (the Twentieth CPSU Congress, Khrushchev’s Secret Speech, and the Hungarian revolution) had a strong impact on the evolution of the Romanian communist regime, paving the way for the withdrawal of Soviet troops from Romania in 1958, the stricter policy toward the Transylvanian Hungarians, and Romania’s greater independence from the USSR in the 1960s. Students complained about their living and studying conditions long before the outbreak of the Hungarian crisis. Ethnic Hungarians from Transylvania listened closely to Budapest radio stations, and Romanian students in Budapest in the summer of 1956 were especially affected by the ferment of ideas there. For the Gheorghiu-Dej regime, the Hungarian revolution and Soviet invasion provided a useful excuse to end the destalinization process and crack the whip conclusivel —carrying out mass arrests, but also granting short-term concessions to ethnic minorities and workers. Of all segments of the Romanian population, university students were the most discontented. Drawing on archival documents, published memoirs, and recent Romanian scholarship, this paper will analyze and compare the student unrest in Bucharest, Cluj, Iaşi, and Timişoara. Due to a combination of psychological, logistical, and historical factors, students in the latter city were especially vocal and organized. On October 30 over 2,000 students from the Polytechnic Institute in Timişoara met with party offi cials, demanding changes in living and study conditions, as well as the withdrawal of Soviet troops from Romania. Another 800-1,000 students convened on October 31, calling for the release of students who were arrested the day before. Obvious discrepancies between the Romanian and Hungarian media sparked their curiosity about events in Hungary, while their cramped dorm rooms actually facilitated student meetings. In the Banat region itself, a tradition of anti-communist protest had prevailed since 1945. Although arrested en masse, these students set a vital precedent—especially for the Timişoarans who launched the Romanian Revolution thirty-three years later.

A general-population telephone survey of 1,753 Ontario adults was used to identify self-other differences in the perceptions of alcohol use, intoxication, and contributing effects of alcohol in incidents of physical aggression among the 152 respondents who had experienced such an incident in the past year. Respondents reported that opponents were significantly more intoxicated and that alcohol was more likely to have contributed to the opponent's aggression than to the respondent's. Self-other differences in the perceived role of alcohol remained significant when controlling for gender, usual drinking pattern of the respondent, whether only the opponent was physically aggressive, and whether the opponent was more intoxicated. These results suggest that people perceive themselves to be less affected by alcohol than their opponents are in incidents of aggression. This self-other difference is likely to influence both the escalation of aggression and the extent to which persons apportion responsibility to themselves and to others.

Reviewed by: "Wir wollten was tun." Widerstand von Jugendlichen in Werder an der Havel 1949–1953 by Iris Bork-Goldfield Phil Leask "Wir wollten was tun." Widerstand von Jugendlichen in Werder an der Havel 1949–1953. By Iris Bork-Goldfield. Berlin: Metropol, 2015. Pp. 196. Paper €19.00. ISBN 978-3863312473. Like all tales of torture and arbitrary punishment, Iris Bork-Goldfield's book is at times hard to read. Her concern is with a group of young people in Werder, west of Berlin, who actively resisted the authorities in the early years of the German Democratic Republic. Having seen the Nazi dictatorship defeated, they did not want it replaced by a communist dictatorship. At the heart of the group were Herbert Herrmann and the author's father, Werner Bork, born in 1932. Bork-Goldfield makes extensive use of an unpublished manuscript written in the 1990s by her father's journalist friend [End Page 452] Benno Kroll; this manuscript was based on interviews, personal knowledge, Kroll's research in the Stasi archive, and reports written by Bork in the early 1950s. Bork-Goldfield expands Kroll's work through conversations with her father and interviews with a number of his fellow resisters. She checks these interviews against the Stasi files in order to overcome the problem of the unreliability of participants' memories, while recognizing that the Stasi files are themselves unreliable (161). A scholar of literature and language, the author tells the story as if it were her father speaking, with effective personal touches. Her approach gives a sense of immediacy and energy, which tempts the reader not to question the authority of the narrator. Anticipating this problem, Bork-Goldfield seeks to justify her imagined narrative voice through extensive footnotes. In the early 1950s, Bork and his group distributed homemade leaflets. They later worked closely, and too trustingly, with the West Berlin organization Kampfgruppe gegen Unmenschlichkeit (Fighting Group against Inhumanity), which was infiltrated by the GDR's Ministry for State Security (the Stasi). Some of the resisters were arrested and tortured in order to extract—successfully—the names of others associated with Herrmann and Bork, then in West Berlin. What is puzzling is the naiveté and cognitive dissonance of the principal resisters. They believed both that their actions would make a difference and that they would have little effect. They also knew that active opposition put them in extreme danger (72, 74). Other accounts of early resistance confirm that it was widely known that young people were being arrested and sentenced to many years in prison by Soviet military tribunals, or that they were simply disappearing. Nevertheless, Bork and his group collaborated with committed Nazis and widened their activities to include espionage for Western intelligence services. No government or occupying power recognizes espionage as legitimate opposition but usually categorizes it as treason. The consequences were disastrous. A tense passage describes a Stasi attempt to trick Herrmann and Bork into returning to Werder, and the reader is relieved by their narrow escape. The Stasi, however, responded by arresting Herrmann's and Bork's friends in Werder. Some were sentenced to long terms in prison or in Soviet labor camps, whether they had been involved in resistance or not. Seven others, of whom two at least were apparently uninvolved, were taken secretly to Moscow and shot. After these arrests and a Stasi attempt to abduct Bork from West Berlin in early 1953, sporadic resistance continued. During the events of June 17, 1953, Bork and others went into East Berlin and sought to get involved. After the Soviet intervention, Bork left Germany, knowing that the Stasi would continue looking for him. He subsequently became a businessman with a family in West Berlin. Only in the 1990s did he discover that his friends had been shot forty years earlier, since such executions were not acknowledged until after the Soviet Union's dissolution (see Arsenij [End Page 453] Roginskij, "Erschossen in Moskau," 2008). Bork was horrified and fought to ensure there was a suitable memorial to them in Werder. There is no indication, however, that he felt any responsibility for their fate. Bork-Goldfield's book contributes to our detailed knowledge of early resistance in the...

There is a robust association between aggression and social prominence by early adolescence, yet findings regarding the direction of influence remain inconclusive in light of gender differences across various forms of aggressive behaviors. The current study examined whether physical aggression and spreading of rumors, as two gender-typed aggressive behaviors that differ in overt displays of power, promote and/or maintain socially prominent status for girls and boys during non-transitional grades in middle school. Peer nominations were used to assess physical aggression, spreading of rumors, and "cool" reputation (social prominence) during three time points between the spring of seventh grade and spring of eighth grade. Participants included 1,895 (54 % female) ethnically diverse youth: 47 % Latino, 22 % African-American, 11 % Asian, 10 % White and 10 % Other/Mixed ethnic background. Cross-lagged path analyses were conducted to test the directionality of the effects, and gender moderation was assessed by relying on multi-group analyses. The analyses revealed mainly reciprocal associations for each form of aggression, suggesting that boys, as well as girls, can both gain and maintain their status by spreading rumors about their peers, just as they do by physically fighting and pushing others in urban middle schools. The implications of the findings for interventions are discussed.

To estimate the point prevalence and cumulative incidence of caregiver-reported aggressive behaviors among people living with advanced Parkinson disease and related disorders (PDRDs) and secondarily examine variables associated with aggression. Caregivers from a clinical trial of outpatient palliative care for PDRD were surveyed about patient aggression at baseline and every 3 months over 12 months. Baseline responses were used for point prevalence. Cumulative incidence was calculated using responses from caregivers with no reported baseline aggression and available data at all other time points. Measures of disease severity, quality of life, mood, and caregiver burden were included in correlation and relative risk models, adjusting for age, sex, and diagnosis. Of 170 caregivers, 31 (18.2%) reported physical aggression, and 18 (10.6%) reported sexual aggression. Twelve-month cumulative incidence for physical and sexual aggression was 21.1% (23/109) and 16.0% (19/119), respectively. Physical aggression cumulative incidence was associated with patient depression (r = 0.37), patient-perceived quality of life (r = -0.26), caregiver burden (r = 0.26), caregiver-perceived patient quality of life (r = -0.26), and caregiver anxiety (r = 0.20). Age, sex, cognitive impairment, and dementia were not associated with aggression. No variables were associated with cumulative sexual aggression. There was a high prevalence and incidence of aggression in our PDRD cohort. This is an understudied issue in PDRD, and our findings highlight the need for increased awareness among neurologists. Providers should consider assessing for aggression when discussing neuropsychiatric symptoms or screening for caregiver burden. Future research should examine the relationship between aggression and patient and caregiver health outcomes. Clinical trial registration number: NCT02533921.

This article examines how the Hungarian crisis and Soviet interventions strengthened the position of the Romanian communist leadership. First, it eroded the respect of several Bucharest officials for the Soviet army, reinforcing their desire to see Soviet troops leave Romania. Second, the crisis brought back memories of earlier historical events that seemed to provide ‘proof’ of Hungarian bellicosity, which the Romanian leadership used to discriminate against ethnic Hungarians in Romania. Third, the crisis aroused fears of Transylvanian irredentism, which Bucharest used to control the population. Fourth, by incarcerating Imre Nagy, Bucharest leaders could witness his suffering, which motivated them to avoid his fate.

Incidents of aggression and self-harm in forensic mental health inpatient settings present a significant challenge to practitioners in terms of safely managing and reducing the harm they cause. Research has been conducted to explore the possible predictors of these incidents and has identified a range of environmental, situational, and individual risk factors. However, despite the often interpersonal nature of the majority of aggressive incidents, few studies have investigated forensic inpatient interpersonal styles as predictors of aggression and even fewer have explored the potential interpersonal function of self-harming behaviors. The current study investigated the predictive validity of the Chart of Interpersonal Reactions in Closed Living Environments (CIRCLE) for incidents of verbal and physical aggression, and self-harm recorded from 204 high-secure forensic inpatients. Means comparisons, correlations, and receiver operating characteristics (ROC) were conducted on recorded incident data at 12, 24, and 48 months following baseline assessment using the CIRCLE. Dominant and coercive interpersonal styles were significant predictors of aggression, and a coercive interpersonal style was a significant predictor of self-harm, over the recorded time periods. When categorizing the inpatients on the basis of short- and long-term admissions, these findings were only replicated for inpatients with shorter lengths of stay. The findings support previous research which has demonstrated the benefits of assessing interpersonal style for the purposes of risk planning and management of forensic inpatients. The predictive value may be time-limited in terms of stage of admission.

Purpose This article examines how the concepts that shaped the communist discourse were visually represented during the athletes’ parades celebrating Romania’s national day from 1953 to 1989. Design/methodology/approach To understand how communist ideology operated, this study utilizes discourse analysis, focusing on the use of metaphors as a means to construct reality. By extending beyond the linguistic domain, discourse analysis can be applied to various fields and purposes. This research employs the Foucauldian Discourse Analysis method to explore how communist power influenced and controlled the visual narrative in the athletes’ parades. Findings The analysis reveals that the core ideas within the communist sports discourse were simple, repetitive and universal. Key concepts such as mass participation in sports, Olympic sports and the Institute of Physical Education and Sports were closely intertwined, helping to reinforce the regime’s message about sports achievements. In the later years of communism, nationalism increasingly dominated the discourse surrounding mass sports. Moreover, Nicolae Ceausescu’s personality cult began to influence the narrative, altering the feedback athletes were expected to deliver during the parades on August 23rd. Research limitations/implications The research highlights how remnants of the former communist system continue to linger, impeding the creation of new frameworks and ideas within the field of sports in post-communist Romania. Practical implications The practical implications of this article consist in highlighting the fact that the communist dictatorship was also exercised through this type of manifestation, in which sport and athletes were tools that served the system. The mandatory character on the one hand but also the political, repetitive and monotonous messages transmitted during the parades, on the other hand, show us why this form of public manifestation can no longer be restarted in Romania, at least as far as sport and athletes are concerned. Originality/value This study is the first to explore the socio-historical dimensions of the August 23rd sports parades during Romania’s communist era, offering a unique perspective on how the regime used sports as a tool for ideological expression.

This article examines the effectiveness of Mode Deactivation Family Therapy, (MDT) in an outpatient setting as compared to Treatment as Usual, (TAU). MDT is an evidenced based psychotherapy and has been shown to be effective treating adolescents with a variety of problems involving emotional disorder, physical and sexual aggression, as well as behaviors associated with anxiety and trauma. In this study, MDT was shown to be superior to TAU in an outpatient setting with improving family relationships and reducing family disharmony of the previous described adolescents. Keywords: Mode Deactivation Therapy, (MDT), Treatment as Usual, (TAU), MDT Family Therapy. Introduction Mode Deactivation therapy (MDT) has been shown to be an effective treatment for a variety of adolescent disorders, Apsche, Bass & Siv (2006). Disorders that MDT has been shown to be effective with include emotional, Apsche & Ward-Bailey (2004) behavioral, Apsche, Bass, Murphy, (2006), physical aggression, Apsche, Bass & Houston, (2007), sexual aggression, Apsche, Bass, Jennings, Murphy, Hunter & Siv (2005), and many harmful symptoms of anxiety and traumatic stress, Apsche & Bass (2006). MDT Family Therapy has been effective in reducing family disharmony in case studies, (Apsche & Ward (2004) and has been shown to be efficacious as compared to TAU, in treating families with a variety of problem behaviors, Apsche & Bass, (2006) and in reducing and maintaining treatment effects thru two (2) years of tracking recidivism rates (Apsche, Bass & Houston, 2007). Apsche, Bass & Siv, (2006) completed a Family MDT clinical study of 14 adolescents with problems with sexual and physical aggression and oppositional behaviors, such as, not following parent's direction, oppositional and verbal aggression. The results suggest that MDT performed Treatment As Usual (TAU); at the eighteenth month of observation, the MDT group has zero, (0) sexual recidivism, while the TAU group had 10 reported incidents or problems with sexual behavior. The MDT group reported (3) three incidents of physical aggression while the TAU group reported (12) twelve incidents. The results were promising for MDT as a Family Therapy, but the small size of the group rendered the effects of the study as having some limitation, and in need of further study with a larger group; however, results are suggestive of a promising methodology. Apsche, Bass & Houston (2007), completed a study of Family MDT with an additional (8) eight families in the community, as compared to a separate TAU group. The Apsche, et. al., 2007, study examined physically aggressive youths with personality and conduct problems. The study had a total of families of (15) fifteen, (8) eight in the MDT group and (7) seven in the TAU group. MDT out-performed TAU at the twenty week interval of treatment. The most compelling point of data was that the MDT group had (0) zero referrals for out of home placements, while the TAU group has referrals fore of home placements. The results are promising, yet the small number of participants limits the claims of the effects of Family MDT. A major problem of treatment research is that large adequate sample sizes are not always available. Referred clients and families are sent for treatment. The sent client or families, by nature, usually enter treatment with a level of resistance. The resistance is based on the issue that someone else determined that there are problems within the family. The sources of these referrals are typically a court or department of Children and Youth. The clinician researcher has to find a strategy to motivate the family to work hard to address their issues and problems. MDT, both in individual and family work, offers the therapist and client(s) the ability to structure, measure and track progress in treatment in the Family Manual, Apsche & Apsche (2007). …

Purpose – Offenders with intellectual disability (ID) have been largely neglected in past forensic literature on assessment of dynamic risk factors. The purpose of this paper is to evaluate the predictive validity of the Short-Term Assessment of Risk and Treatability (START), in a sample of males with IDs in a low-secure hospital (n=28). Design/methodology/approach – A prospective analysis was conducted, with START scores as the predictor variables, and the number of recorded aversive incidents as the outcome measure. Findings – Receiver operating characteristic analysis demonstrated that total START risk scores had a significant high predictive accuracy for incidents of physical aggression to others (area under the curve (AUC)=0.710, p<0.001) and property damage/theft (AUC=0.730, p<0.001), over a 30-day period, reducing to medium predictive validity over a 90-day period. Medium predictive validity was also identified for incidents of verbal aggression, suicide, self-harm, and stalking and intimidation. START strength scores were also predictive of overt aggression (AUC=0.716), possible reasons for this are explored. Research limitations/implications – The small sample size limits the generalisability of the findings, and further research is required. Practical implications – The paper offers preliminary support for the use of the START with ID offenders in low-secure settings. Given the lack of validation of any previous dynamic risk assessment tools, multi-disciplinary teams in such settings now have the option to use a tool which has potentially good validity with an ID population. Originality/value – This study represents the first attempt to examine the predictive validity of the START with ID offenders, and a step forward in the understanding of dynamic risk factors for violence in this population. The significant predictive relationship with incidents of physical aggression and property damage offers clinicians a preliminary evidence base supporting its use in low-secure settings.

Chromis was accredited by the Correction Services Accreditation Panel in 2005 as an intervention designed to reduce violence in offenders whose level or combination of psychopathic traits disrupts their ability to engage in treatment and change. It runs as part of the regime in the dangerous and severe personality disorder unit in HM Prison Frankland (Westgate). A multiple case study investigation into changes over time in participants is currently underway, part of which is reported here. This paper reports on information relating to changes in anger and aggression in Chromis completers. Change in psychometrics and observed incidents of verbal and physical aggression are considered for five case study participants who have completed Chromis and progressed from Westgate to a different location. Findings suggest that cases experienced a reduction in self-reported anger, and expected incidents of physical aggression but had higher than expected levels of verbal aggression after leaving Westgate. These findings offer cautious optimism for the effectiveness of Chromis, although methodological limitations must also be considered. Findings may be seen as positive indicators of Chromis, or at least the approach to working with these offenders across Westgate, in reducing violence. Findings support the continued delivery and evaluation of Chromis. There may be benefit in exploring ways to further understand and address verbal aggression in participants.

The aim of this study was to identify aggressive event incidence rates in the inpatient psychiatric setting, describe characteristics of events and differences based on aggression target and type (verbal vs. physical). A longitudinal study was carried out of aggressive events identified by workers in four inpatient psychiatric units using the Staff Observation of Aggression Scale-Revised (SOAS-R) over 6weeks. A total of 113 aggressive events were recorded resulting in a rate of 13.27 events per bed per year. Verbal aggression was demonstrated in 86% and physical aggression in 57% of events. Most events (70.8%, n=81) targeted a worker. Compared to other targets, workers were 3.4 times more likely to feel threatened (95% CI 1.2-9.6, χ2=5.08, p=0.0242), and less likely to have a visible injury (OR 0.15, 95% CI 0.04-0.6; χ2=7.1, p=0.0078). Event severity ranged from 0 to 21 with a mean of 9.5(SD=5.1), with 20% considered severe. Verbal events had lower mean severity of 6.5(SD=3.8) versus physical events with a severity of 11.8(SD=4.8; t=6.5, df=111, p<0.0001). In 57.5% of events there was no consequence to the victim. For most events (76%) resolution included workers talking to the patient, while 54% involved use of medication. Restrictive measures (physical hold, seclusion or physical restraint) were involved in 24.8% of events. Aggression incidence was similar to incidence found in other studies. Workers were the target of most aggressive events and many were identified as having no understandable provocation. Further understanding of event characteristics will promote more effective prevention and management of aggressive events.

Psychological aggression by self and partner, physical aggression by the partner, and marital dissatisfaction were examined as longitudinal predictors of first instances of physical aggression during marriage. Subjects who were not physically aggressive at a premarital assessment were selected from a sample of 393 engaged couples. Couples participated in three subsequent assessments over the first 30 months of marriage. As hypothesized, individuals' own psychological aggression predicted their initial incidents of physical aggression in marriage. Psychological aggression by their partners also predicted initial incidents of physical aggression. Prior physical aggression by their partners was inconsistently associated with first instances of physical aggression. Contrary to our hypothesis, previous levels of marital dissatisfaction did not predict initial incidents of physical aggression. These findings were consistent across sexes. The results underscore the progression from psychological to physical abuse and have clear implications for understanding the development and prevention of interspousal aggression.