Violent Children and Adolescents: Asking the Question Why

Violent Children and Adolescents: asking the question why

Gwyneth Boswell

Whurr Publishers

Violent Children and Adolescents

Violent Children

and Adolescents:

asking the question why

Edited by GWYNETH BOSWELL MA, PHD De Montfort University

W

WHURR PUBLISHERS LONDON AND PHILADELPHIA

© 2000 Whurr Publishers First published 2000 by Whurr Publishers Ltd 19b Compton Terrace, London N1 2UN, England and 325 Chestnut Street, Philadelphia PA 1906, USA

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of Whurr Publishers Limited. This publication is sold subject to the conditions that it shall not, by way of trade or otherwise, be lent, resold, hired out, or otherwise circulated without the publisher’s prior consent in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed upon any subsequent purchaser. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. ISBN: 1 86156 125 3

Printed and bound in the UK by Athenaeum Press Ltd, Gateshead, Tyne & Wear

Contents

Acknowledgements List of contributors

ix xi

Prologue Gwyneth Boswell

xv

Chapter 1

1

Children who kill: trends, reasons and procedures Paul Cavadino and Rob Allen Chapter 2

19

Adolescent violence: findings and implications from the Cambridge Study David P Farrington Chapter 3

36

Understanding and treating adolescent firesetters Kevin Epps and Clive R Hollin Chapter 4

56

The antecedents of young male sex offenders Victoria Harris and Carl Staunton Chapter 5

71

The link between childhood trauma and later violent offending: a case study Paul Renn v

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Violent Children and Adolescents

Chapter 6

91

Self-directed violence in adolescence: a psychotherapeutic perspective Cairns Clery Chapter 7

104

Violent adolescent female offenders Susan Bailey Chapter 8

121

Violent young people detained in a maximum security psychiatric hospital Deborah Richards and Andrew Smith Chapter 9

138

Aggressive and bullying behaviour in children and adolescents Helen Cowie Chapter 10

151

The influence of film and video on young people and violence Kevin Browne and Amanda Pennell Chapter 11

169

Comparing studies of youth and violence: towards an integrated approach Stephen Parvez Rashid Chapter 12

183

Bulger and beyond: asking the question‘why?’ David James Smith Epilogue Gwyneth Boswell

196

References and Citation Index Subject Index

199 227

Dedication In memory of my brother Christopher Crisall

vii

Acknowledgements

I am extremely grateful to the 17 chapter authors who put aside precious time in their busy lives to share my mission to ask and answer the question ‘why?’ The support and interest of my new academic colleagues in the Community and Criminal Justice Unit at De Montfort University have made more difference to the nature of this endeavour than they will ever know. My son, Peter, a teenage computer ‘whizz’, has patiently passed on as many of his skills as his technophobe mother could absorb. Dan Rashid has done a superbly pedantic job of copy-editing, proof-reading and generally acting as the backstop which kept me sane. Peter Wedge has been a much-valued critical friend. I thank them all — and end by expressing my appreciation to the young people who, in a range of ways, have allowed their frequently unhappy stories to be told in these pages. This book will only have been worth writing if it helps to address and eradicate the reasons for their violence.

ix

Contributors

Rob Allen is Director of Research and Development at the National Association for the Care and Rehabilitation of Offenders (NACRO). Susan Bailey is Consultant Child and Adolescent Forensic Psychiatrist for Salford NHS Trust and Maudsley and South London NHS Trust. She is Senior Research Fellow at the University of Manchester, and Chair of the Resource Network for Adolescents. Her research interests include the mental health of young offenders in the UK and developing old democracies of Europe. She has a special interest in juveniles and in a developmental approach to the understanding of male and female offenders. Gwyneth Boswell is Principal Lecturer in the Community and Criminal Justice Unit at De Montfort University, Leicester. She was previously Senior Lecturer at the University of East Anglia and Senior Probation Officer in Merseyside. Throughout the 1990s, she researched widely into violence in young people and her work in this field is ongoing. In 1998, with Peter Wedge, she completed a major research report for the Department of Health on The Parenting Role of Imprisoned Fathers. She is co-author with Davies and Wright of Contemporary Probation Practice (1993) and author of Young and Dangerous: the backgrounds and careers of Section 53 offenders (1996). Kevin Browne is Professor of Forensic and Family Psychology, School of Psychology, University of Birmingham and Research Coordinator at the Glenthorne Youth Treatment Centre, Birmingham. As a Chartered Forensic Psychologist, he co-edits (with Professor Margaret Lynch) the Wiley book series on Child Care and Protection and the journal Child Abuse Review. His latest publication is Preventing Family Violence, co­ authored with Professor Martin Herbert (Wiley, 1997). Paul Cavadino is Director of Policy at the National Association for the Care and Rehabilitation of Offenders (NACRO). xi

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Violent Children and Adolescents

Cairns Clery works full-time as principal psychotherapist at a regional inpatient psychiatric unit for adolescents run by Surrey Oaklands NHS Trust. Previously a social worker, he has worked with troubled adoles­ cents and their families for 20 years. He has also written, lectured, and run workshops about adolescent crisis management and treatment approaches to deliberate self-harm. Helen Cowie is Research Professor in the School of Psychology and Counselling, University of Surrey, Roehampton. She has written widely on the subject of children’s relationships, in particular on peer support as a challenge to school bullying. Her most recent books include Counselling and Supporting Children in Distress (with Sonia Sharp) and Peer Support in Action (with Patti Wallace), each published by Sage. She is currently a team leader on an EU-funded project ‘Bullying and social exclusion in schools and the workplace’. Kevin Epps is Principal Clinical Psychologist, Glenthorne Youth Treatment Centre (Department of Health) and Honorary Lecturer in Forensic Clinical Psychology, University of Birmingham. David P. Farrington is Professor of Psychological Criminology at Cambridge University and a Fellow of the British Academy. He is a past President of the British Society of Criminology, the American Society of Criminology, and the European Association of Psychology and Law. He received his PhD degree in Psychology from Cambridge University, and the Sellin–Glueck prize of the American Society of Criminology for international contributions to criminology. His main research interest is in the development of offending and antisocial behaviour from child­ hood to adulthood. In addition to over 250 published papers on crimi­ nological and psychological topics, he has published over 20 books, one of which (Understanding and Controlling Crime, 1986) won the Distinguished Scholarship prize of the American Sociological Association criminology section. Victoria Harris is a Lecturer in the School of Social Work at the University of East Anglia, where she is also Director of the Practice Teaching Programme. She is a former Senior Probation Officer with particular experience of working with high-risk offenders, and is currently evalu­ ator for the Norfolk Youth Offending Teams, whose projects include a community-based treatment programme for sexually aggressive young­ sters. Clive R. Hollin is Director of Forensic Courses, and Professor in the Centre for Applied Psychology, University of Leicester. Amanda Pennell is a Graduate Research Associate in Forensic Psychology, School of Psychology, University of Birmingham and received a PhD in 1999 for her work on the effects of video violence on young offenders.

Contributors

xiii

Stephen Parvez Rashid is Senior Lecturer in Social Work in the School of Health and Social Welfare at the Open University. Formerly a social worker and team leader in Birmingham, he specializes in the fields of mental health and of anti-racism. He is co-author, with J. Thoburn and E. Norford, of Permanent Family Placement for Children of Minority Ethnic Groups (Jessica Kingsley, in press). Paul Renn has worked as a probation officer in London for 11 years and is training as a psychoanalytic psychotherapist at the Centre for Attachment-based Psychoanalytic Psychotherapy. He has particular interest in and experience of assessing and working with violent men from an attachment theory perspective. Deborah Richards is a senior forensic social worker at Broadmoor Hospital, working mainly on the female patient admission and assess­ ment unit. She is also a part-time lecturer in criminology at the Open University, and has previously worked for the Probation Service. Andrew Smith is a senior forensic social worker, employed at Broadmoor Hospital for 10 years, and specialising in work with young, male personality-disordered patients. He has previously worked as a proba­ tion officer. David James Smith has been a journalist all his working life. He writes for the Sunday Times Magazine, and is the author of The Sleep of Reason (1994), a serious journalistic account of the James Bulger case. Carl Staunton is a freelance sociologist and researcher with particular interests in the structural and social policy aspects of youth offending. He has previously worked for NACRO and in market research.

Prologue

GWYNETH BOSWELL Down the centuries, there have always existed small minorities of children, and larger minorities of adolescents, who have committed acts of violence and murder. Although significant bodies of literature about child­ hood development and childhood trauma, and about violent youth, have accumulated over the years, there has been surprisingly little attempt to research the possible associations between these phenomena. This is likely to relate to the fact that child welfare and youth justice tend to be studied and practised by different groups of academics and professionals, whose disciplines do not easily overlap, especially in public and political climates which render treatment and punishment the most uncomfortable of bedfellows. The purpose of this book, therefore, is to bring together research and thinking, from a range of standpoints, about the links that exist between childhood experiences and subsequent violence in later childhood or teenage years. Such violence may be defined as: The threat or actual use of physical force or power against another person, which has a high likelihood of resulting in death, injury or deprivation. (Lowry et al., 1995:8)

From time to time, particular cases rise to the forefront of public atten­ tion and gain long-lasting notoriety. In England these have included the 1968 conviction of 11-year-old Mary Bell for the manslaughter of two infant boys, and the 1993 conviction of two 10-year-old boys for the murder of 2-year-old James Bulger. In the USA, during 1999, a public outcry followed a multiple killing of their Colorado schoolmates by two 11-year-old boys. In the same year, in South Africa, petitions for the return of the death penalty accompanied news of the brutal gang-rape and stabbing to death of 14-year-old Valentia Farmer by a 15-year-old boy xv

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together with four adults. Phrases such as ‘born evil’, and ‘the devil incar­ nate’ become easy currency within the media and public debate which surrounds such cases. Frequently, such notions appear to pass as explana­ tion, with little attention being afforded to the fact that unsanctioned violence and murder constitute unusual behaviour for people of any age and, therefore, such behaviour poses a number of questions. In a study of child violence in South Africa, Zwane observed: The tendency now is to emphasise the lurid details of the brutal acts committed by children. Glaringly missing from the media reports are the reasons behind this type of violent behaviour. (Zwane, 2000:2)

The obvious question ‘Why do these children do it?’ seems rarely to be asked. Thus, it is this question which the contributors to this book have been invited to address. However, in order to set the scene properly, this preliminary discourse seeks to address a preceding question: ‘What is so difficult about asking this question “why”?’ The answer may, perhaps, most usefully be sought in an examination of the cultural legitimacy given to violence across the world. As the ‘global village’ becomes more accessible, so it becomes increas­ ingly apparent that violence, both physical and mental, is embedded in prevailing societal cultures. The study of history, in particular, reveals an almost universal culture of physical violence in the shape of militarism. Children and nations have been brought up to believe that battles, and wars and military heroes, conquests, invasions, sieges and campaigns, constitute ‘the history’ of a people. (Elliott, 1988:125)

Elliott further contends that this is true of both militarily powerful countries and many so-called primitive societies, though there is a debate, which he and others have developed elsewhere, surrounding the history of empire in the evolution of armed survival skills in such societies (Said, 1993; Elliott, 1995). Likewise, regimes predicated upon political oppres­ sion have both portrayed violence as a behavioural norm for children and engaged them in it. Child soldiers are the epitome of state-sanctioned violence for the young. Conversely, the apartheid regime in South Africa prompted strikes and demonstrations by schoolchildren against ‘Bantu Education’ in 1976; the response of the authorities was to shoot them. The contemporary primacy of violence is also demonstrated across the world in military/religious architecture, statues, art, music, press and television coverage of more than 300 wars since the end of World War II. It is further enshrined in the response of a range of justice systems to crimi­ nalised antisocial behaviour – i.e. torture and other forms of physical retri­

Prologue

xvii

bution, and capital punishment – all of which, in some countries, may be applied to children, despite wide ratification of the United Nations Convention on the Rights of the Child (UN General Assembly,1989). Similarly, mental and physical violence to victims of child prostitution and child labour is to be seen not only in Asia, the Far East and Central and South America, as popularly imagined, but also in parts of the ‘developed’ world – Europe, North America and Australia (Bureau of International Labor Affairs, 1996, 1998). Physical violence between family members is frequently seen as normal for many societies (Gelles and Straus, 1988). As an example, early in the new millennium, the British Government took the decision not to make the disciplining of children by physical chastisement – i.e. smacking – illegal. At national and international levels, then, it can be argued that the cultural legitimacy of violence is reinforced to successive generations of children. Within individual societies, however, attitudes towards violence may serve to inculcate, condemn or ignore it. Another increasingly familiar media image is that of the abuse of children by adults, whether this be physical, sexual, emotional or organised in nature. The second half of the twentieth century was the time when ‘the battered baby syndrome’ was discovered (Kempe et al., 1962), and when multiple child sexual abuse cases in western countries such as Canada, Belgium and the UK erupted in investigations which became known across the world. In some of these cases, professionals are criticised for interfering too much; in others they are condemned for not stepping in quickly enough, or often enough. It is clear that public feeling runs as high about state interference in family life as it does about the failure of that same state to prevent the abuse or death of a child. It is natural enough to feel strongly about childhood – a collec­ tive experience for all members of society – and perhaps when something goes badly wrong with its happy, innocent image, it is natural also to experience a collective sense of guilt. Two consequences of this discomfort can be to bury one’s head in the sand, and to project the blame elsewhere – to turn a blind eye to evidence of abuse, and to react disproportionately when a culprit is found and charged. A convenient way of dealing with the question ‘why?’ may be, thus, to pass it by altogether, or to consign any potential answer to the realms of fantasy. It is apparent, then, both that legitimised violence forms a backcloth for many children growing up in today’s world, and that individuals with power to counter it may prefer not to acknowledge its existence. This results in confusing models and messages for a young person moving through developmental stages and trying to gain a sense of identity and morality, against a complexity of interacting sociological, cultural, psycho­

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Violent Children and Adolescents

logical and other influences. Studies of violent young people in a range of countries have shown how the oppressed may evolve into the oppressor and the victim and the offender become located in one single, damaged young person (e.g.Widom, 1989b in the USA; Boswell, 1995 in the UK; Wedge, Boswell and Dissel, 2000 in South Africa). However, these are not the only processes at work in the making of violent children and adoles­ cents. Not all young people who have had difficult or violent experiences become violent themselves; not all violent youngsters are found to have had damaging childhood experiences. It is important to discover and to understand all the contributory factors and the way they interact, if the public is to be provided with reliable rather than merely salacious informa­ tion about these matters. The contributors to this volume write from a variety of academic and clinical perspectives. In so doing, they seek to further the reader’s under­ standing of the prevalence of violence in youth, of factors associated with particular types of violence, of specific kinds of influences and contexts, of evidence for links between childhood experiences and later violence, and of the ways in which this body of information might more effectively be presented to the public. Paul Cavadino and Rob Allen begin with a factual, legal and policyorientated account of the relatively small proportion of children who kill, making comparisons with other European disposal practices. David Farrington also considers prevalence, and extracts findings and implica­ tions about adolescent violence, from the important longitudinal Cambridge Study in Delinquent Development. Turning to specific kinds of violence, Kevin Epps and Clive Hollin address the psychosocial under­ standing and treatment of adolescent firesetters, and Victoria Harris and Carl Staunton consider the antecedents of young male sex offenders. Case studies can be particularly instrumental in putting flesh on the bones of interactive processes and highlighting links in a chain of events. In a compelling example, Paul Renn employs attachment theory to show how childhood trauma is linked to later violence. Illustrative case studies are also employed by Cairns Clery, who examines another specific type of violence – that which is self-directed – from a psychotherapeutic perspec­ tive, and by Deborah Richards and Andrew Smith, who describe the assess­ ment and treatment tasks in social work with violent young special hospital patients. Susan Bailey offers a quite different viewpoint in highlighting the importance of gender as a variable in her discussion of violent adolescent female offenders and associated psychiatric issues. From the perspective of contemporary social problems, the subject of violence in schools is examined in Helen Cowie’s account of research into aggressive and

Prologue

xix

bullying behaviour in youngsters; Kevin Browne and Amanda Pennell recount their research into the vexed question of the influence of film violence in encouraging violent acts among the young. Stephen Parvez Rashid looks at studies of youth and violence in four different countries, and makes a plea for an integration of research approaches so that cultural variables, for example, might routinely be considered. In the final contribution, David James Smith shows how it is possible for journalism to cover the subject of young people and violence in a serious, responsible and informative manner that enhances, rather than hinders, public understanding. Despite its title, this book cannot provide definitive answers to all the questions raised when children and adolescents commit acts of violence and murder. It can and does, however, highlight the central importance of asking the question ‘why?’ and, in so doing, makes its modest contribution to the development of a wider portfolio of research, policy and practice which will better identify the ‘risk’ and ‘protective’ factors needed to aid prevention. As Gorky, recalling ‘the abominations’ of a barbarous Russian child­ hood concluded: Our life is amazing, not only for the vigorous scum of bestiality with which it is overgrown, but also for the bright and wholesome creative forces triumphantly forcing their way through it. (Gorky, 1961:303)

To the extent that this volume succeeds in disentangling root and branch, it aspires to render more accurate the professional task of assess­ ment and intervention in this complex arena, which spans the treatment–punishment continuum from child welfare to youth justice.

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CHAPTER 1

Children who Kill: Trends, Reasons and Procedures

PAUL CAVADINO AND ROB ALLEN This chapter examines the statistics on the number of children and young persons found guilty of murder and manslaughter in England and Wales over the last 20 years; summarises the available evidence on why children kill; describes the way in which this country deals with children who commit homicide; analyses the figures on sentencing, length of time in custody, rate of recall and reconviction; and compares this approach with that of other European countries.

How many children kill? Table 1.1 shows the number of children and young persons who were convicted of murder or manslaughter in England and Wales in the period from 1979 to 1998. In total, 180 young people aged 10–16 inclusive were found guilty of murder and 124 of manslaughter during this period. Of young people aged 10–17, 291 were convicted of murder and 264 of manslaughter. Children under the age of 14 – who, understandably, receive most media attention – totalled 8 convicted of murder and 6 of manslaughter. The figures show no consistent trend, fluctuating up and down from year to year. The average annual number of people under 18 found guilty of homicide (murder or manslaughter) in the first 5-year period covered by the statistics, 1979–83, was 31; whereas in the most recent 5-year period, 1994–98, the average number was 28. For those under 17, the annual average was 15 in 1979–83 and 21 in 1994–98. Homicides by those under 14 totalled 3 in 1979–83 and 4 in 1994–98. 1

2

Violent Children and Adolescents

Table 1.1: Children convicted of murder or manslaughter 1979–98

1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998

10–13

Murder 10–16

10–17

10–13

– – – 1 1 – – 1 – 1 – – – – 2 2 – – – –

6 5 5 15 6 5 6 6 4 3 5 8 7 4 13 10 10 26 26 10

20 16 11 22 11 13 12 8 14 7 11 11 13 11 23 16 10 26 26 10

1 – – – – – – – – – – 1 – 1 1 – – 1 – 1

Manslaughter 10–17 10–16 7 5 9 7 8 6 7 8 11 6 9 2 8 5 5 3 6 5 3 7

19 10 16 9 19 14 12 15 18 13 23 9 15 8 12 8 7 8 10 19

Source: Home Office and Statistics Directorate

Although the figures for those under 17 have therefore increased, this is not true of the total for those under 18. This contrasts with the position in the USA where the number of young people under 18 arrested for homicide rose from an annual average of 1325 in 1984–88 to 2779 in 1993–96 (Heide, 1999). There are other offences by children which have fatal consequences. The number of those under 18 found guilty of causing death by dangerous or reckless driving has risen steadily during the 1990s, although the absolute numbers are very small (Table 1.2). In addition, the 1990s have seen two cases of infanticide by juveniles.

The context of juvenile violence The broadly stable pattern in homicide by children is perhaps surprising given the overall rise in the rate of juvenile violence. A recent study of trends in juvenile violence in European countries found that in 1984 approximately 360 of every 100 000 youths aged 14–16 were cautioned or

Children who Kill: Trends, Reasons and Procedures

3

Table 1.2: Juveniles found guilty of causing death by dangerous driving, reckless driving or aggravated vehicle taking 1990–97 1990 1991 1992 1993 1994 1995 1996 1997

4 3 6 7 7 9 10 14

Source: Home Office and Statistics Directorate

convicted by the police for violent offences in England and Wales. In 1994 the figure had climbed to about 580 per 100 000. The rate fell slightly in the following 2 years, but rose again in 1997. The study found sharp increases in the rate of juvenile violence over this period in every country studied, with the rate more than doubling in Germany. It found that the increase in violent crime was not simply part of an overall trend in crime rates; rates for adults stayed stable or increased only moderately during the period. In general, the victims of violent crimes committed by juveniles were other juveniles. Victimisation rates for teenagers and young adults climbed substantially during this period, with particularly high rises in the Netherlands and Germany (Pfeiffer, 1998). Violent crimes cover an enormous multitude of sins, from playground jostles through to murder. Some indication of the level of seriousness can be inferred from the response that is made. In England and Wales in 1997, 87% of males under 14 and 55% of males aged 14–18 known to have committed offences of violence against the person were cautioned rather than convicted. The cautioning rate for girls was even higher. In absolute numbers, more than 7000 boys and almost 2500 girls were cautioned for a violent offence in 1997. Although the majority of these cautions were undoubtedly for minor offences, a surprisingly high proportion of serious violent crime appears to be dealt with by way of a police caution. In 1997, 9% of offenders of all ages cautioned for or convicted of what the Home Office describes as more serious violent crimes were cautioned. For the offence of threat or conspiracy to murder, for example, the proportion was almost 1 in 5. It is difficult to know why so many apparently serious crimes were diverted from criminal proceedings, but, in some cases, the evidence might not have been strong enough to produce a conviction. As far as murder and manslaughter are concerned, we have seen that the relatively small numbers have fluctuated without any consistent trend.

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Violent Children and Adolescents

Yet the figures for those under 18 convicted for a range of the more serious violent offences (attempted murder, threat or conspiracy to murder, wounding or other acts endangering life) do suggest an upward trend during the 1990s. The number of offenders under 18 convicted of wounding or other acts endangering life rose substantially between 1993 and 1997 (Table 1.3). The rise reflects a broader increase in the numbers found guilty of violent offences in the Crown Court. For example, 16 offenders under 14 were convicted of such offences during the 1980s compared with 37 in the years 1990–97. Table 1.3: Juveniles convicted of wounding or other acts endangering life 1993 1994 1995 1996 1997

150 160 173 224 221

Source: Home Office and Statistics Directorate

These figures may in part be explained by changes in processing. It is sometimes argued that society’s increasing intolerance of violence by young people results in more extensive use of the criminal justice system to respond to behaviour which might previously have been dealt with informally. Once in the system, a harsher climate ensures that offenders are charged at a higher level, prosecuted rather than cautioned, committed to Crown Court rather than dealt with by magistrates, and sent to custody rather than kept in the community. A true picture of the extent and nature of violence among young people can really only be obtained from self-report studies. Graham and Bowling (1995) found that 28% of males aged 14–25 and 10% of females admitted committing an act of violence against the person, whereas 9% and 4% respectively admitted so during 1992. The British Crime Survey (Home Office, 1995) found that a third of 12–15-year-olds claimed to have been assaulted in the previous 6 months. Comparative self-report data is not currently available to suggest any trend in the overall level of violence among young people. The fact that rates of homicide by young people have remained relatively immune from broader trends in serious and violent crime offers support to the inference made in a recent literature review that killings by children or adolescents may be more likely to reflect serious personal psychopathology than is the case with most other serious crimes by young people (Rutter, Giller and Hagell, 1998).

Children who Kill: Trends, Reasons and Procedures

5

Why do children kill? There are many different reasons why children kill. Contributory factors which produce the types of disturbance which can lead children to kill include: • • • • • • • • • • • •

serious physical abuse sexual abuse emotional abuse or neglect exposure to repetitive or extreme violence (including witnessing such violence) parental mental illness parental abandonment rejection by parents and others traumatic loss neurological abnormalities conduct disorder substance abuse in a few cases, mental illness.

The combination of factors is different in each individual case. Abuse, rejection and traumatic loss can provoke deep feelings of shame and anger. As Dr James Garbarino puts it: Violent boys are plagued by issues of humiliation and shame. Be they poor, minority, abused children from inner-city war zones or alienated middle-class majority kids from ‘normal’ families, they share these issues . . . These boys are ashamed of who they are inside, and their efforts to compensate for that shame drive that violence. (Garbarino, 1999:228)

Although homicides by children are relatively rare, the conditions listed above unhappily are not – which suggests that a substantial number of other children may be capable of killing. The combination of factors of the type listed above with other circumstances, such as the meeting and friendship of two young people with complementary disturbed personalities, and in adolescence the escalation of behaviour through gang participation, can lead to killings by such children which would not otherwise have taken place. The evidence points to multiple causation and the interaction of causal factors. In a comprehensive review of American research and findings from her own evaluation of 90 adolescents involved in murder, Dr Kathleen Heide writes that ‘many factors often interact when children kill’ and sets out a list of ‘ingredients for juvenile murder’ in the 1990s. These

6

Violent Children and Adolescents

include child abuse, child neglect, absence of positive male role models, witnessing violence, access to guns, involvement in alcohol or drugs, poverty, low self-esteem, inability to deal with strong negative emotions, boredom, prejudice and hatred, and biological factors (Heide, 1999:6). In her books The Case of Mary Bell and Cries Unheard, Gitta Sereny (1974, 1998) analysed one of the two killings by children which have aroused the greatest attention and debate in the course of the last 30 years – the case of Mary Bell who, in 1968 when aged 11, was found guilty of having at the age of 10 killed two small boys, one aged 4 and the other 3. The books describe in detail the bizarre upbringing of a child who was ‘emotionally abused for years by a seriously disturbed mother’ (Sereny, 1995:254). This was a mother who immediately after the birth cried, ‘Take that thing away from me’ and jerked her body away when the new-born Mary was put into her arms; who repeatedly tried to hand her over to relatives, and twice to strangers; who beat and whipped her; who tried to kill her four times; and who, as part of her activities as a sado-masochistic prostitute, subjected Mary from the age of 4 upwards to severe sexual abuse from adult men. Following medical evidence that Mary Bell was suffering from psychopathic disorder, she was found guilty of manslaughter by reason of diminished responsibility. The trial judge, who wished to make a hospital order, was unable to do so because no suitable hospital place was available, and therefore sentenced her to detention for life. Released from detention in 1980 at the age of 23, she is now living under a different name with a teenage daughter. The reprinted edition of The Case of Mary Bell (Sereny, 1995) contained an appendix about the second of this country’s two most publi­ cised cases involving child killers – the murder of 2-year-old James Bulger in 1993 by two 10-year-old boys, Jonathan Venables and Robert Thompson. This describes Robert Thompson’s abandonment, together with his five brothers, by his father; his mother’s subsequent problems of deep depression and drink; the bullying and physical ill-treatment of Robert by his older brothers; and his ill-treatment in turn of his younger brother. It also discusses Jonathan Venables’ early years spent in an ‘atmosphere of tremendous maternal tension’ and his repeated manifesta­ tions of seriously disturbed behaviour as a schoolchild. Finally, she considers the implications of the sexual element of the crime, observing that ‘children who abuse other children have almost invariably been abused themselves’. A study by Dr Gwyneth Boswell entitled Violent Victims examined 200 cases of offenders sentenced as juveniles under section 53 of the Children and Young Persons Act 1933 (Boswell, 1995). Of the total sample, 100 had been sentenced for murder under section 53(1) of the Act and 100 for a

Children who Kill: Trends, Reasons and Procedures

7

range of serious crimes, including manslaughter, under section 53(2). The study found that 72% had experienced emotional, sexual, physical and/or organised abuse as children. This is undoubtedly an underestimate because other cases, where suggestions of abuse were recorded in the files without professional corroboration, were not included in the figures unless there was direct evidence of abuse from an interview with the offender. Fifty-seven per cent of the sample had experienced the loss of a signifi­ cant figure to whom they were emotionally attached, via bereavement or cessation of contact, which was estimated by professionals or by the offenders themselves to have had a distinct impact upon them and their subsequent behaviour. Dr Boswell observed that such loss ‘constitutes a major source of childhood trauma which, depending on how it is handled, may later contribute to disordered behaviour, including aggression and violence’ (Boswell, 1995:21). In 91% of cases there was a recorded or personally related evidence of abuse and/or loss, with 35% experiencing both. Dr Boswell commented: The findings in this report reveal that a high proportion of young people who have committed violent or murderous offences have themselves been the victims of childhood trauma in the form of abuse and/or loss and frequently both. This does not mean, of course, that all youthful victims of trauma will become violent or murderous offenders. That is liable to depend on a whole variety of other variables . . . Self-evidently, however, many members of the current survey had not been effectively helped to think through, interpret or resolve the traumatic event(s), which had occurred in their earlier lives. Whilst this may move the debate one step nearer to potential cause it is probably of most help in considering the kind of work that still needs to be effected with these young offenders. The growing body of work on post-traumatic stress disorder confirms that children suffer the after-effects of traumatic stress in a similar way to adults, and that one way in which unresolved fear or grief can manifest itself, particularly in males, is in later aggressive or violent behaviour. (Boswell, 1995:30)

She recommended that when the cases of children and young persons who commit violent offences come to light, there should be a consistent system of professional assessment with investigations routinely made into abuse and loss experiences amongst other background factors. Such an assessment should aim to offer . . . an appropriate programme of action which will specifically seek to ensure that the young person does not repeat their violent behaviour. In cases where unresolved childhood trauma is found, post-traumatic stress counselling should form a significant part of that programme. (Boswell, 1995:36)

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Violent Children and Adolescents

Or, as Gitta Sereny puts it: How can any individual – whether child or adult – who has been subjected to traumatic events which have affected his development and behaviour, be expected to come to terms with them, with his fears, with his actions and with himself unless he be permitted and helped to face up to these memories? (Sereny, 1995:330)

Childhood trauma leads to violent behaviour not only in childhood and adolescence, but also in adult life. In a report prepared for the Reed Committee, Dr Robert Johnson, then consultant psychiatrist at Parkhurst Prison, described the ‘buried terror syndrome’ induced by child abuse in the context of his work with seriously violent adult prisoners. The terror experienced by these men had become deeply buried for fear that bringing it back to the surface would lead to its re-enactment. Any likeli­ hood of this happening would precipitate an extreme and possibly violent reaction. The psychiatrist’s job was to identify the terror and show that it was now obsolete, a process which could ultimately lead to recovery from violent behaviour. However, many of these men had spent decades in institutions without the questions being asked which could lead them to an understanding of the roots of their violence (Johnson, 1993). In a letter published in the Guardian on 22 February 1993, Dr Johnson wrote: Last week I was asked to evaluate a violent prisoner who was becoming increas­ ingly bitter and aggressive. ‘Were you happy as a child?’ is my standard question. ‘No,’ he replied, ‘my father tried to kill me.’ At the age of three, his father suspended him from a 200 ft bridge by a rope round his ankles to within a few feet of the water below. His mother pulled him back up. If human beings, especially in infancy, were made of wood, then we could expect them to absorb such incidents as a matter of course, and proceed through all this best-of-all-possible worlds like the rest of us virtuous souls. Since all children are highly impressionable, how can we possibly avoid some savage social penalty in later life? This man was serving a life sentence for a violent crime, and believed he would commit more. Unless the childhood damage can be addressed and repaired, how can we expect civilised friendly behaviour from such aggrieved individuals? Without exception, all long-term violent prisoners who have agreed to discuss such painful topics with me have confirmed a history of sickening child abuse. Many have also averred that they would have benefited from skilled caring intervention at a much earlier age. In a civilised society, reparative measures such as these would be explored and implemented as a matter of urgency, if only to allow us all to sleep more soundly at night.

Children who Kill: Trends, Reasons and Procedures

9

Over time young people who have killed can be helped to face their unresolved trauma, develop and mature emotionally, reach an appro­ priate sense of guilt, and learn to control their emotional and aggressive impulses (Bailey, 1998).

How do we deal with children who kill? The age of criminal responsibility in the British Isles is unusually low by European standards: in England and Wales it is 10 years. Children accused of murder or manslaughter are tried and sentenced by the Crown Court. During the trial of the children who killed James Bulger (two boys aged 10 at the time of the killing and aged 11 when tried), most foreign commentators were amazed that children of this age should be dealt with by an adult-style Crown Court criminal trial. Many observers questioned whether such young children were really able to comprehend the complexities of a lengthy criminal prosecution and trial; whether they should have appeared in the full glare of media coverage of Crown Court proceedings; whether they understood all the issues and language used, in order to give as clear instructions as necessary; whether their decision not to give evidence arose from fear of speaking in such a public forum; and whether it was right to lift reporting restrictions after conviction, thereby allowing their names and photographs to be widely publicised with the difficulties which this would pose for their eventual rehabilitation. As the report of the Justice working party on ‘Children and Homicide’ commented: Crown Court procedures expose children to a public hearing, as opposed to the private hearing conducted in youth courts. If cases are particularly notorious, the media may be present in large numbers . . . Language and proce­ dures are complex and likely to be perceived as threatening, and the partici­ pants wear strange ceremonial costumes. These surroundings may engender a fear of giving evidence, which is an experience even adults may find traumatic, and must contribute to the difficulty of understanding procedures which baffle many adults. (Justice, 1996:12)

The working party identified a further unsatisfactory feature of the process as follows: Dealing with juvenile homicide in adult courts, where cases may take many months to come to trial, inevitably means substantial delays in providing the psychological help required by many of the young people; effective therapy can only begin after the verdict because of the need to preserve the integrity of the

10

Violent Children and Adolescents evidence, and the fear that treatment may affect it . . . Neither the interests of the victim, the public, nor the defendant are well served by protracted delays. It is unacceptable for the family of the victim to have to wait up to a year or more for a hearing, which is a critical point in their process of bereavement. By the same token for a child who may be in desperate need of therapeutic help to be unable to receive it, for fear of compromising the legal process, is equally unacceptable. (Justice, 1996:17)

This last point was a notable feature in the Bulger case, which took 9 months to come to trial, during which time the defendants received no treatment in case it prejudiced their pleas. When a child or young person aged under 18 is found guilty of murder, the mandatory sentence under section 53(1) Children and Young Persons Act 1933 is detention during Her Majesty’s pleasure – the juvenile equivalent of the mandatory life sentence. As in the case of adult life sentences, a minimum term known as a ‘tariff ’ is set which the offender must serve to meet the requirements of retribution and deter­ rence. The trial judge makes a recommendation to the Home Secretary on the appropriate length of the tariff period. The Lord Chief Justice also makes a recommendation: in the absence of any mechanism for appeal against the tariff, this is intended to help provide a check against inconsis­ tencies between different judges. However, the Home Secretary has not hitherto had to accept either of these judicial recommendations. In the Bulger case, for example, the trial judge recommended an 8 year tariff period; the Lord Chief Justice recommended 10 years; but the then Home Secretary, Michael Howard, fixed the tariff at 15 years, stating that he had taken account of ‘the judicial recommendations as well as all the other relevant factors including the circumstances of the case, public concern about the case and the need to maintain public confidence in the criminal justice system’. Of the 217 young offenders convicted before their 18th birthday who were serving sentences for murder in 1995, 84% had tariffs of more than 10 years and 20% of more than 15 years. At the end of the tariff period, the Parole Board considers the case and makes a decision on whether the offender will be released on licence. If the Board decides not to release the offender at this point, subsequent further reviews take place at regular intervals. The average time actually served by young offenders detained at Her Majesty’s Pleasure (HMPs) has increased substantially in recent years. Although there are some year by year fluctuations, the underlying trend since 1981 is towards much longer periods in custody. The 40 HMPs released from prison in the years 1981–86 had on average served 8.6 years in custody. The 75 HMPs released in the years 1993–98 had served an

Children who Kill: Trends, Reasons and Procedures

11

average of 13.6 years. This 58% increase in average time spent by juveniles convicted of murder is much greater than the increase in time served by sentenced prisoners as a whole, which went up by 35% during the period. As these are mean figures, it is likely that some young people will have served considerably longer periods in detention, returning to the commu­ nity well into their thirties. The 15-year tariff set by Michael Howard in the Bulger case was challenged by legal action, the result of which has brought about signifi­ cant modifications to the operation of the tariff system. In June 1997 in R v Secretary of State for the Home Department, ex parte Venables and Thompson (3 Weekly Law Reports 23, 1997), the House of Lords held that it was unlawful to apply an inflexible tariff which could not be varied by reason of the progress and development of a child detained during Her Majesty’s pleasure. The House of Lords also held that in fixing the tariff the Home Secretary was exercising a power equivalent to a judge’s sentencing power and that he should not have taken into account public petitions and letters urging that the two boys should never be released. The tariff set by Mr Howard was accordingly quashed. As a result of this judgment, the Home Secretary is now required to review the tariff regularly, so that it can be reduced if appropriate in the light of the offender’s personal development. Progress reports by staff are now considered annually by Home Office officials so that exceptional progress, which might justify a reduction in the tariff, can be brought to Ministers’ attention. Half way through the tariff period, the Home Secretary or another Home Office Minister now examines progress reports to determine whether the original tariff is still appropriate. Even after these modifications, most practitioners in both the criminal justice system and the childcare system continued to regard these proce­ dures with grave disquiet. The feature of the process which was widely regarded as the most objectionable was the role of the Home Secretary in setting the tariff. Setting the tariff is a sentencing decision – yet it was taken not by the trial judge who has heard all the evidence, but by a politician in his or her office with no hearing, no right for the defendant to be present or represented, and no right of appeal. This procedure contravened the basic requirements of natural justice. When politicians make these decisions, there is a danger that they will be influenced by electoral considerations and the prospect of headlines in the tabloid media rather than the merits of the case. This is disturbing enough in adult cases. In the case of children and young persons – where justice demands that the process should take into account their capacity for change, as well as their degree of psychological disturbance – it is indefensible.

12

Violent Children and Adolescents

When a child or young person is found guilty of manslaughter, as opposed to murder, the judge has discretion as to sentence. He or she can impose a sentence of long-term detention under section 53(2) of the Children and Young Persons Act 1933: this can either be detention for an indefinite period or for a fixed term. Alternatively, the judge can pass any of the other sentences available for children and young persons, including non-custodial sentences. Of the 129 juveniles convicted of manslaughter between 1982 and 1997, 97 were sentenced to a long term of detention under section 53. A further 12 received shorter custodial sentences and another 7 care or hospital orders. The remaining 12 received community penalties (11 supervision orders, 1 probation order) and a conditional discharge. Those under 18 convicted of other fatal offences in the 1990s received an even wider range of sentences. Of the 60 convicted of causing death by reckless or dangerous driving or aggravated vehicle taking, more than 70% were sentenced to custody – 27 to detention in a young offender institu­ tion and 16 under section 53. The others received community sentences (11 supervision orders, 2 community service orders and 1 attendance centre order) or, in 2 cases, a conditional discharge. The 2 girls convicted of infanticide received a supervision order and a probation order. Young people detained under section 53(1) or 53(2) may be held in such place and under such conditions as the Home Secretary may decide. Those under the age of 15 are held in local authority childcare units (usually a secure unit) or in the Department of Health youth treatment unit at Glenthorne, Birmingham. Between the ages of 15 and 17 inclusive, young people can be held either in childcare accommodation or in a Prison Service young offender institution. Until 1995 those aged under 161/2 were placed in childcare establishments, but since 1995, there has been greater use of Prison Service establishments for those aged 15 or over. In November 1998 in R v Secretary of State for the Home Department ex-parte J and B (Times Law Reports, 2/12/98), the Court of Appeal upheld the lawfulness of the Home Secretary’s current policy of placing young offenders sentenced under section 53 in young offender institutions rather than childcare establishments, save in exceptional circumstances. Between the ages of 18 and 20 inclusive, offenders are invariably held in Prison Service young offender institutions and, at the age of 21, are trans­ ferred to an adult prison. Dr Gwyneth Boswell commented in her study: The child care system’s facilities are such that they provide the best likelihood of treatment and educational facilities the young person is likely to receive throughout their section 53 career. Staff assert that this often brings the offender to an optimum point for safe release or would do so given the

Children who Kill: Trends, Reasons and Procedures

13

continuity of another year or two in the same setting. However, at the age of 18 years, young people are suddenly effectively re-criminalised by their transfer to the prison system.(Boswell, 1995:117)

Reconviction rates How well do children who kill fare after they have been released from custody? During the period from 1972 to 1993, 1575 people were released from prison on life licence. Of these, 113 were under 18 when they received their life sentence. In 92 of these 113 cases the sentence followed conviction for homicide (71 murder, 21 manslaughter). By the end of 1993, 27 of the 113 had been convicted of a standard list offence; 5 of these convictions were for a grave offence, and 20 of the 113 had been recalled or given a further life sentence. Analysis of the rate of reconviction of life sentence prisoners under 18 when convicted shows about 7% reconvicted within 2 years of release and 22% reconvicted within 5 years. Compared with life sentence prisoners as a whole, reconvictions for those under 18 at sentence appear slightly lower, certainly within the 2-year period where the overall reconviction rate was 10%. More recent data on reconvictions within 2 years of discharge up to the end of 1995 show that only 6% of those under the age of 25 when released were reconvicted, compared with 9% of the total group. Compared with offenders convicted of other offences, these rates are very low: 56% of all sentenced prisoners discharged in 1994 were reconvicted of a standard list offence within 2 years. For imprisoned male young offenders (under 21 at sentence) the rate was 75% and for female young offenders 63%. What are the factors that are likely to affect the reconviction of children who kill? • The first factor is likely to be the number of previous convictions prior to the conviction for homicide. Of life licensees released between 1972 and 1994, only 4% of those with no previous convictions were recon­ victed compared with 10% of those with previous convictions. • The second is the nature of the offence and the relationship between offender and victim. In homicide cases as a whole, the victim is known to the offender in almost two-thirds of cases. Where the offender is under 18, the figure is close to half. In this age group, where there is a relationship, it tends to be less a family one and more in the nature of friendship or acquaintance. • Third, there is a question of the help which an offender receives in addressing his or her difficulties. We know from a Home Office study of

14

Violent Children and Adolescents

juveniles sentenced for grave crimes (including manslaughter) that childcare units deliver far superior regimes to prison service young offender institutions, albeit at much greater cost. The study found that local authority secure units provided significantly more and better quality education; gave more help and advice with detainees’ problems; equipped young people with more qualifications, training and work experience; and had lower reconviction rates (Ditchfield and Catan, 1992). These findings reinforce the case for concern at the shift towards a greater use of prison service establishments for young people sentenced under section 53. The government and Youth Justice Board are committed to raising standards across the secure estate, and it is important to ensure that the special needs of those children who commit the gravest crimes are given the attention they deserve.

Current European Court proceedings In a ruling published in March 1999 in T and V v the UK, the European Commission of Human Rights agreed to refer the case of the two boys who killed James Bulger to the European Court of Human Rights. The Commission considered that the trial procedures adopted prevented the boys from participating effectively in their trial in violation of Article 6 of the European Convention on Human Rights, which states: In determination of his civil rights and obligations and any criminal charge against him, everyone is entitled to a fair and public hearing within a reasonable time by an independent and impartial tribunal established by law.

The Commission considered that: The public trial process in an adult court with attendant publicity must be regarded in the case of an eleven-year-old child as a severely intimidating proce­ dure. The way in which the trial placed the applicant, in a raised dock, as the focus of intense public attention over a period of three weeks, must have seriously impinged on his ability to participate in the proceedings in any meaningful manner. The Commission finds it significant that neither of the children in the proceedings gave evidence. On the basis of the material before it, the Commission is satisfied that their psychological state was such that they could not realistically have been expected to do so in a public, highly charged courtroom. In these circumstances, the primary purposes of the proceedings, the establishment of the facts of the case and the allocation of responsibility, were impaired . . . It can never be required, whatever the form of procedure, that an accused give evidence. However, where the alleged offender is a child, the procedures adopted must be conducive to an active participation, as opposed to passive presence. Otherwise the trial risks presenting the appear­ ance of an exercise in the vindication of public outrage.

Children who Kill: Trends, Reasons and Procedures

15

The Commission held that the fixing of the tariff ‘must be regarded as part of the sentencing procedure’ and that the Home Secretary’s involve­ ment was a violation of Article 6 of the European Convention because he was not ‘an independent and impartial tribunal’. It also found that there had been a violation of the appellants’ right to a review of the lawfulness of their imprisonment under section 5(4) of the Convention, which states: Everyone who is deprived of his liberty by arrest or detention should be entitled to take proceedings by which the lawfulness of his detention should be decided speedily by a court and his release ordered if the detention is not lawful.

Although judicial review proceedings had enabled the applicant to obtain a review of the lawfulness of the procedure adopted for fixing the tariff, the Commission observed that this ‘did not entail any consideration of whether or not the applicant should be released, in respect of which the courts had no effective decision-making power’. The applicant had been detained for 5 years, and the Commission concluded: Five years for an applicant sentenced at age eleven must be regarded as a long period of time. The Commission finds that the failure to provide him with the opportunity for a review of his detention during that period, and the lack of any current opportunity to apply for such a review, is incompatible with the requirements of Article 5 para. 4, as applicable to offenders sentenced at a very young age.

The case was subsequently considered by the European Court of Human Rights. In a judgment published in December 1999, the Court held that the trial procedures had denied the two boys a fair hearing in breach of Article 6(1) of the European Convention; that the lack of an opportunity since the boys’ detention in 1993 to have the lawfulness of their detention assessed by a judicial body breached Article 5(4) of the Convention; and that as the Home Secretary was not independent of the executive, his setting the tariff (which ‘amounted to a sentencing decision’) was in breach of Article 6(1). In February 2000 the Lord Chief Justice, Lord Bingham of Cornhill, issued a Practice Direction concerning the trials of children and young persons in the Crown Court, requiring trial procedures in such cases to be adapted to address the matters raised in the European Court judgment. In March 2000 the Home Secretary, Jack Straw, announced that the new Criminal Justice and Court Services Bill would provide for tariffs to be set in future by the trial judge, and that existing tariffs which had not yet expired would be re-set in line with the recommendation of the Lord Chief Justice where this was lower than the existing tariff.

16

Violent Children and Adolescents

Comparison with other European countries In most European countries, children aged under 14 who commit offences do not appear before the criminal courts. They are dealt with in civil proceedings by family courts (usually sitting in private) which are concerned with the need for compulsory measures of care. These can include long-term detention in secure accommodation, but this is arranged under a care order rather than as a custodial punishment imposed in criminal proceedings. Table 1.4 lists the ages of criminal responsibility in Council of Europe countries; it is clear that the age of criminal responsibility in England and Wales is unusually low. There has been a trend internationally towards raising the age of criminal responsibility in recent years – for example, from 14 to 15 in Norway, from 7 to 12 in Canada and from 9 to 13 in Israel. In a report of February 1995, the United Nations Committee on the Rights of the Child recommended that ‘serious consideration be given to raising the age of criminal responsibility throughout the areas of the UK’. Gitta Sereny reflects as follows on the 1993 trial in the Bulger case: For me, sitting through an almost exact replica of the 1968 trial, much of it had a distressing quality of déjà vu. And during the breaks and the sixteen evenings of the trial days, I found, yet again, that every lawyer, every court official, virtually Table 1.4: Age of criminal responsibility in Council of Europe countries Andorra Austria Belgium Bulgaria Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Italy Latvia Liechtenstein

16 14 18 14 7 15 15 15 15 13 14 12 14 15 7 14 14 7

Lithuania Luxembourg Malta Netherlands Norway Poland Portugal Romania San Marino Slovakia Slovenia Spain Sweden Switzerland Turkey England/Wales Scotland Northern Ireland

Source: House of Lords Hansard, 13 July 1999, Col WA14.

14 18 9 12 15 16 16 14 12 15 14 16 15 7 12 10 8 8

Children who Kill: Trends, Reasons and Procedures

17

every police officer and every member of the media I spoke with had grave misgivings about the case and, yes, the venue of the trial. (Sereny, 1995: ix)

The system of sentencing in England and Wales is also strikingly different from the rest of Europe. According to the Justice working party report (1996), outside the British Isles only two European countries, France and the Netherlands, have indeterminate sentences for convicted juveniles. No other European country has indeterminate sentences which are not judicially supervised. In France and the Netherlands such sentences are reviewed either annually or biennially by the judiciary – where possible by the judge who heard the case and passed sentence – who can order the young person’s conditional release.

Conclusion Even a brief examination of the way in which other nations of Europe deal with children who kill shows that the system in England and Wales is an anachronism. It fails to meet the needs of disturbed juveniles; it fails to meet the requirements of natural justice; and it fails society by placing obstacles in the way of ensuring that these children receive the treatment they need if they are to overcome the violent tendencies which led to their offences. Other European commentators do not consider that their systems are without blemish (Cavadino, 1996). However, the procedures in this country are invariably seen by our European counterparts as aston­ ishingly extreme. As highlighted in a recent review of international research evidence: . . . the children who kill tend to come from very disturbed (often abusive) family backgrounds and also show a wide range of personal problems. Accordingly, in the great majority of cases, it would seem appropriate to consider the homicide as the result of personal psychopathology and serious psychological adversities rather than simply as acts of serious wrongdoing or the consequences of innate evil. At present, that consideration is very poorly represented in the ways in which child killers are dealt with by the British judicial system. (Rutter, Giller and Hagell, 1998)

In the light of these considerations, it is suggested that the system for dealing with young people who commit homicide in England and Wales should be replaced by an approach which is geared to the needs of seriously disturbed children. The age of criminal responsibility should be raised to at least 14; below this age, children who kill should be dealt with by the family proceedings court as children in need of compulsory measures of care. (If, however, criminal trials are retained for children

18

Violent Children and Adolescents

aged 10–13, they should take the form of a tribunal sitting in private and presided over by a judge specially trained in dealing with children. Following a finding of guilt, no criminal penalties should be available. Instead, the case should be remitted to the family proceedings court for a decision on disposal.) When young people are over the age of criminal responsibility, there should be early pleas and accelerated hearings with a view to the early initiation of treatment and therapy. Hearings should be held in private and presided over by a specially trained judge. There should be no mandatory sentences, and courts should have discretion to sentence according to the circumstances of the individual case. When an indeterminate sentence is passed, release decisions should be made by a judicial body, which should regularly review the progress of the case. Its decisions should be based on the progress of the treatment programme, the young person’s develop­ ment and whether he or she is now safe to release. Such an approach would be more just, more humane, and would better serve the needs of society than our present system, which is so markedly out of line with the rest of Europe.

CHAPTER 2

Adolescent Violence: Findings and Implications from the Cambridge Study DAVID P FARRINGTON The main aim of this chapter is to review the childhood predictors of adolescent violence, especially those discovered in the Cambridge Study in Delinquent Development. The Cambridge Study is a prospective longi­ tudinal survey of 411 south London males from age 8 to age 40. In addition, implications of these results for the prevention of adolescent violence will be discussed. The main methods of measuring adolescent violence use official records (e.g. of convictions) or self-reports. The advantage of self-reports is that they reveal many more offences than official records which, to some extent, show only the tip of the iceberg of offending. Also, official records may be limited by biases in police or court processing. Self-reports, however, may be distorted by concealment, exaggeration or forgetting, and the worst offenders may be missing from surveyed samples. Since official records and self-reports have somewhat different strengths and weaknesses, it is important to establish which results are replicated in both methods. If a childhood risk factor predicts both self-reported and official violence, that risk factor is probably related to violent behaviour rather than to any biases in measurement. The validity of self-reports is demonstrated by the fact that they predict later convictions for violence among currently unconvicted people. In the Cambridge Study, 10% of those who admitted assault up to age 18 were convicted of assault between ages 19 and 32, compared with only 5% of the remainder (Farrington, 1989b). The comparison between self-reports and official records gives some indication of the probability of an offender being caught and convicted. In the Cambridge Study, 45% of boys admitted starting a fight or using a weapon in a fight between ages 15 and 18, but only 3% were convicted of assault between these ages. Therefore, only 7% of self-reported violent offenders between ages 15 and 18 were convicted of violence. 19

20

Violent Children and Adolescents

Prospective longitudinal surveys are needed to investigate the child­ hood predictors of adolescent violence. The best of these surveys follow up large community samples of several hundreds, include interview as well as record data, and span a follow-up period of at least 5 years. Farrington (1998) and Hawkins et al. (1998) have provided extensive liter­ ature reviews of longitudinal surveys of youth violence and of results obtained in them. These surveys have been carried out in many different countries, including the UK (e.g. Wadsworth, 1979), the USA (e.g. Loeber et al., 1998), Canada (e.g. LeBlanc and Frechette, 1989), Sweden (e.g. Stattin and Magnusson, 1991), Finland (e.g. Pulkkinen and Pitkanen, 1993), Denmark (e.g. Hogh and Wolf, 1983), and New Zealand (e.g. Henry et al., 1996). The most important risk factors are similar in different countries (e.g. Farrington and Loeber, 1999).

The Cambridge Study Design of the survey The Cambridge Study in Delinquent Development is a prospective longi­ tudinal survey of the development of offending and antisocial behaviour in 411 males. At the time they were first contacted in 1961–62, these males were all living in a working-class inner-city area of south London. The sample was chosen by taking all the boys who were then aged 8–9 and on the registers of 6 state primary schools within a 1-mile radius of a research office that had been established. Hence, the most common year of birth of these males was 1953. In nearly all cases (94%), their family breadwinner at that time (usually the father) had a working-class occupation (skilled, semi-skilled or unskilled manual worker). Most of the males were white (97%) and of British origin. The study was originally directed by Donald J. West, and it has been directed since 1982 by David P. Farrington, who has worked on it since 1969. It has been funded mainly by the Home Office. The major results can be found in four books (West, 1969, 1982; West and Farrington, 1973, 1977) and in summary papers by Farrington and West (1990) and Farrington (1995). These publications should be consulted for more details about the childhood predictor variables discussed here. A major aim in this survey was to measure as many factors as possible that were alleged to be causes or correlates of offending. The males were interviewed and tested in their schools when they were aged about 8, 10, and 14, by male and female psychologists. They were interviewed in a research office at about 16, 18 and 21, and in their homes at about 25 and 32, by young male social science graduates. At all ages except 21 and 25, the aim was to interview the whole sample, and it was always possible to trace and interview a high proportion: 389 out of 410 still alive at age 18

Adolescent Violence: Findings and Implications from the Cambridge Study 21

(95%) and 378 out of 403 still alive at age 32 (94%), for example. The tests in schools measured individual characteristics such as intelligence, attain­ ment, personality and psychomotor impulsivity, whereas information was collected in the interviews about such topics as living circumstances, employment histories, relationships with females, leisure activities such as drinking and fighting, and offending behaviour. In addition to interviews and tests with the male respondents, inter­ views with their parents were carried out by female social workers who visited their homes. These took place about once a year from when the boy was about 8 until he was aged 14–15 and was in his last year of compulsory education. The primary informant was the mother, although many fathers were also seen. The parents provided details about such matters as family income, family size, their employment histories, their child-rearing practices (including attitudes, discipline and parental dishar­ mony), their degree of supervision of the boy and his temporary or perma­ nent separations from them. The teachers completed questionnaires when the boys were aged about 8, 10, 12 and 14. These furnished data about their troublesome and aggressive school behaviour, their attention deficits, their school attainments and their truancy. Ratings were also obtained from the boys’ peers when they were in primary school, about such topics as their daring, dishonesty, troublesomeness and popularity. Information on offending Searches were carried out in the central Criminal Record Office (National Identification Service) in London to try to locate findings of guilt of the subjects, of their parents, of their brothers and sisters, and (in recent years) of their wives and female partners. The latest search of conviction records took place in the summer of 1994, when most of the subjects were aged 40. Between ages 10 and 16 inclusive (the years of juvenile delinquency in England at that time), 85 males (21%) were convicted. Altogether, up to age 40, 164 (40%) were convicted (Farrington, Barnes and Lambert, 1996; Farrington, Lambert and West, 1998). In this chapter, the recorded age of offending is the age at which an offence was committed, not the age on conviction. There can be delays of several months or even more than a year between offences and convictions, making conviction ages different from offending ages. Convictions were only counted if they were for offences normally recorded in the Criminal Record Office, thereby excluding minor crimes such as common assault, traffic infractions and drunkenness. The most common offences included were thefts, burglaries and unauthorised takings of vehicles, although there were also quite a few offences of violence, vandalism, fraud and drug abuse.

22

Violent Children and Adolescents

Of the 760 recorded offences, 119 were classified as violent: 52 assaults causing bodily harm, 28 offences of threatening behaviour, 18 robberies, 18 offensive weapon crimes and 3 sex offences. Assaults had to be relatively serious (involving visible damage worse than bruises, swelling or a black eye) to be counted as indictable bodily harm offences rather than common assault. Threatening behaviour offences usually involved a serious threat of violence. Offensive weapon crimes usually involved sheath knives, flick knives, crowbars, shotguns and the like. Half of those convicted for possessing an offensive weapon also had a conviction for some other violent crime. Only 10 of the males were convicted of sex offences, and 7 of these did not involve violence (3 indecent exposure, 1 obscene telephone call, 2 consensual homosexual offences, 1 sexual intercourse with a younger sister). The other 3 were counted because they involved violence: 1 alleged rape which led to a conviction for unlawful sexual intercourse, 1 violent indecent assault on a female, and 1 man (age 33) who used a 13year-old boy for homosexual buggery and then passed the boy on to other homosexuals for the purpose of buggery (convicted of indecent assault on a male). Up to age 40, 65 of the males were convicted for violence: 16% of 404 at risk, excluding 7 not convicted for violence who died up to age 32. The vast majority of these males (54 out of 65) also had convictions for non­ violent offences. The 36 males (9%) convicted for violence between ages 10 and 20 (committing 53 violent crimes) are a major focus of this chapter; these boys are the officially violent offenders. The adolescent age range was extended to 20 because only 3 boys were convicted for violence between ages 10 and 13, and only 11 between ages 14 and 16, whereas 26 were convicted between ages 17 and 20. About one-third of those convicted for violence between ages 10 and 20 (34%) were also convicted between ages 21 and 40, compared with 8% of those not convicted of adolescent violence (OR = 6.1; 95% confidence interval 2.8–13.5, so p < 0.05).* In order not to rely on official records for information about offending, self-reports of offending were obtained from the males at every age from 14 to 32 (Farrington, 1989b). In this chapter, self-reports of violence committed between ages 10 and 14 and between ages 15 and 18 are analysed. At age 10–14, the self-reported violence measure was a score of the number of violent acts admitted out of 7 (group fighting, fighting *Odds ratios (OR) are used here as the main measure of strength of relationships. Essentially, the OR indicates the increase in risk associated with a risk factor; ORs of 2 or greater, indicating a doubling of the risk, suggest strong predictive relationships.

Adolescent Violence: Findings and Implications from the Cambridge Study 23

strangers in the street, carrying a weapon, attacking someone, using a weapon in a fight, fighting to get away from a police officer, attacking a police officer: see West and Farrington, 1973:170). The 61 males (15%) who admitted 3 or more of these acts were contrasted with the remaining 344 out of 405 interviewed. At age 15–18, the self-reported violence measure was the sum of 4 items, each scored 1–4: number of fights in the previous 3 years, number of fights started, number of times carried a weapon in case it was needed in a fight, and number of times used a weapon in a fight. The 79 boys (20%) with the highest scores (10 or more out of 16) were contrasted with the remaining 310 out of 389 interviewed (West and Farrington, 1977:82). The official records and self-reports of violence were significantly inter­ related. Half of the convicted boys were self-reported violent at age 10–14, compared with only 12% of unconvicted boys (OR = 7.5); 56% of convicted boys were self-reported violent at age 15–18, compared with only 17% of unconvicted boys (OR = 6.2); and 51% of self-reported violent boys at 10–14 were also self-reported violent at 15–18, compared with only 15% of the remainder (OR = 5.9). Previous analyses of violence West and Farrington (1973) reported the prevalence of official and selfreported violence at age 10–14 in the Cambridge Study; West and Farrington (1977) reported the comparable prevalence at age 15–18. Both books also showed relationships between aggression and delinquency; for example, West and Farrington (1977:11) reported that 80% of young adults convicted for violence also had convictions for dishonesty. West and Farrington (1977:149) also found that violent offenders at age 18 were deviant in many other respects, including heavy drinking, drunken driving, drug use, sexual promiscuity, heavy smoking, heavy gambling and having an unstable job record. The first analysis of predictors of self-reported violence (at age 10–14) was published by Farrington and West (1971). Significant predictors at age 8–10 included childhood misconduct, daring, low non-verbal IQ, large family size and low family income. Farrington and West (1971) concluded that self-reported violent boys were similar in many respects to early delin­ quents (those convicted at age 10–14), but that the delinquents were more deprived in regard to low income and poor housing. Farrington (1978) carried out a more extensive study of predictors of aggression at age 8–10 (difficult to discipline, rated by teachers), 12–14 (aggression rated by teachers), 16–18 (self-reported violence) and convic­ tions for violence between ages 10 and 20. The most important indepen­ dent predictors of convictions for violence were harsh parental discipline,

24

Violent Children and Adolescents

a convicted parent, poor parental supervision, a broken family, high daring and low non-verbal IQ. There was considerable continuity from aggression at age 8–10 to violence at age 16–18 (see also Farrington, 1982). Farrington, Berkowitz and West (1982) analysed physical fights reported by the males at age 15–18 (most occurring in pubs or streets). Group fights were more serious than individual fights, involving weapons, injuries and police intervention. A category of aggressive frequent group fighters was identified. The best predictors of these boys at age 8–10 were low family income, large family size, low verbal IQ, daring, troublesome­ ness and low school achievement. Farrington (1989a) investigated the predictors of aggression at age 12–14 (rated by teachers), self-reported violence at age 16–18, selfreported fights at age 32 and convictions for violence between ages 10 and 32. Regression analyses showed that the best predictors of convictions included high daring, authoritarian parents, a convicted parent, low verbal IQ and harsh parental discipline. The best predictors of self-reported fights at age 32 included the father rarely joining in the boy’s leisure activ­ ities at age 12, high self-reported delinquency at age 18 and high daring at age 8–10. Farrington (1991b) showed that the predictors of convictions for violence up to age 32 and of frequent non-violent offenders were very similar, a result later replicated by Capaldi and Patterson (1996). Generally, violent offenders were frequent offenders. Farrington (1993) studied the predictors of bullying at ages 14, 18 and 32, and Farrington (1994) compared the predictors of soccer violence at age 18, aggressive frequent group fighters at age 18, spouse assault at age 32 and convictions for violence up to age 32. In regression analyses, Farrington (1997b) showed that a low heart rate at age 18 (possibly indicating fearlessness or low arousal) was an independent predictor of convictions for violence up to age 40 and of self-reported violence at age 18. Farrington (1997a) investigated the ability of various combined scales to predict convictions for violence between ages 10 and 20 and selfreported violence at age 15–18; Farrington (1998) reviewed a variety of risk factors for these two outcomes. The most recent analysis of violence (Farrington, 2000b) compared predictors of adult convictions for violence (between ages 21 and 40) with predictors of self-reported violence between ages 27 and 32. Interestingly, adolescent convictions for non-violent crimes predicted adult violence better than did adolescent predictions for violent crimes, because offenders were versatile rather than specialized. Boys who were heavy drinkers, drug users, aggressive and hostile to the police as adolescents, tended to be violent as adults. As adolescents, adult violent offenders

Adolescent Violence: Findings and Implications from the Cambridge Study 25

tended to be restless or lacking in concentration, daring, extroverted or impulsive. They often had criminal parents or young mothers and were exposed to harsh parental discipline. They tended to experience parental conflict and broken families, and their fathers tended not to join in their leisure activities. They tended to come from low income families, and in turn they tended to have unskilled manual jobs themselves when they grew up. All of these factors help to identify children with a high potential for adult violence

Childhood predictors This section summarises the most important childhood predictors in the Cambridge Study of: • convictions for violence between ages 10 and 20 • self-reported violence at age 10–14 • self-reported violence at age 15–18. In addition, these results are placed in the context of findings obtained in other longitudinal surveys. Individual factors Among the most important personality dimensions that predict adolescent violence are hyperactivity, impulsiveness, poor behavioural control, and attention problems. For example, in the Dunedin (New Zealand) followup of over 1000 children, ratings of poor behavioural control (e.g. impul­ siveness, lack of persistence) at age 3–5 significantly predicted boys convicted of violence up to age 18, compared to those with no convictions or with non-violent convictions (Henry et al., 1996:618). Many other studies show linkages between these personality dimen­ sions and adolescent violence. For example, in the Copenhagen perinatal project based on over 200 children, hyperactivity (restlessness and poor concentration) at age 11–13 significantly predicted arrests for violence up to age 22, especially among boys subjected to delivery complications at birth (Brennan, Mednick and Mednick, 1993:253). More than half of those with both hyperactivity and high delivery complications were arrested for violence, compared to less than 10% of the remainder. Similarly, in the Orebro longitudinal study of over 1000 children in Sweden, hyperactivity at age 13 predicted police-recorded violence up to age 26 (Klinteberg et al., 1993:383). The highest rate of violence (15%) was among males with both motor restlessness and concentration difficulties, compared to 3% of the remainder.

26

Violent Children and Adolescents

In the Cambridge Study, daring (taking many risks, rated by parents and peers) was the strongest individual predictor of convictions for violence (Table 2.1); 61% of violent boys had been rated daring at age 8–10, compared with 26% of non-violent boys (OR = 4.4). Daring was also the strongest predictor of self-reported violence at ages 10–14 (OR = 3.2) and 15–18 (OR = 3.9). Poor concentration or restlessness at age 8–10 (rated by teachers) predicted convictions for violence (OR = 2.9) but not self-reported violence. The other main group of psychological factors that predict adolescent violence include low intelligence and low school attainment. For example, in the Philadelphia Biosocial Project of nearly 1000 children, low verbal Table 2.1: Childhood predictors of adolescent violence Predictors

Convictions

Age 8–10

Age 10–20

Age 10–14

Age 15–18

4.4 2.9 3.0 2.1 1.8* –2.1*

3.2 1.4* 2.7 2.0 2.0 –1.7*

3.9 1.6* 1.6* 1.6* 1.7 –3.0

3.1 3.4 3.6 3.7 2.8 3.4 3.4

2.2 1.8 3.8 1.8 1.8* 2.9 2.0

2.2 1.9 2.3 1.9 1.4* 2.3 1.7*

2.7 2.1 2.5 1.4*

2.6 1.2* 2.0 1.6*

2.6 2.1 2.6 1.9

4.8 2.4 5.6 3.7

2.5 2.4 2.5 2.9

3.3 1.4* 2.7 2.5

Individual High daring Lacks concentration Low non-verbal IQ Low junior attainment Unpopular Few friends Family Convicted parent Harsh discipline Poor supervision Broken family Parental conflict Physical neglect Low interest in education Socio-economic Low income Poor housing Large family Young mother Behavioural Troublesome Dishonest Antisocial Vulnerable

*p > 0.05 A minus sign indicates a negative relationship.

Self-reported violence (OR)

Adolescent Violence: Findings and Implications from the Cambridge Study 27

and performance IQ at ages 4 and 7, and low scores on the California Achievement Test at age 13–14 (vocabulary, comprehension, maths, language, spelling), all predicted arrests for violence up to age 22 (Denno, 1990:52–3). In Project Metropolitan in Copenhagen, which is a follow-up study of over 12 000 boys born in 1953, low IQ at age 12 significantly predicted police-recorded violence between ages 15 and 22 (Hogh and Wolf, 1983:259). The correlation between IQ and violence was –0.94, and the link between low IQ and violence was strongest among lower-class boys. In the Cambridge Study, low non-verbal IQ at age 8–10 (on the Progressive Matrices) was a strong predictor of convictions for violence (OR = 3.0) and self-reported violence at age 10–14 (OR = 2.7); 47% of convicted boys had an IQ of 90 or less, compared with 23% of the remainder. Low junior school attainment (based on tests of arithmetic, English and verbal reasoning) also predicted convictions and self-reported violence at age 10–14. Parker and Asher (1987) completed an extensive review of research on ‘low-accepted’ children who were either rejected (because of aggressive­ ness) or neglected (because of shyness). They found that the rejected children tended to be involved in delinquency, whereas the neglected children tended to have later mental health problems. Table 2.1 shows that boys who were unpopular at age 8–10 (according to peer ratings) – presumably the rejected boys – in the Cambridge Study tended to be violent according to their self-reports at ages 10–14 and 15–18. In contrast, boys who had few or no friends at age 8 (according to their parents) – presumably the neglected boys – were significantly unlikely to be violent at age 15–18; only 9% of these boys were violent, compared with 22% of the remainder (OR = 0.33, shown as –3.0). This result agrees with the previous finding (Farrington et al., 1988) that boys from crimino­ genic backgrounds who did not get convicted tended to have few or no friends at age 8. It was suggested that shyness and social isolation might act as protective factors against offending for boys from high-risk backgrounds. Family factors Numerous family factors predict violence. For example, in her follow-up of 250 Boston boys in the Cambridge–Somerville Study, McCord (1979:1481) found that the strongest predictors at age 10 of later convic­ tions for violence were poor parental supervision, parental aggression (including harsh, punitive discipline) and parental conflict. McCord (1977:87) also demonstrated that fathers convicted for violence tended to have sons convicted for violence; the OR for this comparison was 3.0.

28

Violent Children and Adolescents

Later, McCord (1996:150) showed that officially violent offenders were less likely than non-violent offenders to have experienced parental affec­ tion and good discipline and supervision. Similar results have been obtained in other studies. For example, in the Chicago Youth Development Study, which is a longitudinal follow-up of nearly 400 inner-city boys initially interviewed at age 11–13, poor parental monitoring and low family cohesion predicted self-reported violent offending (Gorman-Smith et al., 1996:123). Also, poor parental monitoring and low attachment to parents predicted self-reported violence in the Rochester Youth Development Study, which is a follow-up of almost 1000 children aged 13 (Thornberry, Huizinga and Loeber, 1995:227). Broken families between birth and age 10 predicted convictions for violence up to age 21 in the British National Survey of over 5000 children born in 1946 (Wadsworth, 1978:48), and single-parent status at age 13 predicted convic­ tions for violence up to age 18 in the Dunedin study (Henry et al., 1996:618). Harsh physical punishment by parents, and child physical abuse, typically predict violent offending by sons (Malinosky-Rummell and Hansen, 1993). In a follow-up study of nearly 900 children in New York State, Eron, Huesmann and Zelli (1991:175) reported that parental punishment at age 8 predicted not only arrests for violence up to age 30, but also the severity of the man’s punishment of his child at age 30 and also his history of spouse assault. Interestingly, in the Cambridge– Somerville Study, McCord (1997) found that physical punishment predicted convictions for violence especially when it was combined with low parental warmth and affection. In the Cambridge Study, the strongest family predictor of convictions for violence was coming from a broken family at age 10 (separation from a parent for reasons other than death or hospitalisation); 47% of convicted boys had been separated, compared with 20% of unconvicted boys (OR = 3.7). The strongest family predictor of self-reported violence was poor parental supervision (rated by social workers); 31% of poorly supervised boys became violent, compared with 10% of the remainder (OR = 3.8). Having a convicted parent at age 10 and harsh or erratic parental discipline at age 8 were also important predictors of official and self-reported violence. The boys convicted for violence also tended to be living in disharmo­ nious families at age 8 (OR = 2.8). Physical neglect of the boy and low parental interest in education were other important predictors of official and self-reported violence. Socio-economic factors Coming from a family of low socio-economic status predicts adolescent violence. For example, in the US National Youth Survey of over 1700

Adolescent Violence: Findings and Implications from the Cambridge Study 29

adolescents, the prevalences of self-reported felony assault and robbery were about twice as high in lower-class youth as in middle-class ones (Elliott, Huizinga and Menard, 1989:38). Similar results have been obtained for official violence in Project Metropolitan in Stockholm, which is a follow-up of over 15 000 children (Wikström, 1985:133), in Project Metropolitan in Copenhagen (Hogh and Wolf, 1983:253), and in the Dunedin Study in New Zealand (Henry et al., 1996:618). All three of these studies compared the socio-economic status of the family at the boy’s birth, based on the father’s occupation, with the boy’s later violent crimes. The relationship between socio-economic status and adolescent violence was weakest in New Zealand. In the Cambridge Study, low socio-economic status (based on the occupational prestige of the family breadwinner) was not a significant predictor of adolescent violence. This may be because occupational prestige in this project was not a good indicator of affluence or poverty; many of the manual jobs such as docker and printer were better paid at the time than a non-manual job such as bank clerk. Low family income and poor housing, on the other hand, were significant predictors of official and self-reported violence (Table 2.1). Large family size (number of children) is a replicable predictor of violence (Fischer, 1984). For example, in the Oregon Youth Study of over 200 boys, large family size at age 10 predicted self-reported violence at age 13–17 (Capaldi and Patterson, 1996:224). Large family size was a signifi­ cant predictor of both official and self-reported violence in the Cambridge Study; for example, 33% of boys from large families (with five or more children) were violent at age 15–18 according to self-reports, compared with 16% of the remainder (OR = 2.6). Previous analyses in the Cambridge Study (Nagin, Pogarsky and Farrington, 1997) suggested that having a young mother (a teenager at the time of her first birth) predicted convictions of the boys, but primarily because young mothers were associated with large families, criminal parents and broken families. Table 2.1 shows that a young mother predicted selfreported violence at age 15–18, but not very strongly (OR = 1.9). Behavioural factors It is widely believed that ‘nothing predicts behaviour like behaviour’. Studies which have compared childhood aggression with adolescent violence always report significant continuity. For example, in the Orebro (Sweden) follow-up of over 1000 children, two-thirds of boys who were officially recorded for violence had high aggressiveness scores at ages 10 and 13 (rated by teachers), compared with 30% of all boys (Stattin and Magnusson, 1989:714). In the Jyvaskyla (Finland) follow-up of nearly 400

30

Violent Children and Adolescents

children, peer ratings of aggression at ages 8 and 14 significantly predicted official violence up to age 20 (Pulkkinen, 1987:206). Also, in the Woodlawn (Chicago) follow-up study of over 1200 African-American children, teacher ratings of aggressiveness at age 6 predicted arrests for violent crimes up to age 33 (McCord and Ensminger, 1995:10). Almost half of the aggressive boys were later arrested, compared with about a third of their non-aggressive counterparts. In the Cambridge Study, troublesomeness at age 8–10 (rated by teachers and peers) and dishonesty at age 10 (rated by peers) predicted official and self-reported violence. A combined antisocial personality scale at age 10 (based on troublesomeness, conduct problems, indiscipline, dishonesty, stealing, getting angry, daring, poor concentration, impulsive­ ness and truancy; see Farrington, 1991a) was an even better predictor of convictions for violence; 58% of convicted boys were antisocial at age 10, compared with 20% of the remainder (OR = 5.6). Another combined scale that was developed at an early stage was the vulnerability scale at age 8–10, measuring a criminogenic background (West and Farrington, 1973:131). This was based on five explanatory variables: low family income, large family size, a convicted parent, low non-verbal IQ and poor parental child-rearing behaviour (a combination of harsh discipline and parental conflict). Each boy was scored according to the number of risk factors (out of five) that he possessed, and the vulnerable boys were those with three or more risk factors. Table 2.1 shows that this combined measure of a vulnerable background predicted official and self-reported violence.

Implications for prevention The Cambridge Study, and other longitudinal surveys, identify some of the most important risk factors for adolescent violence. It is unclear which of these risk factors are causes. Nevertheless, it is useful to try to tackle these risk factors using prevention programmes. Four types of programmes are especially useful: home visiting, pre-school, parent training and skills training. (For more detailed reviews of risk-focused prevention, see Farrington and Welsh, 1999; Farrington, 1999b.) Home visiting programmes The risk factors of young mothers, harsh discipline, physical abuse and neglect can be targeted in intensive home visiting programmes. For example, in New York State, Olds et al. (1986a, 1986b) randomly allocated 400 mothers either to receive home visits from nurses during pregnancy, or to receive visits both during pregnancy and during the first 2 years of

Adolescent Violence: Findings and Implications from the Cambridge Study 31

life, or to a control group who received no visits. Each visit lasted about 11/4 hours, and the mothers were visited on average every 2 weeks. The home visitors gave advice about prenatal and postnatal care of the child, about child rearing, about infant development and about the importance of proper nutrition and avoiding smoking and drinking during pregnancy. The results of this experiment showed that home visits during pregnancy led to teenage mothers having heavier babies. Also, women who had previously smoked decreased their smoking and had fewer pre­ term deliveries. In addition, the postnatal home visits caused a decrease in recorded child physical abuse and neglect during the first two years of life, especially by poor unmarried teenage mothers; 4% of visited versus 19% of non-visited mothers of this type were guilty of child abuse or neglect. Olds et al. (1997) reported a 15-year follow-up showing that experimental mothers committed half as much child abuse and had half as many arrests as control mothers, and Olds et al. (1998) reported that children of lowerclass experimental mothers committed fewer offences than children of lower-class control mothers. Pre-school intellectual enrichment programmes The risk factors of low IQ and low school attainment can be targeted in pre-school intellectual enrichment programmes. One of the most successful delinquency prevention programmes has been the Perry pre­ school project carried out in Michigan by Schweinhart and Weikart (1980). This was essentially a Head Start programme targeted on disadvantaged African-American children, who were allocated (approximately at random) to experimental and control groups. The experimental children attended a daily pre-school programme, backed up by weekly home visits, usually lasting two years (covering ages 3–4). The aim of the ‘plan–do–review’ programme was to provide intellectual stimulation, to increase thinking and reasoning abilities, and to enhance later school achievement. About 120 children in the two groups were followed up to age 15, using teacher ratings, parent and youth interviews, and school records. As demonstrated in several other Head Start projects, the experimental group showed gains in intelligence that were rather short-lived. However, they were significantly better in elementary school motivation, school achievement at age 14, teacher ratings of classroom behaviour at 6 to 9, self-reports of classroom behaviour at 15 and self-reports of offending at 15. Furthermore, a later follow-up of this sample (Berrueta-Clement et al., 1984) showed that, at age 19, the experimental group was more likely to be employed, more likely to have graduated from high school, more likely to have received college or vocational training and less likely to have been arrested.

32

Violent Children and Adolescents

By age 27, the experimental group had accumulated only half as many arrests on average as the controls (Schweinhart, Barnes and Weikart, 1993). Also, they had significantly higher earnings and were more likely to be home-owners. More of the experimental women were married, and fewer of their children had been born out of wedlock. Hence, this pre­ school intellectual enrichment programme led to decreases in school failure, to decreases in offending and to decreases in other undesirable outcomes. A cost–benefit analysis showed that, for every $1 spent on the programme, $7 were saved in the long run. Parent management training The risk factors of poor parental supervision and inconsistent discipline can be targeted in parent training. Many different types of parent training have been used (Barlow, 1997; Kazdin, 1997), but the behavioural parent management training developed by Patterson (1982) in Oregon is one of the most promising approaches. His careful observations of parent–child interaction showed that parents of antisocial children were deficient in their methods of child rearing. These parents failed to tell their children how they were expected to behave, failed to monitor their behaviour to ensure that it was desirable and failed to enforce rules promptly and unambiguously with appropriate rewards and penalties. The parents of antisocial children used more punishment (such as scolding, shouting or threatening), but failed to make it contingent on the child’s behaviour. Patterson attempted to train these parents in effective child-rearing methods: noticing what a child is doing, monitoring behaviour over long periods, clearly stating house rules, making rewards and punishments contingent on behaviour and negotiating disagreements so that conflicts and crises did not escalate. His treatment was shown to be effective in reducing children’s stealing and antisocial behaviour over short periods in small-scale studies (Patterson, Chamberlain and Reid, 1982; Dishion, Patterson and Kavanagh, 1992; Patterson, Reid and Dishion, 1992). Skills training Impulsivity, poor behavioural control and attention problems might be reduced using the set of techniques loosely termed cognitive-behavioural interpersonal skills training, which have proved to be quite successful (Lipsey and Wilson, 1998). For example, the methods used by Ross in Canada to treat juvenile delinquents (Ross and Ross, 1995) were solidly targeted on some of the known individual characteristics of offenders: impulsivity, concrete rather than abstract thinking, low empathy and egocentricity.

Adolescent Violence: Findings and Implications from the Cambridge Study 33

Ross believed that delinquents could be taught the cognitive skills in which they were deficient, and that this could lead to a decrease in their offending. Reviews of delinquency rehabilitation programmes (Gendreau and Ross, 1979, 1987) showed that those which were successful in reducing offending generally tried to change the offender’s thinking. Ross carried out his own ‘Reasoning and Rehabilitation’ programme in Ottawa, and found (in a randomised experiment) that it led to a large decrease in re-offending for a small sample in a short (9-month) follow-up period. His training was carried out by probation officers, but he believed that it could be carried out by parents or teachers. His programme has been imple­ mented widely in several different countries, including the UK. For example, in Glamorgan, offenders who completed this programme had lower reconviction rates than expected (Knott, 1995). Ross’s programme aimed to modify the impulsive, egocentric thinking of delinquents, to teach them to stop and think before acting, to consider the consequences of their behaviour, to conceptualise alternative ways of solving interpersonal problems, and to consider the impact of their behav­ iour on other people, especially their victims. It included social skills training, lateral thinking (to teach creative problem solving), critical thinking (to teach logical reasoning), values education (to teach values and concern for others), assertiveness training (to teach non-aggressive, socially appropriate ways to obtain desired outcomes), negotiation skills training, interpersonal cognitive problem-solving (to teach thinking skills for solving interpersonal problems), social perspective training (to teach how to recognise and understand other people’s feelings), role-playing and modelling (demonstration and practice of effective and acceptable interpersonal behaviour). Multi-modal programmes Multi-modal developmental prevention programmes, combining skills training, parent training and other interventions, are often more successful than programmes that use only one method of intervention (Wasserman and Miller, 1998). For example, Kazdin, Siegel and Bass (1992) found that a combination of parent management training and problem-solving skills training was more effective in reducing selfreported delinquency than either method alone. Skills training was used as part of a multi-modal programme by Tremblay et al. (1995) in Montreal. They identified about 250 disruptive (aggressive/hyperactive) boys at age 6 for a prevention experiment. Between ages 7 and 9, the experimental group received training to foster social skills and self-control. Coaching, peer modelling, role playing and

34

Violent Children and Adolescents

reinforcement contingencies were used in small group sessions on such topics as ‘how to help’, ‘what to do when you are angry’ and ‘how to react to teasing’. Also, their parents were trained using the parent management training techniques developed by Patterson (1982). This prevention programme was quite successful. By age 12, the exper­ imental boys committed less burglary and theft, were less likely to get drunk, and were less likely to be involved in fights than the controls. Also, the experimental boys had higher school achievement. At every age from 10 to 15, the experimental boys had lower self-reported delinquency scores than the control boys. Interestingly, the differences in antisocial behaviour between experimental and control boys increased as the followup progressed. Another important school-based prevention experiment was carried out in Seattle by Hawkins and his colleagues (Hawkins, von Cleve and Catalano, 1991; Hawkins et al., 1992). This combined parent training, teacher training and skills training. About 500 first grade children (age 6) in 21 classes in 8 schools were randomly assigned to experimental or control classes. The children in the experimental classes received special treatment at home and school which was designed to increase their attachment to their parents and their bonding to the school, on the assumption that offending was inhibited by the strength of social bonds. Their parents were trained to notice and reinforce socially desirable behaviour in a programme called ‘Catch them being good’. Their teachers were trained in classroom management, for example to provide clear instructions and expectations to children, to reward children for desired behaviour and to teach children pro-social (socially desirable) methods of solving problems. In an evaluation of this programme 18 months later, when the children were in different classes, Hawkins, von Cleve and Catalano (1991) found that the boys who received the experimental programme were signifi­ cantly less aggressive than the control boys, according to teacher ratings. This difference was particularly marked for white boys rather than AfricanAmerican boys. The experimental girls were not significantly less aggres­ sive, but they were less self-destructive, anxious and depressed. By the fifth grade (age 10), the experimental children were less likely to have initiated delinquency and alcohol use. Among low-income children, experimental boys were less likely to have initiated delinquency, and experimental girls were less likely to have initiated drug use (O’Donnell et al., 1995). Up to age 18, experimental students reported less violent delin­ quency and less heavy drinking (Hawkins et al., 1999).

Adolescent Violence: Findings and Implications from the Cambridge Study 35

Conclusions The most important childhood predictors of adolescent violence include troublesome and antisocial behaviour, daring and hyperactivity, low IQ and attainment, antisocial parents, poor child-rearing (harsh and erratic discipline, poor supervision), parental conflict and broken families, low family income and large family size. Important policy implications of these results are that home visiting programmes, pre-school intellectual enrich­ ment programmes, parent training and skills training programmes (singly and in combination) should be implemented at an early age to prevent adolescent violence. The best knowledge about risk factors has been obtained in longitu­ dinal studies, whereas the best knowledge of effective prevention programmes has been obtained in randomised experiments. Further longitudinal and experimental studies are needed, especially studies specifically concerned with adolescent violence. More ambitiously, longi­ tudinal and experimental methods could be combined by including prevention experiments in longitudinal studies (Farrington, 1999a, 2000a). The longitudinal experimental design is economical, since it uses the same people to study risk factors and developmental pathways as well as the effects of interventions. Many of the results of the Cambridge Study were obtained years ago. There is no suggestion that the results are not still applicable nowadays, but it is important to obtain up-to-date informa­ tion about risk factors and effective interventions, so that public policies to reduce adolescent violence can be based on the best possible evidence.

CHAPTER 3

Understanding and Treating Adolescent Firesetters KEVIN EPPS AND CLIVE R. HOLLIN Firesetting as a social problem Fire has the potential to cause a great deal of damage to people and property. It is little wonder, therefore, that individuals who set uncon­ trolled fires cause enormous anxiety in others. This is especially evident in those most at risk, such as parents of children who set fires in the home, professionals responsible for the care and treatment of firesetters (e.g. in secure psychiatric facilities), and owners of property particularly at risk from deliberate firesetting (e.g. large corporations, education authorities). This anxiety is reflected in the literature on firesetting and arson, which is dominated by articles on firesetting in children, juveniles and adult psychi­ atric patients (i.e. ‘pathological firesetting’). In addition, there is a smaller literature dealing with firesetting in relation to females, public disorder offences (e.g. during riots and ‘hate crimes’ motivated by religious or racial beliefs), self-incineration and fraud (e.g. bogus insurance claims). The term ‘arsonist’ tends to be reserved for the relatively small number of firesetters whose firesetting has resulted in a criminal conviction, most of whom are adults. The extensive psychiatric literature on adult firesetters has focused mainly on the relationship between firesetting, mental illness and other types of serious psychological dysfunction (see Virkkunen, 1974; Harris and Rice, 1984; Geller, 1992; Barnett and Spitzer, 1994), and the manage­ ment and treatment of firesetting patients detained in secure psychiatric facilities (see Rice and Harris, 1991; Prins, 1994). Historically, the notion that firesetting is a ‘symptom’ of illness, or indeed an illness in and of itself, prevailed, giving rise to terms such as ‘impulsive incendiarism’, ‘monomanic incendiaric’ and ‘pyromania’ (see Bumpass, Fagelman and Brix, 1983; Geller, 1992). This approach also fuelled attempts to gain 36

Understanding and Treating Adolescent Firesetters

37

insight into the mind of the firesetter, giving rise to a number of psychodynamically-orientated case descriptions and an excess of armchair theorising, in which firesetting was often linked to sexual disturbance (Stekel, 1924; Simmel, 1949). Unfortunately, this view of firesetting has held sway for many years, giving rise to the plea that arson should no longer be construed as a psychiatric problem, suggesting that ‘psychia­ trists tend to restrict our understanding of what are essentially social problems’ (Soothill, 1990:786). Given these historical roots, it is perhaps not surprising that academic interest in children and juveniles who set fires initially followed a similar vein (see Bumpass, Fagelman and Brix, 1983). However, firesetting in young people, especially in juveniles, eventually attracted attention from a wider range of professional groups, reflecting concern about juvenile firesetting in community contexts, such as schools (Wooden and Berkey, 1984; Kolko and Kazdin, 1986; Kolko, 1988). Mieszala (1981), for example, estimated that children and juveniles account for up to 60% of non-sanctioned firesetting in the USA, at a cost of several billion dollars each year. Consequently, an alternative view of firesetting in children and juveniles began to emerge, which emphasised the role of social-psychological and developmental processes, the need for empirical research, and the need for community prevention and intervention programmes that are not restricted to psychiatric settings.

Social-psychological approaches to understanding firesetting Social-psychological models, such as social-learning theory, construe firesetting not as a symptom of psychiatric abnormality, but as the outcome of an interaction between individuals and their social and physical environment (see Fineman, 1980; Vreeland and Levin, 1980; Jackson, 1994). These psychosocial models emphasise the need to look for factors within individuals, such as habitual styles of thinking, that place them at risk for firesetting (‘person’ factors), and to consider how these are influenced by a range of social processes and situational triggers (e.g. conflict with a parent or teacher). It follows that some individuals may be at risk of firesetting in a wide range of situations, whereas in others the risk is limited to very specific situations. Learning about fire Psychological models also stress the role of learning and developmental processes, associated with changes in thinking, feeling and behaviour over the course of a lifespan. For example, firesetting behaviour in a child of 5

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years (e.g. placing a lighted match into a waste-basket) is likely to be construed as accidental rather than intentional, even though the damage caused may be extensive, including loss of life (Grolnick et al., 1990). In addition, responsibility for preventing further episodes of firesetting will lie mainly with the parents or other carers through more effective supervi­ sion and restriction of access to fire-lighting materials. The literature makes a distinction between several types of children and juveniles who set fires: • non-firesetters: children and juveniles who have no known history of firesetting or unusual interest in fire • fire-players (Kafry, 1980) (or match-players, Kolko and Kazdin, 1990): children, usually below the age of 7 years, who have a history of playing with matches or other firesetting devices (e.g. cigarette lighters, candles), but have not set fires. In a random sample of 99 boys aged 5–9 years, Kafry (1980) found that 45% had engaged in fire-play, and in 18% of these children this had occurred before the age of 3 years • curiosity firesetters: children, usually between the ages of 8 and 12 years, who have set at least one fire out of curiosity or as the result of experimentation, with no intention to cause damage • firesetters: usually older children and juveniles who are known to have intentionally set one fire to cause damage • repeater firesetters: older children and juveniles who are known to have intentionally set more than one fire to cause damage. It is perhaps not surprising to find that match-play and curiosity fireset­ ting within the home are more prevalent in children who have a parent who smokes (FEMA, 1994). It is generally assumed that a range of learning and developmental processes take place during childhood that serve to reduce the risk of accidental firesetting through match-play (see Kafry, 1980). These processes include the development of moral reasoning and empathic concern for others, and a capacity for means–end thinking, associated with a greater appreciation for the negative consequences (to self and others) of antisocial behaviour. These psychological changes arise from natural maturational processes, such as cognitive growth, combined with exposure to positive social learning experiences both inside and outside the home, and have the effect of increasing self-control and the capacity for responsible, pro-social behaviour. Consequently, a 15-year-old girl who sets fires by placing lighted matches in wastepaper baskets is unlikely to be excused on the grounds that she was not aware of the possible consequences, unless there are mitigating factors that impaired normal development and learning (e.g. intellectual impairment). Indeed,

Understanding and Treating Adolescent Firesetters

39

in Britain, adolescents who set fires in this way (even where damage is minimal) are likely to be charged with the offence of criminal damage or arson, or, where human lives were at risk, the more serious offence of arson-with-intent, and may receive a custodial sentence. It is not known to what extent direct exposure to information about fire safety and the risks of firesetting has an effect on reducing the risk of firesetting, whether intentional or accidental. Several authors have pointed out that exposure to fire is dependent on cultural and social contexts, which change across time (Canter, 1980; Kafry, 1980). Following the introduction of modern heating appliances in most houses, children now have significantly less exposure to fire. The effects of this social change on risk of firesetting are unclear. On the one hand it can be argued that children who are not exposed to fire are less likely to develop an unhealthy interest or preoccupation with fire. However, it can also be argued that lack of exposure may potentially increase fascination with fire when children are first exposed to it; further, in the absence of fire-safety knowledge and skills learned through regular contact, children are less aware of the risks and possible dangers. Inexperienced children who experiment with firesetting, for example, may be overconfident in their ability to extinguish fires, such that the fire soon becomes uncon­ trollable. Psychological functions of firesetting In the same way that some learning experiences reduce the risk of firesetting, other experiences may have the effect of increasing this risk. For some individuals, fire and firesetting may take on a special signifi­ cance, especially where experiences with fire have been rewarding and beneficial. Over time, the reinforcing nature of firesetting experiences, in real life and in fantasy, may serve to increase the risk of intentional firesetting. One of the objectives of psychological assessment and analysis, discussed later in this chapter, is to develop a working hypoth­ esis of the benefits of firesetting to the individual (McGrath, Marshall and Prior, 1979; Jackson, Glass and Hope, 1987a). Frequently, the benefits of firesetting are not immediately clear to the observer. Firesetting behaviour is sometimes associated with very personal, idiosyncratic psychological processes, which may help to explain the failure to find a distinct set of characteristics associated with juvenile firesetting (Forehand et al., 1991). From the clinical and research litera­ ture on firesetting and arson, however, it is possible to identify a variety of psychological benefits that may be derived from firesetting. These benefits can be divided into three broad types:

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• Benefits derived from the experience of watching fire. Some firesetters, probably a minority, derive considerable excitement and gratification from watching fire and the destruction caused to property (see Lewis and Yarnell, 1951). There may be a compelling attraction to fire, and firesetting may be associated with a reduction in psychological arousal or tension, with no regard to the danger to human life. Recidivist adult firesetters who display these characteristics, and whose firesetting serves no other function, are likely to attract the psychiatric diagnosis of ‘pyromania’ (see Blackburn, 1993). • Benefits derived from the social context of firesetting. This factor is especially significant in juvenile firesetting, which often occurs in the context of a delinquent group or gang, or with a friend (Fine and Louie, 1979; Strachan, 1981). Clearly, some members of the group may also derive considerable pleasure from watching the fire itself, as mentioned above. However, it is likely that the majority of delinquents who set fires are not particularly fascinated by fire, but derive excitement from the risks and dangers involved, and from the peer-group social interactions that accompany the experience. In a study by Swaffer and Hollin (1995), in which 17 juvenile firesetters were interviewed about their firesetting behaviour, only 1 individual was found to be fascinated by fire. • Benefits derived from the consequences of firesetting. In this instance, firesetting is used either as a problem-solving tool to achieve an end goal (Jackson, Glass and Hope, 1987a), or as a means of expressing intense personal feelings, such as rage and anger (see Lewis and Yarnell, 1951). Satisfaction is not necessarily derived from the fire itself (although some individuals may clearly derive benefit from this), but from the end product of firesetting. The term crisis firesetter has been coined to refer to adolescents who set fires in response to psychological tumoil (FEMA, 1994). Anger, stemming from a dysfunctional relationship with a father, has been consistently alluded to in the literature on firesetting, supported by some empirical evidence (Regehr and Glancy, 1991). In some instances, fire may be used to gain revenge, perhaps also motivated by intense feelings of anger and hatred toward the victim (Yarnell, 1940; Hill et al., 1982). In this type of firesetting, the wish to cause harm to others is often explicit, and it can be construed as an act of violence, even though there is no direct contact between victim and perpetrator. Revenge was considered to be a primary motive in 58% of the 138 sentenced adult arsonists described by Inciardi (1970). Examples of this type of revenge firesetting seen in clinical practice include an adoles­ cent boy who had been humiliated and sacked by his supermarket boss. Several days later, having ruminated about ways to gain revenge, he

Understanding and Treating Adolescent Firesetters

41

returned and burned down the supermarket. Another adolescent boy set fire to the flat of a man who had been sexually abusing him and his siblings over a number of years, resulting in the man’s death. In both these examples, firesetting can also be construed as an inappropriate way of expressing feelings of anger and, in the second example, as a means of escaping or avoiding an intolerable situation. An alternative scenario is one in which anger and hatred are expressed through firesetting in a more diffuse fashion, with no specific target. Thus, the fire and subsequent destruction can be construed as an external, visual representation of feelings of anger and rage. Consider, for example, the case of a 15-year-old boy encountered in a secure unit with a history of having been teased by other family members because he was perceived to be effeminate. On the same day that his sexual advances to another boy at school were rejected, he made his way into the local shopping centre after school and set fire to the clothes section of a large chain store, causing the death of two people. In other instances, however, the problem-solving firesetter is not inter­ ested in revenge, escape or venting rage, and has no interest in fire or causing damage to people or property. Rather, fire is used to attract atten­ tion. The attention of others may be desired for a variety of reasons. Some adolescents develop a pattern of engaging in dramatic behaviours to gain adult attention, as for example with self-injury and firesetting. Although such behaviours may have initially been motivated by a genuine need to attract adult attention to feelings of loneliness, distress and unhappiness, these types of behaviour can unfortunately create their own schedules of reinforcement: that is, attention from others becomes a primary source of reinforcement, and influences the frequency and intensity of the behaviour. In the case of firesetting, the phenomenon of the ‘hero syndrome’ can provide a powerful source of reinforcement (see Lewis and Yarnell, 1951). This situation occurs when an individual receives praise and recognition for drawing attention to a fire, thereby preventing damage to life and property. The fire may have been an accidental, fortuitous discovery, or set deliberately. Whatever the case, in an effort to receive further praise and adulation, further fires are set and subsequently reported by the perpe­ trator, who basks in the glory of being a hero with little consideration of the damage caused. An example of this type of firesetting is an adolescent boy encountered in clinical practice who was preoccupied with becoming a firefighter. His grandfather had been in the fire service, and the boy was well known to the local firefighters, having been a regular visitor to the fire station. In an attempt to ingratiate himself further, he set fire to a barn, and proceeded to cycle to the fire station to raise the alarm. His plan was successful: he was given recognition and praise for his efforts and,

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temporarily, felt that he was ‘one of the boys’. He repeated this behaviour several times, until the fire service became suspicious, leading to his arrest and subsequent conviction for arson. Clearly, firesetting can fulfil a variety of different psychological functions. Firesetters sometimes lack understanding of the factors which motivate their behaviour, and may gain insight only through psychological treatment (Bumpass, Fagelman and Brix, 1983). It is important to recog­ nise that although many firesetters do not perceive their actions as violent or aggressive, other people, especially the victims of deliberate firesetting, may not share this view. Historically, firesetters have often erroneously been viewed as a homogenous group of non-violent offenders (Hill et al., 1982; Jackson, Glass and Hope, 1987b), and arson continues to be construed within the criminological literature as a property crime, despite the fact that some arson offences clearly involve violent intent.

Firesetting by children and juveniles As noted earlier, a small child may have no intention of causing extensive damage or harm to others, but this may nevertheless occur. For this reason, young children who set fires, usually at home, are often referred by their anxious parents to psychiatric and social services. This referral may be at their own initiative, or on the advice of the fire service or police who have been called to deal with a house fire (Winget and Whitman, 1973). It is not uncommon, therefore, for professionals working in child and adolescent psychiatric services to be referred child firesetters to undertake assessment and treatment (Kolko and Kazdin, 1989a, 1989b). However, surveys of child and adolescent mental health services, in North America and Britain, have revealed a history of firesetting in a significant number of young people referred with other complaints, especially in boys with behavioural and conduct problems (Vandersall and Wiener, 1970; Kafry, 1980; Strachan, 1981; Kuhnley, Hendren and Quinlan, 1982; Stewart and Culver, 1982; Heath et al., 1983; Kolko, 1985; Bradford and Dimock, 1986; Kolko and Kazdin, 1988). A significant proportion of young people referred to fostering projects will also have a history of firesetting, although this may not always be apparent. For example, of the 81 adoles­ cents referred to the Monitor Programme based in Oregon, a specialist community-based foster care alternative to custody for chronic juvenile offenders, 15% of males and 3% of females had a recorded history of firesetting (Chamberlain and Reid, 1994). Few of these studies, however, deal with treatment issues, although there are a number of helpful singlecase studies (Holland, 1969; Eisler, 1974; Awad and Harrison, 1976;

Understanding and Treating Adolescent Firesetters

43

McGrath, Marshall and Prior, 1979; Jones, 1981; Carstens, 1982; Kolko, 1983; Wolff, 1984). In England and Wales, firesetting in children aged 10 years and above may result in criminal proceedings. In a minority of cases, where fireset­ ting has resulted in loss of life, presented a serious threat to life, or caused extensive property damage, conviction may result in sentencing under Section 53 of the 1933 Children and Young Persons Act, for a period of custody between 2 years and life. There is a shift in the pattern of firesetting between children and juveniles, associated with a variety of other changes that accompany adolescent development. An increase in freedom and independence, and involvement in peer-group activities in the absence of parental supervi­ sion, are accompanied by an increase in firesetting in community settings (Stewart and Culver, 1982). Typical targets for this kind of vandalism include areas of grassland, waste disposal skips, derelict buildings, rubbish dumps, schools and other public buildings. It is for this reason that juvenile firesetting is sometimes seen as a significant threat to society, with serious financial implications for both the public and private sector, and causing risk to life. In North America, for example, private corpora­ tions have made significant financial investment in preventing juvenile firesetting through funding educational fire-prevention programmes (e.g. Burger King Corporation, 1979). Reliable data on the incidence of juvenile firesetting are scarce. The majority of small, deliberate fires probably go unreported and undetected. Further, when a fire is reported it is often difficult to attribute responsi­ bility to an individual, because of a lack of forensic evidence. Nevertheless, in the USA, fire service statistics indicate that juveniles are responsible for 60–75% of intentionally set fires (Dittmar, 1991). As noted earlier, it seems likely that many incidents of juvenile firesetting are perpetrated by small groups of youths (Fine and Louie, 1979; Strachan, 1981), where reinforce­ ment is derived from the social context and the feelings of excitement, fear and danger. In some instances a gang leader or dominant group member may exert control over group activity to fulfil personal ambitions – for example, to set fire to a school or to property belonging to a gang rival. Against this background of delinquent group firesetting, however, there are a number of firesetters who operate alone. As noted earlier, individuals who deliberately set fires are motivated by a variety of factors that have been shaped by personal learning experiences, which sometimes include exposure to fire-related incidents. To a greater or lesser degree, individual juvenile firesetters will gain satisfaction from the experience of watching fire, and/or from the consequences of firesetting, such as revenge, escape or avoidance, or attention from others. If detected

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and convicted, the majority of these individual firesetters are likely to be dealt with by the criminal justice system. Typically, their firesetting will be construed as a deliberate, reckless activity which can be prosecuted and dealt with in the same way as other criminal behaviours. Some juvenile firesetters, however, are likely to provoke more concern and anxiety, which sometimes results in psychiatric or psychological evalu­ ation and a referral to treatment services. This is most likely to occur where there are: • evidence of fascination and preoccupation with fire and related phenomena (e.g. bomb-making, explosions) • a history of repeated firesetting • learning difficulties • mental illness, especially where an abnormal mental state (e.g. paranoid delusions, depression) is directly related to the risk of firesetting • intense feelings of anger and hatred towards potential victims, accom­ panied by a desire for retribution and revenge through firesetting • threats to set further fires in particular circumstances (e.g. if the young person is bullied again, or not moved to a different placement). It is likely that the most complex, worrying juvenile firesetters are over­ represented in secure settings (e.g. secure accommodation units, secure adolescent psychiatric units, Young Offender Institutions). Although in their recent survey of 27 young offenders detained in a Young Offender Institution (YOI) under Section 53(2) of the 1933 Children and Young Persons Act, Puri, Lambert and Cordess (1996) found only 2 young people with a psychiatric history, it is significant that one of these had a history of firesetting. This young man presented with a variety of complex problems, including educational failure, behavioural problems, a preoccupation with knives, a history of self-mutilation, anxious ruminations about death and a history of substance abuse. Further epidemiological evidence comes from a survey of young people detained in secure conditions at Glenthorne Youth Treatment Centre, which accommodates some of Britain’s most difficult and delinquent young people (Bullock et al., 1990). Of the 79 young people admitted to the centre over an 18-month period, Falshaw and Browne (1997) found that 33 (42%) had a history of arson, 11 (14%) of whom were convicted of the offence of arson-with-intent.

Adverse childhood experiences and juvenile firesetting The presence of a link between child abuse and juvenile firesetting has been alluded to earlier. Hollin and Epps (1996) describe the case of a

Understanding and Treating Adolescent Firesetters

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juvenile firesetter who set a fire to avoid further incidents of sexual abuse. In these instances, firesetting has been used to escape abusive living environments, to draw attention to their plight as the distressed victims of abuse or neglect, or to attack the perpetrator of abuse. However, it seems likely that the relationship between neglect and maltreatment and juvenile firesetting may extend beyond a few isolated cases seen in clinical settings. In recent years there has been mounting evidence of a link between neglect and maltreatment and delinquency (see Garbarino and Plantz, 1986; Lauritsen, Sampson and Laub, 1991; Zingraff et al., 1993; Jonson-Reid, 1998), often in the context of family dysfunction and educational failure (Henggeler, 1989; Farrington, 1990; Sampson and Laub, 1993). As noted earlier, firesetting is part of the spectrum of antisocial behav­ iours associated with juvenile delinquency, and there is considerable evidence that the families of many juvenile firesetters are characterised by high levels of parental absence, family breakdown and disorganisation, parental psychopathology, erratic styles of parental monitoring and disci­ pline, and low levels of parental involvement with their children (Strachan, 1981; Prentky and Carter, 1984; Kolko, 1985; Bradford and Dimock, 1986; Kazdin and Kolko, 1986; Kolko and Kazdin, 1988, 1989a, 1990). Unfortunately, research in this area has been confounded by defini­ tional and methodological problems, making it difficult to draw firm conclusions about the specific role of maltreatment in the aetiology of delinquency and firesetting behaviour. Measurement of delinquency as a unified concept, for example, is misleading, since it might mean anything from a very minor offence to murder. A similar problem exists in relation to use of terms such as child abuse (physical, sexual, emotional), neglect and maltreatment (Herzberger, 1990; Schwartz, Rendon and Hsieh, 1994). The latter note that ‘clear, concise, easily understood, and agreed-upon definitions of child abuse and neglect continue to elude us’ (p. 644), and conclude that their ‘analysis suggests that the claims that child maltreat­ ment is the leading cause of delinquency cannot be substantiated by avail­ able evidence’ (p. 651). The reluctance of some young people to report abuse also contributes to the lack of accurate information. Finkelhor (1988) suggested that the experience of having been abused is one that many young people find difficult to verbalise, and that disclosure in and of itself can be traumatic. Evidence for this comes from a study by Worling (1995), who pooled data from a number of studies of juvenile sex offenders. He found that the mean frequency of sexual abuse reported by researchers using pre-treatment data was 22% (256 out of 1180 participants), whereas the frequency reported by investigators using post-treatment information was signifi­ cantly higher at 52% (46 out of 88 participants).

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It is perhaps not surprising, therefore, that estimates for the prevalence of neglect and maltreatment in delinquent populations vary enormously (Schwartz, Rendon and Hsieh, 1994). Nevertheless, bearing in mind the measurement difficulties, there is evidence that levels of abuse are particu­ larly high in chronic, recidivist juvenile offenders detained in secure units and custodial settings. In her study of the population of Section 53 offenders, Boswell (1991) estimated that as many as 90% had been physi­ cally or sexually abused; Falshaw and Browne (1997) concluded that 72% of the 79 young people detained at Glenthorne ‘originated from abusive and neglectful family environments’ (p. 453). Unfortunately, even less is known about the links that exist specifically between maltreatment and the development of firesetting in children and juveniles. To date, research has focused almost exclusively on the relation­ ship between abuse and the development of aggressive and violent behav­ iour (e.g. Rivera and Widom, 1990; Widom, 1996; Falshaw, Browne and Hollin, 1996). One exception to this is the study by Jayaprakash, Jung and Panitch (1984), who found a higher incidence of physical abuse in child firesetters than in non-firesetters. Two other studies also provide data on levels of abuse in juvenile firesetters, although they do not report data on comparison groups. Gruber, Heck and Mintzer (1981) found that 35% of the 90 child firesetters in their study had been subject to parental physical abuse, and Epps, Swaffer and Hollin (1996) found undisputed evidence of sexual abuse in 14% of male (N = 35) and 50% of female (N = 12) adoles­ cent firesetters detained at Glenthorne. There is, in fact, evidence that the incidence of physical abuse is even higher in other types of juvenile offender. Rates of physical abuse in studies into sexually abusive adoles­ cents, for example, vary between 40% and 82.6% (Epps, 1999), and are associated particularly with violent sexual offending (Lewis, Shankok and Pincus, 1981). In contrast, however, Truscott (1993) found no difference in the physical abuse histories of the 23 sexual, 51 violent and 79 property offenders in his study. Regrettably, information about neglect and maltreatment in convicted juvenile offenders is not routinely collected, even in those with a history of serious offending who often present with complex psychosocial problems (Epps, Swaffer and Hollin, 1996; Puri, Lambert and Cordess, 1996). From a clinical perspective, it is important to bear in mind that it is the young person’s perception of maltreatment that is often most significant, something that is frequently neglected in the research literature. Parents may consider their behaviour to be benign, but may nevertheless be perceived by children as uncaring, neglectful or even abusive, thereby provoking feelings of intense anger and hatred. It is interesting to note, for example, that, following desertion by his mother during childhood, Isaac

Understanding and Treating Adolescent Firesetters

47

Newton fantasised about setting fire to the house she shared with his stepfather (White, 1997). Fortunately, he refrained from acting on his violent fantasies. Clearly, empirical research is needed into the development of fireset­ ting behaviour and its relationship to a variety of psychosocial variables, including neglect, abuse and maltreatment. All that can be concluded at the present time is that there is some evidence to suggest that improved childcare practices, such as a reduction in physical and sexual abuse, may lead to an overall reduction in delinquency, and fewer incidents of delib­ erate firesetting.

Responding to firesetting behaviour Interventions aimed at reducing the risk of firesetting can be divided into two broad categories: fire prevention strategies and clinical intervention programmes. Fire prevention strategies This type of intervention reflects the concern of the wider community about juvenile firesetting and the possible risk to life and property. Impetus for developing this type of programme in a particular geograph­ ical region typically comes from the fire service, often in conjunction with local educational authorities (see Karchmer, 1983; Horn, 1996) or commercial enterprises with a vested interest in fire prevention (e.g. Burger King Corporation, 1979). Fire services have a long history of running fire safety education and awareness programmes. Schoolchildren are an obvious target for this type of approach. To begin with, they spend a great deal of time in public buildings where fire safety is important. In addition, the fire services recognise that children and juveniles are at increased risk of firesetting, especially at high-risk times of the year. In Britain, for example, the weeks before and after 5 November (Guy Fawkes night) are associated with an increase in firesetting (Home Office, 1988). In the USA, fire safety education has been extended beyond the school context and into community organisations (FEMA, 1983; Gaynor, McLaughlin and Hatcher, 1984; Kolko, 1988). In some states, programme leaders have liaised with clinical psychologists who have experience of working with firesetters. Fineman (1980), for example, has written about his work with the fire service in California. Similar programmes have been developed in Australia (Adler et al., 1992) and, more recently, in Britain (Broadhurst, 1996; Gough, 1998). This interest has, at least in part, been motivated by concern about an increase in juvenile firesetting in several inner-city areas and in schools

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(Horn, 1996; Knights, 1998), and led to the formation of the Arson Prevention Bureau’s Arson in Schools Committee (Gough, 1998). A recent development is the introduction of fire service counselling programmes, in which firefighters volunteer to undertake training in basic interviewing and counselling skills to improve their ability to relate to children and juveniles who are known or suspected to have set fires (Eglintine, Horn and Muckley, 1993). Although this work is at an early stage of development in Britain, and has not been evaluated, this strategy clearly has a number of benefits. Firefighters often have face-to-face contact with young firesetters as part of their routine fire investigation procedures, and are often best placed to deliver advice to families and children about fire safety. The development of personal skills to improve this process and, where neces­ sary, to undertake follow-up counselling is a logical extension of this role. There are also examples of firefighters delivering more complex psycho­ logical interventions, working in conjunction with childcare and mental health professionals. Adler et al. (1992), for example, provide preliminary outcome data on 120 firesetting children and juveniles aged between 5 and 16 years, 61 of whom were treated by the Melbourne Fire Brigade and Royal Children’s Hospital joint programme. The intervention, delivered by firefighters in the child’s home, involved fire-safety education; an 8-week behaviour management programme employing satiation and overcorrec­ tion, based on a report by Welsh (1971); a ‘graphing technique’, developed by Bumpass, Fagelman and Brix (1983), to help children gain awareness of the link between their feelings and dangerous behaviour; and instructions for parents in implementing response-cost and restitution in the case of subsequent firelighting incidents. The remaining 59 children were randomly allocated to a control group, who were provided only with a safety education booklet. Interestingly, the majority of children ceased lighting fires within the first 6 months following referral, and there was no significant difference between the control and treatment groups. Adler et al. conclude that ‘a high percentage of children can be expected to stop fire-lighting, even if they do not receive the firefighter’s intervention’ (Adler et al., 1992:2). However, the authors stress that this was a preliminary evaluation of outcome, and recommend that a follow-up of at least 18 months is required. Clearly, the fire service has the potential, given adequate funding and support, to deliver successful interventions to a significant proportion of juvenile firesetters. It is inevitable, however, that there will continue to be a number of young firesetters whose firesetting behaviour causes more concern, often in the context of a constellation of complex clinical problems that require expertise beyond that of the fire service. Nevertheless, the fire service can continue to play a useful role in clinical

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treatment programmes, providing fire-safety educational materials and training, and access to fire investigation reports. Clinical intervention programmes As noted earlier, it is likely that the most complex and worrying juvenile firesetters are seen in mental health settings and specialist childcare facili­ ties. In some instances firesetting will be the primary referral problem; for example, where the young person has a conviction for arson. In other cases, perhaps the majority, firesetting will simply be one of many problematic behaviours and may become apparent only after a period of information gathering and assessment. Clinical assessment Intervention programmes designed to reduce the risk of firesetting in complex cases tend to be individualised (i.e. clinical), and consider fireset­ ting behaviour in the context of overall personal functioning (DeSalvatore and Hornstein, 1991). As noted earlier, however, firesetters are not a homogenous group, and firesetting behaviour is sometimes associated with very personal, idiosyncratic psychological processes. The goal of assessment is to identify these processes, evaluate the extent to which they place the individual at risk of firesetting, and consider the types of inter­ vention that may reduce risk. The assessment of juvenile firesetters referred for clinical intervention employs many of the same strategies and techniques used to assess other types of offending behaviour, including interviewing (if necessary, with parents, family members and teachers), direct behavioural observation, self-monitoring (e.g. diary-keeping), psychometric testing, questionnaires and rating-scales, and collation of information gleaned from previous reports and records (archival information). The aim of assessment is to arrive at the best possible understanding of the factors that resulted in firesetting behaviour, and the extent to which these factors continue to place the individual at risk. Archival information, if available, will usually provide some indication of the complexity and depth of assessment that is required. As noted earlier, juvenile firesetters with the most complex array of problems are more likely to be referred to specialist treatment units, where assessment will require more time and resources. Where there is a history of psychi­ atric illness, for example, further psychiatric assessment may be warranted. Similarly, evidence of serious conduct disorder, learning diffi­ culties, unexplained educational failure, epilepsy or head injury that has not previously been investigated, may indicate the need for psychological

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or neuropsychological testing, or neurological examination. In these instances, it can be difficult to decide which avenues of investigation to pursue, and how to relate findings to the risk of firesetting. Ultimately, interpretation of clinical information and its bearing on risk of firesetting are a matter of clinical judgement and opinion, guided by clinical experi­ ence and knowledge of firesetting. It is important to achieve an understanding of the sequence of events that resulted in each firesetting episode (Jackson, 1994). Where there is a long history of firesetting and a strong interest in fire reaching back to early childhood, it is useful to encourage the young person to retrace this interest, and to look at early memories and experiences of fire. Kolko and Kazdin (1989a, b) and FEMA (1979, 1983) have developed useful inter­ view protocols for use with children and juveniles. Occasionally, there may be one significant event that provides the stimulus for further interest in fire. This may involve direct exposure to fire, perhaps through watching an older sibling or friend (i.e. a social role model) experimenting with matches. Preoccupation with fire may be reinforced through fantasy, in which fire becomes a dominant image in childhood fantasies of violence and revenge against perceived enemies. Clearly, in this kind of scenario, many years may pass before the fantasy is acted upon, perhaps in response to a specific trigger (e.g. an incident of bullying at school), such that there is no overt evidence of childhood interest in fire. This type of information can only be obtained from close and detailed interviewing, and requires the young person’s co-operation, which is not always forthcoming. The young person may be unco-operative or deceitful, or find it difficult or distressing to recall childhood events. Where available, the use of forensic evidence from the fire service and police (e.g. fire investigation reports) can help to establish the circum­ stances surrounding a particular firesetting event. The incident can be reconstructed during interview and factual information used to prompt recall from the young person about thoughts, feelings and behaviours at specific points before, during and after the offence. Firesetters who are initially reluctant to discuss their index offence of arson may nevertheless be drawn into a discussion about fire and the technical details of the fire service investigation report (e.g. the location where fires were set). Once rapport has been established, it may be possible to identify the distorted thoughts and beliefs that have a bearing on risk. For example, some fireset­ ters consider the consequences of firesetting to be beyond their control: it is the fire, not their actions, that has caused the damage. This type of cognitive distortion can be used to minimise personal responsibility for damage, thereby reducing feelings of anxiety and guilt and the desire to

Understanding and Treating Adolescent Firesetters

51

take part in treatment. There may also be an attempt to attribute blame to others. For example, blame may be apportioned to the fire service for not arriving quickly enough, to the security guards for not patrolling the building effectively, or to the owners of the building for not installing CCTV. Clearly, these types of cognitive distortions would need to be challenged during treatment. Observation and management in residential and institutional settings Where juvenile firesetters are looked after in a residential context, behav­ ioural observation can sometimes shed light on aspects of behaviour that are related to the risk of firesetting, and which inform the daily care and management of the young person. Not surprisingly, firesetters tend to arouse considerable anxiety in residential contexts, especially in the period immediately following admission. Firesetting in childcare settings frequently results in termination of the placement, and makes it difficult to place the young person elsewhere. Managers of residential childcare facili­ ties will be anxious about the risk to other young people and staff, and potential foster carers will find it difficult, if not impossible, to insure their house and contents. Additional supervision and vigilance may be required, especially regarding access to matches and cigarette-lighters, and the hoarding of combustible materials, such as newspapers and magazines. The research literature has drawn attention to three types of behaviour that are especially pertinent to firesetting and which are open to observa­ tion in residential settings: • impulsivity (Siegelman, 1969; Vandersall and Wiener, 1970; Block and Block, 1975) • poor assertion skills (Rice and Chaplin, 1979; Vreeland and Levin, 1980) • strength of interest in fire (Kafry, 1980). Interestingly, the problems of impulsivity and underassertiveness are clearly reflected in the study by Vandersall and Wiener. Of the 20 fireset­ ters in their study, 9 were described as infantile, impulsive, hyperactive and disruptive, and 8 as neat, compliant and ingratiating. There has been considerable speculation about the possible biological determinants of impulsivity and its relationship to criminal behaviour (Pulkkinnen, 1986) and to arson specifically (Virkkunen et al., 1989). In adult firesetters, impulsivity has been used as a legal defence (Cleckley, 1959), and the psychiatric entity ‘pyromania’ is construed as a disorder arising from poor impulse control (Blackburn, 1993). However, research

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in this area has been plagued by conceptual difficulties. Specifically, in some instances the term ‘impulsive’ is used simply to describe behaviour, but in others it is used to explain behaviour. In conduct-disordered and delinquent young people, the term ‘impul­ sivity’ is generally used to describe a variety of behavioural problems which are open to observation (see Herbert, 1987). These problems include over-activity, restlessness, sensation-seeking, distractibility, poor tolerance for frustration, non-compliance, aggression, and poor planning and organisation. High levels of disorganised and unpredictable behav­ iour clearly create problems for risk assessment and for day-to-day care and management. In addition, treatment is likely to proceed at a slow pace, if at all, because of non-compliance and difficulty in acquiring new skills and information. With respect to juvenile firesetters, it remains unclear whether there is a subgroup who have a strong underlying predisposition to impulsive behaviour that serves to undermine self-control. However, there are related clinical conditions, such as attention deficit hyperactivity disorder (ADHD), which can lead to erratic, unpredictable behaviour, and interfere with treatment progress. In these instances, psychiatric evaluation is required, with a view to looking at the possible benefits of pharmacolog­ ical treatment as an adjunct to interventions in firesetting behaviour. The problem of poor assertiveness skills also has a long tradition in research on firesetting. Observation of adult arsonists in institutional settings indicated lower levels of assertive behaviour in comparison to other types of offender (Rice and Chaplin, 1979). This observation led to the hypothesis that prolonged periods of submissive, acquiescent behav­ iour may result in a slow build-up of anger and hostility, and that this inter­ personal conflict is eventually resolved through firesetting as a way of avoiding physical confrontation. This sequence of events is certainly seen in some juvenile firesetters, and is open to observation in residential settings. One young firesetter, detained in a secure accommodation unit, was always pleasant and eager to help staff, and never complained or presented problems. After a period of several weeks it was suggested that he keep a diary of angry thoughts and feelings. The diary revealed a constant flow of angry thoughts, with violent threats and fantasies directed towards several members of staff and young people. This led the treatment planning team to recommend a course of assertiveness skills training, using instruction, modelling and role-play. One of the difficulties inherent in the assessment of firesetters is that no observation can be made of the target behaviour. Juvenile firesetters detained in secure settings, for example, will have no access to fire-raising materials, and will not be exposed to fire during the entire length of their

Understanding and Treating Adolescent Firesetters

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stay. Further, in common with many other types of criminal behaviour, firesetting is often carried out in secret, away from prying eyes. Some offenders are also reluctant to divulge important aspects of their offending behaviour, and associated thoughts, feelings and fantasies. This can make assessment of risk very difficult. Nevertheless, it is sometimes possible to gain some idea about the strength of interest in fire through direct obser­ vation. In addition to providing information about the frequency and persistence of firesetting, some firesetters show a particular interest in television programmes, news items and films depicting fire, perhaps becoming excitable or preoccupied. They may also collect newspaper or magazine articles about fire, and become particularly aroused if the fire service is called to deal with an incident. One adolescent firesetter seen in a secure unit, for example, would race to the window whenever a fireengine arrived, and would stay there until it departed. He maintained a strong interest in fire over a period of several years, and would frequently introduce the topic into conversations. Interestingly, despite continued concern about his risk of firesetting, during the 2 years since leaving custody he has not set any further fires. He has also managed to find stable employment, and appears happy and content. Treatment The design and delivery of individualised treatment programmes should flow from a formulation based on a comprehensive assessment. It is especially important to consider the role of developmental and intellectual factors. Interventions designed for older children may not be suitable for younger children or those with learning difficulties. In the most complex cases, a multi-modal package of interventions will be indicated, addressing the various factors considered to contribute to the risk of firesetting (McGrath, Marshall and Prior, 1979). For example, remedial education, training in assertiveness skills, family therapy, offence-focused counselling, education in fire safety and awareness, and pharmacological interventions, may be used in conjunction over a period of months or even years. In other cases, however, fewer interventions will be required, over a shorter period of time, focused more explicitly on firesetting behaviour. The offence-focused component of treatment programmes generally begins by exploring attitudes to firesetting, with a view to helping the young person to accept personal responsibility for firesetting, increasing awareness of the damaging consequences of uncontrolled fires, and enhancing motivation to participate in treatment. In one of the few larger scale intervention studies, Bumpass, Fagelman and Brix (1983) describe a ‘graphing technique’, referred to earlier, which they used with 29 children. Of these, 25 had set multiple fires, and 19 had been unsuccess­

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fully treated by a variety of other professionals. The graphing technique produces a visual representation of the relationships between the child’s feelings, external events and problem behaviour, and aims to clarify cause–effect relationships and replace firesetting with constructive alter­ natives. Only three patients were reported to have engaged in firesetting during a follow-up period ranging from 6 months to 8 years (M = 2.5 years).

Conclusions It is difficult to avoid the conclusion that the phenomenon of firesetting behaviour in children and juveniles is poorly understood, a view previ­ ously expressed by a number of authors (e.g. Fineman, 1980; Kolko, 1985; Barnett and Spitzer, 1994). Historically, advancement in this field has been hampered by a lack of empirical research and an excess of armchair theorising and speculation. Although this state of affairs has been rectified to some extent, with a number of authoritative literature reviews and a concerted effort to apply a more rigorous, empirical approach (see Kolko, 1985), the area continues to suffer from a lack of large-scale empirical research. The absence of information about the natural history of fireset­ ting behaviour in children and juveniles is especially disconcerting. It is possible that firesetting behaviour follows a variety of distinct develop­ mental pathways, some of which may be associated with an increased risk of persistent, recidivist firesetting. It is now known, for example, that the delinquent behaviour of some juveniles is ‘adolescence-limited’, whereas others follow a ‘life-course-persistent’ pattern, showing antisocial behav­ iour well into adulthood (Loeber and Dishion, 1983; Farrington, 1986; Scholte, 1999). At present, the state of knowledge about treatment outcomes is extremely poor, and even less is known about matching individuals to the most appropriate type of intervention. It seems that many, perhaps the majority, of young firesetters stop setting fires of their own accord; however, given the danger to life and property arising from even one fire, this is no cause for complacency. Of those who are treated, many seem to benefit. However, the lack of controlled studies makes it impossible to draw conclusions about the effectiveness of treatment. The problems encountered in advancing understanding and practice in this field mimic those found in work with other types of young offender, such as sexually abusive adolescents. A complete understanding of fireset­ ting in children and juveniles, and a comprehensive approach to preven­ tion and intervention, can only be achieved through the combined efforts of a wide range of professions (e.g. psychiatry, psychology, social work,

Understanding and Treating Adolescent Firesetters

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education, juvenile justice, fire service), each of which has different conceptual, theoretical, professional and legal frameworks. Juvenile firesetting is clearly a social problem with consequences that extend beyond the young person and the family. At present, it is not clear which firesetters can best be helped by which group of professionals. The term ‘firesetting’ simply describes a behaviour that has multiple determi­ nants, and does not constitute a diagnosis with a well-defined aetiology or prognosis. If practice in this area is to be improved, empirical research must be carried out to explore the extent to which juvenile firesetters can be classified into meaningful subgroups which have clear implications for intervention. It will be especially important to develop reliable methods for identifying high-risk firesetters, and to assess the extent to which risk can be reduced through intervention. This research will necessitate multiagency longitudinal research and controlled treatment studies with follow-up periods that extend well into adulthood.

CHAPTER 4

The Antecedents of Young Male Sex Offenders

VICTORIA HARRIS AND CARL STAUNTON During the last two decades of the twentieth century a great deal of research and literature on the subject of sex offenders and their character­ istics was published. In this context only spasmodic attention was paid to the specific category of adolescent offenders until comparatively recently. This was surprising given that, in the USA, in the early 1980s, an estimated 30–50% of sex offences against children were committed by adolescents (Davis and Leitenberg, 1987), and in the UK in the early 1990s, around 30% of all sex offence convictions or cautions were of young people under 21 years of age (Vizard, Monck and Misch, 1995). A recent literature review concluded that, although the majority of adolescent sex offenders are unlikely to reoffend as adults, it is neverthe­ less the case that a large proportion of adults who offend against children report that related preoccupations began in adolescence (Grubin, 1998). Thus, it is important to examine more closely the features and environ­ ments of these young people (most of whom cannot become ‘offenders’ in legal terms, until at least the age of 10 years) in order to try to discover how and why they come to behave in a sexually violent way. Although knowledge is accumulating all the time, it is still not possible definitively to identify the causes of sexual offending by young people. However, this chapter aims to review some relevant research findings which, overall, show that there are layers of antecedents that, when combined and conjoined, can create sexually aggressive young men who are a risk to society. The review is confined to a consideration of young male sex offenders, since comment on the relatively small group of young females can be found elsewhere in this volume (Bailey, Chapter 7) and in Vizard, Monck and Misch (1995) amongst others. The scope of the chapter also limits full discussion of the possible influences of genetic disposition and chemical 56

The Antecedents of Young Male Sex Offenders

57

imbalance, where research has been sporadic in nature. However, examples of work in these fields can be found in accounts by Quinsey et al. (1993) and Thibaut, Cordier and Kuhn (1996 ) respectively. It is relevant, also, to note that the 1990s saw a resurgence of interest in genetic factors and the way in which they may interact with the environment to produce a range of antisocial behaviours (Hagell, Rutter and Giller, 1999). Sexual offending covers a wide range of deviance extending from simple exposure to sexual murder. To the extent that any such act consti­ tutes an emotional and/or physical assault on the victim, it may be viewed as a violent act, and this provides the context for the present review. The categories of antecedent which most commonly appear in the literature on young male sex offenders are addressed in turn, and the implications of the findings are considered at the end of the chapter.

Family environment It is widely acknowledged that the family environment in which children develop is crucial to their emotional and psychological state as young adults (Finkelhor, 1984; Barbaree, Marshall and McCormick, 1998; Becker, 1998). In a North American study examining the family environments of a group of over 1600 adolescents, Ryan et al. (1996) found that neglect, physical and sexual abuse and loss of a parental figure were prevalent. Interestingly, about 25% of the over 12s in Ryan et al.’s sample, which was taken from a wide range of sex offender treatment programmes, were found to have been sexually abusive, though infrequently convicted, prior to that age. This provides evidence indicative of a gradual progression of inappropriate sexual behaviour, from childhood through to adolescence, and potentially beyond, showing the importance of interim treatment interventions. Also in the USA, Knight and Prentky (1993) had found that 41% of adolescent sex offenders reported physical abuse, compared to only 15% of other offenders. Kaufmann (1994) found that offenders were predomi­ nantly males, with an average age of 17 years, who had observed or experi­ enced sexual abuse and physical violence when they were children. This study found little significant difference between intra- and extra-familial offenders. However, their parents and guardians reported that their children experienced high levels of physical problems and social difficul­ ties, and this was especially true of the extra-familial offenders. A study undertaken in Virginia, examining the family environments of young sex offenders compared with those of other juvenile delinquents, also found a prevalence of social adjustment problems. It showed that cohesion, expressiveness, independence, intellectual-cultural orientation and control were less developed in young sex offenders than in the

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normative sample (Bischof, Stith and Whitney, 1995). Likewise, Barbaree, Hudson and Seto (1993) found similar results to other studies in respect of family instability, frequent violence, and sexual and physical abuse, but also added high rates of disorganisation to their list of antecedents for juvenile sex offenders. They further suggested that family relationships for this group were low in positive and high in negative effect. A UK study, based on a sample of 25 respondents from south-east England, compared sexually victimised boys developing sexually abusive behaviour with those who had not (Skuse et al., 1998). Although small in scale compared with some of the studies in the USA, it provided important confirmation that, although a history of sexual abuse appears prevalent amongst young sex offenders, other factors appear to be equally influen­ tial on the level of risk of these young victims developing into perpetra­ tors, in turn. These include, notably, disrupted and unstable patterns of care during childhood, physical abuse by parental figures and exposure to intra-familial violence (including witnessing), leading to a sense of helplessness. In terms of increased risk of sexual re-offending, the following were also found to be significant: an absent father figure; familial emotional abuse or rejection; childhood sexual abuse of the young offender’s mother – in this study as high as 43%. Work undertaken by Cahn and Lloyd (1996), in relation to intra-familial communication and domestic violence, suggested that aggression develops historically from ‘courtship violence’, when the parents are dating, to violence within the marriage and then to assault on any children of the marriage. This pattern was identified most strongly in the families of adolescent sex offenders, when compared with families of other adoles­ cent offenders and with a normative sample. A number of themes can be seen to have emerged from this brief review. It seems clear that violence within the family including, notably, physical abuse, but also sexual abuse and the witnessing of violence by and to others, is a risk factor for adolescent offending but especially for sexual offending. A history of sexual abuse in mothers of young male sex offenders is significant in the British study but, clearly, requires further research. Social and interpersonal skills deficits appear common, though the likelihood is that these are factors which derive from the more primary family problems. Finally, histories of neglect, discontinuity of care, and loss, show up regularly in these studies and will be further considered under the category of attachments.

Attachments The theory of attachment provides a perspective for understanding the behaviour of children in later relationships (Bowlby, 1969). Secure and

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loving attachments with parents, it is suggested, produce confident young people with good social skills and an ability to make other loving relation­ ships. Those who have suffered significant loss, or relationship disruption from someone to whom they have been emotionally attached – frequently a parent – may not develop these attributes and, indeed, may become deficient in empathetic and interpersonal skills (Bowlby, 1988). In the present context it is material to note that loss may be: an experience which, in common with acts of abuse, constitutes a major source of childhood trauma which, depending on how it is handled, may later contribute to disordered behaviour, including aggression and violence. (Boswell, 1996)

The experience of loss, rejection, lack of warmth or empathy from parental figures can set a template of insecurity upon which subsequent experiences at school, in the extended family and with friends can be superimposed. However, although extra-familial positive experiences, such as with other caring adults or peers, can ameliorate damage from childhood, young people with poor attachment or avoidance behaviour are often less popular with their peers and cannot easily express themselves in the intimate relationships which are a normal develop­ mental feature of adolescence (Marshall et al., 1993) This can also help to explain later low self-esteem, antisocial, fearful and sometimes aggressive behaviour. Research by Marshall has focused on understanding the possible links between disruptive attachment, intimacy-deficit and sex offending. Generally, such investigations have found a prevalence of insecure attach­ ment, high levels of anxiety and social isolation in young male sex offenders. Marshall (1989), for example, found in a study of young males that a significant number reported few social contacts and close friends. The same group also described their parents as having been absent, detached or rejecting. It was suggested that a fear of intimacy appeared to be a major factor in their initial and subsequent offending. Marshall pointed out, however, that although insecure and disrupted attachment was common to many juvenile offenders (65%), a substantial number of them did not go on to offend sexually. Also, not all adolescent sex offenders had an offending history. Some indication of why this should be the case can be gleaned from a study undertaken by Fagan and Wexler (1998) who found that juvenile sex offenders were even more socially isolated than chronically violent juveniles, and particularly so in their lack of relations with peer-aged females. Social isolation indeed merits a category on its own, for which space is not available here. In some cases it appears to derive from problematic

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attachments, but it may also have roots in childhood abuse, other intrafamilial problems, peer-group dynamics, learning difficulties, racism or other forms of discrimination. Some of these features may also interact to produce isolated individuals. American research found social inadequacy common to all adolescent offenders, but young sex offenders demon­ strated higher levels of social isolation and more marked lack of assertive­ ness (Barbaree, Hudson and Seto, 1993). In the most extreme cases of sexual offending – murder with a sexual motive – 77% of a total of 36 respondent murderers reported a sense of isolation during their adoles­ cence, leading to dependence on an internal fantasy world, arguably one in which they felt in control (Ressler, Burgess and Douglas, 1993). It has further been suggested that there may be links between socially isolated, insecurely attached young people and later empathy deficiency. Sex offenders have been shown to have empathy deficits (Marshall et al., 1995), and one explanation for this could be their lack of experience within intimate caring relationships. Therapists working in treatment programmes have also recognised that empathy deficit plays a significant role in their antecedent history (Knopp, Freeman Longo and Stevenson, 1992). An evaluation of the effect of treatment programmes on empathy deficit emphasised the need for therapists to find sophisticated ways in which to encourage empathy towards others, with a further recommenda­ tion that: the impact of shame on the capacity to experience one’s own emotions is examined in relationship to childhood trauma. (Roys, 1997:58)

The goals of a treatment programme at Fort Wayne, Indiana (Newbauer and Hess, 1994) also emphasised the importance of increasing empathy for the abused by the abuser. They additionally stressed the related need to address cognitive distortions in views towards girls and women in general. The work of Barbaree, Marshall and McCormick (1998) has subse­ quently begun to locate empathy deficits in the domain of cognitive distor­ tions which justify offending behaviour, while arising from damaged attachment experiences. In summary, research incorporating the attachment theory framework suggests states of loneliness and isolation in young male sex offenders which appear to be rooted in their earlier childhood experiences of disrupted attachment. These states are characterised by fear of intimacy, high levels of anxiety, low self-esteem, poor social skills, empathy deficits and cognitive distortions. With conventional pathways to sexual relation­ ships thus being denied to them, sexually coercive and victimising behav­ iour may ensue. However, as discussed above, it is important to note that some of the same manifestations may evolve for different reasons, and an

The Antecedents of Young Male Sex Offenders

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analytic approach needs to be taken when investigating their develop­ ment. Whatever the apparent cause, however, the likelihood is that, along with other adolescent sex offenders, some young people with these characteristics are likely to come to the attention of the mental health services.

Psychological disturbance Public perception sometimes tends towards the belief that, owing to their aberrant behaviour, sex offenders suffer from some form of mental illness. However, under the terms of the Mental Health Act 1983, the majority of sex offenders would not be categorised as mentally ill. Nevertheless, psychological disturbance is prevalent. If it is the case that sex offenders have suffered abuse as children, then similar effects to those found in the damaged attachments category appear. Browne and Finkelhor (1986) suggest that the long-term effects of child abuse include fear, anxiety, depression, anger, hostility, inappropriate sexual behaviour, poor selfesteem, tendency towards substance misuse and difficulty with close relationships. Rauch et al. (1996), in research on victims of childhood and adult trauma in the USA, have found that sexual and other abuse can alter a brain region. Survivors of such trauma may also experience flashbacks and other manifestations of post-traumatic stress disorder similar to those suffered by victims of disasters (Yule and Williams, 1990) This may, in turn, lead to states of dissociation which, as De Zulueta (1999) suggests, are sometimes to be found in those suffering from borderline personality disorder. In a study at the young persons unit at Broadmoor Hospital, it was found that subsequent re-offending amongst sex offenders was highest among those patients who were personality-disordered (Reiss, Grubin and Meux, 1996). A study using the Minnesota Multiple Personality Inventory (MMPI) of 61 adolescent sex offenders on a state residential programme found that they demonstrated significantly more psychopathology than did non-sex-offender adolescents admitted to an inpatient psychiatric facility (Herkov et al., 1996). Also using the MMPI, Cooper, Murphy and Haynes (1996) compared a large sample of adolescent sex offenders who had been sexually abused with a matched sample who had not – a total of 300 respondents. They found that the abused group scored higher on the schizophrenia and psychopathic deviate scales, as well as on interpersonal problems, than the non-abused group. Sexually inappropriate behaviour was evident in seriously mentally ill children and adolescents in a public sector psychiatric hospital over a 5­ year period (Adams et al., 1995). Of 499 subjects, only 296 exhibited no

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inappropriate sexual behaviours. A French study by Lakey (1994) found a high degree of psychiatric diagnosis and cognitive distortion amongst the male adolescent sex offenders studied. In a study undertaken by Graham (1996) it was discovered that sex offenders in a treatment setting in Canada had high levels of dissociation and alienation, especially amongst the 70% of offenders who had been sexually abused. In considering these findings, it is important to avoid generalisations from studies on young people who are already patients of the psycholog­ ical and psychiatric services. Additionally, as Becker (1998) notes, results can be influenced by whether they are being evaluated or treated, and whether on an inpatient or outpatient basis, the most serious psychopathology being found in incarcerated youth. However, sexual abuse and some of the features associated with it do appear to be in evidence, and an abused adolescent sex offender’s presence in an institu­ tion or outpatient programme may well represent an earlier failure to recognise or intervene in an unresolved childhood trauma.

History of sexual abuse Background sexual abuse in the lives of young male sex offenders has already featured significantly in preceding sections, which show that it overlaps with other adverse childhood and adolescent experiences. To an extent, this supports Grubin’s (1998) literature review which suggests that these experiences are difficult to disentangle from one another in terms of significance. His work shows that offenders who target male victims, or victims of both sexes, are more likely to have a history of sexual abuse than are those who only target females, and that those who are abused at a younger age appear to start offending earlier. Vizard, Monck and Misch (1995) noted that rates of young sexual offenders reporting victimisation vary from 30% to 70% across a range of studies. Thus, while the figures in some studies provide convincing evidence, it has not been possible consistently to establish that the ‘cycle’ of sexual abuse (i.e. where the abused go on to become abusers themselves) is a reality. Also, the fact that only around 1% of young women aged 14–20 years appear to be involved in committing sexual offences, as against 18% for other offences (Vizard, Monck and Misch, 1995), tends to challenge the ‘cycle’ theory. Given that there is a greater frequency of abuse to girls than to boys, the ‘cycle’ theory predicts that a corresponding number of sexual abusers would be women – and this is not the case. This may, however, be explained by a cultural bias that predisposes women towards internalising trauma rather than externalising it. The Diagnostic and Statistical Manual of Mental Disorders (DSM IV), for example, shows

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that external disruptive behaviour disorders are much more common in boys than in girls; internalised anxiety and repressive disorders are either equally likely or more common amongst girls (APA, 1994). However, the ‘cycle’ theory also raises a real danger that the behaviour of victims or survivors of sexual abuse will be further influenced by the potentially selffulfilling prophecy that they themselves will go on to become abusers. One explanation for sexual abuse by abused adolescents may surround the notion of the helpless victim’s need to regain power and control, by abusing in turn, but there are alternative views of the progression from victim to perpetrator. In a study of the sexual abuse of children, Eisenmann and Kristsonis (1995) found that sexual abuse leads to ‘imprinting’, a process in which abusers repeat to others what has been done to them. These children did not appear purposefully or knowingly to groom victims; nor did they pre-plan their actions or seek to manipulate. Rather, they modelled this particular piece of learned behaviour along with other learned behaviours. Several other studies (e.g. Cooper, Murphy and Haynes, 1996; Dhawan and Marshall, 1996; Graham, 1996; Spaccarelli et al., 1997) cited a familial history of sexual abuse as a risk factor in the development of a perpetrator. However, this traumatic history is usually combined with additional factors such as, for example, cognitive distortions based on mythical beliefs and misinformation about women. A significant finding by Awad and Saunders (1991) was that physical abuse was more prevalent than sexual abuse in the backgrounds of male adolescent sex assaulters, though this may relate to the fact that physical abuse is more socially acceptable and less embarrassing to reveal than sexual abuse (Boswell, 1996). In summary, there is strong evidence in some cases that sexual abuse has been an antecedent of adolescent sex offending and, in those cases, it may be argued that the ‘cycle’ of sexual abuse is a theory that holds weight. However, since research findings have not been consistent in this field, it cannot be said to be a theory which applies universally, and its links with other significant antecedents require continued investigation.

Pornography Pornography seeks to objectify sexual activity. Dworkin (1981) states that exposure to pornography, particularly at a young age, can distort the development of appropriate behaviour and stunt positive emotional sexual relationships. Some commentators have argued that sex and violence are inextricably linked. Dworkin (1981) and MacKinnon (1983) developed this thinking in the USA during the 1960s, leading to the lobby against child pornography, which itself influenced later legislation.

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Surprisingly, however, there was no specific legislation on the taking, showing or distribution of indecent photographs of children until the Protection of Children Act 1978. In fact, simple possession of child pornography material was not made illegal until 1987. This reflects the views expressed in the widely discussed President’s Commission on Obscenity and Pornography 1970, where only 12% of professionals, in answer to the question ‘Do you think that the reading of obscene books plays a significant role in causing juvenile delinquency?’, answered in the affirmative. The Commission was unable to conclude that ‘exposure to erotic materials is a factor in the causation of sex crimes or sex delin­ quency’ (Holmes, 1983:208). However, the development of more sophisticated methods of assess­ ment and treatment of sex offenders suggests that pornography is widely used in both the planning and fantasising of an offence and in the subse­ quent reinforcement of the experience. One study explored the relation­ ship between sexual attitudes and abuse of sexually explicit materials in 80 convicted male sex offenders and 96 unconvicted males (ages 13–19 years). It found that being a sex offender was significantly associated with the use of sexually explicit materials (Zgourides, Monto and Harris, 1997). Emerick and Dutton (1993) studied the history of the violence perpe­ trated by 76 adolescent sex offenders aged 10–28 years. In investigating the possible effects of the use of pornography and the severity of the assault, they found that the number of female child victims assaulted by the offenders was significantly related to the strength of pornography used as a stimulus during masturbation. These effects may be even more powerful when the pornography links violence and sex. Earlier research had suggested that the sexual aggression is further heightened when the material is coercive and violent (Donnerstein, 1980; Malamuth and Donnerstein, 1982). However, although the use of pornography amongst sex offenders seems common, and sometimes entrenched, more work is needed on exactly how its use fits into risk of offending and offending patterns. Howitt (1995), when looking at a number of case studies of adult sex offenders resident in a private clinic, found that dedicated child pornog­ raphy was notably absent. What was apparent, however, was that the residents created their own pornographic materials in order to reinforce their fantasies. Superficially, these materials seemed innocuous, consisting for example of figures of children cut from catalogues, fashion magazines and newspapers. Institutional life can also, however, facilitate the collection of explicit pornography. As Wyre observed when considering the case of Robert Black, a multiple child sex murderer in the UK:

The Antecedents of Young Male Sex Offenders

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For more than a decade Robert Black was allowed to amass a collection of one hundred and ten child-pornography magazines and fifty-eight films or videos. (Wyre, 1995:237)

This finding was echoed in research undertaken by Wieckowski et al. (1998). From a sample of 30 males aged 12–15 years, they reported that the majority were exposed to sexually explicit materials within their homes as young children. One of the ways in which young men reinforce their fantasies is through the use of pornography. In an evaluation of treat­ ment of adolescent sex offenders, Fisher and McGregor (1997) found that in order successfully to treat this group, their sexual fantasies needed to be controlled and realigned within normal limits. Fantasy was found to be of great importance in terms of reinforcing their behaviour. In a series of public hearings organised by Dworkin in Minneapolis in 1983, clinicians working with sex offenders, counsellors from rape-crisis centres and female victims of male sexual abuse identified pornography as a central causative factor in sexual crime. They concluded that it was used by men before and during sexual abuse, as well as afterwards through recording or recounting (Dworkin and MacKinnon, 1988). In a study of the family histories of 36 sexual murderers, discussed earlier, a marked use of visual sexual stimuli was found. Pornography ranked highest; 81% had used pornography as children or adolescents as part of their sexual fantasy life (Ressler, Burgess and Douglas, 1993). The exponential growth of the internet has made such material much more available, including to unprotected children and adolescents. As Holmes (1983) discovered, in a study of the sex offender and the criminal justice system, younger viewers experience more arousal than adults when viewing such material. Davis, McShane and Williams (1995) pointed out that not only do perpetrators have more and easier access to pornog­ raphy but also to bulletin boards, referrals and ‘talk’ networks. However, although it is generally accepted that the interest in and consumption of pornography is present, and increasingly available for the majority of young males, it appears from the self-reporting of offenders, the testimony of victims and the knowledge of clinicians, that when it is used as part of a pattern of offending or to augment negative fantasies and beliefs, it can become a powerful reinforcing mechanism. As with other antecedents, however, it seems unlikely that pornography, in itself, would lead to sexual offending unless it were instrumental in triggering other factors which already predisposed the young person towards such behaviour.

Substance misuse Although there appears to be an obvious relationship between the use of alcohol and other drug use, and antisocial behaviour – particularly among

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young males – it would be spurious to claim that substance misuse is in itself a causal factor in sexual offending. Wolfers makes an important observation regarding the only clear relationship between the perpetrator and victim of sexual abuse and the transactional nature of substance abuse: There is no proven link in the general population between substance abuse and child sexual abuse, except in situations where sexual abuse appears to be used for monetary gain in order to fund the use of drugs and alcohol. (Wolfers, 1992:102)

This suggests that, in the case of young people who allow themselves to be sexually abused to fund drugs or alcohol, and subsequently become abusers themselves, substance abuse could form part of an antecedent overall picture. Wolfers’ view is supported by the Calouste Gulbenkian Foundation (1995), in its report on children and violence, which finds that young people tend to become implicated in violence through the course of distribution and purchase, rather than through direct pharmacological influence. This report also points to the evidence that parental substance misuse is a risk factor both for the abuse of, and later violence by, their children. However, it can be argued that alcohol and drug abuse are a normative part of modern adolescent cultural development. It is generally accepted that, since the late 1960s, drug and alcohol abuse form the basis of a rite of passage for adolescent males, and much of the evidence suggests that drug and alcohol consumption dramatically decrease with the onset of adulthood (e.g. South, 1995). A discussion of this issue, in relation to sex offenders, suggests that: There are no data to indicate whether adolescents who commit sexual offences are more likely than other adolescents to have a history of alcohol or drug use problems, or whether there is a higher incidence of adolescent sex offenders in the drug or alcohol abusing population of adolescents. (Davis and Leitenberg, 1987:420)

They go on to assert that intoxication at the time of the offence is uncommon and suggest that claims of being intoxicated or under the influence of drugs may be used more frequently as a way of avoiding responsibility. Lightfoot and Barbaree (1993) give an empirical analysis by way of a comprehensive table of sex offenders and documented alcohol and drug abuse. They summarise their findings by commenting that prevalence rates of drug/alcohol abuse vary from very low to very high. It appears from this analysis that there may be a dichotomy between empirical evidence of substance misuse, which suggests there is no causal connec­

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tion, and a strong theoretical model which offers a persuasive association, particularly between alcohol and aggression. The key aspect of this theoretical model is the pharmacological perspec­ tive, from which it is argued that alcohol depresses the higher brain centres and, in turn, influences more primitive brain centres. In other words, alcohol removes inhibitions, thus allowing more primal and aggressive urges to become predominant and causing some individuals to become gregarious to the point of being sexually oppressive. Moreover, the psycho­ logical perspective on the effects of alcohol indicates that it is a powerful precursor of violent and oppressive behaviour. Here, the psychological makeup of the individual concerned may be the true determining factor in producing aggression. Collins (1981) has suggested that two major psycho­ logical variables, specifically an overt style of exercising personal power and a culturally based belief in the aggression-producing properties of alcohol, interact with the physiological effects of alcohol on human cognition to increase the likelihood of interpersonal violence occurring after drinking. Of these two perspectives, the theorists who emphasise the indirect effects of alcohol on aggression offer examples of the tendencies produced by alcohol. For example, McClelland et al. (1972) are respon­ sible for the power motivation view of alcohol use, which suggests that men drink in order to feel stronger and more powerful. So if, on examina­ tion, it emerges that there is a relationship, at least theoretically, between alcohol and aggressive social behaviour, it is certainly a complex process involving cognitive and pharmacological effects. In fact the main issue here is that there is undoubtedly an effect on sexual behaviour. There also appears to be a relationship between the use of alcohol, the inadequate young person, and the potential for sex offending: Adolescent sex offenders have repeatedly been described as being more likely to be socially isolated with low to borderline intellectual functioning. They are, therefore, at higher risk for inappropriate behaviour if they consume alcohol and are subsequently exposed to a social situation that involves a combination of complex, subtle cues. (Lightfoot and Barbaree, 1993:212)

The issue of assessment of young sex offenders and the substance misuse question is further argued as follows: Most assessments seem to be designed to address a dichotomous question – is there or is there not an alcohol or drug problem? Whereas the more important question should be – is substance use a risk factor for offending, independent of the presence of a substance abuse or dependence? In other words, was alcohol and/or another drug used before the current and previous offences? If yes then substance use is part of the offence cycle and must be identified . . . in treatment. (Lightfoot and Barbaree, 1993:218)

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To the extent that alcohol and drug use play a part in the lives of adoles­ cents, it seems safe to assume that they are sometimes present in the sex offending process. However, there may be more specific links, where such influences combine with other contributing factors. Theoretical perspec­ tives serve to demonstrate the dangers, particularly of the effects of alcohol on certain individuals. However, there appears to be no strong empirical evidence that alcohol or drug use causes young people to commit sex offences.

Societal and cultural context Thus far a series of antecedents has been described which may, in a variety of combinations, increase the risk of an individual’s becoming a perpe­ trator of sexual abuse in adolescence. Other such factors, including, notably, a history of non-sexual offending/antisocial behaviour, and general educational dysfunction, are further discussed by Vizard, Monck and Misch (1995). All these phenomena can now be set in a contemporary cultural context. In many parts of Europe and the USA, post-modern society (sometimes described as post-feminist) essentially still reflects an era in which attitudes towards women are ambivalent. Women’s bodies are used as advertising aids, ‘soft’ pornography has exploded into ‘middle-shelf ’ magazines directed towards men and the incidence of rape is globally prevalent (Levi, 1995). It appears that adolescent males are growing up in a culture of mixed messages, reinforced by a wide range of media – television, advertising, music and videos, lifestyle magazines aimed at young men – together with aspects of a present-day male youth culture labelled ‘new laddism’. Where adolescent females appear to be keen to reformulate or reprocess feminist ideas, for example ‘girl power’, men in general and young men in particular have not developed the means by which to analyse their masculinity in the same way. It therefore seems that an area always fraught with difficulty – adolescent male sexuality – in some ways now appears to be even more so. Throughout the literature there is an emphasis on the need to analyse adolescent sex offending against a non-offending control group. In an attempt to study these factors in the context of the norm, researchers questioned a non-forensic sample of male university students about their sexuality in general but, in particular, concerning any orientation towards children. They found that 22% of young males experienced an attraction to children, with 7% admitting they would abuse children if they could get away with it (Briere and Runtz, 1989). Research published by the Zero Tolerance Charitable Trust has been described as ‘shocking’ (Brooks, 1999:7). A study of over 2000 young

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people aged 14–21 years reported that 1 in 6 men thought they might force a woman to have sex. Equally disturbing were their views on violence towards women: 1 in 4 men thought it acceptable to use physical violence under certain circumstances – e.g. if the woman in question had slept with another man. Coleman (1996) stresses the importance of challenging offenders’ attitudes within adolescent sex offender treatment programmes. However, it appears that treatment programmes, too, can be jeopardised by preva­ lent values within society: Even young adolescent males who have committed quite violent sexual acts will receive a mixture of responses from adult males some of which, at least, are favourable. (Hollows, 1991:64)

Growing up in a societal and cultural context which emphasises the desirability of sexual prowess, particularly in men, arguably constitutes a strong pressure to attain this goal at all costs. As Coleman (1996) further stresses, it may well be necessary for the outlook of the general population to change if an attitudinal shift is to be brought about in adolescent male sex offenders. Thus, there may also be a case for blanket prevention measures, one result of which might be an improved ability to distinguish between societal and other influences on adolescent sex offending.

Conclusion In an attempt to address ‘the question why?’, this review has aimed to provide the reader with a flavour of some of the most frequently mentioned factors in the literature on adolescent sex offending. It has not, however, sought to identify taxonomies or causes. Indeed, although this is a topic on which almost everybody has some kind of theory, a review of this kind merely serves to reinforce the fact that there are so many poten­ tially interlinking factors that a universal theory is almost certainly unattainable. Nonetheless, taking the previous coverage of the factors of family environment, attachments, psychological disturbance, sexual abuse history, pornography, substance misuse and societal or cultural context, it is clear that all have a part to play at different times and with different individuals. It is suggested that what should be taken particularly seriously is the way in which adolescents, at their stage of development, are liable to interact with these. Adolescence is known to be a time at which young people are seeking to make the often difficult transition from child to adult, and are therefore struggling to find their identity (Erikson, 1968). In this process, they are subject to numerous influences and, though there

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are some known predisposing factors, those which combine to succeed in edging them towards sexual violence, and onward into criminalisation, may have done so as much by chance as through any predictable pattern. However, as Grubin (1997) has remarked: Effective prevention of a problem requires an understanding of its causation, something beyond mere recognition of associations. Risk changes over time, place and circumstances and effective management depends upon being able to adapt risk assessment into a dynamic system. (Grubin, 1997:225)

Thus it is crucial that the attempt to research this challenging group of young people continues, so that increasing knowledge about the funda­ mental questions they pose to our society will gradually lead to more sophisticated understandings, not least about the content and focus of their treatment within the criminal justice system.

CHAPTER 5

The Link Between Childhood Trauma and Later Violent Offending: A Case Study

PAUL RENN Research findings relating to young offenders show a history of maltreat­ ment and loss in up to 90% of the sample population (Boswell, 1996; Fonagy et al., 1997). These findings accord with my clinical experience as a probation officer working with adult offenders in the community. In particular, I find that those who commit violent offences have themselves been victims of childhood abuse or suffered neglect or loss experienced as catastrophic. Indeed, the acting out of unresolved childhood trauma in a criminal way is a consistent feature in the behaviour of those with whom I work and, moreover, strongly associated with substance misuse. In the light of these factors, I have developed my practice in ways capable of dealing both with adult offending and with the long, perseverative shadow cast by childhood trauma. This study illustrates the application of an integrated relational perspective that I have found effective with such cases in a probation setting. It is presented as an example of my day-to-day work with violent offenders in a generic field team, not as an exception. A case study can provide only an impression of the complex interaction that takes place in a session; the main intention here is to emphasise the connection between childhood trauma and subsequent violent offending. In line with Boswell’s (1998) advocacy of research-minded practice, the study seeks to demonstrate the vital importance of asking offenders about their traumatic backgrounds at the point of assessment. It emerges that such pertinent information is funda­ mental to one of the key principles of effective practice – that of matching the offender’s risk, needs and style of learning to an appropriate method of inter­ vention (Chapman and Hough, 1998). Names have been changed and personal circumstances disguised in order to protect identities. 71

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John, the subject of this case study, has given his permission for this chapter to be published. He is 48 years old and grew up in a large family, being one of eight children. He is the youngest of four brothers (one of whom died several years ago) and has two older and two younger sisters. He spoke of his father as being ‘distant and always at work’, and his mother as ‘over-protective’, recalling that she had played out an elaborate pretence regarding his father’s occupation by telling neighbours he worked in a bank, whereas, in fact, he was a barman. John completed his secondary education at the age of 15, leaving school with no qualifica­ tions. By this time, he was misusing illicit drugs and alcohol. He went on to develop a dependency on the latter. As a consequence, John’s employ­ ment record is inconsistent and, in the main, made up of manual and semi-skilled work. John has had a series of unstable relationships with women charac­ terised by violent behaviour, possessiveness and sexual jealousy on his part. Because of his problematic attitude to women, John consulted his GP when aged 18. He was referred for psychiatric assessment but not offered ongoing treatment. John married when aged 28, but insisted ‘there never was a true love’, adding, ‘I haven’t wanted to commit myself ’. He avoided doing so in part by ‘always having relationships with two women at the same time’. This situation obtained during the course of his 13-year-long marriage which John described as an ‘on–off affair’. He related how he would often pick fights with his wife to give himself an excuse to leave home and go on a drinking binge. The marriage was childless, but John has three children from a subsequent relationship which, typically, was brief, intermittent and volatile. He has had no contact with his children for several years and was unaware of their current whereabouts. At the time we met, John was largely estranged from his own family and not in an intimate relationship. John has been involved with the criminal justice system for over 30 years, appearing before the courts for the first time as a juvenile. Though he has convictions for motoring offences and, when younger, burglary, drink-related violence is the most prominent and consistent feature of his offending behaviour. The latter commenced in adolescence and, as mentioned above, was the reason why John was eventually referred for psychiatric assessment. He has convictions for grievous bodily harm, assault with intent, assault on the police, possession of a firearm and criminal damage, on one occasion going to his ex-partner’s home armed with an axe which he used to break in. John has been subject to a range of sentences including discharges, fines, probation, community service and imprisonment. He has had numerous sojourns in rehabilitation units for his alcohol problem, but always returned to misusing drink. One of his

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brothers also has an alcohol problem, but John is the only member of the family to become embroiled with the law. The index offence, was committed 4 years ago and consisted of a serious assault on John’s partner, Sylvia. The couple had been in a relationship for 2 years, but lived separately. John came to suspect Sylvia of being sexually involved with someone else. He went to her home in a drunken state one evening and accused her of having sex with another man, calling her a ‘slag and a whore’. When Sylvia denied John’s accusation he attacked her with his fists and feet in a blind, uncontrollable rage, causing serious injury to her head and body and desisting only when finally she told him ‘what he wanted to hear’. At court, the photographic evidence of Sylvia’s injuries was said to be ‘horrific’. John denied the offence when arrested, maintaining that Sylvia’s injuries were self-inflicted. He was convicted after a jury trial and sentenced to 21/2 years imprisonment. I picked up John’s case on transferring to the probation office in his home area. John’s reputation at the office was that of a perpetual client with whom everything had been tried – the sort of case that gets passed on with some alacrity to a newly arrived team member! I wrote to John in prison to introduce myself as his new through-care officer. In his reply, he alluded to the attack on Sylvia, saying, ‘It wasn’t anger, it was alcohol talking, I’m not angry by nature’. Though clearly John was distancing himself from his anger and violence in this statement, there was at least an implicit admission of his assault on Sylvia. I met John for the first time during his temporary release from prison on home leave. He had managed to retain his local authority tenancy by sub-letting to a male alcoholic friend, but previously had lived alone. John was due to be released on licence a month later and his period of supervi­ sion would run for 8 months. At this first meeting, I asked John specific questions about childhood experiences in respect of separation, loss and abuse. He was clearly surprised and puzzled by the tenor of my questions, as he had not been asked about such issues before. After some initial hesitation, John spoke of having had frequent separations from his family from about the age of 5 years. These were the result of a series of opera­ tions for ENT problems which necessitated his admission to hospital. He recalled struggling with the nursing staff on one occasion as he fought to retain consciousness while being held down and given ‘gas’. Despite these traumatic experiences, John’s narrative style when discussing them was dismissive, in that he did not believe they had had an adverse effect on him. The dismissive quality of his narrative, together with his propensity for violence in intimate relationships, indicated that he may have developed an insecure-avoidant pattern of attachment organisation (Main and Weston, 1982). In reviewing studies linking insecurely attached

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children and subsequent criminal behaviour, Fonagy and his colleagues (1997) suggest that insecure attachment constitutes a distinct risk factor. Further, they argue that patterns of attachment operate as mechanisms of defence to help the child cope with idiosyncrasies of parental caregiving, and that criminality involves disturbance of attachment processes. These findings accord with De Zulueta’s (1993) proposal that violence is attach­ ment gone wrong. It soon became clear that John’s ideal view of himself was that of a passive, non-violent man who, in his own words, ‘wouldn’t hurt a fly’. My tentative hypothesis at this point was that John was carrying powerful unprocessed emotional pain; that he was disowning feelings of anger and hatred, and that, without the capacity to contain and transform such emotions, these built up in response to stressor events, generating intense internal conflict which eventually became overwhelming. At such times, John resorted to binge drinking. Under the disinhibiting effect of alcohol his repressed emotional turmoil was unleashed and acted out in the form of a violent rage. This clinical picture indicated that John might be prone to experiencing a traumatic stress reaction when embroiled in an intense, emotionally charged situation (Herman, 1992; De Zulueta, 1993). In formulating this hypothesis, I had in mind psychoanalytic theories of development, infancy and attachment theory research findings, previous experience of work with violent men, and the litera­ ture on trauma. As an example of the latter, Herman (1992) argues that traumatic events shatter the construction of a self that is formed and sustained in relation to others. I assessed John as being sufficiently psychologically minded and personally stable to engage in a therapeutic relationship. By psychologi­ cally minded, I mean there had been some indication during the initial interview that John had the ability to draw analogies, use metaphor, think symbolically and make links between the past and the present (Coltart, 1992). Nevertheless, I harboured reservations about John’s ability to engage in a therapeutic process. These misgivings centred on the fact that he was denying the index offence and that his record of attending appoint­ ments when supervised in the past had been far from exemplary. Further, as noted above, John was resistant to the idea that past experience may have a maladaptive effect on behaviour in the present, specifically in relation to his alcohol misuse, as he had been told at a rehabilitation unit that ‘alcoholism is a disease’. He therefore expressed a good deal of scepti­ cism about the prospect of change, having passively accepted this fatalistic diagnosis. However, I explained what our work together would involve, emphasising the collaborative nature of the process. John responded by saying that he would ‘give it a go’ as nothing else he had tried had been

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successful. He signed a standard medical consent form giving me permis­ sion to contact his GP in order to discuss any relevant issues. I took the view that an integrated relational approach was indicated in John’s case. As conceived by Mitchell (1988), a relational perspective integrates attachment theory, object-relations theories, and interpersonal/intersubjective models within a broad paradigmatic framework. The therapeutic process is inherently interactive and thus requires the active participation of both parties. Individual meaning is understood by refer­ ence to the offender’s relational matrix and the context within which interaction takes place. The process focuses on the offender’s subjective experience in the here-and-now which is explored with the purpose of helping him or her deal more objectively with ‘reality’. Reality is viewed in terms of narrative intelligibility, rather than historical veracity, and is validated consensually (Mitchell, 1997). Attachment theory played a central part in my assessment of John and I anticipated that this approach would underpin my intervention with him. Indeed, I have found attachment theory a powerful tool in explicating offending behaviour and assessing risk and, moreover, eminently adapt­ able to working effectively with offenders in a probation setting. From this perspective, specifically as informed by cognitive science and develop­ mental psychology, the person’s inner world of subjective experience is structured, shaped and organised by patterns of attachment and interper­ sonal interactions into representational models (Bowlby, 1998). In devel­ oping Bowlby’s theoretical concepts, Main, Kaplan and Cassidy (1985) suggest that patterns of secure and insecure attachment organisation are internalised in the form of working models. These models are representa­ tional of ‘states of mind’ in relation to patterns of attachment. Further, Main et al.’s (1985) research with subjects in their adolescence indicates that, once established, patterns of attachment tend to persist over time and become actively self-perpetuating because information experienced as potentially disruptive is countered by perceptual and behavioural control mechanisms. Internal working models are, therefore, thought to mediate experience of actual relationships and events, and to guide and direct feelings, behaviour, attention, memory and cognition. Main and her colleagues (1985) devised the Adult Attachment Interview in order to measure attachment status in adults. Using this research tool and Ainsworth et al.’s (1978) Strange Situation procedure, which observes and measures the attachment status of children, Main et al. (1985) demonstrated a link between a particular narrative style and a specific pattern of attachment. Their research findings suggest that malig­ nant childhood events relevant to attachment may cause difficulty in integrating and organising information, and that such difficulty may play a

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determining role in the creation of security in adulthood. As noted above, Main, Kaplan and Cassidy (1985) conclude that internal working models derived from insecure patterns of attachment organisation are resistant to change because error-correcting information is being defensively and selectively excluded from consciousness, resulting in perceptual distor­ tion of relationships and events. Their findings from research undertaken in Baltimore have been replicated in studies carried out in Germany by the Grossmans (1991). Along similar lines, Peterfreund (1983) suggests that different internal working models are in operation during different activities and in different situations, making predictive calculation and adaptive behaviour possible. In advocating a ‘heuristic’ as opposed to a ‘stereotypical’ approach to the process of psychoanalytic therapy, he, too, stresses the significance of information processing and error-correcting feedback in this process, arguing that these are the means by which perceptually distorted internal working models are modified, updated and fine-tuned. Peterfreund’s synthesising approach reflects both Bowlby’s emphasis on empirical observation of human relationships, and the fact that many of the concepts underpinning attachment theory are derived from cognitive psychology and developmental psychology. Attachment theory, therefore, may be seen as acting as a bridge between cognitive science and psycho­ analysis (Holmes, 1993). Given the setting within which I work, my intervention with John would be brief and time-limited. In fact, I had a total of 13 sessions with John, each session lasting an hour. Initially, I saw him once a week. Subsequently, sessions were scheduled on a fortnightly basis, and towards the end of his licence, once a month. I had a follow-up meeting with John 6 months after his supervisory period had ended. I incorporate such meetings into my practice, seeing them as serving a dual purpose of evalu­ ating the effectiveness of my work and providing the offender with a sense of continuity and connection to a secure base (Bowlby, 1988). In my experience, the availability of an ongoing link at this critical time helps preclude the often-noted (though anecdotal) phenomenon whereby the offender re-offends towards the end of the supervisory period, seemingly in reaction to the loss of a relationship that has become significant. The first meeting following John’s release from prison focused on helping him recognise and own disturbing thoughts and feelings. An example of this difficulty arose when John spoke in mild terms about the friend whom he had allowed to stay at his home while he was in prison. John returned to find the place a complete tip and rent arrears of over £1000 owing to the housing department. At first John spoke of feeling ‘a bit let down’ and, later, when I questioned his passive response, of being

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‘angry and annoyed’, vacillating between these two attitudes. It seemed to me that John was quite confused as to how he actually felt about his friend and in two minds about how to respond, speaking in the same breath of going to reason with this person and of beating hell out of him! This narrative appeared to provide a glimpse of the conflict character­ ising John’s inner world of object relations. On the one hand, he seemed to be identifying with the hurt, angry, disappointed child who had been let down and whose trust had been betrayed; on the other, to be identifying with a dismissing parent who deflected and perhaps even forbade the expression of difficult thoughts and painful feelings. This situation seemed to be re-created in the session, in that John anxiously deflected any attempt on my part to connect with him on an emotional level. Indeed, I felt under immense pressure not to talk about meaningful issues and events and I experienced a sense of futility and despair. It would have been all too easy to have succumbed to this sense of hopelessness and given up the attempt to engage John. Instead, I sought to understand his emotional state and subjective experience by reflecting on the impact he was having on me, viewing this interaction as a form of unconscious communication. I shared with John aspects of how I was experiencing being with him, wondering whether my countertransferen­ tial thoughts and feelings mirrored something of his own experience (Casement, 1990). John confirmed that he had felt a mounting sense of anxiety, verging on panic, adding that he usually avoids talking about his feelings. Avoidance of this sort, particularly in men, may reflect the way in which gender, culture and inner prohibition coalesce, resulting in a defen­ sive splitting of thought from feeling. Somewhat paradoxically, John seemed relieved by the realization that inner emotions may be recognised, shared and understood (Benjamin, 1992). As a consequence of this interchange, a more reflective mood prevailed and John went on to recall memories of a traumatic event that had taken place when he was aged 8. Tentatively, John related how he and his then best friend, Ricky, had been playing near a fast-flowing river. John’s memories of the event were somewhat vague and hazy, but he recalled that Ricky had slipped on the moss-covered embankment into the river and drowned. John came to believe that people suspected him of having pushed his friend into the river. Indeed, I found myself silently questioning whether John might have had a hand in Ricky’s death. I closely observed the nuances of his facial expressions, vocal inflections and bodily posture when discussing this traumatic event, as well as monitoring my own inner responses. I detected nothing at that time, or subsequently, to indicate that John’s narrative was anything other than authentic in regard to this matter. I therefore concluded that Ricky’s death had, indeed, been a tragic accident.

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In addition to feeling blamed and accused, John came to view himself as a ‘bad’ person because his attempts to save Ricky had failed. John went on to speak of having confused and intangible memories of being in court in the aftermath of Ricky’s death and of growing up feeling burdened by ‘guilt’. The court in John’s memory was probably that of the coroner who carried out the inquiry into the circumstances of Ricky’s death. It seemed likely that, in a similar way to those who live through a major disaster, John experienced a deep sense of guilt at having survived when Ricky had died (Herman, 1992; De Zulueta, 1993), and that this whole situation was exacerbated by his having to appear at the coroner’s court. John said this happened in the autumn and that he had ‘wiped Christmas out’ by getting drunk for the first time. I wondered whether the trauma of Ricky’s drowning had reactivated John’s earlier trauma, that of being held down and ‘gassed’ in hospital – drowning in gas, as it were. John became deeply thoughtful and reflective following this observation, and he sat in silence for a considerable time. He looked sad and forlorn and his eyes brimmed with tears. When he surfaced from this pensive mood he seemed to recognise aspects of himself as if for the first time. He spoke of persistent feelings of sadness, anxiety and watchfulness, and questioned whether these could be linked to his disturbing childhood experiences. Although the session had been a challenging and painful one, John seemed buoyed up and expressed the hope that ghosts could finally be laid to rest. During subsequent sessions, John and I tried to give meaning to what, in symbolic terms, he was acting out unconsciously by means of his offending behaviour. It seemed to me, at least in part, that he was re­ enacting a destructive and self-destructive pattern of behaviour in identifi­ cation with the ‘bad’, traumatised 8-year-old child who had been unable to mourn Ricky’s death and was left carrying a tremendous burden of guilt. My hypothesis was that an aspect of this re-enactment involved John being drawn compulsively and repetitively to stand accused in the dock of a court, thereby reliving the trauma and, at the same time, confirming his negative core assumption or unconscious fantasy of himself as a bad, guilty person. Moreover, I wondered whether the experience of being adjudged guilty and sentenced to a period of incarceration had the tempo­ rary effect of assuaging John’s deep and pervasive sense of badness. This hypothesis rang true for John and seemed to go some way towards filling gaps in his personal history by beginning to provide his fragmented experience with coherent meaning. He elaborated on these thoughts, saying that he feels safe and secure in prison, whereas on the outside he is continually assailed by feelings of panic, anxiety and an impending sense of danger, as if something dreadful were about to happen.

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At this point in my work with John, my assessment had crystallised. Keeping relevant research findings and clinical studies firmly in mind, I based my assessment of John on the theoretical premise that cognitiveaffective states associated with his traumatic experiences had been subject to perceptual distortion, defensive exclusion and selective inattention (Main, Kaplan and Cassidy, 1985). In line with Herman (1992), I concluded that the lack of an appropriate response to John’s trauma had left him with a pervasive sense of alienation and disconnection in his relationships. I was, moreover, reminded of research findings concerning the effects of parental separation and divorce on children. These show that, in the absence of age-appropriate communication, the child has diffi­ culty in coping with the reality of the losses involved and, instead, resorts to self-blaming fantasies of being bad, unloved and unlovable (Wallerstein and Kelly, 1980). Several of these aspects seemed to feature in John’s case. I concluded, therefore, that the main therapeutic task was to facilitate a process of mourning by assisting him to make connections between detached, split-off thoughts and emotional affect associated with the traumatic events he had described (Bowlby, 1988). This work had, of course, already commenced to some extent during the assessment process. By this stage, John seemed committed to working on these unresolved issues and he stuck doggedly to the task. He admitted to being desperate for a drink after the previous session, but told me that, instead, he had made a conscious effort to think about what we had discussed. In line with Main’s (1991) research into meta-cognitive monitoring, I had enjoined John in quite a directive way to develop a dialogue with himself; to use his mind in a new way so as to contain and assimilate raw psychic pain, and to step outside of himself in order to monitor his thoughts and feelings. Following Fonagy et al.’s (1997) development of Main’s (1991) research, these strategies were designed to enhance John’s ‘reflective function’, thereby increasing his capacity to contemplate and understand both his own and others’ mental states in a coherent way (Fonagy et al., 1997). The overall therapeutic aim was to assist John better to manage his emotional and mental anguish without becoming overwhelmed to the extent that he acted out by misusing alcohol and behaving violently. As the weeks went by, John reported that he was keeping his drinking within sensible limits. He looked healthier, with clear eyes and a better colour to his complexion, and he seemed more at ease with himself. This was reflected in the way he related to himself over the issue of alcohol. Whereas in the past he would behave towards himself as some sort of punitive ‘policeman’ when attempting to give up alcohol, he reported a new-found sense of liberation. I thought this change might indicate a

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greater integration of an alienated superego or bad internal persecutory object, together with a growing capacity on John’s part to tolerate ambiva­ lence by experiencing himself as both good and bad, loving and hating (Spillius, 1988). The impression of John being less anxious and conflicted was quite pronounced, and he related how, before this improvement, the mere act of leaving home to catch a bus to the town centre would engender anxiety, panic and a sense of danger which he would quell with drink. John also reported noting changes in the way he was responding to others, and they to him, acknowledging that in the past he would often deal with his aggressive impulses by provoking aggression in others, thereby giving himself a ready excuse to be violent and resort to alcohol misuse. He spoke of decorating his flat, and we came to see this as an external manifestation of the tidying up his inner life was undergoing. He went on to recall feeling acutely persecuted and paranoid as a child following Ricky’s death, saying that he lived in a state of fear and anxiety about the prospect of being attacked by Ricky’s family because ‘they thought I’d killed Ricky’. Such fears may well have been realistic but, in my opinion, were also likely to have been fuelled by fantasies of retalia­ tion which flourished in the absence of an attuned, containing parental response. It seemed to me that John’s later violent behaviour reflected Greenberg et al.’s (1993) proposal that children who are insecurely attached develop an internal working model of relationships charac­ terised by anger, mistrust and hostility. As noted above, Main, Kaplan and Cassidy’s (1985) longitudinal research has demonstrated that internal working models developed in childhood tend to persist over time. Certainly, lack of trust became a major issue for John as he developed into adolescence and adulthood. He spoke of his surprise at being able to talk to me about personal and painful matters, and he went on to risk rejection by asking if he could contact me after his licence had ended should a crisis arise. I agreed to this request and, as mentioned previously, said that I would like to have a follow-up meeting with him in any event. This exchange seemed to indicate that John was internalising his relation­ ship with me in the form of a good object or secure base, but that he still needed to feel there would be the opportunity for direct proximityseeking should something untoward occur (Bowlby, 1988). I was encour­ aged by the fact that John was beginning to make links between his traumatic childhood situation and the anxiety, panic and aggression manifested in later years. John ended the meeting by saying that, when aged 28 and on the point of marrying, ‘my mother told me I’d changed when I was 8’. Apparently,

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she had offered no explanation as to why this should have happened. Significantly, John went on to say that no one in his family had ever alluded to Ricky’s death, and that he had suffered amnesia between the ages of 8 and 11. It seemed to me that, lacking the emotional and cognitive capacities to assimilate the traumatic event unaided, John’s only option was to resort to a form of dissociation. For whatever reason, it would appear that John’s parents were insensitive to his needs and unable to help him deal with the aftermath of the tragedy, perhaps misguidedly believing that ignoring the event was for the best. Indeed, there was nothing to suggest they were intentionally cruel or malign, but rather, for reasons stemming from their own attachment histories, they were defen­ sively excluding John’s attachment behaviour cues from consciousness (Main, Kaplan and Cassidy, 1985). John is likely to have perceived his parents’ dismissive response to his distress as both frightening and fright­ ened, and thus to have experienced his own state of arousal as a danger signal for abandonment (Main and Hesse, 1990). As a consequence, he seems to have inhibited his mentalising capacity, becoming increasingly detached from his parents, as well as from aspects of his subjective experi­ ence, particularly states of anxiety and rage (Fonagy, 1999). John’s material brought to mind research which addresses the aetiology of cognitive disturbance in children. For example, Liotti (1992), following Main (1991), posits a connection between disorganised/disoriented attachment and dissociative disorders. According to Liotti’s hypoth­ esis, the child’s disorganised/disoriented attachment behaviour corresponds to the construction of an internal working model of self and attachment figure that is multiple and incoherent, as opposed to singular and coherent. Liotti suggests that a multiple internal working model of this kind may predispose the child to enter an altered, detached state of consciousness (dissociation) in the face of further traumatic experiences. Similarly, Davies and Frawley (1994), in their work with adult survivors of childhood sexual abuse, view dissociation as existing on a continuum, with multiple personality disorder representing the most extreme form of mental defence against severe, protracted trauma. From a constructivist perspective, Stern (1997) views cognition as an amalgam of thought and feeling and an integral aspect of a continuous phenomenological process operating within the interpersonal field. Under optimal conditions, the function of this process is to organise, structure and unify subjective experience, thereby providing the individual with a sense of coherence and meaning. However, Stern (1997) argues that experience may be split for defensive reasons in reaction to trauma and result in the isolation of emotion from mentation. Fonagy et al. (1997) elaborate on Main’s (1991) research into meta-cognition, positing

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that the child’s capacity to explore the mind of the other and develop as a thinking and feeling being arises within the matrix of a secure attachment relationship. Insecurity of attachment, on the other hand, undermines the child’s capacity to reflect on and integrate mental experience. Such individuals, it is argued, lack insight into the representational basis of human interaction and intentionality. This being so, they resort to concrete solutions to intrapsychic and interpersonal problems, attempting to control their subjective states and self-cohesion through physical experience such as substance misuse, physical violence and crime. Much of the aforementioned theory and research was generated by Bowlby (1988) who presented a paper in 1979 entitled ‘On knowing what you are not supposed to know, and feeling what you are not supposed to feel’. Here, Bowlby cites findings by Cain and Fast (1972) to show how distorted communication between parent and child, which disconfirms the child’s thoughts and feelings of real events, may engender intense guilt and lead the child to develop a chronic distrust of other people and of his or her own senses, together with a tendency to find everything unreal. The response of John’s parents (though he spoke only of his mother in this context) would seem to suggest that emotional issues were character­ istically dismissed and deflected. Moreover, as we have learned from John, his mother appears to have entered prolonged periods of denial during his childhood, as evinced by her refusal to acknowledge the reality of her husband’s actual employment status. Main and Weston’s (1982) research has demonstrated a significant link between such parental characteristics in terms of narrative or dismissing style on the one hand, and insecure– avoidant attachment behaviour in children on the other. Further, as noted above, children with an insecure–avoidant pattern of attachment have been found to show a marked lack of empathy towards peers in distress. Indeed, Main and Weston observed a distinct tendency in such insecurely attached children to behave in an aggressive and hostile way, as did Grossman and Grossman (1991). In John’s case, as with so many men who suffer unresolved childhood trauma, substance misuse and violent behav­ iour followed. The links between these factors were, again, highly reminis­ cent of the work on trauma by De Zulueta (1993) and Herman (1992). During the eighth meeting with John, issues surrounding sexuality and gender were discussed. Given the avoidant pattern of attachment behav­ iour characterising John’s adult intimate relationships, I silently questioned the security of his masculine identity. Despite being a stocky, powerfully built and somewhat gruff and macho man, John was sporting a long ponytail hairstyle. Moreover, as already noted, he generally adopted a

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passive, non-aggressive stance, seemingly disowning authentic thoughts and feelings in a way reminiscent of Winnicott’s (1988) concept of the false self. I therefore wondered whether John might be employing a feminine identification to defend against being overwhelmed by anger and rage arising out of ambivalent feelings of separation from, and engulfment by, the symbiotic mother (Stoller, 1986). After some initial embarrassment about the subject, John spoke in an enlightened way about how men and women incorporate both masculine and feminine attributes. These issues led on to a general discussion during which John was able to acknowledge that heterosexual men with an insecure sense of gender identity may experience homosexual panic and deal with such feelings by denying aspects of their sexuality that create anxiety, and instead project them on to others. We discussed the way in which defensive behaviour of this kind, allied to a morbid fear of difference, may act as a touchstone for violence which targets minority groups – for example, ‘gay bashing’ and racist attacks. Although the latter appeared not to be features of John’s offending behaviour, this discussion seemed further to enhance his reflec­ tive function or mentalizing capacity, in that he seemed more able to perceive others as separate from himself and as having distinct feelings, intentions and desires (Fonagy et al., 1997). Before the ninth session, John attended the funeral of a family friend. During this session, John volunteered the information that he had consumed about six pints of beer at the wake. We discussed this in the context of what the death of his friend had evoked in John. He said that his predominant feelings were of anxiety and guilt. Somewhat surprisingly, John linked these feelings directly to a fearful anticipation that I would ‘misjudge’ him for drinking. I wondered whether this dynamic again constituted a transference re-enactment connected with John’s childhood trauma. At that time, whether in reality or in fantasy, John did indeed feel misjudged and blamed for Ricky’s death. Furthermore, as we have seen, it would appear that his parents’ response lacked empathy and was dismis­ sive of his emotional pain and distress. On an unconscious level, there­ fore, John may well have been expecting a similar response from me, as it would seem that I was being attributed a parental role. His relapse provided the opportunity to resolve some of these issues, in that it enabled him to re-experience his traumatic attachment to a dismissing, emotionally unavailable parent in a way that was bearable. My task at such times was to survive John’s omnipotent destructive fantasies without collapsing or retaliating (Winnicott, 1988). This ‘holding’ response appeared to help John recognise my existence as a separate person avail­ able to be used and related to intersubjectively (Benjamin, 1992). Moreover, by relating to John in this unfamiliar way, I became a new devel­

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opmental object, different from the original developmental object being sought in transferential re-enactments (Hurry, 1998). John went on to speak of the positive changes he felt were occurring, saying that he would never have been able to stop at six pints in the past. He then related how, at the wake, he had felt the need to speak to members of his family, telling each in turn that he loved and missed them. His eyes welled with tears as he spoke of this reconciliation. This, and the very need to make reparation, seemed to suggest that John was estab­ lishing a connection with his emotional life and, in Kleinian terms, becoming more securely located in the depressive position, as opposed to the paranoid-schizoid position. Thus, John’s capacity to tolerate ambiva­ lent feelings and depressive guilt was enhanced, as was his ability to integrate aspects of his internal world of object-relations. As a result of this integrative process, he was more able to relate to others as whole objects rather than as part-objects (Spillius, 1988). John opened the tenth meeting by saying he felt on an ‘even keel’, adding that he was continuing to spend a good deal of time thinking about past experiences, as well as monitoring his thoughts and feelings, particu­ larly when in an emotionally disturbed mood. At such times, in line with my suggestion, he would try to trace the immediate trigger of the distress and then make links to the past. The current session focused in a direct way on John’s violence to women. This issue had been a delicate subject up to this point because John’s violent behaviour, especially in regard to women, jarred with his ego-ideal, leaving him feeling deeply ashamed. At our first meeting, John had displayed a pronounced tendency to minimise his culpability and blame the victim. Indeed, we will recall that he had completely denied the offence initially and was convicted following a jury trial. John’s capacity for denial brought to mind his mother, who, as we have seen, deployed the self-same defence mechanism with equal convic­ tion. By this stage in my relationship with John, however, a secure thera­ peutic alliance had been forged. Thus, we were able to work on this form of defensive behaviour in an open and forthright way. This facilitated John’s acceptance and active responsibility for his violent behaviour. My thinking in respect of John’s violence was that he had repressed and split off his anger and rage as a child, primarily in relation to his mother, because separations from her and the family had been managed insensi­ tively, as had the later trauma in respect of Ricky, the effects of which had become frozen in time. This hypothesis received some confirmation when John went on to speak of becoming angry with a man who had recently beaten his wife. On discussing this incident, it became clear that much of the anger generated in John by this situation was not only about the man’s physical abuse of the woman (and, I suspect, John’s need to distance

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himself from such ego-dystonic behaviour), but also because this person had subsequently flatly denied that the assault had taken place, even though all his acquaintances knew full well that it had. This scenario appeared to have powerful associations and resonances with John’s childhood in that, in a similar way, everyone had known that Ricky had drowned. As noted above, despite the reality of this traumatic event, John’s emotional and cognitive experience of it had been denied or, at best, left unacknowledged. Thus, John’s capacity for meta-cognitive monitoring was fatally compromised since the information he was receiving about the traumatic event was contradictory and distorted. This, in turn, seems to have led to the development of a multiple, incoherent internal working model in respect of his attachment to his mother, and a concomi­ tant state of dissociation (Main, 1991; Liotti, 1992). This fraught situation is likely to have been exacerbated by the separations John experienced at a younger age when hospitalized and subjected to surgical intervention. The clinical evidence indicated that these factors had contributed to the develop­ ment of a predominantly insecure–avoidant pattern of attachment organisa­ tion which, in line with Fonagy et al. (1997), I viewed as an adaptive defence mustered in the face of unattuned caregiving. Moreover, the overall clinical picture suggested that insecurity stemming from separation anxiety had interfered with John’s capacity to differentiate himself from his attachment figure and, thereby, attain a state of ‘mature dependence’ (Fairbairn, 1996). Bowlby (1998) emphasises that anger at an attachment figure who fails to provide the expected comfort at times of stress is a normal and integral aspect of the attachment system. It would appear that this safety valve was not available to John as he lacked both external and internal permission to experience disturbing negative affect. He had little option, therefore, but to develop a defensive organisation against anger and rage, partly identi­ fying with qualities and characteristics of his relationship with his mother as a way of defending against feelings of guilt and anxiety (Freud, 1993). When these mental defences were overwhelmed, John’s repressed, infan­ tile murderous rage was acted out with the destructive force of an adult. In the latest incident of this repetitive pattern, this internal dynamic was externalised, being displaced from John’s original primary attachment figure (his mother) and projected on to Sylvia whom, at the point of the breakup of their relationship, he perceived as untrustworthy, rejecting and abandoning. Thus, Sylvia became a vehicle for John’s intolerable and persecutory self states, that is for the internalised aspects of his relation­ ship with his mother that he experienced as frightening and unmanage­ able (Fonagy, 1999). Further, aggression, rather than love, seems to have become an emotionally ‘rewarding’ way for John to express his ambivalent world of object relations (Dicks, 1993).

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Fear of abandonment, then, seems to have been the primary factor activating John’s attachment behavioural system and identification with the incoherent internal working model of his relationship with his mother. The clinical evidence, combined with John’s forensic history, indicated that his mentalising capacity was prone to being overwhelmed by intense separation anxiety and accompanying hatred and rage when he felt threat­ ened by the loss of a female partner with whom he had formed an intimate attachment. With regard to the index offence, the significance for John of Sylvia’s perceived sexual infidelity lay in the fact that it represented her indepen­ dence of mind and psychological separateness. In my opinion, any move by her towards a separate, independent existence would have conflicted with the explicit and implicit role expectations that John had brought to the relationship, being construed as a threat to his sense of security (Dicks, 1993). Thus, John’s violence was, in part, a frantic attempt to control Sylvia so as to ensure her continued availability, both to protect him against infantile loneliness and immature dependence (Dicks, 1993; Fairbairn, 1996) and to carry the alien, persecutory parts of himself (Fonagy, 1999). The thought of abandonment by Sylvia instilled terror in John because loss was experienced as a retraumatisation and, therefore, as a threat to the coherence and stability of his sense of self (Herman, 1992; De Zulueta, 1993; Fonagy, 1999). I was struck, moreover, by the fact that John’s vicious assault on Sylvia had been triggered at the very point when she denied sexual infidelity, and that John continued to beat her mercilessly until she told him the ‘truth’. Again, I silently wondered to what extent this ghastly episode was a re­ creation in the present of unresolved aspects of John’s childhood relation­ ship with his mother who, throughout his life, adamantly denied the reality of his traumatic experience. Thus, it would appear that John’s violence not only had the effect of making him feel coherent and real, but also of eliciting the response from Sylvia he so desperately needed to hear – a voice validating the ‘truth’ of his subjective experience (Fonagy, 1999). Clearly, John’s violent behaviour could easily have escalated out of control and led to a charge of murder or manslaughter. Sharing these thoughts with John seemed to have a sobering effect on him and again engendered a state of deep reflection. At the twelfth session, John announced with great confidence that he no longer thought of himself as an alcoholic. I was surprised to see that he had had his hair cut short. I wondered whether this dramatic change in his personal appearance was symbolic of a firmer sense of masculine identity, together with a concomitant lessening of his need to defend against feelings of anger and aggression. In terms of Mahler, Pine and Bergman’s

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(1985) process of separation-individuation, I asked myself whether John’s apparent sense of a more secure male identity indicated the achievement of a higher level of psychological separation from the internalised symbi­ otic mother. John again spoke of feeling more at peace with himself, seeing this as manifested in his ability to entertain more positive thoughts and feelings about himself and others, and by the fact that he had got himself a job. He then drew a creative analogy with a childhood situation, telling me that he had underachieved educationally because he had gone deaf in one ear as a result of his ENT problems. Having been seated at the rear of the class­ room, John had been unable to hear with clarity what the teacher was saying and his school work suffered accordingly. Once this problem had been identified, John was brought forward to a front row desk and subse­ quently came top of the class. With a twinkle in his eye, John said that now the problem of his unresolved trauma had been recognised he could move to the top of the class in terms of his emotional and psychological devel­ opment! Though clearly there was an element of affectionate teasing in this comment, it seemed to me that John’s narrative competence had markedly improved, in that he now appeared able to speak in a coherent, concise and plausible way about his painful childhood experiences. This new­ found autobiographical capacity seemed to indicate that John had begun to mourn and, thereby, integrate previously unassimilated traumatic experiences (Holmes, 1996). Thus, from an attachment theory perspec­ tive, the positive therapeutic change reported by John and observed by me indicated that maladaptive internal working models of himself in relation to others, as well as to the traumatic event of Ricky’s death, had begun to be modified and updated. In addition to the improvement in John’s narra­ tive competence, change was manifested in his enhanced sense of security and reflective capacity. These improvements were dependent on John’s ability gradually to organise and integrate error-correcting information received as an ongoing aspect of the therapeutic process (Peterfreund, 1983; Main, Kaplan and Cassidy, 1985). At the final meeting, John reiterated his belief that a ‘weight’ had been lifted from him. Specifically, he spoke of no longer feeling persistently anxious, paranoid and persecuted, or of experiencing a deep and perva­ sive sense of sadness and depression. He was still in employment and managing his drinking. I confirmed that I would contact him in 6 months time and that he could telephone me in between times should the need arise. John expressed a sense of loss and frustration at not having had this kind of help years ago. He questioned why, in over 30 years of being involved in the criminal justice system, no one had thought to talk with

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him about his early traumatic experiences, saying he felt that much of his life had been wasted as a result. This situation emphasises again the importance of obtaining relevant information about the offender’s forma­ tive experiences and personal history as part of a process of effective assessment. John’s sentiments were tinged with some residual idealisation of me, and I thought that his feelings of loss were being conflated with sadness at the ending of our relationship. I acknowledged the paradox he seemed to be highlighting – that even positive change involves loss in one form or another. From Fairbairn’s (1996) perspective, such loss entails relinquishing the tie to the internalised, split-off bad object or saboteur. This process is resisted precisely because attachment to what is familiar (even when of negative quality) provides a sense of continuity to the personality – a case of better the devil you know! Therefore, with regard to the process of therapeutic change from an object-relations perspective, it would seem that my relationship with John had been sufficiently ‘holding’ and ‘good enough’ to facilitate the loosening of this negative tie and the develop­ ment of a more authentic sense of self as mirrored by my attuned response to his ego needs (Winnicott, 1988). Moreover, in line with Bion’s (1984) thought, the therapeutic process was dependent on my capacity to contain, transform and give meaning to John’s raw emotional pain – the guilt, terror and depression associated with his childhood trauma. In this way, his psychic pain became available for mental work, being symbolically transformed by means of thinking, imagining and remembering (alpha elements). Hitherto, John’s untransformed emotions and sense impres­ sions (beta elements) had been experienced as intolerable and uninte­ grated ‘things-in-themselves’, and thus were split off and evacuated by means of projective identification. This defensive process had left John feeling depleted and paranoid and, therefore, fearful of persecution and retaliation (Bion, 1984). As a consequence, John tended to bolster his mental defences against overwhelming anxiety with alcohol. This, in turn, had a disinhibiting effect on him, thereby markedly increasing his propen­ sity for violent behaviour, particularly in situations involving loss and abandonment. Looked at from an intersubjective perspective, my work with John consisted of an intertwining of both interpersonal and intrapsychic processes during which he and I created a shared reality. Therefore, John’s personal history, particularly with regard to the focus on his traumatic childhood experiences and subsequent violent offending, was co-created, being constructed and given meaning in the here-and-now of the thera­ peutic relationship (Benjamin, 1992). Thus, though the ‘reality’ of John’s subjective experience was mediated by his personal narrative and under­

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stood by reference to his relational field, my theory, patterns of thought and systems of ideas were important influences in this process, organising and integrating the material John brought to each session and thereby providing shape and structure to his inner world (Mitchell, 1993). As seen from a more overtly hermeneutic perspective, the therapeutic process required active engagement with John’s dissociated experience which, once represented symbolically by means of language, could be reflected upon, creatively interpreted and given a new and more resonant meaning (Stern, 1997). As agreed, I contacted John for a follow-up discussion 6 months later. His progress had been sustained, in that he was still in work, keeping his consumption of alcohol within sensible limits, and had not re-offended. Prior to the ending of John’s supervisory period I had liaised with his GP who, in consultation with John, agreed to refer him to the local mental health resource centre. John had an assessment session there with a clinical psychologist. It was mutually agreed that no further work was needed at that stage. It remains to be seen whether my brief intervention with John proves to be effective in the long term. I was keenly aware that far more might have been achieved therapeutically, not least on consolidating the progress John had made. This, however, was not a viable option, given the constraints of time and resources obtaining within the probation service. Nevertheless, I consider that the work undertaken with John helped to resolve the childhood trauma underlying his adult offending behaviour. This, in turn, enhanced his sense of security and capacity for narrative competence and reflectiveness, thereby strengthening his ability to activate alternative models of interaction (Fonagy and Target, 1998). These interlinking positive therapeutic changes should potentiate further personal growth and so provide John with a greater ability to empathise with others and make more moral, reasoned choices in the future. It has been suggested that reconviction rates should be used to evaluate effectiveness and measure successful outcome (Chapman and Hough, 1998). At the time of writing, John’s name has not appeared on the local court list, nor have any requests for pre-sentence reports been received from non-local courts. It would seem reasonable to assume, therefore, that four years have elapsed since John last offended. Further, in terms of cause and effect, it may be accepted that identifying the links between John’s unresolved childhood trauma, emotional detachment, substance misuse and violent offending was vital in order to work effec­ tively with him and fulfil the core aims of the probation service, namely to reduce the risk of offending and protect the public from harm.

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Postscript On being invited to contribute a chapter to this book, I met with John some 6 months after our follow-up contact to obtain his consent to publish an account of our work. He was enthusiastic about the aims of the book, expressing the hope that it might assist traumatised young people receive the help they need in good time, rather than years after the event, as in his case. John was effusive about the work we had engaged in, saying, ‘I’d never talked to anyone as I’d talked to you’. He had remained largely free of symptoms of panic, paranoia and depression, telling me, ‘I feel a lot more confident than I used to’, adding, ‘I now think before I act’. John was still in work, even though this entails travelling some distance from his home. As we parted, he told me, ‘I don’t need to drink and be violent any more because I’ve accepted myself for who I am’.

CHAPTER 6

Self-Directed Violence in Adolescence: A Psychotherapeutic Perspective CAIRNS CLERY Acts of self-injurious behaviour* (SIB) include cutting, burning, swallowing glass, head-bashing, etc. Why this behaviour occurs, and why it is a characteristically adolescent phenomenon, is addressed in this chapter. In terms of understanding the causes of SIB the approach adopted here is predominantly psychodynamic, whereas a mainly systemic approach is used to explain its function. The term ‘psychodynamic’ refers to a theory of the conscious and unconscious mind which includes internal (i.e. psychological) objects and mechanisms, which have a relationship or fit with one another, and some of which can change. The term ‘systemic’ refers to the same thing in context – that is, broadened to include the outside world of external objects and relationships (family, school, wider society). Using both theoretical frameworks in combination enables some meaning to be given to an activity in many ways beyond understanding. The chapter employs a developmental perspective, and some psychobiological research findings are acknowledged. Illustrative clinical case material is included throughout.

Context In 1997–99, 21% of all 363 referrals to a regional inpatient psychiatric unit for adolescents involved severe cases of young people who deliberately used violence against their own bodies without intending to kill themselves. Seventy-nine percent of those cases were young women. There are some adolescents whose self-injurious behaviour is so alarming that anthropological or sociological explanations, in terms of * The term ‘self-injurious behaviour’ is used in this chapter to describe non-suicidal deliberate self-harm, or self-directed violence.

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culture or lifestyle or social context, although illuminating, cannot fully account for it. A theory of trauma, defined in its widest sense as an unbear­ able experience causing serious physical or psychological pain, shock and damage, has to be brought into the equation. It is argued in this chapter that severe adolescent self-directed violence does not occur in a vacuum, that external determinants can usually be found to have been involved in its aetiology and that its repetition often reflects a family context of the kind described by Bentovim (1995) as a trauma organised system. For a variety of reasons, SIB is often viewed as typically occurring in adolescence. Whether it is seen as acted out anger, or frustration turned against the self, as an inarticulate communication, or as a misguided attempt to gain control over or cut off from painful feelings, SIB is also often perceived as exemplifying immaturity, the inability to communicate either in a direct childlike manner or in a properly articulate adult way. Acting out, being inarticulate or being misguided are not in themselves exclusively adolescent behavioural features, but they are often seen as adolescent characteristics. Adolescence itself may not be regarded as pathological, but behaviour characteristic of it often is. Hence initially innocuous, and indeed genuinely innocent teenage experiments in finding, learning, defining and mapping the borders or limits of both the individuating self and of societally determined standards of acceptable behaviour, easily lend themselves to being psychiatrised or criminalised by the adult world. Academically neutral or clinically affirmative reframes of such experimental behaviour as ‘rites of passage’ or ‘boundary testing’ are generally looked on, with suspicion, as being all very well but at the same time tantamount to condoning various kinds of self-harm and/or the potential for developing psychiatric problems. It is unsurprising that SIB, when associated with recurrent suicidal behaviour, constitutes one of the five diagnostic criteria in the International Classification of Mental and Behavioural Disorders, ICD-10 (WHO, 1992) for Borderline Personality Disorder. It may be that there are as many reasons why young people engage in SIB as there are adolescents who do so. It is usually a private act, uniquely personal to the perpetrator, even though she or he may subsequently display the evidence of their behaviour for others to see. SIB tends to be a female activity. Perhaps one reason for this is that boys are socialised to direct their conflicts externally, i.e. against others, and their violent behav­ iours therefore generally tend to be criminalised. In contrast, it may be that adolescent girls have been socialised to direct their conflicts inter­ nally, i.e. against themselves, and their violent behaviours therefore tend more often to be psychiatrised. But ways of understanding adolescent SIB rest on observations and assumptions. This means that consideration

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must be given not only to the context in which an adolescent commits selfinjury, but also to that of the adult trying to understand it. In one context a self-injurious act may be a communication, but not in another. Sometimes the setting in which an adolescent finds herself and the need for feelings of togetherness can lead to contagion of SIB, and peer pressure to engage in it (Taiminen et al., 1998). Clearly this is particularly true in institutions. Sometimes SIB is used to prevent or control communication, perhaps about unbearable or shameful feelings. Then again, SIB may not always express current psychological conflict. Sometimes what was an initially defensive adaptation to adverse external circumstances develops into a self-destructive maladaptive behaviour over the course of time (Shapiro, 1992), so that what was once a solution becomes a problem. Often SIB is a reaction not simply to adverse or traumatic external circumstances, but also to inner imperatives. Thus the traumatised psyche, as Kalshed (1996) shows, can itself become self-traumatising, as evidenced by SIB. In short, the particular circumstances of each case of SIB will, therefore, best answer the question as to why it has occurred.

Case study: Lynn Now 16, Lynn was put up for adoption at her biological mother’s request when she was 8 months old. Her mother, who was herself 16 when Lynn was born and living in a hostel in the north of England run by a charitable religious organisation, at first wanted to keep her. Hostel staff described Lynn as ‘fractious and difficult to care for’. Mother and child were described as ‘failing to bond’ before the former finally left Lynn to live with her older boyfriend, who was not Lynn’s father. She saw her daughter again twice before asking for Lynn to be adopted and ceasing contact with her altogether. Lynn was then fostered by the childless married couple who subsequently adopted her. For the next 4–5 years her adoptive mother experienced her as an extremely unhappy child who would cry inconsolably for long periods of time, but who successfully achieved the developmental milestones. Subsequently, between the ages of 5 and 12 (when she reached puberty), she seemed to become more responsive and appeared more settled, although generally quiet and withdrawn. She rarely showed anger, aggression or hostility towards her adoptive parents. She negotiated the change to secondary school successfully but within a year took her first overdose, and would or could not say why she had taken it. Between ages 12 and 15 she took a total of 15 overdoses, each more serious than the last. Throughout this period she would also sporad­ ically but superficially injure herself, scratching her forearms and calves with razor blades or broken glass. Just before her 15th birthday, she was

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admitted to a psychiatric unit for adolescents, on a voluntary basis, for what eventually turned out to be a period of 8 months. Treatment, for Lynn, involved an intensive programme (i.e. frequent sessions) of individual, family and group psychotherapy. During this time, she made only one more attempt on her life, following an invitation to her adoptive father, who had recently separated from her adoptive mother, to meet with hospital staff to discuss her treatment. In contrast, self-inflicted harm to the skin and tissue of her arms and legs became much more frequent and extreme, often requiring stitches, and with damage to tendons twice being only narrowly avoided. She became extensively scarred, and would volunteer no explanations for specific incidents of selfinjury; in fact, she hardly talked at all in any context. She did, however, confide that she had had a full sexual relationship with a violent adult male in his early thirties, which began just before her fourteenth birthday. She also alleged that her adoptive father had physically abused her repeat­ edly before he left the family home. She would usually injure herself on the ward, when not being directly supervised, or at weekends when she went home. Gradually the frequency and severity of her self-harm became so worrying that a decision was made, at her adoptive mother’s instigation, to treat her compulsorily under a section of the Mental Health Act 1983. It was explained to her that this was in order to keep her closely observed, to give her many wounds some time to heal, and to let her know that although her right not to talk about what was prompting her to harm herself would be respected, the abusive extent of her SIB would be contained. Following this intervention, Lynn began to talk, the section was not renewed and SIB occurred only twice over the next 6 months. She was then discharged from hospital. One week before she left the unit she disclosed systematic sexual abuse by her adoptive father and a ring of his paedophile friends, from the age of 8 until puberty. She said she hoped that by sharing this information she could leave some of the memories behind her and get on with her life without having to harm herself again. During those years, she said, he had frightened her into silence by threat­ ening to kill her and her mother if she ever told anyone.

Causes of SIB The first few months of life, as Winnicott (1965) described, are best charac­ terised in terms of the dyadic relationship between mother and infant. The emotional attachment which the mother enables to develop between them, based on nurture and responsiveness, provides the baby with a ‘good enough’ containing structure within which maturational processes

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can occur. Bowlby (1969) demonstrated that when there is disruption to this bonding process, the subsequent effects on the infant’s psychological integrity or sense of self can be devastating. The earliest formation of an identity, defined by Erik Erikson (1980) as a persistent sense of sameness, is diffused, experienced at times as hardly persisting at all. It is likely that this was Lynn’s experience, given that she lost her biological mother just as she reached an age when most babies appear to start becoming consciously aware both of their own existence, and that of the person mothering them as a separate individual with a personality of her own, rather than simply a source of nourishment and warmth. She may well have sensed and taken in her mother’s uncertainty about whether she wanted her. The failure to achieve a bond or connection together as a nursing couple is thus explained not just by Lynn having been a ‘difficult’ baby, but also by this internalisation of her mother’s ambivalence towards her. That she was actually rejected and abandoned by her mother compounded and confirmed the damage already done. As an adaptation it may have led to her starting to search for alternative ‘DIY’ ways of ‘nurturing’ the development of her sense of herself, by way of what Kalshed (1996) refers to as the psyche’s archetypal self-care system. Information about her early developmental history is patchy, but her adoptive mother reported infantile headbanging at night as a regular feature. Was this a precursor of later SIB? And if it was, can SIB be viewed as serving some kind of positive function in terms of self-preservation or self-protection? Favazza (1998) suggests that one of the functions of SIB, of self-mutilation in particular, is to provide immediate and brief respite from feelings of depersonalisation, and immediate access to a heightened sense of self. So the answer to this latter question is partly affirmative but there will be further discussion of the purposes SIB can have, both positive and negative, in the next section. Lynn may well have unconsciously sought to defend herself against her overwhelming feelings of loss and abandonment during her infancy by way of psychic numbing or depersonalisation, psychological coping strate­ gies which would again become useful to her when her adoptive father was sexually abusing her between the ages of 8 and 12. Later on, however, once she had become a teenager and after her adoptive parents had separated, and she had been admitted into hospital, these coping strate­ gies became problems themselves (so-called borderline states) because they not only left her feeling cut off from her own emotions, but were also redundant as solutions given that she was no longer being abused. On one of the rare occasions when she did talk about it, she described SIB as liter­ ally ‘cutting through the numbness’. But she also owned that it was a moot point whether this ‘cutting through’ was to or from depersonalisation.

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A 4-year empirical study of the childhood origins of self-destructive behaviour by Van der Kolk, Perry and Herman (1991) concluded that, although childhood trauma plays a part in its initiation, it is the lack of secure attachments which contributes to its continuance. During adoles­ cence, attachments are realigned, the teenager moves from the childhood experience of being parented, or looked after with love, to the young adult state of having been parented in the past, and now beginning to look after her- or himself. That is the paradigm. In fact, the quality of attach­ ment varies from individual to individual and from family to family, as does the pace at which each young person becomes more self-reliant and mature. But it is a natural part of the adolescent process, as a good enough experience of being parented is internalised, that attachment to parent figures becomes less directly dependent and less secured in them. Where the parenting has not been good enough during childhood, where it has been abusive or disrupted or lost altogether, and trauma has led to damage to, or diffusion of, the developing sense of identity, the likelihood of subsequent SIB is markedly increased (Boudewyn and Liem, 1995; Silverman, Reinherz and Glaconia, 1996). In Lynn’s case, having lost her natural mother at 8 months, and then being sexually abused from the age of 8 years, her attachments were far from secure, and once in hospital she struggled with post-traumatic stress. Tulloch, Blizzard and Pinkus (1997) have found that the absence of a family confidante is very strongly associated with adolescent self-injury. Her adoptive mother was a kind and loving person but, in order to protect her, Lynn had been unable to confide in her and tell her what was happening. The number of Lynn’s urinary tract infections had caused her mother to wonder whether something of the kind might be going on, but it never occurred to her to suspect her husband until after he had left and her daughter’s infections decreased in frequency. It is significant that once she had been admitted to hospital for inpatient psychiatric treatment, Lynn’s increasingly dangerous attempts on her life virtually ceased altogether, to be replaced by SIB of escalating seriousness. She felt physically and emotionally safe enough to stop trying to kill herself, except when her adoptive father’s presence threatened; but what he had done to her was so traumatic for her that it was difficult, if not impossible, for her to talk about it. This is likely to have had a physiolog­ ical basis. In their study of the neuroanatomy of post-traumatic stress disorder, Rauch et al. (1998) have demonstrated that traumatic stress affects the brain by triggering a limbic switch from the hemisphere respon­ sible for speech and verbalisation over to the hemisphere governing non­ verbal functions. Similarly, De Zulueta (1993) has shown that recurring stress can lead to biochemical patterns and pathways being laid down,

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thus establishing a psychobiological basis for activities like SIB. This is consistent with Van der Kolk’s (1989) view that people who repeatedly injure themselves usually do so because current stress is purposefully, albeit often not consciously, experienced as a recurrencing of past trauma. They use SIB to anaesthetise their feelings by activating endoge­ nous opoid systems. The actual activity of SIB, or re-experiencing being a victim of abuse or trauma, releases endorphins which have a calming, soothing effect. Lynn sometimes talked about being addicted to SIB. At other times she referred to it as a part of herself: ‘It’s how I am’, she once said on being found late at night bleeding from the arms and legs in the ward bathroom. Before being admitted into hospital but after she became pubertal and her adoptive father’s sexual interest in her waned, Lynn almost immedi­ ately got into another physically and sexually abusive relationship with an adult male. This certainly raised the therapeutic question as to whether the need for re-enactment of trauma played a major part in her psychopathology although, at that time, full information about what had happened to her was not yet known. With hindsight, it is clear that once she had been admitted to hospital, she no longer felt compelled to repeat the trauma interactionally by way of unsuitable sexual relationships, but could instead go directly to the solipsistic physically traumatising experi­ ence of severe self-harm, which would have the same endorphin-releasing psychobiological effect. Thus SIB was not only caused by, but also expressed, her unverbalisable feelings about what had happened to her. At the same time it anaesthetised them, diverted her attention away from them on to her skin and flesh, and gave her a form of physiological relief to which she could become addicted. Kalshed (1996) describes a typical example of the fragmentation of consciousness which occurs when trauma hits the developing psyche of a child. On the outside, at the level of what Winnicott (1988) called ‘the false self ’, she or he might appear to be coping, or progressing very well. This coping part ‘looks after’ that part of the psyche which is not coping at all well, which is hidden away internally, and which as a result of trauma is regressed and functioning at an earlier developmental level. But it is in fact not possible for the part of the personality which deals with the external world adequately to take care of the child’s internal world at the same time without cost. With Lynn the cost was self-directed violence and an unhappy silence about what her adoptive father had done to her. She always made sure that her appearance was perfect. She always wore make­ up, dressed well and carried herself with poise, so nobody could possibly have guessed what damage she was doing to herself beneath this outward appearance. Lynn’s cutting and burning of herself served to help her

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manage and control her own feelings about her unbearable and unspeak­ able memories. She loved her adoptive mother and felt guilty in relation to her for having been the object of her adoptive father’s sexual attentions. The last thing she wanted was for her adoptive mother to find out that her husband had been sexually abusing her.

The uses of SIB Babiker and Arnold (1997) distinguish on the one hand between the meaning of SIB, in terms of why and how it can be understood, and on the other, the purpose it serves in the person’s life, in the context and system of relationships within which she finds herself. Such a clear conceptual distinction is reconciled in clinical practice by respect for the actual person engaging in SIB and her own personal story about why she does it and what it is for. Different understandings and interpretations will have differing amounts of explanatory power and therapeutic usefulness for each individual at different times. Most adolescents do not find it easy to look at their own behaviour, let alone attempt to understand it, because by definition adolescence is a time not just for action but for acting out, expressing issues and conflicts through behaviour rather than by verbalisa­ tion, and often with scant or at best only subsequent regard for the conse­ quences. In terms of SIB, they often tend to switch from problemdominated narratives (White, 1991) about it which do not recognise the positive function that it may initially have had as a survival response (Lindberg and Distad, 1985), to the opposite extreme of viewing it as wholly ‘good’ and the only thing which helps them make sense of their place in the ‘bad’ adult world. Nevertheless, purposive systemic stories are much more usual than psychodynamic causal ones from self-injurious young people themselves. Perhaps this is partly because answering the aetiological question ‘why?’ requires time and trust in the therapist, which can often take years to develop. The immediacy of the pressure in the here-and-now to inflict selfdirected violence is overwhelming. If the most common response to the question ‘why?’ is a sad shrug of ‘I don’t know’, then the next is ‘I wanted to feel more in control’. And when this is elaborated upon, it almost invari­ ably turns out to be not just about difficult feelings connected with experi­ ences imposed upon the young person earlier in her childhood, but also with wanting more say and more power in the present situation she finds herself in. In other words, it can be both communicative and meaningful. Perhaps incongruously, it is also often about wanting to recover ownership of her own body.

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Case study: Liz Liz is 16. She has an older brother and sister, both of whom are still in their teens. Her mother manages a boutique and her father works on the railway. He is a member of an amateur jazz band. Her brother and sister openly smoke cannabis at home, sometimes joined in this activity by their mother. Liz used to smoke cannabis regularly too until she had a psychotic breakdown which led to her admission as a psychiatric inpatient for treat­ ment of a schizophrenia-like illness and self-injurious behaviour. When Liz first came for individual psychotherapy sessions, she said that she was being ‘taken over’ by what she called ‘That’. She was quite clear that That existed as an entity in its own right with a voice audible only to herself. That had taken control of her face, she said, making her smile when she felt like crying, and driving her mad, for example by telling her that it would help her if she cut herself, or that she would be all right if she jumped in front of a moving train. She said that That told her that she would never again be allowed to be herself, i.e. well, which, she said, left her feeling as if all her nerve-endings were on fire. That had also told her that she should not communicate with anyone, as doing so would make her feel worse than she did already. She found that deliberately hurting herself, usually by cutting, helped her both to cry and, as she put it, ‘to feel real’. After spending a weekend at home she would often return to the unit having injured herself, or telling nursing staff that she had had to resist doing so, because That’s voice was so much more intrusive and persecutory at home than it was in hospital during the rest of the week. So far as she could, Liz tried to disregard That’s injunction on commu­ nicating anything about her feelings and experiences. She said that she knew she was paranoid and that That was an imaginative figment, but at the same time That had a voice, personality and presence which were all as real to her as I was, if not more so, because That was always with her. She said That was ‘taking (her) personality away’ and that she would never be able to get it back. She spoke sadly about her envy of ‘normal’ people, i.e. those without delusions or a major mental illness, and said that sometimes she used SIB to make up for the fact that she could not cry despite feeling so depressed about being psychotic. She used her psychotherapy sessions to notice a pattern: in situations which she found difficult and from which she would want to withdraw, That’s voice became louder and more insistent. The situation she found most difficult, and from which she most wanted to withdraw, was living at home with her family. She dated this feeling from around the age of 13 when her mother had excitedly taken her into the bathroom and, after

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locking the door and making her promise not to tell, had confided in explicit sexual detail that she had a lover, that he was not her first, and that she intended one day to leave her father. ‘I suddenly grew up into an adult in that bathroom’, she would later say. A further year of such confidences followed before her mother did eventually leave, returning at weekends to smoke cannabis with her adolescent children. Liz would join in with this but over the next couple of years became increasingly paranoid and confused each time she did so. Her siblings were angry and jealous of her exclusive relationship with their mother, and would emotionally and sometimes physically abuse her, insisting that she did all the cooking and domestic chores in the house. It was at this time that she started secretly to injure herself. Although Liz’s father was concerned about how her siblings were treating her, neither he nor his older children would take on the household and culinary tasks formerly undertaken by his wife, and he did not stop the bullying. Instead he tried to compensate for their cruelty to her by being kind to her himself – she was seen as his favourite too – and by helping her with her violin practice. Liz’s mental state deteriorated and her SIB escalated. She stopped going to school and spent most of her time alone in her bedroom. Her parents reached the decision to seek professional help after Liz declared that That had told her that she must seriously harm herself and embark on a ‘journey of no return’, and was then found incoherent and confused in the local shopping precinct having hammered a six-inch nail into the top of her left leg.

Meanings and purposes Haley (1980) draws attention to the link between symptom and familial system in cases of adolescent psychological disturbance. Clearly the context for Liz’s disturbance was having to be prematurely faced with the main issue of late adolescence, i.e. leaving home, just when her adoles­ cence was in fact starting. The hierarchical boundary between mother and child was blurred by her mother’s treatment of her as if she were an adult friend rather than a 13-year-old daughter. A paradoxical consequence of this for her mother was that Liz’s attachment to her altered and she actually began to feel less close to her. The fact that she did not show it suggests extreme role reversal, an inversion of the parental hierarchy. Liz ‘looked after’ her mother emotionally by listening to her stories about her ongoing sex life and responding as appropriately as she could without expressing any feelings of her own about it. Indeed the fact that it was her mother who left home after this time, only returning to smoke cannabis at weekends, suggests that she herself was re-experiencing adolescent family

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life cycle issues (Carter and McGoldrick, 1989). The effect of this on her youngest child was to prompt within her a sudden step-functional change (Hoffman, 1981) into a parentified or at best siblinged role in relation to her, the traumatic impact of which triggered the slow but relentless devel­ opment of an incipient psychosis (i.e. ‘That’). Liz coped with this inner threat of annihilation of her personality by utilising SIB to re-traumatise herself and thus literally shock herself into maintaining her tenuous sense of sanity. To put it another way, self-injury helped her to feel defended against feelings of unreality which were more unbearable to her than physical pain. She said it helped her, albeit only temporarily, ‘to take (her) body back from That and feel more real again’. A mad solution to the problem of going mad was not helped by the fact that both her parents were placing her in double binds (Bateson, 1972); her mother by confiding in her as if she were getting closer to her just when she was in fact initiating the process of her own departure from the family home, and her father by, on the one hand treating her as his favourite, while on the other hand, and at the same time, doing nothing to protect her from the violence of her siblings. Liz also used SIB as a substitute for crying, something she had been desperate but unable to do since her mother first confided in her in the bathroom. Solomon and Ferrand (1996) have suggested that there may be a link for self-injurious young women between crying and bleeding, and this might be the beginning of one explanation as to why cutting or other­ wise piercing the skin is a predominantly female activity. In Liz’s case the link was explicit. She was quite clear that the blood she drew was identical with the tears she was unable to cry about her situation. Specific acts of SIB have a single action/multi-meaning function (Clery, 1998). That is, the performance of a particular self-injurious act operates to reconcile otherwise often contradictory feelings across many different levels of conscious and unconscious meaning: for example, punishing, purging, re-enacting, controlling unbearable feelings, and so on. Its very ambiguity as both a solution and a problem reflects the ambivalent psychological reality of adolescent existence, caught between the future adult and the past child states. Perhaps this is why some research studies show SIB to be a particularly adolescent activity (Kendall-Tackett et al., 1993) in the context of abuse or trauma. Bentovim (1995) highlights the way in which action, rather than talking or thinking, characterises the trauma-organised system. In reaction to the emotionally abusive way in which her mother managed her separation, instead of talking about it together, Liz’s siblings ‘blamed the messenger’, or rather the message receiver, Liz herself, by physically abusing her. Similarly, her parents went into denial about it as if nothing had

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happened. Although it also served as a survival response, both to this familial victimisation and her own burgeoning psychosis, SIB on Liz’s part signified that something most definitely had happened (Crowe, 1996). At the same time, as a behaviour, it was consistent with the patternmaintaining family script (Byng Hall, 1995) which decreed action rather than words as a coping strategy.

Conclusion Adolescent self-injury has to be understood, in both causal and purposive terms, in a variety of different ways. It often occurs when the adult world of words is inadequate for the expression of different, linguistically contra­ dictory and incoherent meanings. At the same time, the childhood world of trust in and dependence on responsible adults has often been, or is felt to have been, betrayed. Either way, it is no longer available. Abuse and major interpersonal problems in the family often provide the context (Romans et al., 1995). In the normal course of development, the adoles­ cent, as part of the process of adolescence, is engaged upon a search for her own way of coping both with her own internal world and the outside world into which she is growing up. Both healthy and pathological methods of so doing are open to her. To a limited extent, SIB, at least initially, can be viewed as a choice, like smoking a first cigarette or using it to burn the skin. This can occur experi­ mentally or accidentally and lead to the discovery that self-injury allows the young person to ‘feel more real’ or ‘more cut off ’ in relation to others, depending on how she herself frames it. Whether the ‘choice’ subse­ quently becomes more like an addiction depends upon a number of factors including past or present trauma, the quality of the psychobiolog­ ical experience, and how the family constellation around the adolescent has organised itself. But, by the time patterns of SIB have become entrenched, it is clear that the young person feels she has no alternative. The best therapeutic stance in terms of both understanding why she is harming herself, and in beginning to engage her in therapy, is to recognise and openly acknowledge this from the outset. Generally speaking, adolescents do not do violence to themselves without reason. Accessing those reasons can be experienced as more painful than the physical pain being inflicted upon herself by the young person, especially when they may be confusing, guilt inducing, shaming and based upon unbearable and horrifying experiences such as abuse. For the self-injurious young person to develop different ways of expressing or coping with hitherto unverbalisable feelings, it is vital that her own reasons for harming herself are heard, and acknowledged in a

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safe and containing manner, which respects both the person and the extremely difficult process she is going through in seeking alternatives to it. This may take months or even years of therapy (if she is able to get it), during which there will be many setbacks, given the power of SIB, over and against words, to carry so many different meanings at the same time. In other words, adolescence itself may well have to be outgrown before SIB can also be left behind.

CHAPTER 7

Violent Adolescent Female Offenders

SUSAN BAILEY Official crime statistics of all countries have consistently demonstrated that the crime rate for young females is several times less than for young males (Heidensohn, 1997). Young women appear less likely to be recidivist or to commit really serious crime; their offending careers tend to be shorter. It is, therefore, somewhat surprising that there has been relatively little interest shown in the research into female/male differences in antisocial behaviour in general, and violence in particular (Rutter, Giller and Hagell, 1998). Recent British statistics indicate a peak age of offending of 15 years for females (Graham and Bowling, 1995). Wikström (1990) reported a peak age of between 22 and 24 for young females in Sweden, suggesting that there may be two peaks in young females and an international varia­ tion in offending patterns. All the evidence goes to support the conclusion that, compared with young males, young females commit fewer and different crimes and follow different offending careers. Although there has been evidence over the years that young females are treated differently by the criminal justice system (Morris, 1987), this does not account for the overall difference in statistics with respect to young offenders. A real differ­ ence in behaviour exists. Known risk factors for delinquency do vary by sex but this still does not offer a full explanation of gender differences in rates of juvenile crime and the associated evolution of severe antisocial behaviour and parallel acts of violence through childhood and into adoles­ cence (Loeber and Hay, 1994). Two particular crimes of violence associated with females are those of infanticide and physical abuse of children. When women kill, it is often assumed that they are mentally disturbed. In particular, the mysterious workings of the female body have long been blamed for women running riot and becoming violent. The creation by the law of the offence of infan­ ticide was an important stage in this tradition. The offence only applies to 104

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women who kill their children under the age of 12 months when the balance of the mind is disturbed as a result of childbirth or lactation. The offence reached the statute books in England in 1922, and was later modified in 1938 (Wilczynski, 1997). The infanticide provisions are under­ pinned by two contradictory assumptions. On the one hand, mothers are presumed to be naturally benign, tender and nurturing, and therefore incapable of harming their children unless mentally disturbed. On the other hand, there are fears that women’s very biology makes them inclined towards murderous attacks on their children, and that this requires special provision within the criminal law. The uneasy balancing act between these twin assumptions is reflected in a number of unique features of the infan­ ticide legislation which run counter to traditional criminal law principles. When offenders commit crimes, the law presumes they are sane until it is shown otherwise. Yet the infanticide provisions enshrine a virtual presumption that a certain class of offender is mentally disturbed. Further, it has to be shown only that the offender’s imbalance of mind coincided with the criminal act, rather than having directly caused it. Of particular interest in adolescent females is the act of neonaticide (killing of an infant within 24 hours of birth) and undisclosed teenage pregnancy, which will be discussed later. To a lesser extent than infanticide, the killing of family members is more characteristic of females than males. Homicides by females are three times as likely to be of a family member and less likely than in males to be of a stranger. Feminist sociological perspectives have suggested that there may be routes into crime for females which are much less characteristic of males. Examples include crimes that arise from a relationship with a violent male or through friends or partners who misuse drugs, and more limited evidence of serious crimes of violence related to severe depressive illness which is more common in females (Daly, 1994). During the 1970s young females tended to be treated more harshly than young males, being brought before the courts for such non-criminal matters as being in moral danger or beyond control. Young females were more likely to be formally cautioned, to be brought to court and placed in some form of institutional care for lesser offences. However, recent British statistics (Home Office, 1997) indicate that young females tend now to be dealt with less harshly than their male counterparts. In 1994 56% of females appearing in court for the first time were given an absolute or conditional discharge, compared with 48% of male first offenders. In the case of individuals aged 21 years or more with at least 10 convictions, 22% of males but only 13% of females were sentenced to immediate imprison­ ment. This differential processing of males and females should tend to lead to an increase in the sex ratio over time; in fact the opposite has taken

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place and the sex ratio has gradually but steadily diminished over the last 40 years. Crimes by females have been increasing at a faster rate than crimes by males. This chapter considers how gender, crime and violence are linked, how the small but significant rise in violent crimes carried out by adolescent females is understood, and the ways in which these issues are being addressed by the mental health services.

Psychiatric assessment of young females Psychiatric assessments, in general, lay emphasis on the qualities of psychological and social functioning rather than on the criminogenic process. However, in adolescent forensic psychiatry there is a clear emphasis on the relationship between any mental disorder and offence specifics. Given the transitional nature of adolescent influences on mental health and young females, assessment involves not only the consideration of the presence or absence of illness or disorder, but also an evaluation of the various components of development, which must encompass person­ ality, social and moral development, including empathy and ability to form relationships. Physical and intellectual development will have a consider­ able bearing on psychological development. Any judgement about the presence or absence of psychiatric disorder has to take into account different presentations at different stages through development. The inter­ play between assessment, development and presence or absence of disorder is highlighted in the assessment of adjustment to a trauma, or a series of negative life events. Concepts of resilience and vulnerability are concerned with the factors that impinge on the ability to cope. Nowhere is this seen more vividly than in the lives of violent adolescent females whose critical early years have been characterised by a series of abusive experi­ ences. Those coming to the attention of the adolescent forensic services have commonly started repetitively to self-harm and exercise control over their lives through an array of high-risk behaviours, such as firesetting and sustained repetitive, assaultative behaviour, the latter not infrequently against their residential carers. Psychiatric disorders in adolescence fall into three main developmental categories: continuing childhood disorder; mental illness typical of adult­ hood; and disorders which, although not confined exclusively to adoles­ cence, are characterised in the main by difficulties in surmounting this particular stage of development. The acquisition of a personal identity remains the main developmental task for young females reared in supportive and caring environments; supplementary tasks are attainment and proficiency in the adult sexual role, the transition from being nurtured to being able to care for others,

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learning to work and be self-supporting, and leaving home. The early life experiences of adolescent females presenting with aggressive and violent behaviour render such tasks at times not only alien but frequently impos­ sible to achieve. This situation, in turn, acts as a strong reinforcer for escalating maladaptive coping strategies to survive for the moment, while young women are unable to plan or think of the future. In the field of forensic psychiatry, written communication between a range of disciplines, particularly in the medico-legal arena, is a key component. Thus, a common language of reliable and valid diagnoses is vital if safe practice is to be implemented. Two main formal classification systems for psychiatric disorder are in use: the World Health Organisation’s International Classification of Disease, tenth revision (ICD-10; WHO, 1992), and the fourth revision of the Diagnostic and Statistical Manual of the American Psychiatric Association (APA, 1994). Each allows a multi-axial approach to classification, thus allowing different aspects of an adolescent’s problems to be recorded separately without requiring an artificial judgement about the primacy of each. Both systems are for use across the whole life-span and therefore increase the opportunity for safe transition, both meeting needs and managing risk as an adolescent female moves into adult services. Assessment of a high-risk female adolescent with a possible mental health problem can be beset with many difficulties. Not least of these is the viewing of the adolescent solely as a target of and for complaint, the still prevalent attitude of stigma attached to mental illness adding to discrimi­ nation against this already negatively labelled group of young female offenders. In reality, however, the greatest obstacle remains lack of confi­ dence and previous negative experiences for young females who are trying to articulate their innermost thoughts and feelings to and with others. At the point of assessment by an adolescent forensic mental health team, there is often an already established pattern of poor relationships with the authority figures of parents, teachers, social workers and the police. Add to this the expectation from the judicial process of clear explanations for crimes, with accompanying exact diagnosis and prediction of future risk, and the process of assessment for both assessor and young female can appear a daunting one. In practice, assessment has to strike a balance between engagement, the need to elicit information, and formal mental state examination. There can be, and often is, conflict between these three, further compounded by whether the assessment is a stand-alone exercise for the purpose of report to court, when the practice of least harm must be one of a set of competing priorities, or whether the assess­ ment is but a prelude to long-term treatment for the young female facing the possibility of a life sentence for an act of extreme violence. In a world that demands increased sharing of information, and, at times, full disclo­

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sure of all information between professional agencies, in order to protect the public, this is further compounded and complicated by walking the difficult tightrope of the traditional patient–doctor confidentiality bound­ aries (Bailey and Harbour, 1999).

Psychiatric disorders and violence Oppositional defiant disorders, characterised by frequent severe temper tantrums for the child’s developmental level, arguments with adults, defiance of rules and blaming others for mistakes, have similar rates in girls and boys. Children are often touchy, angry, resentful, spiteful and hold vindictive attitudes (Campbell, 1995). Conduct disorders, however, were shown by an American twin study to occur in males up to four times more frequently than in young females (Simonoff et al., 1997). Conduct disorder is defined in terms of rather more serious behaviour including violence, fighting, cruelty and setting fires as well as by overtly delinquent acts such as stealing and burglary. It does, however, subsume lying and truanting. McGee et al. (1990) found that non-aggressive conduct disorders, mainly comprising truancy and the use of alcohol or cannabis, are more frequent in girls. However, Zoccolillo (1993) has argued cogently that the prevailing systems of psychiatric diagnosis under-estimate the overall rate of conduct disorder in girls. Pervasive and persistent hyperkinetic disorders are much more frequent in males, with a sex ratio of about 4:1. Antisocial personality disorders in adult life are some 5–6 times as frequent in males as in females. This condition is defined in terms of pervasive patterns of disregard for and violation of the rights of others that have been present from as early as mid-adolescence. The US epidemiolog­ ical catchment area (ECA) showed a lifetime prevalence in males of 4.3% and in females of 0.7% (Robins and Regier, 1991). Follow-up studies (Zoccolillo et al., 1992) revealed that the ways in which pervasive social malfunction is shown varied by gender. Crime in adult life is a common feature in men but less common in women, who are more likely to show problems in interpersonal relationships. Information on young females is again scant. The emphasis on the study and development of psychopathic personality in late adolescence has focused predominantly on males (Christian et al., 1997). There is an urgent need to explore the evolution of such personality types in young females. Key indicators include: Family features • parental antisocial personality disorder • witnessing violence • abuse, neglect, rejection

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Personality features • callous, unemotional, interpersonal style • evolution of violent and sadistic fantasy • people regarded as objects • morbid identity • paranoid ideation • hostile attribution Situational features • history of repeated loss and rejection in relationships • threats to self-esteem • crescendos of hopelessness and helplessness • social disinhibition – group processes, substance misuse • changes in mental state over time. Most of the literature on adult females who are violent consists of the study of women held in penal establishments or maximum security hospitals. Here, two main types of personality disorder are highlighted. Firstly, antisocial personality disorder, with pervasive patterns of disre­ gard for and violation of the rights of others, has its onset from about the age of 15 years. The emphasis in the American literature is on borderline personality disorder, with pervasive instability of mood, difficulties in interpersonal relationships and self-image associated with marked impul­ sivity, huge fear of abandonment, identity disturbance and recurrent suicidal behaviour. These features are also highly characteristic of the young females in a study of the first 100 admissions to an adolescent forensic secure psychiatric unit (Bailey, Thornton and Weaver, 1994). Follow-up of these young women has shown that they fared badly in adult life, developing major psychotic illness, schizophrenia and high rates of successful suicide in their early twenties. Their histories and clinical presentations bear a strong resemblance to those adult females admitted to maximum security hospitals, particularly those with histories of fireset­ ting, violence and early histories of loss, trauma, sexual abuse and post­ traumatic stress disorder. Early onset psychosis is, in itself, rare in both males and females. It can be associated with violent behaviour but the association is complex. Psychosis with onset in the teenage years has a tendency to go unrecog­ nised, the psychotic behaviour being attributed to the very process of adolescence. The risk of violence, however, tends to lie less in the actual psychosis than in the previous history of antisocial behaviour and unsup­ portive rearing. Nevertheless, it remains important, in any overall assess­ ment of young females by multi-professional agencies, to consider the

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possibility of early onset psychosis. Literature in this field has been limited to date but there is emerging strong evidence that there is a prodromal phase of non-psychotic behavioural disturbance which can last between 1 and 7 years in about half of early onset cases of schizophrenia (Maziade et al., 1996). The importance to non-mental health practitioners lies in the nature of the non-psychotic behavioural disturbance which can include obsessive compulsive disorder, avoidant personality, anxiety states, selfharm and, in particular, externalising acts of violence. Characteristically, the violent adolescent female will experience multiple periods of ‘at-risk mental states’, which are significantly affected by life events and family stress. In the lives of chaotic young females who repetitively self-harm, and are in unsupportive environments, it is impor­ tant, therefore, to look for any clear change in the baseline level of social functioning, even if the baseline itself is normally chaotic. At-risk mental states associated with violence include perceptual changes in ideas of reference, and paranoid delusions. Mental states in young females which should alert professionals to risk of imminent violence include subjective feelings of tension, ideas of violence, delusional systems that incorporate those currently close to the young female, persecutory delusions with fears of imminent attack, feelings of sustained anger and fear, passivity experiences, reduction of self-control, believing oneself to be controlled by others, and command hallucinations telling one what to do. Protective factors in working with such young females are their capacity to respond to and comply with both social treatments and medical treatments, good social networks, valued home environments, and no interest in or knowledge of weapons or other means of violence. Especially important is not only good insight into their psychiatric illness but equally insight into any previous violent aggressive behaviour. A critical protective factor against violent acts is a fear of their own potential for violence, not only against others but turned against themselves. Such severe self-harm includes atypical cutting, of breasts and genitals, and attempts at self-immolation. The latter can, and does, result in serious risk to self when they discover the power of fire in removing their flash­ backs of past abuse.

Understanding gender differences It can be argued that criminological research is either very male-orientated or gender-blind in the sense that there is no consideration of whether or not crime in females may differ in its origin (Gelsthorpe, 1997). In seeking to understand differential risk factors between girls and boys, it appears likely that the gender difference in hyperactivity plays a major role in the

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parallel difference between females and males and the life course of persistent antisocial behaviour (Taylor, 1994). Biologically based gender differences in aggression are reasonably well documented. There is evidence from early in childhood that they apply across cultures (Quay, 1993). High physiological reactivity seems to serve as a protective factor against antisocial and violent behaviour, and that could be implicated in the gender difference between females and males (Rubin et al., 1997). Rutter, Giller and Hagell (1998) suggest that adolescent females respond to stress and adversity in a different way to boys, though boys and girls seem equally vulnerable to the ill-effects associated with institutional care, as emphasised by the high rate of crime in women who had an insti­ tutional upbringing as children. They conclude that, over the course of the last 40 years, the male–female sex ratio of crime in the UK has fallen from about 11:1 to just below 4:1. This variation alone makes it implausible that biological difference is the only factor at work. It is possible, however, that biological factors link with other factors predisposing to violence. Antisocial girls are much more likely than other girls to become teenage mothers. This may well expose such girls to a range of social difficulties and make it more likely that they will experience failures in parenting. As a consequence they may have a higher rate of interpersonal conflict including violence with partners and children alike. On the other hand, their domestic commitments in late adolescence and early adult life may possibly make it more difficult for them to be part of a delinquent peer group and thus to engage in criminal activities including violence outside the home (Maccoby, 1998). However, there has been a noticeable and significant shift over the last 20 years, and between 1985 and 1994 female juvenile crime arrests more than doubled. It is unlikely that a change in women’s social representations of aggression, or the shift in views and expectations that accompanied the women’s rights and feminist movement, could be seen as responsible for this phenomenon (Snyder and Sickmund, 1995). According to Coleman (1997), in England and Wales approximately 15 000 adolescent girls are in care, either accommodated by the local authority or subject to a Court Order. Offences of violence are the second most common crime committed by female offenders and, with no current specific provision for young female offenders under 17 within the prison system, it is likely that the majority remain within social services provision and supervision. It is known that, of the adult female prison population, 30–50% have been in care compared with 2% of the general population (Quinton and Rutter, 1998). Drug and alcohol misuse by females is reported to be influenced by different factors from that by males

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(Bodinger-Deuriate, 1991). In their seminal epidemiological study of adult female offenders in British prisons, Maden, Swinton and Gunn (1994) revealed a higher proportion of psychiatric disturbance, person­ ality disorder and substance misuse than in adult male prisoners. Research in the USA shows that adolescent female offenders have experi­ enced more sexual abuse at a higher frequency than their male counter­ parts (Chesney-Lind, 1987), with significant relationships between child abuse before the age of 11 and later delinquency. Widom and White (1997), in an important American prospective design cohort study, report that among abused and neglected children, females but not males are at a significantly higher risk for substance misuse, dependence diagnosis and arrest for violent crimes in adulthood. These females are also at greater risk for co-morbidity, for substance abuse and violent arrests compared with controls. Thus, understanding both the changing trend of violent behaviour in girls and protective factors which still operate for girls should help inform preventive measures for both sexes. The link between childhood abuse and adult substance abuse and violent behaviour, is emerging for women but not, as yet, for men. Substance misuse and drug dependency present a considerable problem for adult women in prison. Girls who engage in violent behaviour present a useful and vital study group in trying to under­ stand the pathway from experiences in childhood to serious antisocial violent behaviour in adulthood.

Emerging research from adolescent forensic mental health services The Adolescent Forensic Service based at the Salford NHS Trust accepts nationwide referrals. The service consists of two components: a 10-bed medium secure inpatient psychiatric unit; and a Forensic Adolescent Consultation and Treatment Service providing an outreach component. The two services form part of a broad-based supra-regional adolescent forensic service. Local referrals are from the areas of health, social services, education and the criminal justice system, but referrals beyond the catch­ ment area are via health services only. Girls constitute a constant fifth of all referrals to the Adolescent Forensic Service. Although they are in a minority, the number of girls referred is substantial enough to consider whether their health, social and educational needs differ from those of the boys. Existing services for adolescent offenders have been developed from a knowledge base of studies on male adolescent offenders (Miller et al., 1995). Thus, little information has hitherto been available about girls with high-risk behav­

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iours who come to the attention of the mental health services. More recently, however, a series of studies conducted by the service has given some insight into violence, vulnerability and gender. In a health needs survey of a sample of 192 young offenders appearing before a large city centre youth court, 19% had significant medical problems, 42% had a history of significant and damaging substance misuse and 7% had psychiatric problems of a nature and degree that required immediate treatment and intervention (Dolan et al., 1999). Of the group requiring acute intervention, the majority were young females. Although they only represented a small proportion of the overall sample – 9 out of 192 youngsters – they presented as being at most risk, in particular, risk to self. The most vulnerable group, with most psychosocial difficulties, these young females were most likely to be placed in custodial remand. It is diffi­ cult to establish whether, in these cases, the courts were acting totally on the basis of the level of risk the young female presented to others or in the benign belief that they were rescuing young girls at risk of sexual activity and substance misuse. A study of 100 ‘looked after’ girls referred to the Adolescent Forensic Service over a 6-year period has given further insight on adolescent females who presented to health services through a pathway from social service provision for children with difficult behaviour. Nearly half these females were already in social services secure provision at the time of referral (Jasper, Smith and Bailey, 1998). Specific findings included: • 79% had behavioural disturbances in more than one major area of functioning (violence, substance misuse, non-violent offending, delib­ erate self-harm), with nearly a quarter demonstrating disturbed behav­ iour in all four of these areas. • The referrers identified only 54% of those who could be described as violent or aggressive as such; 68% of those who self-harmed were described as such by the referrers. • 47% of those who were recognised as having behaved in a way which was against the law had been charged with an offence; 71% of those who had physically attacked someone had not been charged by the police. • 71% had experienced at least one form of childhood abuse, the majority (56%) having been multiply abused. • Many were not having their educational needs met, with 45.5% of those who should have been attending school not doing so, and only 11% of the group having ever been ‘statemented’ as having special educational needs.

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The subgroup of 68 violent girls was not greatly different from those who did not harm others through violence. In particular, they did not contain a greater proportion of girls who had experienced childhood abuse. A significantly greater proportion of the violent girls appeared to misuse substances than in the non-violent group. The subgroup of 71 girls who had experienced childhood abuse contained a significantly greater proportion of those who set fires and were destructive to objects. No specific associations were found between the type of abuse experienced and behaviour, other than for deliberate self-harm. The subgroup of 76 girls who self-harmed contained a greater proportion of those who had experienced childhood sexual abuse and those who misused substances. It is worth noting that, for 35 of the girls who self-harmed, there was no evidence in the vast array of information available that they had been sexually abused; an important finding in view of the belief widely held amongst professionals working with young people that girls who harm themselves have been sexually abused. There appeared to be very little difference between those a court had deemed to require secure accommodation and those who had not. In a study of 100 consecutive referrals of 50 girls and 50 males aged 11–17 to an Adolescent Forensic Mental Health Service, a group of young people at the extreme end of the violent behaviour continuum was studied in detail (Bailey, 1999). The aim of the study was to examine the characteristics of a population of adolescent males and females who demonstrated violent behaviour, and to generate testable hypotheses about risk and protective factors. Although traditional theories may state that girls are less likely to engage in violent behaviour, these groups of individuals were perceived to demonstrate equally aggressive behaviours. A number of factors became clear during the analysis of the information, which suggested that, for some areas, there was a ‘gender disadvantage’. In relation to referrals, boys were often referred by members of the criminal justice system and girls by members of a health discipline. Similarly, in relation to legal status, boys were more likely to be accommo­ dated in a penal institution, girls more likely to be under some type of care order or section of the Mental Health Act 1983. In relation to family history, females were more likely to have experi­ enced emotional abuse or sexual abuse, to have had previous psychiatric contact, and to have been separated from main carers later in life (10 years upwards). For males, the picture emerged of a group who were equally likely to have experienced physical abuse, demonstrated a higher drug/alcohol misuse rate, and experienced separation from main carers at an earlier age (under 10 years).

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It had been anticipated that the range and degree of disturbed behav­ iour demonstrated by young females would be different from that demon­ strated by males. The results indicated that males were more likely to engage in substance misuse, whereas females were more likely to engage in deliberate self-harm, overdosing and promiscuous behaviour.

The impact of gender It became apparent that both groups experienced dysfunctional upbringing in relation to the level of abuse experienced, and in relation to periods of separation from primary carers. The researchers had antici­ pated that areas of responses to aggressive or violent behaviour (either by the young person or their carer) would have specific consequences. The socialisation process of females and males has typically followed predeter­ mined pathways, regardless of the explosion of literature that claims a narrowing of the differences between them. Experience of previous research had demonstrated that carers expected boys and girls to behave differently and responded in accordance with predetermined actions. As this study was retrospective it was difficult directly to ascertain specific parenting or attributional styles. It became clear that no significant differ­ ence existed between girls and boys in relation to witnessing violence in the home environment. Carers or professionals reported that boys experi­ enced earlier onset of recorded violent or aggressive behaviour (although the authors acknowledge that girls may have been engaged in aggressive behaviour that was not recorded). The acts of violence perpetrated by both groups demonstrated that females planned their behaviour, and that girls were more likely to commit their violence alone, and to use a weapon. The girls engaged in hitting, punching, stabbing, strangulation and kicking. In relation to offending behaviour, both groups were fairly evenly matched regarding the types of violence – e.g. assault, grievous bodily harm (GBH), wounding – and exactly matched where the charges incorporated GBH. The exception for this particular group lay in the number charged with murder; it contained only 5 girls. In the ongoing assessment and treatment of 70 children and adoles­ cents who have murdered (Bailey, 1996), and consistent with the interna­ tional literature, it emerges that these young people share a constellation of psychological, cognitive, neuropsychiatric, educational and family systems disturbance (Myers, Burgess and Nelson, 1998). However, no single variable of those studied reached statistical significance, reinforcing the heterogeneity of young people who commit this final violent act. Two significant subgroups did, however, emerge in earlier research by Lewis et al. (1985): those girls and boys with family backgrounds characterised by

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mental illness and violence within the family with evidence of insecure attachments; and a subgroup of all males with neuropsychological difficul­ ties. Certainly, for both girls and boys, when parental behaviours were chronically inconsistent or rejecting, the children learned to live in an almost constant state of uncertainty about the physical or emotional avail­ ability of the parent, resulting in the experience of frequent and intense anger. Anger and insecurity had become central to the children’s model of making relationships, leaving them at heightened risk of aggression in late childhood. Whatever the background difficulties of the young people, girls and boys showed clear signs of ‘out of control’ behaviour in the 6 months leading up to the offence, which went beyond the normal rebelliousness of an adolescent in a stable family, and there was escalation of antisocial behaviour in those young people from chaotic backgrounds. Excluding those girls charged with infanticide, and those acting in extreme circum­ stances in self-defence, the trajectory to and behaviour at the time of the killing was the same in both girls and boys. This was especially the case when two young people were involved in the act of murder, witnessing the actions of the other, this fuelling their own acts of violence against vulnerable victims. There is an increasing recognition of post-traumatic stress disorder (PTSD), not only following past abusive experiences in the lives of some of these young girls, but also from witnessing the acts of a co-defendant at the time of a killing, and from witnessing their own actions. Where adoles­ cents kill vulnerable victims who are strangers, at the moment of the act of fatal violence they forget who they are and, feeling generally angry without anybody in particular to be angry at, their rage and retribution spill out. In long-term therapeutic work with adolescent females who kill, it is necessary to absorb and to encompass their initial disbelief and psycholog­ ical denial of their act, PTSD, grief for loss of personal freedom, removal from family and, eventually, grief about their victim. The development of victim empathy, grief, remorse and understanding takes considerable time. The parallel processes of education, avocation and socialisation in secure care placements are critical. The public interest, and right to safety, are too often drowned in the general outcry that follows a juvenile homicide, especially when the perpetrator is a young female. The voyeuristic media interest satisfies the punishment priority but does nothing to inform future successful preventive interventions in high-risk girls. Follow-up of young homicide offenders, female and male, shows that, where social interventions made during sentence are firm, consistent and caring, and where young people can resolve issues of past abuse and the reality of their own acts of violence, they can and do move

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on to return to society, live safely and contribute positively to society as partners and mothers. Their guilt and shame is for life; their childhood and adolescence have been taken away. For girls and boys, prognosis is poor where families cannot or will not accept the guilt of their child, because of their own problems, or where there are marked neuropsycho­ logical difficulties.

Infanticide From a series of adolescent females (14–17 years) referred to the Adolescent Forensic Service who had killed their newborn child within 24 hours of birth, a pattern emerges that is not associated with the classical picture of psychiatric disorder in adult women following childbirth. The young girl comes from a stable but over-controlling background and denies to herself the existence of her pregnancy. Usually adults surrounding her have suspicions, but these are not pursued. Labour is characterised by the girl thinking she has bad period pains, taking a hot bath, precipitate birth in the bath or in the toilet, immediate shock, tending to her own physical needs, bleeding, followed by the realisation that there is a baby – which by then has usually not survived. The young girl acts in a semi-automatic fashion, cleaning herself, sometimes going to make a drink, not telling her family, returning to bathe and wrap the baby in a bag placed near her bed. During the hours that follow, she is seeking and wishing for movement to come from the baby. The next day, she either discloses the birth to the family, attempts to bury the child or seeks help. This pattern can vary, despite the core similarities; on occasions, there is direct violence to the already dead baby. There remains wide variation in the response of the legal system in respect of waiting time to trial, findings and disposal (Marks, 1996).

Sexual offending In a study of 121 sexually offending adolescents (Dolan et al., 1996), there were no adolescent female sexual offenders. Since this original study, the service has assessed 10 young female sexual perpetrators. The level of violence in the sexual acts is a matter of concern. These young females are sexual perpetrators in their own right, not through acts of omission, or acting under threat from more powerful males. As with adolescent males, they are a heterogeneous group, some with learning difficulties, having reached menarche, left to babysit younger children, and with porno­ graphic videos available (Bailey and Smith, 1999). Others are sexually aroused by their acts, which contain sadistic components and the need to

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control others. Fifty per cent of this small group of 10 had themselves been sexually abused, less than might have been expected.

Arsonists In a study of 100 adolescent arsonists, 25% were female and had experi­ enced high levels of sexual abuse; some had carried out self-immolation of breasts or genitals. Their acts of firesetting were accompanied by vivid fantasies of destroying their past abuser by fire or, in some cases, the ‘mother’ figure who had failed to protect the young girl from abuse. For them, firesetting provided an immediate sense of relief and displacement of anger. These girls, if secured because of their level of risk to others, would often escalate their level of deliberate self-harm when denied the ‘safety’ route of firesetting (Bailey and Smith, 1999).

Focusing services’ responses towards violent females Any national strategic framework offering treatment for young violent offenders must consider appropriate provision for young females which takes into account their special needs. A study of children in the criminal justice and secure care systems surveyed secure units, young offender institutions, social services, youth justice, probation, and child and adolescent and forensic psychiatrists in England and Wales, with a number of important findings (Kurtz, Thornes and Bailey, 1998). • There were overwhelmingly more boys than girls in secure units, both child and adolescent psychiatry and social services. • Children’s services considered twice as many boys as girls for secure placement. • 42% of social services’ children’s services had not placed a single girl during the year of the study. • The ratio of boys to girls in the caseload of forensic psychiatrists was 7:1. • Court reports were prepared for about 10 times as many boys as girls. • Approximately three times as many boys as girls were admitted to secure units. • The most common problem, as presented for boys and girls, was violence. • The need for secure placement was confirmed by child and adolescent psychiatrists in 82% of those referred to them, boys and girls equally.

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In the light of these findings, how can the needs of high-risk girls be met in the predominantly male environment of secure care, with no young offender institutions for girls? The advent of the Crime and Disorder Act 1998, establishment of Youth Offending Teams, and government mandate via the National Youth Justice Board should, theoretically, ensure equality of service provision for dangerous girls, but the nature of their implemen­ tation remains to be seen. Intensive community-based services for substance misusing, aggressive girls, especially those with past histories of abuse, need to develop along the lines of the Multisystemic Therapy programmes operating in South Carolina (Henggeler, 1996). The juvenile justice system expects a longterm reduction in rates of offending. Young offenders, including violent girls, have a right to a full range of cost-effective interventions. It is suggested that service delivery for these girls should: • fit the developmental needs of female adolescents • include specific risk and need assessment schedules • address pertinent factors across family, peer, school and residential contexts • offer treatment specificity and integrity of treatment delivery • increase the competence of families and carers in intensive community programmes, offering 7 day a week, 24 hour a day support. Within secure care provision, the research suggests that many girls in these settings, and those who have behaved in similar high-risk ways, have a range of mental health needs rather than presenting with a single problem. Some of these needs are related to their high-risk behaviour, others are not, but nevertheless require intervention. The clinical staff providing mental health services to these girls, therefore, need access to expertise in a range of skills, not all of which are the sole domain of the forensic specialist. Girls who behave violently and those in secure care cannot readily access services. Needs in the following areas should be specifically addressed: • Sexual/reproductive health, including education; contraceptive advice; information about and help for sexually transmitted diseases; appro­ priate support for problems around menstruation; support and access to relevant resources in the event of a pregnancy. • Post-abuse counselling, when the adolescent female is ready to engage in it, from an appropriate adult, taking the issue of the gender of the therapist into account.

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• Medical and psychiatric assessment followed by appropriate treat­ ment of parasuicidal behaviour, remembering that the distraction and attention provided by the emergency may be an important component in reinforcing the use of this behaviour as a coping strategy. • Different leisure interests developed by girls should be catered for in their placement. • Eating problems are far more common in girls than in boys and may need to be managed. Girls will want to eat different foods from boys and maintain their fitness through different forms of exercise. In terms of long-term prevention and protective processes, resilience mechanisms need also to be developed in girls. These include: • reducing sensitivity to risk • understanding the impact of risk • reducing negative and increasing positive chain reactions, thereby promoting the self-esteem and self-efficacy of females • opening up positive opportunities and enabling violent females to process negative experiences in a positive manner • acceptance rather than denial of violent behaviour. Finally, as this chapter has shown, girls are a significant minority in the workload of a forensic child and adolescent mental health service. They have complex multiple needs which require both assessment on an individual basis and appropriate treatment planned on the basis of that assessment. In terms of violence, their thinking is much like that of violent boys. However, they need services to recognise and adapt to their differ­ ences from boys. Failure to meet their specific therapeutic and associated practical needs could well result in the perpetuation of cycles of abuse from this generation to the next.

CHAPTER 8

Violent Young People Detained in a Maximum Security Psychiatric Hospital DEBORAH RICHARDS AND ANDREW SMITH Broadmoor Hospital is one of 3 Special Hospitals in England and Wales providing psychiatric assessment and treatment for male and female patients in conditions of maximum security. It has beds for 428 people detained under the Mental Health Act 1983. The Hospital is principally an adult environment providing treatment in a graduated manner across 28 wards. Specialist provision for some young male patients aged 16–30 years is offered on a 25-bedded unit which seeks to deliver therapeutic services in a structured manner. Service developments are in hand to provide a similar facility for young female patients for whom currently only partial provision is made. Treatment processes tend to be long and complex. There is nevertheless optimism for creative work with ‘developing minds’, not least because youth presents unique opportunities for change. Although young patients in Special Hospitals are a heterogeneous group, they have common features which are particularly evident in the personality-disordered group. As children they experienced frequent exposure to severe and traumatising experiences, often from infancy and throughout their subsequent development. These experiences include physical and sexual abuse, emotional neglect and humiliation, exposure to significant levels of insecurity, and estrangement from primary carers, with many being brought up within multiple welfare or criminal justice environments. Besides experiencing developmental delay, rapidly by­ passing important stages of age-appropriate growth and maturation, a number fail to acquire adequate pre-morbid levels of social and interper­ sonal competence sufficient to mitigate the sequelae of their pathological nurturing experiences. Thus, their potential for the development of selfregulatory and coping mechanisms in the face of further life stressors, which might serve to protect them from later participation in high-risk 121

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lifestyles and cycles of violence, is restricted. Accelerated entry for young people into a maximum security psychiatric environment signifies severe pyschopathology, and their clinical profiles are far from straightforward. The anonymised case histories and generalised descriptions of young patients in this chapter are gained from the authors’ experiences of working with this client group and from compiling social history reports tracing the development of the individual from infancy to admission. In order to best identify a patient’s needs, assess dangerousness and risk, and target appropriate treatment, it is an essential component of the assess­ ment process to investigate developmental sequences in antisocial and offending careers.

The hospital context The guiding criterion for admission to maximum security is that it has to be clinically demonstrated that the patient presents a ‘grave and immediate danger to the public’ ((Taylor et al., 1991). A further principle cited is that patients should be cared for ‘under conditions of no greater security than is justified by the degree of danger they present to themselves or others’. Thus, irrespective of the offence which led to admission, by virtue of the admission criteria, the patients described in this chapter could all be categorised as violent offenders, since there are clear clinical concerns about their actual and potential harm to others. The average length of stay for patients at Broadmoor is 8 years. Dell, Robertson and Parker (1987) have shown that, for the mentally ill, this is associated with the severity or chronicity of the psychiatric disorder rather than the nature of the offence; for those suffering from psychopathic disorder, the main determinant of length of stay is the nature of the offence. In considering security needs, Taylor, Maden and Jones (1996) identi­ fied three groups: • those requiring perimeter security to protect particular people or groups in society and to modify the stressors of everyday life • those requiring constant internal security as they are persistently volatile and destructive to self, property and others • those who require both. Thus, those who are admitted to a Special Hospital form a unique group who display significant levels of dysfunction; this is even more apparent in the younger population.

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The legal context There are a number of measures provided in the Mental Health Act (MHA) 1983 pertaining to the psychiatric care and detention of mentally disor­ dered offenders of all ages in England and Wales. If a young offender is convicted of an offence (other than murder) punishable by a custodial sentence, the Court may make a Hospital Order, which lasts for 6 months (Section 37 MHA 1983). Since a Magistrates Court cannot imprison a juvenile, the case has to be remitted to the Youth Court under Section 7(8) of the Children and Young Persons Act (CYPA) 1969. The Court must satisfy itself, having received medical evidence, that the offender is suffering from mental illness, psychopathic disorder, mental impairment or severe mental impairment (as defined in Section 1(2) MHA 1983). The mental disorder must be of a nature or degree which makes it appropriate for the juvenile to be detained in hospital for medical treat­ ment. Additionally, in the case of mental impairment or psychopathic disorder, such treatment must be held to be likely to alleviate or prevent a deterioration in the condition (Section 37(2)(i) MHA 1983). Hospital Orders are renewable if continued detention is deemed necessary for the protection of the public or in the interests of the patient’s own health and safety (Section 20 MHA 1983). Under Section 41 of the MHA 1983, the Crown Court can add a Restriction Order to a Hospital Order where it is necessary to protect the public from serious harm. A Youth Court or Magistrates Court cannot impose a Restriction Order but may, provided the offender is over 14 years of age, commit the case to the Crown Court. The Restriction Order can be for the same period as the Court could have sentenced the offender to custody; in practice, most Restriction Orders are without limit of time and are thus effectively indeterminate. Restricted patients cannot be discharged without the consent of the Secretary of State or a direction from a Mental Health Review Tribunal. As a consequence, although the offender becomes a patient detained in a healthcare setting, the criminal justice system retains a degree of control over the patient. The Home Secretary has power, provided appropriate medical reports have been submitted, to direct the transfer of a sentenced prisoner or young offender (including those detained under Section 53 CYPA 1933) to a psychiatric hospital for treatment (Section 47 MHA 1983). The majority of patients in Special Hospitals have either been ‘sentenced’ to hospital or have transferred from prison, but there are a number who are not admitted via the criminal justice system. Such patients display the coincidence of mental disorder and antisocial behav­ iours and, as a consequence, could be in contact with the criminal justice system or are subject to significant risk.

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Ethical considerations The treatment of adolescents and young adults in the Special Hospital system poses complex ethical questions for all clinicians. The principle that ‘the welfare of the child is paramount’ (Children Act 1989) is a crucial consideration when working with young people and, from the outset, placing vulnerable youths in a predominantly adult setting is a source of concern. That these adults themselves have extensive mental health diffi­ culties and offending careers exacerbates professional anxieties. In the late nineteenth century fears began to be voiced about incarcer­ ating young offenders with adults and thus risking possible contamina­ tion. ‘Prison was seen to produce that which it should prevent, to manufacture delinquents instead of mending them’ (Garland, 1985:62). The Prevention of Crime Act 1908 adopted the juvenile-adult category of 16–21 years and the Children Act 1908 prohibited the imprisonment of children under 16 and established the principle of special juvenile courts and institutions separate from those used for adult offenders. Yet, there is no separate Special Hospital provision for patients under the age of 21 and few adolescent secure beds in medium security. In child protection terms, a crucial tension arises as there are times when patients under the age of 18 are accommodated on wards where Schedule 1 Offenders (those convicted of offences against minors under the Children and Young Persons Act 1933) are also resident. Indeed, Eastman (1993) notes the inadequacy of forensic psychiatric services for particular groups including adolescents. Historically, youth justice has oscillated between the competing objec­ tives of justice and welfare, care and control. For our patient group, issues of assessing and managing risk have to predominate and the primary ethical responsibility of caring for the patient has to be balanced against the protection of others. For most patients, admission to Broadmoor Hospital is, in itself, a traumatic event. This can be further heightened by the institution’s high profile, often based on biased and emotive media coverage given to the hospital and a minority of infamous patients detained there. Young, mentally disordered offenders have sometimes been publicly vilified, their histories of acute privation and trauma attracting little compassion or prominence. Special Hospitals are structurally forbidding at first sight in terms of architecture, prominent security and institutional custom and practice. Moreover, there are inevitable contradictions between care, health and criminal justice systems and their respective priorities and cultures. Working with young people in Broadmoor accentuates such issues.

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Features of violent young special hospital patients Between 1993 and 1998, 26 male and 6 female patients under the age of 21 were admitted to Broadmoor Hospital; 12 men and 4 women were under the age of 18. Patients under 21 and under 18 account for a signifi­ cantly greater proportion of the overall female patient population than for the male population. There are a number of women each year who, when compared to their male counterparts, score less highly in terms of the admission criteria. They reach maximum security more quickly than men because of the gaps in provision and inadequacies of treatment for women in medium security. Two-thirds of the male and female groups suffered primarily with a mental illness, with the remainder classified under the heading of psycho­ pathic disorder. All of the men had reached Broadmoor via the criminal justice system, compared with two-thirds of the females. One woman had been convicted of homicide, compared with five men. Antisocial behaviour Farrington (1991a) charts a life-span continuity in antisocial behaviour from childhood to adulthood, and Loeber (1988) argues that a higher frequency of offending is related to an increased likelihood of violence. Although their formal contact with the criminal justice system varied, all the young Broadmoor patients have significant and enduring histories of antisocial behaviour including violence. In general terms, a progression from disobedience to lying, stealing, truanting and escalating offending behaviour is discernible. With the personality disordered group, the age of onset of criminal activity tends to be younger than for the mentally ill group. The men have more substantial criminal convictions than the women and greater experience of criminal justice placements. The majority of young patients have consumed varying amounts of alcohol before committing serious offences, and almost all report histories of significant abuse of alcohol, drugs or solvents from a young age. This is, perhaps, not surprising given that the use of alcohol and other drugs is often implicated in violent offending (Prins, 1986) and that substance abuse is high among young offenders compared with other young people (Ramsay and Percy, 1996). Most young Broadmoor patients select victims in close proximity to their fragmenting social lives: sexual intimates; parents; siblings; their own young children; property of neighbours; passers-by, etc. The quality and intensity of the violence perpetrated is often extreme, ranging from psychotically driven homicide (including ritualistic and bizarre compo­ nents), sexual jealousy, wounding and homicide, intra-familial and

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random homicide, to violent rapes, and firesetting with the intent of endangering life. Developmental factors It is a common orthodoxy that childhood experiences, positive and negative, assist in the development of children’s schematisation of their world and the acquisition of developmental competence. Further, Mulvey and Lidz (1984:387) contend that ‘the family environment appears to provide one of, if not the most, influential and enduring elements in the maintenance and development of violent behaviour’. In this context, the life histories of the young patients in Broadmoor Hospital seem to explain, in large measure, why they have become violent and destructive. Almost without exception, members of this patient group have experienced profound psychological, personal and social disruption caused by trauma. For some, trauma can be a transitory life experience, successfully negotiated with the availability of protection from caregivers and other social supports. For others, particularly those suffering serial trauma, functional impairment can result, often with tragic consequences. The level and degree of exposure to trauma appears to be strongly associ­ ated in our patient group with the severity of subsequent malfunctioning. Within the terms of their developmental spectrum, the exposure to acute forms of privation and neglect starts in infancy. Childhood is characterised by excessive vulnerability and recurrent exposure to risk and, in the most extreme cases, the repeated accumulation of adverse experiences begins to merge and become the normal and ‘expected’ way of being. The phenome­ nology of those events becomes progressively internalised and further enhanced as the individual progresses through subsequent development. The capacity for growth and normal development is often replaced by the requirements to survive and to seek comfort and nurture from many quarters. As emerging adolescents, to be marginal and marginalised, to be unwanted and seemingly unattractive, to be abused and humiliated reacti­ vates many of the unresolved victim traumas of early development, unleashing powerful feelings of hostility, anger and aggression. Family histories Labelle et al. (1991) state that studies of adult, adolescent and child murderers almost unanimously report the presence of serious family disorganisation. A number of Broadmoor patients have a family history of criminality both in parents and in older siblings. Another pronounced feature is the presence of substance abuse and parental psychopathology, either in the formal sense of mental disorder and repeated episodes of

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hospitalisation, or in accounts of parental behaviours which describe highrisk and disturbed behaviours. Inter-generational transmission of similar behaviours tends to be higher in the personality disordered group; a high incidence of familial mental illness is documented in both groups. ‘Socio-economic status and employment status have also emerged as consistently strong indicators of an increased likelihood of involvement in violent behaviour’ (Mulvey and Lidz, 1984:386) and in subsequent mental ill-health (McLeod and Shanahan, 1993; Brooks-Gunn et al., 1993). Clearly, not all children growing up in economic disadvantage become violent or mentally disordered. However, all the young patients with a personality disorder diagnosis come from impoverished areas. There is also a high level of environmental deprivation in the mentally ill group. Mental ill-health and environmental stressors inevitably impact on effective socialisation practices and parenting capacities. Many of our patient group were expected to adopt age-inappropriate caring roles for themselves, siblings and often their parents. The cases of C and A C is of Black African origin and was admitted to Broadmoor at the age of 17 from a secure adolescent psychiatric unit. Although without previous convictions, for the preceding 4 years she had become increasingly dangerous towards others, making numerous attempts to stab and strangle. In terms of family background, C’s mother had three children by three different men and the birth fathers were absent. C was placed with numerous largely neglectful carers from the age of 6 weeks, including one white family whom her mother later found to be ashamed to be caring for a black child. At the age of 3, language delay was attributed to social depriva­ tion and specialist speech therapy was given. At the age of 10, C’s baby sibling died at birth. C was deeply traumatised by the sight of the dead child. The following year another sibling was born who had special needs. Her mother became depressed and C was expected to look after the child. By the age of 12, C had become socially isolated and withdrawn; by 13, she was overdosing and threatening to jump under trains. C’s first psychiatric admis­ sion was at the age of 131/2, and her mother and younger sibling were felt to be at considerable risk of serious violence from C when she was disturbed. The majority of young Broadmoor patients come from homes where the birth parents no longer live together and most of them experienced early separation from at least one parent before the age of 10. In all cases where personality disorder was the primary diagnosis, marital discord, poor parental supervision, low parental involvement, inconsistent and harsh punishment were found.

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Bowlby’s attachment theory describes people as social beings who need relationships with others for survival and development (Bowlby, 1988). Early parental relationships have unique significance and insecure attachments can hinder the development of identity, neurotic defences and internal cognitive structures, having a negative effect on the internal processing of belief systems, perceptions of events and relationships, and the effective management of internal and external stress and anxiety. Secure attachments can provide a defence against traumatic experiences. Indeed, Macfarlane (1988) found that in children who have been exposed to serious trauma, the quality of the parental bond is probably the single most important determinant of long-term damage. Rutter (1995) proposes that failures in early attachments may be risk factors for later psychiatric disorders; and van Ijzendoorn and Bakermans Kranenburg (1996) found an over-representation of insecure attachments in clinical populations. Additionally, high levels of challenging behaviour in children can exacer­ bate negative parenting practices and reduce parental ability to monitor their offspring’s activities (Patterson, 1992). The vast majority of young patients have had contact with a number of so-called ‘helping agencies’ during their early lives. Of those children accommodated by local authorities, most had numerous placements of variable quality, often a long way from home. A number were further traumatised and abused in care, already seemingly rejected and disowned by their families and communities. The case of A illustrates how chaotic and emotionally deprived childhoods can be replicated in care. A was convicted of several serious arsons and was admitted just after becoming 17. His mother and father both describe emotionally and economically deprived childhoods. During their marriage, which ended when A was aged 8, the father was habitually drunk and violent to his wife. There was often no heat or food in the home. His mother had periods of depression and regularly self-harmed. He often had to care for her. She was malnourished during pregnancy, requiring admission to hospital. A’s mother subsequently made a good second marriage, but found herself caring for her step-son at home, whilst her own son demonstrated growing behavioural difficulty. A was very demanding and seemingly fearless; he sustained a number of head injuries during infancy and, aged 3, his behaviour was diagnosed as having a hyperkinetic disorder. He was placed in a special nursery until moving to primary school. There, he was aggressive to others, and peers taunted him for ‘being mad’. A’s father introduced him to alcohol and encouraged A to watch adult movies with him. From the age of 7, A was regularly truanting and stealing, resulting in a referral to Child Guidance. Aged 9, he was made subject to a Place of Safety Order; 13 residential place­ ments followed over the next 4 years. A was sexually assaulted in 2 of these placements, aged 9 and 12. He abused alcohol, drugs and solvents from the

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age of 11 and became notorious for violence towards staff and peers. By 12, A was disclosing murderous, satanic preoccupations and reporting violent sexual fantasies from the age of 14. He started to self-harm by lacerating his limbs from the age of 13. He reported voices telling him to do some of these things. Between the ages of 13 and 16, he had three placements in secure adolescent units and spent 6 months in a Young Offenders Institution. In one 12 month period, over 130 incidents of violence, sexual disinhibition, self-harm and suicidal behaviour were recorded. Upon release from the Young Offenders Institution, A was homeless; within months he was admitted to a psychiatric hospital and committed the index arson offences having self-discharged against medical advice. Following admission to Broadmoor, a schizo-affective psychosis emerged; apart from a few incidents against property, there has been no violence, fire-setting or threats. Abuse and neglect A striking feature of this group of patients is their clear accounts of being victimised thoughout their life. Childhood victimisation is held to have longterm developmental consequences (Widom, 1989a). One recent study found that nearly three-quarters of young people convicted of the most violent and serious offences and held in secure care or custody had themselves been the victims of physical, sexual or emotional abuse (Boswell, 1995). Mullen et al. (1993) found an association between child­ hood abuse and significantly elevated rates of adult psychiatric disorder, and Widom (1989b) links neglect and physical abuse to later violent offending. Salzinger et al. (1991) report that the combined effect of witnessing violence and being abused produces poorer adjustment in children than experiencing either alone. Violence is also modelled as an acceptable behaviour, a means of maintaining power and control in relationships, and a means of resolving conflict or managing stress and anxiety. Children learn to be violent (Bandura, 1973b) with abusive parents providing a powerful role model. Violence and aggression become a substitute for pro-social behaviours and can be reinforced by inappropriate exposure to media portrayals of aggressors as heroes. Many of the young Special Hospital patients gained formidable reputations in their localities which, given the lack of more positive rewards, in all probability assisted a sense of power and efficacy, reinforcing aggressive repertoires. Others may seek to escape violence in the home by running away or making suicide attempts (Jaffe, Sudermann and Reitzel, 1992), behaviours that are not uncommon amongst the younger subset of Special Hospital patients. Besides having to contend with the dynamic of being in a dependent relationship with an abuser, the victim often continues to suffer outside the home, at school and in local neighbourhoods. Social withdrawal and emotional retardation can inhibit the development of supportive peer

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relationships. This, coupled with social ostracism, may increase a sense of difference and isolation from peers and a loss of self-esteem, and confi­ dence in self-efficacy. It can also lead to an increased sense of identity with similarly traumatised peers in a bid to find social approval. The case of N Almost all young patients who were abused as children experienced retal­ iatory rage at some point in their development. The case of N provides an extreme example of this. N was admitted to Broadmoor at the age of 17, having killed his mother in a frenzied attack after a row. Both N and his mother were said to have been drunk at the time. He subsequently reported that his mother had become verbally abusive and critical; the trigger for N’s rage appears to have been when she compared him unfavourably with his siblings and screamed that he was unwanted. N was the second of three children. N’s mother was herself an adoles­ cent when her first child was born. N was placed on the ‘at risk’ register before birth. N recalled seeing his father, who was black, just once. His mother abused substances and the children were often left unattended; the home was filthy and infested; the children were inadequately dressed and frequently hungry. N was enuretic until aged 9 and recalls ‘being smelly’. He describes a world of ‘no toys’ where ‘hugs were banned’. For a number of years, a stepfather provided some security and stability but N witnessed much marital violence. N describes seeking affection and atten­ tion outside the family and even took to keeping one of the many pests in the home as a pet. He had literacy and numeracy problems at school, was tormented about body odour and taunted by both black and white peer groups about being of mixed race. He was referred to child psychological services at the age of 8 as teachers were concerned about his regressed behaviour which included social withdrawal, thumb-sucking and rocking in class. Following the stepfather’s departure when N was aged 10, his eldest brother started to beat N and N’s mother. N attended secondary school for 2 months before running away from home, living casually with members of a rebellious, but mutually loyal older peer group on the housing estate. Under their influence, N began to use cannabis regularly and alcohol from the age of 10; from the age of 12 he began to abuse solvents and use hard drugs, funding such activities by acquisitive offences. He was first convicted at the age of 12 and had accumulated 80 recorded offences by the age of 17. At the age of 12, N was made the subject of a Care Order and had numerous placements. At one juncture he was accommodated in a secure unit, having attempted to strangle a carer. Continued offending led to several placements in Young

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Offenders Institutions. N had no family contact for 4 years against his wishes. At the age of 17, he was accommodated in a hostel close to the family home and an attempt made to rekindle family relationships. N killed his mother less than 2 months after returning to the local community. The developmental stage of a child influences how he or she makes sense of trauma and impacts on the nature of his or her response psycho­ logically and behaviourally. Adolescents can present as stuck at the emotional and cognitive level at which they were first traumatised, and the case of N is perhaps an exemplar of this phenomenon. Deliberate self harm and suicidal behaviour Self-injurious behaviour has been associated with a combination of risk factors including childhood trauma and neglect (Van der Kolk, Perry and Herman, 1991), and depression and suicidal behaviour in adolescence have been linked to a variety of adverse environmental conditions, parental mental disorder and childhood abuse (Petersen, Compass and Brooks-Gunn, 1991). Significantly higher levels of self-injury are found in the young female Special Hospital patients and an earlier age of onset is observed. Self-harm amongst the younger male patients is more common than amongst their older counterparts. Although the frequency of self-harm in the male group is less than in the female patient popula­ tion, the actual degree of self-mutilation tends to be more serious and potentially life-endangering. As with self-injurious behaviour, members of the female patient population tend to make more frequent suicide attempts. An inpatient setting can afford some protection from external stressors, but the risk of self-harm and suicide remain ever present, particularly as treatment begins to confront patients’ histories and behaviours.

Clinical factors Mental illness An established psychiatric history is found in only a few cases, although case file reviews suggest that many young patients were severely mentally disturbed before being detained. Two-thirds of the young people detained in Broadmoor between 1993 and 1998 have been diagnosed as suffering from a mental illness. However, the identification of an illness per se does not always give an understanding of the motive for violence, and as Taylor (1982) among others notes, there is little evidence that mental illness is a significant predisposing factor for violence. In some cases, though, violent behaviour can be directly attributed to an individual’s mental illness; for

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example, a psychotic person who is assaultative in response to auditory hallucinations or paranoid delusions. Failure to diagnose sooner Children are generally less adept at expressing themselves verbally in a clinical interview than adults, and evidence of disturbance is thus frequently founded more on reported observations of parents, teachers and others. It is seldom the child who initiates a psychiatric contact, and he or she may be unwilling to co-operate with the assessment process. It is also recognised that there are clinical challenges in distinguishing between the normal emotional turbulence of the teenage years and an emerging psychiatric disorder. Compared to conduct/adjustment/personality disorders, there also seems to the authors to be a reluctance on the part of the medical profession to diagnose mental illness too soon, fearing the negative consequences of labelling. However, it can also be argued that failure to diagnose mental illness in the face of psychological and social disintegration is, for the patient, and often for his or her family, a seriously traumatising experience in itself. The case of H The case of H illustrates some key issues. From the age of 13, H experienced seeing faces on her bedroom wall and hearing the voice of a deceased grandfather. H describes being ‘terri­ fied’ by these experiences, being aware that they were ‘not normal’. Her hitherto excellent school performance declined, she developed an eating disorder and became irritable, angry and rebellious. Mental health profes­ sionals viewed H’s reports of visual and auditory hallucinations as ‘attention-seeking’ and as mechanisms to retreat from taking responsibility for antisocial behaviour. Essentially, this patient was diagnosed in lay terms as ‘bad, not mad’. H describes feeling bewildered and frightened by symptoms and worried about the deterioration in her behaviour. She felt acutely frustrated by the lack of support and help available and began to be rejected by her family. She began to self-medicate on alcohol from the age of 15 to the point of unconsciousness, experimented with illegal drugs, started cutting and made repeated suicide attempts by overdosing. H had frequent psychiatric admissions, but she was most commonly diagnosed as suffering from a borderline personality disorder. There was also clinical dispute about treatability. Having stabbed a partner and set several fires on the instructions of auditory hallucinations, H was eventually admitted to Broadmoor. She has subsequently been diagnosed as having a full-blown psychotic illness and

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her antecedent behaviour is in large part seen now in terms of the prodromal stages of an emerging mental illness.

A growth-promoting environment? None of the young patients described thus far has experienced a complete developmental process. For most, their formative years were punctuated by significant traumas, inconsistency and victimisation. This develop­ mental disruption is further complicated by the circumstances of their index offence, and their admission into a maximum secure psychiatric environment could present an additional traumatising experience. Fragile family systems are further compromised and threatened and tenuous community ties are broken. A common fantasy, and sometimes a reality, is that the offence behav­ iour will become repetitive; the crime can indelibly mark the patient and be elevated as the patient’s defining characteristic, particularly when there are few other positive social and interpersonal competencies readily on display. The quest of therapeutic work is to seek a comprehensive under­ standing and repair of these fragile yet volatile individuals although, in the early admission phase, energies may need more urgently to be directed at containing the excesses of aggression and the expressed desire to avenge past hurt. Adshead (1998:67) suggests that the ‘asylum function’ of hospital can provide a secure base and can be a ‘positive attachment figure for patients, especially those who did not experience secure attachments in child­ hood’. Indeed, one of the primarily initial objectives of treatment is the stabilisation of acute symptoms, and a secure hospital can provide a safe environment in which patients can embark on the road to recovery. As inpatients, the female group commit more verbal and physical assaults against staff than their male counterparts. The need for intensity of staff input and internal security may mean that patients can only be humanely and effectively treated in maximum security. However, inevitable tensions arise between the requirements of a safe, secure and controlled environ­ ment and one which can facilitate – within those limitations – the develop­ ment of new skills, independence, self-determination and personal responsibility. The structure of large secure institutions can contribute to feelings of powerlessness, hopelessness and a loss of individuality. Psychiatric wards can, in themselves, be stressful environments (Kalogerakis, 1971) and settings which ‘infantilise and disempower patients will encourage regres­ sion’ (Adshead, 1998:67). Treatment can be further complicated by compulsory confinement which, in itself, can militate against the develop­

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ment of positive therapeutic alliances. There is a tendency for patients to feel disadvantaged, disregarded and marginalised, perceiving treatment as something which is ‘done to them’ rather than collaboratively worked on. The very nature of a secure and highly supervised environment can feel punitive, particularly to young people, and restricts opportunities for safe risk-taking behaviour, a salient component of developing self-determination and responsibility. Young people are easily bored, and there are constraints on providing age-appropriate social and sporting activities, in which high spirits and natural exuberance can be unleashed positively. However, owing to the hospital’s size, there is much space within the secure perimeter, an expanding pool of clinical expertise (Taylor, Maden and Jones, 1996) and a range of occupational and educational opportuni­ ties on offer. Furthermore, the hospital is big enough to allow for segre­ gated living accommodation according to gender and peer group. Therapeutic gains emerge slowly, which is not surprising, given the chaotic and abusive backgrounds of patients. Young patients, particularly with histories of abuse in families or in care settings, tend to have problems with trust and with authority. Expectations about their social world, of others and of their own personal integrity may be skewed. The majority have had previous encounters with helping professionals, and an air of cynicism can pervade initial clinical encounters. The genuineness of professionals may be questioned as some patients lack the capacity to understand why others would want to care for them; others will make excessive and unreasonable demands on carers in an attempt to sabotage the treatment process before it even starts. Young people report experiencing anxiety in working therapeutically and openly with adults, fearing the consequences of self-disclosure. Additionally, many have experienced significant losses, separations and rejection. Fears of dependency, further loss and abandonment may stand in the way of open engagement with clinicians. Some patients are so severely broken by the intrusive legacy of their abusive past or by their clinical symptoms that they seem unable to focus on the present. There is a greater tendency, at least initially, for young offender patients to dissociate from the reality of their offence and their predicament, experiencing difficulty in accounting for their intentions and motives. Some patients are amnesic of childhood histories, making self-report unreliable or misperceived. Many are often seen as lacking empathy and remorse but, particularly in the early stages of an admission, remorse might not be accessible to the youth who has shut down the capacity to feel. Furthermore, chronic exposure to violence has been shown to desen­ sitise children to the effects of their own violence on victims (Widom, 1989c). Avoidance and dissociation are mechanisms that many exposed to

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external threat employ as a protective mechanism serving to obliterate intrusive and distressing feelings, to suppress retaliatory instincts and anger and to maintain distance from the reality of their life’s experiences. Those who have had interruptions in their emotional development may be unable to identify, interpret or communicate emotional signals and are left overwhelmed with the intensity of their feelings. In a ‘total institution’ (Goffman, 1968), it is essential not to overlook the importance of quality-of-life issues and normalising experiences. There is also a need to engage with the added stigmatisation and social exclusion which mentally disordered offenders face. There is undoubtedly an added stigma attached to having been a Broadmoor patient. In Broadmoor, the treatment of the severely disordered patient is a multidisciplinary responsibility. Wards within the hospital are (where resources allow) staffed by a Consultant Forensic Psychiatrist and psychia­ trists in training, senior psychologists, a large and experienced nursing team, a senior forensic social worker, senior psychotherapists, speech and language therapists, teachers and occupational therapists. Uniquely, the young male personality-disordered ward, within the context of a secure environment, attempts to promote the ethos of a ‘community’ embracing all patients and staff. It is organised around a programme of structured group work ranging from discussion to demanding psychodynamic groups. Following a comprehensive and systematic evaluation of patients, their clinical, emotional and behavioural needs are identified, and individu­ alised treatment plans are crafted with consideration for individuals’ own stage of emotional and psychological development and their capacity for such work. Given the value placed on the quality of the client–therapist relationship, stress is placed on the importance of therapists relating to patients in a way that is congruent with their cognitive state. Treatment usually involves the combination of psychological and pharmacological strategies within the therapeutic and supportive milieu of a ward setting. The range of treatment interventions in Special Hospitals is wide, offering counselling and support, psychodynamic, cognitive and behavioural therapies on an individual and group basis. There is also access to music, art and drama therapies, family therapy and need-specific treatments such as social skills training, anger and anxiety management, alcohol and drug programmes, offending behaviour programmes and relapse prevention work. Social work with patients, and their families or carers, is an integral part of the treatment package. For young patients, the search for a personal context within an abusive family of origin is a painful quest; for families who had been under consid­ erable stress and may bear the scars of the patient’s journey to Broadmoor,

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such work presents its own difficulties. Nevertheless, there may be improvements in relationships and in environmental and economic condi­ tions, and some families display the capacity to reconstitute themselves around the patient’s needs. Although there may be positive outcomes in some respects, there are also times when abusers become ‘champions of a cause’, sceptical and critical of the treatment endeavours, with the patient being caught between the need to make sense of his or her background and primary experiences, and the continued desire for parental contact and approval. Although geographical dislocation from a patient’s commu­ nity and family may be disadvantageous, it can also assist in facilitating separation from a dysfunctional family.

Conclusion The group of young patients described here consists of individuals who have been subjected to multiple abusive and rejecting experiences throughout their lives; all have been assessed as posing a serious and significant risk to others and themselves. The link between excessive and adverse childhood experiences and later psychopathology is the subject of ongoing debate and research (Quinton, Rutter and Gulliver 1990; Glick, 1997). The intermediate devel­ opmental phase of adolescence, the crucial site of identity formation and the key transitional stage towards adult maturation is a uniquely troubling and, at times, traumatic period even for the better adjusted young person. Those entering adolescence after negotiating difficult and traumatic child­ hoods are at greater risk of developing subsequent psychopathology (Erlenmeyer-Kimling et al., 1990). Young people may well already be displaying significant levels of disorder, engaging in high-risk behaviours, paying little regard to their physical or mental health. A review of their social histories suggests that childhood traumas adversely affect crucial developmental transitions in these youngsters, compromising the acquisition of self-regulating processes, and the achievement of emotional health and well-being. Psychiatric morbidity and disturbed, often violent, behavioural repertoires can thus be seen as the developmental sequelae of repeated exposure to adversity and abuse. Traumas vary in terms of degree and nature of the threat; the level of exposure appears to be strongly associated, in this patient group, with the severity of subsequent malfunctioning. More systematic and empirical research with young Special Hospital patients is required further to develop understanding in this field. It is a matter of concern that very young people end up in Broadmoor, although specialist provision is available to treat and manage the

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complexity of their psychopathology. This is a challenging and intensive process for patients and staff. Progress can be achieved by working towards structured therapeutic goals to break the cycle of the reverbera­ tions of trauma, although, in so doing, clinicians need to guard against overlooking young patients’ needs as emerging adults undergoing a crucial social transition from adolescence. There is a developing knowledge base about damaged young people becoming damaged and damaging adults. Concerted efforts are needed to identify those at greatest risk, and more robust intervention strategies are required to prevent the rapid escalation into a maximum secure psychi­ atric environment. Increasing the safety of children within families, reducing patterns of victimisation and assisting parents who are ill and under stress need prioritisation, for, as the Report of the Commission on Children and Violence (Calouste Gulbenkian Foundation, 1995:32) comments, ‘Violence by children is inextricably linked to violence to them’.

CHAPTER 9

Aggressive and Bullying Behaviour in Children and Adolescents HELEN COWIE The nature of aggressive behaviour Aggression among peers is a common facet of development, and has been identified as one of the most substantial problems in modern society. Aggressive behaviour seems to emerge in the pre-school period (Crick, Casas and Mosher, 1997) and persists throughout the school years (Björkqvist, Lagerspetz and Kaukiainen, 1992; Olweus, 1993; Scott, 1996). Some studies indicate that aggressive behaviour appears to be stable over time and resistant to change (e.g. Huesmann et al., 1984; Pulkkinen and Pitkanen, 1993). Farrington (1989a, 1991b) found that aggressive children often become violent adults. The distinction between verbal and physical aggression has been investigated by Björkqvist, Lagerspetz and Kaukiainen (1992), on the basis of peer nominations. They add a third category of indirect aggression, which is aggression not aimed directly at a person but via a third party. Examples of physical aggression would be ‘hitting’, ‘kicking’, ‘pushing’; of verbal aggression would be ‘insults’, ‘name-calling’; and of indirect aggres­ sion would be ‘telling false stories’, spreading rumours’, ‘excluding from the peer friendship group’. Girls may show less physical aggression than boys, have similar rates of verbal aggression to boys, but show substan­ tially more indirect aggression. This sex difference has been confirmed in later studies, in particular by Crick and Grotpeter (1995); they define the term as relational aggression. Researchers also confirm that indirect aggression becomes more prevalent with age. For most children, aggressive behaviour is kept within reasonable bounds so that they do not disrupt peer group activities or cause longstanding pain or distress to others. However, some children show unusu­ ally high levels of aggression; this behaviour can endure over time, and 138

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frequently requires adult intervention. Genetic factors play a part (e.g. Caspi et al., 1995). However, there is a great deal of evidence to suggest that home circumstances have a strong impact on the emergence of aggression and antisocial behaviour. Children who experience ineffective discipline, lack of parental warmth and poor parental monitoring at home are more likely to behave aggressively with their peers. Patterson, DeBaryshe and Ramsey (1989) suggest that the social skills of parenting play a substantial part in the prevention of aggression in children. The peer group too can have a powerful influence on whether a young person will behave aggressively or not. Studies by Cairns et al. (1988) indicate that pupils with disruptive friends are more likely to become disruptive themselves. Highly antisocial boys, for example, were found by Cairns et al. to be in antisocial friendship networks. The friendships were often of short duration, but were perceived as satisfying by the young person. In other words, aggressive children, though rejected by many of their peers, will still congregate with others of a similarly antisocial type. Hargreaves (1967), in his investigation of delinquent cliques in secondary schools, also identified pupils who were aggressive and extremely antisocial, who were acknowledged as leaders but who were, at the same time, unpopular and feared by the peer group at large. These young people had achieved high status in the peer group through their skill at fighting, their consistently aggressive behaviour and their antisocial stance. Thus, there was evidence that, as they grew into adolescence, aggressive children would tend to gravitate towards antisocial groups, with accompanying high status. As suggested earlier, such aggression may well be a predictor of adult violence and crime. In the Cambridge Study in Delinquent Development, Farrington (1995) found that boys who were aggressive in childhood or adolescence tended to be more deviant in adulthood, lived in worse home circumstances, were more likely to be in conflict with and violent towards their wife or partner, were more likely to be unemployed, to be drunken drivers and drug takers, and to commit more offences involving violence. Farrington indicates, however, that the continuity was not specific to aggression, but was part of the general continuity in antisocial and deviant behaviour from childhood onwards. The outcomes for victims of aggression are also disturbing. Kochenderfer and Ladd (1996, 1997) found that being victimised by peers preceded kindergarten children’s feelings of loneliness and their unwill­ ingness to attend school. Olweus (1992) carried out a longitudinal study of a sample of males who had been victimised from sixth to ninth grade. He concluded that the depression and low self-esteem demonstrated by these young men were the consequence of earlier victimisation by their

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peers. Owens, Shute and Slee (2000) carried out a qualitative analysis of the forms that indirectly aggressive behaviour takes. They found, in their study of 54 adolescent girls in 2 Australian schools, that the most predominant forms of indirect aggression included bitching (including talking about others, spreading rumours, breaking confidences, criticising others’ appearance) and excluding peers from the group. Another behaviour involved speakers using code names in plotting against another person; the targeted girl might well suspect the plot, but would be unable to prove that the others were talking about her. Teachers would rarely detect this insidious form of aggres­ sion. Each year, in these schools, there had been cases in which the ostracism was so severe that girls left the school; in some instances, their reputation followed them and the social exclusion continued.

Bullying: a sub-set of aggression School bullying is one form of aggressive behaviour that in recent years has aroused a great deal of concern on the part of practitioners and researchers (Olweus, 1993; Whitney and Smith, 1993; Slee and Rigby, 1998). Olweus, like Björkqvist and his colleagues, distinguished between direct bullying – with relatively open attacks on the victim – and indirect bullying, which may take the form of social isolation and exclusion from the group. He viewed bullying as a subcategory of aggression or aggressive behaviour and considered that bullying is ‘aggressive behaviour with certain special characteristics such as repetitiveness and an asymmetric power relationship’ (Olweus, 1999:12). Bullying is particularly unpleasant since it is directed at vulnerable people who are usually unable to defend themselves. Bullied children, as Smith and Morita (1999) point out, may be outnumbered, or be younger, or weaker, or simply less confident. Researchers have discovered that some victimised children are passive and withdrawn and virtually never attack other children, whereas other victimised children are socially active, disruptive, and sometimes even highly aggressive. Olweus (1978) labelled children who score highly on both aggression and victimisation ‘provocative victims’ and labelled children who are victimised but not aggressive as ‘passive victims’. The definition of provocative victims seems to imply that these children in some way provoke their attackers. In fact, there are also children, with a high score both in aggression and victimisation, who bully certain peers and are victims with others. For this reason, some researchers prefer to define these two categories of ‘victim’ children as ‘aggressive victims’ and ‘non-aggressive victims’. The increasing number of research studies in the field of bullying gives an indication of the seriousness with which the issue is being taken.

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Whitney and Smith (1993) did not find any primary school where fewer than 19% of pupils reported being bullied at some time during the term, with name-calling, being physically hit and being threatened the most common types of direct bullying and being isolated, being left out of groups, and having rumours spread the most common types of indirect bullying (Smith and Sharp, 1994). Some bullying is carried out by physical means, for example, hitting, kicking, pushing; but, as Olweus (1999) indicates, a great deal is expressed without violence, for example, bullying with words, gestures or social exclusion. Researchers in this field are increasingly aware of the damage that can be done to young people and adults by behaviour that is indirectly aggressive, such as spreading rumours, bad-mouthing and socially excluding targeted individuals. Indirect aggression becomes more prevalent as children become older, and is more evident among girls than boys (Björkqvist, Lagerspetz and Kaukiainen, 1992).

The effects on victims Research shows that victims respond in different ways to such aggression. Some express their pain overtly. Alternatively, some victims react with counter-aggression, a response which labels them as ‘bully-victims’ or ‘provocative victims’, and which can further escalate the cycle of violence. Ignoring the bullying is a common strategy that is sometimes successful in discouraging the bully. However, the price paid by the victim can be high since he or she may feel the need to suppress the overt expression of emotions of anger and fear, and to appear to be unconcerned about growing self-doubt and diminishing self-esteem. Berdondini (1999) observed 117 8–11-year-old children in a junior school in Italy before, during and after a co-operative group work inter­ vention to counteract bullying. She found that the children nominated by their peers as victims were much more likely to present a blank, emotion­ less face during small group interactions. Even when they were being subjected to domineering behaviour by a member of the group, they typically did not convey any emotion. Interviews with the children also confirmed the finding that these victims tended to minimise or even deny their feelings, and that this behaviour created misunderstanding. Unfortunately for the victims, their intended ‘nonchalance’ in the face of aggressive behaviour was often contradicted by their body language. Peers interpreted the response as strange or even provocative. Fellow pupils would comment that the blank face was not normal in the circumstances and would compare it with their own spontaneous emotional expressive­ ness when they were upset. One danger was that aggressive children

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might bully them more in order to elicit a reaction, such as crying; meanwhile, children in the role of bystanders might find the lack of emotional response difficult to understand and one that did not lead them to proffer help. Some victims may seek help from peers, teachers or parents. However, many withdraw, staying silent about their suffering. Smith and Shu (1998) found that 30% of bullied children had told no one; boys and older pupils were more likely to under-report than girls and younger pupils. There is some evidence that many bullied children are too afraid to talk to anyone about their experiences of aggression at the hands of peers since the admission of being upset can provoke derision or hostility from peers and retaliation from the bullies (Naylor and Cowie, 1999). So it often seems safer for a victimised young person to endure the abuse without confiding in anyone. The accounts given by participants in the Owens, Shute and Slee study (2000) centred on awareness of the perceived need of girls for close, intimate personal relationships within the peer group, and the knowledge that indirect aggression could have extremely damaging effects on victims, as the following interview reveals: Student 1: I remember that day that T was like walking around crying or something because nobody liked her. They came up to us and said, ‘Don’t, whatever you do. T is trying to get into the group. Don’t let her in, ’cause she’s a bitch and she spread rumours about us and everything. The last group she was in was our group.’ Student 2: And she just gave up.

One girl who had been ostracised for a time commented that ‘it was the worst year in my whole life’. Other victims reported that their initial reaction had been one of confusion followed by denial that this could be happening to them. The feelings of psychological pain included hurt, loss of self-esteem, anxiety, loss of self-confidence and fear about future relationships. In some cases, this had been accompanied by suicidal thoughts. Witnesses indicated that they had been aware of the victim’s suffering but did not intervene for fear that they too might become the target of indirect bullying.

Explanations of aggression: social-cognitive information processing One influential explanation, based on a model of social-cognitive informa­ tion processing, focuses on the social cognitions of individual victims and perpetrators. From this perspective, aggressive children and adolescents

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interpret their environment as being hostile and so become accustomed to responding to perceived threats (Crick and Dodge, 1994). Furthermore, such young people have been shown to prefer an aggressive strategy to deal with conflicts over other problem-solving approaches (KeltikangasJarvinen and Pakasiahti, 1999). Perry, Williard and Perry (1990) have demonstrated clear differences between the social cognitions of aggressive and non-aggressive children, with aggressive children giving greater value to the outcomes of violence, such as enjoyment of the victim’s distress, a sense of power, and gaining tangible rewards, such as money or possessions. This contrasted strikingly with non-aggressive peers who demonstrated a much wider range of problem-solving strategies in the face of conflict, such as seeking help from an adult, using mediation or conciliation, and other pro-social methods. Even where non-aggressive young people do not make use of pro-social interventions, it seems they are more likely than aggressive peers to withdraw from a conflict situation. Hall, Herzberger and Skowronski (1998) found that when there are interventions to increase the empathy for others on the part of aggressive children, aggression decreases. But, by the time of adolescence, as we have seen, aggressive young people will have gravitated to social networks that affirm antisocial behaviour, so it is much more difficult to change their belief, founded in experience, that they win respect through such violent actions. It is also interesting to note that both aggressive and non-aggressive children expect to be rejected by some peers when they behave aggressively, but aggressive children care less about the rejection and seem to consider that the benefits in terms of outcomes outweigh the disadvan­ tages.

The social context of aggression Looking at individual characteristics of bullies and victims is not the only way of understanding the problem. Increasingly investigators are turning their attention to the whole social context within which the aggressive acts take place. Salmivalli et al., for example, have found that the social interac­ tional perspective offers an alternative explanatory model since it takes account of all the participants’ perceptions and interpretations of the aggressive incident, including onlookers and bystanders, and sets their social constructions of the phenomenon in the wider context of school, community and culture. Salmivalli et al. (1996) found that, on the basis of peer nominations, it is possible to assign a participant role to 87% of the pupils present at a bullying episode. The most common types of participants are ‘assistants’,

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who physically help the bully, ‘reinforcers’, who incite the bully, ‘outsiders’, who remain inactive and pretend not to see what is happening, and ‘defenders’, who provide help for the victim and confront the bully. These researchers look beyond the individual aggressive child to the social system within which the aggressive acts take place. Salmivalli (1999) points out that these social roles can become self-fulfilling prophe­ cies since the behaviour of the individual tends to become increasingly similar to the expectations directed to him or her by the group. When the person assigned the victim role tries to get out of it, the group can often ‘punish’ behaviours contrary to the role and reward only those that confirm it. Even moving the victim to another class or school may not be the solution since the person brings with them the insecurity and fearful expectation that they will be bullied again, and the peer group is likely to perceive the newcomer as a target for bullying. Children or adolescents in the role of bullies may also come to believe that they are unable to behave in any other way, and in a similar way may be reinforced by the group for their antisocial behaviour. Salmivalli, Kaukiainen and Lagerspetz (1998) found that children and adolescents in similar or complementary participant roles tended to associate with one another. For example, similarity in aggression may be one criterion that is used by the group to judge an individual’s eligibility for entry. Young people are selectively allowed into peer group networks and gradually the network influences the values and behaviour of its members. Bullies may well be disliked by other members of the class, but typically they have a group of friends composed of other bullies, assistants and reinforcers. The defenders of victims and outsiders, by contrast, will often form networks with one another. Victims are more likely to be outside all networks, but where they are in one, they share it with defenders, outsiders or other victims. Rivers (1999) draws an interesting parallel with the role of the scape­ goat in different societies and at different historical periods. As a way of dealing with the ills in a society or in situations where a transgressor could not, for some reason, be identified, a weaker member of the community could be forced to adopt the role of scapegoat. Those who were disabled, or deemed to be different, were particularly liable to be the victims of this type of aggression, even to the extent of losing their lives. The aspect of difference or deviation from the group’s norms leads to cruel discrimina­ tion against such persons and their being labelled as ‘outsiders’. The resulting rejection by the group in turn can lead the victims themselves to perpetuate their low status though social incompetence and negative selfperceptions, a response that will negatively influence the responses of bystanders towards the victim (O’Connell, Pepler and Craig, 1999).

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Theory of mind It has been common amongst the social information processing theorists (e.g. Perry, Williard and Perry, 1990) to consider some children – often, aggressive children – as having ‘social skills deficits’ and showing ‘maladaptive behaviour’. However, although aggressive children may have different social information processing styles, these are not necessarily deficits. We have seen how the forms of aggressive behaviour change with age, becoming more sophisticated with indirect and relational forms of aggres­ sion by middle and later childhood. These forms of aggression might be thought to require more social skills to execute them effectively. In fact, Kaukiainen et al. (1999) did find a correlation between a measure of social intelligence and the use of indirect aggression especially, in a sample of 10–14-year-old children in Finland. With bullying too, Sutton, Smith and Swettenham (1999a) hypothe­ sised that ringleader bullies would be socially skilled, able to understand how to hurt victims, how to gather followers to help them and how to avoid detection by adults. The same researchers (1999b) have reported empirical results confirming that, of the Salmivalli participant roles, ringleader bullies do in fact score the highest on theory of mind type tests (recognising complex emotions, double-bluff and deception, etc). These children did, however, score lower on empathy tests. These findings suggest that aggressive and bullying children may sometimes have good social skills, but skills put to antisocial ends and not tempered by empathy for feelings of others. Whether such aggressive and bullying behaviour is maladaptive cannot be assumed; sometimes aggres­ sive behaviour achieves desirable ends for the aggressor. The extent to which this is true will depend on the broader social and institutional context in which the behaviour occurs.

What triggers an aggressive incident? As an illustration of the eruption of aggressive actions in a particular social context where the signals are ambiguous, we consider the young person’s state of mind, the presence of some kind of perceived threat or provoca­ tion, and the behaviour of members of the group in a range of participant roles. A relatively minor incident, for example a group of young people laughing together at a shared joke, could be the first stage in an escalating series of attacks and counter-attacks if one person perceives the laughter as a form of social exclusion.

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Janice was sitting alone in the school dining room reading a magazine as she ate her lunch. At a nearby table, Jane, Anne and Julie were talking in whispers and intermittently shrieking with laughter. Janice felt increasingly uncomfortable and self-conscious about being alone. She became convinced that the girls were laughing at her. When the group got up noisily and moved past her table, Julie brushed against Janice and knocked her magazine to the floor. Janice leapt to her feet, swore at Julie and pushed her roughly.

How can these events be interpreted? From the perspective of one outsider, Janice’s angry response may be an understandable way of expressing her frustration at being excluded from a social group. From another, Janice may be viewed as a touchy individual inclined to take offence at the slightest thing. The group may genuinely believe that they intended no harm and experienced the laughter as simply fun. That day, Julie and her friends Anne and Jane were laughing about the party they had been to the night before. Their laughter was not directed at Janice. Julie brushed against Janice accidentally because she was laughing so much. Her friends corroborated the story that their shared jokes were not about Janice. Clearly there is no one correct interpretation, but an understanding of the social context can cast new light on the events. Since Janice came to the school from the north of England 2 months ago, she has not been able to make any friends. Julie regularly passes comments about Janice’s clothes and hairstyle. She laughs at her accent and mimics her publicly. Whenever any other pupil sits near Janice, they are subjected to similar treat­ ment. Janice has recently become morose, usually sits on her own and is rarely chosen to join in activities. She was the only girl in the class who was not invited to the party.

In the next sections, a number of policies and interventions that have been developed to tackle the problem of aggression amongst young people are considered. In particular, those that address directly the issue of peer group relationships are examined. A number of these, especially peer support interventions, could possibly have offered a lifeline to Janice and so prevented the aggressive interchange.

Policies to prevent aggressive behaviour in schools The Elton Committee (DES, 1989) recommended that schools should develop a whole school behaviour policy with clear principles. The committee suggested that such a policy should be developed through widespread consultation with parents, teachers, other school staff and pupils. The committee recommended that the policy should:

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• contain a minimum number of positively phrased guidelines for behav­ iour • offer rewards for positive behaviour as well as sanctions for inappro­ priate behaviour • avoid group punishments or punishments which involve humiliation • be applied with consistency and fairness while retaining a degree of flexibility for unusual circumstances • provide direct action against bullying and harassment • offer support for teaching as well as non-teaching staff • be subject to regular evaluation and open to change • address on-site and off-site behaviour (adapted from Sharp and Cowie, 1998:114). The whole school policy approach aims to create a structure in which there are clear guidelines on what behaviour is and is not acceptable, and in which there are sanctions against those whose behaviour contravenes the policy. Currently, regular inspections are made by the Office for Standards in Education (OFSTED), and these include a scrutiny of each school’s anti-bullying policy and the ways in which it is implemented and evaluated. From September 1999, it has been a legal requirement that all schools have a policy and that they implement it effectively. In 1991–93, the Department for Education (DFE) funded an AntiBullying Project at the University of Sheffield, which developed and evalu­ ated interventions against school bullying. Detailed results are presented in Smith and Sharp (1994). The main intervention was to devise a whole school policy against bullying in each of the 23 schools involved (16 primary and 7 secondary). The researchers found that there were variations in the extent to which the schools developed and implemented the whole school policy. In general, those which put more time and energy into the anti-bullying policies, and which consulted widely with the whole school community, had the best outcomes in terms of a reduction in the incidence of bullying. In a follow-up study (Eslea and Smith, 1998), it was found that antibullying work presented challenges as well as opportunities. One impor­ tant factor appeared to be the extent to which the anti-bullying policy had been kept alive by the school after the project ended. In schools where the policy continued to be monitored and developed, it was more likely that bullying would decrease further. The Crick Report (Advisory Group on Citizenship, 1998) has recom­ mended that lessons on citizenship be included in the curriculum. The Government is now committed to education for future citizens – the young people in schools – with the aim of teaching pupils to be active,

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responsible members of their school community. The Crick Report stresses that it is important to manage the learning environment in such a way as to encourage pro-social behaviour, and to increase co-operative relationships based on trust, among peers and between teachers and pupils. The Report recommends that active citizenship should take place both within the school and in the community: It is obvious that all formal preparation for citizenship in adult life can be helped or hindered by the ethos and organisation of a school, whether pupils are given opportunities for exercising responsibilities and initiatives or not; and also whether they are consulted realistically on matters where opinions can prove relevant both to the efficient running of a school and to their general motivation for learning. (Advisory Group on Citizenship 1998:25)

This report has implications for the recognition of interventions to counter aggressive behaviour in schools and offers opportunities for the development of strategies and structures that foster co-operative and prosocial behaviour amongst young people.

Putting the policies into practice: the potential for young people to help their peers There are excellent overviews of interventions to tackle the problem of aggression in schools (e.g. Smith and Sharp, 1994). This chapter ends with an overview of initiatives that focus particularly on the peer group itself. Peer support interventions recognise that pupils themselves have the potential to assume a helpful role in tackling a problem. Peer support systems, whether formal or informal, tend to incorporate the use of basic counselling skills, including active listening, empathy for a person with social or emotional difficulties, a problem-solving approach to interper­ sonal difficulties and a willingness to take a supportive role. Adults play a significant role in this process by giving young people appropriate skills and by providing a supportive environment in which to practise their skill. They train young people to provide a direct response to requests for help with regard to a specific problem such as victimisation. They give the peer helpers skills and strategies for helping the victim find solutions to a problem. Though the direct action is taken by the peer helpers, adults retain a supportive and supervisory role without imposing solutions. The non-punitive nature of peer support offers clear and genuine channels of communication amongst those involved (Cowie, 1998). Rigby (1997) argues that, if bullying is viewed as a conformist response to group pressure, especially in terms of what members of the peer group expect of an individual, then approaches to change the behaviour of

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bullies should attempt to minimise the impact of the group. This is in line with the no-blame methods advocated by Pikas (1989) and by Robinson and Maines (1997) in which an aggressive, blaming stance on the part of adults is abandoned in favour of a constructive approach that builds on positive behaviour in the group through contract-making and co-operative group work. The argument is that pro-social behaviour can be learned in the context of the class or school group, and that it can be nurtured through encouragement, praise and the acknowledgement of success. Salmivalli (1999) argued that the power of the peer group to promote antisocial behaviour such as bullying can be harnessed to end it, and suggests that if young people succeed in addressing the problem, all participants, not only those directly involved, gain a positive experience of active citizenship. She claims that it is possible to ‘restructure’ networks of aggressive young people and so change the quality of interpersonal relationships for the better. Some arises spontaneously, as Salmivalli and her colleagues discovered, where ‘defenders’ (more often girls) run for help or comfort the victim, or where girls demonstrate constructive conflict resolution abilities (Österman et al., 1997). Some pro-social behaviour can be fostered by teachers in the classroom through co-operative group work where democratic values are promoted and reinforced (Foot et al., 1990; Hertz-Lazarowitz and Miller, 1992; Cowie et al., 1994; Cowie, 1995). Mediation and conflict resolution build on listening skills by adding a step-by-step process that facilitates individuals who are in conflict to agree to a mutually acceptable solution. The main components include the idea that conflict is not bad in itself; that conflict need not be a contest; and that it is important to distinguish between what people want and why they want it. Nersnaes (1999) describes the use of mediation programmes of intervention in Norwegian schools. During the mediation itself, the pupils themselves are responsible for resolving the conflict and for working out a joint solution. One outcome has been that, through participation in the process of mediation, pupils develop competence in handling conflict, gain insights into its origins and its solution, and acquire new communication skills. There is scientific confirmation of these observations. In a Canadian study of the effects of student-mediated conflict resolution in primary school, Cunningham et al. (1998) found that, over time, interventions of this type improve the social climate of a school and significantly reduce physical aggression during break-times. The mediators detected conflict early and were able to intervene quickly before it escalated. The authors conclude that, as a relatively low-cost intervention, it merits wider use and further study as part of an anti­ violence school programme.

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Naylor and Cowie (1999) investigated a sample of 52 schools with wellestablished anti-bullying policies and systems of peer support. They found that the pupils perceived these schools as being safer than those without these facilities, and valued the fact that the staff cared about them enough to establish and support such systems. Furthermore, in these schools the proportion of victimised children who told no one of their plight was substantially lower than in other schools.

Conclusion In establishing systems such as those described above, schools give valuable opportunities for bystanders to act pro-socially in defence of vulnerable peers. For any school to become safer from violence and aggression, educators must ensure that the way in which relationships are managed does not generate an environment that promotes rather than discourages aggressive ways of resolving disputes and disagreements. School staff must become aware of the psychological processes that underlie aggression and of the specific contexts in which it can escalate. Adults must consider their own ways of relating, both to the young people in their charge and to one another, and reflect on the messages that they are putting across in their everyday interactions. Individual teachers who are concerned with the pastoral systems in the school are also recom­ mended to learn techniques that reduce rather than escalate violent responses in their pupils. Teaching methods that emphasise co-operative values are especially influential in facilitating pro-social values amongst the whole school community. Finally, systems of peer support against violence are increasingly being adopted by schools to counteract bullying. This gives a clear role for the bystanders to find a vehicle for their feelings of empathy for victims and can broaden the acquisition of informal antibullying roles amongst the peer group.

CHAPTER 10

The Influence of Film and Video on Young People and Violence KEVIN BROWNE AND AMANDA PENNELL During the 1990s, the unresolved question of whether violence in the media has a damaging impact on its audience once again resurfaced in people’s minds. In the UK, the whole debate was highlighted with the murder of James Bulger by two 10-year-old boys. Violent films, especially Child’s Play 3 and Juice, were cited in the Bulger case, the murder of Suzanne Capper and the kicking to death of Les Read (Guardian, 27 November and 22 December 1993). The similarity between certain aspects of these crimes and parts of the video films made people believe that these violent films had caused the individuals concerned to commit terrible crimes. The claims from individuals and the British tabloid newspapers as to the linkage between certain acts of murder and violent video films were heavily criticised and these allegations were actually shown to be unfounded by closer examination of the above three cases. Vine (1995) suggests that some people are struggling so hard to find an answer as to why two 10-year-old boys would brutally torture and kill a toddler that in desperation they make a rash judgement that videos caused the crimes. David Gauntlett (1995), the author of a study at the University of Leeds, argues that television is being irresponsibly blamed for societal problems. Culf (1995) suggests that it is dangerous to oversimplify and ignore the complex causes of antisocial behaviour, such as growing up in a violent home or living in a violent community. On the other hand, Newson (1994a) strongly believes that there is an established causal relationship between violent videos and criminal behav­ iour. Her report, Video Violence and the Protection of Children, was cited by David Alton MP in support of his proposed Amendment to the Criminal Justice and Public Order Bill 1993. This amendment would have meant tighter restrictions on videos which were considered to be psychologically damaging to children. However, as James Ferman, director of the British 151

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Board of Film Classification (BBFC) said, ‘the amendment would have resulted in the banning of films such as Schindler’s List from video on the grounds that it presented a bad role model for children’ (Douglas, 1995). The UK Government decided to reject David Alton’s proposal and re­ examine the issue in order to make its own amendments. The Home Affairs Committee (1994) commissioned several experts from the relevant fields of psychology and communication research together with organisa­ tions involved in the protection of children, to give evidence on this debate for a special report, Video Violence and Young Offenders (Home Office Affairs Committee, 1994). This chapter examines the available evidence pertaining to this impor­ tant contemporary issue, with particular reference to the authors’ own research study of the effects of video violence on young offenders (Browne and Pennell, 1998).

Research evidence Generally, researchers are divided about the effects of media violence on young people (Vine, 1995). On one side of the debate there are ‘media pessimists’ such as Canterwall (1989), Newson (1994b) and Strasburger (1995), who believe that television or screen violence can be very harmful to children and adolescents, and in the most extreme cases can be a causal factor in aggressive and violent criminal acts. On the other side are the ‘media sceptics’, including among others Cumberbatch and Howitt (1989). They claim that there is no reliable evidence to suppose that violent film and television causes harm. Indeed, Cumberbatch (1995) has subsequently reviewed the methodological limitations of those studies claiming an effect. Somewhere between these two extremes are various points on the continuum, where people believe that the evidence of a link between violent media entertainment and violence may vary in strength depending on the vulnerability of the audience (Browne and Pennell, 1998). The effects of television violence The American Psychological Association claims that the average American child or teenager views 10 000 murders, rapes and aggravated assaults per year on television alone (Huston et al., 1992). So what kind of impact does this kind of viewing material have on young people? Meta-analysis is a procedure which combines summary data collected from a group of studies to calculate average effect size. This type of analysis has been applied to a large proportion of studies and supports the finding that aggressive or antisocial behaviour can be

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increased after watching violent television (Strasburger, 1995). Strasburger cites, for example, Andison (1977) who found that in 77% of studies, media violence was linked to aggression in the audience. Comstock’s (1991) main conclusion in his review of more than 1000 studies was that, although some group and cultural distinctions appear, a positive association between violent entertainment and aggressive behaviour travels well. However, as the critics have pointed out, associations between aggres­ sion and media violence are quite distinct from causal relationships and this must be kept in mind. Itzin (1994) writes: Correlation does not prove causality. It never can. Causality is a standard of proof that rarely, if ever, can be achieved, and is barely, if ever, required. However, correlation itself is evidence. (Itzin, 1994:59)

Longitudinal studies carried out in the USA measured the cumulative effects of viewing violence over a period of time, with the aim of providing evidence of causality as well as producing correlations (Strasburger, 1995). With particular reference to the studies by Huesmann and colleagues (1984, 1986) discussed below, the effects of television violence and aggressive behaviour were looked at retrospectively and prospectively to identify whether early aggression predicted watching more violent television in later life, or whether early violent television viewing predicted later aggressive behaviour, in an attempt to determine cause and effect. The studies produced remarkable results when they surveyed a cohort of people at three different ages (8, 19 and 30 years). At age 30, they found a relationship between watching television violence at age 8 and aggres­ sive or antisocial behaviour 22 years later (Lefkowitz et al., 1972; Huesmann et al., 1984). However, the reverse relationship, that being aggressive at age 8 predicted violent television consumption 11 years later, was not observed to be true. Therefore, ‘If a child’s observation of media violence promotes the learning of aggressive habits, it can have harmful lifelong consequences’ (Huesmann, 1986:129). It can still be held that, despite the above findings, these studies still cannot produce conclusive proof of causality, as television, in itself, was not the only or even the major influence on children’s aggressiveness. The authors actually found that parental behaviour was also related to the level of aggression in the child participants. Despite the longitudinal design of these studies (using retrospective and prospective methods to provide a stronger case for causality), it is perhaps more accurate to interpret the results as proving an association between viewing violent television and

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later aggressive behaviour. This is because of the problems of controlling for other influencing factors (e.g. style of parenting). In the UK, Belson (1978) studied 1565 London male teenagers and found that those who watched a greater amount of violent television committed markedly more seriously harmful criminal acts. The less serious categories of criminal acts were also positively associated with greater exposure to violence on television. The most well-known naturalistic studies compared places which had television with places which did not, to see if there were differences in levels of aggression. Williams (1986) compared three towns in Canada: ‘Notel’ (no television), ‘Unitel’ (one station) and ‘Multitel’ (multiple stations). The towns were nearly identical apart from whether they had television or not. Data on children’s physical and verbal aggression were obtained for the 2-year period before television was introduced and for the 2-year period after its introduction. It was concluded from the results that aggression increased in the children of ‘Notel’ after the introduction of television and that they had caught up with their peers from ‘Unitel’ and ‘Multitel’ in the post-television 2-year period. Further work carried out in Holland by Vooijs and Van der Voort (1993) emphasised the importance of role models of television violence. Their studies indicated that although most children reject violent behaviour committed by ‘baddies’ and were less likely to be influenced by it, they think that the ‘goodies’ could do no wrong.

Concepts relating to the effects of violent film A number of concepts to explain the effects of violent film have emerged from social learning and cognitive theories. One is disinhibition, whereby watching violence on the screen reduces inhibitions towards violence (Bushman and Geen, 1990). Violence becomes seen as a ‘normal’ response to stress and frustration and acceptable to society which, in effect, changes people’s own moral code and attitudes towards the use of violence (Parliamentary Office of Science and Technology, 1993). Desensitisation has been said to occur through repeated exposure to violent images as people become more accepting of real-life violence and demand more extreme forms of violence on the screen (Gunter and McAleer, 1990). The problem then becomes circular: the audience demands more explicit violence, the film-makers respond by making their films more graphic, which in turn desensitises the audience, and a vicious circle is established. The theory is that exposure to screen violence makes people less concerned about others, so they are more likely to behave aggressively towards them (Thomas et al., 1977).

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Perhaps the most prominent theory, partly developed from the research on screen violence, is social learning theory. Bandura, Ross and Ross (1963) carried out a series of laboratory experiments to investigate the circumstances under which children would imitate aggressive behav­ iour. Firstly, the children were mildly frustrated (by not being allowed to play with toys), then they watched a film where an adult starts hitting and kicking a Bobo doll (plastic punching bag with a red nose). They were divided into three groups: those who saw the aggressor being rewarded; those who saw the aggressor being punished; and a neutral group who saw no consequences of the behaviour. The model-rewarded group and the control group showed a considerable number of aggressive behav­ iours, with the model-punished group only showing limited imitation. This showed that despite having the learnt aggressive acts in their reper­ toire, they would only be acted out in favourable circumstances. It would therefore appear that there is here a strong case of ‘observational learning’ dependent on perceived efficacy. Imitation was demonstrated in these experiments and a subsequent one inviting the children to recall the aggressive acts. All the experimental children could perform the aggressive acts they had witnessed if the circumstances were right. This is consistent with the social learning theory developed by Bandura (1973a,b). Evidence for the imitation of violent characters in film, which has led on to aggressive acts and criminal proceedings, does exist. In August 1987 a 17-year-old man was found in possession of a glove which had Stanley knife blades attached to the end of each of the fingers and thumb. He was arrested in his car, where he appeared to be trying to hide the weapon. The young man was fined for possessing an offensive weapon, and the mitigation for his defence was that he was inspired by the Nightmare on Elm Street films (Certificate 18), where the main character, Freddie Krugger, uses a similar weapon to attack his victims. Although there was blood (not the suspect’s own) on the glove, the young man was never charged with any further offences as no victims or witnesses came forward (Ross, 1997, personal communication). However, evidence of such direct imitation from films and videos, called ‘copy-catting’, is rare and it is assumed that, if there is any influence, it is more indirect for the vast majority of individuals. Where evidence of direct imitation from violent film has been observed, the individual concerned is most likely already to have developed a tendency to behave in a violent manner (e.g. Michael Ryan and the Hungerford shootings). Therefore, viewing violent films may have different influences on different people: it may desensitise those without violent tendencies to tolerate higher levels of violence in their environment, whereas people with

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violent tendencies may increase their behavioural repertoire of aggressive behaviour by imitating what they see.

Theories on the effects of violent film The theories developed by Berkowitz (1984, 1993) and Huesmann (1986) are based on establishing what role violent stimuli have in cognitive processes which would lead to the viewer becoming aggressive. Berkowitz’s (1984) ‘cognitive neo-association’ theory works on the principle that cognitions and thoughts are interconnected by means of association. The connecting pathways are strengthened by ‘similarity and semantic relatedness’. Therefore, he suggests that television and film violence might prime other (already present) aggressive ideas, feelings and actions, immediately after viewing through ‘semantically strength­ ened associative pathways’. This leads to the priming of aggression, with viewers being more likely to have aggressive ideas and actions after watching film violence (Josephson, 1987). Huesmann and Eron (1986) developed a ‘social cognitive’ theory in which they describe violence on the screen being learnt as a cognitive script to be used in social situations. The aggressive script is learnt as a way to behave; whether people will use it depends on the amount of similarity between the situation at the time of retrieval and the situation at the time the script is encoded in memory. The concept of triggers is found in both cognitive theories, together with the notion of ‘cue-triggered aggression’. Huesmann and Eron (1986) suggest that aggressive behaviour would be retrieved if a retrieval cue was present. However, Berkowitz (1984, 1993) claims an ordinary situational stimulus could be paired with an aggressive scene, and in a subsequent situation it could be used to elicit aggression, especially if the person was already in an aggressive mood (i.e. was frustrated or angered). Evidence for these ideas was provided by Berkowitz and Geen (1967). They found that participants who were given the opportunity to be aggressive (in this case, giving electric shocks) would act more strongly if the victim was linked to the aggressive film in some way. Other studies do not support these results, and critics have suggested that violent films do not produce aggression per se but produce arousal instead (Tannenbaum and Zillman, 1975; Zillman, 1979). Nevertheless, other studies have illustrated Berkowitz’s theory by investi­ gating how individual differences in aggression interact with the violent stimuli in the elicitation of related aggressive thoughts and actions. These studies emphasise that individual differences, such as the predisposition to be aggressive, may play an important role in the effects of screen violence.

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Susceptibility to violent film Dorr and Kovanic (1981) reviewed several studies that looked at individual differences, concluding that screen violence can affect viewers of both sexes and of different ages, social classes and ethnic origins. Studies have shown that more aggressive youths are more likely to be influenced by exposure to screen violence. For example, a 1978 study (Sebastian et al.) surveyed boys in a minimum secure prison: those who saw aggressive films were more aggressive afterwards than the ones who saw a non-aggressive film. Studies on susceptibility to the effects of screen violence emerged after it was suggested in the US Surgeon General’s Scientific Advisory Committee Report (1972) that the causal relationship between viewing violence and behaving aggressively was only true for those people predis­ posed to being aggressive. Hence there may be ‘vulnerable’ individuals who are particularly susceptible to what they see on the screen (Parliamentary Office of Science and Technology, 1993). Browne (1995) states that not everyone who watches violence on the screen will become violent. However, for the 3–10% of the population who are predisposed to being violent when frustrated, possibly as a result of growing up with violent parents, these films are unhealthy. Several factors are correlated with having a violent disposition, including a history of poor parental role models, inconsistent discipline and being abused by a parent. All these factors can lead to the develop­ ment of a delinquent personality and result in a child having a poor sense of self-worth and low moral development (Browne and Herbert, 1997). The lack of self-esteem and moral norms means that the child interprets what he or she sees on the screen in a distorted way by evaluating charac­ ters and scenes immaturely. Lefkowitz and Huesmann (1981) suggest that in order fully to understand and determine which people are susceptible to screen violence it is necessary to take a cognitive approach by explaining how people understand what they watch, and how they evaluate what they see, in terms of their own moral understanding. Latterly, it has been argued that measurements of, for example, skin responses or brain waves do give us insight into when audiences get excited, but they provide little qualitative data on why they get excited (Buckingham, 1996). It is therefore necessary to see the viewer as ‘actively’ watching the screen. Reactions to what is being viewed are produced by the viewer ascribing some meaning to them and judging whether or not the actions accord with their own moral standards and experiences. The viewer’s moral and other evaluative standards for personal conduct are key elements in the complex causal network upon which reactions to screen imagery depend (Vine, 1994).

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Media violence, delinquency and crime Research on media violence with young offenders has arisen as a result of the theory that they are a ‘vulnerable audience’. Certain factors have been repeatedly linked to delinquency and crime such as poverty, one-parent families and a lack of parental care and affection coupled with inconsistent discipline and severe physical punishment (Browne and Herbert, 1997). These background characteristics have also been linked with people’s susceptibility to screen images (Vine, 1994). A UNESCO review in the 1960s stated that television viewing is a contributory factor to delinquency and crime, but it is likely to affect only those children who are already maladjusted and prone to commit crimes. Television in itself could not, it was argued, render a normal, well-adjusted child delinquent. It was seen as dangerous in the case of an already aggres­ sive child being able to gain hints about how to express hostile feelings, rather than in terms of it being capable of making a non-aggressive child actually become aggressive (UNESCO, 1961, 1964). Halloran, Brown and Chaney (1970) conducted a study of individuals (juvenile delinquents and non-delinquent controls) aged 10–20 years to determine if there were any relationships between delinquency and the mass media. The authors found that juvenile delinquents differed from controls in their viewing behaviour. This difference was not due to the amount of television they watched or the actual programmes viewed, but to how they actually perceived and used the various programmes. Delinquents were more interested in ‘exciting’ programmes, but were less able to say who they identified with on the screen. Recent studies on young offenders have concentrated on those predis­ posed to being aggressive. Bailey (1993) investigated 40 adolescent murderers and 200 young sex offenders, and claimed that repeated exposure to violent and pornographic videos was a significant factor in these crimes, including, in some cases, actual imitation of the screen image. Bailey proposes that these individuals are lacking internal bound­ aries, driven by distorted ideas and have unstable and violent feelings as well as deviant role models from real or fictional sources. This further supports the suggestion that there is some maladjustment or abnormality, possibly stemming from family background, which underlies and influ­ ences young offenders’ interpretations of screen images. As some researchers have suggested, experiencing ‘real’ violence in the home has a considerable effect on the predisposition to violence in the child (Jaffe, Wolfe and Wilson, 1990; Browne, 1993), which, in turn, could be reinforced by violence on the screen. The question is, do children or adolescents with violent tendencies seek out violent films and, if so, do

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these films reinforce their aggressive thoughts and lead to more frequent violent behaviour? This chicken-and-egg dilemma was discussed earlier with reference to Huesmann et al.’s (1984, 1986) longitudinal studies, where early aggressive behaviour (age 8) was not found to predict the amount of violent television viewed at age 19, but violent television viewing at age 8 did predict later aggressive behaviour. Hagell and Newburn (1994) examined the viewing habits of young offenders and school children. In this Policy Studies Institute study, 78 offenders aged 12–18 were compared with over 500 schoolchildren of a similar age. Despite the fact that the offenders had less access to television and video equipment, the two groups watched a similar amount of televi­ sion. However, the offenders were no more likely to choose violent programmes or films than the control group. When they were asked to name their favourite films, the boys from both groups listed Terminator 2 as their favourite. As for television programmes, all the young people liked soap operas and dramas, with the most popular programme for offenders being a British police drama, The Bill, whereas the schoolboys and girls liked Australian soaps (Home and Away and Neighbours, respectively). It was found that the viewing habits of offenders and non-offenders were very similar and, thus, it was concluded that ‘studies of what offenders watch need to be supplemented by research which examines how they watch and how they understand what they see’ (Hagell and Newburn, 1994:90). This work of Hagell and Newburn (1994) supports the points put forward by Vine (1994) and Buckingham (1996) – that there is a need to evaluate the role of mental representations and moral evaluation which may influence viewing behaviour and its effects. Individual differences are, perhaps, a reflection not of what is watched but rather of what is remem­ bered.

Research by the authors In 1995, the Home Office commissioned a study of the effects of video violence on young offenders (Browne and Pennell, 1998). Groups of offenders and non-offenders were shown a violent video film. Immediate reactions were monitored, as well as impressions and memories of the film some while later. They were also psychologically assessed and asked about film preferences. Aims and methods of the study The research was concerned with whether violent young offenders do view violent videos differently from either non-violent offenders or non­

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offenders. Four specific questions were addressed. Do violent young offenders: • • • •

view video films more often than the other two groups? identify more often with violent scenes and characteristics? remember more from violent videos? have more violent childhood experiences which influence their video film preferences?

The study group consisted of 122 males between 15 and 21 years of age, in the following three groups: • 54 violent offenders (all had been convicted at least once of an offence against the person) • 28 non-violent offenders and • 40 non-offender school college students as a control sample. Participants were asked about their viewing habits and shown a violent video film appropriate for their age (i.e. Certificate 15 or 18). They were then interviewed about their recollections and interpretations of the film immediately afterwards, 4 months later and again after 10 months. Participants were also assessed for family background, predisposition towards anger, empathetic concern and moral maturity. Interviews with offenders took place at two secure institutions, and with non-offenders at their places of study. Viewing choices Offenders spent more time watching satellite and television films: 53% watched on 3 or more days a week whereas most school/college students (72%) watched on only 1–2 days. Preferred programmes also differed – offenders were significantly more likely than non-offenders to choose soap operas (74% compared with 35%) and police dramas (40% compared with 0%). Violent offenders were more likely than non-violent offenders to prefer police dramas. Offenders spent significantly longer watching video films than nonoffenders. Nearly two-thirds watched more than 2 days a week compared with only 20% of school students. Non-offenders tended to prefer science fiction and comedy films. The general preference of offenders was for violent films and violent offenders were more likely than non-violent offenders to favour such films. Of all those who chose violent films as their favourite, 89% were offenders and only 11% non-offenders.

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A Certificate 18 film was named as the favourite or last film watched by about 70% of offenders and non-offenders. There was no difference between 15–17-year-olds and 18–21-year-olds (whether offenders or not) in naming a Certificate 18 video as their favourite (even though 15–17year-olds should not legally be supplied with such films). The participants, whether or not in a secure institution, appeared, therefore, to be watching age-inappropriate films. The violent film shown as part of the study was age-appropriate and may have been considered ‘tame’ in comparison to films usually watched. Identification with film characters When asked ‘If you could be anyone in a film, who would you be?’, similar proportions of the groups wanted to be a violent character. However, when asked ‘why they would be that character’, 20% of offenders but only 5% of non-offenders said ‘because they were violent’. When asked to select favourite actors, two-thirds of offenders named stars such as Van Damme, Schwarzenegger or Stallone who typically play violent characters. Only one quarter of school/college students listed such actors. Again, this preference was more pronounced for violent offenders. Recollections of the experimental violent video film Characters in film In the initial and 4 month follow-up interviews, offenders and nonoffenders were broadly similar in terms of which film character they identi­ fied with most or remembered best. But after 10 months, significantly more offenders (82%) than non-offenders (43%) identified with a vindic­ tively violent character. When asked why they would be that character or why they remembered them the most, offenders were more likely to give reasons related to the character’s violent nature. Recalling scenes and story-line In the follow-up interviews, there was no difference between offenders’ and non-offenders’ recollections of the ‘gist’ of the film. Offenders were slightly more likely to recall (incorrectly) the start as being violent. Violent scenes were more likely than other kinds to remain in the memories of both violent and non-violent offenders. Attitude to the film Of violent offenders, 72% said that a violent part of the film excited them the most, compared with 65% of non-offenders and 35% of non-violent

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offenders. In the follow-up interviews, more offenders than non-offenders thought the film lacked violence (40% versus 18%) and action (39% versus 23%). Film influences Participants were asked about the influence on them of both the study film and any others seen since the last interview. Non-offenders were more likely to say they had copied dialogue from a film. No one said they had copied violent behaviour from the study film. One non-offender and one offender said they had copied violent aspects of other films. Three offenders said that a film seen in the last 3 months had influenced them. One ‘liked the idea of robbing a van and getting away with it’ (unnamed film), another ‘wanted to get a driving licence’ (Licence to Drive) and a third ‘wanted to nick a Porsche and get a gun’ (Bad Boys). Only three people at the 4 month follow-up interview (none at the 10 month interview) claimed the study film had influenced them. Two were offenders. One said, ‘it gave me a high afterwards’ and the other, ‘I know to check for police when robbing’ (the police had caught the film charac­ ters in the act of stealing motorbikes in No Surrender). The non-offender said the film (ID – about football violence) had depressed him. One violent offender (still in prison when followed up) thought it was a good idea to slash the victim’s Achilles tendons so he could not escape (as shown in Last Gasp). Psychometric assessments The film had non-immediate influence on empathy of the participant’s state or level of anger. However, there were pre-existing group differences in these and other respects. Offenders had a lower level of moral develop­ ment, were less able to appreciate others’ viewpoints or empathise and/or were more likely to have aggressive temperaments and distorted percep­ tions about violent behaviour. These differences indicate that low moral development and distorted perceptions about violence underlie preferences for violent films and violent film characters. Low empathic concern plus higher aggression could lead to individuals seeking out violent films for entertainment. Films may then reinforce these thoughts and feelings, creating more entrenched cognitive and behaviour patterns. Nevertheless, the study provides little evidence that offenders were more influenced by the experimental film than non-offenders, although they did recall vindictively violent characters twice as often.

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Violent childhood experiences and film preferences Participants were asked how conflicts at home were typically resolved, ranging from ‘reasoning behaviour’ to ‘severe violence’. Highly significant differences emerged between the groups in the use of violent behaviour to resolve parent–child conflicts. Violent offenders had most often suffered violence from both parents and responded aggressively. Non-violent offenders tended to have experienced violence more from their fathers or stepfathers than their mothers. Offenders were also more likely to have witnessed interparental violence. Non-offenders both witnessed and suffered family violence less often than the other two groups. These findings suggest that victims may be particularly prone to become offenders and highlight the possible influence of home violence on violent film preferences. Multivariate analysis confirmed that personality and social background were more important in identifying those who commit offences than factors associated with violent films. Below, characteristics which discrimi­ nated offenders in the study (whether violent or non-violent) from nonoffenders are arranged according to the strength of association with offending behaviour: • • • • • • • • • • • • • • •

physical confrontational thoughts stepfather present (previous family breakdown) angry temperament low level of moral development low empathy score parental violence to young person low intellectual ability preference for violent films young person violent to parents young person witness to spouse violence favourite actor plays violent roles identification with ‘bad guy’ in film film lacks violent action poor reading ability violent reason for remembering actor in film.

Implications of recent research In contrast to Hagell and Newburn’s (1994) study, which found no differ­ ences between the viewing preferences of school or college students and

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young offenders, the Browne and Pennell (1998) study has demonstrated that differences do exist. Offenders viewed more video films, satellite and television films, selected police- or crime-oriented programmes and expressed preferences for violent films more often than non-offenders. Offenders were also more likely to identify with violent role models in the films that they watched. However, no differences were found in viewing habits between violent offenders and non-violent offenders. The differences in scores on the psychometric assessment indicated that particular cognitions underlie a preference for violent films and identification with violent characters. Compared with non-offenders, offenders are less able to appreciate other people’s viewpoints or to feel empathy in general, and are more likely to have an aggressive tempera­ ment, with cognitive distortions about behaving aggressively (e.g. physical confrontational thoughts). This low empathic concern, coupled with higher aggression, leads to the individual seeking out violent film for entertainment. This, in turn, may reinforce violent thoughts and feelings, thereby creating more entrenched cognitions. In the majority of violent films (e.g. Pulp Fiction), the victim’s perspective is rarely taken. This may make it easier for offenders to lack concern for others and to be unaware of the implications of their violent behaviour for others. Berkowitz’s (1984) cognitive neo-associative theory suggests that film violence could connect and activate other aggressive ideas and feelings, leading to the individual being ‘primed’ for aggression after viewing screen violence. This could mean that, for those individuals with such predispositions to aggression and lower empathy, watching such scenes is potentially dangerous. The argument put forward by Thomas et al. (1977) about desensitisation to film violence is in accordance with this view. Thus, he maintains that people are less concerned about others, but also more likely to behave aggressively after viewing film violence. However, a full testing of the ‘priming’ argument may be confounded by moral and legal constraints, which make it unethical to show partici­ pants films classified as being age-inappropriate. In view of the findings that offenders watch more films than non-offenders and that offenders have preferences for violent films, the film violence shown in the Browne and Pennell (1998) study may have been considered too ‘tame’ in compar­ ison with what was usually watched by the individual. Jo and Berkowitz (1994) theorise that for those who already hold violent and aggressive thoughts (which are interconnected), what they watch in terms of film violence can remind them of other occasions where similar aggressive thoughts occurred. The associations made between these are subconscious, but can be reinforced by repeated viewing of violent imagery. It is possible that this subconscious activation is stronger

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for those who hold violent thoughts and feelings associated with violent peer groups and backgrounds. This would explain why some people are more vulnerable to violent images than others. For those who already have well-established violent cognitive pathways, the prominence of violence in their lives, particularly as a result of growing up in a violent home, may have continually strengthened these aggressive thoughts. These are then subconsciously activated and reinforced when individuals are exposed to violent entertainment. Thus, remembering a character because they are violent may be associated with having real-life violent role models, which are interconnected with the offender’s aggressive thoughts and feelings, activated by the film. The Browne and Pennell (1998) study certainly provides support for the concept of victims becoming offenders (when a person who has been victimized during their life then goes on to victimise others) and highlights the association of violence in the home with violent film preferences. There was a higher proportion of violent offenders than non-violent offenders or non-offenders who had suffered violence from both their parents and who had more often responded with aggression to their parents. Non-violent offenders were more likely to have suffered violence from their fathers or stepfathers but less often from their mothers. Nonoffenders witnessed and suffered family violence from both parental figures less often than the other two groups. However, it has to be remembered that not all people from violent homes turn into offenders. Indeed, for some people, this early victimisation can lead to a lifetime of vulnerability and victimisation inside and outside the home environment where it first started. Only one in six people from a violent family goes on to offend (Widom, 1989c) and other components such as the lack of angry temperament or attachment to high moral standards may act as protective factors (Falshaw, Browne and Hollin, 1996). Browne and Pennell (1998) argue that when factors associated with offending, such as growing up in a violent family, aggressive personality, distorted cognitions about conflict resolution, lack of empathy and morals, are present in an individual, a liking of violent films can distin­ guish those who commit offences. In view of the possible link between a preference for violent videos and crime, it is surprising that there are no recommendations or regulations concerning the videos viewed by young offenders within secure institu­ tions. Indeed, Browne and Pennell’s (1998) research has shown that there is some evidence for those under the age of 18 viewing Certificate 18 films while in secure accommodation. For those oriented towards violent action, even films appropriate for their age should be further censored, in recognition that this is a

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vulnerable group. It could be argued that we are taking the most violent individuals in society and placing them in situations where their manage­ ment and control is based partly on video film entertainment, which may in turn reinforce their violent tendencies. This experience may contradict any progress made on an anger management programme in these institu­ tions. The findings of the Browne and Pennell (1998) study support the notion that individuals from violent backgrounds are more vulnerable to offending behaviour and have a preference for violent films, but this may be modified by personality and moral values. Therefore, the theoretical model shown in Figure 10.1 is proposed. Figure 10.1 is based on the findings that a history of family violence, distorted thoughts about physical confrontation, low empathy and poor moral development are associated directly or indirectly with offending and a preference for violent films. It is argued that, as a result of a young person growing up in a violent family, they are more likely to witness, be victims of and perpetrate aggressive acts after seeing real violence in the home environment. The victim-to-offender concept as a consequence of childhood physical and emotional maltreatment is well established (Browne, 1993; Browne and Herbert, 1997). However, as discussed above, not all victims become offenders, partly because of personality characteris­ tics, such as temperament and moral development, that provide a protec­ tive barrier for them. Growing up in a violent family

Distorted ideas about physical confrontation

Low empathy and moral values

Offending behaviour

Preference for violent film

Aggressive temperament Feedback of positive reinforcements for violence

Highly significant association Significant association Postulated association

Figure 10.1: A tentative model for the development of preferences for violent film.

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In contrast to Huesmann et al. (1984, 1986), who propose that viewing violent television is a precursor to violent behaviour, the opposite is proposed: that the well-established link between poor social background and delinquent behaviour (Farrington, 1995) may be extended to the development of a preference for violent film. This in turn reinforces distorted cognitions about conflict resolution and responses to frustration.

Conclusion Clearly, current legislation on film censorship is not enough to protect vulnerable audiences from the potential effects of screen violence, as it has been shown that people (including young offenders in secure accom­ modation) do watch age-inappropriate films. Nor is it correct to say that reducing some aspects of violence in films will remove the problem as this fails to take account of the fact that some young people look at the violent scenes in isolation from the overall story-line. Rather than the whole film being viewed in real time, as at the cinema, violent scenes may be played over and over again or freeze-framed, and non-violent scenes fast-forwarded to the next violent episode. Thus, violent imagery may often be seen out of context and the consequences of such violence not observed. It appears that the key role is played by the family, as this seems to be the starting place for offending behaviour and a preference for film violence. There is a path from having a violent home life, to being an offender, to being more likely to prefer violent films. This is associated with cognitive distortions and low moral development, which may act as enhancers when present and protective mechanisms when absent. Perhaps one way to limit the effects of film violence is to reduce the preva­ lence of family violence and weaken the development of distorted cogni­ tions and low moral values for those individuals involved. In addition, critical viewing skills for violent imagery need to be promoted to enable individuals with distorted cognitions about violence to understand the various concepts behind what they are watching – for example, that the violence portrayed is distinct from real violence and that the impact on the victim is often very unrealistic and underplayed. Previous research has suggested that viewing violent television is a precursor to violent behaviour. In contrast, the Home Office Research Study by Browne and Pennell (1998) suggests that the well-established link between poor social background and delinquent behaviour extends to the development of a preference for violent films. This, in turn, may reinforce distorted perceptions about appropriate means of resolving conflict and responding to frustration and provocation. Their research

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highlights the importance of family background and the offender’s own personality and thoughts in determining the effects of film violence. Thus, contemporary research confirms that video film violence is seen differently by young offenders, especially those from violent homes. Offenders were more likely to prefer actors who typically play characters whose use of severe violence appears positive and successful – a dangerous role model for young people, particularly those predisposed to crime and delinquency.

CHAPTER 11

Comparing Studies of Youth and Violence: Towards an Integrated Approach STEPHEN PARVEZ RASHID This chapter considers the complex relationships between youthful violence and the social and cultural settings in which it occurs. It reviews a range of approaches to the subject, through an examination of four recent studies, each undertaken in a different country. The piece discusses the varied theoretical and methodological assumptions which underpin these studies, and concludes by advocating a more integrated research approach to the investigation of a multi-faceted phenomenon which is now manifesting itself on a global scale.

Approaches to understanding the problem At least four theoretical approaches can usefully be distinguished in understanding the phenomena surrounding youth and violence. These may be loosely characterised as the psychological, the sociological, the anthropological and the historical. None of these is self-contained; indeed, they often overlap, and subsume a range of other approaches. Frequently, however, studies will implicitly give preference to one over another. • The psychological heading, perhaps more than any other, contains a diversity of perspectives, which may include the study of parent–child relationships from a variety of theoretical positions, of attachment patterns and of child-rearing methods. All of these have in common an underlying assumption that experiences and relationships early in life have a significant impact on later behaviour (e.g. Barbaree, Marshall and McCormick, 1998). By implication, from such viewpoints, youthful violence may be traced to difficulties in early childhood. The focus of many of these psychological perspectives is on intra-familial relation­ 169

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ships, so that the significance of wider social factors may be under­ played. • The sociological approach, by contrast, pays far more attention to those wider social factors, which include the economic and the polit­ ical. The role of social structures, of concepts of disadvantage, depriva­ tion and discrimination, of the notion of ‘underclass’, in seeking to understand why adolescents from particular social and ethnic groups are over-represented in criminal statistics on violence and most other categories of crime, again indicates a different construct for addressing the problem (Stewart, Smith and Stewart, 1994). • The anthropological approach has focused on the ways in which different societies have marked the transitions from childhood through adolescence to adulthood. It has encompassed the study of physiolog­ ical influences as well as the psychological interest in child-rearing patterns in attempting to interpret the development of adolescents in different societies. Recent interest in cultural psychology has informed the anthropological effort to explain ways in which different societies conceptualise various issues. For example, in child development, Japanese researchers have sought to incorporate the culture-specific concept of amae, as formulated by Takeo Doi, into their understanding of attachment patterns in Japanese society. (Miyake et al., 1985; see also Rashid, 1996). • The historical approach advocates that attitudes and behaviours within particular societies cannot be understood without an appreciation of the context, which has shaped perceptions within that society. In societies marked by violent conflict, these historical factors, and the ways in which they are perceived, may be crucial for making sense of behaviours and attitudes. De Zulueta (1993), for example, describes oppression of Serbian groups by the Ottoman Army and, much later, by Croatians, which helps to explain the present-day attitudes of the Serbs of the Vojna Krajina towards other ethnic groups. This, in turn, provides a context for children of both sexes being schooled in weaponry at an early age, the consequent ‘cult of the gun’ and an overall climate of violence. In these circumstances, it is argued, the roots of violence as it is lived in the present will be found in the events of the past. The focus now turns to four recent studies of youth and violence, which provide examples of the extent to which different theoretical approaches are employed in order to generate exploration and explana­ tion in this complex field.

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Four studies of youth and violence These four studies have been selected on the basis that they represent studies of youth and violence from sharply contrasting social settings. • The first is a longitudinal study of Dutch adolescents who had been arrested for serious offences (Scholte, 1999), and it endeavours to identify factors which predict continued violence into young adult­ hood. • The second is a study of aggression among delinquent adolescents in north-western Russia (Ruchkin, Eisemann and Hägglöf, 1998), which explores the role of social factors in the aetiology of aggression. • The third study examines the violence which surrounds a population of high-school youth in inner-city New York (Moses, 1999) and explores the relationship between exposure to violence and symptoms of depression and hostility. • The fourth item to be considered is rather different, in that it does not take the form of an academic paper. Instead it is a volume of essays from South Africa, which emerged from the Goldstone Commission’s inquiry into the impact of public violence (i.e. day-to-day violence emanating from political policy) on children during and since the apartheid years, when violence against the majority population was part of a strategy to maintain white minority rule (Rock, 1997). These four studies differ from each other in their focus, their method­ ology, their findings and the attention they pay to the cultural factors which distinguish them. Their theoretical emphases are sometimes similar, sometimes different and, at other times, interlocking. They merit careful consideration, since each gives rise to different questions and offers partic­ ular insights, from which a more comprehensive picture can be constructed.

The Dutch study: Den Haag Scholte’s (1999) study is entitled ‘Factors predicting continued violence into young adulthood’. Notable amongst these factors are previous delin­ quency (undefined), parental control and support, all of which receive extensive coverage in the study. The study is predicated upon the assump­ tion, perhaps a cultural norm or belief, about the passage of adolescents to young adulthood. ‘As this transition takes place in the family, we primarily focused upon family factors’ (Scholte, 1999:4) Clearly this assumption would not be true for all societies, nor even for some individuals within the author’s own society.

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The research was based on a random sample of 150 Dutch juveniles who were in contact with the police department at The Hague in 1984. The mean age was 14.6 years and three-quarters were male. The sample was followed up in 1985 and in 1991, when the response rate was 80% and 77% respectively. The juveniles were interviewed and their answers were used to establish psychosocial measures under the following headings: • • • • •

perceived control of juveniles by their parents; perceived support of juveniles by parents perceived family conflict; perceived deviancy of peers self-reported delinquency.

Despite the stated research title, however, the distinction between violent and non-violent offending under the delinquency umbrella was never made clear, at least in the published account. In the sample of arrested youth, about three-quarters admitted to delin­ quent acts during adolescence, over twice the rate for Dutch adolescents generally. By the time they reached adulthood, about one-third were reporting offending behaviour. This suggested to Scholte that, amongst the arrested youth, two-thirds were ‘adolescence limited’ offenders, but one-third were ‘life-course-persistent’ offenders, a distinction attributed to Moffit (1993). Males were more likely to fall into the second of these two categories. A cross-sectional analysis led to the conclusion that ‘a perceived lack of parental supervision and the perceived deviancy of peers were major risk factors for the delinquency of the arrested juveniles in the adolescent years’ (Scholte, 1999:15). However, since cross-sectional correlates do not imply causal connections, it was not possible to discern whether lack of parental supervision led to delinquency or vice versa. In order to identify factors predictive of continued violence into adulthood, Scholte prospectively related family rearing conditions and the perception of deviant peers to delinquency at the onset of adulthood. This revealed two important findings: • firstly that more serious delinquent behaviour during adolescence led to a continuation of delinquent behaviour in early adulthood • secondly that an increase in perceived parental control, allied to a decrease in perceived parental support in adolescence, was linked with subsequent delinquency in early adulthood. The author regarded this latter finding as support for evidence from earlier studies that ‘highly restrictive and (emotionally) cool parenting

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heightens the risk for serious developmental psychopathology at adult­ hood’ (Scholte, 1999:15). It was noted, however, that there was also some association between lax parenting and continued delinquency. This apparent contradiction may be explained by curvilinear theories (Stice, Barrerra and Chassin, 1993), suggesting that each may act as a separate mechanism which heightens the risk of persistent psychopathology thoughout life. Scholte concluded that these findings should make it possible to distin­ guish between Moffit’s (1993) two categories of ‘adolescence-limited’ offenders, who merit less serious interventions, and ‘life-course-persistent’ offenders, who represent a considerable challenge to professionals. In his view, the links between the latter category and certain forms of child-rearing raise the possibility of preventive work with families which are very restrictive and emotionally cool, as well as with those where parental supervision is extremely lax. From the foregoing, it is clear that Scholte’s work falls very much within the psychological approach. No attention is paid to such matters as socio­ economic status or social disadvantage. There is no discussion surrounding the finding that males are more likely than females to become ‘life-course-persistent’ offenders. The causes of parental stress, to which passing reference is made, are not explored or seen as relevant to the situation. The roots of restrictive and emotionally cool parenting appear to lie within the family, which is seen as insulated from, or independent of, the wider society in which it is located. Cultural factors are not discussed and Dutch society, in which the study takes place, is not characterised in any way. The writing gives the impression that the assumptions and findings of the study will be universally relevant. This is surprising because, in his work on stigma and comparative welfare services (Scholte et al., 1999) he has shown an awareness of cultural factors, describing Dutch society in the following terms: Holland is a relatively rich trade country with a social democratic tradition and Calvinistic roots. Its economic resources are quite extensive, so that economic deprivation is less often a cause of family problems than in less fortunate countries. The scale and scope of its welfare provision are also quite extensive, but the strong Calvinistic ideology leads citizens to believe that they themselves are primarily to blame when things go wrong in social life. (Scholte et al., 1999:390)

Examination both of the structural dimension of relative economic wealth and of the cultural dimension of a ‘strong Calvinistic ideology’ would undoubtedly have been of relevance to these self-reporting delin­ quents, to their families and to the intra-familial interactions studied by

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Scholte. It would almost certainly have widened the perspectives of under­ standing of the antecedents of youthful violence in this setting.

The Russian study: Arkhangelsk Conducted by Ruchkin, Eisemann and Hägglöf (1998), the Russian study is entitled ‘Aggression in delinquent adolescents versus controls: the role of parental rearing’. In contrast to the Dutch study described above, it opens with a brief account of the major social upheavals within the former Soviet Union over the past decade, and their devastating impact on the life and health of the Russian population. The study covers the Arkhangelsk region of north-western Russia, where geographical remoteness and the extremely severe climate further exacerbate problems of daily living. It forms part of a wider research project on juvenile male criminality and has a strong clinical focus. It is particularly interesting because it is set in a society undergoing major social changes, which include ‘a dramatic increase in all types of violent crime . . . the total amount of crimes in the Arkhangelsk region . . . since 1991 has more than doubled’ (Ruchkin, Eisemann and Hägglöf, 1998:276). As for crimes committed by adolescents in the region, the authors reported that in the years 1995–97 inclusive, the rate had fluctuated. Twothirds of the reported crime involved theft, then come robbery and ‘hooli­ ganism’, a term for antisocial behaviour from the Russian penal code. The authors noted that violent crime (undefined) by adolescents had increased relative to other crimes in recent years and also that nearly half of the adolescents involved in crime were neither employed nor involved in studying. They acknowledged that the very difficult socio-economic situation had contributed to the increase in crime but, like Scholte, their interest was in the impact of family environment on adolescents who committed crime: they cited the findings of social-learning theorists (Bandura and Walters, 1963; Bandura, 1973a) and patterns of learned aggression across generations in support of their approach. In their study, Ruchkin, Eisemann and Hägglöf sought to explore the links between parental rearing and aggression in 192 delinquent male adolescents detained in the juvenile correction centre for the Arkhangelsk region. The nature of their delinquency unfortunately remained undefined, but may be assumed to have included some violent offences. A group of 108 male adolescents at school acted as controls. The former were slightly older (mean age 16.6 years) than the latter (mean age 15 years). Adolescents from single-parent families were excluded from both groups. Three instruments were used in this study: the Aggression Questionnaire, developed by Buss and Perry (1992); the EMBU inventory,

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developed by Perris et al. (1980), which assesses the subjects’ own memories of perceived parental rearing behaviour; the Marlowe–Crowne Social Desirability Scale, developed by Crowne and Marlowe (1960). All these instruments were translated into Russian and were administered by Dr Ruchkin. The possible impact of language translation and cultural transfer upon the young people’s interpretations of these documents was not, however, discussed. The authors found that the delinquent adolescents scored significantly more highly than the control group on all parts of the Aggression Questionnaire, namely on the subscales for hostility, anger, verbal aggres­ sion and physical aggression. The EMBU inventory showed that the delin­ quent group scored significantly more highly than the controls on rejection, on overprotection from both parents and on maternal emotional warmth. Furthermore they found that, for the delinquent adolescents, hostility correlated with parental rejection and lack of paternal emotional warmth, whereas for controls it was associated with maternal rejection and lack of paternal emotional warmth. Multiple regression analysis showed that for delinquents most of the aggression scores were related to paternal rejection. By contrast, in the control group, hostility and anger were related to maternal rejection, verbal aggression to lack of paternal emotional warmth, and physical aggression to both maternal rejection and lack of paternal emotional warmth. The authors concluded that parental rejection, as described in the EMBU, might have contributed to the development of hostile attitudes. They noted that, for the delinquents, the fathers’ role predominated, whereas for the controls, the mothers’ role was more pronounced. They attributed the correlations between paternal rejection and aggression scores among the delinquents to rejective rearing practices by fathers. Finally they concurred with comments by Conger et al. (1994) on the importance of the relationship between parental economic stress and hostility towards their children, thus increasing adolescent emotional and behavioural problems. Given the emphasis by the authors in the introduction to their study on the dire economic position of Russian families over the past decade, it would seem particularly important to have explored the impact of such factors on delinquent adolescent behaviour. It might be expected that single-parent families, who were excluded from this study, would have found problems of poverty and associated stress even more significant. Evidence from Harwin (1996), writing on Russian child welfare generally, suggests that increased poverty and the stresses associated with it since the end of communism have led to the rediscovery of the ‘social orphan’ and to the breakup of families. There would certainly be scope for explo­

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ration of the impact of these structural factors in the wider study to be conducted by these authors. This research may be regarded as another example of an intra-familial study. Like the Dutch work, it fails to make proper distinctions between violent and non-violent delinquency but, unlike it, includes social and economic factors as a backdrop. Thus wider social issues are acknowl­ edged as relevant but not integrated in the attempt to explain behaviour. This study portrays a civil society in crisis, which leads to the question of whether the increase in crime generally, and violent crime in particular, is the root or the fruit of conflict. The authors do not discuss their findings about the relative importance of maternal and paternal rejection in the context of Russian family traditions or of the Soviet legacy and, conse­ quently, historical and cultural dimensions to their investigations are lacking.

The American study: New York The third study, ‘Exposure to violence, depression and hostility in a sample of inner-city high-school youth’, is based in New York. Here, Moses (1999) was concerned to establish the prevalence of violence in a popula­ tion of public high-school youth, the impact of their exposure to violence and demographic differences in exposure to and effects of that violence. In her review of the literature, Moses noted the considerable body of evidence showing that violence was a regular feature in the lives of American inner-city youth. This was often linked with drug- and gang-related crime, with males being especially vulnerable. Firearms-related deaths were described as the second most common form of death for all 15–19 year olds, and African-American males aged 15–24 were found to be seven times more likely to be murdered than their white counterparts (Fingerhut and Kleinman, 1990). Moses supported the view of earlier researchers that this situation is significantly related to problems endemic to the inner city, such as poverty, the drug trade, and the growth of gang membership. She also considered the findings of a large-scale survey of 3735 adolescents from inner-city and suburban publicly funded schools, conducted by Singer (1994). This research found alarmingly high rates of exposure to violence amongst inner-city youth; 50% of them, for example, had witnessed at least one shooting in the past year. Singer as well as DuRant et al. (1994, 1995) had also found that exposure to violence was significantly associated with depression and anger. Being female and witnessing violence in the home were regarded as most predictive of distress. The New York public high school studied by Moses was one to which students commuted from predominantly low-status socio-economic

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neighbourhoods; 337 students, aged 14–19, took part. The overwhelming majority of the sample was African-American (44.5%) or Hispanic (50.9 %), the remainder being of either Asian or multi-ethnic origin. Female students were in the majority (62%). The study data were collected by means of a questionnaire completed by the students. This included questions about gender, ethnicity and age, but not about socio-economic status, since school statistics consistently showed that all pupils came from the lowest rung of the socio-economic ladder. Exposure to violence was gauged by the responses to questions about six violent events: witnessing the shooting of a family member; of a friend; of a stranger; experiencing rape; being shot or stabbed; being beaten up or ‘jumped’ (i.e. ambushed). Subscales from the Symptoms Checklist 90, devised by Derogatis (1979), were used to measure depres­ sion and hostility. Moses reported that nearly two-thirds of the sample (62.9%) had witnessed a lifetime average of 3.41 of the types of violence listed; nearly 38% witnessed none of them. Males reported significantly more exposure to violence than females, with the exceptions of rape and of violence against family members. About 14% of female students reported at least one rape in their lifetimes. Moses considered that this was likely to be an underestimate, since there were, for example, several female students who had not indicated a history of rape on the quantitative portion of the survey, but went on to describe sexually abusive situations on the back page. Black students were more likely than Hispanic students to have witnessed violence against family members and to have been raped. When the distress symptoms of depression and hostility were correlated with exposure to violence, Moses found that depression scores were associated with witnessing violence against family members and with being raped. By contrast, hostility scores were associated with all the variables, except for witnessing violence against strangers. Moses commented that this latter finding was worrying, since it suggested that these adolescents had become desensitised to violence in adjusting to their environment. In effect, unless it directly affected their world, it ceased to have an impact. Although recognising that this may have constituted a useful short-term coping mechanism, Moses expressed concern about its impact on emotional development into adulthood. She also reported that in focus groups and written responses, the students indicated that witnessing and experiencing violence made them depressed, angry and often violent themselves. It is a pity that existing research findings about the links between witnessing or experiencing violence and becoming violent as an adolescent or young adult (e.g. Widom, 1989a,b,c; De Zulueta, 1993) were

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not further explored here, especially in the light of Moses’ very significant summary of her findings: Students in the sample were exposed to an inordinate amount of violence . . . Witnessing and experiencing violence was an extremely common event. (Moses, 1999:27)

Moses’ study contains other limitations, such as the non-random nature of the sample and the reliance on recollection and self-report. Nevertheless, it provides a picture of a sub-cultural group, distinguished by ethnic minority and low socio-economic status, which inhabits a world where violence is common and has a very significant impact on the lives of young people. Her study raises the fundamental question of how children and young people can develop normally and non-violently in environ­ ments which developmental psychologists would regard as abnormal. Further attention to the cultural ‘risk’ and ‘protective’ factors within the ethnic groupings studied would also, perhaps, have provided a key to a deeper understanding of this complex issue.

The South African study: Spirals of Suffering This volume of papers edited by Rock sets out in considerable detail the impact of political violence on black children in South Africa during the apartheid years and into the post-apartheid period. It arose from the work of the Goldstone Commission of Inquiry Regarding the Prevention of Public Violence and Intimidation, which was set up in 1991 and reported in 1994. A major part of its work focused on the experience of children, especially since 1976, when children and adolescents in Soweto and other black townships rebelled against the imposition of Afrikaans as the language of instruction in their schools. This was met with increasing levels of repression from the state authorities and thus began a lengthy period of escalating violence, forming one of the ‘spirals of suffering’ prompting the title of the book. The consequences of that period remain within current South African society, in the form of continuing violence, often by young people and adults who have been traumatised by past violence. The authors recognise that: the state of South African society today is a direct consequence of the tyranny of apartheid with its origins in colonial rule beginning centuries ago; and two generations, let alone three years are needed to right the wrongs it fomented and perpetuated. (Rock, 1997:2)

Placing the problems of violence in contemporary South African society in a historical and political context was a major theme of the papers in this

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volume. This was true for detailed accounts of working with traumatised children (Miller, 1997), and for discussions about the presentation of post­ traumatic stress in children (Eagle and Michelson, 1997), as well as for the more wide-ranging surveys of political and community violence. Several South African studies, which were scrutinised by the Goldstone Commission, showed that ‘children traumatised by public violence typically exhibit symptoms ranging from extreme anger, fear and shock to debilitating helplessness and despondency’ (Duncan and Rock, 1997:2). Dawes and Tredoux (1990) found that some 9% of children in their study could be diagnosed with serious conditions, ranging from conduct disorder to post-traumatic stress disorder (PTSD). Duncan and Rock considered this to be a conservative estimate of the number of children traumatised by political violence in South Africa since, often, symptoms were likely to emerge several years after the exposure to violence. In their overview, the editors cited a common finding from several studies that ‘the more frequently children are exposed to acts of violence the more likely it becomes for them to begin perpetrating acts of violence’ (Duncan and Rock, 1997:32). They noted that children and adolescents were increasingly primary perpetrators in acts of public violence, such as ‘necklacing’ (the killing or serious maiming of individuals by placing a rubber tyre doused with petrol round the neck and setting it alight) and the murder of political opponents. One consequence of public and polit­ ical violence, reported by the authors, is the detrimental impact on health and social services for children. The overview concludes with reference to the four assumptions on which the Goldstone Report was based (Duncan and Rock, 1997:36–7). In summary, these are: 1 Political violence has a negative effect on, or undermines, the optimal development of children. 2 The high levels of violence which have dominated the South African socio-political landscape are primarily a function of past and present political, social and economic policies, rather than of intra-individual factors as is frequently assumed. Thus, interventions will be effective only if socio-political transformation and economic change accompany them. 3 Children do not exist in a vacuum but rely on their relationships with other people and social structures for physical and emotional support. If these supports are in any way compromised, children suffer. Studies by Setiloane (1991) and Letlaka (1990) are cited to argue that the loss of primary caregivers through public violence is particularly damaging for young children, and that such children frequently experience diffi­ culty in developing trust towards others and the world at large.

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4 The way in which traumatic events will be experienced will inevitably vary, and will not necessarily follow a predictable sequence. This list of assumptions provides a clear indication of the combination of psychological, sociological (notably political) and historical perspec­ tives underlying the theoretical starting point for Spirals of Suffering, which places it at odds with the three academic papers reviewed earlier. Assumptions 1 and 2 relate very clearly to the influence of the historical and political approaches. Although the need for this macro-approach is arguably more apparent in South Africa, it is nevertheless in marked contrast to the intra-familial approaches adopted by the Dutch and Russian studies, both in terms of explanation and in terms of the focus for intervention. Assumption 3 is consistent with attachment theory but adds the dimension of public violence. Assumption 4 invokes the psychological approach by suggesting that, even where the course of events is wholly outside the control of the individual, each person’s response to these events will be different and potentially lead to its own manifestations. This is perhaps the point at which further examination of the influences of cultural factors integrated into the respective behaviours, attitudes and lifestyles of white, ‘coloured’ and black people in South Africa could have enhanced the quality of data available to researchers.

Discussion Some of the differences in the theoretical and methodological content of these studies have already been noted, but it is worth bringing them together for further discussion. • First, it is noteworthy that no definition of violence is common to the four studies. The Dutch and Russian studies do not define it at all, appearing to view it as a self-explanatory term. The Russian study does not seek to distinguish the notion of violence from the notion of aggression highlighted in its title. The American study is very clear about the forms of violence under discussion. The South African study gives examples, especially of public violence, but also states emphati­ cally that violence defies categorisation. It is likely that cultural and linguistic understandings of the phenomenon vary but, since they are not made explicit, the reader’s interpretations of the findings may be flawed or incomplete. • Secondly, the studies differ in methodology. Scholte’s is a longitudinal study, which combines official records with interviews, from which the measures in which he is interested are derived. The Arkhangelsk study

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is the only one to use a control group and it relies on questionnaires, adapted from the existing research literature. Moses’ research relies on self-report questionnaires, administered on a particular day at a partic­ ular school in inner-city New York. The South African volume is a compilation of findings, submitted to the Goldstone Commission, together with more general essays, and also particular accounts of practice, which include case examples. It is also possible, though not explicit, that each of the researchers’ choices of methods reflect cultural research preferences, or cultural understandings of how best to elicit responses from particular sample populations. Cross-linguistic interpretation is a further issue to take into account here. • Thirdly, the focus of the studies is also different. The Dutch and Russian researchers focus on intra-familial issues for clinical intervention. Although Moses also places her findings in the context of clinical inter­ vention, the focus of her research is more community based. The major focus of Rock and his colleagues is societal and is informed by political and historical analysis. At the same time it includes examples of community based and clinical interventions. Again, it is possible that these foci reflect cultural traditions and assumptions and contain cultural ingredients which are not, at present, discernible. • Fourthly, the studies draw on different theoretical orientations. Scholte’s reliance on family factors related to delinquency appears to derive from attachment and associated child development theories. Ruchkin, Eisemann and Hägglöf draw explicitly on research from the tradition of social-learning theory. Given the Russian context and the predominance of behavioural approaches to psychology in the former Soviet Union, this is not surprising. Moses’ study, and the range of other research upon which she draws, appear to reflect a variety of psychosocial perspectives. Rock and his contributors make use of a wide range of theoretical approaches. These include: attachment theory; the work of Langer (1989), which combines both psychoanalyt­ ical and political insights; the theory of PTSD and its methodological adaptations in group and community work with traumatised children and other survivors of political violence. It is of note, however, that neither this nor any of the other studies makes reference to anthropo­ logical perspectives. • Finally, issues of gender and ethnicity are considered unevenly across the four studies. Scholte makes some reference to gender, which he does not explore, and none to ethnicity. His account does not give the reader any sense that Dutch society is multiracial and multi-ethnic. The Archangelsk study deals only with male delinquents. It notes differ­ ences between paternal and maternal influences amongst delinquent

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adolescents and the control group, but seeks no explanations. Ethnicity is not mentioned. Moses does discuss ethnicity and gender explicitly. Rock and his contributors are not consistent in addressing these issues. Again, any consideration of these factors under an anthropological/cultural umbrella is missing.

Conclusion Although the four studies that have been examined here are not in any way representative of research investigations of youth and violence across the international range, they do provide some important pointers for a greater understanding of this problem in a world context. They demonstrate that definitions of phenomena under study may be assumed rather than made explicit. They show that that no one broad theoretical approach adequately provides a full picture of the antecedents of youthful violence, although each offers insights and explanations at a particular level. One gives particular credence to the historical approach, all incorporate psychosocial factors, but none affords serious consideration to anthropo­ logical ingredients, notably the cultural variations which might begin to help make sense of the phenomenon of youthful violence in a global context. Cross-cultural studies are complex, and often limited in the success of their application (e.g. Hartman et al., 1999) but more work needs to be undertaken in this field if the place of tradition, language and symbols, now fast transmitting themselves across multiracial nations, is to be properly understood (Brah, 1996). It is, perhaps, natural that the acquisition of knowledge derived from a particular form of professional training or academic discipline, and within a specific country or culture, may lead to a preference for seeking a level of explanation which relates to that knowledge. This is an issue for crossdisciplinary work in general, but the more complex the phenomenon under study, the more important it becomes. The challenge facing acade­ mics and professionals here is to find ways to integrate these different approaches to seeking explanation, not just for the sake of theoretical completeness but in order effectively to address and prevent the growing problem of violence in young people across the world.

CHAPTER 12

Bulger and Beyond: Asking the Question ‘Why?’

DAVID JAMES SMITH The Bulger case Before asking the question ‘why?’, it may be worth stopping to consider another question: ‘who wants to know?’ As anyone who works with or cares for children will recognise, at a certain age they are, most of them, persistent in their search for explana­ tions. They do not shy from tricky issues such as death, sex or the break­ down of relationships. They are seekers of knowledge and understanding and the question ‘why?’ often seems uppermost in their minds. When the tables are turned, of course, they will suddenly become much less curious. When asked to explain an action or mood or a pattern of behaviour of their own, they may look at the floor or study the ceiling and say nothing or say, ‘I don’t know’ or ‘it wasn’t me’. They may not yet have a language to articulate such things, they may find the question discomfiting, or the feelings it arouses uncomfortable. Essentially, perhaps, they are avoiding the question because it is about them, it is too personal. You could have observed similar floor and ceiling routines among the adult population in the spring of 1993, after James Bulger was killed in Liverpool by two 10-year-old boys. Though by no means a one-off in terms of the crime committed and the age of the defendants, the case was, certainly, unique in its impact, in the publicity that was provoked and the attention focused upon it. There was a sense in which the wider commu­ nity wanted an explanation, an answer to the question, why did they do it? Yet for all the talk of soul-searching, there was a sense, too, that the question was rhetorical, that any plausible or realistic answer was not wanted, could not be dealt with, perhaps because it was too close for comfort, not just because of what it might say about the two boys but because of its implications for us all. It was easier, by far, to dismiss the two 183

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boys, push them away, outside our frame of reference, beyond our communal boundaries. At best they were psychopaths, at worst they were, literally, little devils, monsters, demons, born evil, ‘evil bastards’, born to kill. Hanging would be too good for them, as any self-respecting radio talkshow contributor could tell the listeners. The victim of the crime, who was not quite 3 years old, and had always been known to his parents and family as James, became ‘Jamie’ to most of the media. It was as if his identity had been appropriated, and, thus senti­ mentalised, he came to embody a kind of angelic innocence, his muchpublished image a sharp counterpoint to that of the two boys. One of the policemen who dealt with the case was reported to have said of one of the boys that he had looked into his eyes and seen evil. This was what people seemed to want or need to hear. Who wanted to hear that these two boys might themselves have suffered in their short lives? That this suffering might in some way be linked to the terrible crime they had committed? That, by virtue of their age, their lack of maturity and development, they seemed to be the living proof of the theory that violent offending behaviour has its origins in childhood experience. This was no-go territory for many commentators and the wider public. Such notions could not be considered as an expla­ nation but were, rather, an attempt to excuse the inexcusable. The editor of one national broadsheet newspaper said to the author, in the course of one of many ‘why?’ discussions which followed a familiar pattern, ‘yes, but plenty of people get abused as children – they don’t all go out and murder someone’. As an observation this was unarguable. Still, you could flip that around, and make the point that what was truly remark­ able then was not that such cases occurred, from time to time, but that they did not occur more often. Meanwhile, modern armies of counsellors, social workers, psychiatrists, psychologists, teachers, doctors, even policemen, could be called to testify to the myriad ways in which child­ hood experiences of abuse, loss, damage in all their forms might make themselves known to the victim, perhaps creating other victims in turn, in later life. In their grief, one could readily understand the hatred that the parents and wider family of James Bulger felt, and often publicly expressed, towards the two boys. Yet the mood of the wider community seemed hostile and vengeful too. The two boys seemed to be the focus of a collec­ tive anger, to such an extent that it seemed a reflection of our own failings rather than theirs. In this atmosphere, the boys advanced into the criminal justice process which would determine their lives for many years to come, at least into early adulthood. Here too there was no room for the question ‘why?’ – no

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consideration, in court during their trial, of the reasons why they might have committed such an act. There was some irony in this, an unhappy paradox, because for these two boys the court was the gateway to a prison system which would demand of them that they answer, and demonstrably understand the answer to, that very question. The system – the Department of Health, the Prison Service, the Home Office – would invest considerable resources, the expertise of highly trained staff in secure units, the services of specialist psychiatrists, to encourage and assist the two boys to reach this understanding. The deployment of these people, it could be argued, was a clear acknowledgement that ‘the system’ recog­ nised that the two boys were in grave need of help and would benefit from it. Society was being helped too because the boys could eventually be reintegrated with the minimum of risk that they might re-offend. But this was at the back-end of the process which began with a trial. It seemed that the hind legs of the donkey had got ahead of the front legs. At the front, in court, there was little or no interest in the boys’ welfare, no recognition of the help that might be needed. It was a double-bind too, because the absence of any such consideration during the trial meant that the boys had to be kept well away from any psychiatrists who might, in the course of their work, have prompted admissions that could undermine the boys’ defences. In their denial of what they had done, both boys told their solicitors they were innocent of the crime. The solicitors, challenged with taking directions from 10-year-old clients – another absurdity of the process – had no option but to enter pleas of not guilty. It was not for them to say, ‘Now come on, son, we know you did it really’. Although there might have been a case to argue for manslaughter on the grounds of diminished responsibility, the boys were adamant that they had not committed the crime and, in any event, neither would counte­ nance the idea that he was, as one of the two put it, ‘a nutter’. So the boys were prevented from receiving any initial counselling which might have warded off the effects of post-traumatic stress disorder and which might have made early incursions along the road leading to the answers to that big question. They were, in a very real sense, locked into their denials. One of the two was told, on arrival at his first unit after he had been charged, to tell others he had been arrested for ‘twoccing’, that is, taking a vehicle without consent. This advice, on the face of it, was for his own protection, but perhaps it was given with the smooth running of the estab­ lishment in mind too. Certainly, it is hard to see how this further encour­ agement to deny was best for the boy’s emotional well-being. In the event, both boys had limited interaction with psychiatrists before their trial. Although one boy had seen a psychiatrist for the supposed benefit of his defence, both psychiatrists ended up appearing as expert

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witnesses for the prosecution (and against the boys) to shore up the Crown’s rebuttal of the (recently abolished) ‘doli incapax’ assumption that children of that age do not know right from wrong .The appearance of the psychiatrists, which took up 20 minutes of the 17-day trial, was the only moment when the court showed any interest in the boys’ mental health. At the end of the trial, after the boys had been found guilty of murder and sentenced to be detained during Her Majesty’s Pleasure, indefinitely, under Section 53 of the Children and Young Persons Act 1933, the judge addressed the court to the effect that he suspected that ‘exposure to violent video films’ might in part have been an explanation for their crime. Though the police had collected some evidence that one of the boys had watched some violent videos, this had never been referred to in court and was not a part of the prosecution case against the boys. There was no evidence that either of the boys had ever watched the now notorious film Child’s Play 3 which depicted killing on a funfair train track. The judge’s comments seemed to fit the general mood and indeed to pander to it. Videos, surely, were a distraction from the true issues but perhaps it was, in some obscure way, comforting to people to think that the crime had arisen out of the watching of violent films. Here was something tangible for people to seize upon, a way of rationalising such a terrible and, for many, inexplicable crime. To a lay observer at the trial, such as myself, the judge’s comments appeared to be born of personal prejudice. Prejudice, in its various guises, informed a great deal of the commen­ tary around the case. There was prejudice against Liverpool, against the working classes, against children as ‘little hooligans’ of which these two were only the latest and most extreme examples. In a case where objective and cautious comment could do so much to further the public debate which quite properly surrounded it, the boys were heavily disadvantaged. One writer, with a considerable reputation for describing the criminal mind in books, had stood at the front of the public gallery one day and watched while the boys were being led downstairs from the dock. ‘He’s such a sweet boy, that one’, the writer had said, in my hearing. ‘That other one, he’s a little thug: the fatty.’ The ‘little thug’ was observed not to cry or show any emotion for most of the trial and this was often ascribed to his supposed psychopathic tendencies when, in fact, as I understood it, he was determined not to let himself down by exposing his feelings. Another writer of repute was said to have outlined a theory of what had caused the boys to kill to a colleague on the train north from London, on the way to begin research into the case. The pet theory would later be expounded in a lengthy article with limited supporting evidence. None of this could quite undermine the legitimate role which serious journalism and thoughtful commentary could play in presenting the case

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to the public and, in particular, in examining the lives and the states of mind of the two boys. This author attempted to do so for a variety of audiences (Smith 1994a,b, 1996). Inevitably, this kind of reporting could be intrusive and difficult for those involved. But – and I speak with a vested interest here – it could help to create a more sympathetic climate for the two boys and counter some of the excesses in the chorus of disap­ proval. Issues of privacy and disclosure pose great difficulties for anyone involved in reporting or writing about such cases. Children do, of course, have and deserve an absolute right to privacy. Yet the trial judge in the Bulger case allowed the two boys to be identified following their convic­ tion. He was under no obligation to explain his reasons and did not do so publicly, though my understanding at the time was that he felt the tide of publicity was unstoppable. Their names had already been disclosed in foreign publications over which the courts had no control, and to prevent the circulation of such publications in the UK was impractical if not impos­ sible. The judge was, however, careful to create restrictions that would prevent publicity regarding the boys’ future care and welfare. Putting names and faces to the crime they committed seemed to be one more notch in their public vilification. At the same time, once stripped of anonymity they could not be so readily dismissed, they became recognis­ ably human, a part of us, which was where they belonged. The public might not want to know but, with some encouragement, it might begin to look at the case from a more balanced perspective, it might begin to reflect on the nature of childhood and parenting, and the social stresses that impose themselves on families. Out of these considerations a climate of tolerance could begin to emerge in the society which these two boys would one day have to re-enter. No one could give the public a defin­ itive answer to the question ‘why?’. Not yet anyway, and maybe never. But any broadening of the debate must be constructive.

Beyond the Bulger case Following the death of James Bulger in 1993 the case was often referred to as ‘unique’ in terms of the ages of the defendants and the seriousness of their crime. In fact, though it is by no means commonplace, it had happened before and will, in all likelihood, happen again. Perhaps it is important to remember, too, that children are far more likely to be killed or harmed by adults they know than themselves to kill or harm. If there is a rare quality to the facts of the Bulger case it may be that the victim was not previously known to the two boys. There is, also, the possibility that the Bulger case is distinctive because it was a premeditated crime. There was some evidence of a previous attempt at abduction, but whether or not

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there was any formed intent to kill in advance of the abduction is still not known. In his book about children who kill, Patrick Wilson (1973) presented summaries of some 55 cases, going back over 200 years. In most of the cases cited by Wilson, the victim was known to the perpetrator, as playmate, friend, relative or, in a significant number of cases, as a child placed in their charge. It is worth observing that the vast majority of these cases pre-date the advent of violent videos or films or television programmes. In an attempt to update Wilson’s research in 1993, I uncovered some 15 further incidents, over the intervening twenty years, where children had killed in the UK (Smith, 1994a). There was no sugges­ tion in any of these cases, either, of a causal link with media depiction of violence. Publication of Wilson’s book was probably prompted by the contempo­ rary case of Mary Bell, which was the closest modern parallel to the Bulger case, though one is known by the name of the perpetrator and one by the name of the victim. Mary Bell killed two small boys aged 4 and 3 by stran­ gulation, one just before and one just after her 11th birthday in 1968. Mary Bell was diagnosed as having a psychopathic personality disorder and was convicted of manslaughter on the grounds of diminished responsibility. Her co-accused, a young girl who was 2 years older and had been present at both killings, was acquitted. Bell’s childhood seems to have been characterised by instability and some violence (Sereny, 1974; 1998). Her mother had been treated for psychiatric illness and spent long periods away from home. She was said to have once tried to give Mary away to a woman she met outside an adoption agency, who was distressed at being refused a child. Still, Mary was brought up in an area of north-east England marked by poverty, and was said not to have stood out in school as being particularly troubled, among so many other children with troubles of their own. The vast majority, if not quite all, of the killings catalogued by Wilson emerge out of such impoverished environments and, although being poor is hardly a predisposition to murder, it would be wrong to overlook the additional pressures it creates on families, parents and children. For instance, it seems self-evident that a child who creates or takes the opportunity to kill is acting outside the care and control of his parents or carers. Children of larger families, or children whose parents are busy working or otherwise preoccupied with the challenges life presents, are free, or freer, to roam; free, or freer, to make mischief or worse. There can be, and certainly was historically in some communities where children have killed, a culture of casual violence both inside and outside the home, plainly associated with the prevailing conditions of

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hardship and very often related to the consumption of alcohol, which is, of course, in itself, both a symptom and a cause of problems. There is a sense sometimes, for this writer at least, of the past bearing down upon the present and it is tempting to wonder what might be disclosed if it were possible to conduct a forensic examination of the lives of a violent child’s forebears, back across the generations, and, particularly, to what extent a far-reaching cycle of despair might reveal itself. This may not explain why children kill, but it helps to create a context in which the crimes can be considered – a context which, quite properly perhaps, roots the crimes firmly in the community where they took place. Of the half-dozen instances where children killed younger children in their care – the Bulger case being, in some ways, a tragic parody of these circumstances – all but one were young females and all but one were very young servants, and, no doubt, very cheap labour, in a family’s employ. Most of the cases date back to the 19th century and there is too little surviving detail to draw any reliable conclusions, but they share in common the potentially abusive, or at least unhealthy, relationship between an employer and an employee who is far too immature to have such a burden of responsibility as the care of small children. In one case, dating from 1881, a 13-year-old girl was hired out by her father at a fair to a couple with three children under 6, two of whom were dead within 4 weeks. The girl was the eldest of six and was said to have been obliged to take care of her siblings too, before being sent away from home to begin the new job, perhaps to aid the financial support of her own family. The girl was convicted of murder and sentenced to death, which was commuted to life imprisonment. Over 100 years later, in 1992, an 11-year-old girl killed a child she was babysitting, superficially because the child would not stop crying. How many adults, emotionally fully-formed, have been driven to the brink by the cries of babies? The girl was convicted of manslaughter. Such cases, involving children killing younger children who have been placed in their care, form part of a larger observable pattern – that, in the vast majority of cases, the victims of children who kill are younger. (Even in those cases where the victim is older, the victim is often somehow weaker, in one or two cases being elderly and frail, or in others a woman subjected to an assault by a male adolescent. In some cases the crime has been a joint enterprise, the perpetrator gaining strength as part of a group.) The most obvious point about this must be the power the older child can exert over the younger victim. Though the power implicit in the act is physical there must be, of course, an emotional element too. This ultimate abuse of power seems to suggest the extreme expression of some anger, frustration or distress which, in everyday circumstances, is a familiar and appropriate

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emotional response in all children. Children have so little control over their lives and have yet to learn the containment of feelings which condi­ tions the reactions of most adults. It thus seems quite understandable that children who are in some way disturbed or troubled may act out their feelings in a way that is inappro­ priate or extreme. Furthermore, in a certain context, the acting out may not be at all inappropriate or extreme. For example, if children are subjected to or witness violence by parents or older siblings in the home, it would hardly be surprising if, among a range of possible responses, they became violent themselves outside the home. It is possible to consider all cases where children kill in this background context, or at least to take it as a starting point. If the act of killing itself is an abuse of power, then what, in his or her brief life, has driven the child to that moment? In what ways might adults have abused their own power over that child? In what profound ways might children have felt their own sanctity infringed? What loss, separation, illness, abuse, be it physical, sexual, emotional, verbal – all of these, none of these? Dismiss nothing, consider everything, start with the obvious and work inwards, for who knows what goes on in the secret lives of families? Who knows exactly what had gone on in the seven short years of a young boy who, in London in 1920, went to play with two smaller boys at the side of a canal? One of the two had a toy aeroplane which he refused to give to the 7-year-old. The 7-year-old said he would drown him if the plane was not handed over. The smaller boy pulled a face. The 7-year-old threw him into the water and then kicked away his fingers as he tried to cling on to the bank, until he drowned. The 7-year-old was too young to face criminal charges but was placed into care and moved through a series of residential homes where he was violent, a thief, a bed-wetter, a compulsive eater, by turns cruel and tender towards animals and keen to seek out the affection of the adults around him. This case is recounted in Wilson’s book as the youngest example of a child who had killed. There is no record of what happened to him and nothing to explain with certainty why he might have behaved as he did, though there are a few intriguing clues. Wilson rather ungenerously describes the boy’s mother as ‘an unmarried Welshwoman, a stupid and erratic creature’. She was working while bringing up the boy alone, with the support of his grandmother. The boy was an only child who had never known his father. After fracturing his skull in an accident (trying to jump on the back of a lorry), he had begun truanting and petty stealing. A neigh­ bour was paid to look after him while his mother and grandmother were both at work. The boy he killed was said to have regularly taunted him as a ‘bastard’. Perhaps the boy’s aggression was provoked by his injury, but

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more likely it was bound up with his experiences at home, where he may not have been shown much love or care and may even have felt unwanted, may have felt the absence – the loss – of a father-figure and felt a welling of anger and resentment at being reminded of this in the taunts of the boy he killed. Wilson (1973:15) makes the general observation that, on the basis of his research, ‘there is ample evidence that the majority of the violent children came from broken or unhappy homes or were effectively homeless’. In the aftermath of the Bulger case, amid the moral panic, there was a firm conservative push towards what could best be called oldfashioned values and a disapproving tilt at modern society: the drift away from the church, the breakdown of community and the nuclear family, the casual attitude to divorce, the rise of lone parents – single mothers, naturally – a laxity towards the care and discipline of children. The span of the centuries over which Wilson researched certainly reflects a time when there was a stern approach to discipline within rigid family and commu­ nity structures. This does not appear to have inhibited the occasional childish impulse to kill. The Cambridge Study in Delinquent Development (West and Farrington, 1973) made a persuasive connection between family break­ down and children becoming involved in crime. The long-term observa­ tion of a group of urban, working-class boys suggested that ‘delinquents’ were more likely to emerge from families where discipline was either strict or inconsistent and the parents passive or rejecting. The study also indicated that although the loss of a parent was important, it was only important in cases where there had been parental conflict. Parental separation without conflict was not a significant predictor of children turning to crime. Parental conflict within families was more likely to lead to delinquency. It may be a big leap from petty crime to a killing, but, as Wilson has implied, family discord may often be a significant factor.

Back to Bulger It so happens, in the way of contemporary reporting, that we now know a great deal about the lives of the two boys who killed James Bulger. Or, at least, we know a great deal about their lives up to the time of the incident, which occurred some 6 months after their 10th birthdays – their birthdays are 10 days apart. They are now nearly 18 years old, on the cusp of adult­ hood, and have spent most of the last 8 years in secure units, beyond the public gaze. Although we know so much about them, no one could pore over this information and arrive at a reliable explanation of the reason why they killed. No one could say with certainty what is significant. And there is

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no way of knowing, as it were, what is not yet known about their early lives. The detail in the public domain, though considerable, is still fragmentary and incomplete. There must be sensitivity, too, both towards the family of James Bulger and to the two boys, who have an entitlement to privacy and, no doubt, also have an uncomfortable awareness of the extent to which they are the objects of universal fascination. Even so, to proceed on the basis of caution, relying on the information in the public domain, it does not seem excessively intrusive or inappro­ priate to consider what might have made them kill while, in this instance, preserving their anonymity. Certainly there is much in the previous section of this chapter which could be applied to the case. There were three previous cases where children had killed on Merseyside, each involving some street play which had gone disastrously wrong – a stabbing, a 2-year-old drowned in a rain puddle by an 11-yearold, and an argument over fairness in a game which had ended with a 9year-old boy and his friend throwing a 7-year-old boy into the Leeds–Liverpool canal. Like the Bulger case, these incidents suggest an urban environment in which children enjoyed considerable freedom to stray beyond adult control. Liverpool streets have traditionally been a playground and perhaps a place for hard-pressed parents to pack off their children. Merseyside has historically enjoyed more than its fair share of poverty and deprivation. The courts and cellars of the Victorian era were among the worst housing conditions in the country and, even at the city’s height as a trading port, there was considerable unemployment, casual labour and low wages. The children of the poor were characterised as ‘ragged street urchins’ who begged and hustled and generally lived on their wits. Nothing indicates the harshness and the violence of life in those days more than the popular Shrove Tuesday spectacle which involved setting a cock loose in a ring among a group of small boys whose hands were tied behind their backs – the winner being the boy who emerged with the cock between his teeth. It is possible to sense this legacy in certain aspects of contemporary Liverpool life, for instance in the ready resort to extreme violence among some of its adult criminals. And certainly in the wandering existence of one of the two boys in the Bulger case who was a familiar presence on the streets around his home. He was popularly described as ‘streetwise’, though this hardly made him unique among his peers. The childhoods of both boys could be said to have been turbulent and unstable. In both families there is evidence of violence in the home as well as great inconsis­ tency. Both boys had experienced the loss of their father from the home, though only in one case was there a total loss of contact too, after the father had left the family to set up home with a new partner.

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This was the father of the boy who, during the trial, was known as Child A. Child A, at the time of his offence, was the fifth of seven children, a baby having recently been born out of a new relationship his mother had begun. His mother and father had married when they were 18. As his mother would later describe, she had married to escape her life at home, where she felt worthless and unloved and was often beaten by her father who regularly beat his wife too. As is sometimes the pattern, Child A’s mother did not escape violence in marriage, and her husband could be physically abusive, especially after he had been drinking. As the children came along, he was verbally and physically abusive towards them too. And so, as the children grew up, the older children bullied the younger children, including Child A. Child A’s mother was treated for depression and made one or two attempts at suicide, as would at least two of his older brothers. His father left home when he was 6 years old and he had no further contact with him before the offence. A week after his father left, the family home was destroyed by fire. His mother began drinking heavily and was not always around to look after her children. Some of the older brothers became involved in petty crime and ended up in residential care. Child A began truanting, stealing from shops and bullying his younger brother. He went to the same school as his older brothers before him and was regarded not so much as troubled but as troublesome, his card marked by the reputa­ tion of his family. Amid such overwhelming unhappiness, it seems almost superfluous to speculate on what might have made Child A kill. There is the abuse of power by his parents: the violence, the verbal and emotional abuse, the neglect and lack of care, the lack of protection from the bullying of his older brother. There is the loss of his father, which was sudden and dramatic, followed, in a real sense by the loss of his mother, caught up in her own depression. How much must Child A have felt unloved, unpro­ tected and wounded by the double rejection he experienced from his parents? It isn’t difficult to imagine the worthlessness he might have felt – and picked up from his mother – and the welling anger and resentment inside him which might have been made manifest in the urge to do something terrible. On the face of it, his co-accused, Child B, had a more stable family background. His parents had married in their twenties and Child B was the middle one of three children. The eldest child was born with a cleft palate and the frustration of making himself understood led to behav­ ioural difficulties and his attendance at a special school. Child B’s parents separated when he was 3 and later divorced, but his father maintained regular contact, at least for a while. Both parents were said to have some

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history of depressive illness. About a year after the separation, the police were called when Child B’s mother left the children alone in the house. The eldest child continued to have behavioural problems which prompted a monthly weekend of respite fostering. The youngest child showed signs of learning difficulties and began attending the same special school. When Child B was 7 he began exhibiting antisocial behaviour in class at the state school he attended. Later he was seen by an educational psychologist who said he seemed unable to cope with the pressures on him. The problems at school worsened and he became increasingly disruptive both there and at home. His mother thought it might be his diet that was causing the problem. He and his brother were bullied by local children. His father had less contact with the family for a while and was dismissive of the bullying. When he was 8, Child B attacked another boy in class, attempting to choke him with a 12-inch wooden ruler. It took two teachers to pull him off. He changed schools and moved into the same class as Child A, both boys having been kept back a year because of their slow learning progress. At about this time, Child B’s parents attempted a reconciliation, taking a family holiday together and then living under the same roof for half the week. Child B’s behavioural problems continued. He and Child A sometimes bullied children at school and started truanting together. A catalogue of all the many incidents involving the disruptive or strange behaviour of Child B at school would lead, powerfully, to the conclusion that he needed help and would end up causing serious harm to himself or someone else if nothing was done. In the event, not much was done and this is what happened. But, of course, it is easy to say this with the benefit of hindsight. There is the sense that Child B was deeply troubled by his parents’ separation and the on–off nature of their subsequent relationship, which must have felt very unstable and insecure. There is the sense too that his parents worked harder to deal with the difficulties of his two siblings, taking extra care because of their special needs. It may be that, as middle children often do, he felt overlooked or disregarded or somehow less valued and loved. Perhaps his parents way of coping with Child B’s problems was to deny or downplay them. His mother’s belief that his diet might be the source of his behavioural troubles and his father’s dismissive approach to his being bullied may well have fed the feeling that he was being overlooked. There is, too, the suggestion of vulnerability about his parents, in their own depressive history and in the passivity with which they seem to have approached the problems they encountered. Perhaps Child B was picking up these signals and perhaps, too, they were increasing his sense of frustration and bewilderment at what was happening to him. The choking incident with the ruler could be taken to

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be a clear indication of the rage inside Child B, which was allowed to fester unabated and untreated for a further 2 years before James Bulger was abducted and killed. There were some indications, at the time, that there may have been a sexual element to the killing. This was by no means conclusive and there is no suggestion that either boy had ever been sexually abused. None of this, however, is meant to be definitive. One educated guess may be as good as another, while the true answer remains buried away inside those boys, waiting to be unravelled.

Epilogue

GWYNETH BOSWELL The contributors to this volume have each, in their different ways, sought to provide the reader with an informed perspective on particular aspects of child and adolescent violence. Asking the question ‘why?’, however, tends to produce more subsets of questions in its wake. To the extent that universal theorisation can be a realistic aim, this is right and proper; it shows, however, that such an undertaking amounts to a long-term project. At this stage, a number of important themes and findings have been identified by these authors. Undoubtedly, for example, legitimised violence at both macro and micro levels is modelled for children across many societies. Some children are directly at risk and, periodically, in chronic danger as a consequence; others may experience the effects largely through media filters. The longitudinal research of Farrington (Chapter 2), supported by similar findings in other such studies across the world, highlights the spectrum of intra-familial problems as significant predictors of later violent behaviour. All the contributors corroborate this prediction to a greater or lesser degree, some firmly supporting the notion of inter-generational cycles of violence, others like Epps and Hollin (Chapter 3), calling for more evidence from empirical research and controlled experiment, especially where particular types of violence such as firesetting are concerned. Most note that, although young perpetrators of violence are frequently survivors of some earlier violence, victimisation or other trauma, it is not the case that all such survivors will become perpetrators. Here, it is neces­ sary to look at the contribution of other recurring components in the research literature, so that risk and protective factors may more effectively be identified. Violent children and adolescents are not a homogeneous group. The majority are males who externalise their violence, and Bailey (Chapter 7) 196

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has reminded the reader that generalisations about pathways to violence cannot necessarily be extended to the small minority of young women who become violent. Gender socialisation is an important behaviour variable which may well be responsible for the higher rate of internalised (i.e. self-harming) violence by young women, of the kind described by Clery (Chapter 6) in a residential psychiatric unit for adolescents, and Richards and Smith (Chapter 8) in relation to their very damaged and damaging maximum security hospital clientele. Race and culture are two other crucial variables which, as Rashid (Chapter 11) suggests, need more routinely to be included in research designs if the homogeneity trap is to be avoided. The preceding chapters have shown that a range of key biological and psychosocial ingredients recur in the investigation of youthful violence. It is probable that the nature and degree of their respective influences are unique to each case. The common factor, however, as Harris and Staunton have noted (Chapter 4), is that all these young people are negotiating the transitions from childhood through to adolescence, and from adolescence through to adulthood. It is for this very reason that, as Cavadino and Allen (Chapter 1) have illustrated, some countries prefer to address violent and murderous acts by children and adolescents via a welfare/treatment model, rather than a justice/punishment model. At these stages of devel­ opment, young people will be seeking identity and, thus, particularly receptive to the influences of peer groups as Cowie (Chapter 9) has demonstrated in her work on bullying, and to the effects of watching film and video, frequently a peer group activity. However, as Browne and Pennell (Chapter 10) have discovered, a violent home life is likely to be the ingredient which interacts with watching violent images to trigger violent offending – and this returns the reader to the most frequently cited antecedent, that of intra-familial problems and conflicts. The accounts of specific cases, provided by Renn (Chapter 5) and James Smith (Chapter 12) in particular, point persuasively to the need to examine all the links in the chain leading to violent behaviour rather than following causal blind alleys which stop, for example, at ‘substance abuse’ or ‘evil eyes’. Renn, indeed, provides a real body of hope for the practi­ tioner in the process of tracing these links back to their roots, addressing the roots, in his case via therapeutic means, and demonstrating a successful outcome both in the growth of the individual being worked with, and in his cessation of violent behaviour. A phenomenon such as violence, which appears as a consequence of interlinking influences, requires both interdisciplinary and interprofes­ sional attentions, if expertise is to be drawn together to develop a solid body of explanatory knowledge. It also requires national and international

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research frameworks, each functioning with a co-operative rather than a competitive ethos, so that similarities and differences, successes and failures can be learned from and built on for the benefit of the world at large. In this way, the public may be provided with a responsible informa­ tion service, which would demonstrate, amongst other things, how people could use reliable research messages to engage in prevention measures and maximise community safety. The quest to answer the question ‘why?’ must, therefore, continue to progress down its exploratory path, not least because all members of society have a responsibility to nurture the physical and emotional health of the next generation, and to contribute to the security and well-being of the communities in which they live.

References and Citation Index

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Reconciliation. xvi

Subject Index

abuse, 59, 73, 97, 101–2, 116, 129, 134–6, 184, 193 abuse of power, 190,193 child(hood) abuse, 6, 8, 28, 31, 44–5, 58, 61, 71, 81, 97, 112–14, 129, 131 emotional abuse, xvii, 5–7, 58, 114, 129, 193 physical abuse, 5, 45–7, 57, 104, 114, 121 sexual abuse, xvii, 5–7, 45, 57–8, 62–3, 66, 68–9, 81, 94–6, 109, 112–14, 121, 129, 195 Adolescent Forensic Service, 112–13, 117 age(s) of criminal responsibility, 9, 16–18 aggression, 7, 23–4, 27, 29–30, 52, 58–9, 80, 85–6, 93, 111, 116, 126, 129, 133, 153–4, 165, 171, 174–5, 180, 190 alcohol and aggression, 67

indirect aggression, 138

sexual aggression, 64

aggressive(ness), 8–9, 24, 27, 29–30, 33–4, 42, 56, 67, 80, 82, 113, 119, 128, 152–9, 162–5 aggressive behaviour, xviii–xix,

138–150 passim

alcohol abuse/misuse, use, 34, 65–8, 72, 74, 79–80, 108, 111, 114, 125, 128, 130, 132 drug abuse/misuse, 21, 23–4, 34, 65–6, 68, 72, 105, 111, 114, 125, 128, 130, 132, 139 see also substance abuse/misuse

American, 5, 60, 63, 108–9, 112, 152, 176, 180 North American, xvii, 42–3, 57 African-American, 30–1, 34, 176–7 American Psychiatric Association, (APA), 63, 107, 152 anthropological, 91, 169–70, 181–2 antisocial behaviour, xvi, 20, 30, 32, 34–5, 38, 45, 54, 57, 59, 65, 68, 104, 109, 111–12, 116, 122–3, 125, 132, 139, 143–5, 149, 151–3, 174, 194 antisocial disorder(s), 108–9

antisocial personality scale, 30

assessment(s), xviii, xix, 7, 39, 42, 49, 52–3, 64, 67, 70–2, 75, 79, 88–9, 106–7, 109, 115, 119–22, 132, 162, 164 see also psychometric assessment(s); treatment attachment theory, xviii, 58, 60, 75–6, 128, 180–1 attachment(s), 59–60, 74, 81–2, 85, 96, 133, 170 Bell, Mary, xv, 6, 188 biology, biological, 6, 51, 105, 111, 197 psycho-biological, 91, 97, 102 biological mother, 93, 95 Broadmoor (Hospital), 61, 121–2, 124–7, 131–2, 135 see also special hospital(s) Bulger, James, xv, 6, 9–11, 14, 16, 151,

227

228 183–4, 187, 189, 191–2, 195 bullying, xix, 140–5, 193–4, 197 Calouste-Gulbenkian Foundation (1995), 66, 137 Cambridge Study in Delinquent Development, xviii, 19–20, 23, 25–30, 35, 139, 191 Canada, xvii, 16, 20, 32, 62, 154 child pornography, 63 childhood predictors of violence, see predictors childhood trauma, xv, xviii, 7–8, 59, 71, 82, 88–9, 96 Children Act 1908; 1989, 124 Children and Young Persons Act 1933, (section 53), 6, 10, 12, 14, 44, 123–4, 186 Children and Young Persons Act (CYPA) 1969, 123 cognitive distortion(s), 50–1, 60, 62–3, 164, 167 cognitive theories, 154, 156, 164 conduct disorder, 5, 49, 51, 108, 179 Crick Report (Advisory Group on Citizenship), 147–8 Crime and Disorder Act 1998, 119 criminal justice system, 4, 10–11, 44, 65, 70, 72, 87, 104, 112, 114, 118, 123–5 cultural factors, 171, 173, 180 delinquency, 21, 23–4, 27, 31, 33–4, 45, 47, 64, 104, 112, 158, 168, 171–6, 181, 191 delinquent(s), 23, 32–3, 40, 43–4, 46, 52, 54, 57, 108, 111, 124, 139, 157–8, 167, 171–5, 181, 191 education(al), 12, 14, 21, 26, 28, 33, 43–45, 47–9, 53, 55, 72, 87, 112–3, 115–6, 119, 134, 147, 194 ‘Bantu Education’, xvi Elton Committee (DES) 1989, 146 empathy, 32, 59–60, 82–3, 89, 106, 116, 134, 143, 145, 148, 150, 162–6 empathic concern, 38, 160, 162, 164 empathetic skills, 59 ethnicity, 181–2 ethnic (groups), 157, 170, 177–8

Violent Children and Adolescents European Commission of Human Rights, 14–15 European Convention on Human Rights, 14–15 European Court of Human Rights, 14–15 families, 5, 25, 27–9, 35, 45, 48, 58, 117, 119, 128, 134–7, 158, 173–6, 187–8, 190–2 intra-familial, 58, 60, 125, 169, 173, 176, 180–1, 196–7 feminist, 68, 105, 111 post-feminist, 68 film (violence), xix, 53, 151–168 passim, 197 see also media, television, video (violence) fire(s), firesetter(s), firesetting, xviii, 36–55, 114, 118, 126, 196 forensic, 43, 50, 86, 106–7, 109, 112–14, 117–20, 124, 135, 188 gender, 82–3, 110–11, 113–115, 181–2, 197 genetic factors, 57, 139 Glenthorne Youth Treatment Centre, 12, 44, 46 Goldstone Commission (Report), 171, 178–9, 181 heterosexual, 83 historical (context/perspective), 169–70, 176, 178, 180–2 Home Secretary, 10–12, 15, 123 homicide, 4–5, 9, 13, 116, 125–6 see also murder or manslaughter homosexual, 22, 83 impulse(s), 9, 80, 191 impulsivity, 21, 25, 32, 51–2, 109 impulsive, 25, 30, 33, 36 infanticide, 104–5, 116–17 isolation (social), 27, 59–60 journalism, 186 justice, 11 justice/welfare, xv–vi, xix, 124, 197 natural justice, 11, 17

Subject Index

229

offenders, female, 104–30 passim young offenders, 7, 10, 12–13, 44, 56–70 passim, 71, 104, 113, 119, 123–5, 152, 158–60, 164–5, 167 Young Offender Institution(s), 44, 118, 129–31

148–150, 154, 165, 172, 192, 197 penal, 109, 114, 174; see also punishment penalty, 8, 12, 18, 32 death penalty, xv pornography, 63–5, 68–9 see also child pornography post-traumatic stress disorder (PTSD), 7, 96, 109, 116, 179, 181, 185 predictors, 19–20, 23–9, 35, 196 prevention programmes, 30–1, 33–5, 37, 43, 47 Prevention of Crime Act 1908, 124 Protection of Children Act 1978, 64–5 protective factors, 27, 110, 112, 114, 165, 196 psychiatric, xviii, 36–7, 40, 42, 44, 49, 51–2, 61–2, 72, 91–2, 94, 96, 99, 106–8, 110, 112–14, 117, 120–4, 127–9, 131–3, 136–7, 188, 197 psychological, xvii, 9, 11, 14, 17, 26, 36–40, 42, 44, 48–9, 57, 61–2, 67, 69, 86–7, 91–3, 95, 100–01, 106, 115, 126, 130–2, 135, 142, 150–1, 159, 169–70, 173, 180 psychometric assessment(s), 49, 162, 164 psychosocial, 197 factors, 182 models, 37 perspectives, 181 punishment, xv, 16, 28, 32, 116, 127, 147, 158, 197 capital punishment, xvii, xix; see also death penalty see also penal, penalty

parents, parental/parenting, 5, 21, 24–35, 37–8, 42–3, 45–6, 48–9, 57–9, 66, 74, 77, 79–83, 93, 95–6, 100–101, 107–8, 111, 115–6, 125–9, 131–2, 136–7, 139, 142, 146, 153–4, 157–8, 163, 165, 169, 171–5, 184, 187–8, 190–4 peers, peer-group(s), 21, 27, 30, 33, 40, 43, 59–60, 82, 93, 111, 119, 128–30, 134, 138–144, 146,

race, racial, multi–racial, see ethnicity right(s), xvii, 11, 14–16, 94, 108–9, 111, 116, 119, 187 see also UN Committee, Convention risk factor(s), xix, 19–20, 22, 24, 30–2, 35, 58, 63, 66–7, 74, 104, 110, 128, 131, 172, 178, 196 at risk, 22, 36–7, 39, 49, 110, 113, 116, 127, 130, 136–7, 196 high-risk, 27, 47, 55, 67, 106–7, 112, 116, 119, 121, 127, 136

learning difficulties, 44, 49, 53, 60, 117, 194 longitudinal surveys/studies, 19–20, 25, 28, 30, 35, 80, 139, 153, 159, 171, 180, 196 loss, 5, 7, 57, 59, 71, 73, 76, 79, 86–8, 95, 109, 116, 130, 133–4, 142, 179, 184, 190–3 maltreatment, 45–7, 71, 166 manslaughter, 7, 12–14, 185, 188–9 maximum security hospital, 109, 197 maximum security, 121–2 media (violence), 151–3, 158, 188 see also film, television, video (violence) mental health services, 42, 61, 106–7, 112–4, 119–20 mental health professionals, 48, 132 Mental Health Act 1983 (MHA), 61, 94, 114, 121, 123 multi-ethnic, see ethnic(ity) murder or manslaughter, 1–3, 86 murder, xv, 3–6, 11–13, 57, 60, 115, 151, 188 neglect, 5, 6, 27, 28, 30, 31, 45, 46, 47, 57, 58, 71, 109, 112, 121, 126, 127, 129, 131, 193

230 self-esteem, 6, 59–61, 109, 120, 130, 139, 141–2, 157 self-harm, 110, 113, 115, 118, 129, 131 self-injurious behaviour (SIB), 91–103, 131 self-report(s), 19, 22–3, 31, 134, 181 self-reported (violence), 22–3, 26–7, 29, 172 self-reporting, 65 sex offenders, female, see offenders, female sex offenders, male, 56–68 social-learning theory, 154–5, 181 social-psychological models, 37; see also psychosocial models sociological, xvii, 91, 105, 169–70, 180 South Africa, xv-vi, 171, 178–81 South African society, see South Africa special hospital(s), 121–5, 129, 135–6, substance abuse/misuse, 5, 61, 65–7, 69, 71, 82, 112–13, 115, 125–6, 197 suicide, 109, 129, 131–2, 193 tariff, 10–11, 15 television (violence), 152–4, 156, 159, 167, 188 see also film, media, video (violence) therapy, 9, 18, 102–3, 119, 127, 135 family therapy, 53, 94, 135 psycho-therapy, 94, 99 trauma, 9, 61, 78–9, 84, 87, 92, 97, 101–2, 109, 124, 126, 131, 133, 136–7, 196;

Violent Children and Adolescents see also childhood trauma treatment, xv, xviii, xix, 10, 12, 17–8, 32, 34, 36, 42, 44, 48–9, 51–55, 57, 60, 62, 64–5, 67, 69–70, 72, 94, 96, 99, 107, 110, 112–3, 115, 118–25, 131, 133–5, 197 see also assessment(s) UN Committee on the Rights of the Child, 16 UN Convention on the Rights of the Child, xvii, USA, xv, xviii, 2, 20, 37, 43, 47, 57, 61, 68, 108, 112 see also American victim(s), xvii, 3, 6, 7, 10, 13, 33, 40, 42, 44–5, 57–8, 61–6, 71, 84, 97, 116, 125–6, 129, 134, 139–145, 148–50, 155–6, 162–7, 184, 187–9; bully- or provocative victims, 140–41 victimisation, 3, 62, 102, 129, 133, 137, 139–40, 148, 165, 196 video violence, 151–168 passim, 186, 188, 197 see also media, television (violence) violence, defined, xv; no definition of, 180; legitimised, xvii; predicted, 19–35 passim; political, 178–9, 181 Youth Offending Teams, 119