D. Seifert

The organization of autobiographical and nonautobiographical memory in posttraumatic stress disorder (PTSD).

Disorganized trauma memory seems to play an important role in the pathogenesis of posttraumatic stress disorder (PTSD). However, it is unclear whether memory organization of nonautobiographical material (i.e., sequence memory) is also impaired in PTSD. A novel task designed to assess nonautobiographical memory for content and order information was administered to trauma survivors with (n = 26) and without PTSD (n = 55) as well as to nontraumatized healthy adults (n = 30). In addition, traumatized participants were asked to give a detailed narrative of the traumatic event and an unpleasant autobiographical event. Transcripts of both types of narratives were analyzed with regard to disorganization. Results indicated that trauma memories were more disorganized than memories of an unpleasant event in the PTSD group in comparison with the non-PTSD group. However, no differences were found for memory organization of nonautobiographical material among trauma survivors with and without PTSD and nontraumatized controls. With regard to memory accuracy of nonautobiographical material, group differences were more strongly associated with trauma exposure than with PTSD.

Violence against children: further evidence suggesting a relationship between burns, scalds, and the additional injuries

Up to 22 % of all child maltreatment cases involve non-accidental burns or scalds. In the time period of 2000 until 2007, 20 children with non-accidental burns and scalds in conjunction with other mechanisms of injury were examined at children’s hospitals in Hamburg and at the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, by experts in forensic medicine. The fact that these children presented with additional injuries due to blunt and sharp force and sometimes had signs of neglect emphasize the urgent need for a multidisciplinary cooperation between pediatricians and forensic medical experts to ensure the early identification and prevention of child maltreatment. A new approach for Germany, enforcing mandatory child well-being examinations is discussed.

Quantitative analysis of victim demographics and injury characteristics at a metropolitan Medico-Legal Center.

For the timeframe of February 1st, 2003 until December 31st, 2005, all forensic medical experts at the Medico-Legal Center of the Institute of Legal Medicine in Hamburg, Germany, completed a standardized questionnaire for every consenting surviving violence victim (n=2733) age 14 and older. Central to the quantitative analysis of the data collected was the extraction of specific injury characteristics from the sample population. A correlation was demonstrated between injury typologies and four possible perpetrator-victim constellations, each of which was subcategorized into sexual and non-sexual assaults.

Modellprojekt zur Implementierung eines medizinischen Kompetenzzentrums für Gewaltopfer in Hamburg

ZusammenfassungIn Hamburg erfolgt die klinisch-rechtsmedizinische Untersuchung von verletzten Gewaltopfern seit 1998 als niedrigschwelliges Angebot. Alle Opfer von Gewalt werden auf eigenen Wunsch, unabhängig von einer Anzeige bei der Polizei, im Institut für Rechtsmedizin kostenlos untersucht. Verletzungen werden dokumentiert, Spuren gesichert und rechtsmedizinische, gerichtsverwertbare Gutachten erstellt. Es werden dabei im interdisziplinären Verbund mit anderen Abteilungen der Universitätsklinik Konzepte für spezifische Opfergruppen entwickelt. Der Aspekt der Psychotraumatisierung kann durch ein im Institut für Rechtsmedizin bestehendes Angebot psychologischer Krisenintervention berücksichtigt werden. Im ersten Jahr der auf dieser Basis seit 2003 als Modellprojekt weitergeführten Ambulanz wurden 1.071 Patienten (62% Frauen, 38% Männer, ca. 21% ausländische Nationalität) untersucht, 40% von ihnen außerhalb des Institutes. Die berichtete Sachlage deutete in 26,5% der Fälle auf einen Partnerschaftskonflikt, in 17,7% auf ein Vergehen gegen die sexuelle Selbstbestimmung hin. Raubtaten wurden in 6,1%, andere Aggressionskonflikte in 30,5% der Fälle dargestellt (15% Sachlage unklar). Der Fremdtäteranteil betrug insgesamt 30%. Die als Modellprojekt konzipierte Hamburger Initiative hat das Ziel, den Versorgungsbedarf bei Gewaltopfern zu erkennen, das Angebot des rechtlichen Opferschutzes zu optimieren und Rechtsmedizin als integrierendes und vernetzendes Element im existierenden regionalen Hilfesystem zu etablieren.AbstractA medico-legal competence centre for victims of violence was established in Hamburg in 1998 where a low threshold of intervention is provided. Victims who come to the Competence Centre to have their injuries documented are not required to report the offence to the police. A forensic documentation of injuries as well as the securing of biological evidence is available for free. The service is expanded to provide victims not just with the possibility of further examination by the appropriate departments of the University Hospital Hamburg-Eppendorf, but also with in- house psychological support. In 2003, 1071 victims of violence were examined (62% females, 38% males, about 21% with foreign nationality). The underlying history was violence in intimate partnerships in 26.5% of the cases, sexual violence in 17.7%, robbery in 6.1%, and other categories of non-intimate violence in 30.5% (history unknown in 15%). The project analyses the provision of care and legal aid for acute cases and thereby contributes to an improvement in the situation of victims of violent crime by connecting existing services in the public health system in Hamburg.

Experiences of Health and Health Care Among Women Exposed to Intimate Partner Violence: Qualitative Findings From Germany

Through qualitative interviews with six female survivors of intimate partner violence (IPV) in Germany, we explored their experiences with health and health care within the context of a universal access health system. Using phenomenological analysis, we learned that they view violence as a burden on health; expect health professionals to acknowledge the link between IPV and health with empathy; and experience barriers to acute mental health services despite a lack of financial barriers in seeking treatment. We discuss how our findings compare with other international research, as well as the implications for the health care systems response to IPV.

Gewaltforschung zum Thema „häusliche Gewalt“ aus kriminologischer Sicht

Domestic violence continues to be a subject of public interest and media presence, especially when it involves spectacular cases ranging from abuse of children to fatal violence in the family. Although domestic violence has been the subject of scientific research for the last three decades, there is still no clear evidence of prevalence and etiology of this particular kind of violence. Since the introduction of the German Violence Protection Act which came into force in January 2002, domestic violence has been met with severe societal and legal sanctions. The consequences for culprits are not only theoretical but also include an increase in criminal proceedings and improved civil court protection. Therefore medical staff, particularly legal medicine, is more than ever confronted with the need to standardize documentation of injuries resulting from domestic violence. In addition, legal medical specialists are often confronted with the victimsrsquo personal and social problems. This paper gives an insight into the historical background and recent law reforms which have created legal sanctions and protection against domestic violence.

„Dental neglect“@@@Dental neglect: Kinderzahnärztliche Untersuchungen in der klinisch-rechtsmedizinischen Ambulanz@@@Pediatric dental examinations in clinical forensic outpatients

ZusammenfassungHintergrund„Dental neglect“ umschreibt die Vernachlässigung der intraoralen Pflege mit Auftreten zahnmedizinischer Befunde bei vernachlässigten/misshandelten Kindern.Material und MethodenDie Studie beinhaltete die folgenden Teilaspekte: 1) retrospektive Auswertung rechtsmedizinischer Untersuchungsprotokolle (n = 190), 2) prospektive befundbogengestützte Dokumentation intraoraler Befunde durch rechtsmedizinische Ärzte (n = 50), 3) Untersuchung durch eine Kinderzahnärztin bezüglich Karies bei Kindern mit Verdacht auf Vernachlässigung oder Misshandlung (n = 115).ErgebnisseIn Untersuchungsprotokollen und prospektiver rechtsmedizinischer Dokumentation fand sich Karies bei 10–12 % der Kinder. Kinderzahnärztliche Untersuchungen ermittelten Karies in mehr als 40 %, Plaque/Gingivitis in 68 % und kieferorthopädischen Behandlungsbedarf in 29 % der Fälle.SchlussfolgerungMinderschwere Fälle von Karies entgehen der weniger geübten rechtsmedizinischen Diagnostik bei der intraoralen Untersuchung. Eine frühzeitige Diagnose führt zu Handlungsoptionen für Therapie und Prophylaxe langfristiger Schädigungen der Zahngesundheit. Die interdisziplinäre kinderzahnärztlich-rechtsmedizinische Zusammenarbeit zu Diagnose und Therapie des Dental neglect ist daher anzustreben.AbstractBackgroundDental neglect refers to pathological intraoral findings in cases of child neglect and abuse.Materials and methodsThis study included the following aspects: (1) retrospective analysis of charts from clinical forensic examinations (n = 190), (2) prospective standardized documentation of intraoral findings in clinical forensic examinations (n = 50) and (3) intraoral examinations by a pediatric dentist (n = 115) concerning caries in cases of suspected child abuse and neglect.ResultsRetrospective chart analysis and prospective clinical forensic documentation revealed the presence of caries in 10–12 % of the children examined. In contrast, intraoral examinations by a pediatric dentist led to the finding of caries in more than 40 %, plaque and gingivitis in 68 % and recommendations for orthodontic treatment in 29 %.ConclusionsLess severe cases of caries and dental neglect are not detected by an intraoral clinical forensic examination by forensic doctors. In contrast, early diagnosis can lead to further steps in therapy and prophylaxis thus reducing the risk of negative long-term health consequences. The results indicate the necessity of an interdisciplinary cooperation of forensic medicine and pediatric dentistry in the diagnosis and therapy of dental neglect.

Interpersonal violence in road rage. Cases from the Medico-Legal Center for Victims of Violence in Hamburg.

Aggressive behavior in traffic is a widespread phenomenon. Up to 90% of the population are involved in mild forms such as shouting or gesturing. More dramatic cases with injury to individuals affect at least 1100 people in the US annually. Certain factors such as a male sex, a young age and an urban residency have been identified to contribute to the likelihood of road rage. Central to this analysis is the determination of specific features regarding the conflicting parties, the crime scene and the injury pattern in violent offenses related to traffic. In a retrospective study spanning 10 years, cases of road rage-linked injuries were identified amongst patients at the Medico-Legal Center of the Institute of Legal Medicine in Hamburg, Germany. The data were digitized and then analyzed using descriptive statistics via SPSS. There are disproportionately large numbers of males (85.7%) and motorists (61.2%) amongst road rage perpetrators. Usually the conflicting parties have no prior relationship (89.7%). In 68.1% of the cases, the violence applied was exclusively physical. Objects were utilized in 31.0% of all cases, and in more than half (55.6%) of these cases the vehicle was used as a weapon. The resulting trauma in road rage is mostly blunt and applied to the face and the extremities. There are characteristic features regarding the demographics, time and place of incident, as well as severity and pattern of injury in road rage associated offenses. Identifying these factors may lead to appropriate measures in the reduction of road rage.

Violence-research on the subject of “domestic violence” from a criminological point of view

Domestic violence continues to be a subject of public interest and media presence, especially when it involves spectacular cases ranging from abuse of children to fatal violence in the family. Although domestic violence has been the subject of scientific research for the last three decades, there is still no clear evidence of prevalence and etiology of this particular kind of violence. Since the introduction of the German Violence Protection Act which came into force in January 2002, domestic violence has been met with severe societal and legal sanctions. The consequences for culprits are not only theoretical but also include an increase in criminal proceedings and improved civil court protection. Therefore medical staff, particularly legal medicine, is more than ever confronted with the need to standardize documentation of injuries resulting from domestic violence. In addition, legal medical specialists are often confronted with the victimsrsquo personal and social problems. This paper gives an insight into the historical background and recent law reforms which have created legal sanctions and protection against domestic violence.

Gewaltforschung zum Thema ?husliche Gewalt? aus kriminologischer Sicht@@@Violence-research on the subject of ?domestic violence? from a criminological point of view

Domestic violence continues to be a subject of public interest and media presence, especially when it involves spectacular cases ranging from abuse of children to fatal violence in the family. Although domestic violence has been the subject of scientific research for the last three decades, there is still no clear evidence of prevalence and etiology of this particular kind of violence. Since the introduction of the German Violence Protection Act which came into force in January 2002, domestic violence has been met with severe societal and legal sanctions. The consequences for culprits are not only theoretical but also include an increase in criminal proceedings and improved civil court protection. Therefore medical staff, particularly legal medicine, is more than ever confronted with the need to standardize documentation of injuries resulting from domestic violence. In addition, legal medical specialists are often confronted with the victimsrsquo personal and social problems. This paper gives an insight into the historical background and recent law reforms which have created legal sanctions and protection against domestic violence.