Distress after criminal victimization quantitative and qualitative aspects in a two-year perspective

Abstract: This thesis explores distress and reactions after crime by a previously unknown perpetrator in a two-year perspective. Distress was investigated at eight months and two years, using quantitative and qualitative methods. The specific aims of the thesis were (I) to explore the level of distress and the role of risk factors for post-traumatic and general symptoms eight months post crime, (II) to examine the natural course of adjustment at a two-year follow-up in female and male victims of interpersonal violence, III) to investigate the relationship between shame, guilt, and distress among 35 victims of a single severe violent crime, and (IV) to use qualitative analysis to describe individual post-crime trajectories. The following questionnaires were used: Symptom Check List 90 (Derogatis & Cleary, 1977), Harvard Trauma Questionnaire (Mollica et al., 1992), the Test for Self-Conscious Affect (Tagney et al., 1989). Data were also obtained via semi-structured interviews, including the use of visual analog scales for subjective mental health measures. The participants in paper I were male and female Swedish adult victims of reported interpersonal violence eight months earlier. Participants were between 18 and 66 years of age (n=41). At follow-up (Paper II) the sample size had decreased (n=35). In paper III, adult victims (aged 18-64) of reported interpersonal violence were assessed within two weeks of reported crime (n=35). In paper IV a subsample of 11 adult crime victims were drawn from among the participants from papers I and II.Paper I showed that women reported more distress than men. Prior trauma, adverse childhood, female sex, previous psychiatric history, and unemployment were all associated with more distress. Peritraumatic reactions (especially secondary emotions following cognitive appraisals after the event) predicted the three core PTSD symptoms and comorbid conditions, together with female sex and psychiatric history. Paper II confirmed most of the risk factors at eight months and that, in general, no further recovery took place between eight months and two years. Paper III showed that shame-proneness and event-related shame were highly intercorrelated and related to higher symptoms levels, while the guilt measures were unrelated to each other as well as to symptoms. Paper IV explored narratives of victimization; the results suggest that individual differences within the same trajectories of recovery should be expected.