Attachment theory and ethics related to violent offenders

Attachment Theory and Ethics related to Violent Offenders

Damian Abrahams

Concordia University College of Alberta

Abstract

Violence in society comes in many forms: domestic violence, sexual assault, homicide, suicide, child abuse, lateral violence, the list can go on. The perpetrators of violence impact the lives of many, and, when caught, immediately surrender their normal rights as human beings. This literature review will focus on two areas: 1. Attachment theory, as I theorize that the foundations of violent behavior are built during attachment development. 2. I will also focus on male, female, and Aboriginal offenders housed in minimum, medium, and maximum-security institutions, the rights they have or do not have, and the policies in place to interact with, evaluate, and ultimately release them into society. It was very difficult to find published, peer reviewed information on the ethics in dealing with violent offenders, so for the purpose of finding accurate, up-to-date information, psychologists working in the institutions were contacted and questioned.

Violent Offenders in Canada

Perpetrators and victims of violence represent a large cross section of people within society and manifests in a variety of ways. Violence, as defined by Serin and Preston (2001), is “the intentional and malevolent physical injuring of another without adequate social justification”. This definition accounts for overt violence. Psychological, emotional, lateral, sexual, and self-directed violence occurs covertly as well. In my experience working with victims and offenders I have been exposed to these covert forms of violence. Psychological violence occurs when perpetrators influence how their victims think or what they believe about themselves. Emotional violence occurs within families with children being the victims. Children are told not to feel a certain emotion or are ridiculed for expressing emotions. Lateral violence occurs largely in Aboriginal communities and consists of gossip, spreading of rumours, nepotism, and bullying. Lateral violence in Aboriginal communities typically occurs in the workplace. Sexual violence involves any unwanted physical contact, verbal remarks, and explicit preference for males or females. Self-directed violence includes self-injury, suicide, and, I believe, self-defeating thoughts and beliefs.

In dealing with the Aboriginal population, police officers, lawyers, and sheriffs often overlook the reason why Aboriginal offenders commit their acts of violence and attribute it to being morally impoverished. Though this is true, children’s morals are instilled in them by their parents, and when a child has a disorganized or avoidant attachment to the parent, the parent is often neglectful, inconsistent, or instills fear in the child. (Ainsworth, 1960) There is no transmission of morals taking place.

Attachment Theory

Mary Ainsworth (1989) is a pioneer in attachment theory, which she defines as a basic system of behavior that is biologically rooted and, therefore, is universal in nature. Attachment is a two-tiered behavior system that persists against genetics, culture, and individual experiences. The first system consists of reproductive behavior, parental behavior, feeding, and exploratory behaviors. The second system is an inner organization and is guided by genetics and influenced by the child’s environment. An example of environmental influence is object permanence where an infant fails to retain memory of an object (Shaffer, Kipp, Wood, and Willoughby, 2010). Only through games like peek-a-boo with a primary caregiver will the infant learn to build an expectation of presence. These types of environmental influences also build the infant’s inner expectations of his or her parents. For example, the infant learns a cry will beckon a parent. Ainsworth’s research suggests that young children are anchored in the motivations and plans of their caregiver and that this ability serves the child well. The child eventually learns he or she can ultimately influence those plans.

Components of attachment

John Bowlby first proposed the tenets of attachment theory in 1969. A child who is under threat or fear returns to his or her Safe haven to be soothed by his or her caregiver. The child feels safe enough to explore his or her surroundings from his or her Secure Base. When exploring the surroundings of the safe base, the child returns to caregiver after a period of time, this is called Proximity maintenance. Separation distress occurs when the child becomes distressed in the absence of a caregiver.

Ainsworth built on Bowlby’s work and introduced secure, ambivalent and avoidant attachment types. Securely attached children are distressed when separated from his or her primary caregiver but is confident of the caregiver’s return. When under threat or fear, the child will seek out the caregiver. Ambivalent attachment is defined by the extreme distress when the primary caregiver leaves due to the uncertainty of return. The child ultimately learns the caregiver cannot be depended on. Avoidant attachment style is exhibited by the avoidance of caregivers and no preference between the primary caregiver and a stranger. Main and Solomon (1986) added disorganized attachment style that is characterized by a lack of clear attachment and mixed responses to the caregiver (i.e. between avoidant and resistant). Children under this attachment style appear to be dazed, confused, and/or apprehensive.

Attachment failure

Registered psychologist Sonya Vellet works for the Calgary Urban Project Society in Calgary, Alberta and runs a vlog (Video Log) on Youtube called What Happens when Attachment Doesn’t Happen? Vellet says that children tend to have peer difficulties in school but are competent in dealing with adults. This is due perhaps to having to be vigilant in their interactions with adults who have predictable behavior. Children with failed attachment are also competent when away from their primary giver. I attribute this learned behavior to being necessary for survival. They also are unregulated emotionally and will withdraw when upset rather than seek comfort. Vellet describes them as having no strategy in place to deal with stress. I think is a grey area as teenagers typically are not fully equipped with planning, organization, or problem solving skills as they are still developing the areas of the brain responsible for these executive functions (Pinel, 2000).

Attachment of female violent offenders

According to Rossegger et. al. (2009), female offenders were found to have “absent and/or criminal parents” who were often neglectful. This parenting style leads to what Vellet (2010) refers to as an “irresolvable paradox”—the source of support becomes the source of fear. Compared to their male counterparts, female offenders reported higher levels of stressors such as sexual abuse, alcoholic parents, and family violence during childhood (Lewis, 2010). Absent or neglectful parenting styles prevents the child from forming loving and lasting relationships later in life (Lewis, 2010) and lays a strong foundation for violent behaviors later in life.

Women offenders, alcohol, and personality disorders

Alcohol has a stronger predictive factor for violence in females than in males, as high as three times as much (Weizmann-Henelius, Putkonen, Naukkarinen, & Eron, 2008). 60 women were included in Weizmann-Henelius’s study; all were convicted of murder or manslaughter. 81.7% were under the influence of alcohol at the time of their crime, and 89.6% were found to have a personality disorder (Antisocial Personality Disorder being the most prevalent) as determined by a Structured Clinical Interview for DSM Disorders. Due to alcohol, female violent offenders were found to be characteristically closer to male offenders in that they were more violent, used more brutal methods of attack, and used more weapons as compared to non-intoxicated female offenders. An alarming fact is that women with substance abuse disorder are 55 times more likely to commit violent crimes, and are 49 times more likely to take another person’s life (Eronen, 1995 as cited in Weizmann et. al., 2009). Victims of female offenders were not as emotionally close to their attackers as I would have thought. Out of 83 victims, 58 were strangers, friends/acquaintances, and 17 were husbands or common-law. Ex-husbands and parents were safest with three victims, while children accounted for 5 of the total victims.

Aboriginal violent offenders

Aboriginal people in Canada are over represented in the jail system, some jails, like Stoney Mountain, report a 79% Aboriginal population. Prisons in Edmonton, Alberta report the same numbers. It is not just Aboriginal men who are over represented, women and youth also have higher numbers behind bars than other ethnicities in Canada. Is it that Aboriginal people are more likely to commit crimes? Or are there underlying factors that contribute to these higher numbers of incarceration?

Residential Schools

In 1857 the Government of Canada passed the Gradual Civilization Act that was meant to assimilate the First Nations people into European society (Brezeau, 2007). Under this act missionaries and government representatives, formally called “Indian agents”, asserted their power over the First Nations people who were seen as an inferior race. At the height of residential schools, there were 150 schools being operated by the various church entities with over 150,000 First Nations, Métis, and Inuit children attending the government-funded schools (Brezeau, 2007). The goal of residential schools was to abolish the Aboriginal (First Nations, Métis, and Inuit) way of life, and to assimilate the Aboriginal people into the dominant race.

Because of the sense of dominance, numerous accounts of multiple forms of abuse have come to light across the country in recent years. The main complaint of being in residential school is sexual abuse at the hands of the priests and nuns who were trusted to “take the Indian out of the child.” Students in the Residential Schools endured substandard conditions; they were forced to eat the minimal requirements for sustenance, while the school administrators dined on fine meals in a luxurious dining room (Brezeau, 2007). The students were not allowed to live their previous life. They were disconnected from their family, siblings who attended the same school were forbidden to communicate with each other, and their spiritual beliefs were met with punishment.

In the short term, the Residential School system succeeded in its intent: segregate the Aboriginal community, minimize Aboriginal culture, silence the fluent tongues, and remove the “Indian” from the children of the community. That success, however, left many generations crippled. The parents of the students no longer had purpose, they had no one to pass knowledge onto, the children faded into an existence where they were not accepted by their home community, nor were they sufficiently equipped to cope with the stresses of their new society. These children grew up without parenting skills, they grew up to disrespect authority because it was authority that came to apprehend them, and they grew up in an alien society not knowing how to function normally and effectively.

To give a clear idea of what occurred in residential schools, here is an account from one of the survivors courtesy of the research conducted by The Indian Residential School Survivors Society:

Psychological and emotional abuses were constant: shaming by public beatings of naked children, vilification of native culture, constant racism, public strip and genital searches, withholding presents and letters from family, locking children in closets and cages, segregation of sexes, separation of brothers and sisters, proscription of native languages and spirituality. In addition, the schools were places of profound physical and sexual violence: sexual assaults, forced abortions of staff-impregnated girls, needles inserted into tongues for speaking a native language, burning, scalding, beating until unconscious and/or inflicting permanent injury.

Intergeneration Trauma

The Residential School experience was the beginning of a major problem for Canada’s Aboriginal population. Effects of the above-mentioned trauma resonate in Aboriginal youth in spite of the many successes of recent years. Many young Aboriginals have those issues deeply engrained into who they have become. Problems with authority figures remain. Authority figures have been oversimplified and are not limited to police officers. Security guards, teachers, principles, school counselors, even parents and other members of the family are grouped in as an authority figure.

Many Aboriginal youth overlook the simplicity of sexuality. Sexuality is life—it ensures the communal family remains strong. Sexuality today has fallen under the influence of media, advertisements portraying women and men in their underwear; pornography is easily accessible on the Internet, and pressures from their peers to have sex all impinge on how an Aboriginal youth views his or her sexuality. Young woman believe they have to look like the woman in the advertisement, young men believe they have to perform like the men in the videos they find on the Internet and, in addition to that, they learn how to treat woman from those same videos. Everything has come to the point where communication about sex has been reversed: allowing a child to watch pornographic videos or images is easier than talking to them about sex and sexuality. In First Nations societies, it has always been the responsibility of the parents and even extended family members to teach their children about sexuality, the purpose of sex, and to even celebrate milestones in sexual maturity. The maladaptive ways of sexualizing Aboriginal youth that is occurring today stems from the shame of sexual abuse experienced in residential schools.

The children who suffered these abuses grew up to become violent offenders, drug and alcohol abusers, and sexual abusers. The biggest setback that young Aboriginals experience, however, is their lack of a healthy identity. Aboriginal people have long struggled with their legal identity. To be registered with the Canadian government as an “Indian”, which entitles the registrant to all the treaty rights their band falls under, one must be of First Nations descent (Brown, J., Higgit, N., Wingert, S., Miller, C., Morrissette, L, 2005). While Métis and Inuit people have been neglected the same rights. In the past, a First Nations person could lose their registration with the Government through marrying a non-Aboriginal person, but only a First Nations woman marrying a non-Aboriginal male would lose her status and all their children would not be entitled to treaty rights. When a First Nations male married a non-Aboriginal female, there were no consequences.

Aboriginal youth today face many factors that skew their identity further. Pressure to be accepted by their friends causes them to make changes to their identity, often for the worse, in order to be accepted. They end up behaving in ways they know is wrong, or joining gangs when they know it is not the right thing to do. This often comes from the lack of attention they receive from their family. The problem, then, is not a lack of identity; rather, they identify with the wrong aspects of the world around them. The shame their parents felt about being First Nations, Metis, or Inuit in residential schools can be felt, leading to a rejection of identifying as Aboriginal, claiming, instead, to be of Central American or Milado (Black and White) descent.

In the long term, however, the Residential School system failed. New generations of Aboriginal people understand that the way they were living was not how they were meant to live. They are discovering the culture they had lost, a culture that had come from the underground just as strong as it was when it was outlawed. The language was preserved and is again being transmitted to the younger generations, the children who suffered in residential school are overcoming their trauma and are even returning to academia to gather the skills needed to live in society rather than survive. These new skills are being passed onto their children. For the cultural elements that have been lost forever, new traditions and rituals are being created and are now stronger than ever. It turns out that the Indian in the child can never be removed.

Fire water

Alcohol is a factor that is a sensitive issue among Aboriginal people. We must be careful to not oversimplify alcoholism and Aboriginal people. In fact, the writer, who is First Nations, has a large circle of Aboriginal friends where only a small percentage consume alcohol, and an even smaller percentage who are problem drinkers. In the writer’s work with Aboriginal violent offenders 100% of them were under the influence of alcohol during their violent episode, that is not to say, though, that only Aboriginal people get violent when they drink, nor is it safe to say that only Aboriginal people are alcoholic, especially among those who are active in Aboriginal culture (Currie, et. al., 2011).

Joseph Johnston did extensive research on Aboriginal offenders in Canada in 1997, he reached approximately 50% of the federally incarcerated Aboriginal offenders in all levels of security. Johnston found 57.1% reported alcohol problems. 68% of those were violent offenders while 14.7% reported being forced to attend residential school.

In terms of needs, Johnston (1997) noted that, as determined by Case Management Officers, 88.2% of the offenders needed help addressing substance abuse problems but only 5.7% thought they needed help with addictions issues while 30% of them actually made the effort to address these issues.

Case Study-Gary Mattson

On the morning of 3 December 2009, Gary Mattson, who had no change to pay the fare, boarded a bus in Northeast Edmonton and requested to get on for free. Video footage, courtesy of the Edmonton Journal, of the dialogue shows Mr. Mattson speaking with the driver, Tom Bregg, in an appropriate manner. In what seemed like an unprovoked attack, Mr. Mattson punched Mr. Bregg two times before pulling him out of his seat and into the street. Mr. Mattson then stomped on Mr. Bregg’s head 15 times before leaving the scene. The media covered the incident extensively and painted Mr. Mattson as a mentally unstable, vicious, and remorseless maniac. One report by CBC News Edmonton (2010) stated: “After refusing to pay his fare, Mattson punched Bregg and pulled him out of his seat…then dragged Bregg on to the sidewalk and stomped on his head 15 times”. The language in the article makes it seem like Gary refused to pay his fare then attacked Bregg, but in reality some time elapsed and there was an interaction between the two. Because of this assault, Gary Mattson received the label of dangerous offender, ensuring that he will be incarcerated indefinitely.

I have helped Mattson with his addiction issues in 2009, and from what I know of Mr. Mattson he is not the mentally unstable, vicious, remorseless maniac he is made out to be. His background does include trouble with alcohol, but having watched the video I do not believe he was intoxicated at the time of the assault. His past also includes assaults, but each of them were not to the degree of the Bregg assault, nor were they ever unprovoked. Mr. Mattson does not go around looking for a fight. Mattson has a strong sense of protection when it comes to his family and being a First Nations man. These are his two triggers for violence. I feel that Bregg mentioned one of these two to Gary which set him off. This is not to justify his actions, I believe that Bregg has a part in the story and is not the innocent victim he is made out to be.

Aboriginal offenders and attachment

In terms of attachment theory, Johnston (1997) also found that 41.1% of the prisoners reported having absent or neglectful parents, 32.2% reported growing up in a single parent family, and 28.6% grew up in the foster care system. Other abuses such as physical (45.2%), sexual (21.2%) and severe poverty (35.3%) were also reported which I feel are important to note but are not within the scope of this paper.

Personality Disorders

Personality disorders have been found to be more associated with violent offenders than with non-violent offenders. Symptoms of personality disorders, such as compulsiveness, high emotional outbreaks, paranoia, and unstable relationships contribute highly to violent episodes.

Personality disorders correlated with violence

Tikkanen, Holi, Lindberg, and Virkkunen (2007) found that 39% of the 114 violent offenders they interviewed had Borderline Personality Disorder, 5% were diagnosed with Narcissistic Personality Disorder, 14% had Paranoid Personality Disorder, and 44% had two or more personality disorders. Ross and Fontao (2007) found that among the violent offenders they included in their research, Antisocial Personality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, and Schizotypal Personality Disorders were predominant. Both studies employed the Structured Clinical Interview for DSM Disorders to gather their information.

Ethics in working with violent offenders

Dealing with violent offenders is not typically something that psychologists do in a private practice setting. As such, the College for Alberta Psychologists does not have guidelines for interacting with them posted on their website. I theorized that the guidelines psychologists followed were set by the institutions in which the convicted violent offenders were housed. I spoke with two registered psychologists, one in a medium security jail and the other in a minimum security jail, and a psychological testing assistant who works in a maximum security jail.

Minimum security

Gregor Cotfas is a registered psychologist at Grierson Institution, a minimum security jail in Edmonton, Alberta. As well, Mr. Cotfas works at Edmonton Area Parole. Mr. Cotfas confirmed my theory: “ethical codes and guidelines within the institution must be followed. Inmates must be behind glass or shackled. Because psychologists are hands-off for those inmates who aren’t as violent, guards are often in the room when I’m interviewing them”.

When an inmate is up for release psychologists are included in the determination of level of risk. Mr. Cotfas says that there are several methods in doing so: the Hare Psychopathy Checklist-Revised, a Balanced Risk Assessment, the HCL-20 and more. Three of these evaluation instruments must be used but Mr. Cotfas says that most psychologists use more.

The Parole Board of Canada, Mr. Cotfas says, requires a mental health assessment to be completed before any prisoner is released. If they are found to be of significant risk recommendations are provided by the mental health team to bring their risk level down and the inmate will not be released until the inmates are found to be of no risk to the safety of society.

Mr. Cotfas validates, to an extent, my theory that poor attachment is a forecast for later violent behavior: “It’s a rule [they] have little or no attachment. As kids the inmates are often abused, neglected, or jump from foster home to foster home”. I think that with little to no primary caregiver present to attach to, many children, such as the ones Mr. Cotfas is referring to growing up in the foster care system, are nourished by disorganized/disoriented attachment, they never are given the chance to attach in the first place.

Medium security

Dr. Richard Howes works at Stoney Mountain Institution, a medium security jail in Winnipeg, Manitoba. Dr. Howes states that in a medium security jail the institution regulates all interactions with the inmates. The institution dictates his interactions; contact with inmates depends on their level of offence. If an inmate is an extreme offender the inmate is shackled and in their cell. Even for those inmates who are not extreme offenders there must be guard present.

In regards to release into society, Dr. Howes says there are a variety of criteria considered in his evaluation. In assessing their risk the main test they use is the HCR-20 where higher scores reflect higher risk. The criteria on the HCR-20 are found in Appendix 1 and are courtesy of Dr. Howes.

Inmates who are deemed to be of low risk to society are recommended to outside sessions and Corrections is obliged to abide at no cost “to the person”. What is interesting is Dr. Howes’s use of words. Only now, when referring to the inmates leaving jail, are they referred to as a person. Their rights as people are not considered when decisions are being made about their life while they are incarcerated. Only after they are released do they become people again, but even then their rights are restricted. I do not believe their full rights as people are ever restored. Dr. Howes says, in regards to error in calculating risk, his team would rather make a type one error, predicting risk when there is none, than a type two error, detecting no risk when actually there is risk: “We would rather lock up someone innocent than release a prisoner who will reoffend”.

Maximum security

Shawn works at Edmonton Institution, colloquially known as The Max, the maximum-security prison in Edmonton, Alberta. Shawn is a psychological testing assistant. I was unable to speak with a registered psychologist, as they were all busy. Shawn works directly with both inmates and the registered psychologists and felt he was best able to answer my questions. When the psychologist works with inmates at Edmonton Institution their standards of best practice are set out by the institution while the ethics in dealing with them from a psychological aspect are guided by psychology. When an inmate is in a psychologist’s office, it is a clinical setting.

When considering release, protection of society and public safety are considered first and foremost. A balanced risk assessment is primarily used in the maximum security setting, a balanced risk assessment consists of a panel of experts, usually a forensic psychologist, a social worker, members from the parole board, and anyone else the Parole Board of Canada deems necessary. The goal of the assessment is always to get the inmates down to a medium security level before release into the community is considered.

Outside referrals are started one year in advance of their release, mental health assessments are completed in that same time period and are required as part of their parole. Paperwork to get identification is put into place, relocation planning is put into practice if the inmate does not want to stay in the city they were arrested, and vocational training is provided to get them ready for employment.

Conclusion

The two components covered of this paper, attachment theory applied to violent offenders, and ethics in working with violent offenders, has laid down strong groundwork for additional research in both areas. I did find indirect evidence that violent offenders have poor attachment styles. This conclusion, however, is deduced from the interview responses of having absent or criminal parents, being in an array of foster homes, and having a stress-filled childhood. These reports coupled with the description and implications of attachment lead me to believe that poor attachment does lead to violent behavior. None of the sources reviewed actually set out to associate attachment with violent offenses. This weakness implies that further research is needed to better understand and more effectively treat violent offenders.

Through my interviews with psychologists who work directly with violent offenders, my suspicions of institutional guidelines being imposed on psychologists, and that violent offenders have little to no rights were confirmed. Because of the history and nature of their “clients”, psychologist’s who work with violent offenders must closely follow protocol set out by the institution in which they work. Given that prisoners have very little rights, it would be interesting to find out what the consequence for not following protocol would be.

Prisoners do have rights, but those rights are need based; as in they need to eat, they need to have a place to sleep, and they need exercise. Releasing a violent offender, however, the rights and protection of society is considered ahead of the inmate’s. I hypothesize that inmates never regain their full rights even when released back into society. Why there is little documentation on the ethics in dealing with violent offenders remains to be seen. Even if the guidelines are set out by non-psychological entities, this knowledge would be valuable to all who hope to work with this population.

References

Abracen, J., Looman, J., DiFazio, R., Kelly, T., Stirpe, T. (2006). Patterns of attachment and alcohol abuse in sexual and violent non-sexual offenders. Journal of Sexual Aggression, 12, 19-30. doi: 10.1080/13552600600722963

Ainsworth, M. (1989). Attachments beyond infancy. American Psychologist, 44, 709-716. doi: 10.1037/0003-066X.44.4.709

Bezeau, R., Hoskins, J. (Producers), & Bezeau, R. (Director). (2007). Fallen feather: Indian industrial residential schools [Motion picture]. Canada: Independent.

Bouman, Y., De Ruiter, C., Schene, A. (2008). Quality of life of violent and sexual offenders in community-based forensic psychiatric treatment. The Journal of Forensic Psychiatry & Psychology, 19, 484-501. doi: 10.1080/14789940701877669

Brown, G., Mangelsdorf, S., Neff, C. (2012). Father involvement, paternal sensitivity, and father-child attachment security in the first three years. Journal of Family Psychology, 26, 421-430. doi: 10/1037/a0027836

Brown, J., Higgitt, N., Wingert, S., Miller, C. & Morrissette, L. (2005). Challenges faced by Aboriginal youth in the inner city. Canadian Journal of Urban Research, 14 (1), 81-106.

Calgary Urban Project Society. (2010). What happens when attachment doesn’t happen? Available from http://www.youtube.com/watch?v=aDh1C-PubYQ

Craig, L.A., Browne, K., Beech, A., Stringer, I. (2006). Differences in personality and risk characteristics in sex, violent, and general offenders. Criminal Behaviour and Mental Health, 16, 183-194. doi: 10.1002/cbm.618

Currie, C., Wild, T.C., Schopflocher, D.P., Laing, L., Veugelers, P., Parlee, B., McKennitt, D. (2011). Enculturation and alcohol use problems among Aboriginal university students. The Canadian Journal of Psychiatry, 56, 735-742.

Fields, D., Abrams, L. (2010). Gender differences in the perceived needs and barriers of youth offenders preparing for community reentry. Child and Youth Care Forum, 39, 253-269. doi: 10.1007/s10566-010-9102-x

Hoaken, P., Allaby, D., Earle, J. (2007). Executive cognitive functioning and the recognition of facial expressions of emotion in incarcerated violent offenders, non-violent offenders, and controls. Aggressive Behavior, 33 412-421. doi: 10.1002/ab.20194

Johnston, J.C. (1997). Aboriginal offenders survey: casefiles and interview sample. Research Branch Correctionalk Services Canada

Lewis, C. (2010). Childhood antecedents of adult violent offending in a group of female felons. Behavioral Sciences and the Law, 28, 224-234. doi: 10.1002/bsl.929

Lim, L., Day, A., Casey, S. (2011). Social cognitive processing in violent male offenders. Psychiatry, Psychology, and Law, 18, 177-189. doi: 10.1080/13218711003739490

Main, M., Solomon, J. (1986). Discovery of an insecure-disorganized/disoriented attachment pattern: procedures, findings, and implications for the classification of behavior. In T.B. Brazelton & M. Yogman (eds.), Affective Development in Infancy, 95-124. Norwood, New Jersey: Ablex.

Mitchell, T., Maracle, D. (2005). Healing the Generations: Post Traumatic Stress and the health status of Aboriginal populations in Canada. Journal of Aboriginal Health, 2, 14-25. Retrieved from http://www.naho.ca/jah/english/jah02_01/JournalVol2No1ENG4headinggenerations.pdf

Pinel, J. (2000). Biopsychology (4th edition). Boston: Allyn & Bacon

Ross. T., Fontano, M.I. (2007). Brief report self regulation in violent and non-violent offenders: a preliminary report. Criminal Behavior and Mental Health, 17, 171-178. doi: 10.1002/cbm.651

Rossegger, A. Wetli, N., Urbaniok, F., Elbert, T., Cortoni, F., Endrass, J. (2009). Women convicted for violent offenses: Adverse childhood experiences, low level of education and poor mental health. BMC Psychiatry, 9, 81. doi: 10.1186/1471-244X-9-81

Serin, R., Preston, D.,  Ashford, J., Bruce D., ; Reid, W.(2001). Managing and treating violent offenders. Treating adult and juvenile offenders with special needs. (pp. 249-271). Washington, DC, US: American Psychological Association, x, 518 pp. doi: 10.1037/10390-009

Shaffer, D., Kipp, K., Wood, E., Willoughby, T. (2010). Developmental Psychology (3^rd Canadian ed.). United States of America: Nelson Education.

Tikkanen, R., Holi, M., Lindberg, N., Virkkunen, M. (2007). Tridimensional personality questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality. BMC Psychiatry, 7:36. doi: 10.1186/1471-244x-7-36

Weizmann-Henelius, G., Putkonen, H., Naukkarinen, H., Eronen, M. (2008). Intoxication and violent women. Women’s Mental Health, 12, 15-25. doi: 10.1007/s00737-008-0038-1

Appendix

 HCR-20 variables

Historical variables

Previous violence (and offending), young age at first violent incident, relationship instability, employment problems, substance use problems, major mental illness, psychopathy, early maladjustment, personality disorder, and prior supervision failure.

Clinical variables:

Lack of insight, negative attitudes, active symptoms of major mental illness, impulsivity, and unresponsiveness to treatment.

Risk variables

Plans lack feasibility, exposure to destabilizers (i.e. conditions/factors which may trigger violent episodes including lack of professional support, difficulty in handling basic social and life skills, alcohol), lack of personal support, non-compliance with remediation attempts (i.e. rules, medication regime), and stress.