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Working with Victims of Crime: The Basics
Information Sheet: The Basics of Victim Reactions and Coping
Developed from Hill, J.K. (2004). Working with Victims of Crime: A Manual Applying Research to Clinical Practice, Ottawa ON:
Justice Canada.
Reactions
- As people deal with being victimized, caregivers can identify common reactions. These reactions are normal, but may still mean
that the victim requires help to deal with being overwhelmed. Table 1 lists some common reactions discussed in research.
Table 1: Common Reactions to Crime Victimization
| Mood/Emotions |
Social |
Thinking/Memories |
Physical |
Fear/phobias 1, 3, 4, 5
Anger/hostility 1, 2, 3, 4, 7
Embarrassment 1
Anxiety 2, 5, 7
Depression 2, 4, 6
Grief 1, 2, 4
Guilt, shame 4, 5, 6
Difficulty controlling emotions 4
Apathy 5
Lower self-esteem 7
|
Changes in relating to people 2, 6
Avoidance 5, 7
Alienation 5
|
Intrusive memories 2
Lower self efficacy 2
Vigilance 2
Flashbacks 5
Confusion/poor concentration 4, 5
Dissociation 4
|
Nausea 1
Stomach problems 1
Muscles tension 1
Sleep problems 2
|
1 Casarez-Levison (1992)
2 Everly et al., (2000)
3 Greenberg and Ruback (1992)
4 Leahy, Pretty and Tenenbaum (2003)
5 Mezy (1988)
6 Nishith, Resick and Griffin (2002)
7 Norris, Kaniasty and Thompson, (1997)
|
- Anger is a difficult emotion for the victim, supports and workers. Much care is needed to make sure that it is handled properly
(Greenberg & Ruback, 1992). Workers should understand that anger is a natural reaction to victimization but that it can also
interfere with getting better. Thus, there is no easy answer to how to handle anger; training/ judgement and empathy are your best
tools for deciding how to help victims showing anger. Supervision/consultation will be key in dealing with your reaction to anger
and other emotions.
Severity of Reaction
- All crime victims experience some distress upon being victimized (Norris et al., 1997).
- Research indicates that violence during the crime increases the severity of the reaction and about 50% of victims of violent
crime report moderate to severe reactions (Norris et al., 1997).
- Sexual assault victims reported more severe reactions and took longer to heal than non-sexual assault victims (Gilboa-Schechtman
& Foa, 2001).
- Workers need to be careful of groups that mix victims that have severe reactions with those that have less severe reactions.
Social comparison (feeling better off or worse off) with other group members may interfere with treatment if not handled properly
(Greenberg & Ruback, 1992).
- Workers should think about how to best match client needs to service level as a way to benefit clients (see Table 2 below).
Table 2: Severity by Service Type: A proposed model
| Needs Level | Description | Possible service options |
|---|
| Low |
They are coping well with few symptoms, easily managed through natural coping skills and social support. They may not have
experienced a severe crime and/or may have many ways to cope. |
Minimal services: information sharing, provide written material, brochures of available supports, and education about signs of
deeper problems.
These services would also be useful for those who do not feel they have any problems, but are trying to hide their suffering.
|
| Moderate |
Experiencing some symptoms and need to expand coping skills or need a place to deal with overwhelming emotions. Generally they
cope well but are overwhelmed by being victimized. |
Peer run support groups, paraprofessional and volunteer support. Some professional support may be needed but only on a short term
basis. |
| High |
Experiencing many symptoms and display poor coping behaviours. Overwhelmed by being victimized and with few effective supports.
Severe trauma may have occurred. Likely evidence of multiple problems and multiple victimizations. |
Need for professional treatment. This may include long-term individual or group therapy or even hospitalization to help the
person stabilize. |
- Women may be at risk for more severe reactions as they are more likely than men to experience sexual assault or repeated
victimizations (including sexual assault) (Pimlott-Kubiak & Cortina, 2003).
- Professionals need to be careful of causing the victim even more distress (secondary victimization) by not being sensitive to
the victim's state of mind (Campbell, Sefl, Barnes, Ahrens, Wasco & Zaragoza-Diesfeld, 1999).
Previous Victimization
- Researchers have found that previous victimization is a very strong predictor of further victimization (Byrne et al., 1999;
Messman & Long, 1996; Norris et al., 1997; Nishith et al., 2000).
- Victims who have had a bad reaction to previous trauma are likely to have a bad reaction to new trauma (Brunet et al., 2001).
- Previous victimization likely affects the victim's reaction to new victimization, perhaps through low self-esteem, learned
helplessness, poor relationship skills/choices, difficulty reading risky situations or poverty (Byrne et al., 1999; Messman & Long,
1996; Nishith et al., 2000). These results remind us that we need to go beyond the specific crime and ask about trauma history and
use this in our interventions.
Diagnoses Common to Victims
- Diagnoses commonly linked to being a crime victim include: depression, anxiety and post-traumatic stress disorder (PTSD).
- Depression symptoms can include: low mood, low appetite/weight loss, sleep problems, energy changes, self-blame/guilt,
worthlessness/ hopelessness, difficulty concentrating and thoughts of death (American Psychiatric Association, 1994).
- Anxiety symptoms can include: fear/distress/worry, physical symptoms (e.g., sweating, shaking, difficulty breathing, nausea,
chest pain, dizziness, etc.), behaviour change (e.g., avoidance, rituals) and behaviours that try to reduce distress (American
Psychiatric Association, 1994).
- PTSD is a form of anxiety disorder that is linked to a specific incident, such as a crime, natural disaster, accident, etc.
(American Psychiatric Association, 1994).
- PTSD may include symptoms such as: fear, helplessness, intrusive and recurrent memories, nightmares, reliving the event, intense
distress, being jumpy; avoidance/suppression of thoughts/feelings, and specific symptoms such as sleep problems, irritability, angry
outbursts, poor concentration, hypervigilance and exaggerated startle response (American Psychiatric Association, 1994).
- Some risk factors to developing PTSD include: Crime/trauma related factors (Brewin et al., 2000; Gilboa-Schechtman & Foa, 2001;
Ozer et al., 2003), lack of social support (Brewin et al., 2000; Ozer et al., 2003), additional life stress (Brewin et al., 2000;
Ozer et al., 2003), previous PTSD (Brunet et al., 2001; Ozer et al., 2003) and dissociation during or immediately following the crime
(Ozer et al., 2003).
When Do I Need to Refer to Mental Health Professionals?
- Worker should carefully consider when to refer to mental health professionals.
- Workers untrained in mental health issues should consult and make appropriate referrals to mental health professionals.
- Partnerships with healthcare, telehealth, consultation and visiting professionals are possible solutions to isolated workers.
Table 3: Common Coping Strategies
| Positive Coping Strategies |
Negative Coping Strategies |
Information seeking 5
Self-comparison/emphasize the positive aspects of surviving 1, 5, 12,20
Social comparison 4, 5, 9, 20
Activities to regain control 4,5
Activism 5
Time to heal 3, 5, 16, 18
Getting support 2, 4, 7, 10, 15, 16
|
Avoiding behaviour 2, 5, 13, 21, 22
Denial and Self -deception 14, 19, 20, 21
Dissociation 6, 11, 16
Obsessing about the crime 4, 8
|
1 Davis et al. (1998)
2 Everly et al. (2000)
3 Gilboa-Schechtman and Foa (2001)
4 Greenberg and Ruback (1992)
5 Hagemann (1992)
6 Harvey and Bryant (2002)
7 Hoeksema and Davis (1999)
8 Holman and Silver (1998)
9 Layne et al. (2001)
10 Leymann and Lindell (1992)
11 Martínez-Taboas and Bernal (2000)
12 McFarland and Alvaro (2000)
13 Mezy (1988)
14 Mikulincer et al. (1993)
15 Nolen-Hoeksema and Davis (1999)
16 Norris et al. (1997)
17 Ozer et al. (2003)
18 Resick et al. (2002)
19 Stillwell and Baumeister (1997)
20 Thompson (2000)
21 Ullman (1999)
22 Wolkenstein and Sterman (1998)
Coping
- When victims' lives are upset by a crime, they will try to cope in the best way they know how.
- Coping strategies can be divided into good strategies and bad strategies. Using bad strategies can make the victim feel worse
(Dempsey, 2002).
- Table 3 lists the different coping strategies often used by victims.
Positive Coping: Social Support
- Social support is very important for many victims as they try to make sense of their victimization (Greenberg & Ruback, 1992;
Leymann & Lindell, 1992; Norris et al., 1997).
- Victims find support from their family and friends more useful than support from professionals (Leymann & Lindell, 1992).
- Victims need to known that support is available, even if they do not access it (Norris et al., 1997; Ozer et al., 2003).
- Supports can be a key source of information (Hagemann, 1992).
- Professional supports could be important when family and friends are overwhelmed (Mikulincer et al., 1993; Nolen-Hoeksema & Davis,
1999).
Negative Coping: Avoidance
- Avoidance, either through drugs, avoiding locations, denial or dissociation is a common way victims cope with overwhelming
emotions (Bromberg, 2003; Everly et al., 2000; Hagemann, 1992; Mezy, 1988; Thompson, 2000; Wolkenstein & Sterman, 1998).
- Although avoidance may help the victim deal with initial distress (Hagemann, 1992; Harvey & Bryant, 2002; Ullman, 1999), it is
linked to long-term problems (Bromberg, 2003; Halligan et al., 2003; Ozer et al., 2003; Ullman, 1999).
- Avoidance through the use of drugs and alcohol can interfere with decision making and problem solving, which creates even greater
challenges to positive healing.
Self-Efficacy
- Self-efficacy is a merging of self-esteem with a belief that you can change your environment (Bandura, 1997). Basically, people
who believe they can successfully handle the crisis (self-efficacy) will have more positive thoughts, emotions and behaviours.
- High self-efficacy may reduce the chances that the victim will have a negative reaction to trauma (Thompson, Kaslow, Short &
Wyckoff, 2002).
- Self-efficacy can affect coping choices by people picking those coping strategies that they feel will succeed (Bandura, 1997).
- Successful treatment programs include elements of building self-efficacy to help victims (Nishith et al., 2002; Resick et al.,
2002).
Other Information Sheets in this Series:
The Basics of Self-Care
The Basics of Victimization
The Basics about Deciding to Refer to Mental Health Professionals
The Basics about the Stages of Change
The Basics to Cover in an Initial Interview
References:
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman and Company.
Brewin, C. R., Andrews, B. & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in
trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68 (5), 748-766.
Bromberg, P. M. (2003). Something wicked this way comes: Trauma, dissociation, and conflict: The space where psychoanalysis,
cognitive science, and neuroscience overlap. Psychoanalytic Psychology, 20(3), 558-574.
Brunet, A., Boyer, R., Weiss, D. S. & Marmar, C. R. (2001). The effects of initial trauma exposure on the symptomatic response to
a subsequent trauma, Canadian Journal of Behavioural Science, 33 (2), 97-102.
Byrne, C. A., Resnick, H. S., Kilpatrick, D. G., Best, C. L. & Saunders, B. E. (1999). The socio-economic impact of interpersonal
violence on women. Journal of Consulting and Clinical Psychology, 67 (3), 362-366.
Campbell, R., Sefl, T., Barnes, H. E., Ahrens, C. E., Wasco, S. M. & Zaragoza-Diesfeld, Y. (1999). Community services for rape
survivors: enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67 (6), 847-858.
Casarez-Levison, R. (1992). An empirical investigation of coping strategies used by victims of crime: Victimization redefined. In
E. Viano (ed.) Critical issues in victimology: International perspectives (pp. 46-57). New York: Springer Publishing Co.
Davis, C. G., Nolen-Hoeksema, S. & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of
meaning. Journal of Personality and Social Psychology, 75 (2), 561-574.
Dempsey, M. (2002). Negative coping as mediator in the relation between violence and outcomes: Inner-city African American youth.
American Journal of Orthopsychiatry, 72 (1), 102-109.
Everly, G. S., Flannery, R. B. & Mitchell, J. T. (2000). Critical Incident Stress Management (CISM): A review of the literature.
Aggression and Violent Behavior, 5, 23-40.
Gilboa-Schechtman, E. & Foa, E. B. (2001). Patterns of recovery from trauma: The use of intraindividual analysis. Journal of
Abnormal Psychology, 110 (3), 392-400.
Greenberg, M. S. & Ruback, R. B. (1992). After the crime: Victim decision making. New York: Plenum Press.
Hagemann, O. (1992). Victims of violent crime and their coping processes. In E. Viano (ed., Critical issues in victimology:
International perspectives (pp.58-67). New York: Springer Publishing Co.
Harvey, A. G. & Bryant, R. A. (2002). Acute Stress Disorder: A synthesis and critique. Psychological Bulletin, 128 (6), 886-902.
Holman, E. A. & Silver, R. C. (1998). Getting "stuck" in the past: Temporal orientation and coping with trauma. Journal of
Personality and Social Psychology, 74 (5), 1146-1163.
Layne C. M., Pynoos, R. S., Saltzman, W. R., Arslanagic, B, Savjak, N., Popovic, T. Durakovic, E., Music, M., Campara, N., Djapo,
N. & Houston, R. (2001). Trauma/Grief-Focused Group Psychotherapy: School-Based Postwar Intervention With Traumatized Bosnian
Adolescents. Group Dynamics, 5 (4), 277-290.
Leahy, T., Pretty, G. & Tenenbaum, G. (2003). Childhood sexual abuse narratives in clinically and nonclinically distressed adult
survivors. Professional Psychology: Research and Practice, 34(6), 657-665.
Leymann, H & Lindell, J. (1992). Social support after armed robbery in the workplace. In E. Viano (ed.), The Victimology Handbook:
Research findings, treatment, and public policy (pp. 285-304). New York: Garland Publishing Inc.
Martínez-Taboas, A. & Bernal, G. (2000). Dissociation, psychopathology, and abusive experiences in a nonclinical Latino university
student group. Cultural Diversity and Ethnic Minority Psychology, 6(1), 32-41.
McFarland, C. & Alvaro, C. (2000). The impact of motivation on temporal comparisons: Coping with traumatic events by perceiving
personal growth. Journal of Personality and Social Psychology, 79 (3), 327-343.
Messman, T. L. & Long, P. L. (1996). Child sexual Abuse and its relationship to revictimization in adult women: A review. Clinical
Psychology Review, 16(5), 397-420.
Mezy, G. (1988). Reactions to rape: Effect, counselling and the role of health professionals. In. M. Maguire & J. Pointing (eds.).
Victims of crime: A new deal (pp. 66-73). Milton Keyes: Open University Press.
Mikulincer, M., Florian, V. & Weller, A. (1993). Attachment styles, coping strategies, and posttraumatic psychological distress:
The impact of the Gulf War in Israel. Journal of Personality and Social Psychology, 64 (5), 817-826.
Nishith, P., Mechanic, M. B. &. Resick, P. A. (2000). Prior interpersonal trauma: The contribution to current PTSD symptoms in
female rape victims. Journal of Abnormal Psychology, 109 (1), 20-25.
Nishith, P., Resick, P. A. & Griffin, M. G. (2002). Pattern of change in prolonged exposure and cognitive-processing therapy for
female rape victims with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 70 (4), 880-886.
Nolen-Hoeksema, S. & Davis, C. G. (1999). "Thanks for Sharing That": Ruminators and their social support networks. Journal of
Personality and Social Psychology, 77 (4), 801-814.
Norris, F. H., Kaniasty, K. & Thompson, M. P. (1997). The psychological consequences of crime: Findings from a longitudinal
population-based studies. In R. C. Davis, A. J. Lurigo and W. G. Skogan (eds), Victims of Crime, 2nd ed. (pp. 146-166). Thousand Oaks,
CA: Sage Publications.
Ozer, E. J., Best, S. R., Lipsey, T. L. & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults:
A meta-analysis. Psychological Bulletin, 129(1), 52-73.
Pimlott-Kubiak, S. & Cortina, L. M. (2003). Gender, victimization, and outcomes: Reconceptualizing risk. Journal of Consulting and
Clinical Psychology, 71(3), 528-539.
Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C. & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with
prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal
of Consulting and Clinical Psychology, 70(4), 867-879.
Stillwell, A. M. & Baumeister, R. F. (1997). The construction of victim and perpetrator memories: Accuracy and distortion in
role-based accounts. Personality and Social Psychology Bulletin, 23(11), 1157-1172.
Thompson, M. (2000). Life after rape: A chance to speak? Sexual and Relationship Therapy, 15(4), 325-343.
Thompson, M. P., Kaslow, N. J., Short, L. M. & Wyckoff, S. (2002). The mediating roles of perceived social support and resources
in the self-efficacy-suicide attempts relation among African American abused women. Journal of Consulting and Clinical Psychology,
70 (4), 942-949.
Ullman, S. E. (1999). Social support and recovery from sexual assault: A review. Aggression and Violent Behavior, 4(3), 343-358.
Wolkenstein, B. H. & Sterman, L. (1998). Unmet needs of older women in a clinic population: The discovery of possible long-term
sequelae of domestic violence. Professional Psychology: Research and Practice, 29(4), 341-348.
August 2004
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