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The Diversity of Violent Human Behavior

On December 26, 1990, the New York Times printed this account of nine homicides on Christmas Eve and Christmas Day in New York City (Finder, 1990):

A 31-year-old immigrant from Ethiopia with a load of Christmas packages was shot and killed in the driveway of his house in Far Rockaway, Queens, on Christmas Eve. … Mr. Berhane Waldermarian, the police said, appeared to be the victim of a failed robbery attempt. He was approached by two men, one carrying a shotgun, in front of his home at 1423 McBride Street late Monday evening. He put down his Christmas packages and was shot once in the stomach. The men fled without taking anything. … He died at St. John's Hospital at 12:35 a.m. yesterday.

Belinda Jackson, a 20-month-old girl, died of "multiple trauma" early Monday evening at Bronx-Lebanon Hospital, the police said. Her mother, Ruby Jackson, of 1691 Davidson Avenue in the Morris Heights section of the Bronx, was charged with homicide yesterday. … The child appeared to have been struck in the head with a sharp object.

Maria Martinez, 67 years old, of 1652 University Avenue in the Morris Heights section of the Bronx, died several hours after she was punched in the face by her son, Heriberto Altreche. The incident occurred at 8:50 p.m. Monday during an argument at a family Christmas gathering. … Mr. Altreche, 37, also punched his sister, the police said. Mrs. Martinez died several hours later at Montefiore Hospital. Mr. Altreche was charged with assault for punching his



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Page 31 1 The Diversity of Violent Human Behavior On December 26, 1990, the New York Times printed this account of nine homicides on Christmas Eve and Christmas Day in New York City (Finder, 1990): A 31-year-old immigrant from Ethiopia with a load of Christmas packages was shot and killed in the driveway of his house in Far Rockaway, Queens, on Christmas Eve. … Mr. Berhane Waldermarian, the police said, appeared to be the victim of a failed robbery attempt. He was approached by two men, one carrying a shotgun, in front of his home at 1423 McBride Street late Monday evening. He put down his Christmas packages and was shot once in the stomach. The men fled without taking anything. … He died at St. John's Hospital at 12:35 a.m. yesterday. Belinda Jackson, a 20-month-old girl, died of "multiple trauma" early Monday evening at Bronx-Lebanon Hospital, the police said. Her mother, Ruby Jackson, of 1691 Davidson Avenue in the Morris Heights section of the Bronx, was charged with homicide yesterday. … The child appeared to have been struck in the head with a sharp object. Maria Martinez, 67 years old, of 1652 University Avenue in the Morris Heights section of the Bronx, died several hours after she was punched in the face by her son, Heriberto Altreche. The incident occurred at 8:50 p.m. Monday during an argument at a family Christmas gathering. … Mr. Altreche, 37, also punched his sister, the police said. Mrs. Martinez died several hours later at Montefiore Hospital. Mr. Altreche was charged with assault for punching his

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Page 32 sister. The police said they were awaiting autopsy results on Mrs. Martinez before deciding whether to file more charges. In another incident, at least two people were shot at 2:30 a.m. yesterday during a fight at a Christmas party at 2831 Valentine Avenue in the Bedford Park section of the Bronx. … An unidentified 34-year-old man was shot and killed and a 28-year-old man was wounded. Other people were shot at the party but fled, witnesses told the police. No arrests have been made. A cab driver was killed Monday night in a dispute with a customer over a fare at the Ging Chinese Restaurant at 94-03B 63rd Drive in Rego Park, Queens. … The driver, whom they did not identify, followed the passenger into the restaurant about 8:30 p.m. They argued and the driver was shot once in the head. The passenger fled and the driver died at 10:20 p.m. in Elmhurst General Hospital. Other slayings included that of a 33-year-old man, Ragip Mekuli, in the lobby of an apartment building at 3344 De Kalb Avenue in the Norwood section of the Bronx. The police said he was shot during a dispute with his brother-in-law, whom they did not identify, but who is being sought for questioning. Anthony Rodriguez, an 18-year-old Bronx man, was shot and killed on Monday night at Arthur Avenue and East 178th Street in the East Tremont section of the Bronx. Mr. Rodriguez, who lived at 1900 Belmont Avenue, was standing on the corner at 8:50 p.m. when two men dressed in black clothing and with black hoods fired a shot at him and missed, the police said. He ran down the street and was shot twice in the back. The suspects fled, and Mr. Rodriguez died at 9:40 p.m. at St. Barnabas Hospital. Detectives were also investigating two unidentified bodies. A man in his mid-20's was found at 2:55 a.m. yesterday near 150 Hope Street in an industrial area in the Williamsburg section of Brooklyn. His pants pockets had been turned inside-out and he had been shot many times in the back and buttocks, police said. In the second case, a man who had been shot in the head was found slumped over the steering wheel of a car at 11:30 p.m. Monday at the corner of Blake Avenue and Tapscott Street in the East New York section of Brooklyn. … No arrests have been made, the police said. Crime statistics use a single phrase to describe this array of tragic deaths: murder and nonnegligent manslaughter. That category also includes many other kinds of killings, and many other kinds of circumstances. Although these violent events are lumped together for purposes of measuring and counting, each differs in its details. The questions surrounding such violent events are many. How

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Page 33 were alcohol and drugs involved? Which killings resulted from disputes over the marketing of illegal drugs? In the case of shootings, how were the weapons acquired? Why did a Christmas Eve robbery attempt end as a homicide? What could motivate a mother to beat her infant daughter to death? Were the victims who were killed by nonfamily members acquainted with their killers? Could the intervention of others have averted it? How can one respond to the living victims? The questions provoked by these violent deaths could well be asked about thousands of violent events that occur every day all over the country. Is life in the United States more violent than ever before? Is New York (or Atlanta or Detroit) a more dangerous place to live than the suburbs, the country, or a small city? Who bears the greatest risk of becoming a victim of violence, and can anything be done to avoid it? What kind of people commit violent acts? What do we know at this point about why? What do the circumstances surrounding violent events tell us? These kinds of questions are asked every day by the people who are touched by a violent event or news of one. Similar questions are asked by law enforcement agents and others who investigate crimes and by those whose job is to intervene in the lives of offenders, victims, and their families. The panel has considered these and other questions in seeking to prevent and understand violent criminal behavior and how to control it and its consequences. The Search for Understanding and Strategies for Prevention and Control Two concerns animate a search for the causes of violence. The principal scientific goal is to understand violent behavior in terms of the same concepts that attempt to explain other human behaviors. The principal policy goal is to find better ways to prevent and control violence. To name a cause of violence is often to suggest something about who or what should be held accountable for it, or even about what actions show some promise of preventing it in the future. Despite limitations of research studies, much has been learned about the causes of violence and from evaluations of interventions to prevent and control it. This report points to many findings about what causes violent behaviors and about how they respond to pharmacological, developmental, criminal justice, and public health interventions.

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Page 34 Biological, medical, epidemiological, and social scientists have all contributed to the understanding of violence. Each discipline offers explanations of certain violent behaviors. In turn, these partial explanations point to different opportunities for interventions to prevent violent behaviors or ameliorate their consequences. But it is mistaken to view these explanations as mutually exclusive alternatives that suggest competing strategies. Rather their diversity suggests a rich array of complementary partial solutions to different aspects of a complex problem. Full understanding of the causes of violence will not be achieved in the foreseeable future—nor is that understanding necessary in order to make progress in reducing violence. A successful intervention at just one point in a long causal chain can prevent some events or reduce their consequences, for example, emergency medical services keep some serious injuries from becoming deaths. This principle is of course not unique to violence. For example, the incidence of AIDS is being reduced by intervening in the behaviors through which the HIV virus is transmitted (Coyle et al., 1991). These interventions are taking place at several levels: in subcultures (e.g., prostitutes and homosexuals), in the environment (e.g., by providing sterilized needles to intravenous drug users), and by changing individual behaviors (e.g., safe sex practices). In this way, prevention is coming about without full understanding. And independent of these preventive efforts, it is anticipated that biological research will lead to understanding cellular-level processes and to a vaccine—an alternative preventive tactic. So too in the case of violence. Awareness of the diversity of violence and the complexity of its causes expands awareness of opportunities for intervention. Because the interactions across levels of explanation are understood so incompletely, awareness of intervention opportunities rarely translates into universal prescriptions for preventing violence. Rather, we recommend programs of well-controlled evaluations of interventions—suggested by existing knowledge and refined over time by altering the interventions and replicating the evaluations—as a means of improving prevention and control while accumulating understanding of causes. Later in this volume, we call for several such programs focused on specific components of "the violence problem." The Panel's Approach The strategy of focusing on specific components is not unlike that taken by scientists investigating cancer—a label that, like

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Page 35 violence, applies to diverse phenomena. This strategy has led to carcinoma-specific recommendations such as sunscreens to reduce the risk of skin cancer and high-fiber diets to reduce the risk of colon cancer. For the diverse events labeled "violent," many classification schemes are possible. The choice of a scheme should depend on its purpose. Different classification systems may be needed to understand violent or aggressive acts by human as compared to nonhuman primates, for example. Similarly, useful classifications for the clinical treatment of people who have behaved violently differ from classifications used to prescribe criminal sanctions. Rather than seeking a single classification system for violence, a preferable strategy involves different classification systems for causal explanation, for prevention, or for interventions that meliorate their consequences. While the preferred strategy involves multiple classification schemes, much of what is known about violent events is based on records classified for the purposes of criminal justice agencies. The categories of behavior used in those data are based largely on violations of the criminal law, and a wide range of violent behaviors fall within each category. Because we must depend on research using these categories, most empirical findings concern categories that lump together diverse behaviors. This limits our knowledge of how to understand, prevent, and control each behavior. Preventing the death of either Mr. Waldermarian or Belinda Jackson would have required different tactics, neither of which is likely to be discovered through analyses of some aggregate "homicide." We therefore, in later sections of this volume, call for greater disaggregation in the measurement of violence. Definition of Violence The panel limited its consideration of violent behavior to interpersonal violence, which it defined as behavior by persons against persons that intentionally threatens, attempts, or actually inflicts physical harm. The behaviors included in this definition are largely included in definitions of aggression. A great deal of what we believe about violence is based on psychosocial research on aggressive behaviors (Dollard et al., 1939; Berkowitz, 1962; Eron, 1987, 1990; Eron et al., 1971), and there is substantial stability in aggressive behavior from infancy to adulthood though its forms change. That is, children who show aggressive behavior at age 8 are more likely than others to exhibit delinquent, criminal, or

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Page 36 violent behavior in adolescence and adulthood (Olweus, 1979; Farrington, 1989, 1991). Little is known, however, about what distinguishes aggressive children who grow up to commit violent acts from those who do not. Later in this volume, we call for a large-scale longitudinal study of the factors—in communities, peer groups, families, and the individuals themselves—that influence this outcome. The panel chose to concentrate primarily on the behavior of individuals and small groups rather than on the behavior of large collectivities, for three reasons. First, within the past 25 years at least half a dozen major reports have given substantial attention to collective violence, and it appeared that little new knowledge might be added by another similar effort (President's Commission on Campus Unrest, 1970; Winslow, 1972). Second, incidents involving individuals and small groups account for the vast majority of violent interpersonal acts in the United States, and the consequences of these acts are of major policy interest to public health and criminal justice agencies. Third, the panel sought to understand violent behavior by bringing together basic knowledge from the biobehavioral and social sciences; these converge most clearly at the individual and group process levels rather than the collective behavior level. The panel's definition deliberately excludes consideration of human behavior that inflicts physical harm unintentionally. Generally, traumatic injuries and deaths in this circumstance are classified as unintentional (Committee on Trauma Research, 1985), even when they occur as a result of corporate policies (e.g., to expose workers to toxic chemicals) that increase the risk of injury or death for some category of persons. Also excluded are certain behaviors that inflict physical harm intentionally: violence against oneself, as in suicides and attempted suicides; and the use of violence by state authorities in the course of enforcing the law, imposing capital punishment, and providing collective defense. One implication of our limited scope is that we do not consider the important question of why some violent behaviors are criminalized while others are not. Historically, for example, attempted suicide was criminalized in most Western countries until the early twentieth century—1960 in England (Hart, 1968). Violence against spouses is still in the process of becoming treated as criminal. We recognize that understanding will be enhanced in future research by studying a broader range of violent behavior using classes based on behavioral rather than legal categories. Currently, however, there are severe empirical limitations to such

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Page 37 work, since many of the data on violent behavior come from data collection systems that derive from the criminal law, especially those grounded in law enforcement and criminal justice discretionary decisions about behavior and events. Alternative systems of data collection, such as emergency and continuing medical treatment of injuries, capture more noncriminal violence and they are underutilized (Mercy and Houk, 1988). However, they also currently have severe limitations for a behavioral approach to violence because they include little if any information on the perpetrators and surrounding circumstances—information that is useful for understanding violent events but irrelevant to the objectives of physicians and emergency response teams. Our definition of violence also excludes events such as verbal abuse, harassment, or humiliation, in which psychological trauma is the sole harm to the victim. However, especially in the context of violence in the family and sexual violence, we do attend to the psychological consequences of threatened physical injury. Diversity in Perspectives Four public institutions are concerned more or less directly with violence or its consequences and bring a variety of resources and problem-solving techniques to the problem of violence. They also generate and use different kinds of knowledge about it. The criminal justice system focuses primarily on detecting violations of the criminal law and dealing with adult violators. Criminal justice agencies generate data and utilize research on such topics as the detection of offenders, arrests, criminal justice decision making, and the crime control effects of criminal justice sanctions. Recently, criminal justice interest has broadened to the management of programs for remediating certain consequences of violence (e.g., victim compensation, counseling rape victims), and crime prevention programs (e.g., neighborhood watch). The juvenile justice system, traditionally concerned with preventing juvenile delinquency through early interventions, has moved closer to the adult criminal justice model in recent decades. Research intended for use by juvenile justice authorities is still most likely to focus on early detection, prevention, and treatment of delinquency than on the narrower included problem of violent behavior. Systems that provide social services and treat mental health, alcohol abuse, and drug abuse are also concerned with violent behavior. In this area the emphases are on the prediction of dangerousness

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Page 38 based on individual behaviors and diagnoses and on the management of patients' violent behavior. This work emphasizes the underlying neuroanatomical, neurophysiological, neurochemical, and behavioral mechanisms; the links through those mechanisms to the presenting problem; and interventions with those mechanisms to manage violent behavior. Monahan and his network of collaborators (1990) are currently assessing this work and have concluded that the data from risk assessment research do not provide much useful information on the risk of violence for the mentally disordered. In the past decade, the public health system has begun to apply its traditional public education, assessment, and prevention principles in new initiatives to prevent intentional injuries and deaths. The public health approach seeks to locate populations at risk of intentional injury and to reduce risks by modifying the hazard, reducing the harm associated with the hazard, or repairing the harm more effectively. Compared with the approaches of the other institutions, the public health system gives less attention to the development, motivation, punishment, or rehabilitation of persons who commit violent acts and more attention to identifying and modifying elements of situations that surround violent events. It also stresses the roles of the public—as potential victims or as members of community-based organizations—in protecting the public health. And it stresses the role of emergency medical services in reducing the loss of life from violent events. The Role of Values Research findings, policy choices for the control of violence, and public values are inevitably intertwined. Policy advocates can be expected to selectively publicize findings that support their positions and the methodological flaws in studies that produce contradictory findings. So long as the policy-making arena resembles a free market of ideas, all perspectives are represented and the accumulation of evidence and resolution of scientific disputes at least raise the level of public policy debate. Unfortunately, new scientific evidence about the causes of violence or about the effectiveness of some intervention might also be rejected merely because its implications conflict with citizens' ethically charged beliefs about such matters as personal responsibility, social justice, and biological determinism. Many people are more attached to their personal values than to their beliefs about causes of violence. In effect, people use their convictions

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Page 39 about policy to judge the accuracy of findings and the effectiveness of interventions, rather than the other way around. People's convictions may even cause them to oppose undertaking particular studies. Violence control policy is therefore less innovative and effective than it should be, and knowledge of how to control violence is less advanced than it could be because some important questions are never investigated and because experience with some preventive interventions never accumulates. Plan of the Report Chapter 2 reports patterns and trends in violence and in the characteristics of its victims and perpetrators. In Part II, we look behind patterns and trends to summarize what is known about the connections between violence and risk factors that conventional wisdom considers to be causes of violent events. Evidence about these connections is drawn from basic research and from evaluations of experience with interventions to modify the factors. Chapter 3 presents overviews of aggressive and violent behavior from three perspectives: the biological, the psychosocial, and the social context of surrounding communities. We then turn to specific factors that are currently receiving public attention as possible causes of violence. Chapter 4 examines alcohol and other psychoactive drugs, Chapter 5 discusses violence in families, and Chapter 6 considers firearms. Part III is concerned with the development of strategies for preventing and reducing violence and for advancing its understanding. Chapter 7 begins by examining the nation's experience between 1975 and 1989 to consider the effectiveness of greater use of incarceration as a means of violence control. Then, as an aid to thinking about a broader array of interventions to prevent and control violence, the panel proposes a matrix for classifying the factors discussed in Part II. The matrix groups risk factors according to their temporal proximity to the violent behavior: predisposing factors, situational elements, and triggering events; it then arrays them across individual and social levels of description. Lacking a testable general theory of violence, we use the matrix merely to highlight the rich array of targets for interventions to prevent and control violence. It ends by explaining the value of careful evaluations as a means of simultaneously advancing the basic understanding of violence and the capacity to prevent and control it.

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Page 40 Finally, Chapter 8 presents the panel's views on science, policy, and violence control and proposes other areas that are ripe for improving intervention strategies. In it the panel makes four recommendations for advancing the understanding of violence as a basis for more effective prevention. One of these, a multicommunity longitudinal study, is intended to advance the integrated understanding of violence causes at the biological, individual, community, and microsocial levels. References Berkowitz, L. 1962 Aggression: A Social Psychological Analysis. New York: McGraw-Hill. Committee on Trauma Research 1985 Injury in America. Washington, D.C.: National Academy Press. Coyle, Susan L., Robert F. Boruch, and Charles F. Turner, eds. 1991 Evaluating AIDS Prevention Programs, Expanded Edition. Washington, D.C.: National Academy Press. Dollard, J., N. Miller, O. Mowrer, and R. Sears 1939 Frustration and Aggression. New Haven: Yale. Eron, L. 1987 The development of aggressive behavior from the perspective of a developing behaviorism. American Psychologist 42:435-442. 1990 Understanding Aggression. Presidential Address. World Meeting of ISRA. Unpublished, June 12, 1990. Eron, L.D., L. Walder, and M.M. Lefkowitz 1971 Learning of Aggression in Children. Boston: Little Brown. Farrington, D.P. 1989 Early predictors of adolescent aggression and adult violence. Violence and Victims 4:79-100. 1991 Childhood aggression and adult violence: Early precursors and later-life outcomes. Pp. 5-29 in D.J. Pepler and K.H. Rubin, eds., The Development and Treatment of Childhood Aggression. Hillsdale, N.J.: Erlbaum. Finder, Alan 1990 9 are killed in disputes or at parties over the Christmas holiday. New York Times, December 26, p. B1. Hart, H.L.A. 1968 Punishment and Responsibility. Oxford: Oxford University Press. Mercy, J.A., and V.N. Houk 1988 Firearm injuries: A call for science. New England Journal of Medicine 319(19):1283-1285. Monahan, John 1990 Research Network on Mental Health and the Law: Continuation

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Page 41 Proposal for Phase II Support and Proposal for a Phase I-Phase II Transition Period. October 11. Olweus, D. 1979 Stability of aggressive reaction patterns in males: A review. Psychological Bulletin 86:852-875. President's Commission on Campus Unrest 1970 The Report of the President's Commission on Campus Unrest. Washington, D.C.: U.S. Government Printing Office. Winslow, Robert W. 1972 Crime in a Free Society. Selections From the President's Commission on Law Enforcement and Administration of Justice, the National Advisory Commission on Civil Disorder, the National Commission on the Causes and Prevention of Violence, and the Commission on Obscenity and Pornography. Encino, Calif.: Dickenson Publishing Company.