The Journal of Forensic Psychiatry & Psychology Vol. 23, No.

3, June 2012, 392409

Approach and escalation in stalking

Troy E. MCEwana,b*, Rachel D. MacKenziea, Paul E. Mullena,b and David V. Jamesc
a Victorian Institute for Forensic Mental Health, Melbourne, Australia; bCentre for Forensic Behavioural Science, Monash University, Melbourne, Australia; cFixated Threat Assessment Centre, London, UK

(Received 29 August 2011; nal version received 14 March 2012)

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Approach and escalation from communication to approach are important considerations in stalking, because intrusive behaviours cause victims distress, and approach is a pre-requisite for attack. This study reports the rst detailed examination of these behaviours in a general stalking sample, specically a cohort of 211 cases referred to a specialist clinic. In non-exintimate stalkers, approach was associated with psychosis and intimacy seeking motivation. The same associations applied to escalation, only more strongly so. A comparison of approach-only cases with escalators showed that the former were signicantly less likely to be intimacy seekers and more likely to have non-psychotic diagnoses and to assault. These results are striking similar to those in public gure samples. No associations with approach or escalation were found in ex-intimate cases. These results illustrate the importance of treating psychosis, the substantial overlap between risk factors in public gure and general population victims, and the importance of motivation in stalking risk assessment. Keywords: stalking; risk assessment; escalation; approach; threat assessment

Introduction Stalking refers to a pattern of unwanted intrusions by one person into the life of another in a manner which would cause a reasonable person anxiety or fear. Such intrusions broadly fall into two groups communications and approaches. Types of communication commonly experienced by victims involve telephone calls, e-mails, letters and increasingly, mobile phone text messages (SMS) and new forms of social networking, such as Twitter or Facebook. Sending or leaving the victim unsolicited materials (e.g. money, clothing or more disturbing items like dead animals or cons) may also occur, as may indirect methods of communication, such as ordering or cancelling services (Mullen, Pathe, & Purcell, 2009). Approaches are
*Corresponding author. Email: troy.mcewan@monash.edu
ISSN 1478-9949 print/ISSN 1478-9957 online 2012 Taylor & Francis http://dx.doi.org/10.1080/14789949.2012.679008 http://www.tandfonline.com

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behaviours that increase the stalkers proximity to the victim, and comprise accosting, following, spying on the victim, and loitering near or entering the victims home or workplace. A central concern to those experiencing stalking is whether or not the behaviour is likely to become more intrusive. The potential for approach behaviours is of particular import, partly because of the greater degree of intrusion and the concomitant heightening of fear that this occasions, and also because approach is a sine qua non of almost all forms of violent attack. However, there have been few studies or reviews in general population stalking samples touching upon which stalkers are more likely to approach the victim (Kropp, Hart, & Lyon, 2002; Palarea, Zona, Lang, & Langinrichsen-Rohling, 1999), or which stalkers are likely to progress from intrusive communications to approach. The process of moving from communicating with or about the victim to approach behaviour has previously been termed escalation in studies of public gures, public ocials and celebrity harassment, and stalking (Calhoun, 1998; Dietz & Martell, 1989; Dietz et al., 1991a, 1991b; James et al., 2010a; Scalora et al., 2002a, 2002b). Abnormal communications and approaches were rst studied systematically in the late nineteenth century in the context of attacks on prominent people (Laschi & Lombroso, 1886; Regis, 1890), but only subject to quantitative analysis in the late 1980s. In fact, the rst empirical studies of stalking behaviour used samples comprising public gures and celebrities (Dietz & Martell, 1989; Dietz et al., 1991a, 1991b). Over the next two decades, the two literatures drew apart, with stalking research focussing on epidemiology, psychopathology and the link with domestic violence, while the public gure research moved into the new eld of threat assessment, with a predominant focus on preventing violent attack. Over the past ve years, similarities between stalking in the general community and the stalking and harassment of prominent people have become increasingly apparent, with evidence emerging to indicate that, with the exception of those who have previously had a sexual relationship with the victim, stalkers and harassers of the general populace share characteristics and risk factors with stalkers and harassers of public gures (James et al., 2009, 2010b, 2010c; MacKenzie et al., 2009). For victims, law enforcement personnel and mental health professionals dealing with stalkers, the overall frequency or variety of stalking behaviours is perhaps of less concern than the occurrence of particular behaviours which, in the absence of specic intervention and management, are associated with adverse outcomes. Adverse outcomes and their associated risks concern the separate domains of persistence, recurrence and psychosocial damage to victim and stalker, as well as that of violence which has received the greatest (and arguably disproportionate) attention (Mullen et al., 2006). Whilst escalation (from communication to approach) has been

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used both as a risk domain in the assessment of public gure stalkers (MacKenzie et al., 2009) and as a single risk factor in assessing stalking risk (Kropp, Hart, & Lyon, 2008), virtually no information exists about this domain in general population victims. In the absence of detailed research on approach and escalation in the general stalking literature, some guidance can be drawn from research into the behaviour of those who stalk public gures. James et al. (2010b) examined factors associated with approach and escalation in a sample of those harassing and stalking members of the British royal family. Approach was associated with a series of factors, most notably psychotic illness and grandiosity. Escalation had similar associations, which were even stronger than for approach. In addition, escalation was associated with energised forms of behaviour, such as multiple communications and using multiple means of communication. Both approach and escalation were associated with motivations which concerned a personal sense of entitlement towards the individual in question, rather than the pursuit of a cause or grievance. In those who escalated to approach, signicantly fewer used threatening language in their communications than those who communicated but did not approach. However, amongst those escalating from communication to approach activity involving breach or attempted breach of security perimeters or cordons, the proportions using threatening language were higher than in those that only communicated. Meloy et al. (2011) reviewed six of the largest studies of public gure stalking in an attempt to identify common factors associated with approach and with escalation from communication to approach. The six studies, variously examining harassment of US politicians, Hollywood celebrities and the British royal family, identied ve common precipitants of approach. Mental illness, common in all the public gure stalker samples, was signicantly more prevalent amongst approachers in ve of the six studies. Across all studies, those who approached were more likely to use multiple means of communication and contact multiple targets during their campaign. Requests for help were signicantly associated with approach in four of the six studies. Threatening and antagonistic communications were signicantly less frequent amongst approachers in all six studies. In summary, despite denitional dierences between studies, it was possible to ascertain that the associations of approach and escalation in the British royal family study were broadly reected in the studies of politicians and celebrities in the USA. Given the lack of attention to approach and escalation in the general stalking literature, the aims of this study were as follows: rst, to identify factors associated with approach and escalation in a general forensic sample of stalkers: and second, to compare these results with associations with approach and escalation from the public gure stalking literature. In order to do this, it was necessary to separate the stalking sample into two groups:

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those that were former sexual intimates of their victim, and those that were not. In addition, we wished to ascertain any dierences between those that approached after communicating (escalation) and those that approached without any previous communication (approach-only). Finally, we wanted to examine the relationship between threats and violence in those that approached and in those that escalated from communication to approach. Method Study sample Study subjects comprised a consecutive sample of 232 stalkers referred for assessment to a specialist community stalking clinic in the state of Victoria, Australia. Cases were excluded if they refused to participate, if their English language skills were inadequate or if their mental state was such that they were unable to participate or to give informed consent, resulting in a nal sample size of 211. The clinic has specic expertise in stalking, and referrals can be made based on the presence of stalking behaviour alone, without any evidence of mental disorder (Warren, MacKenzie, Mullen, & Oglo, 2005). Referral sources comprised the courts, community-based correctional services, and mental health services, both outpatient and inpatient and private clinicians. There were two self-referrals. Each subject was interviewed at length both by a psychiatrist and by a psychologist specialised in the assessment of stalkers. Historical and demographic data were collected, and each participant was subject to a battery of psychometric instruments. Operationalised denition of stalking The 211 clinic attendees who formed the nal study sample had either been convicted of stalking or stalking-related oences (e.g. malicious communications, breaches of intervention orders, repeated threats), or had engaged in campaigns of harassment exceeding two weeks, the watershed established by Purcell, Pathe, and Mullen (2004). Stalking-type behaviours within the context of a current intimate relationship were excluded. Denition of stalking behaviours Unwanted communication was identied as present if the stalker, or proxy representatives, had made any contacts to the victim either verbally, in writing, through sending unsolicited materials or by ordering or cancelling goods or services related to the victim. Unwanted approach was identied where the stalker loitered near, followed, spied upon, invaded property, or accosted the victim with hostile or conciliatory intent whether in domestic,

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occupational or social locations. Violence was dened as physical contact with the victim with the intent to coerce or harm. Diagnoses Diagnoses were allocated according to DSM-IV-TR criteria (American Psychiatric Association, 2000). Those with schizophrenia, delusional disorder and bipolar disorder involving delusional beliefs were combined into the category of psychosis. Substance misuse was dened as the harmful use of alcohol or prescription medications, or the use of illicit substances. Personality disorder was recorded in the presence of a diagnosis or problematic traits based on clinical interview and psychometric testing (Minnesota multiphasic personality inventory, 2nd edition: Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989, or Millon Clinical Multiaxial Inventory, 3rd edition: Millon, Millon, & Davis, 1994). Stalker motivational groups Each stalker was classied according to Mullen and colleagues motivational typology (Mullen, Pathe, Purcell, & Stuart, 1999), which is endorsed as the standard in the eld by the Group for the Advancement of Psychiatry (Pinals, 2007). From their research and clinical experience, Mullens group identied ve categories of stalkers: the rejected, intimacy seekers, the incompetent, the resentful and the predatory. The rejected stalker commences stalking after the breakdown of an important relationship that was usually, but not always, sexually intimate in nature. In this group, the stalking reects a desire for reconciliation, revenge or a uctuating mixture of both. The intimacy seeker desires a relationship with someone who has engaged his or her aection and who, he or she is convinced, already does, or will, reciprocate that love despite obvious evidence to the contrary. This includes the pursuit of a soul mate, parental gure or inclusion in a family. The incompetent suitor also engages in stalking to establish a relationship. However, unlike the intimacy seeker, he or she is simply seeking a date or a sexual encounter. The resentful stalker sets out to frighten and intimidate the victim to exact revenge for an actual or perceived injury. The predatory stalker pursues the victim to obtain sexual gratication (e.g. through voyeurism or theft of personal belongings), or in preparation for a sexual assault. Clinicians trained in the typology allocated participants to one of the ve types based on the information obtained during clinical interview and provided by the referral source (e.g. witness statements, summary of charges and prior assessment reports). Dicult cases were discussed within the clinic team and the majority decision was accepted. One participant was excluded

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from analyses between stalker types as she met criteria for more than one stalker type. Statistical analysis Analyses were conducted using SPSS (version 17, SPSS Inc., Chicago, IL, USA). To determine dierences between groups on categorical variables, chi-square analyses (w2) and odds ratios (OR), with 95% condence intervals, were used for discrete variables. When the required statistical assumptions were not met, Fishers exact test was used. The eect size (f) (Siegel & Castellan, 1988) was also calculated for each measure of association, because eect sizes enable interpretation of the data beyond, and independently of, the information provided by p values and take into account the reduced power of uneven sample sizes.

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Multiple testing The role of approach and communication in stalking is a virtually unexplored area. As the purpose of this study was to explore possible associations, rather than the testing of specic hypotheses, multiple testing was used. No corrections to signicance values were incorporated to compensate for multiple testing. In consequence, conclusions drawn in the account below from p values larger than .01 should be treated with caution. Results Description of the overall sample Table 1 presents frequencies of the demographic, clinical and behavioural variables for the full sample and also those for the sub-divisions of ex-intimates and non-ex-intimates which are used in between-group comparisons. The ex-intimate and non-ex-intimate groups were compared on four preselected parameters, chosen from an examination of the literature. Ex-intimates were found to be more likely than non-ex-intimates to communicate, (w2 6313, p .012, f 7.174, OR 2.44, CI 1.205.00), and escalate, (w2 14,601, p .000, f .264, OR 3.13, CI 1.725.56). Nonex-intimates were signicantly more likely to be suering from psychotic illness (w2 11,350, p .001, f .232, OR 4.39, CI 1.7610.87). There was no signicant dierence between the two groups in terms of approach. Approach Seventy-four percent (157) of the whole stalker sample approached the victim. Associations with approach were examined separately in ex-intimate and non-ex-intimate stalkers (see Table 2).

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Table 1. Demographic, clinical and behavioural characteristics of the stalker sample, used in the subsequent analyses. Total (N 211) N, (%) Gender (male) Age Victim gender (female)a Employed Diagnostic group Axis I diagnosis (excluding psychotic disorders)b Psychotic disorderc Personality disorderd Substance misuse at time of stalking Motivational group Intimacy seeking Incompetent suitor Rejected Resentful Predatory Communication Any form of communication Telephone calls Written communication SMS Unsolicited materials Multiple forms of communication Approach Any form of approach Loiter or spy Follow victim Accost victim Enter victims home Escalation (communication and approach) 190 35.6 169 106 (90) (SD 10.8) (80.1) (50.2) Ex-intimate (N 71) N, (%) 68 35.8 63 38 (95.8) (10.3) (88.7) (53.5) Non-ex-intimate (N 140) N, (%) 122 35.6 106 68 (87.1) (11.0) (75.7) (48.6)

87 (41.2) 46 (21.8) 94 (44.8) 100 (47.4) 28 40 78 45 19 151 111 64 34 35 64 (13.3) (19.0) (34.3) (21.3) (9.0) (71.6) (52.6) (30.3) (16.1) (16.6) (30.3)

29 (40.8) 6 (8.5) 36 (50.7) 38 (53.5) 71 (100.0) 59 49 22 26 14 33 (83.1) (69.0) (31) (36.6) (19.7) (46.5)

58 (41.4) 40 (28.6) 58 (41.4) 62 (44.3) 28 40 7 45 19 92 62 42 8 21 31 (100.0) (100.0) (9.7)e (100.0) (100.0) (65.7) (44.3) (30.0) (5.7) (15.0) (22.1)

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157 99 42 97 19 97

(74.4) (46.9) (19.9) (46.0) (13.7) (46.0)

58 33 16 44 21 46

(81.7) (46.5) (22.5) (62.0) (29.6) (64.8)

99 66 26 53 8 51

(70.7) (47.1) (18.6) (37.9) (5.7) (36.4)

Notes: aIn 20 cases (9.4%) victims of both genders were harassed; bOnly depression and substance abuse or dependency disorders were present in more than 10% of the sample. See McEwan et al. (2009) for further detail; cSchizophrenia accounted for 75% of diagnoses, delusional disorder (erotomanic type) accounted for 13% of diagnoses; dEither diagnosed disorder or identied problematic traits. Cluster B most prevalent, accounting for 50% of cases; e Rejected non-ex-intimate cases involved individuals rejected by their parents or close friends.

Associations with approach in non-ex-intimates In non-ex-intimates, approachers (n 99) were signicantly more likely than non-approachers (n 41) to have an intimacy seeking motivation (OR 3.94,

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Table 2. Characteristics signicantly associated with approach by stalkers, compared to communication-only cases. Ex-intimate (n 71) approach: communicationonly w2, p Psychotic disorder Intimacy seeking Resentful Telephone calls SMS 6.9%: 15.4% .99, p .301a 69.9%: 69.2% .00, p 1.000a 37.9%: 30.8% .24, p .756a 46.6%: 46.2% .001, p 1.000 Non-ex-intimate (n 140) approach: communicationonly w2, p, f 35.4%: 12.5% 7.26, p .007, .23, 24.2%: 7.5% 5.10, p .024, .19 27.3%: 45.0% 4.10, p .043, 7.17 28.9%: 82.9% 34.40, p .000, 7.50 0.0%: 19.5% 20.09, p .000, 7.39 17.5%: 34.1% 4.57, p .033, 7.18

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Multiple forms of communication

Note: aFishers exact test.

CI 1.1213.95), and to have a psychotic illness (OR 3.83, CI 1.3810.66). Overall 87.5% of psychotic stalkers approached the victim. Non-approachers were signicantly more likely than approachers to have a resentful motivation (OR 2.18, CI 1.024.69), make telephone calls to the victim (OR 11.90, CI 4.7430.30), use multiple means of communicating with the victim (OR 2.44, CI 1.065.59), and send SMS (no approachers sent an SMS). Associations with approach in ex-intimates Amongst ex-intimates, no signicant dierences were found between the 58 who approached and the 13 who did not on any of the demographic, clinical or behavioural characteristics listed in Table 1. Escalation In considering escalation, those who only approached were excluded from the base sample, leaving a total sample of 151 stalkers. This comprised 54 stalkers (36%) who communicated but did not approach, and 97 (64.2%) who both communicated and approached (i.e. escalated). Associations with escalation in non-ex-intimates Forty-one non-ex-intimates who communicated and escalated to approach in the course of the harassment were compared with 51 non-ex-intimates who

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communicated but did not escalate (see Table 3). Stalkers with an intimacy seeking motivation were signicantly more likely to escalate (OR 6.72, CI 1.8224.91), as were those with a psychotic disorder (OR 5.31, CI 1.7915.77). Sending unsolicited materials to the victim was also strongly associated with escalation (OR 6.90, CI 1.8725.56). Those who did not escalate from communication to approach were signicantly more likely to be suering from Axis I disorders other than psychosis (OR 2.63, CI 1.106.33), or to have made telephone calls (OR 3.98, CI 1.4910.64) or sent SMS to the victim (no-one who escalated sent an SMS to the victim). Escalation in ex-intimates

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Fifty-nine ex-intimate stalkers communicated with the victim during their campaign. No demographic, clinical or behavioural characteristics dierentiated between those who only communicated (n 46) and those who communicated and escalated to approach (n 13). Comparison of approachers who communicated with those that did not The 46 non-ex-intimates who approached the target without communicating were compared with the 53 that communicated as well as approached (i.e. escalated) (see Table 4). Those who approached and communicated were more likely to be women (OR 5.88, CI 1.2027.78) and be intimacy seekers

Table 3. Characteristics signicantly associated with escalation by stalkers, when compared with communication-only cases. Ex-intimate (n 59) escalation: communicationonly w2, p Psychotic disorder Axis I disorder (excluding psychosis) Intimacy seeking Sending unsolicited materials Telephone calls SMS
Note: aFishers exact test.

Non-ex-intimate (n 92) escalation: communicationonly w2, p, f 43.1%: 12.5% 10.084, p .001, .333 27.5%: 50.0% 4.870 , p .027, 7.231 35.3%: 7.5% 9.756, p .002, .327 35.3%: 7.3% 10.099, p .001a, .331 54.9%: 82.9% 8.123, p .004, 7.97 0.0%: 19.5% 10.89, p .01, 7.344

8.7%: 15.4% .496, p .605a 39.1%: 38.5% .002, p .965 21.7%: 30.8% .457, p .485a 87.0%: 69.2% 2.262, p .204a 47.8%: 30.8% 1.196, p .351a

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Table 4. Characteristics signicantly associated with approach-only cases when compared to approach and communication (escalation) cases. Ex-intimate (n 58) approach-only: escalate w2, p Female stalker Axis I disorder, other than psychosis Intimacy seeking Predatory Loitering or spying 0.0%: 6.5% .825, p 1.000a 50.0%: 39.1% .464, p .496 58.3%: 56.5% .013, p .910 16.7%: 30.4% .903, p .479a 50.0%:32.6% 1.246, p .264 66.7%: 73.9% .250, p .720a 50.0%: 45.7% .072, .788 Non-ex-intimate (n 99) approachonly: escalate w2, p, f 4.3%: 20.8% 5.811, p .016, 7.242 52.2%: 26.4% 6.909, p .009, .264 10.9%: 35.8% 8.367, p .004, 7.291 30.4%: 5.7% 10.627, p .001, .328 78.3%: 58.8% 4.202, .04, .208 41.3%: 13.7% 9.376, .002, .311 69.6%: 39.2% 8.958, p .003, .304 21.7%: 45.3% 6.054, .014, 7.247 21.7%: 3.8% 7.462, p .006, .28

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Following Multiple forms of approach Threats Assault

Note: aFishers exact test.

(OR 4.55, CI 1.5513.5). In contrast those who approached without communicating were more likely to be predatory stalkers (OR 7.30, CI 1.9427.03). They were more likely to have non-psychotic Axis 1 disorders (OR 3.29, CI 1.427.04). A smaller proportion of approach-only cases than escalators was psychotic (26.1% vs. 43.4%), but this dierence did not reach statistical signicance. Those who approached without communicating were signicantly more likely to engage in multiple forms of approach (OR 3.54, CI 1.528.20) and in two specic forms of approach: loitering/spying (OR 2.51, CI 1.036.17), and following (OR 4.43, CI 1.6411.91). They were also signicantly more likely to assault (OR 7.09, CI 7.0934.48). Those who approached and communicated were more likely to threaten (OR 2.94, CI 1.237.19). No dierences were found between ex-intimate approach-only and escalator cases (n 12 and n 43, respectively). Relationship between threats and violence In the overall sample, threats were present in 105 (49.8%) cases, and violence occurred in 39 (18.5%). Amongst ex-intimates, threats were made by 54 participants (76.1% of the sub-sample), and violence was present in 27 cases (38% of the sub-sample). Amongst non-ex-intimates, threats were

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present in 51 cases (36.4% of the sub-sample), and violence in 12 cases (8.6% of the sub-sample). Amongst those who approached, ex-intimates accounted for 27 of the 39 cases involving violence. Amongst those whose stalking behaviour escalated from communication to approach, ex-intimates accounted for 21 of the 23 cases that involved violence. Twenty of the 23 stalkers (87%) who escalated and were then violent uttered threats. In approach cases, explicit threats were signicantly associated with violence in ex-intimate approachers (w2 6.864, Fishers exact p .017, f .344, OR 5.778, 95% CI 1.43023.342), but not in non-ex-intimate approachers. Amongst all those who escalated, threats were associated with violence (w2 9.890, Fishers exact p .002, f .319, OR 6.667, 95% CI 1.82424.370), but this did not hold for either ex-intimate or non-exintimate escalator sub-samples.

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Discussion The aims of the study were to identify variables associated with approach and escalation amongst ex-intimate and non-ex-intimate stalkers, and to compare the latter with results from the public gure stalking literature. Non-ex-intimate stalkers The study found that approach in non-ex-intimate stalkers was associated with the presence of psychotic disorder and with intimacy seeking motivation. In addition, approach was negatively associated with resentful motivation. Escalation was associated with the same two main factors as approach, but more signicantly so. These results indicate that it is those with psychotically driven desires for intimacy with a given individual who are more prone to approach or escalate, rather than those driven by grievances, persecutory delusions or what have been termed xations on a cause (Mullen et al., 2009). These ndings are strikingly similar to those found in the only detailed study of the issue in public gure cases (James et al., 2010a), where psychotic illness and forms of intimacy seeking (in the form of love, friendship or kinship) were the strongest associations with both approach and escalation, the associations similarly being stronger with escalation. Denitional issues make comparisons with US public gure studies less than straightforward, but the association between escalation and psychosis was again evident in four of ve major studies concerning politicians or celebrities (Meloy et al., 2011). The fact that there are similar associations for approach and escalation across diverse groups and in dierent countries strengthens the ndings of the current study. It also constitutes further evidence that the phenomena of stalking and harassment and their core associated risk factors

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are fundamentally similar, whether the victims are ordinary members of the population or those with a more prominent public image, whether through celebrity, accumulation of wealth, election to public oce or accident of birth. Sending unsolicited materials, which is associated with escalation in the current study, may reect the same phenomenon as sending multiple communications which is associated with escalation in the Royal Family study and in the four US public gure studies for which relevant data is available (Meloy et al., 2011). However, there are some evident dierences in ndings between the current study and the public gure studies. The use of multiple forms of communication was signicantly associated with escalation in the Royal Family study and in the four US studies which collected relevant data: however, no such association was apparent in the current study. The making of telephone calls was associated with escalation in the Royal Family study, but negatively associated with escalation in the current study. The making of telephone calls, the sending of SMS and the use of multiple forms of communication were negatively associated with approach in the non-ex-intimate group in the current study, whereas, in the British royal family study, no association was found between these variables and approach. The reasons for these disparities in ndings are open to speculation, but it may well be that accessing dierent types of contact details (e.g. telephone numbers, e-mail and postal addresses, fax numbers) for non-ex-intimate victims is easier with a public gure than a private citizen, allowing for a greater breadth of communication types. Public gures, after all, depend upon open forms of communication with their core base in order to maintain their position, and this involves publishing details of their whereabouts and of multiple methods by which they may be contacted. It seems understandable that these might be utilised by psychotically energised intimacy seekers. Overall, it would appear to be the case that the public prole of the victim is more relevant to the style of pursuit or intrusion than to the fundamental associations of these behaviours. Some issues were not explored in as much detail in the current study as in that concerning the British Royal Family (James et al., 2010a). In particular, the current study did not look at specic components of mental state. In the royal family study, it was particularly notable that the mental state item, grandiosity, was associated with both approach and escalation. Similar ndings can be discerned in US studies of celebrities and politicians (Meloy et al., 2011). This presumably reects a psychotically driven sense of entitlement to an individual. Future research with general population victims would benet from a more specic examination of stalker mental state items, in particular psychotic symptoms. This study also explored the dierences between those that communicate before approaching (i.e. escalate) and those who approach without

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communicating (termed approach-only). It was found that, in the sample of non-ex-intimates, approach-only cases were signicantly less likely to be intimacy seeking in motivation and more likely to include the predatory stalker group. They were also more likely to have a non-psychotic Axis 1 disorder, more likely to engage in multiple forms of approach, less likely to be women, and more likely to engage in assault. These characteristics are all consistent with the predatory motivation. A smaller proportion of the approach-only group were psychotic (26% vs. 43%). These ndings echo those from the royal family study (James et al., 2010a, 2010b, 2010c, 2010d) which likewise found that those who approached without communicating were signicantly less likely to be intimacy seekers. Also, the royal family study found that a range of individual symptoms of psychosis were signicantly less likely to be found in approach-only cases (delusions, persecutory ideas, grandiosity and being rambling or confused in speech). In terms of multiple forms of approach, the approach-only cases in the royal family study were more likely to go on to attempt or succeed in breaching security barriers, which reects a greater intensity of approach activity. There were no assaults of royal personages in the study; however, approachonly cases were more likely to behave in an intimidating manner on approach, which may well represent a similar phenomenon to assault. Escalation, Approach and Violence Given that approach is generally held to be associated with violence (Dietz & Martell, 2010; McEwan et al., 2009; Palarea et al., 1999), it appears at rst glance something of a conundrum that intimacy seeking is associated with approach. Intimacy seekers have been found to present a lower risk of attack, with violence being linked rather to those with a grievance or pursuing idiosyncratic, sometimes psychotically motivated, quests for justice (public gure cases: James et al., 2007, 2008, 2009, 2010d: general stalking McEwan et al., 2009). However, this simply emphasises that motivational type alone does not dictate risk, and that greater attention should be given to examining the interaction of motivation with other characteristics when structuring risk assessment in stalking. In considering risk factors for violence in approach, factors concerning intimacy seekers will dier from those concerning the resentful and must be examined separately (MacKenzie et al., 2009). In other words, dierent motivational groups carry dierent risk factors for a given domain of risk. In terms of the association between threats and violence, threats were signicantly associated with violence in ex-intimate approachers, but not in non-ex-intimates, which indicates both that threats should be taken seriously in ex-intimates and that their absence in non-ex-intimates does not indicate a lower risk of violence. In escalators as a whole, threats were strongly associated with violence, and this may simply reect the fact that

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threats and violent are not infrequently almost concurrent in stalking cases (McEwan et al., 2009). The absence of any signicant associations with escalation in the ex-intimate and non-ex-intimate sub-groups may be a consequence of smaller sample sizes. As regards the comparisons of approach-only cases with escalators, there is a disparity in the non-exintimate group between the making of threats, which is signicantly less common in approach-only cases (see Table 4), and assault, which is markedly more frequent in that group. It might be thought that previous communication in escalators would be likely to aord additional opportunity to make threats, but this is unlikely to be the whole explanation, given that there was no signicant dierence in the making of threats between the approach-only cases and escalators in the ex-intimate sample. The fact that assault is signicantly more frequent amongst approachonly cases in non-ex-intimates is of some interest. Only 3.8% of escalators assaulted, compared with 21.7% of the approach-only cases. This indicates that approach may be a more ominous behaviour in terms of violence when it has not been preceded by forms of communication. This probably reects once again dierences in motivation between approach-only cases and escalators. In the current sample, the smaller proportion of predatory stalkers in the escalating group (three of nineteen [15.8%], compared to 48 [34.2%] of other non-ex-intimates) may be of relevance. Predatory stalkers rarely use communication to intrude on the victim as, unlike other stalker types, they usually have little interest in alerting the victim to their intentions. The purpose of their pursuit, to full sexually deviant desires or in preparation for a sexual assault, leads them to use approach behaviours and may of itself result in increased prevalence of violence (Mullen et al., 1999). A typical case of predatory stalking might involve seeing the victim by chance and following them to locate their home or travel pattern. The stalker then repeatedly loiters near the victim over a number of days or weeks (often at the home at night) and may engage in voyeurism or deviant fantasies about the victim. Occasionally, predatory stalkers reveal their presence by stealing personal items, such as underwear, or by leaving sexually explicit material where the victim will nd it. This almost never alerts the victim to the presence of other stalking behaviours and is usually dismissed as an isolated event. In a signicant minority of cases, the pattern of predatory behaviour will culminate in a sexual assault in the victims home or in public. In the current sample, predatory stalkers committed onethird of all assaults by non-ex-intimates, whilst constituting only 13.5% of the group. However, small numbers in these sub-groups in this study did not permit more detailed exploration of these issues. As might be evident from the above example, in many cases predatory stalkers can be thought of and assessed as sex oenders. A number of authors, including the creators of the motivational typology, have expressed

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reservations about the utility of the predatory category for this reason (Mullen et al., 1999; Pinals, 2007). It has to be acknowledged that predatory stalking and sex oending do frequently co-occur; however the two groups are not identical. Predatory stalkers exist who do not commit sexual oences (although they may oend in other ways), and equally, there are sexual oenders who do not stalk their victims prior to committing sexual assault. Despite her concerns, Pinals (2007) concluded that the concept of predatory stalking was useful given that it has several elements in common with [other types of] stalking, such as the existence of a xation on a particular person, repetitive behaviours related to the object of pursuit, and the notion that the behaviour would cause fear in the victim if the victim were aware of it (p. 57). Decisions about whether to classify those who engage in both stalking and sexual violence as stalkers or sexual oenders must be based on which label is most useful for the assessors purpose in the individual case, and the management and treatment options that are available. The risk of sexual violence in cases of predatory stalking may best be assessed with tools designed for the wider population of sex oenders (MacKenzie et al., 2009; MacKenzie & James, 2011; McEwan, Pathe, & Oglo, 2011). Ex-intimate stalkers In contrast to the ndings for non-ex-intimate stalkers, none of the demographic, clinical or behavioural variables included in this study were able to dierentiate between those ex-intimates who approached and those who did not, nor between those who communicated and those who escalated to approach, nor between escalators and approach-only cases. This powerfully illustrates the error of considering all stalkers as a single entity, rather than as comprising dierent groups of people with dierent motivations who express their underlying drives in similar constellations of behaviour. In terms of risk assessment, many associations for given domains of risk vary according to individual motivation, and risk factors also vary according to the domain of risk under consideration (e.g. persistence, escalation, psycho-social damage, recurrence, violence, etc.). Risk assessment must therefore be structured to take account both of motivation and of risk domain. The dierence in results between ex-intimate and non-ex-intimate stalkers also illustrates the folly of dealing with all stalkers under the umbrella of domestic violence, which is currently policing practice in the UK and many other jurisdictions. This study is the rst of its kind in a sample of general population stalkers. It used structured assessment and data collection procedures that are a signicant strength not present in many other clinical studies of stalkers. Nonetheless, it is clear that the results in the more detailed subanalyses are limited by the small numbers in some sub-groups. There is also a possibility that mental illness may have been over-represented in the sample due to the fact that the clinic where data was collected sits within a

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forensic mental health service. However, if so, this may have been an advantage in terms of over-sampling a particularly relevant factor for study. Conclusion This study shows that there are specic variables that are associated with approach and with escalation amongst non-ex-intimate stalkers. Given that approach is associated with violence in the stalking literature and is of particular import in terms of the distress that it causes to victims, there is a strong argument for early identication of the presence of risk factors for approach when law enforcement or mental health personnel are assessing a stalking situation. As psychosis is one of the strongest predictors of approach and escalation, the ndings of this study oer support for the role of mental health professionals in assessing and managing cases of non-exintimate stalking. Early identication of psychotic symptoms and assertive management incorporating mental health treatment may go some way towards reducing the impact of intrusive and distressing stalking situations on victims, and on the stalkers themselves. Overall, the study provides further evidence for the importance of motivation as a primary issue in the assessment of risk, and for the separation of risk into dierent domains with specic constellations of risk factors. It also suggests that escalation may be a domain of risk (rather than a risk factor) that is useful to consider in nonex-intimate stalking cases, as well as public gure cases. Finally, it adds to the evidence that similar risk factors apply, whether victims are members of the general public or prominent gures in society. This is important because it indicates that research ndings relating to the former victim group can cautiously be applied to the latter, and vice versa, once ex-intimate cases have been removed from the samples. This increases the size of the research base that can be applied in the assessment and management of risk in cases of stalking and harassment. References
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