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versión impresa ISSN 0213-6163
Eur. J. Psychiat. vol.22 no.4 oct./dic. 2008
Stefan Stieger*, Christoph Burger**, Anne Schild**
* Medical University of Vienna
** University of Vienna. Austria
Background and Objectives: Community-based studies of stalking in European countries are scarce. The aim of the present study was to replicate the epidemiological study by Dressing and colleagues, which analyzed a sample drawn from a middle-sized German city (Dressing et al., 2005) by using a general population sample (urban as well as rural citizens) from Eastern Austria.
Methods: In a survey of 401 persons from Eastern Austria we tried to replicate the study on the lifetime and point prevalence of stalking in a German urban community. The survey included a stalking questionnaire and the WHO-5 well-being scale.
Results: Nearly 11% of the respondents (n = 43, 37 women, 6 men) reported having been stalked. Victims scored significantly lower on the WHO-5 well-being scale. We found no significant differences in stalking and well-being between rural and urban areas.
Conclusions: Epidemiological data on stalking collected in an Austrian community closely resemble the data derived from a community-based sample in a middle-sized German city. We also inquired about the living environment of the participants (rural or urban), but found no difference between the two. Furthermore, the lifetime prevalence of being a stalking victim is associated with currently impaired psychological well-being as measured by the WHO-5 Well-being Index.
Keywords: Stalking, Epidemiology, Psychological well-being, Austria.
Research on the impact of stalking is limited by a paucity of consistent, agreed upon definitions, a clear demarcation of the concept1,2 and, particularly in European countries, epidemiological studies3-5. Thus, the reported prevalence rates predominantly refer to English-speaking countries, ranging from 12% to 32% for women and 4% to 17% for men6-8. So far, only one community-based epidemiological study on stalking has been performed in a continental European country, namely Germany4. The data were obtained from a middle-sized German city and not from the general population. In order to bridge this gap we replicated the study of Dressing et al.4 and investigated a general population sample drawn from the population of Eastern Austria. To our knowledge the current study is the first to report on stalking in Austria. In order to avoid the problem of discordant definitions and to ensure meaningful comparisons, we used the same definition of stalking as did Dressing et al.4, but did not restrict our sample to urban citizens.
Subjects and data collection
Study participation was solicited in Vienna and surrounding Eastern Austrian areas through personal contacts (various occupational and living backgrounds) (n = 401). Participants were contacted face-to-face and explicitly informed of the fact that data collection was anonymous. Each questionnaire was placed in a sealed envelope and inserted into a box which was then shaken. Participants were informed that the data would be prepared and analyzed by different persons in order to maintain the highest possible anonymity.
Only one of the contacted individuals returned the questionnaire with the majority of the questions left blank. Thus, 400 questionnaires (224 women [56%], 176 male [44%]) served as the basis for the following analyses. The mean age of women was 29.4 years (s.d. = 12.9) and that of men, 32.1 years (s.d. = 13.3). Nearly equal numbers of respondents lived in urban and rural areas (59% vs. 41%). Comparing our sample to the census of Eastern-Austria (provinces: Vienna, Lower Austria, Upper Austria, Burgenland, Styria)9, in our sample women were slightly but not significantly overrepresented (51% female vs. 49% male; odds-ratio OR = 1.2; 95%-CI = [1.0 - 1.5]; Hasselblad and Hedges10 unbiased odds ratio-to-Cohen's d transformation11 d1 = 0.10; d-based effect sizes around 0.20 or lower are considered as small, around 0.50 as medium, and around .80 or higher as large11). More people were residing in urban areas (51% vs. 49%; OR = 1.4; 95% CI [1.1 - 1.7]; d1 = 0.18) and the average participant was younger than the general population between 14 and 60 years of age (mean age for women: 37.9 years, one-sample t-test t = -9.90, p < 0.001; d = 0.66; mean age for men: 37.7 years, one-sample t-test t = -5.78, p < 0.001; d = 0.44). Although younger adults between 18 and 29 years are the primary targets of stalkers8, the prevalence and incidence rates may have been slightly biased.
Instruments and stalking definition
The survey included a short introduction about stalking, questions on demographic variables, a self-reported stalking questionnaire, and the WHO-5 Well-Being Index12. The stalking questionnaire was adapted from Voss & Hoffmann13 and advanced by adding six additional stalking behaviours which had been frequently reported in other studies on the subject (such as invading the victim's home or following the victim by car). If the respondents stated any instance of harassment, they were asked to provide additional information about the duration and frequency of the particular intrusion as well as whether it was still continuing. They were also asked to provide detailed information about the nature and the extent of certain intrusive behaviours (such as sexual harassment or sexual violation), their relationship to the stalker, possible motives of the stalker, and behavioural and psychological responses to the harassment. Participants were subsequently asked to fill the WHO-5 Well-Being Index. This index is a 5-item scale for measuring positive well-being and has proved to be a good screening instrument for the detection of depression in the general population14. The sum score ranges from 0 to 25 whereas a score below 13 indicates poor well-being. The internal consistency of the scale was satisfying (Cronbach's χ = 0.82). In contrast to Dressing et al.4 we skipped the psychological dependency scale but added a question about the living environment (urban or rural).
We used a more restrictive definition of stalking2,4, in line with the definition provided by Meloy1. In order to be categorized as a stalking victim, the following criteria had to be met: at least 2 different intrusive behaviours had to be reported, lasting for a minimum of 2 weeks and provoking fear.
First of all, descriptive analyses were conducted and summarized. Lifetime incidence was defined as the percentage of stalking victims who had experienced stalking at any time in their lives. Stalking victims who reported being stalked at the present time were used to calculate the point prevalence of stalking. Comparisons of descriptive data were analyzed with Pearson's χ2 test. When two contingency tables were compared, a Breslow-Day test as a measure of homogeneity between odds ratios was performed. We used a multifactorial ANOVA to analyze age differences in the factors "sex", "being a stalking victim", and "living environment". We used a t-test and the d effect size described by Cohen11 to compare well-being scores. A linear regression was computed to identify the impact of stalking on current psychological well-being.
Based on our above mentioned definition of stalking, 43 individuals (11%) were classified as stalking victims. When comparing the number of stalking victims in rural and urban areas, a Breslow-Day test as a measure of homogeneity between odds ratios revealed a non-significant difference (ORurban = 5.74; ORrural = 5.72; χ2 < 0.1, p = 0.996). Women constituted 86% of the stalking victims while 81% of the stalkers were men. The question as to whether male stalkers are more common in urban than in rural areas revealed no significant difference (ORurban = 2.21; ORrural = 5.22; χ2 < 0.1, p = 0.320). Women were predominantly stalked by men (88%) while men were nearly equally stalked by men and women (60% male stalkers). Eight individuals reported that they were still being harassed (they constituted 19% of the victims; 5 women and 3 men). This corresponds to a point prevalence rate of 2.0%.
We compared the data obtained in the present study with those of Dressing et al.4 (see Table I). No significant differences were registered with regard to the relationship between the stalker and the victim (χ2 = 2.17, p = 0.963), the stalker's motivation (χ2 = 1.06, p = 0.906), stalking behaviours (χ2 = 13.60, p = 0.192), impact on the victims (χ2 = 1.71, p = 0.888), and physical and mental symptoms (χ2 = 17.11, p = 0.072).
In contrast to Dressing et al.4, we found neither age differences nor interactions with regard to the factors "sex" (F[1,391] = 0.03, p = 0.862), "being a stalking victim" (F[1,391] = 1.57, p = 0.211), and "living environment" (F[1,391] = 2.20, p = 0.139). Women were stalked more frequently than men (17% vs. 3%; χ2 = 17.7, p < 0.001).
The WHO-5 Well-Being Index score of stalking victims was significantly poorer than that of participants with no prior stalking experience (x¯ = 12.8 ± 5.1 vs. x¯ = 15.3 ± 4.7; t = 3.18, p = 0.002; medium effect size Cohen's d = 0.5111). On the categorical level, 52% of the victims and 27% of the non-victims scored in the pathological range of 12 and below (χ2 = 11.4, p = 0.001), which is in line with the data reported by Dressing et al.4 (57% v. 27%).
A linear regression analysis was performed to identify the impact of the lifetime incidence of stalking on current psychological well-being. The variables age, sex, and living environment were included simultaneously in the model. The model explained 4% (adjusted R2) of the variation in WHO-5 scores (F[4,368] = 3.43, p = 0.009). Only the fact of being a stalking victim or not could explain variations in the WHO-5 scores (standardized coefficient β = -0.151, t = -2.87, p = 0.004). The stated living environment had no impact on the WHO-5 score (β = 0.026, t = 0.50, p = 0.620). Contrary to Dressing et al.4, we registered no influence of age on the WHO-5 score (β = -0.065, t = 1.250, p = 0.212).
The reported epidemiological data on stalking collected in an Austrian community closely resemble the data derived from a community-based sample in a middle-sized German city4. Despite the potential limitation of using a sample that is younger than the general population, we registered nearly the same cumulative lifetime incidence (17% women vs. 3% men) and point prevalence rate of stalking victims (2.0%) as did Dressing et al.4 (17% vs. 4%; 1.6%), who used a stratified random sample from a middle-sized German city. This similarity was understandable in view of the fact that Germany and Austria are very similar in terms of cultural, linguistic, societal, and sex-role-typical aspects. In addition to the factors covered by Dressing et al.4, in the present study we also inquired about the living environment of the participants (rural or urban), but found no difference between the two.
The rates registered in the present study are comparable to those reported by Dressing et al.4 as well as those concerning representative samples from English-speaking countries such as England and Wales7 (12% overall, 16% female, 7% males) and the USA8 (8% women, 2% males).
In line with Dressing et al.4, we found that the lifetime prevalence of being a stalking victim is associated with currently impaired psychological well-being as measured by the WHO-5 Well-being Index. The percentage of victims scoring in a pathological range (52%) is not only in line with Dressing et al.4 (57%) but also with Kamphuis and Emmelkamp15 (59%).
To our knowledge, this is the first study reporting lifetime prevalence rates and point prevalence rates of stalking in Austria. Although the only epidemiological data from Germany were collected from a middle-sized city, our results are very similar. This emphasizes the validity of the German data although further studies are needed to confirm this observation. Furthermore, we found no difference between stalking victims from rural and urban areas although samples with higher rates of stalking victims are needed to obtain more specific data on this aspect.
We thank investigators for their help in collecting the data. We are also indebted to Mr. Harald Dressing for providing additional information about the study on stalking which served as the basis of comparison for the present study.
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Department of Basic Psychological Research
School of Psychology
University of Vienna
Received 26 May 2008
Revised 2 October 2008
Accepted 17 October 2008