Stalking: The Veiled Epidemic

Through high-profile media cases and in film, the American public has had glimpses into the psychological phenomenon and criminal behavior known as stalking. But do these glimpses truly represent the types of stalking offenses that are commonly perpetrated? Academicians and public policy makers have only begun to focus attention on stalking in the past 10 to 15 years. As is often the case, the dissemination of information relevant to treating clinicians often lags behind by many years. Thus, many mental health professionals have not been adequately trained to recognize stalking behavior and to treat those who perpetrate it.

The following review of stalking is designed to draw attention to this important societal problem and to assist clinicians in recognizing stalking behaviors and intervening in a therapeutic manner.

Definitions

While legal definitions differ somewhat from state to state, a generally accepted clinical definition of stalking is “an abnormal or long-term pattern of threat or harassment directed toward a specific individual,” and “the willful, malicious, and repeated following and harassing of another person that threatens his or her safety.”¹ From a legal standpoint, the crime of stalking generally consists of 4 elements:

• Repeated, unwanted involvement with the victim

• Explicit or implicit threats made to the victim

• Reasonable fear experienced by the victim

• The intention to instill fear in the victim

This last condition, which is stipulated by many states, is not always present in the clinical setting, such as when a stalker wishes to pursue a romantic relationship with the victim and intends no harm.

Facts on stalking victimization

Using data from the National Violence Against Women Survey, Tjaden and Thoennes² reported the lifetime prevalence of stalking victimization in the United States to be 12% for women and 4% for men. These researchers, whose definition of stalking required victims to feel only “somewhat frightened,” reported that women are 3 times more likely to be stalked than raped in a 1-year period.

Research indicates that no one is immune from being stalked—children, celebrities, health care professionals, women, men, straight and gay individuals, and otherwise average citizens.^2,3 However, the majority of stalking victims (74% to 80%) are female.^2,3 The average age of stalking victims, male or female, is 28 years old.² Individuals from low-income households, as well as those who are divorced or separated, are at increased risk for stalking victimization.³ While whites and minorities are equally likely to be victimized, most victims are targeted by persons of their own race.³

Typical perpetrators and why they stalk

No single profile accurately captures the various etiological and motivating factors for stalking behavior. Instead, typological frameworks have been used to examine factors such as the stalker’s relationship with the victim, apparent motivation, and psychiatric diagnosis.^4-7 We know that the majority of stalkers are male (68% to 87%), and most stalkers—male and female combined—are in their 30s.^2-5,8 Most stalkers (80% to 85%) are unmarried at the time of the offense; roughly half have never been in an intimate relationship; half have criminal records; and approximately 40% are underemployed or unemployed.^4,5,9,10 Rates of perpetration do not differ by race.²

Various studies show that 25% to 78% of stalkers have Axis I disorders; 17% to 32% have substance use disorders; and 25% have a history of suicidal ideation or self-injurious behavior.^4,9-12 While most were not psychotic at the time of the offense, 17% of stalkers in one study had a history of schizophrenia, and 15% had delusional disorder.^4,9,10 Axis II diagnoses (especially cluster B) were highly prevalent, particularly among nonpsychotic stalkers.^9,10,12-14

Among victims of stalking, the majority know their stalkers, who are typically similar in age to them.^2-5,8 In up to 30% of cases, victims are stalked by former intimate partners, and in 57% of cases the stalking behavior began before the dissolution of the relationship (Table).^2,3,5,8