No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
An Ecological Model of the Impact of Sexual Assault On Women's Mental Health
Abstract
This review examines the psychological impact of adult sexual assault through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology contribute to post-assault sequelae. Using Bronfenbrenner's (1979, 1986, 1995) ecological theory of human development, we examine how individual-level factors (e.g., sociodemographics, biological/genetic factors), assault characteristics (e.g., victim-offender relationship, injury, alcohol use), microsystem factors (e.g., informal support from family and friends), meso/ exosystem factors (e.g., contact with the legal, medical, and mental health systems, and rape crisis centers), macrosystem factors (e.g., societal rape myth acceptance), and chronosystem factors (e.g., sexual revictimization and history of other victimizations) affect adult sexual assault survivors' mental health outcomes (e.g., post-traumatic stress disorder, depression, suicidality, and substance use). Self-blame is conceptualized as meta-construct that stems from all levels of this ecological model. Implications for curbing and/or preventing the negative mental health effects of sexual assault are discussed.
... The National Intimate Partner and Sexual Violence Survey (NISVS; Smith et al., 2017) indicates that about one in three women living in the United States (U.S.) report experiencing some form of rape, sexual coercion, or non-consensual sexual contact in their lifetime. Research has consistently demonstrated that exposure to sexual violence is associated with a host of negative mental health outcomes, including increased risk of developing anxiety, depression, problems with substance use, and posttraumatic stress disorder (PTSD; Campbell et al., 2009). Rates of PTSD are especially prevalent among female survivors and reports indicate that between 17 and 65% of women who have experienced sexual assault will develop the disorder (Campbell et al., 2009). ...
... Research has consistently demonstrated that exposure to sexual violence is associated with a host of negative mental health outcomes, including increased risk of developing anxiety, depression, problems with substance use, and posttraumatic stress disorder (PTSD; Campbell et al., 2009). Rates of PTSD are especially prevalent among female survivors and reports indicate that between 17 and 65% of women who have experienced sexual assault will develop the disorder (Campbell et al., 2009). Notably, research also shows that PTSD and depression often co-occur, with one study reporting that among a national sample of female rape survivors, comorbidity rates were between 13 and 28% (Zinzow et al., 2012). ...
... Prior research has extensively examined the various correlates of PTSD and depression among survivors (see Campbell et al., 2009 for review). More specifically, research has documented the role of individual responses and contextual influences, such as social support and reactions to disclosures, on mental health outcomes (Campbell et al., 2009;Ullman & Peter-Hagene, 2014;Ullman et al., 2007). In addition to these factors, feminist theorists assert that responses to trauma and psychological distress must be understood in the context of sociocultural factors, systems of oppression, and the power inequalities that cause violence to exist (Brown, 2006). ...
In the current study, we investigated potential direct and indirect effects of exposure to sexual violence on posttraumatic stress disorder (PTSD) symptom severity and depression, and anti-sexual activism and feminist identification as moderators of these effects, among a sample of 440 United States women who had experienced sexual assault in adulthood. We found that sexual violence exposure was both directly and indirectly related to PTSD symptom severity via less trauma coping self-efficacy, greater behavioral and characterological self-blame, and more shame. Sexual violence exposure was also indirectly related to depression via the same explanatory variables, except for behavioral self-blame. Contrary to our hypotheses, results indicated that involvement in anti-sexual activism and feminist identification did not buffer the direct and indirect links between exposure to sexual violence and PTSD symptom severity and depression. However, we found that involvement in anti-sexual assault activism was associated with greater coping self-efficacy and higher depression, and feminist identification was associated with less self-blame and shame. Results from this study may inform clinical interventions for survivors of sexual violence and improve overall care for this population.
... Sexual violence is one of the most traumatic experiences a woman can face during her lifetime. It poses serious short-and long-term consequences on both physical and mental integrity, including physical injury, unwanted pregnancy, sexually transmitted infections (STIs) and a higher risk for posttraumatic stress disorder, chronic pain, depression, drug, and alcohol abuse and even suicide (1)(2)(3)(4). Even though violence against women has been present from time immemorial, only in the past decades has there been increasing awareness of this devastating human rights violation. ...
... As the quality of the immediate care after a sexual assault can affect physical and emotional recovery from the incident, it is important to optimize the examination conditions as much as possible (13). Conversely, if victims fail to receive empathetic and supportive care, the examination can be perceived as retraumatization and re-victimization and can even be experienced as a 'second rape', reinforcing feelings of powerlessness, shame and guilt (4,17,37). Even though the examination conditions (represented by the protection of privacy, the adequacy of premises and the feeling of preparedness for the examination) in our study were evaluated as positive by the majority of the women, the examination was still considered to be an additional psychological burden by more than half of the victims. ...
Background/aim:
The objective of this study was to assess the perception of the forensic medical examination (FME) by victims of sexual violence. Based on patient-related outcomes gained in terms of personnel, chronological and spatial parameters, an additional aim was to derive improved examination procedures.
Patients and methods:
A total of 49 sexually assaulted women were enrolled in this study. After standardized FME by a forensic doctor followed by a gynecologist, women were asked to complete a questionnaire addressing general perception, preferences regarding attending staff's sex, sequence and time frame of the examinations performed. The attending gynecologist also completed a questionnaire addressing demographic and medical parameters of the patient as well as assault-related information.
Results:
The examination setting in general was evaluated positively. Nevertheless, 52% of examined victims perceived the FME as an additional psychological burden. Overall, 85% of the affected women preferred a female forensic physician and 76% a female gynecologist to perform the examination. When women said they experienced a violation of their privacy during the gynecological examination, a male was more often present (60% vs. 35%, p=0.0866). Regarding the sequence of the examination components, 65% of the victims preferred to start with their medical history followed by the forensic and then the gynecological examination.
Conclusion:
Forensic medical and gynecological examination after sexual assault is an essential procedure, yet it is a potentially further traumatizing experience for the victim. The identified patient preferences should be taken into account in order to diminish further trauma.
... That victims are responsible for and blameworthy for their sexual assaults is one of the most common rape myths (see Edwards et al., 2011, for a review). In general, police response to victims of sexual assault is overwhelmingly negative and re-traumatizing for victims, but particularly for victims of substance-involved sexual assault (see Campbell et al., 2009;Sleath & Bull, 2017, for reviews). Police overall believe that alcohol intoxication specifically does not always represent "real" rape, and they view victims who were intoxicated at the time of the assault as less credible (see Parratt & Pina, 2017, for a review). ...
... Although we did not use lifestyle and/or routine activities theories as a framework, we should consider the limitations of these theoretical approaches, particularly in a community sample, and focus more on the structural conditions of these types of assault (e.g., how criminalization of drugs creates risk for sexual assault during voluntary drug use) and the context of these types of assault (e.g., see Fileborn's (2016) study of unwanted sexual attention in bars and nightclubs which begins to address the social/spatial context of this violence). A social-ecological framework (Menard, 2005) combined with an intersectional feminist perspective may be a useful framework, which has typically been applied to reporting and/or help-seeking, but could also be extended to understanding other outcomes as well (Campbell et al., 2009;Menard, 2005). Considering behavior in context in both the design and analysis of data from multi-level studies of sexual assault is needed to avoid the limitations of studies assessing factors at the individual level only. ...
Sexual assaults involving victim substance use at the time of the assault are common, but little is known about how different types of substances used at the time of the assault impact post-assault outcomes. The current study sought to compare victim alcohol use, drug use, and combined substance use in sexual assaults among a community sample of 693 victims. It was hypothesized that victims in the combined substance use assault type would report overall worse post-assault outcomes, more contextual and interpersonal traumas, and higher assault severity. Our results partially confirmed these hypotheses, but victims in the drug-involved assault type group overall reported higher assault severity and worse post-assault outcomes. These findings are probably partially attributed to the demographic characteristics of victims in the drug-only group (e.g., Black victims) who are more likely to experience a higher severity of violence. Implications for future research and policy regarding drug decriminalization are discussed.
... The social-ecological theory reveals the complex relationship between individual risk factors (including personal and partner factors), family, community, societal level, IPV, and mental health (Tekkas Kerman and Betrus, 2020). Thus, this complexity emphasizes the interaction between the individual and society on health outcomes (Campbell et al., 2009;Mojahed et al., 2020;Tekkas Kerman and Betrus, 2020). Personality traits are well-established to be associated with aggressive behavior and may enhance or inhibit aggressive moods and actions (Bettencourt et al., 2006;Barlett and Anderson, 2012). ...
... The current study also revealed that social support might reduce psychological distress by decreasing IP psychological violence. Social support is a key ecological determinant for the interaction of life events and mental health outcomes (Campbell et al., 2009;Tekkas Kerman and Betrus, 2020). This study demonstrated that social support from neighborhood and family members could predict depressive symptoms and hopelessness among women who experienced IPV (Pickover et al., 2021). ...
Aim
This study proposes investigating the risk and protective factors of intimate partner (IP) psychological violence and psychological distress to better promote psychological wellbeing for nurses and health outcomes for patients.
Design
A cross-sectional study.
Method
This cross-sectional study was carried out chiefly in Guangdong, Hunan, and Shaanxi provinces, in the east, central, and west of the Chinese economic areas, respectively. It was conducted in October 2021 using convenience sampling. A total of 843 nurses were eligible for the final analysis. Single-factor linear regression models were used to identify potential factors associated with IP psychological violence and psychological distress. In addition, the structural equation model was used to explore the role of personality traits and social support in the association between IP psychological violence and psychological distress.
Results
The predictors for the score of IP psychological violence among nurses were participants' married status, contact frequency with a partner, perceived past-year psychological and physical violence experience, the alcohol consumption of partners, and personality traits and social support of partners. Moreover, the alcohol consumption of participants, the past-year experience of IP psychological violence, the score of psychological violence, personality traits, social support, and the personality traits of partners were associated factors affecting the psychological distress of nurses. In the structural model, the personality trait of partners had a direct pathway to psychological violence and social support. The results demonstrated that psychological violence significantly increased psychological distress.
Conclusion
Personality traits and social support are essential factors influencing the relationship between IP psychological violence and psychological distress.
Impact
The findings of this study emphasize the possibility and importance of identification and intervention for reducing IP psychological violence based on personality traits and social support.
... Thurston et al., 2019). Sexual assault experienced within the past year has been shown to significantly predict engagement in self-harm behavior among college women (Chang, Lee, et al., 2019;Chang, Schaffer, et al., 2019) and, tragically, 23%-44% of sexual assault survivors report experiencing suicidal ideation following a sexual assault, with 2%-19% reporting at least one suicide attempt in their lifetime (Campbell et al., 2009). Women who have been sexually assaulted are also at increased risk for alcohol use disorder (AUD; Dworkin, 2020). ...
Understanding the mental health outcomes of sexual assault among college women is a public health priority. Although research has identified risk factors for the development of mental health problems following an assault, few studies have utilized a strengths-based approach to identify personal and social resources that may mediate the sexual assault-mental health link. Prior studies allude to the role of resilience and perceived campus belonging in explaining the relationship between sexual assault and mental health. This study represents the first application of the stress process model using a large sample of college women to examine (a) the association between sexual assault and mental health (i.e., psychological distress, suicidality, self-harm) and alcohol use problems and (b) the role of resilience and perceived campus belonging as partial mediators of these associations. Data were collected as part of the Spring 2021 American College Health Association National College Health Assessment (ACHA-NCHA; n = 31,328, Mean age = 20.26, SD = 1.64, 58.8% White), a cross-sectional, online survey that samples college students from 143 self-selected United States colleges. To test our primary hypothesis, a structural regression model was conducted, which included a latent sexual assault predictor, manifest resilience and campus belonging mediators, a latent mental health outcome, and a manifest alcohol use problems outcome. Mental health and alcohol use problems were positively associated with sexual assault and negatively associated with resilience and campus belonging. Resilience partially mediated the association between sexual assault and mental health. Campus belonging partially mediated the association between sexual assault, mental health, and alcohol use problems. This model explained 23.2% of the variance in mental health and 5.9% of the variance in alcohol use. Resilience and campus belonging may represent modifiable factors that can be targeted in trauma-focused interventions in efforts to improve victimized college women's mental health.
... Selain itu munculnya problem terkait dengan saluran kencing dan kandungan seperti rasa sakit di dasar panggul dan radang panggul, munculnya rasa sakit atau kejang ketika menstruasi, perdarahan berlebihan di saat menstruasi, disfungsi seksual, perdarahan di luar waktu menstruasi, keputihan, perdarahan di saluran dubur, infeksi saluran kencing dan rasa sakit pada saat berkemih (Golding et al. 1998, Campbell et al. 2006, & Latthe et al. 2006). Secara kejiwaan, para penyintas juga mengalami kecemasan, gejala-gejala depresi (Bonomi et al. 2007, Campbell et al. 2009, Burnam et al. 1988) hingga episode depresi mayor dan post-traumatic stress disorder (Coker et al. 2002, Dutton 2009, Masho 2007) yang menggiring mereka melakukan perilaku berisiko (Felitti 1998) seperti merokok, mengonsumsi alkohol dan narkotika, kegemukan, kurang olahraga, dan berganti-ganti pasangan seks. Keadaan yang sangat mengguncang ini membuat mereka juga enggan mengikuti pemeriksaan kesehatan dalam upaya pencegahan berbagai penyakit seperti pemeriksaan pap smear dan payudara (Spring & Friedrich 1992, Farley & Minkoff 2002, & Harsyani et al. 2003). ...
Sexual violence is an act of rape, sexual coercion, and harrasment, as well as sexual contact with coercion or threat using force. It is timely to consider that sexual violence is discussed in schools and take it as serious issue with empathy towards the victims and not only being considered as women’s issues that can only be discussed among women. Public awareness against it is crucial to be raised. This is important for women and girls as victim of violence to be survivors. These actions should also involve men in advocating against sexual violence. By providing an understanding of how men should behave toward women and listening to the testimony of women survivors of sexual violence of the trauma and its impact on women’s lives, it is expected that young men since early age will have a sensitivity in dealing with sexual violences.
... One study in 2009 examined how individual-level factors (sociodemographics, biological/genetic factors), microsystem factors (informal support from family and friends), meso/ exosystem factors (contact with the legal, medical, and mental health systems, and rape crisis centers), macrosystem factors (societal rape myth acceptance), and chronosystem factors (sexual revictimization and history of other victimizations) affect adult sexual assault survivors' mental health outcomes (depression, suicidality, and substance use). 20 In our study, depending on the definition of systems, we use Bronfenbrenner's ecological systems theory to classify the protective factors into personal environment: youth characteristics (micro and chrono), intimate environment: family and friend (meso), and public environment: school and societal (exo and macro). Intervention and prevention efforts could be achieved by identifying and understanding these factors through this classification. ...
Background and objectives
Recent literature reported a higher risk of suicide attempts among sexual minority youth. Discovering the risk and protective factors of suicide attempts among this vulnerable population can play a key role in reducing the suicide rate. Our research aims to systematically search for the risk and protective factors for suicide attempts among sexual minority youth.
Methods
We have conducted a systematic review of published studies of associated factors for suicide attempts in sexual minority youth. Four databases up to 2020 were searched to find relevant studies.
Results
Twelve articles were included. For sexual minority youth, the identified risk factors associated with suicide attempts are early coming out, being unacceptable by families, dissatisfaction with sexual minority friendships, too few friends, physical abuse, sexual abuse, and bullying. The identified protective factors for suicide attempts are feeling safe at school, teacher support, anti-bullying policy, and other adult support.
Conclusion
Both risk and protective factors for suicide attempts stem directly from the environments in which youth grew up: family, school, and the internet. Effective preventive measures among sexual minority youth need to be developed and implemented. Societal-level anti-stigma interventions are needed to reduce the risk of victimization and awareness should be raised among family and friends.
... The integration of social work into GP can focus on enhancing primary care and facilitating care in the community and people's homes, prevention and self-care (College of Social Work, Royal College of General Practitioners [CSWRCGP], 2014). Moreover, by exploring pathways for referral and responding to domestic violence, sexual assault or homelessness that adversely affect people's health social work engagement can respond to social health issues (Hwang, 2001;Koziol-McLain et al., 2008;Campbell et al., 2009). Browne et al. (2012)'s study found that equity-orientated primary health care services that engaged social workers were able to address the social determinants of health as legitimate and routine patient care; use trauma informed practice through empowering and respectful interventions; tailored patient centred care to the local contexts and considered experiences of oppression and racism in shaping patients' health, life opportunities, quality of life and access to health care. ...
Social work and social work student placements in general practice [GP] can contribute to wholistic healthcare. The overall aims of this research were to develop, implement and evaluate a field education placement curriculum for social work student placements in GP clinics. Between December 2021 and June 2022, six students completed their social work placements in four GP practices in North Queensland. Data collection included student records and an online survey that invited students, field educators, task supervisors, mentors, allied health professionals and GPs to provide feedback about the usefulness of the developed materials, the benefits and challenges of the placements, the services provided by the students, patient outcomes and feedback, social work learning, service delivery overall and the value of, and satisfaction with, the social work GP placements. Social work student placements in GP practices offer a valuable broadening of field education learning opportunities for social work and can benefit GP settings. Such placements need to be particularly carefully scaffolded and supported through a comprehensive curriculum, supervision, and a welcoming GP setting. Students interested in embarking in such a learning journey need to be highly confident and competent in social work practice.
... Specifically, it may lead to the assumption that everyone who experiences a traumatic event will be traumatized or develop PTSD when in fact, SAMHSA (2014) reports that many trauma victims are resilient. Lifetime prevalence rates for developing PTSD after a sexual assault have been found to be between 17 and 65% indicating that not every survivor will develop PTSD (Campbell et al. 2009). In addition, it is unclear how these interviews can be used on individuals making a false report who obviously have not been traumatized by a non-event. ...
The forensic complainant interview is a unique opportunity to gather essential forensic information and is a central component of most sexual assault investigations. Past criticisms of these interviews have focused on inappropriate and harmful questioning, but there has been little attention to questions regarding the reliability, validity, cultural tailoring, and stakeholder acceptability of these. We conducted a literature review regarding all studies psychometrically investigating interview protocols used for sexual assault complainant interviews. Inclusion criteria required articles to include the investigation of an interview protocol used with adult sexual assault complainants or analog complainants. The literature search revealed six semi-structured protocols used for sexual assault interviews, all with very limited psychometric data, an inability to address some important forensic interview goals, and possible confirmation biases. This review also uncovered a trend to insert neuroscience into interview protocols despite problematic interpretations of this research and a lack of evidence of the usefulness of its inclusion. Unfortunately, these limitations indicate that currently there is no best-practice evidence-based sexual assault interview protocol. The importance of the problem of sexual assault necessitates a need to serve all those affected by recognizing the need for more rigorous development and testing of forensic interview protocols.
... Students with marginalized identities, such as those who are black, gay or bisexual, transgender or gender non-binary, have a disability, or have several intersecting marginalized identities, experience higher rates of sexual violence than their peers (Coulter et al., 2017;Coulter & Rankin, 2020;Findley, Plummer, & McMahon, 2016;Ford & Soto-Marquez, 2016;Scherer, Snyder, & Fisher, 2016). Sexual assault has been linked to a number of adverse health and social outcomes, including acute and long-term mental and physical health consequences as well as harmful educational outcomes like lower GPA and increased risk of dropping out (Banyard et al., 2020;Campbell, Dworkin, & Cabral, 2009;Jordan, Combs, & Smith, 2014;Mengo & Black, 2016;Wasco & Campbell, 2002). Despite the existence of victim advocacy services (e.g., counseling, advocacy, investigatory), only 15-25% of college victims of forcible rape and 7-13% of victims of rape while incapacitated seek help from one or more of these services (Cantor et al., 2015;Krebs et al., 2007). ...
Sexual assault among university students is prevalent and has detrimental effects. Digital modes of communication are preferred by young adults, but there is limited data on digital crisis intervention. The purpose of this program evaluation is to utilize web-based crisis chat transcripts from a university service to ascertain the processes that hotline responders use. We reviewed 224 de-identified transcripts of chats that took place between November 2018 – June 2020. The coding framework included structural codes (chat characteristics), descriptive codes (conversation topics), and process codes (essential components of digital crisis intervention). Our findings have implications for the training of text- and web-based hotline responders.
... The Ecological Model was chosen as the theoretical basis of this study. It was widely used in health-promoting and analysing the relative factors (Campbell et al., 2009;Sabbah et al., 2017). Considering that the factors influencing the wellness for organ donation are multi-dimensional, the dimension of factors can be classified into personal characteristics, individual behaviours, interpersonal networks, community and public policy. ...
To explore the acceptances and associated influences of organ donation in mainland China. The shortage of organ donors has limited the development of organ transplantation in China. It is important to recognise the target population who has high intention to donate their organs may change the status. We conducted a cross‐sectional, multi‐stage sampling study collected demographic data and individuals' willingness to accept organ donation. A stepwise linear regression analysis was adopted to evaluate the factors related to the attitudes toward organ donation. We collected 11,031 valid samples for the survey. The willingness to donate organs among Chinese residents averaged 56.93 points. To be specific, males (β = −.03), religious believers (β = −.01) and parents with a different number of children (all: β = −.04) are less willing to donate their organs. Respondents who live in an urban area (β = .03), have higher education level (High school or junior college β = .04, Bachelor degree or above β = .09), feel anxious (mild, moderate β = .02), feel pressured (moderate, severe β = .08), have higher scores of the Short‐Form Health Literacy Instrument (HLS‐SF12) (β = .31), The Self‐Management Scale (SHMS) (β = .16), EuroQol Five Dimensions Questionnaire (EQ‐5D) (β = .04) and EuroQol Visual Analogue Scale (EQ‐VAS) (β = .24), are more positive to donate. This study firstly discusses the public acceptance of organ donation through a nationwide sample around China. In this study, we discovered that Chinese residents' acceptance level of organ donation and that gender, house, anxiety, pressure, social support and health literacy were the main influencing factors on residents' attitudes. To figure out the Chinese public acceptance and its influencing factors of organ donation can help nurse transplant coordinators to recognise the target population and the obstacles of organ donation. At the phase of collecting data, participants were recruited to fill the questionnaires.
... The potential influence of victimization on perceptions of peer norms is conceptually supported by research showing the experience of sexual violence to be associated with negative alterations in social cognition, including exaggerated negative beliefs about others (e.g., "most people have bad intentions"), and heightened activation of threat detection processes (Campbell et al., 2009;Chapman et al., 2012;Lanius et al., 2017;Müller et al., 2018). These changes may in turn manifest in hypervigilance and increased sensitivity toward social cues, such as peers' expressions of violence-condoning attitudes, leading victims to develop higher perceptions of the prevalence of those attitudes among their peers. ...
The experience of sexual victimization may lead to increased threat-biased information processing, including increased perceptions of peer attitudes that condone sexual violence. The perception that peers generally condone sexual violence may in turn inhibit survivors of sexual violence from intervening to address risk for harm among their peers. To assess this possibility, the present study examined the direct and indirect association between sexual victimization by a romantic partner, perceived peer rape myth acceptance (RMA), perceived social barriers to bystander intervention, and bystander behaviors over 2-month follow-up in a sample of 843 high
... The serious impacts of sexual violence are well-known and include physiological, psychological, social, and financial harms for both victims and communities (Adams et al., 2018;Butt et al., 2011;Campbell et al., 2009;Ewin, 2011;Fergusson et al., 2012). Treatment for men and women who have a history of sexual offenses is a critical feature of criminal justice and forensic mental health system responses to sexual violence. ...
Treatment programs for people with histories of sexual violence form a critical part of criminal justice service rehabilitation. Completion of these programs is often a precondition of release. Meta-analytic reviews suggest moderate benefit is associated with treatment completion, although effect sizes vary. This study examined whether commencement of open versus closed group programs was associated with treatment completion and recidivism. Participants were 426 adult men who commenced treatment between April 1, 2014, and December 31, 2017. Participants were followed-up until June 30, 2018. Programs varied by type (open versus closed), location (in-custody versus in-community) and intensity (moderate versus high). No significant differences were observed between open and closed programs for treatment completion but men who were treated in-custody were more likely to complete treatment when compared to those men who commenced treatment in the community. No significant differences were observed between open and closed programs for sexual or for any recidivism.
... However, according to the findings of the present study, this strategy can create fear and uncertainty that may lead some survivors to decide against having the FME and/or drop out of the investigation. Having an FME is associated with higher likelihood of conviction (Campbell et al., 2009;Hansen et al., 2020;Lovell et al., 2018). Discouraging survivors from having the FME may thereby limit survivors' access to justice and medical treatment. ...
Although specialized sexual assault services have been established throughout the world to better meet survivors’ needs, many survivors remain underserved. Survivors who are simultaneously experiencing additional adversities (e.g., survivors with mental illness and/or substance abuse) appear particularly underserved by formal support systems. The present study therefore set out to explore the formal help-seeking experiences and needs of survivors facing various adversities apart from the sexual assault. Interviews were conducted with five survivors seeking formal support for sexual assault in Denmark. Interviews were analyzed using Interpretive Phenomenological Analysis. Five themes are presented: 1) “Sexual Assault as Lived Experience”, 2) “Survivors’ Needs”, 3) “Accessing Sexual Assault Services”, 4) “SAC-Therapy”, and 5) “The Criminal Justice System”. Theme 1 made evident that the experience of sexual assault and its aftermath is deeply personal and contextual. Themes 2-5 demonstrate how such personal and contextual aspects impact service utilization and needs. Implications and recommendations are provided. Above all, meeting survivors’ needs will require a more person-centered approach that acknowledges the unique context of survivors’ sexual assault experiences.
... Many of the accounts given by victims of and witnesses to crime during investigative interviews relate to traumatic events (e.g., murder, rape, the abuse and exploitation of children and vulnerable adults, terrorist incidents). While the extent to which traumatic events affect individuals varies (e.g., Kamphuis & Emmelkamp, 1998;Deffenbacher et al., 2004;Salmon & O'Kearney, 2014) some, perhaps most, of these victims and witnesses will be traumatised (e.g., Campbell et al, 2009;Jakobsen et al., 2016;Lui et al., 2017). While the contribution of rapport to the process and product of an investigative interview has been recognised in the research and guidance for some time (e.g., Milne & Bull, 1999;Collins et al., 2002;St-Yves, 2006;Fisher & Geiselman, 2010;Kim et al., 2020), its importance in the management of trauma has recently been emphasised (e.g., Smith & Milne, 2018;Risan et al, 2020;Jakobsen, 2021). ...
The risk of infection arising from face-to-face contact during the current coronavirus pandemic has contributed to an increasing interest in the use of remote technology by law enforcement organisations for the purpose of conducting investigative interviews. Such technology was used widely to interview suspected offenders who were in custody during the pandemic but law enforcement agencies in the United Kingdom were more cautious about using it with victims, witnesses and non-custodial suspects. This caution stems from concerns about the ability of interviewers to control the interview environment, build rapport and manage trauma throughout the process. This paper will review the limited research on the use of remote technology to conduct investigative interviews and considers relevant literature from other contexts (e.g., therapy) that might be used to inform the debate. While the use of remote technology can certainly offer more flexibility and greater access to justice during investigations, further research is needed into how and when it may be used safely and effectively and into identifying the situations in which using it can be productive and those in which it should only be used with caution.
... HEM consists of five layers, with the core layer corresponding to the innate personality traits, including gender, age and susceptibility; The second layer comprises behavioural characteristics; the third layer corresponds to interpersonal network of society, family and community; the fourth layer corresponds to living and working conditions, including occupational factors, place of residence, economic status; and the fifth layer corresponds to the social, economic, cultural and other relevant policies both at local and national levels [22]. The upstream factors include the third, fourth and fifth layers, the midstream factors are the second layer, and the downstream factors are the core layer [23]. The HEM model has been used to investigate various types of behaviours, for example, in predicting and explaining eating behaviour [24] and exercise behaviours [25]. ...
Background
Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder, yet it remains undiagnosed in a large proportion of adults.
Objective
This study aims to investigate the status of patient delay and provider delay in OSA patients and examine related factors affecting patient delay in OSA individuals in China.
Methods
A cross-sectional design was conducted on a sample of 309 OSA patients (aged from 18 to 76, median age of 47 years, 84.8% male) in Northeast China. Participants were required to complete the sociodemographic questionnaire, the symptom characteristics questionnaire, the help-seeking attitude scale (HSAS), the social support rating scale and the chronic disease self-efficacy scales (CDSES) to test the hypothesis. Binary logistic regression analysis was conducted to explore factors that account for the patient delay.
Results
The median patient delay among OAS patients in this study was 22 months, the median provider delay was one month, and the median total delay was 26 months. As shown by multivariate analysis results, patients who have snored for over 6 years (OR = 3.377, 95%CI: 1.175–9.702) were more likely to experience prolonged patient delays. Per capita monthly family income above 3000 RMB (OR = 0.172, 95%CI: 0.052–0.571), taking up residence in cities or towns (OR = 0.484, 95%CI: 0.248–0.946), higher self-recognition of the disease (OR = 0.793, 95%CI: 0.647–0.972), higher objective support (OR = 0.825, 95%CI: 0.739–0.921) and stronger self-efficacy (OR = 0.674, 95%CI: 0.525–0.867) were significantly associated with shorter patient delays.
Conclusion
Patient delay is common in Chinese OSA patients. The upstream factors affecting the patient delay in individuals with OSA include income, place of residence, and objective support; midstream factors include self-recognition of the disease and self-efficacy; downstream factors include years of snoring.
•
KEY MESSAGES
• Despite being a high-prevalence disease, many obstructive sleep apnoea (OSA) patients are not clearly diagnosed and treated.
• The factors affecting the delay in seeking medical treatment in individuals with OSA included income, place of residence, objective support, self-recognition of the disease, self-efficacy and years of snoring.
• Investigations into OSA patients’ care-seeking behaviours can better reflect the secondary prevention of OSA, and it is crucial to pay attention to the delayed phase of patients.
... Whilst there is much variation in the available prevalence data of USEs across UK and Irish university students, the potential impact of this experience has been well documented within the US and other countries. Adverse consequences include significant psychological distress (Campbell et al., 2009;Carey et al., 2018), diminished academic performance (Jordan et al., 2014) impacts on interpersonal relationships (Faravelli, et al., 2004) and possible dropout from educational courses (Huerta et al., 2006;Mengo & Black, 2016). Moreover, a strong body of work also exists with regards to risk factors related to USEs while at university, with research highlighting the role of alcohol (Behnken, 2017), 'lad culture' (Phipps & Young, 2015) and lack of consent awareness and education (Kilimnik & Humphreys, 2018;Thomas et al., 2016) as possible precursors. ...
The report focuses on unwanted sexual experiences among Northern Irish university students
... In the United States (U.S.), roughly 20% of women and 7.0% of men report sexual violence (SV), including sexual assault, relationship violence, sexual harassment, and stalking (herein termed "sexual violence"), while they pursue their undergraduate education (Krebs et al., 2016). In addition to adverse academic and career outcomes, SV can result in long-and short-term physical and mental health consequences (e.g., Campbell et al., 2003Campbell et al., , 2009Chen et al., 2010;Mengo & Black, 2016;Potter et al., 2018;Yuan et al., 2006). Despite campus SV response efforts, 95% of student victims 1 do not seek help in the aftermath of a violent incident and most are unaware of the resources and supports their college provides (Holland & Cortina, 2017). ...
The COVID-19 pandemic forced institutions of higher education to transition and work in ways that were new and innovative. Even though most colleges and universities transitioned to a virtual platform, the issues that students face continued, including sexual violence (SV). For many campus prevention and response professionals, reaching students during the pandemic posed unique challenges. The COVID-19 pandemic began when the project team was 18-months into a 4-year grant to administer and evaluate the efficacy of a SV prevention and response app, uSafeUS®, at 15 4-year colleges. In this paper, we describe the transition of engaging students with the app in traditional in-person settings to remote and hybrid learning settings. The project team, in collaboration with the campus partners, devised new ways to use the app to support victims of SV and their allies, along with campus professionals in their efforts to support students. These efforts included changes to collaboration (e.g., virtual platforms) and student engagement strategies. We describe how the lessons learned from this transition are important for continuing to engage campus communities in SV prevention and response, even as campuses slowly transitioned back to hybrid and in-person activities. The knowledge gained from this transition are attributable to an ongoing and open collaboration between campus practitioners and the project team.
... It is vital to continue to expand research on SV among female Veterans beyond MST, as there are many negative health consequences as a result of SV experienced in partner relationships, [48][49][50] as well as childhood and adulthood sexual abuse/assault. [51][52][53] Furthermore, SV survivors often experience more than one form of sexual abuse/assault, 54,55 and the effects of such cumulative trauma can have a negative impact on an individual's health. 56,57 Research with women veterans has identified multiple time periods of sexual violence experience and association with increased risk over time, highlighting the need for such more inclusive measures of sexual violence. ...
Introduction
Experience of sexual violence (SV) is prevalent among the Veteran population and associated with many negative mental and physical health outcomes including suicidal behavior, obesity, post-traumatic stress disorder, anxiety, depression, and poor sexual and reproductive functioning. Although Veterans of any gender may experience SV, women Veterans are particularly at risk. Research on SV among Veterans has focused primarily on the experience of SV during military service (military sexual trauma, MST), although Veterans may also experience SV prior to and following military service. The aim of the current study was to construct a more comprehensive method of identifying SV among Veterans Health Administration (VHA) patients as documented in medical records in a national cohort of 325,907 Veterans who used VHA care between 2000 and 2018 in order to inform future research in this area.
Method
We used three indicators to identify SV in VHA medical records: (a) the MST screen, (b) the sexual violence item of the intimate partner violence (IPV) screen, and (c) International Classification of Disorders (ICD) codes (versions 9 and 10) representing adult sexual abuse and assault. Univariate descriptive analyses were conducted to determine the exclusivity and overlap of the SV measures.
Results
The universal MST screen was the most commonly identified indicator of SV in the data. However, including the IPV and ICD indicators identified an additional 5% of Veterans who had experienced SV, accounting for thousands of patients.
Discussion
The results of the current study indicate that using the three-pronged approach of SV collection is a more comprehensive method of identifying patient SV experience through VHA medical records and contributes uniquely to the methodology of studying social factors’ impact on health care. Clinical screening and documentation of SV allow for the assessment of health impacts and trends through examination of medical records data.
Access to quality sexual assault (SA) care in rural communities is limited by challenges surrounding building and sustaining a skilled SA nurse examiner workforce. Telehealth can facilitate access to expert care while cultivating a local sexual assault response. The Sexual Assault Forensic Examination Telehealth (SAFE-T) Center aims to decrease disparities in SA care by providing expert, live, interactive mentoring, quality assurance, and evidence-based training via telehealth. This study examines multidisciplinary perceptions of pre-implementation barriers and SAFE-T program impact using qualitative methods. Implications for the implementation of telehealth programs to support access to quality SA care are considered.
Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur.
Background:
A long line of research has examined whether being the victim of sexual assault is associated with negative and maladaptive outcomes, but has mainly focused on women and girls.
Aims:
To replicate and extend prior research by examining whether various measures of sexual assault are related to physical ill-health, depression and/or suicidal ideation, regardless of sex or age of victim. Our research questions were (1) is sexual assault related to health problems, depression and suicidal ideation and (2) do these associations differ between men and women?
Method:
We analyse data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a longitudinal study of a US nationally representative sample of nearly 21,000 young people recruited for the first wave of interviews when most of the participants were between ages 12 and 18 years. We used Wave 4 data, collected for participants who were in their 20s and 30s, on experience of both physical sexual assault and non-physical sexual assault and mental state, allowing for some characteristics measured in Wave 1. Allowing for missing data, sample sizes were between 6868 and 10,489 for the women and 6024 and 10,263 for the men.
Results:
Statistically significant associations were revealed between the physical and non-physical measures of sexual assault and the health problems scale, the depression scale and the measure of suicidal ideation. These associations remained statistically significant even after controlling for key covariates measured at Wave 1, including exposure to delinquent peers, poverty and demographic characteristics.
Conclusions:
Sexual assault at some time and of whatever kind, although more commonly reported by women than men, is similarly associated with serious physical and mental health problems during their 20s and 30s. More sequencing detail is required for better prevention of harms.
This literature review focused on homicide bereavement (HB) risk factors. A content analysis was conducted on 83 empirical papers published in English from January 2000 to December 2021 in peer-reviewed journals. Extracted HB risk factors were synthesized according to six main dimensions: individual level; situational homicide-related factors; and micro, meso, exo, and macro social levels. The review demonstrates that macro-level and situational homicide-related risk factors are in special need of further study. In addition, how HB risk factors interact with one another to influence HB also requires further study. Future research may benefit from examining whether and how individuals experiencing HB influence related factors at various social levels. Last, given that almost all reviewed studies were conducted in Western societies, the sociocultural and ethnic diversity in HB risk factors is in dire need of future study.
Undergraduate students who experience campus sexual assault (CSA) are faced with a wide array of potentially detrimental mental health and educational outcomes that may significantly impact their sense of wellbeing. Many researchers have focused on documenting these consequences of CSA, but there is a dearth of research on students’ post-assault experiences. Specifically, there is a lack of scholarship exploring students’ lived experiences of navigating their post-assault lives in their campus environment through the lens of resilience. The purpose of this study was to explore the phenomenon of resilience among undergraduate students who have experienced CSA, through a qualitative phenomenological inquiry. This study used critical conceptual understandings of resilience, including socio-ecological and intersectional feminist theoretical perspectives and social work discourses of resilience, to further complicate how the phenomenon is often described in scholarship. The findings revealed four key themes of the phenomenon to include resilience within the context of agency, coping, connection, and hope. Recommendations and implications across social work research, policy, and practice are presented, specifically those identified by the participants as recommendations for change in addressing CSA and supporting student experiences of resilience.
Domestic burglary victimization is a potentially traumatic experience, because most people consider their home as an extension of the self and a place where the self is protected against others. Intrusions to such a highly valued place are therefore considered as attacks to both one's personhood and one's safety and privacy and may render victims at risk of psychological distress. In view of the legal obligations most countries have with regard to screening crime victims for psychological distress, this study systematically reviewed the literature on determinants of psychological distress in domestic burglary victims. Web of Science, EBSCO, and ProQuest databases and reference lists were searched between February and July 2022 to identify relevant studies. In all, 10 studies met all inclusion criteria and were evaluated according to the Cambridge Quality Checklists. These checklists have been developed to assess the methodological qualities of observational research. Findings of included studies suggest that female sex, damages caused by the burglary, and evaluations of the police response are potential determinants of psychological distress. However, given the dearth of research and the old age and theoretical and methodological limitations of included studies, it is too early to draw definite conclusions about the predictive value of these and other factors and to provide directions for screening policies. Future research should use prospective designs to overcome these limitations and ensure that domestic burglary victims at risk of psychological distress are timely referred to adequate professional help services.
Unlabelled:
The focus of the wider study on which this paper is based was to uncover the social context of the sexual victimisation phenomenon in three selected institutions of higher learning in Durban, KwaZulu-Natal Province, South Africa. The objectives of the study were to examine the nature of sexual victimisation against female students in selected universities in Durban; to determine the factors that contribute to the sexual victimisation of female students; to investigate the effects of sexual victimisation on female students and to explore the reasons for female students' reluctance to report sexual victimisation. The sample comprised a total of 60 participants who had been purposively selected from three universities in the study area. The data were collected by means of interviews and were thematically analysed. The study found that incapacitated rape is more common on campuses than forcible rape, which is when perpetrators use threats and/or physical force. This could be attributed to the excessive use of alcohol and drugs by both victims and perpetrators. The study also confirmed that female students are reluctant to report sexual victimisation to the authorities. A key recommendation is that security measures need to be upgraded to ensure a safe environment for female students on campuses in the study area.
Supplementary information:
The online version contains supplementary material available at 10.1007/s43545-023-00611-z.
Sexual assault (SA) continues to be a serious problem on college campuses in the United States. This meta-analysis sought to identify correlates for SA victimization on college campuses, as well as examine if there were any differences in correlates for men and women. Database searches utilizing Boolean search terms were used to identify studies to be included in the meta-analysis. Studies were included if they provided quantitative data on correlates for SA victimization among college students. A total of 118 studies yielding 405 unique effect sizes were included in this study. The strongest correlates for SA victimization among college students were physical intimate partner violence (IPV) perpetration, physical IPV victimization, emotional IPV victimization, and prior SA victimization. Other significant correlates were related to mental health (e.g., hopelessness, suicidal ideation, trauma symptoms, anxiety symptoms, depressive symptoms), and factors related to a campus party culture (e.g., binge drinking, alcohol use, drug use, Greek membership). We were able to compare seven correlates between men and women. Results of the meta-analysis also highlight the need for future research to examine additional correlates for SA victimization, as well as examine race/ethnicity and gender as separate categories when trying to further understand correlates for SA victimization.
Experiencing sexual violence may have serious long-term consequences for victims. Seeking help may decrease the chances of developing long-term physical and psychosocial problems. Still not every victim seeks help, and especially with victimization of sexual violence, there may be several reasons as to why. The barriers to help-seeking are diverse and may depend on several contextual factors. This study, as part of a larger research project, aimed to determine the barriers that victims of sexual violence experience in their decision to seek help in a non-college setting. This mixed-methods study included an online survey ( N = 133) and open-ended survey ( N = 207) amongst victims of 18 years and older. The online survey data were analyzed using chi-square tests for independence and t-tests; the open-ended survey data were analyzed using a descriptive approach. The online survey data showed that minimization of the incident was higher for non-help-seekers, whilst distrust toward support providers and issues with the accessibility of help were higher for help-seekers. No further significant associations were found between the decision to seek help and the barriers to help-seeking. From the open-ended survey data, three categories of barriers were distinguished: (a) individual barriers, such as feelings of shame, (b) interpersonal barriers, such as the fear of negative social reactions and (c) sociocultural barriers, such as societal stereotypes regarding sexual violence. The findings suggest that victims experience various, but primarily individual, barriers to help-seeking and that these barriers do not strongly differ between help-seekers and non-help-seekers. This study highlights the importance of addressing barriers to help-seeking on an organizational and societal level to encourage help-seeking.
Background
Sexual assault (SA) has numerous negative outcomes on physical, sexual and mental health, social life, financial stability and overall quality of life. It is known as one of the most traumatogenic event. However, not all people who experienced SA will develop negative functional outcomes. Multiple risk and protection factors can influence their psycho-socio-judicial trajectories. The way by which these factors impact trauma adaptation are not always clear. Guided by an ecological framework, this project aims to (1) describe psycho-socio-judicial one-year trajectories of people recently exposed to SA, to (2) identify predictive factors for the development of posttraumatic stress disorder (PTSD) at first forensic examination using artificial intelligence and to (3) explore the notions of “victim” and “trauma” and the needs and experiences of people who have been sexually assaulted.
Methods and design
This longitudinal multi-centric cohort study will use a mixed-method approach. Quantitative cohort data will be collected based on questionnaires repeated in time, starting from first forensic examination and covering up to a year after the SA, measuring factors associated with PTSD, mental, physical, social and overall functional outcomes, and psycho-socio-judicial trajectories. Qualitative data will be based on semi-structured interviews with members of the cohort, people who experienced SA but not included in the cohort, and actors professionally involved in their psycho-socio-judicial care. Bivariate and multivariate analyses will be performed to study the associations between each variable and mental, physical, social and judicial outcomes. Predictive analyses will be conducted on multiple prediction algorithms to predict PTSD. Qualitative data will be integrated to the quantitative data to identify psycho-socio-judicial trajectories of participants and data on the representations of the place and usefulness of the notions of “trauma” and “victims” will be used independently.
Discussion
This project will collect numerous data never before collected over such long periods, which will lead to unprecedented results on psycho-socio-judicial trajectories of people who experienced SA. By being based on the entire psycho-socio-judicial chain and on the perspective of people who experienced SA, this work will allow to make innovative recommendations to improve their care at all levels, from the initial forensic examination.
This paper reports on the curriculum development for social work student placements in primary health care. Social work in General Practice [GP] is an emerging area for social work practice, able to fill a gap in primary health. The inclusion of social work in GP practices can be complex. Social work placements offer an opportunity for students to become familiar with this practice setting and undertake social work relevant learning; however, they need to be well prepared for such placements and able to articulate and use social work knowledge and processes. They offer an opportunity for GPs to understand what social workers can do and offer to the GP community. We have used available research, support of an active reference group and two surveys to develop a curriculum for social work students in GP practices. We provide an overview of the literature and the methods of developing the curriculum. We describe how feedback and curriculum design principles were used. Core aspects of the curriculum and accompanying resources are outlined. The discussion highlights that the curriculum was a valuable tool in not only inducting students into a GP placement setting but as a meaningful reference guide throughout the entirety of placement.
Background and objectives:
Hazardous substance use is a major public health concern among individuals with a history of sexual victimization. Although increased religiosity has been known to serve as a protective factor against hazardous substance use, religious individuals with a history of sexual victimization may be at a greater risk for hazardous substance use due to difficulties reconciling sexual victimization with their religious beliefs. Individuals with greater trauma-related shame may engage in hazardous substance use as a means of coping with the traumatic event.
Method:
The present study consisted of 614 participants (Mage = 34.57, 50% women).
Results:
Results suggested that organizational, nonorganizational, and intrinsic religiosity were positively associated with hazardous alcohol use at higher, but not lower, levels of trauma-related shame. Organizational and intrinsic religiosity were positively associated with hazardous drug use at higher, but not lower, levels of trauma-related shame.
Conclusions and scientific significance:
This is the first study to examine the role of trauma-related shame in the relationship between religiosity and hazardous substance use. The findings underline the importance of targeting trauma-related shame in religious individuals with a history of sexual victimization.
Understanding penal decision-making has become a central concern of criminologists over recent decades. Although scholars acknowledge the complex, multi-faceted, and contextual nature of penal decision-making, many rely on a single level of analysis to study the process. There is a rich literature on the socio-political, organizational, and individual context of decision-making, but few studies consider the impact of multiple influences simultaneously. To address this gap, this article uses a multi-level framework to shed light on the systems, processes, and actors that shape penal decision-making in Ireland. It draws on two case studies, namely probation and parole, to demonstrate that macro-, meso-, micro-, and individual-level influences must be considered to achieve a comprehensive understanding. Our analysis shows that macro-level systems such as legal and political processes play an important role in shaping probation and parole decisions. At the meso-level, institutional policies, values, and culture come into play while practitioner agency operates at the micro-level to support, alter, or subvert macro- and meso-level developments. Finally, the characteristics and behavior of victims and offenders can shape decision-making at the individual level. The article concludes with a reflection on the implications of this analysis for criminological knowledge.
The victim-offender overlap in sexual violence: A compa rative study among victims, offenders,
and victim-offenders
The complex nature of the victim-offender overlap in sexual violence is not fully captured as the factors tend to be more explanatory for either perpetration or victimization. Therefore, this study aims to distinguish between the characteristics of victim-offenders, only-offenders and only-victims
of hands-on sexual violence. Through a multinomial logistic regression, based on survey data from a Belgian nationally representative sample (n = 710), demographic characteristics, resilience, the strength of their social network and mental health were compared.
The results indicated that sex and migration background predicted membership of the different groups. Regarding social connectedness, persons without a partner were more likely to be victim-offenders than victims. Furthermore, a history of self-harming behavior was strongly associated with victim-offenders. This article concludes with suggestions for future research into this topic and recommendations for rehabilitation services.
Background
Sexual violence, especially childhood sexual violence, is a serious social issue, yet the prevalence of childhood sexual violence among university students is unknown. We aimed to investigate the prevalence of these experiences and assess their associations with depressive symptoms.
Methods
The study included 29,311 participants, mean (SD) age 20.5 (1.4) years, from a cross-sectional survey of a multi-stage stratified cluster random sample from all universities in Guangdong province of China. Data were obtained through an anonymous electronic questionnaire from December 2 to 15, 2019. Undergraduates' experiences of childhood sexual violence were self-reported. Current depressive symptoms were measured by Center for Epidemiological Studies Depression Scale (CESD-10). Stress measures in recent months were measured by the College Student Stress Scale.
Results
The prevalence of childhood sexual violence experience among university students was 4.8 % (95 % confidence interval (CI) = 4.6 %–5.0 %), 7.3 % (95 % CI = 6.9 %–7.7 %) for female students and 1.8 % (95 % CI = 1.6 %–2.0 %) for male students. Sexual violence in childhood was related to students' current depressive symptoms after adjustment for stress and socio, demographic characteristics (adjusted prevalence ratio (PRa) = 1.36, 95 % CI = 1.30–1.42). Significant differences in the association between childhood sexual violence and depressive symptoms were also found by sex.
Conclusions
Experiences of childhood sexual violence among university students are not negligible and associated with their current depressive symptoms. The association between childhood sexual violence and depressive symptoms among female and male students is different. Schools, families, and society as a whole should be encouraged to provide education on healthy sexual behavior preventive interventions related to sexual violence for childhood students.
Many studies have shown that being a victim of an assault or crime increases the chance of revictimization, and the current chapter deals with this aspect of victimization. The concept of revictimization has been defined in many different ways but the common theme that arises is the repetition of the victimization of the same person, which can be physical, sexual, emotional, or any form of abuse. Studies showed that revictimization exists and it happens especially in sexual assault and intimate partner violence. Though these are the two distinctive forms of violence, some underlying features may be there as common core reasons for revictimization. This chapter explores the factors associated with the revictimization of sexual abuse and intimate partner violence (IPV) to delineate the common factors in both the violations. From the background of ecological and violence perspectives, and clinical and research experiences with different forms of violence and crimes, the author introduces a conceptual framework for revictimization. As it is a thread of conceptual formulation of theory, empirical studies are required to validate it.KeywordsRevictimizationVictimizationSexual abuseIntimate partner violenceMultifactorial deficits and boost theory
Background: The conspiracy community known as QAnon rose to prominence in the mainstream media over the last several years. To curb its spread, social media platforms have blocked QAnon-related activity.
Analysis: This article demonstrates why QAnon cannot be addressed as a problem of information. Instead, it argues in favour of an ecological approach, which highlights the forces that make people vulnerable to QAnon-related conspiracies and other types of misinformation.
Conclusion and implications: This article demonstrates why QAnon cannot be addressed as a problem of information. Instead, it argues in favour of an ecological approach.
We examined longitudinal associations between binge drinking (BD), depressive symptoms, and sexual violence (sexual harassment and sexual assault) among sexual and gender minority (SGM) and non-SGM emerging adults. Data were drawn from four annual web-based surveys of a diverse cohort of 2,553 emerging adults, spanning from approximately age 19 (2016) to age 22 (2020). About 18% were SGM individuals. We tested a multigroup parallel process latent growth curve model (recent depression symptoms; past-year BD) with time-varying covariates (past-year sexual harassment; sexual assault) to determine associations of sexual violence with BD and depression outcomes over time, and whether growth curves and associations differed by SGM status. For both SGM and non-SGM emerging adults, past-year sexual harassment was associated with depressive symptoms at each time point, but harassment was not associated with BD. For both groups, sexual assault was associated with both depressive symptoms and BD. To our knowledge, this is the first study to examine longitudinal, contemporaneous associations of sexual violence (including both harassment and assault as distinct constructs), with BD and depressive symptoms among racially and ethnically diverse emerging adults, comparing SGM and non-SGM groups. Although our models do not disentangle directionality or causality, the findings suggest the need to address sexual violence victimization (assault and harassment) in the context of depression screening and treatment, and vice versa. We discuss a number of intervention strategies currently in use for an implicitly non-SGM general population that could be adapted for greater inclusion of and relevance to SGM populations.
Dating app facilitated sexual violence (DAFSV) includes behaviors such as unwanted sexual comments/harassment, unsolicited sexual photos, and gender/sexuality-based harassment - and could extend to sexual violence when meeting partners face-to-face. The effects of sexual violence on mental health are well-established; however, research on DAFSV has been limited. The goal of the current study was to understand college students' experiences of DAFSV and investigate cross-sectional associations with indicators of mental health (i.e. depression and anxiety symptoms) and well-being (i.e. self-esteem, loneliness, perceived control). Participants were college students in the United States who used dating apps (N = 277) and identified primarily as women (64.6%) and heterosexual/straight (74.0%). Most participants (88.4%) self-reported at least one instance of DAFSV. Women (vs. men) and sexual minority (vs. heterosexual/straight) individuals experienced more frequent DAFSV. Regression analyses indicated that DAFSV frequency was associated with higher depression and anxiety symptoms, higher loneliness, lower self-esteem, and lower perceived control. This study highlights the importance of DAFSV for a broad range of well-being indicators. Given that dating apps are one of the most common means of meeting partners, research is needed to better understand these initial interactions, prevent DAFSV from occurring, and mitigate the impact of DAFSV on health outcomes.
This chapter explores the experiences of Muslim American women as they move through their twenties, i.e., emerging adulthood. It examines how two large sociocultural factors—marriage and higher education—intertwine and can present as developmental protective factors, risks, or both, depending on the moment a woman finds herself in on her life path trajectory. The chapter also explores other aspects of emerging adulthood for these women, such as seeking out alternate safe spaces, considering what an authentic sense of self might be, and using goal-oriented focus to combat new and persisting developmental risks. Similarities and contrasts are presented between other American emerging adult groups, and a discussion of non-conformist life path trajectories introduces the potential for reshaping gender expectations within South Asian Muslim communities.KeywordsMuslim American emerging adulthoodMarriageEducationExtended adolescenceRisksProtective factors
Objective: Empowerment Self-Defense (ESD) is a sexual violence prevention approach backed by rigorous empirical research, yet its availability on college campuses is limited. This manuscript evaluates the feasibility and efficacy of an ESD program embedded within a university counseling center. Methods: Participants completed an 8-session ESD intervention and group counseling program. Results: Feasibility and acceptability of this program were demonstrated by excellent participant retention and supported by institutional buy-in and counselor involvement. Pre-post assessments demonstrated that participants reported significant reductions in posttraumatic stress symptoms, F (1, 56) = 22.46, p < .001 and improvements in both interpersonal self-efficacy, F (1, 56) = 88.81, p < .001, and self-defense self-efficacy, F (1, 56) = 100.20, p < .001. Conclusion: The findings support the use of ESD programming as part of college campus sexual violence efforts and provide a blueprint for administrators and college mental-health centers who wish to offer this effective program to the college students they serve.
An estimated 90% of reported sexual abuse cases result in a plea agreement. The present study investigated the perception of plea agreements involving a teacher-adolescent student child sexual assault case. A 2 (teacher gender: male or female) x 2 (student gender: male or female) x 2 (punishment type: probation or jail) within-participant design was used with participant gender included as a between-participant factor. Perceptions of the plea agreement served as the dependent variables. Participants (N = 52; 48.1% male, 51.9% female) each read the eight vignettes in a random order and then rated their perceptions (e.g., support for the judicial process, degree of justice served, how upset they were by the plea) of a plea agreement on a 7-point scale. It was found that participants showed less support for plea agreements (1) offered to male teacher offenders compared to female teacher offenders and (2) when the punishment was probation compared to jail time. Additionally, participants’ emotional reactions (e.g., how upset) mediated the relationship between the independent variables (defendant gender and punishment type) and participants’ perception of the plea agreements. Results and implications are discussed in terms of procedural justice and the importance of public perceptions of pleas.
Little attention has been paid to views of the police among sexual assault survivors. Understanding views of the police among a large population of crime victims who have historically been silenced and mistreated by our criminal-legal system can help inform recent and ongoing conversations about police funding and criminal justice reform. Qualitative interview data from a community sample of sexual assault survivors explored how police-detective interactions during sexual assault investigations shape views of the police. Negative interactions led to negative views of the police and for some were based on a culmination of positive and negative experiences. I share recommendations for responding to sexual assault that consider sexual assault survivors’ experiences with and views of the police.
The 2019 Kenya Violence Against Children Survey highlighted the increased prevalence of sexual violence experienced by girls; 62.6% of girls who have experienced childhood sexual violence reported multiple incidents before age 18. Studies have shown that transactional sex (TS) relationships are a source of sexual violence, particularly age-disparate TS. TS is defined as sex that is a nonmarital, noncommercial relationship driven by the assumption that sex is exchanged for material support or other benefits. TS is common among adolescents and young women in sub-Saharan Africa, with the prevalence varying from as low as 5% to as high as 80%. This qualitative study explored the factors influencing age-disparate TS relationships in two rural districts, Mutomo and Ikutha Wards of Kitui South Sub County, Kenya. Four focus group discussions were conducted with primary (12–14 years of age) and secondary schoolgirls (15–18 years of age). The study results identified several main themes, which were grouped into two major themes: influencing factors and consequences. Influencing factors include material/basic needs, school-related influences, parental influence, peer pressure, and perpetrator access, while consequences include health and social consequences. Our study found that girls’ sense of agency, social pressure, and economic vulnerability impacted their decision to engage in age-disparate TS. These relationships’ power dynamics and exploitative nature increase girls’ risk of experiencing gender-based sexual violence and adverse health and social outcomes. Our study suggests that explicitly addressing individual risk behaviors will not effectively reduce the incidence of TS relationships. Interventions should be focused on understanding the social-cultural beliefs of TS and shifting the narrative that has continued to fuel a patriarchal society in which women and girls have limited decision-making power in relationships.
Identifying potential mechanisms underlying the association between posttraumatic stress (PTS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol‐involved assault or non–alcohol‐involved assault, using baseline assessment data from a larger study examining cognitive and emotional risk factors for problem drinking. Conditional path analysis was used to examine the indirect effects of posttraumatic cognitions on the association between PTSS and alcohol use consequences, with assault type as a moderator. The findings revealed a significant indirect path from PTS to alcohol use consequences through posttraumatic cognitions, B = 0.21, SE = 0.04, p < .001, 95% CI [0.13, 0.29], β = .16, R2 = .32. Exploratory analyses revealed a significant conditional indirect effect through self‐blame cognitions, R2 = .31, whereby the indirect effect of self‐blame on the association between posttraumatic stress and alcohol consequences was present among participants who experienced alcohol‐involved assault, B = 0.10, SE = 0.03, p < .001, 95% CI [0.06, 0.16], β = .07, but not among those who experienced a non–alcohol‐involved assault, B = 0.03, SE = 0.03, p = 0.32, 95% CI [−0.02, 0.08], β = .02. Posttraumatic cognitions are a potential mechanism underlying the link between posttraumatic stress and alcohol consequences. Addressing posttraumatic cognitions, particularly those related to self‐blame, may be an important target for interventions promoting healthy recovery following alcohol‐involved assault.
Past findings have indicated that sexual and gender minority (SGM) individuals experience disproportionate rates of emotional, physical, and sexual assault compared to their heterosexual/cisgender counterparts. While these findings are robust, many studies report homogenous groupings of SGM participants. This practice likely masks important between group differences. We sought to address this issue by examining reported base rates of emotional, physical, and sexual assault within 12 months of data collection, split across specific sexual (heterosexual, gay/lesbian, bisexual, questioning, queer, pansexual, asexual, and demisexual) and gender (cisgender men, cisgender women, gender nonconforming female assigned at birth [FAB], and gender nonconforming male assigned at birth [MAB]) identity groups. Our data came from the 2020-2021 Healthy Minds Study, a large survey of college students living in the United States (N=119,181). Results indicated most forms of assault were higher in SGM groups compared to heterosexual and cisgender individuals, both on univariate and multivariate (e.g., one or more type of assault) levels. Demisexual individuals reported the highest base rates for emotional assault (45.7%), whereas pansexual individuals reported highest rates of physical assault (12.5%) and sexual assault (17.3%). Demisexual individuals reported the highest multivariate base rate of experiencing at least one form of assault (49.5%), and pansexual individuals reported the highest multivariate base rate of experiencing all three forms of assault (4.7%) within the past 12 months. Gender nonconforming FAB individuals reported the highest univariate and multivariate base rates across assault types compared to all other gender identity groups. With few exceptions, compared to heterosexual and cisgender men (referents), all other sexual and gender identity groups reported significantly higher adjusted odds of experiencing each assault type. These data suggest SGM individuals experience disproportionate levels of assault.
Following a sexual assault, women experience a host of negative psychological consequences. While some survivors label their sexual assault experience as such (i.e., are acknowledged survivors), other survivors do not. The effect of acknowledgment of sexual assault on postassault outcomes has yielded mixed findings. It was hypothesized that social reactions may account for the relationship between acknowledgment status and psychological symptoms. Results indicated that acknowledged survivors reported more severe posttraumatic stress disorder symptoms, which were partially accounted for by turning against social reactions. Future studies should explore the mechanisms responsible for these relationships and analyze the individual social reactions.
This article derives from part of a larger study on sexual violence prevention in teacher education that analyses the narratives of fifteen teacher candidates in an Ontario university. It begins by providing a rationale for the research, which engages emerging teachers as key stakeholders in prevention education. Narrative inquiry was conducted to understand the experiences of teacher candidates who were troubled by the programme’s lack of education and training on sexuality education and sexual violence prevention. Teacher candidates reflected that their first education about consent and sexual violence occurred in a postsecondary rather than an elementary or secondary school context. As part of the teacher certification programme, participants felt entitled to learn about sexuality education methodologies and sexual violence prevention education. As emerging teachers, they expressed the desire to know how to teach young people about sex and consent, healthy relationships, boundaries, and the sociopolitical contexts of sexual violence, as well as how to sensitively respond to disclosure. Most pointedly, participants understood the power that effective sexuality education by trained teachers may have in reducing victimisation, thereby contributing to educational equity. Findings are discussed in relation to the literature on feminist understandings of sexuality education and sexual violence prevention.
Qualitative data are used to examine the process by which women come to label their unwanted sexual experiences With dating partners as sexual abuse or assault, as well as the factors that impede such labeling. Issues of consent, causal attributions, and minimization were found to be central to understanding why women did or did not label. Labeling was generally a gradual process and was most often triggered by social support seeking. Women who did not label typically defined the incident as something less serious than sexual abuse or assault, although some provided definitions indicating that they had felt victimized.
In 1996, the World Health Assembly declared violence a major public health issue. To follow up on this resolution, on October 3 this year, WHO released the first World Report on Violence and Health. The report analyses different types of violence including child abuse and neglect, youth violence, intimate partner violence, sexual violence, elder abuse, self-directed violence, and collective violence. For all these types of violence, the report explores the magnitude of the health and social effects, the risk and protective factors, and the types of prevention efforts that have been initiated. The launch of the report will be followed by a 1-year Global Campaign on Violence Prevention, focusing on implementation of the recommendations. This article summarises some of the main points of the world report.
Does experiential avoidance predict PTSD severity among rape survivors? We tested a hypothesized model where causal attributions, cognitive schemas, and memory characteristics mediated the relationship between experiential avoidance and PTSD. Experiential avoidance was measured as a cognitive coping strategy; women scoring high on this measure did not try to integrate or make meaning of their rape experiences, but rather attempted to block out memories of their rapes or minimize or rationalize their rape experiences in some way. Data were cross-sectional. Participants were rape survivors (N = 139; 23% with current PTSD). Results included a measurement model of social cognitive factors and PTSD and the structural model. Two sets of pathways were delineated, both exacerbated PTSD. Overall, 60% of the variance in PTSD was explained. The results suggested that the effects of experiential avoidance on psychological outcomes were detrimental, but small. Re-experiencing was the only memory characteristic to mediate the rape-PTSD relationship. Causal attributions and maladaptive belief changes were far more powerful than any other predictors in explaining prolonged distress. Neither was strongly affected by levels of avoidance.
Beginning with Koss, Gidycz, and Wisniewski’s pathbreaking study, the sexual victimization of female college students has emerged as salient research and policy concern. Building on this earlier work, we used a national, random sample of 4,446 female college students to focus on an issue of continuing importance: the level and determinants of victims’ willingness to report their sexual victimization. The analysis revealed that although few incidents—including rapes—are reported to the police and/or to campus authorities, a high proportion are disclosed to someone else (mainly to friends). Incidents were more likely to be reported to the police when they had characteristics that made them more “believable” (e.g., presence of a weapon or assailant who was a stranger). The use of alcohol and/or drugs by offenders and/or victims had a unique effect, causing students to be more likely to disclose their victimization to friends but not to campus authorities. The implications of the findings for extant debates and for future research are also explored.
Pre-trauma beliefs about the safety of the world and one's own invulnerability are thought to influence post-trauma reactions. The current study examined whether two trauma characteristics that are hypothesized to relate to perceptions of safety, assault location and assailant identity, predict the rate and severity of post-traumatic stress disorder (PTSD) in female rape victims. It also attempted to reduce the confound of assault brutality. Results indicated that women assaulted in locations rated as safe had significantly more severe overall PTSD symptoms than women assaulted in dangerous locations. However, contrary to our prediction, women assaulted by dangerous assailants reported significantly more severe PTSD symptoms than women assaulted by assailants rated as safe. Assault brutality and violation of safety expectations may represent two distinct aspects of the assault, both influencing the severity of posttrauma reactions.
The purpose of the present article is to review the literature on the psychological impact of rape on adult female victims. Typical patterns of recovery, types of symptoms, and variables affecting recovery are all reviewed. Among the problems discussed are fear and anxiety, posttraumatic stress disorder, depression, poor self-esteem, social adjustment issues, and sexual dysfunctions. The moderating variables that are reviewed are preassault variables such as prior psychological functioning and life stressors; within-assault variables such as acquaintanceship status, level of violence, and within-crime victim reactions; and postassault variables such as social support and participation in the criminal justice system.
This study is based on qualitative analysis of interviews with 30 rape survivors. Participants who had been raped by men they knew often delayed telling anyone about the rape and experienced more negative reactions than those attacked by strangers. Reactions ranged from support and inconsistent support to silence/avoidance and hostility. The unpredictable pattern of reactions made all the survivors more hesitant about discussing their experiences with others. The results suggest the critical importance of the social context in which survivors discuss sexual victimization and why, at times, silence may be the most logical response.
Backlash critics of campus rape research have claimed that researchers exaggerate their figures by labeling as rape victims those women who experience bad dates. Although researchers have compared stranger with acquaintance rape victims, they have not compared women raped while too drunk to resist and those raped by force. This study of 65 rape victims (in a sample of 388 college seniors) found no evidence for critics' claims. Women raped by intoxication are not less emotionally affected and do not blame themselves more. Most women did not classify their experiences as rape, although all were victims under criminal law. This lack of recognition is what causes hidden victims, who do not report or seek help.
In this study, 102 female rape survivors were interviewed regarding their first post-assault disclosure. Qualitative analysis revealed that nearly 75% of first disclosures were to informal support providers and over one third of the disclosures were not initiated by the survivors themselves. Over half of the survivors received positive reactions and less than one third felt the disclosure had a detrimental impact on their recovery. Loglinear analysis suggested that survivors who actively sought help from informal support providers were more likely to receive positive than negative reactions. In contrast, survivors who actively sought help from formal support providers were more likely to receive negative than positive reactions. When disclosure to formal support providers was initiated by the formal support providers themselves, however, survivors received exclusively positive reactions. Implications for future research are discussed.
Consistent evidence demonstrates that many women who encounter the trauma of rape experience a range of both acute reactions and chronic psychological sequelae. This article reviews both the short- and long-term psychological adjustment issues associated with rape. In addition, we propose a culturally inclusive ecological model of sexual assault recovery (CIEMSAR), which integrates and extends existing models to better examine the complex factors leading to differential postrape adjustment. Important components of the CIEMSAR are placing rape in the broader sociocultural context of the United States and explicated socioracial and ethnic factors influencing the recovery process. The five primary factors of CIEMSAR are outlined, including (a) macrosystem or sociocultural context factors; microsystem/individual factors such as (b) assault characteristics, (c) person variables, (d) coping responses; and mesosystems factors such as (e) social-support systems. Suggestions for future research are also provided.
The prevalence and impact of adult sexual assault (ASA) were examined in a stratified random sample of the general population. Among 941 participants, ASA was reported by 22% of women and 3.8% of men. Multivariate risk factors for ASA included a younger age, being female, having been divorced, sexual abuse in childhood, and physical assault in adulthood. Childhood sexual abuse was especially common among sexually assaulted men and women (61 and 59%, respectively). ASA victims were more symptomatic than their nonassaulted cohorts on all scales of the Trauma Symptom Inventory (TSI; J. Briere, 1995), despite an average of 14 years having passed since the assault. Assaulted men reported greater symptomatology than assaulted women, whereas nonassaulted men reported less symptomatology than nonassaulted women.
This paper reviews epidemiological estimates of criminal victimization derived largely from nationally based studies in the United States. Origins of conflicting rates and prevalences are explained in terms of varying methodology. Risk factors for victimization, including age, race, gender, and disability, are also outlined, and derived from both national and geographically limited U.S.‐based studies. Finally, mental health outcomes of violence are documented, with conclusions drawing on both national and regionally specific studies. These outcomes focus on posttraumatic stress disorder, but also include depression, substance abuse, and panic.
Demographics, assault variables, and postassault responses were analyzed as correlates of PTSD symptom severity in a sample of 323 sexual assault victims. Regression analyses indicated that less education, greater perceived life threat, and receipt of more negative social reactions upon disclosing assault were each related to greater PTSD symptom severity. Ethnic minority victims reported more negative social reactions from others. Victims of more severe sexual victimization reported fewer positive, but more negative reactions from others. Greater extent of disclosure of the assault was related to more positive and fewer negative social reactions. Telling more persons about the assault was related to more negative and positive reactions. Implications of these results for developing contextual theoretical models of rape‐related PTSD are discussed.
This study examined the role of social support in the partner violence–psychological distress relation in a sample of African American women seeking medical care at a large, urban hospital (n = 138). Results from bivariate correlational analyses revealed that partner violence was related to lower perceived social support and greater psychological distress, and lower social support was related to more distress. Furthermore, findings based on path analysis indicated that low levels of social support helped account for battered women's increased distress. Findings point to the need for service providers to screen for partner violence in nontraditional sites, such as hospital emergency rooms, and to address the role of social support resources in preventive interventions with African American battered women.
This research examined how the legal, medical, and mental health systems respond to the needs of rape victims. A national random sample of rape victim advocates (N = 168) participated in a phone interview that assessed the resources available to victims in their communities. as well as the specific experiences of the most recent rape victim with which they had completed work. Results from hierarchical and iterative cluster analysis revealed three patterns in victims' experiences with the legal, medical, and mental health systems. One group of victims had relatively positive experiences with all three systems, a second group had beneficial outcomes with only the medical systems, and the final group had difficult encounters with all three systems. Multinominal logistic regression was then used to evaluate an ecological model predicting cluster membership. Community‐level factors as well as features of the assault and characteristics of the victims predicted unique variance in victims' outcomes with the legal, medical, and mental health systems. These findings provide empirical support for a basic tenet of ecological theory: environmental structures and practices influence individual outcomes. Implications for ecological theory and interventions to improve the community response to rape victims' needs are discussed.
Objective: The authors examined the relationships among history of previous assault, severity of rape, acute plasma cortisol level after rape, and development of rape-related post-traumatic stress disorder (PTSD). Method: Blood samples were drawn from 37 adult female rape victims within 51 hours after they had been raped. The subjects were assessed for history of previous assault and for the presence of PTSD 17-157 days (mean=90 days) after the rape. Results: Women with a history of previous assault had a lower mean acute cortisol level after the rape but a higher probability of subsequently developing PTSD. A significant interaction between history of previous assault and the severity of the index rape was observed: only women who had never been assaulted before had higher cortisol levels following high-seLlerity rapes (those which included injury or multiple types of penetration) than low-severity rapes. Conclusions: The authors conclude that previous traumatization may attenuate the acute cor-tisol response to trauma. (Am] Psychiatry 1995; 152:1675-1677) S tudies have shown that stressor severity predicts posttraumatic stress disorder (PTSD) (1-3). Given the role played by the hypothalamic-pituitary-adrenal (HPA) axis in the stress response (4), the acute cortisol response to trauma should be related to stressor characteristics. Previous exposure to trauma is also an important risk factor for PTSD (5). Animal studies have shown that a previous history of stressors may alter the HPA axis response to a subsequent stressor (6, 7). To our knowledge, the relationships among history of previous assault, stressor severity, and HPA axis response have not been investigated in human trauma victims. Data are also lacking regarding the acute biological responses to trauma in individuals who go on to develop PTSD compared with those who do not. Several studies indicate that subjective distress immediately following
Despite the proliferation of rape crisis centers and other improvements in the treatment of rape victims over the past 20 years, many victims still find themselves the victims of what has been called a "second rape" by doctors, lawyers, judges, police, and administrators that process them. This book takes a critical look at the organizations and officials that process rape victims to see how the structure of their respective organizations often prevent them from providing responsive care.
The chapter describes the single and multifactor theories that have been used to explain male violence against women. Early evolutionary theories argued that male violence was rooted in genetics and biology due to natural selection pressure. It was also argued that rape, in particular, was a reproductive strategy. Social learning theories focus on the socialization experiences of men that lead them to be violent toward women. Intrapsychic theories focus on acts of violence as manifestations of deviations in one's personality. Feminist theories integrate features of social learning theory and sociocultural theory by stressing the impact of sociocultural influences on the learning process. Certain sociocultural variables are common to all types of male violence against women. Cultures in which less traditional gender roles are prescribed and in which male dominance and female subordination are not encouraged show fewer instances of male violence against women, supporting the idea of sociocultural contributions to such violence.
The purposes of this study were (a) to examine a new model of the relations between attributions and long-term recovery among rape survivors and (b) to test the applicability of this model to other life events that differ in terms of controllability (i.e., bereavement and relationship loss). Among rape survivors, both behavioral and characterological self-blame were associated with poorer recovery, as was more often thinking about why the rape occurred; the belief that future assaults are less likely was associated with better recovery; and beliefs about past control were unrelated to beliefs about future control. Self-blame was associated with poorer recovery and perceptions of past and future control were unrelated for both bereavement and relationship loss. The relations between thinking about ''why'' and recovery, and future control appraisals and recovery, differed across events, however. Implications for research and practice are discussed.
The primary purpose of this study was to examine whether self-blame mediates the relations between various predictor variables and postrape trauma. To answer this question archival data collected from a sample of 25 rape victims seen at a hospital-based rape crisis program were analyzed. Results suggested, first, that self-blame was significantly related to postrape depressive symptoms. Second, both prior mental health problems and prior victimization were also associated with increased postrape depression. Correlations between these predictor variables and self-blame suggested that only prior incest was associated with self-blame as well as depression. Regression analyses testing whether self-blame mediated the relation between incest and postrape depression were consistent with the interpretation that incest victims tend to engage in more self-blame and, as a result, are more depressed. The implications of these findings for both research and practice are discussed.
To understand the way children develop, Bronfenbrenner believes that it is necessary to observe their behavior in natural settings, while they are interacting with familiar adults over prolonged periods of time. His book offers an important blueprint for constructing a new and ecologically valid psychology of development.
This study examined partner abuse, mental health, and coping in a sample of African American women survivors of partner abuse (N = 126). The mediating effects of social support and spirituality, as culturally relevant factors in coping, on the relationships between partner abuse and both depression and post-traumatic stress disorder (PTSD) symptoms were investigated. Findings from hierarchical regression analysis indicated that PTSD symptoms remain significantly related to partner abuse after controlling for the effects of social support and spirituality. Findings point to practice and research implications regarding African American women survivors’ mental health and ways of coping.
Male violence is an enduring feature of women's lives from childhood through old age. The review covers child sexual abuse, rape, and partner violence with emphasis on the prevalence of violence, its mental health consequences, the course of recovery, and mediators and moderators of traumatic impact. The primary focus is depression and posttraumatic stress disorder, the two major diagnostic entities through which postassault emotions and behaviors have been conceptualized and measured. The effects of psychiatric conceptualizations of victimization and patterns of individual recovery are critically reviewed. The PTSD paradigm as the sole foundation for most victimization research is also debated. Following the review, mental health services for victimized women are examined. The article concludes with public policy recommendations to improve the availability and accessibility of mental health services with emphasis on reaching those survivors who are less likely to consult the formal system.
Negative social reactions are common responses to disclosures of sexual assault. A study was undertaken to evaluate the psychometric characteristics of a new measure of social reactions to sexual assault victims, the Social Reactions Questionnaire (SRQ). Good reliability and validity were demonstrated for the measure in three samples of sexual assault victims: community volunteers, college students, and victims contacting mental health agencies. The SRQ provides a much needed measure of both the positive forms of social support and several negative social reactions received by sexual assault victims disclosing their assaults to a range of informal social network members and formal support providers.
The present study assessed the acute reactions of women who had experienced sexual assault within a framework of posttraumatic stress disorder (PTSD). One hundred women treated for sexual assault at a university hospital emergency department were interviewed within 72 hours of the incident. Of the 30 women reinterviewed 6 to 8 weeks later, 22 (73.3%) met the full criteria for PTSD, and an additional 5 reported symptoms in either the intrusive or avoidant domain. Twenty (66.7%) of the women met the criteria for PTSD based on an early draft of DSM-III-R. A prior history of sexual assaults was positively correlated with the presence of PTSD and the use of an informal support network was negatively associated with PTSD symptoms.
Although research on sexual assault and its postassault consequences has grown, information on knowledge of postassault experiences for African American women remains limited. A large sample of African American women (N = 495) were surveyed about their sexual assault experiences, attributions of blame, disclosure, and social reactions received following assault. Age, educational attainment, and sexual assault severity were examined in relation to postassault factors. Exploratory analyses were conducted to identify potential differences in sexual assault experiences and postassault outcomes for African American women. Although African American women reported similar sexual assault characteristics, their postassault reactions and experiences differed according to their age and educational attainment.
One-hundred-nineteen undergraduate females participated in a study examining the roles of child sexual assault, attributions, and coping on adjustment to rape. Participants completed anonymous questionnaires that assessed for child sexual abuse history, adult victimization history, attributions of blame for the adult assault, coping strategies for the adult rape, and trauma symptoms. Rape victims with a history of child sexual abuse were found to have higher levels of trauma symptoms, made greater use of nervous and cognitive coping strategies, and were more likely to make attributions of blame towards themselves or society. Current symptoms were related to types of coping and attributions of blame, with history of child sexual abuse having an indirect relationship to these variables. The results suggest the importance of attributional and coping variables, as well as child sexual abuse history, as mediators of postrape adjustment.
Alcohol is associated with risk of sexual assault among women and with increased risk of experiencing completed rape once attacked. In particular, alcohol use prior to sexual assault by both offenders and victims may affect the severity of sexual victimization experienced by women. Little research has explored the mechanisms (e.g., social context, behavior) through which alcohol may affect outcomes of sexual attacks using multivariate analysis. This study analyzed the role of alcohol in sexual assaults experienced by a national sample of female college students. A hierarchical multivariate regression showed that victim alcohol abuse propensity and both victim and offender alcohol use prior to attack were directly associated with more severe sexual victimization to women as measured by the Sexual Experiences Survey. This study suggests that alcohol use plays both direct and indirect roles in the outcomes of sexual assaults. Rape and alcohol abuse prevention efforts can benefit from incorporating information about alcohol's role in different assault contexts.
The present study investigated disclosure of sexual assault to members of one's social network in a convenience sample of sexual assault victims (N = 155) completing a mail survey. Three sets of correlates (demographics, assault characteristics, postassault experiences) of the timing of sexual assault disclosure and subsequent social reactions received from social network members were examined. Delayed disclosure was associated with childhood sexual assault history, completed rape, and avoidance coping, whereas early disclosure was associated with offender preassault alcohol use and postassault medical attention. Negative social reactions were more common among women who used avoidance coping and victims who told physicians or police about their assaults. Positive social reactions were associated with higher income, less physical injury due to the assault, less self-blame, less postassault distress, and saying that a friend/relative or a rape crisis center was helpful regarding the assault. Implications of these results for research and treatment of sexual assault survivors are discussed.
Lifetime experience with sexual assault and psychological reactions to assault were assessed in a random community sample. Of the 15 emotional and behavioral reactions to sexual assault that were measured, anger, sadness, and anxiety were the most commonly reported (59%, 43%, and 40%, respectively) and fear reactions were the most persistent. Men were significantly less likely than women to report 11 of the 15 reactions. Factor analyses showed that the items could be reliably described by three factors: sexual distress, fear/anxiety, and depression. Demographic characteristics of the respondent and circumstances of the assault were utilized in regression models as predictors of the assault reactions factors. Age, physical threat, and assault outcome (intercourse) were related to sexual distress; gender, assault outcome, physical threat, and talking to someone about the assault were related to fear/anxiety; and physical threat and assault outcome were predictive of depressive symptoms.
A sample of 391 adult females were interviewed about lifetime criminal victimization experiences, crime reporting, and psychological impact. In total, 75% of the sample (n = 295) had been victimized by crime, and 41.4% of all crimes were reported to the police. Reporting rates differed by crime type. Burglary had the highest reporting rate (82.4%); and sexual assault the lowest (7.1%). Of all crime victims, 27.8% subsequently developed posttraumatic stress disorder (PTSD). Major implications are the following: Prevalence rates are extremely high and reporting rates are low. The prevalence of PTSD indicates that crime has both an immediate and long-term psychological impact. Suggestions for improved victim services are discussed.
This article discusses the feminist response to the diagnosis of posttraumatic stress disorder (PTSD), which is used to identify and treat the psychological symptoms of women who have been sexually and physically abused.Feminist reaction to PTSD is often contentious and appears to divide along political lines, roughly conceptualized as liberal, radical, and socialist.The author reviews the theoretical stances of these factions in regard to gender issues, politics, and psychology and considers their responses (actual or probable) to the PTSD diagnosis.
This article takes a critical look at the current trend toward applying trauma theory to the understanding of women's experiences of violence and abuse. Multicultural feminist theories and the author's standpoint as a survivor are used to deconstruct pathologizing and exclusionary assumptions implicit in much trauma work. Elements of a survivor-centered approach are articulated and offered as legitimate ways of knowing. This epistemological shift is intended to give researchers and practitioners a more socially contextualized, culturally inclusive, and strengths-oriented understanding of the social distribution of traumatic injury.
A volunteer community sample of 159 primarily (77%) African American battered women were interviewed about forced sex by their partner (or ex-partner). Almost half (45.9%) of the sample had been sexually assaulted as well as physically abused. Except for ethnicity, there were no demographic differences between those who were forced into sex and those who were not, and there was no difference in history of child sexual abuse. However, those who were sexually assaulted had higher scores on negative health symptoms, gynecological symptoms, and risk factors for homicide even when controlling for physical abuse and demographic variables. The number of sexual assaults (childhood, rape, and intimate partner) was significantly correlated with depression and body image.
This study conceptualizes rape trauma as embedded in the cultural construction of rape and consequently manifested in the psychological process of individual rape survivors. The author conducted indepth interviews with 35 female rape survivors in Taiwan to examine their self-reported traumatic experiences in relation to the cultural meaning of rape in Chinese society. In analyzing the interview accounts, this study identified several kinds of trauma predominantly experienced among the interviewed rape survivors. This study found that the psychological trauma among individual rape survivors in Taiwan, although similar to rape trauma symptoms documented in Western literature, seems to manifest a relatively distinct cultural construction of rape in Chinese society. Study implications for rape-related educational and treatment programs in Taiwan are suggested in the context of Chinese cultural construction of rape.
Most published research on the victim–offender relationship has been based on small samples that consisted mainly of women who were raped by nonintimate and nonromantic acquaintances, who viewed their experience as rape, and/or who were seeking treatment. In the present study, 489 rape victims were located among a national sample of 3, 187 female college students by a self-report survey that avoided reliance on helpseekers. Two sets of comparisons were performed. First, the experiences reported by victims of stranger rape (n = 52) were compared with those of victims of acquaintance rape (n = 416). Then, the experiences of women assaulted by different types of acquaintances were compared including nonromantic acquaintances (n = 122), casual dates (n = 103), steady dates (n = 147), and spouses or other family members (n = 44). Rapes by acquaintances, compared with strangers, were more likely to involve a single offender and multiple episodes, were less likely to be seen as rape or to be revealed to anyone, and were similar in terms of the victim's resistance. In general, acquaintance rapes were rated as less violent than stranger rapes. The exception was rapes by husbands or other family members which were rated equally violent to stranger rapes but were much less likely to occur in a context of drinking or other drug use. In spite of these different crime characteristics, virtually no differences were found among any of the groups in their levels of psychological symptoms. A significant feature of these data is that they have tapped the experiences of unreported and unacknowledged rape victims, a group that is potentially much larger than the group of identified victims.
This study examined correlates of past-year chronic medical conditions and lifetime contact with health care professionals for mental health and substance abuse problems in women with differing histories of sexual victimization (N = 627) identified from the National Comorbidity Survey (e.g., assault in childhood, adulthood, or both life phases). Posttraumatic stress disorder (PTSD) and stressful life events were associated with greater odds of chronic medical conditions among women sexually assaulted in childhood only. Additional traumatic events were associated with greater odds of chronic medical conditions among victims of adult sexual assault. Older age and being married were associated with greater odds of lifetime health care professional contact for mental health/substance abuse issues among certain victim subgroups. Stressful life events were related to greater help-seeking for child victims, and traumatic events were related to greater help-seeking in adult victims. Alcohol dependence symptoms and PTSD were each associated with greater odds of lifetime health care professional contact among women victimized in both life phases, whereas depression was related to greater odds of help-seeking for women victimized in one life phase only. Psychosocial factors may play unique roles in health outcomes for women with different sexual assault histories.
