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Wamoyi J, Ranganathan M, Mugunga S, Stöckl H. "It Gives You a Feeling of Pride when You Touch Her": The Role of Masculinity in Sexual Harassment of Adolescent Schoolgirls in Tanzania. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP108-NP127. [PMID: 35350928 DOI: 10.1177/08862605221080957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual harassment or the unwanted offensive behaviours that women and girls experience is a pervasive global challenge. Yet, there is limited evidence on the lived experiences of sexual harassment from school-based settings in sub-Saharan Africa. We explore students' perceived experiences, perpetration, and drivers of sexual harassment in schools in Mwanza, Tanzania. This study employed a qualitative research design involving 30 in-depth interviews and seven focus group discussions with 30 male and 40 female secondary school pupils aged 13-19 years. Data was analysed using a thematic approach. The findings show that experiences of sexual harassment among schoolgirls were widespread. Common forms of harassment were verbal and non-verbal gestures of a sexual nature. The desire to prove one's masculinity and peer pressure were key drivers of perpetration among schoolboys. Teachers took advantage of their positions of authority to sexually harass female pupils and employed corporal punishment to those who resisted their advances. Sexual harassment had multiple negative outcomes, including schoolgirls dropping out of school and mental health issues, such as anxiety, stress and poor academic performance. Girls rarely reported sexual harassment for fear of further victimisation and stigma from others. Sexual harassment of girls is common in secondary schools in Mwanza and is mainly driven by peer pressure and the desire to prove one's masculinity. Given its harmful effects, there is a need to implement clear policies to protect girls, support confidential disclosure and reporting and to address toxic masculinity norms among young men.
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Hayes S, Lonergan A, Trompeter N, Bussey K, Hay P, Mitchison D. Longitudinal relationship between experience of sexual harassment and 2-year body image and weight outcomes in adolescence: mediation through self-objectification and psychological distress. Eat Weight Disord 2022; 27:3095-3108. [PMID: 35834106 PMCID: PMC9803756 DOI: 10.1007/s40519-022-01432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The current study investigated the experience of sexual harassment as a risk factor for weight gain and weight/shape concerns in a community sample of adolescents, with potential mediating factors self-objectification and psychological distress. METHOD 1034 Australian adolescents (aged 11 to 19 years) from the EveryBODY longitudinal study of disordered eating pathology participated. Data were collected through online surveys annually for 3 years. Participants completed self-report measures of demographics, sexual harassment, psychological distress, self-objectification, weight/shape concerns and BMI percentile. RESULTS A parallel mediation model adjusting for baseline scores found no direct effect between baseline experiences of sexual harassment and change in BMI percentile or weight/shape concern after 2 years. Experiences of sexual harassment significantly increased self-objectification scores after 1 year in female adolescents. Subsequently, higher self-objectification significantly increased the risk of greater weight/shape concern after 1 year in female adolescents. However, no significant mediating relationship was found in the relationship between sexual harassment and weight/shape concern or BMI percentile for either gender. Psychological distress was found to be a clear risk factor for weight/shape concern in both genders after 1 year. CONCLUSIONS Intervention programmes in schools should focus on developing policies to reduce sexual harassment, self-objectification and distress in adolescents. LEVEL OF EVIDENCE Level IV, longitudinal multiple time series without intervention.
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Mennicke A, Coates CA, Jules B, Langhinrichsen-Rohling J. Who do They Tell? College Students' Formal and Informal Disclosure of Sexual Violence, Sexual Harassment, Stalking, and Dating Violence by Gender, Sexual Identity, and Race. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP20092-NP20119. [PMID: 34798795 DOI: 10.1177/08862605211050107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Disclosure of interpersonal violence (i.e., sexual violence, sexual harassment, dating violence, and stalking) is often the first step toward receiving social and systemic support. Research demonstrates that sexual assault and dating violence survivors on college campuses are more likely to disclosure to informal sources (i.e., friends and family) than formal sources (e.g., police, Title IX, counseling centers). However, there is limited research examining disclosure rates after other forms of violence (i.e., stalking, sexual harassment), and little is known about the impact of the survivors' identities on disclosure. Utilizing four academic years (2016-2019) of aggregated campus climate data from a large Southeastern university, the current study examined rates of disclosure across experiences of sexual violence, sexual harassment, dating violence, and stalking while identifying whether the prevalence and type of disclosure (formal versus informal-only) differed by gender, sexual orientation, and/or race/ethnicity. Of 8,017 participants, 4.6% reported sexual violence, 18.9% reported sexual harassment, 12.3% reported dating violence, and 11.3% reported stalking in the past academic year. Results of multinomial logistic regression indicated that, across all four types of violence, men (as compared to women) had lower odds of disclosing both informally-only and formally. Bisexual as compared to heterosexual students had higher odds of formal disclosure of sexual harassment and stalking while gay/lesbian students had higher odds of formally disclosing sexual harassment. Individuals of another race/ethnicity (compared to White students) had lower odds of informal-only disclosure of dating violence. Findings underscore the need to implement programs to improve the social reactions of friends and family members receiving disclosures, and to increase culturally-tailored service provision.
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Silver E, Silver S. The Influence of Moral Intuitions on Americans' Divergent Reactions to Reports of Sexual Assault and Harassment. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP20040-NP20064. [PMID: 34654340 DOI: 10.1177/08862605211050102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Drawing on insights from moral psychology, we examine the influence of moral intuitions on Americans' divergent reactions to reports of sexual assault and harassment. We hypothesize that Americans whose moral intuitions emphasize care and protection of the vulnerable will show a greater willingness to believe reports of sexual assault and harassment, while those whose moral intuitions emphasize social order and cohesion will show greater skepticism toward such reports. Using data from a nationally representative sample of USA adults (N =1050), we find strong support for both hypotheses. We also find that the influence of moral intuitions on reactions to reports of sexual assault and harassment is partially mediated by respondents' willingness to attribute responsibility to victims of sex crimes. Our results hold when females and males are examined separately. The study provides compelling evidence that a moral intuitionist approach is useful for understanding Americans' divergent reactions to reports of sexual assault and harassment.
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Salerno-Ferraro AC, Erentzen C, Schuller RA. Young Women's Experiences With Technology-Facilitated Sexual Violence From Male Strangers. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17860-NP17885. [PMID: 34271829 PMCID: PMC9554274 DOI: 10.1177/08862605211030018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Stranger-perpetrated harassment was identified decades ago to describe the pervasive, unwanted sexual attention women experience in public spaces. This form of harassment, which has evolved in the modern era, targets women as they navigate online spaces, social media, texting, and online gaming. The present research explored university-aged women's experiences (n = 381) with online male-perpetrated sexual harassment, including the nature and frequency of the harassment, how women responded to the harassment, and how men reportedly reacted to women's strategies. Trends in harassment experiences are explored descriptively and with thematic analysis. Most women reported receiving sexually inappropriate messages (84%, n = 318), sexist remarks or comments (74%, n = 281), seductive behavior or come-ons (70%, n = 265), or unwanted sexual attention (64%, n = 245) in an online platform, social media account, email, or text message. This sexual attention from unknown males often began at a very young age (12-14 years). The harassment took many forms, including inappropriate sexual comments on social media posts, explicit photos of male genitalia, and solicitations for sex. Although most women reported strong negative emotional reactions to the harassment (disgust, fear, anger), they generally adopted non-confrontational strategies to deal with the harassment, electing to ignore/delete the content or blocking the offender. Women reported that some men nevertheless persisted with the harassment, following them across multiple sites online, escalating in intensity and severity, and leading some women to delete their own social media accounts. These results suggest the need for early intervention and education programs and industry response.
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Jennings JM, Grieb SM, Rietmeijer C, Gaydos CA, Hawkins R, Thurston RC, Blanchard J, Cameron CE, Lewis DA. Advancing Sexual Harassment Prevention and Elimination in the Sciences: "Every ... Health Organization Must Do Something Similar". Sex Transm Dis 2022; 49:663-668. [PMID: 35921636 PMCID: PMC9508977 DOI: 10.1097/olq.0000000000001683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sexual harassment is pervasive in science. A 2018 report found that the prevalence of sexual harassment in academia in the United States is 58%. An activity held at an international scientific congress was designed to advance sexual harassment prevention and elimination and empower binary and nonbinary persons at risk for harassment, discrimination, and violence. The objective is to describe the activity and outcomes to provide a promising model for other scientific communities. METHODS A description of the plenary and key components as well as the data collection and analysis of selected outcomes are provided. RESULTS Among 1338 congress participants from 61 countries, 526 (39%) attended the #MeToo plenary, and the majority engaged in some way during the plenary session. Engagement included standing for the pledge (~85%), participating in the question and answer session (n = 5), seeking counseling (n = 3), and/or providing written post-it comments (n = 96). Respondents to a postcongress survey (n = 388 [24% of all attendees]) ranked the plenary as number 1 among 14 congressional plenaries. In postanalysis, the written post-it comments were sorted into 14 themes within 6 domains, including: (1) emotional responses, (2) barriers to speaking out, (3) public health priorities, (4) reframing narratives about the issue, (5) allyship, and (6) moving the issue forward. CONCLUSIONS Scientific organizations, agencies, and institutions have an important role to play in setting norms and changing enabling policies toward a zero-tolerance culture of sexual harassment. The activity presented offers a promising model for scientific communities with similar goals. The outcomes suggest that the plenary successfully engaged participants and had a measurable impact on the participants.
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Zeighami M, Zakeri MA, Mangolian Shahrbabaki P, Dehghan M. Bitter silence allows sexual harassment to continue in workplace: A qualitative study in Iranian nurses. Front Public Health 2022; 10:971522. [PMID: 36172206 PMCID: PMC9511045 DOI: 10.3389/fpubh.2022.971522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/22/2022] [Indexed: 01/25/2023] Open
Abstract
Background Sexual harassment in the workplace is continuing. However, the rate of sexual harassment disclosure is low, which causes many problems. Non-disclosure of sexual harassment can cause nurses' psychological distress and physical harm, and affect their productivity and quality of care. Therefore, the present study aimed to investigate the reasons why Iranian nurses stayed silent and did not disclose sexual harassment in their workplace. Method This qualitative descriptive-explorative study was conducted to investigate the reasons why Iranian nurses (n = 18) stayed silent on sexual harassment. Conventional content analysis and purposeful sampling method were used in this study. Data was collected through in-depth semi-structured interviews. Maximum variance in terms of age, sex, work experience, education level, marital status, and type of hospital and ward was considered in order to obtain rich information. Guba and Lincoln criteria were used to increase the study's trustworthiness, while the Graneheim and Lundman approach was used to analyze the content. Results The research data indicated 112 codes, a major category, 4 subcategories, and 9 primary categories. The major category, "The missing link is bitter silence; sexual harassment is still going on," includes four subcategories: fear of social stigmas, organizational and legal barriers, family barriers, and personal barriers. Conclusions Nurses cannot break their silence on sexual harassment because they are afraid that disclosure of sexual harassment has negative consequences for their personal and professional lives. Policies and strategies should be developed to encourage nurses to disclose sexual harassment. This issue must be studied socially, culturally, and politically.
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Wang S, Eklund L, Yang X. The Association Between Sexual Harassment and Mental Health Among Chinese College Students: Do Gender and Social Support Matter? Int J Public Health 2022; 67:1604922. [PMID: 36119449 PMCID: PMC9474648 DOI: 10.3389/ijph.2022.1604922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: This study examined the association between sexual harassment (SH) and college students’ mental health in the Chinese context and its gender differences, exploring the moderating role of social support. Methods: Data were from the Third Survey of Chinese Women’s Social Status and included 5,032 college students. We employed the ordinary least squares (OLS) regression models with interaction terms to report the moderating effects of gender and social support on the association between SH and mental health. Results: Gender harassment and unwelcome sexual attention were negatively associated with mental health among all students, with no observed gender difference. Financial and large-scale emotional support moderated the association between unwelcome sexual attention and women’s mental health but were not buffer factors for men. Learning support aggravated the adverse association between gender harassment and men’s mental health. Conclusion: SH is a significant trigger for men’s and women’s mental health problems. When they are subjected to SH, financial and emotional support are protective resources for women, but learning support is risky for men.
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Williamson B. Sexual Harassment in Psychiatry Residency: a Call to Action. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:532-533. [PMID: 34173218 DOI: 10.1007/s40596-021-01497-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/25/2021] [Indexed: 06/13/2023]
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Herrmann A, Seubert C, Glaser J. Consequences of Exposure to Violence, Aggression, and Sexual Harassment in Private Security Work: A Mediation Model. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9684-NP9711. [PMID: 33380234 PMCID: PMC9136388 DOI: 10.1177/0886260520984432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While exposure to violence and aggression is well known for its detrimental effects on employees' health as well as organizational outcomes, certain high-risk work domains have scarcely been researched. Thus, this study set out to determine negative consequences of work-related exposure to four forms of harmful behaviors in private security. In a sample of 487 German-speaking security guards, 23% had experienced outsider-initiated violence, 56% aggressive acts, 30% vicarious violent acts, and 3% were sexually harassed over the past 12 months. Additionally, 19% reported substantial to extreme worries about violence. By presenting an integrated model of negative consequences to outsider-initiated violent, aggressive as well as sexual harassing acts, we strived to extend previous research by showing that turnover intention (as an ultimate negative behavioral outcome) is only indirectly related to these experiences via worries about violence and psychosomatic complaints. Structural equation modeling provided support for the model and plausibility for a sequential "two-step" prediction of turnover intention. Further, we provided support that worries about violence are not solely triggered by directly experiencing physical violence but also vicarious violence, aggressive acts, and sexual harassment. Consistent with previous studies, worries about violence were identified as a central mediator in the transmission process from exposure to harmful behaviors at work to negative consequences, that is, psychosomatic complaints and turnover intention. Our findings have implications for the detailed understanding of consequences emerging from exposure to workplace violence and aggression as well as the development of effective prevention strategies especially in high-risk occupations such as private security.
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Leigh S, Thomas AG, Davies J. The effects of sex and outcome expectancies on perceptions of sexual harassment. PLoS One 2021; 16:e0261409. [PMID: 34910767 PMCID: PMC8673621 DOI: 10.1371/journal.pone.0261409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022] Open
Abstract
Using an outcome expectancy framework, this research sought to understand sex differences in the underlying beliefs that influence harassment perception. One hundred and ninety-six participants (52% women) read a series of vignettes depicting common examples of digital male-on-female sexual harassment. They were asked to what extent they thought each scenario constituted sexual harassment, and how likely the perpetrator would experience positive and negative outcomes. Consistent with predictions, women were more likely to consider the behaviours as harassment than men were. Both sexes harassment perceptions had significant relationships with their outcome expectancies, but we also found evidence of a sex specific moderation; the link between men's negative outcome expectancies was moderated by their positive ones. The results suggest that perceptions of harassment may have sexually asymmetrical underpinnings. Measuring the interplay between positive and negative outcome expectancies in relation to sexual harassment perception is a novel approach, that may have implications for the development of anti-sexual harassment interventions. Implications for theory and future research directions are discussed.
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Huang R, Hewitt DB, Cheung EO, Agarwal G, Etkin CD, Smink DS, Shanafelt TD, Bilimoria KY, Hu YY. Burnout Phenotypes Among U.S. General Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2021; 78:1814-1824. [PMID: 33935019 DOI: 10.1016/j.jsurg.2021.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/10/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Although well-established metrics exist to measure workplace burnout, researchers disagree about how to categorize individuals based on assessed symptoms. Using a person-centered approach, this study identifies classes of burnout symptomatology in a large sample of general surgery residents in the United States. DESIGN, SETTING, PARTICIPANTS A survey was administered following the 2018 American Board of Surgery In-Training Examination (ABSITE) to study wellness among U.S. general surgery residents. Latent class models identified distinct classes of residents based on their responses to the emotional exhaustion and depersonalization questions of the modified abbreviated Maslach Burnout Inventory (aMBI). Classes were assigned representative names, and the characteristics of their members and residency programs were compared. RESULTS The survey was completed by 7415 surgery residents from 263 residency programs nationwide (99.3% response rate). Five burnout classes were found: Burned Out (unfavorable score on all six items, 9.8% of total), Fully Engaged (favorable score on all six items, 23.1%), Fatigued (favorable on all items except frequent fatigue, 32.2%), Overextended (frequent fatigue and burnout from work, 16.7%), and Disengaged (weekly symptoms of fatigue and callousness, 18.1%). Within the more symptomatic classes (Burned Out, Overextended, and Disengaged), men manifested more depersonalization symptoms, whereas women reported more emotional exhaustion symptoms. Burned Out residents were characterized by reports of mistreatment (abuse, sexual harassment, and gender-, racial-, or pregnancy and/or childcare-based discrimination), duty hour violations, dissatisfaction with duty hour regulations or time for rest, and low ABSITE scores. CONCLUSIONS Burnout is multifaceted, with complex and variable presentations. Latent class modeling categorizes general surgery residents based on their burnout symptomatology. Organizations should tailor their efforts to address the unique manifestations of each class as well as shared drivers.
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Reed G, Ahmad SR, Khoong EC, Olazo K, Jagsi R, Mangurian C, Sarkar U. Evaluation of Sexual Harassment Policies at Medical Institutions to Understand Attention to Harassment of Physicians by Patients. JAMA Netw Open 2021; 4:e2135131. [PMID: 34787660 PMCID: PMC8600387 DOI: 10.1001/jamanetworkopen.2021.35131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This quality improvement study assesses the policies of top US medical centers for addressing sexual harassment of physicians by patients.
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Lall MD, Bilimoria KY, Lu DW, Zhan T, Barton MA, Hu YY, Beeson MS, Adams JG, Nelson LS, Baren JM. Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US. JAMA Netw Open 2021; 4:e2121706. [PMID: 34410392 PMCID: PMC8377562 DOI: 10.1001/jamanetworkopen.2021.21706] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. OBJECTIVE To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. DESIGN, SETTING, AND PARTICIPANTS In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. MAIN OUTCOMES AND MEASURES The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. RESULTS Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]). CONCLUSIONS AND RELEVANCE In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.
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Sterud T, Hanvold TN. Effects of adverse social behaviour at the workplace on subsequent mental distress: a 3-year prospective study of the general working population in Norway. Int Arch Occup Environ Health 2021; 94:325-334. [PMID: 33130968 PMCID: PMC7873096 DOI: 10.1007/s00420-020-01581-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 09/05/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We aimed to provide an integrated picture of the relationship between different facets of adverse social behaviour (ASB) at work and mental health problem. METHODS Data were provided from a longitudinal nationwide study of the general population in Norway. Eligible respondents were in paid work during a reference week in 2013, or temporarily absent from such work, and was interviewed at 3-year follow-up (n = 3654, response at baseline/follow-up = 53.1%/71.8%). We investigated the prospective associations of self-reported exposure to ASBs, including threats/acts of violence, bullying, sexual harassment and workplace conflicts, with mental distress (the Hopkins Symptoms Checklist) at follow-up, by means of multiple logistic regression. RESULTS In total, 6.6% (242 individuals) were classified with mental distress at follow-up. Work-related predictors were sexual harassment (OR = 1.64 07, 95% CI 1.03 - 2.61), bullying (OR = 2.07, 95% CI 1.19 - 3.60) and workplace conflicts (OR = 1.51, 95% CI 1.07 - 2.13). An elevated, but non-statistically significant association was observed for threats/acts of violence. No significant interactions were found between ASB and mental distress score at baseline. Overall there were few indications of substantial confounding related to age, sex, education level or occupation. After adjusting for these factors, the overall population attributable risk of mental distress attributable to any exposure to ASB was 11.3% (95%CI 0.6-22.3). CONCLUSIONS We observed robust associations between exposure to three out of four types of ASB and risk of mental distress. Taken together, the results underscore that adverse social behaviour at the workplace may have a substantial impact on the level of mental distress in the general working population.
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McClain T, Kammer-Kerwick M, Wood L, Temple JR, Busch-Armendariz N. Sexual Harassment Among Medical Students: Prevalence, Prediction, and Correlated Outcomes. Workplace Health Saf 2020; 69:257-267. [PMID: 33331247 DOI: 10.1177/2165079920969402] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few studies are dedicated to understanding the extent and impact of sexual harassment among medical students. The aim of this study was to use behaviorally specific measures to examine prevalence of sexual harassment toward medical students. Associated mental health and academic impacts were also studied. METHODS A multisite survey was conducted at four medical schools. Sexual harassment was measured using the Sexual Experiences Questionnaire (SEQ), a valid and reliable instrument. Students were also surveyed about depressive and post-traumatic stress disorder (PTSD) symptoms and their level of academic engagement. We also assessed their perceptions of institutional response and whether they felt safe at their institution. FINDINGS The final sample included 524 medical students (response rate = 13%). Findings revealed that 36.6% reported sexual harassment by a faculty/staff member and 38.5% reported harassment by a fellow student. The odds of harassment by faculty/staff, as well as peers, were significantly higher for women with an adjusted odds ratio (AOR) = 9.83, 95% confidence interval (CI) = [3.74, 25.80] and multiracial students with an AOR: 2.93, 95% CI: [1.16, 7.39]. Those who experienced sexual harassment were more likely to report academic disengagement and symptoms of depression and PTSD. CONCLUSION/APPLICATION TO PRACTICE Sexual harassment in medical schools can potentially limit a student's academic success and negatively impact their mental health. Supportive services and efforts to address peer and professional cultures that promote harassment are needed. Experiences of harassment require swift and competent responses by medical school leadership in collaboration with occupational and/or student health services to mitigate detrimental impacts and support medical students throughout their training.
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de Bourmont SS, Burra A, Nouri SS, El-Farra N, Mohottige D, Sloan C, Schaeffer S, Friedman J, Fernandez A. Resident Physician Experiences With and Responses to Biased Patients. JAMA Netw Open 2020; 3:e2021769. [PMID: 33226429 PMCID: PMC7684448 DOI: 10.1001/jamanetworkopen.2020.21769] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Biased patient behavior negatively impacts resident well-being. Data on the prevalence and frequency of these encounters are lacking and are needed to guide the creation of institutional trainings and policies to support trainees. OBJECTIVE To evaluate the frequency of resident experiences with and responses to a range of biased patient behaviors. DESIGN, SETTING, AND PARTICIPANTS A retrospective survey was sent via email to 331 second- and third-year internal medicine residents from 3 academic medical centers in California and North Carolina. First-year residents were excluded owing to their limited interactions with patients at the time of participant recruitment. Data were collected from August 21 to November 25, 2019. MAIN OUTCOMES AND MEASURES Descriptive statistics were used to report the frequency of experience of various types of biased patient behavior, residents' responses, the factors impeding residents' responses, and residents' experiences and beliefs regarding training and policies. RESULTS Overall, 232 of 331 residents (70%) participated; 116 (50%) were women; 116 of 247 (47%) were White (participants had the option of selecting >1 race/ethnicity); and 23 (10%) identified as lesbian, gay, bisexual, transgender, or queer. The frequency of resident-reported experience of types of biased patient behaviors varied. The most common behaviors-belittling comments and assumption of nonphysician status-were reported to be experienced 1 or more times per week by 14% of residents (32 of 231) and 17% of residents (38 of 230), respectively. Women, Black or Latinx, and Asian residents reported experiencing biased behavior more frequently. Forty-five percent of Black or Latinx residents (17 of 38) encountered instances of explicit epithets or rejection of care. All 70 Asian residents reported experiencing inquiries into their ethnic origins. Most women residents (110 of 115 [96%]) experienced role questioning behaviors, and 87% (100 of 115) experienced sexual harassment. The need to prioritize clinical care and a sense of futility in responding were the most common factors (cited by 34% of residents [76 of 227] and 25% of residents [56 of 227], respectively) significantly impeding responses to biased behaviors. Eighty-five percent of residents (191 of 226) never reported incidents to their institution. Eighty-nine percent of residents (206 of 232) identified training and policies as necessary or very necessary. CONCLUSIONS AND RELEVANCE This survey study suggests that biased patient behavior is experienced frequently by internal medicine residents. Non-White and women residents reported experiencing a disproportionate burden of these incidents. Residents' responses rarely included institutional involvement. Residency programs and health care systems should prioritize training and policies to address biased patient behavior and support affected residents.
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Magnusson Hanson LL, Nyberg A, Mittendorfer-Rutz E, Bondestam F, Madsen IEH. Work related sexual harassment and risk of suicide and suicide attempts: prospective cohort study. BMJ 2020; 370:m2984. [PMID: 32878868 PMCID: PMC7463167 DOI: 10.1136/bmj.m2984] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To analyse the relation between exposure to workplace sexual harassment and suicide, as well as suicide attempts. DESIGN Prospective cohort study. SETTING Sweden. PARTICIPANTS 86 451 men and women of working age in paid work across different occupations responded to a self-report questionnaire including exposure to work related sexual harassment between 1995 and 2013. The analytical sample included 85 205 people with valid data on sexual harassment, follow-up time, and age. MAIN OUTCOME MEASURES Suicide and suicide attempts ascertained from administrative registers (mean follow-up time 13 years). RESULTS Among the people included in the respective analyses of suicide and suicide attempts, 125 (0.1%) died from suicide and 816 (1%) had a suicide attempt during follow-up (rate 0.1 and 0.8 cases per 1000 person years). Overall, 11 of 4095 participants exposed to workplace sexual harassment and 114 of 81 110 unexposed participants committed suicide, and 61/4043 exposed and 755/80 513 unexposed participants had a record of suicide attempt. In Cox regression analyses adjusted for a range of sociodemographic characteristics, workplace sexual harassment was associated with an excess risk of both suicide (hazard ratio 2.82, 95% confidence interval 1.49 to 5.34) and suicide attempts (1.59, 1.21 to 2.08), and risk estimates remained significantly increased after adjustment for baseline health and certain work characteristics. No obvious differences between men and women were found. CONCLUSIONS The results support the hypothesis that workplace sexual harassment is prospectively associated with suicidal behaviour. This suggests that suicide prevention considering the social work environment may be useful. More research is, however, needed to determine causality, risk factors for workplace sexual harassment, and explanations for an association between work related sexual harassment and suicidal behaviour.
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López V, García-Quiroga M, Benbenishty R, González L, Squicciarini AM, Sánchez P. Sexual harassment by peers in Chilean schools. CHILD ABUSE & NEGLECT 2020; 107:104602. [PMID: 32562963 DOI: 10.1016/j.chiabu.2020.104602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although a significant amount of literature has explored peer sexual harassment in higher education, little is known about peer sexual harassment in primary and middle school. Among existing studies, most have examined individual student characteristics that predict peer sexual harassment without considering the importance of the classroom and school context, which may prevent or promote such harassment. OBJECTIVE The purpose of this study was to identify individual and school-related factors predicting sexual harassment victimization. METHODS A sample of 17,364 Chilean students from Grades 5 through 8 in 405 schools with low socioeconomic status answered instruments concerning peer sexual harassment, other types of peer victimization and discrimination, and perceptions of classroom and school climate and norms against sexual harassment. Data were analyzed through hierarchical multivariate regression. RESULTS Experiences of being sexual harassed by other students were reported by 13.5 % of students, with higher frequencies in male students, students from Grades 5 and 6, and students with lower individual socioeconomic status. School-related experiences of being discriminated against due to sexual orientation, ethnic origin, and disability were the strongest predictors of sexual harassment victimization. CONCLUSION We discuss how peer sexual harassment might be understood as a consequence of peer social discrimination based on sexism, racism, and ableism. We also discuss the need to provide inclusive school climate policies that allow all students to feel safe and included.
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Lind MN, Adams-Clark AA, Freyd JJ. Isn't high school bad enough already? Rates of gender harassment and institutional betrayal in high school and their association with trauma-related symptoms. PLoS One 2020; 15:e0237713. [PMID: 32813685 PMCID: PMC7444512 DOI: 10.1371/journal.pone.0237713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 08/01/2020] [Indexed: 12/01/2022] Open
Abstract
Germinal studies have described the prevalence of sex-based harassment in high schools and its associations with adverse outcomes in adolescents. Studies have focused on students, with little attention given to the actions of high schools themselves. Though journalists responded to the #MeToo movement by reporting on schools’ betrayal of students who report misconduct, this topic remains understudied by researchers. Gender harassment is characterized by sexist remarks, sexually crude or offensive behavior, gender policing, work-family policing, and infantilization. Institutional betrayal is characterized by the failure of an institution, such as a school, to protect individuals dependent on the institution. We investigated high school gender harassment and institutional betrayal reported retrospectively by 535 current undergraduates. Our primary aim was to investigate whether institutional betrayal moderates the relationship between high school gender harassment and current trauma symptoms. In our pre-registered hypotheses (https://osf.io/3ds8k), we predicted that (1) high school gender harassment would be associated with more current trauma symptoms and (2) institutional betrayal would moderate this relationship such that high levels of institutional betrayal would be associated with a stronger association between high school gender harassment and current trauma symptoms. Consistent with our first hypothesis, high school gender harassment significantly predicted college trauma-related symptoms. An equation that included participant gender, race, age, high school gender harassment, institutional betrayal, and the interaction of gender harassment and institutional betrayal also significantly predicted trauma-related symptoms. Contrary to our second hypothesis, the interaction term was non-significant. However, institutional betrayal predicted unique variance in current trauma symptoms above and beyond the other variables. These findings indicate that both high school gender harassment and high school institutional betrayal are independently associated with trauma symptoms, suggesting that intervention should target both phenomena.
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Soliman HH, Abdelmonem AA, Koran J. Adolescents' Perception of the Threat of Sexual Harassment: The Development of an Index. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:570-585. [PMID: 31638879 DOI: 10.1080/10538712.2019.1667469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/01/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
In Egypt female adolescents are on a daily basis victims of various forms of sexual harassment as young females are unable to justify their feelings, thoughts and behaviors toward such violent and hostile activities. Therefore, this study develops an adolescents' sexual harassment index (ASHI), which measures female adolescents' perception of the threat of sexual harassment based on cultural, environmental and societal aspects. A total of 874 adolescents age 17-18 in Egypt participated in a survey consisting of 65 items of 7 variables: threat of SH, exposure, society awareness, child's characteristics, social engagement, religiosity and the effect of the media. Using factor analysis with oblimn rotation, the analysis explained 42.38 percent of the variation in the study variables, leading to a four-factors solution: society awareness, interpersonal characteristics, personal engagement and sense of self and reality.
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Husum TL, Thorvarsdottir V, Aasland O, Pedersen R. 'It comes with the territory' - Staff experience with violation and humiliation in mental health care - A mixed method study. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 71:101610. [PMID: 32768105 DOI: 10.1016/j.ijlp.2020.101610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The aim of this study was to investigate staff's experiences with violation and humiliation during work in mental health care (MHC). A total of 1160 multi-professional MHC staff in Norway responded to an online questionnaire about their experiences with different kinds of violation and humiliation in the MHC setting. In addition, a sample of professionals (eight MHC nurses) were recruited for in-depth individual interviews. METHOD The study used an explorative mixed method with a convergent parallel design; this included a web-based questionnaire to MHC staff in combination with individual interviews. The sample is considered to be equivalent to staff groups in MHC in Norway. RESULTS Between 70 and 80% of the staff reported experiencing rejection, being treated with disrespect, condescending behaviour or verbal harassment. Male workers were significantly more often victims of serious physical violence, and women were significantly more often targets for sexual harassment. In interviews, participants said they considered being exposed to violence and humiliation to be part of the job when working in MHC, and that experience, as well as social support from colleagues, helped MHC practitioners to cope better with violent situations and feel less humiliated at work. DISCUSSION A high amount of MHC staff report experiences of being violated and humiliated during work. The participants' perceptions of the users and their behaviour seem to influence their experience of feeling violated and humiliated. Knowledge about the dynamics of aggression between staff and users in MHC may be used in safeguarding staff and users, prevent coercion and heighten the quality of care.
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Makini GK, Hishinuma ES, Guerrero AP, Goebert DA. Protecting Youth in the Mental Health Service Settings. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:80-86. [PMID: 32490391 PMCID: PMC7260874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The authors present the development of the field of psychiatry with the evolution of patient safeguards. They address the recent publicized events involving sexual harassment and abuse perpetrated by mental health service providers who have harmed youth who were under their direct psychiatric care. Recommendations are provided for primary care physicians and parents and legal guardians to further ensure patient safety.
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Lessard LM, Watson RJ, Puhl RM. Bias-Based Bullying and School Adjustment among Sexual and Gender Minority Adolescents: The Role of Gay-Straight Alliances. J Youth Adolesc 2020; 49:1094-1109. [PMID: 32246306 DOI: 10.1007/s10964-020-01205-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/24/2020] [Indexed: 11/27/2022]
Abstract
Adolescents identifying as sexual and/or gender minorities face many challenges at school due to stigma-based peer harassment. This study examined the extent to which sexual and gender minority adolescents experience bias-based bullying across a range of stigmatized identities and attributes, as well as the potential of gay-straight alliances (GSAs, also referred to as gender-sexuality alliances) to reduce simultaneously multiple forms of bias-based bullying, and in turn support school adjustment. Using a United States sample of diverse sexual and gender minority adolescents (N = 17,112; Mage = 15.57, SDage = 1.27), multiple mediation analyses indicated lower levels of multiple forms of bias-based bullying (based on body weight, gender, religion, disability, gender typicality, sexuality) at schools with versus without GSAs, and in turn higher perceived school safety, as well as higher grades and reduced school suspension (due to less weight- and sexuality-based bullying). The findings shed light on the broad-reaching stigma-reduction potential of GSAs.
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