[Rape and transgression. Forensic medicine and sexual morality in Spain in the 19th century]

The purpose of this paper is to analyse the importance of the contribution of the Spanish forensic medical discourse in the 19th century, and its application in cases of sexual harassment, to legitimize the sexual moral value of the time. For that reason we will analyse the main forensic medicine treaties edited in Spain during this century.

Humiliation: its nature and consequences

In this article, we present a new analysis of what is involved when individuals undergo significant public humiliation. We describe the structure of humiliation-that is, the factors that, taken collectively, render certain life events and circumstances humiliating; the most common destructive consequences of being subjected to them; and several personality factors that, when present, can serve to amplify the damaging effects of humiliating experiences. The analysis is intended to enable forensic clinicians, lawyers, judges, and other relevant parties to understand better what happens when individuals are humiliated and to identify more precisely the damage that such persons sustain. It is also intended to have heuristic value for the discussion, confrontation, and alleviation of humiliation in correctional, jurisprudential, clinical, and general societal contexts.

Commentary: is the paradigm for humiliation sufficiently complex?

The authors Torres and Bergner present a simple, elegant paradigm for understanding the phenomenon of humiliation. They suggest it may have universal applicability and may be of heuristic value for clinicians and policy-makers involved in forensic and social arenas. They offer case examples to illustrate its utility. It is open to question, however, whether the paradigm is sufficiently complex to encompass all the variables in actual situations. In real life, the evolution of humiliation is a highly complicated, often messy process that takes place over time and often results in intense feelings of humiliation in more than one person, often affecting several persons. The authors' examples are reexamined from alternate assumptions about what may have happened in each case. An additional case example illustrates a high degree of interpersonal complexity, suggesting that actual situations may be too unwieldy to allow for simple analysis by the paradigm.

Staff attributions about challenging behaviours of people with intellectual disabilities and transactional stress process: a qualitative study

BACKGROUND

Staff explanations about challenging behaviours of people with intellectual disabilities are purported to play a significant role in the way they respond to them. Despite attempts made in research to understand the mechanisms of causality, a lack of association between attributions, emotions and behaviours is reported. This study investigates these relationships within a broader framework including attributions in the transactional stress model of Lazarus and Folkman.

METHOD

A qualitative design has been selected; semi-structured interview format was used in order to investigate implication of attributions in stress regarding Weiner's model of helping behaviour. A case study method has been adopted to allow consideration of ecological data, a case study representing a special encounter with a challenging behaviour. Categorical analysis was conducted.

RESULTS

The results suggest three main issues. First, it appears that Weiner's model is too restrictive in order to explain the complexity of contextualised encounters. Second, a need to differentiate types of attributions within a temporal perspective is highlighted. Finally, consideration of the coping role of attributions is suggested.

CONCLUSIONS

A need to extent the research concerning attribution is suggested. The insertion of research into ecological contexts and the introduction of coping concept regarding staff attributions of challenging behaviours would allow a broader view of the role of attributions.

Tolerance of sexual harassment: a laboratory paradigm

The present study attempted to develop a laboratory analogue for the study of tolerance for sexual harassment by using an online speed-dating paradigm. In that context, the relation between participants' sexual harassment attitudes, perpetrator attractiveness, perpetrator status, and perceived dating potential of the perpetrator were examined as factors influencing participants' tolerance of sexually harassing behavior. Participants were 128 female college students from a small northeastern public university. Results indicated that attractiveness, high social status, and attitudinal beliefs about sexual harassment were all predictive of tolerance for sexual harassment, providing preliminary support for the validity of this paradigm. In addition, participants' self reported likelihood to date a bogus male dating candidate was also predictive of tolerance for sexual harassment, over and above the aforementioned variables, suggesting that dating potential can play a role in perceptions of sexual harassment. Further, this experiment demonstrated that perceptions of sexual harassment can be assessed using the in vivo measurement of behavior. In addition, using an online environment not only provides a contemporary spin and adds a greater degree of external validity compared to other sexual harassment analogues, it also reduces any risk of potential physical sexual contact for participants.

Inmate harassment and rape: an exploratory study of seven maximum- and medium-security male prisons in Israel

Prisons deprive male inmates of heterosexual relationships and thus prevent them from asserting their masculinity via "traditional" means. Accordingly, many prisoners experience extreme emotional, psychological, and physical distress, which turns several of them to intimidation, aggression, and re-establishment of their sense of dominance through homosexual activities with coerced partners. This study, based on 760 hours of phenomenological semi-structured interviews undertaken in a random sample of 1.5% of the male prisoner population in Israel, analyzes the neglected issue of homosexual rape in Israeli prisons. The study finds that (a) sexual harassment or homosexual rapes rarely take place in Israeli prisons and (b) Israeli inmates view homosexual rape in prison as disgusting and disgraceful and conceptualize it in highly negative emotional terms.

Sexual harassment and posttraumatic stress disorder: damages beyond prior abuse

This study examined the extent to which harassment experiences correlate with posttraumatic stress disorder (PTSD) symptoms, and whether diagnosable PTSD on the basis of sexual harassment occurs after accounting for prior PTSD, prior sexual abuse, and prior psychological dysfunction. The sample consisted of a two-wave panel of 445 women who had received a domestic violence protective order from a Kentucky court. Hierarchical linear and logistic analyses confirmed that sexual harassment experiences were significantly correlated with PTSD symptoms after controlling for an extensive set of trauma variables measured in both the baseline and follow up interviews. Our findings lend further evidence that claims of PTSD from sexual harassment may be credible even if claimants have been victims of other forms of trauma.

Youth at work: adolescent employment and sexual harassment

OBJECTIVE

An examination of the frequency and impact of workplace sexual harassment on work, health, and school outcomes on high school girls is presented in two parts. The first compares the frequency of harassment in this sample (52%) to published research on adult women that used the same measure of sexual harassment. The second part compares outcomes for girls who experienced harassment versus those who did not.

METHODS

Students in a small, suburban high school for girls completed a paper and pencil survey during class. A modified version of the Sexual Experiences Questionnaire (SEQ: Fitzgerald et al., 1988) was used to identify sexually harassed working teenagers. Work attitudes, assessments of physical health and mental health, and school-related outcomes were measured using standardized scales. Data were analyzed using difference of proportions tests, t-tests, and regression.

RESULTS

The percentage of harassed girls was significantly higher than the figures reported in most studies of working women. Girls who were sexually harassed were less satisfied with their jobs and supervisors, had higher levels of academic withdrawal, and were more apt to miss school than their non-harassed peers.

CONCLUSIONS

Sexual harassment significantly impacts employed high school girls' connections to work and school. It not only taints their attitudes toward work but it also threatens to undermine their commitment to school. Educators, practitioners and community leaders should be aware of the negative impact this work experience may have on adolescents and explore these issues carefully with students who are employed outside of school.

PRACTICE IMPLICATIONS

Teenage students, stressed by sexual harassment experienced at work may find their career development or career potential impeded or threatened due to school absence and poor academic performance. In addition, the physical safety of working students may be at risk, creating a need for teenagers to receive training to deal with sexual assault and other types of workplace violence. Educators, practitioners, and community leaders should be aware of the negative impact this work experience may have on adolescents and their overall school experience and explore the issue of sexual harassment carefully with students who are employed outside of school.

From the kitchen to the bedroom: frequency rates and consequences of sexual harassment among female domestic workers in Brazil

Sexual harassment has been investigated mostly in developed countries. The authors examined frequency rates and consequences of sexual harassment among female domestic workers in Brazil. Twenty-six percent had been sexually harassed at work during the past year. Live-in workers were at significantly greater risk for experiencing sexual harassment than those residing in their own homes, when controlling for participants' age, race, and social class. Women residing in their employers' residences used more alcohol and drugs than their counterparts. Harassed women had significantly higher self-esteem impairment and anxiety and depression than nonharassed women. Nonharassed women residing in their own homes had the best physical well-being. Concerning participants' worst sexually harassing experiences, the perpetrators were likely to be men (75%), who also engaged in more severe types of sexual harassment than female perpetrators. The emotional reactions to such incidents were significantly more negative when perpetrated by men than by women. Implications for foreign in-home workers employed by Europeans and North Americans are discussed.

LGB and questioning students in schools: the moderating effects of homophobic bullying and school climate on negative outcomes

Lesbian, gay, and bisexual students (LGB) and those questioning their sexual orientation are often at great risk for negative outcomes like depression, suicidality, drug use, and school difficulties (Elliot and Kilpatrick, How to Stop Bullying, A KIDSCAPE Guide to Training, 1994; Mufoz-Plaza et al., High Sch J 85:52-63, 2002; Treadway and Yoakam, J School Health 62(7):352-357, 1992). This study examined how school contextual factors such as homophobic victimization and school climate influence negative outcomes in LGB and questioning middle school students. Participants were 7,376 7th and 8th grade students from a large Midwestern county (50.7% Female, 72.7% White, 7.7% Biracial, 6.9% Black, 5.2% Asian, 3.7% Hispanic, and 2.2% reported "other"). LGB and sexually questioning youth were more likely to report high levels of bullying, homophobic victimization, and various negative outcomes than heterosexual youth. Students who were questioning their sexual orientation reported the most bullying, the most homophobic victimization, the most drug use, the most feelings of depression and suicidality, and more truancy than either heterosexual or LGB students. A positive school climate and a lack of homophobic victimization moderated the differences among sexual orientation status and outcomes. Results indicate that schools have the ability to lessen negative outcomes for LGB and sexually questioning students through creating positive climates and reducing homophobic teasing.

Universal problems during residency: abuse and harassment

OBJECTIVES

Perceived abuse or harassment during residency has a negative impact on residents' health and well-being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan.

METHODS

In 2007, a multi-institutional, cross-sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol-associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi-square analysis.

RESULTS

A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol-associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%).

CONCLUSIONS

Mistreatment during residency is a universal phenomenon. Deliberation on the occurrence of this universally wrong tradition in medical culture will lead to the establishment of strong preventive methods against it. Current results indicate that alcohol-associated harassment during residency is a Japanese culture-specific problem and effective preventive measures against this are also urgently required.

Peer sexual harassment victimization at school: the roles of student characteristics, cultural affiliation, and school factors

This study examines the links between students' reports of sexual harassment victimization by peers and a number of individual and school contextual factors. It is based on a nationally representative sample of 16,604 students in Grades 7 through 11 in 327 schools across Israel who completed questionnaires during class. Hierarchical Linear Modeling was used to examine the links. Overall, approximately one in four students (25.6%) were victims of at least one unwanted and unwelcome act of harassment by peers (such as being touched or pinched in sexual manner) in the prior month. The most vulnerable groups were Israeli-Arab boys and students with negative perceptions of their school climate. The school correlates associated with higher levels of victimization were a higher share of students with less-educated parents, larger schools and classrooms, and negative school climate. The interactions between gender and school-related factors indicate that the gender patterns are different for Israeli-Arab and Jewish schools and for schools with different concentrations of students' families with low socioeconomic status. The study emphasizes the need for an ecological perspective in addressing school-based sexual harassment.

Prevalence and mental health correlates of harassment and discrimination in the workplace: results from a national study

This study describes past-year prevalence and effects on mental health and drinking outcomes for harassment and discrimination in the workplace (HDW) in a nationally representative random digit dial phone survey conducted in 2003-2004 (n = 2,151). HDW measures included experiences and perceptions of sexual harassment (SH) and generalized workplace harassment (GWH), and perceived harassment or discrimination because of race or ethnicity. Prevalence was examined by sex, race, age, occupation, marital status, and education. Effects of HDW were assessed controlling for demo-graphics and job and life stressors. Experiencing multiple types of HDW was common. SH was more prevalent among women, and Blacks and those of other or mixed race or ethnicity experienced the highest levels of HDW overall. HDW variables explained additional variance in problem drinking and mental health beyond life and job stressors, particularly for women. This study demonstrates that HDW is a prevalent problem associated with poor mental health and problem drinking in the U.S. workforce.

Graduate students' perceptions of contrapower sexual harassment

This study compared the perceptions of 172 graduate students to traditional versus contrapower sexual harassment. Graduate students are a unique sample due to their dual role as a student and a teacher. After controlling for attitudes toward feminism and sexual harassment, participants viewed contrapower sexual harassment as less indicative of sexual harassment than traditional sexual harassment. Those with teaching experience perceived the scenarios provided as more indicative of sexual harassment than participants without teaching experience, and this effect was magnified for males. These findings suggest that people take sexual harassment less seriously in contrapower sexual harassment than in traditional sexual harassment. Furthermore, it is possible that teaching experience makes graduate students more aware of the complicated power differentials involved in classroom settings.

Relationship violence in adolescence

Previous experience with violence or a deficit in interpersonal skills may lead to violence in adolescent relationships. In this article we focus on various forms of interpersonal violence (bullying, sexual harassment, coercion, and relationship violence) that adolescents may experience and pay special attention to risk factors, help-seeking behaviors, and sequelae.

Predicting perceptions of sexual harassment based on type of resistance and belief in token resistance

This study examined perceptions of sexual harassment based on belief in women's use of token resistance and a victim's physical or verbal resistance to unwanted sexual attention, described in experimentally manipulated vignettes. Findings from 541 undergraduates revealed that a stronger belief in token resistance was associated with weaker perceptions of sexual harassment. Results showed that any type of resistance led to stronger perceptions of sexual harassment than no resistance at all, except for those with a stronger belief in women's use of token resistance. Perceptions among those with a stronger belief strengthened only when there were two forms of resistance offered simultaneously. These findings extend the literature by investigating the influence of physical resistance on sexual harassment perceptions.

Sexual harassment in the workplace: it is your problem

AIM

Sexual harassment and hostile work environments are explored. Managerial roles are discussed, including taking a proactive approach and dealing appropriately with an employee's claim.

BACKGROUND

Nurse managers must confront the issue of sexual harassment as complaints continue to develop throughout the industry. Because managers are responsible for employees' actions, it is essential that they familiarize themselves with what constitutes the act and how to handle a claim.

EVALUATION

Sexual harassment is defined by US Civil Rights Acts (1964 and 1991), US Equal Employment Opportunity Commission, UK's Equal Opportunities Commission, American Nurses Association and the Royal College of Nursing. Frederick Herzberg's Two-Factor Theory of Motivation is also related to workplace sexual harassment.

KEY ISSUES

Sexual harassment is a widespread problem within the industry, claiming both men and women as its victims. Managers can be held responsible for sexual harassment even if they are unaware of the existence of behaviour.

Sugar and spice and puppy dogs' tails: the psychodynamics of bullying

Bullies and their victims are more likely to engage in violent behavior than those who have never been involved in bullying. In both aggressor and victim, bullying is a sign of potential psychiatric disorder. It is primarily physical in children, becomes relational aggression in adolescents, and often appears in the form of sexual harassment in adulthood. The causes of bullying include the desire to control, revenge, envy, and emotional distress. Bullies have often themselves been bullied. Teachers are frequently reluctant to report bullying, even if they view it as a problem. Bullying deprives children of safety and security, but prevention and intervention are all too often not part of school curricula. The unique characteristics of bully and victim, risk factors leading to bullying behavior, the influence of the parents, and the roles of gender relationships and sex differences are explored in this article.

Sexual harassment against nurses in Turkey

PURPOSE

To identify the prevalence and sources of sexual harassment against nurses in Turkey, its consequences, and factors affecting harassment experiences.

DESIGN

Descriptive survey. Participants (N=622) were selected from nurses working in eight Ministry of Health hospitals in Turkey.

METHODS

Participants were surveyed with a Sexual Harassment Questionnaire, consisting of the sociodemographic characteristics of participants, types of sexual harassment, sources, feelings, ramifications, and ways to cope with sexual harassment behaviors. Frequency and percentage distributions, chi-square, and logistic regression were used for data analysis.

FINDINGS

The results showed 37.1% of participants had been harassed sexually. Physicians were identified as the primary instigators of sexual harassment. The most common reactions against harassers were anger and fear; frequently reported negative effects of sexual harassment were disturbed mental health function, decline in job performance, and headache. "Did nothing" was the coping method used most commonly by the nurses. About 80% of sexually harassed nurses did not report the incident of sexual harassment to hospital administration.

CONCLUSIONS

The lower working status and power of nurses in the workplace, poor working conditions in healthcare settings, and insufficient administrative mechanisms, including the present law and regulations against sexual harassers, were identified as important factors in the work environment in Turkey.

Sexual violence among men in the military in South Korea

This research is about sexual violence among men in the military in South Korea. The authors investigated the frequencies, causes, and circumstances surrounding sexual violence and looked for characteristic features of sexual violence among men in the military in South Korea. They found a high frequency of physical sexual violence and a high level of repetition of sexual violence. Of perpetrators, 81.7% had themselves been victimized. However, the soldiers tended to minimize sexual violence, preferred not to address the issue if possible, criticized or ignored the victims, and did not trust the reporting procedures in place. The authors found that sexual violence was mobilized as a tool in the military to control hierarchy and to create certain masculinities. Regarding the relevance of masculinity, as a salient feature of militaries in general, they believed it might emerge as a common feature across national and cultural differences.

Multiaxiale Klassifikation von Stalkingfällen

Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behaviour that leads to the victim's perception of being harassed and of him or her being rendered fearful. Physical assault and even homicide may occur in the context of stalking. Anglo-Saxon studies have revealed a lifetime prevalence of being a victim of stalking ranging from 4-7% in men and 12-17% in women. Recently, these rates have been confirmed by the first community based study carried out in Germany. As a stalker can have a number of victims during his or her lifetime, the prevalence of stalkers may be less than this, although at present data for this are lacking. Although the phenomenology of stalking appears to be rather homogenous, fairly distinct stalker typologies and perpetrator-victim relationships have to be considered. Requests for psychiatric and forensic assessment of stalkers are increasing. According to the German penal code, psychiatrists must provide expert opinion on criminal responsibility and the placement of stalkers. So far, all typologies of stalkers refer to the Anglo-Saxon cultural background and do not consider the special needs of German forensic psychiatry. In particular, the psychopathological dimension is widely neglected in common typologies. The present paper proposes a multiaxial typology of stalking that considers the psychopathological dimension, the relationship between stalker and victim and motivational aspects. Consequences for the forensic psychiatric assessment according to section 20, 21 StGB are outlined. It should be pointed out that stalking is not a new diagnostic category, but only involves, at a descriptive level, deviation from a normal behavioural pattern. The central components of the forensic psychiatric assessment remain the known diagnostic categories, the effects of which on behaviour can be analysed.

[The effects of stalking on psychiatrists, psychotherapists and psychologists. Prevalence of stalking and its emotional impact]

Stalking in the psychiatric context describes a pathological behaviour which is characterized by repeated persecution, harassment, or menacing of or assault on a person. Because of the association between stalking and mental disorders, psychiatrists, psychologists and psychotherapists belong to particularly exposed professions. If they fall victim to stalking during their career, disruptive impacts up to posttraumatic stress disorder (PTSD) can be the consequence. A total of 117 psychiatrists, psychologists or psychotherapists in Graz participated in an anonymous interview. To register possible experiences with stalking defined behaviour, a modified version of the questionnaire of Kamleiter was used. The prevalence and severity of posttraumatic stress symptoms were determined using the Impact of Event Scale of Horowitz. The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced non-violent threats. Most of the offenders (41.9%) were diagnosed as suffering from schizophrenia, schizotype and delusional disorders (F2) followed by disorders of adult personality and behaviour (F6) (30.2%). Some 44.4% of the victims developed symptoms of PTSD, which were usually only slight. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for the prevention and protection of potentially affected professions have to be developed.

Nature & prevalence of stalking among New Zealand mental health clinicians

Stalking involves recurrent and persistent unwanted communication or contact that generates fear for safety in the victims. This pilot study evaluated the nature and prevalence of stalking among New Zealand nurses and physicians working in mental health services. An anonymous questionnaire asking respondents to describe their experiences with 12 stalking behaviors was distributed to 895 clinicians. Results indicated that regardless of discipline, women were more likely than men to have experienced one or more stalking behaviors, including receiving unwanted telephone calls, letters, and approaches; receiving personal threats: and being followed, spied on, or subject to surveillance. Women also reported higher levels of fearfulness as a consequence of stalking behaviors. Nearly half of the stalkers were clients; the remaining were former partners, colleagues, or acquaintances. In client-related cases, the majority of respondents told their colleagues and supervisors first, and the majority found them to be the most helpful resource. The results of this pilot study indicate a need for further research focused on the stalking of mental health clinicians in New Zealand and for development of workplace policies for adequate response to the stalking of mental health clinicians.

The Boston-area HASWIC Research Circle: an innovative participatory method for coloring in the picture of a special work environment

Recent qualitative studies have investigated some of the hazards affecting women in non-traditional trades such as construction. However, one-time interactions among researcher participants, and between researchers and participants, in standard settings such as focus groups and interviews, cannot provide the time, space, and relationships to fully explore tradeswomen's in-depth knowledge of their work environment. This study applied a Scandinavian method called the Research Circle to convene a group of experienced women construction workers repeatedly over a period of two years so they could collaborate with researchers in explaining workplace issues. The results both validated and expanded upon previous findings about health and safety for women in construction, including gender discrimination, lack of access to sanitary facilities, retaliation for reporting hazards and injuries, and inadequate training and equipment. Especially important, findings illustrate some of the complex hierarchical social structures involved in both female and male construction workers responding to hazardous conditions.

Precarious existence and deteriorating work conditions for women in India: implications for health

The Indian economy has experienced economic growth post-1991 but has demonstrated an inability to generate adequate employment and even less of "quality" employment for much of its labor force. This article is based on data collected from conversations with women workers on the theme of "women, work and health," with an emphasis on, one, task allotment and working conditions in the household; and two, those related to conditions of work at the worksite and the gendered experience of such work. While narratives cannot establish causality between particular work environments and related adverse outcomes, they nevertheless provide crucial insights into what is likely to be blighting these women's lives. Advocates of women's work outside their home need to pay attention to both their remuneration for work and the costs to their health and well-being of such employment, so that policies aimed at employment generation also are sensitive to the adverse outcomes of such employment.

Workplace harassment patterning, gender, and utilization of professional services: findings from a US national study

This study constitutes the first national longitudinal survey to address the relationship between workplace harassment and service utilization. We examine how patterns of sexual harassment and generalized workplace harassment are linked to utilization of mental health, health, legal, spiritual, and work-related services, and whether and how gender influences these relationships. Data derive from a random digit dial telephone survey with a continental US sample of employed adults. Eligibility criteria were being 18 years of age or over, and being employed at least 20 h per week at some time in the 12 months prior to the wave 1 survey. Out of 4116 households with eligible individuals, 2151 agreed to participate at wave 1. At wave 2, 1418 participated, thus, the overall response rate was 34.5%. We show that the patterning of workplace harassment over two time points (chronic, remission, onset, never harassed) is associated with the use of different types of services. Gender partially moderated the relationship between workplace harassment and services.

Retheorizing sexual harassment in medical education: women students' perceptions at five U.S. medical schools

BACKGROUND

The literature consistently reports that sexual harassment occurs with regularity in medical education, mostly in clinical settings, and most of it goes unreported. Reasons for nonreporting include the fear of retaliation, a reluctance to be viewed as a victim, a fear that one is being "too sensitive," and the belief that nothing will be done.

PURPOSE

We wanted to examine with greater concentration the stories women students tell about sexual harassment, including what they count as sexual harassment, for more or different clues to their persistent nonreporting.

METHODS

We used focus groups to interview 30 women students at 5 U.S. medical schools. We used systematic inductive guidelines to analyze the transcribed data, linking to and building new theoretical frameworks to provide an interpretive understanding of the lived experiences of the women in our study.

RESULTS

Consistent with previous literature, most of the students interviewed had either witnessed or observed sexual harassment. We selected 2 theoretical lenses heretofore not used to explain responses to sexual harassment: 3rd-wave feminist theory to think about how current women students conceive sexual harassment and personality theory to explain beliefs about nonreporting.

CONCLUSIONS

Medical educators need new ways to understand how contemporary women students define and respond to sexual harassment.

What can we learn from the first community-based epidemiological study on stalking in Germany?

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.

Sex differences in the experience of unwanted sexual attention and behaviors during childhood

Girls receive considerable amounts of unwanted sexual attention (UWSA) and behaviors (UWSB). Less is known about boys' unwanted sexual experiences. The primary goal of this study was to obtain a descriptive profile of the types and perpetrators of childhood UWSA/B. Secondary goals were to examine sex differences in emotional reactions to UWSA/B and influence of perpetrator. As many as 100 male and 100 female undergraduates completed the Exposure to Sexual Attention Scale and the Emotional Reaction Checklist. Results indicated that the majority of participants experienced UWSA/B during childhood, with females reporting higher rates of UWSB than males. Sex differences were also observed regarding types of perpetrators and emotional reactions. Findings are discussed as they relate to the sociocultural norms in which children are reared.

Posttraumatic stress disorder in female veterans with military and civilian sexual trauma

This study examines relationships among military sexual trauma (MST), nonmilitary sexual trauma, and posttraumatic stress disorder (PTSD). A sample of 196 female veterans was assessed for trauma occurring before, during, and after military service, and for current PTSD. The prevalence of MST was higher than that of premilitary and postmilitary sexual trauma. Premilitary trauma did not significantly increase the odds of experiencing MST, but did increase the odds of experiencing postmilitary sexual trauma. Logistic regression analyses revealed MST was more strongly associated with PTSD than was premilitary or postmilitary trauma. Women with MST had the greatest increased odds of developing PTSD. Understanding risk factors for and taking steps to prevent MST may reduce cases of PTSD in female veterans.

Cyberspace Violence against Girls and Adolescent Females

Children and adolescents today are the first generation raised in a society in which technological literacy is essential for effective citizenship in the 21st century. With many more youth using digital technologies for educational and recreational purposes, there has been an increase in social problems in cyberspace, exposing them to different forms of cyberviolence. This article gives an overview of the developments in cyberspace, describes different types of cyberviolence, and focuses on cyberbullying among girls and adolescent females as both victims and perpetrators of cyberbullying. At-risk online activities among girls and adolescent females as well as strategies to promote cybersafety are presented. Current research and future directions for research are reviewed.

Workplace harassment from the victim's perspective: a theoretical model and meta-analysis

Although workplace harassment affects the lives of many employees, until recently it has been relatively ignored in the organizational psychology literature. First, the authors introduced an attribution- and reciprocity-based model that explains the link between harassment and its potential causes and consequences. The authors then conducted a meta-analysis to examine the potential antecedents and consequences of workplace harassment. As shown by the meta-analysis, both environmental and individual difference factors potentially contributed to harassment and harassment was negatively related to the well-being of both individual employees and their employing organizations. Furthermore, harassment contributed to the variance in many outcomes, even after controlling for 2 of the most commonly studied occupational stressors, role ambiguity and role conflict.

Risk factors for peer sexual harassment in schools

This study introduces potential risk factors for victimization and perpetration of sexual harassment among teens not previously studied. The first set of analyses compared histories of perpetration and victimization by gender, as well as the relationship between risk factors and perpetration or victimization. For girls (r = .544) and boys (r = .700), the relationships between perpetration and victimization histories were very strong. Most proposed risk factors were also significantly related to perpetration and victimization histories for both genders, including alcohol use frequency, delinquency, histories of family violence and victimization, cultural and personal power, and retaliation, with all increasing as perpetration or victimization history increased. For girls, two direct paths were moderately related to victimization--delinquency and family victimization. For boys, only one variable--perpetration history--was related to victimization history. Four variables were directly related to greater sexual harassment perpetration-greater personal power, delinquency, family violence, and family victimization.

Sexual harassment of women in urban China

Using data from the Chinese Health and Family Life survey, this study analyzed the prevalence of and risk factors for sexual harassment in China in the year 2000. It was the first study to use a general population sample to examine all types of harassment in an Asian country. The dataset was a stratified probability sample with 3,821 participants, and was nationally representative (apart from Hong Kong and Tibet) of China's adult population aged 20-64. In total, 12.5% of all women and 15.1% of urban women reported some form of harassment in the past year. Among urban women age 20-45, most cross-sex harassment was not from supervisors or superiors (1.4%) but from coworkers and other peers (7.0%), strangers (4.6%), dates and boyfriends (3.6%), and others (2.6%). Multivariate analysis of risk factors for cross-sex harassment suggested that, despite its predominance in the Western literature on sexual harassment, the power differentials approach, focusing on male-female power differentials in patriarchal societies, was of modest utility. The results were more consistent with a more comprehensive routine activities approach borrowed from criminology, which emphasizes situational opportunity, perceived benefit to the harasser, and reduced costs for the harasser. The most striking result from the data represents the area receiving the least attention in the West, namely, the perpetrator's perception of "benefit," deriving from the victim's inadvertent "signaling."

Initiation, desistance, and persistence of men's sexual coercion

Patterns of sexually coercive behavior were examined among 266 Asian American and 299 European American men over 1 year. Noncoercer (n = 358), desister (n = 120), initiator (n = 39), and persistent (n = 48) sexually coercive groups were identified. The strongest predictor of sexual coercion was past sexual coercion. Persistent sexual coercers were higher than the other groups in delinquency and hostile masculinity and were nearly twice as likely to engage in laboratory sexual harassment. Loss of face attenuated self-reported sexual coercion and laboratory sexual harassment risk among Asian Americans and attenuated only laboratory sexual harassment risk among European Americans. These findings suggest that the heterogeneity of sexually coercive behavior and ethnicity are important research and clinical considerations.

Workplace violence in Queensland, Australia: The results of a comparative study

This paper presents the results on workplace violence from a larger study undertaken in 2004. Comparison is made with the results of a similar study undertaken in 2001. The study involved the random sampling of 3,000 nurses from the Queensland Nurses' Union's membership in the public (acute hospital and community nursing), private (acute hospital and domiciliary nursing) and aged care (both public and private aged care facilities) sectors. The self-reported results suggest an increase in workplace violence in all three sectors. Although there are differences in the sources of workplace violence across the sectors, the major causes of workplace violence are: clients/patients, visitors/relatives, other nurses, nursing management and medical practitioners. Associations were also found between workplace violence and gender, the designation of the nurse, hours of employment, the age of the nurse, morale and perceptions of workplace safety. Although the majority of nurses reported that policies were in place for the management of workplace violence, these policies were not always adequate.

Sex and power in the academy: modeling sexual harassment in the lives of college women

The authors build an integrated model of the process by which academic sexual harassment undermines women's well-being; also examined is harasser power as a potential moderator of this process. Data from 1,455 college women suggest that sexual harassment experiences are associated with increased psychological distress, which then relates to lower academic satisfaction, greater physical illness, and greater disordered eating. The cumulative effect is greater disengagement from the academic environment, which in turn relates to performance decline (i.e., lower grades). Regardless of how frequently the harassment occurred, academic satisfaction was lower when the harassment came from higher-status individuals (i.e., faculty, staff, or administrators). At the same time, harassment was equally detrimental to mental health, regardless of who perpetrated it. The article concludes with implications for theory, research, and intervention.

College women's experience of stalking: mental health symptoms and changes in routines

BACKGROUND

Stalking is a serious public health and societal concern affecting many college women.

PURPOSE

The purpose of this study was to explore college women's experiences of stalking. The specific aims were to compare victims and nonvictims on physical and mental health indicators and to identify lifestyle changes made in response to being stalked.

METHODS

In this cross-sectional design, 601 women from two universities completed a stalking questionnaire, a mental health screening tool, and an injury checklist. Data analysis included frequencies, multivariate analysis of variance, analysis of variance, and chi(2) analysis.

RESULTS

A quarter of the sample reported experiencing stalking, most often by an intimate or dating partner. Individuals who reported experiencing stalking reported significantly more mental health symptoms and lower perceived physical health status than individuals who did not. Victims reported changing routines, behaviors, and activities.

CONCLUSIONS

Psychiatric nurses must be knowledgeable about stalking and its impact on health. Nurses can provide support, services, and community referrals.

[Mental health impact of stalking in men and women]

Using data from the Mannheim stalking study, the present report analyses gender differences with regard to various mental health indicators and potential mediator effects of stalking victimization. Furthermore, we were interested in whether the impact of stalking on mental health was comparable for men and women. The study included a postal survey of 675 community residents on the experience of intruding harassment and on mental health indicators. In the Patient Health Questionnaire (PHQ-D, Lowe et al. 2001), women scored higher on most of the subscales (depression, anxiety, somatic complaints, stress, psychosocial impairment) than men. Furthermore, more women fulfilled criteria for at least one threshold or subthreshold mental disorder syndrome according to DSM-IV, and more women were under psychotropic medication. However, the identified associations were completely mediated by the higher prevalence of stalking victims in women. In contrast, the associations of stalking victimization with poor mental health, psychosocial functioning, and use of medication were largely comparable across gender.

The association between in-service sexual harassment and post-traumatic stress disorder among Department of Veterans Affairs disability applicants

OBJECTIVE

The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally representative sample of Department of Veterans Affairs PTSD disability applicants.

METHOD

The study was a cross-sectional survey.

RESULTS

Of 4,918 eligible veterans, 3,337 (68%) returned surveys. Nonresponse bias appeared to be minimal. After adjustment for other reported traumas, women's reported in-service sexual harassment severity was significantly associated with PTSD symptom severity (p < 0.0001). The effect seen was about the same size as that seen for combat exposure among the men and for in-service sexual assault among the women. Men showed no association between in-service sexual harassment and PTSD (p = 0.33), although power was low for this test.

CONCLUSION

Sexual harassment significantly contributed to female veterans' PTSD symptoms; its contribution to men's symptoms was unclear. We discuss mechanisms through which sexual harassment might affect PTSD symptom severity, including the possibility that sexual harassment sometimes meets the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, definition of a criterion A stressor.

Retirement and drinking outcomes: lingering effects of workplace stress?

This study assesses the degree to which sexual harassment (SH), generalized workplace abuse (GWA), and psychological workload (PWL) impact drinking behaviors in retirement. A mail survey was completed at four points in time by a cohort of 1654 employees initially drawn from a university workplace. Questionnaires assessed experiences of SH, GWA, PWL and drinking behaviors. Hypotheses were tested involving (1) the extent to which SH, GWA, and PWL experienced while working were associated with frequency and quantity of drinking in retirement, (2) the extent to which drinking levels of retirees differed from those of current employees experiencing similar stress levels, and (3) the extent to which gender moderated these relationships. Retirees reporting earlier stressful work environments report higher levels of alcohol consumption during retirement compared to those retirees reporting less stressful earlier work environments. Gender moderated these relationships. The findings of this study suggest that there may be a residual effect of workplace stress during retirement.

Intersections of 'sanitation, sexual coercion and girls' safety in schools'

OBJECTIVE

To explore safety for girls in schools, particularly how girls perceive and negotiate dangers and risks associated with the use of toilets.

METHODS

Participatory action research over a period of 3 days at three schools in South Africa. Informants were 81 girls 16 years and older, teachers and other relevant school personnel. Data were collected through focus group discussions, in-depth interviews, participant observation, mapping and photography.

RESULTS

Toilets had inadequate or no sanitation. Both their use and their avoidance were risky for female students and discouraged hygienic practices. Experience of sexual violence from male students and teachers was a major theme, but unrelated to school toilets. Male teachers used various strategies and opportunities to gain sexual access to the girls and previous experience of victimization prevented the girls from reporting them.

CONCLUSION

To ensure a healthy school environment that promotes gender equality, all threats to safety, including the physical and social environment, must be considered.

Erotomania revisited: thirty-four years later

Erotomania (also known as De Clerambault's syndrome) is usually described as a rare delusional syndrome that characteristically involves a woman who believes that a man, typically of higher social, economic or political status, is in love with her. Two cases are reviewed here that have been followed for over 30 years, making these some of the longest, single-case longitudinal studies yet reported. De Clerambault's syndrome remains a ubiquitous nosological psychiatric entity with uncertain prognosis. In 1980, we reported in this journal one woman diagnosed as having erotomania. At that time, she had been followed for approximately eight years. She has now been studied for over 30 years. In De Clerambault's original work, as reported by Enoch and Trethowan, a woman whose chronic, erotic delusion remained unchanged was followed for 37 years. Despite some psychological advances, our original patient, like De Clerambault's, has remained essentially entrapped by her psychotic thought disorder and erotomania. A thorough review of the literature to date was contained in our 1980 article and so, to avoid repetition, we refer the interested reader to that reference. At this time, the original patient's history will be presented along with the course of her disorder and treatment implications. Secondly, another patient will be presented and her case reviewed. Finally, we will argue that this disorder is not as rare as has been claimed and call for the continued recognition of this syndrome as its own entity despite recent opinions that such use be discontinued.

[Stalking--what does the family doctor need to know?]

Stalking is a widespread phenomenon, which for the stalked person is associated with a not inconsiderable risk of becoming the victim of an act of violence. Furthermore, stalked persons may develop significant psychological problems, and therefore often seek out a doctor as their first contact. Another reason for this is the still unsatisfactory legal situation and widespread ignorance of the stalking problem on the part of the police and the courts. In the light of the above, it is of great importance that the physician should thoroughly familiarize himself with the problems associated with stalking.

Have you been sexually harassed in school? What female high school students regard as harassment

The aim of the study was to explore what behaviors experienced from peers and school staff at school are acknowledged as sexual harassment, and perceived as problematic, by female high school students, and what other factors may be relevant. Analyses were performed of responses (to 540 questionnaires) in an anonymous self-report mail survey from a random sample of female Swedish high-school students (59% response rate). Exposure to relevant behaviors, of varying levels of severity, alone, does not explain the acknowledgment of harassment. Many students were subjected to many of the potentially offensive behaviors without labeling them as sexual harassment, despite the fact that they saw many of them as problematic. Further, viewing the relevant behaviors as problems in one's school did not necessarily lead to acknowledging that sexual harassment in general was a problem. However, the behaviors seen as problems were less likely to be dismissed as sexual harassment than personal experiences. This was especially true of the most common behaviors, namely verbal ones. The results demonstrate female students' reluctance to label incidents as sexual harassment, despite the fact that actual behaviors are perceived as environmental problems. Potentially offensive sex-related behaviors become normalized in the school environment and are difficult to address, when little support is provided by schools.

Hazards of stigma: the sexual and physical abuse of gay, lesbian, and bisexual adolescents in the United States and Canada

Some studies suggest lesbian, gay, and bisexual (LGB) teens are at higher risk than peers for violence at home, in school, and in the community. That can bring them into the child welfare system or services for runaway and homeless teens. This study compared self-reported experiences of sexual and physical abuse based on sexual orientation and gender in seven population-based surveys of youth. The authors used c2 and age-adjusted odds of abuse to compare bisexual to heterosexual, mostly heterosexual, and gay and lesbian students. They also provide case studies to illustrate the experiences of such youth.