Mental health consequences of sexual assault among first-year college women

Predictors of Disclosure Recipients' Social Reactions to Victims' Disclosures of Dating and Sexual Violence: A Longitudinal Study of College Students

Dating violence (DV) and sexual violence (SV) are pernicious issues among college students that lead to deleterious outcomes, which are more likely when victims receive more negative social reactions (e.g., blaming the victim) and fewer positive social reactions to disclosure (e.g., providing emotional support). Most research studies have examined victims' reports of social reactions to their assault disclosures, with only a few cross-sectional studies of predictors of disclosure recipients' provision of positive and negative social reactions to victims. The purpose of the current study was to address these gaps in the literature. Participants were 481 college students (76.4% women, 89.2% White/Non-Hispanic) who reported being a disclosure recipient during the past six months (measured at Time 2 to cross-sectionally and longitudinally predict their social reactions to victims' disclosures). Results suggested that both victim and disclosure recipient characteristics (e.g., gender, race), disclosure recipient perceptions of victims (e.g., empathy for victim, blame of victim, victims' coping) and both disclosure recipient and victim behavior at the time of disclosure (e.g., drinking, distress) were related to disclosure recipient social reactions. These findings underscore the need for programs for potential informal disclosure recipients that target psychological variables (e.g., post-traumatic stress disorder) and behavior at the time of disclosure, as well as their perceptions of victims more generally, in addition to improving their knowledge and ability to respond with positive social reactions and avoid negative social reactions.

Prevention of sexual violence among college students: Current challenges and future directions

Objective Preventing sexual violence among college students is a public health priority. This paper was catalyzed by a summit convened in 2018 to review the state of the science on campus sexual violence prevention. We summarize key risk and vulnerability factors and campus-based interventions, and provide directions for future research pertaining to campus sexual violence. Results and Conclusions: Although studies have identified risk factors for campus sexual violence, longitudinal research is needed to examine time-varying risk factors across social ecological levels (individual, relationship, campus context/broader community and culture) and data are particularly needed to identify protective factors. In terms of prevention, promising individual and relational level interventions exist, including active bystander, resistance, and gender transformative approaches; however, further evidence-based interventions are needed, particularly at the community-level, with attention to vulnerability factors and inclusion for marginalized students.

Sexual Violence Among Gender and Sexual Minority College Students: The Risk and Extent of Victimization and Related Health and Educational Outcomes

A multisite survey conducted at eight campuses of a southwestern university system provides the data for the present study, total N = 17,039 with 1,869 gender and sexual minority (GSM) students. Sexual violence was measured using the Sexual Experiences Survey (SES), and analysis included both the participant's risk of experiencing sexual violence and the extent (or total count) of sexual violence experienced. This study poses the following research questions: What effects do gender identity and sexual orientation have on the risk and extent of sexual violence among students and, among victims, what is the relationship between gender identity/sexual orientation and mental health (posttraumatic stress disorder [PTSD], depression) and academic environment (disengagement and safety) outcomes for university students? Multilevel, random effect hurdle models captured this sequential victimization dynamic. GSM and cisgender heterosexual (CH) female students are predicted to be 2.6 and 3 times, respectively, as likely to experience sexual violence compared with CH male students. In addition, GSM students experiencing sexual violence are also expected to experience a greater number of sexually violent acts (74% more) over their college career compared with victimized CH male students. The models confirm that the risk of victimization increases over time (13% per year for CH male students), but GSM students are expected to experience an additional (10%) increase in risk of victimization per year compared with CH male students. GSM and CH female students are also predicted to be more likely to have PTSD and experience more severe depression symptoms than CH male students. GSM students are expected to experience significantly higher rates of PTSD, worse depressive symptoms, and greater disengagement than CH female students. The discussion explores how institutions of higher education might recognize the resilience of GSM students and consider the protective potential of social and community support when developing programs or interventions for diverse populations.

Walking the Walk: Testing a Theory-Derived Measure of Campus Sexual Assault Policy Implementation

Institutional Theory posits that organizations sometimes engage in practices that are inconsistent with their stated policies-a process called "decoupling"-due to three types of legitimacy pressures: normative, coercive, and mimetic. Limited previous research suggests that such decoupling between policy and practice may be occurring in institutions of higher education (IHEs) when addressing sexual assault. The objective of this study was to test a measure designed to assess sexual assault policy implementation using the constructs of Institutional Theory. The measure was tested with a national sample of 210 staff and faculty at IHEs who work on sexual assault prevention and response on their campuses. This study assessed (a) the reliability of the measure; (b) the degree to which the measure identified legitimacy pressures and decoupling in the sample; (c) the degree to which legitimacy pressures were linked to decoupling in the sample, as the theory suggests; and (d) the degree to which campuses and individual characteristics were differentially associated with decoupling and legitimacy pressures. Principal factor analysis resulted in a factor structure that conformed reasonably well to the existing constructs of Institutional Theory, with the addition of a new construct reflecting an institution's stated commitment to addressing sexual assault. Regression analyses found that only normative legitimacy pressures significantly predicted decoupling and commitment. Higher decoupling scores were found for public campuses and larger institutions. Campus-based victim advocates reported significantly higher rates of decoupling than Title IX coordinators. The findings suggest that the process of policy implementation may vary across campus types and that further research is needed to better understand the impact of campus sexual assault regulatory attention.

Silencing by design: Lessons learned about child sexual abuse from a university sexual assault survey

Background:

University students have been recognized as particularly being vulnerable to sexual victimization.

Purpose:

With little research to date, and acknowledgement for the need of a better understanding of sexual violence, our study analysed the CQUniversity Sexual Assault Survey’s qualitative responses. An open-ended qualitative question allowed students to provide information anonymously.

Methods:

A total of 109 participants contributed responses with 17 respondents commenting on the fact that the survey omitted to ask about child sexual abuse prior to the cut-off age of 12 years.

Results:

University students revealed unexpected disclosures of prepubescent child sexual abuse victimization and ongoing sexual victimization into adulthood. Furthermore, students’ comments indicated negative impacts including distress, mental health and substance use problems, distrust, and interpersonal difficulties. Strong feelings about ‘silencing’ prepubescent child sexual abuse in university surveys were expressed with a request that questions about child sexual abuse prior to the age of 12 years be included.

Conclusion:

Our study found that child sexual abuse victimization is important to students. Recommendations indicate the need for future research about sexual violence among university students without age restrictions to gain a better understanding about the impact of trauma including revictimization experiences.

Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis

BACKGROUND

Effective targeting of services requires that we establish which undergraduates are at increased risk of mental health problems at university. We aimed to conduct a systematic review and meta-analysis of the prevalence and risk factors for mental health problems in undergraduates.

METHODS

We searched MEDLINE, PsycInfo, EMBASE and the Cochrane Central Register. Eligible studies were assessed using the Quality of Prognostic Studies checklist and narratively synthesised. Pooled prevalence of depression and suicide-related outcomes, and associated risk factors (odds ratios) were estimated using random-effects meta-analyses.

RESULTS

Sixty-six eligible studies of varying quality were included in a narrative synthesis. The pooled prevalence of depression (eight studies; 13,790 participants) was 25% (95% CI 17%, 35%) and the pooled prevalence of suicide-related outcomes (four studies; 2,586 participants) was 14% (95% CI 0%, 44%). Thirteen studies contributed to meta-analytic syntheses of 12 depression-related and four suicide-related risk factors. Presenting with a current mental health problem, negative rumination, parent separation, experiences of sexual harassment and parental depression significantly predicted depression outcomes. Childhood adversity, baseline mental health problems and financial difficulties significantly predicted suicide-related outcomes.

LIMITATIONS

Student mental health is a heterogeneous research area and is hampered by the use of imprecise terms, both for describing risk factors and mental health outcomes. These inconsistencies limit the extent to which datasets can be meaningfully synthesised.

CONCLUSIONS

This review evidences the importance of a range of risk factors for poor undergraduate mental health. Interventions should be developed to target modifiable risk factors and prevent poor mental health outcomes. Systematic review registration: PROSPERO registration CRD42019144927.

Prospective Predictors of Receiving Disclosures of Intimate Partner Violence and Sexual Assault Among College Students

OBJECTIVE

Previous research has indicated that many undergraduates receive disclosures of sexual assault and intimate partner violence (IPV) from their peers; however, much of this research has been cross-sectional. The present study assessed the extent to which demographic characteristics and victimization history predicted whether participants received disclosures over the subsequent 6 months. Directional hypotheses assessed whether psychological symptoms and attitudes predicted, or were consequences of, disclosures at follow-up.

METHOD

College students (n = 867) from a broader treatment intervention study completed pretest (Time 1) and 6-month follow-up surveys (Time 2).

RESULTS

Individuals who reported new disclosures at follow-up (56%) were more likely to be women, have previous experience receiving either sexual assault or IPV disclosures, and have experienced sexual assault or IPV victimization in their lifetime and across the follow-up period. Sexual orientation did not predict receipt of disclosures at follow-up; intervention group did not moderate these relationships. Results of longitudinal structural equation models found that although higher Time 1 posttraumatic stress disorder symptoms and depressive symptoms predicted disclosure status at follow-up, Time 1 disclosure status did not predict subsequent increases in posttraumatic stress disorder and depressive symptoms. Attitudinal variables were not significantly associated with disclosures reported at Time 1 or follow-up.

CONCLUSIONS

Findings suggest the importance of attending to personal experiences of victimization within interventions aiming to improve responses to disclosure. Although individuals with higher distress are more likely to receive subsequent disclosures, disclosure does not appear to lead to increases in long-term psychological distress.

Healthy Romantic Relationships: Attitudes and Perceptions of College Students

Sexual assault (SA) is a serious issue affecting college students in romantic relationships. Having strong understandings of what constitutes healthy romantic relationships (HRR) can protect students by allowing them to better recognize SA and other problematic behaviors in relationships. However, little research has explored how students conceptualize HRR. Utilizing qualitative thematic analysis, this study analyzed data from individual and focus-group interviews from a sample of 45 students at a southwestern university in the United States. Findings indicated that students understood HRR to be characterized by direct communication, respect, and mutual satisfaction. However, their experiences showed that these ideals were not always achieved. This discrepancy may be explained by the influence of social norms, particularly around sexual behavior and gender role expectations. Implications and recommendations for social workers/counseling professionals are discussed.

Virtual Reality or Augmented Reality as a Tool for Studying Bystander Behaviors in Interpersonal Violence: Scoping Review

Background

To provide participants with a more real and immersive intervening experience, virtual reality (VR) and/or augmented reality (AR) technologies have been integrated into some bystander intervention training programs and studies measuring bystander behaviors.

Objective

We focused on whether VR or AR can be used as a tool to enhance training bystanders. We reviewed the evidence from empirical studies that used VR and/or AR as a tool for examining bystander behaviors in the domain of interpersonal violence research.

Methods

Two librarians searched for articles in databases, including APA PsycInfo (Ovid), Criminal Justice Abstracts (EBSCO), Medline (Ovid), Applied Social Sciences Index & Abstracts (ProQuest), Sociological Abstracts (ProQuest), and Scopus till April 15, 2020. Studies focusing on bystander behaviors in conflict situations were included. All study types (except reviews) written in English in any discipline were included.

Results

The search resulted in 12,972 articles from six databases, and the articles were imported into Covidence. Eleven studies met the inclusion and exclusion criteria. All 11 articles examined the use of VR as a tool for studying bystander behaviors. Most of the studies were conducted in US young adults. The types of interpersonal violence were school bullying, dating violence, sexual violence/assault, and soccer-associated violence. VR technology was used as an observational measure and bystander intervention program. We evaluated the different uses of VR for bystander behaviors and noted a lack of empirical evidence for AR as a tool. We also discuss the empirical evidence regarding the design, effectiveness, and limitations of implementing VR as a tool in the reviewed studies.

Conclusions

The reviewed results have implications and recommendations for future research in designing and implementing VR/AR technology in the area of interpersonal violence. Future studies in this area may further contribute to the use of VR as an observational measure and explore the potential use of AR to study bystander behaviors.

Sexual Assault and Co-Occurrence of Mental Health Outcomes Among Cisgender Female, Cisgender Male, and Gender Minority U.S. College Students

PURPOSE

The aim of this study was to examine the co-occurrence of mental health (depression, anxiety, nonsuicidal self-injury, and suicide ideation) and substance use outcomes among cisgender female, cisgender male, and gender minority college students exposed to sexual assault (SA).

METHODS

Data were drawn from a 2018 U.S. national survey of college student well-being (N = 50,438). Inverse propensity-weighted three-step latent class analysis was used to examine co-occurrence of outcomes while adjusting for 31 potential confounders of the relation between SA and outcome classes.

RESULTS

Four latent classes were identified for cisgender female and male participants and two for gender minority participants, reflecting a range from low to high risk of co-occurring outcomes. SA was associated with significantly and substantially increased odds (odds ratio: 2.03-3.64) of membership to the highest-risk outcome class compared with the lowest-risk class across gender identity subgroups.

CONCLUSIONS

SA in the college setting is associated with substantially increased odds of co-occurring depression, anxiety, nonsuicidal self-injury, and suicide ideation, regardless of gender identity.

A program to improve social reactions to sexual and dating violence disclosures reduces posttraumatic stress in subsequently victimized participants

Objective: Research consistently documents the high rates and deleterious outcomes of dating and sexual violence (DSV) among college students. Thus, there is an urgency to identify cost-effective interventions that can mitigate the negative outcomes associated with these forms of violence. The purpose of the current study was to conduct secondary analyses to assess whether a two-session, face-to-face social support intervention (i.e., Supporting Survivors and Self) would confer psychological benefits for participants who subsequently experienced DSV victimization. Method: Participants were 187 full-time undergraduate students from a university in the northeastern United States who reported at least one form of DSV in the six months following implementation of the program. Results: No intervention effect was identified for self-blame or depressive symptoms among subsequent victims. However, the intervention led to lower levels of overall posttraumatic stress symptoms, including avoidance and changes in cognition and mood symptoms, for participants who experienced unwanted sexual intercourse and/or physical intimate partner violence in the treatment versus the control condition. Gender did not moderate intervention effects. Conclusion: Overall, results suggest that interventions aimed at providing social support to survivors may lead to some benefits for individuals who are subsequently victimized. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Examining the DSM-5 latent structures of posttraumatic stress disorder in a national sample of student veterans

To date, no studies have examined the latent structures of posttraumatic stress disorder (PTSD) within a sample of student veterans. To examine these constructs in a student veteran sample (n = 297), confirmatory factor analysis (CFA) was conducted on six different models of PTSD, including a one-factor model, based on the 20 symptoms found in the DSM-5; PTSD was assessed using the PCL-5. Global fit statistics suggest that fit across all models, including the 1-factor model, were good [RMSEAs(0.054-0.056); CFIs(0.928-0.940); SRMRs(0.043-0.045)], and the AIC was lowest for the seven-factor hybrid model. Statistical tests and fit guidelines for nested models suggest there is no quantitative advantage of a five, six, or seven-factor model over the existing DSM-5 four-factor model. Given the high percentage of student veterans that screened positive for a probable PTSD diagnosis (53 %) in this study compared to non-student veterans (11-20 %) and the general student population (11-15 %) found in other studies, further research is needed to assess the clinical utility of these symptoms and model structures.

Organizational influences on the intimate partner violence and sexual violence screening practices of college health care providers

Experts and professional organizations in the U.S. have issued recommendations that health care providers (HCPs) should screen women for intimate partner violence (IPV) and sexual violence (SV). Despite the high rates of IPV and SV experienced by female college students, investigators have found that providers are not screening for IPV and SV in college health centers. In this study, a cross-sectional survey design was utilized to: (a) examine college HCPs' reports of IPV/SV screening behaviors and (b) identify the individual-level and organization-level structure and process characteristics that promote or inhibit IPV/SV screening. A total of 773 college HCPs (physicians, nurse practitioners, and registered nurses) were invited to participate in the study using two separate sampling frames. The final sample included 210 college HCPs. Providers reported low rates of IPV/SV screening (median = 20%). Screening rates varied by provider type with nurse practitioners reporting the highest screening rates. Urban location was associated with a three and one-half times greater likelihood of IPV/SV screening. Use of an electronic health record that included a prompt to screen was associated with a three-fold increase in the likelihood that HCPs would screen for IPV/SV. Further study is needed to better understand how organizational factors influence providers' screening behaviors in college health centers and how these influences are mediated. Future studies should include larger and more diverse samples of colleges and examine geographical variations in screening practices.

Identifying suicide risk among college students: A systematic review

Mental health research highlights the need to focus on suicide risk in college students. However, evidence for associated risk and protective factors in this cohort is mixed. This review synthesizes data from 29 independent studies (N = 11,557 participants). Self-reported depression, cumulative stressful life events, sleep difficulties, a disconnection from others, and a sense of hopelessness demonstrated significant associations with heightened suicide risk. Reasons to live and hope provided significant protective effects. The findings highlight key intervention targets, pointing to the importance of cognitive-behavioral interventions to ameliorate suicidal thoughts but also build dispositional hope and goal-directed thinking.