Predictors of rape: findings from the National Survey of Adolescents

Risk factors for PTSD diagnosis in young victims of recent sexual assault

BACKGROUND

Sexual assault is associated with a high risk of developing PTSD. Little is known about the PTSD onset in children who have recently been victimized by sexual assault. It is important to identify children at risk for PTSD after sexual assault to prevent chronic problems and revictimization.

OBJECTIVE

The first aim of this study was to describe the development of post-traumatic stress symptoms in the four weeks after sexual assault. The second aim was to analyse whether pre-assault factors, assault-related factors, social support, and post-traumatic stress, measured at two weeks post-assault, were associated with an indication of PTSD.

METHOD

From January 2019 to March 2021, data were collected of victims aged 8-17 years (n = 51; mean age = 15.00; SD = 1.78) who had contacted a Sexual Assault Centre. Severity of post-traumatic stress symptoms was measured at two and four weeks post-assault. The study was designed to use a multivariate logistic regression analysis. The study included female victims only.

RESULTS

Most of the victims (58.8%) showed a decline in the severity of post-traumatic stress symptoms in the four weeks after sexual assault. However, 27.4% showed an increase and 13.7% showed no change in symptoms. More than two-thirds of the children (70.6%) showed severe post-traumatic stress symptoms at four weeks post-assault, i.e. had an indication of PTSD. Since only one significant difference was found, the multivariate analysis was not executed. A significant difference was found between severity of symptoms at two weeks and an indication of PTSD at four weeks (t(49) = -5.79; p < .001).

CONCLUSION

Children with high levels of post-traumatic stress at two weeks post-assault are at risk for PTSD indication at four weeks post-assault. Further research is needed to determine whether early trauma-based treatment for children with high post-traumatic stress symptoms can prevent the development of PTSD.

Prospective Predictors of Sexual Revictimization Among College Students

This study examined the prevalence rates of sexual violence revictimization during each year of college. In addition, the impact of key mental health concerns on these rates was investigated. Incoming first-year students at a large, urban university completed a survey about their exposure to incidences of sexual assault before college and about their mental health symptoms. During each subsequent spring semester, experiences of sexual assault and mental health symptoms were reassessed. The sample was limited to individuals who reported sexual assault for at least one time period (N = 3,294). More than 60% of individuals who endorsed an initial incident of sexual assault reported no subsequent incidences, leading to an overall revictimization rate of 39.5%. Rates of revictimization were higher for those identifying as women, as compared to men, and those identifying as White, as compared to those identifying as Asian or "other." Trauma-related distress and increased symptoms of alcohol use disorder (AUD) and depression were all related to a greater risk of experiencing revictimization. Given that experiencing an initial sexual assault greatly increases the risk of experiencing revictimization, and considering the notable prevalence rates of sexual assault on college campuses, it is imperative to examine trends in revictimization throughout the course of college. Examining factors that increase risk for experiencing revictimization is crucial to developing university-wide effective prevention and intervention efforts. In addition to the efforts to increase the reporting of incidences of sexual assault, universal programming efforts should also focus on factors that promote resilience in the face of sexual assault, such as reducing risky drinking behavior, increasing social support, and reducing stigma around the reporting of mental health symptoms.

Violence exposure, posttraumatic stress, and affect variability among African American Youth: A time sampling approach

The current study examines the immediate and short-term impact of daily exposure to community violence on same-day and next-day levels of posttraumatic stress symptomatology and various affective states (i.e., dysphoria, hostility, and anxiety), in a sample of 268 African American adolescents living in urban, low-income, high-violence neighborhoods (Mage = 11.65; 59% female). In addition, the moderating role of affective state variability on this relationship was examined. This study utilized experience sampling method and a daily sampling approach, which contributes a more robust investigation of the short-term effects of violence exposure in youth. Hierarchical linear modeling revealed that community violence exposure was positively associated with same-day and next-day symptoms of posttraumatic stress. Violence exposure also exhibited an immediate effect on dysphoria, anxiety, and hostility levels. Youth variability in dysphoria exacerbated the effect of violence exposure on concurrent or next-day posttraumatic stress, dysphoria, and hostility. Moreover, variability in anxiety and hostility exacerbated the experience of next-day hostility. The clinical implications relating to these findings, such as the importance of implementing screening for posttraumatic stress following exposure, the incorporation of preventative treatments among those at risk of exposure, and the targeting of emotion regulation in treatments with adolescents, are discussed.

The role of age and mode of delivery in the STEPS intervention: a longitudinal pilot-study in treatment of posttraumatic stress symptoms in Danish survivors of sexual assault

Background: The STEPS programme has been succesfully implemented as a group-based treatment of trauma symptoms after rape for adolescents. The STEPS intervention was translated from Dutch to Danish and offered to adults in addition to adolescents as well as an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. The programme was translated from Dutch to Danish and expanded to adults in addition to adolescents as well as to an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. Objective: The present study observes  development in trauma symptoms and ICD-11 diagnostic status during an adapted version of the intervention programme 'STEPS' for survivors of sexual assault. Methods: A prospective uncontrolled study was conducted, monitoring symptoms of posttraumatic stress and other trauma-related symptomatology before treatment, after treatment and at 6 and 12 months' follow up for 103 referrals receiving individual or group-based STEPS. Tentative diagnoses of posttraumatic stress disorder (PTSD) and complex PTSD were assigned to participants according to the ICD-11 to observe the development in diagnostic status across time, and multilevel modelling was used to assess the development of symptom severity and to assess the moderating effect of age-group and mode of delivery. Results: A loglinear function representing large and statistically significant decline in symptomatology over time provided the best fit for all measures of trauma-related symptomatology. The decline was not moderated by age-group or mode of intervention. Dropout rates were independent of mode of intervention and age. Conclusion: The adaption of the STEPS programme to adults and as an individual intervention is feasible and maintains effect sizes comparable to those observed in the original intervention. Further research using randomized controlled trials is needed to ascribe the observed effect to the STEPS programme.

Knowledge, perception and experience of sexual entrapment among undergraduate students of the University of Ibadan, Nigeria

Background: Deceit into sexual activities without the victim being aware of the intended action is common in tertiary institutions as the environment promote activities that make students vulnerable, especially females, young and new students. The resulting physical, psychological and social consequences, including harassment, sexual assault, non-consensual sex, injury, psychological trauma and suicide attempts, have affected many young people. This study was aimed at exploring the knowledge, perception, experience of sexual entrapment among undergraduate students of the University of Ibadan, Ibadan, Nigeria. Methods: This multi-stage cross-sectional survey involved 422 participants using semi-structured questionnaire and an in-depth interview guide. Quantitative data were analyzed statistically, while Qualitative data was analyzed thematically. Results: Mean age of respondents was 20.5±3.0 years, 52.6% were males, 58.8% and 81% had a good knowledge and perception of sexual entrapment, respectively. Prevalence of sexual entrapment was 18%, affecting more males (55.3%) and first year students (39.5%), 59.2% of the perpetrators are friends of the victim. Students were entrapped on campus through; emotional support (42.1%), money (34.2%), accommodation assistance (7.9%), material things/gifts (21.1%), assignment assistance (10.5%), help with registration (4.0%), religious activities (6.6%), debt repayment (11.8%) and counseling (9.2%). It resulted to; unwanted sex (34%), rape (4%), pregnancy (1.3%), STDs (4%), Injury (13%), psychological trauma (27.6%), loss of trust (52.6%) and attempted suicide (23.7%) among victims. Effective coping mechanisms were adopted by 55.3% of respondents. There was a significant association between knowledge and perception; knowledge and experience; perception and experience (p<0.05). Findings from the in-depth interview revealed care, tutoring, political positions, and pretense to need help as other tactics. Conclusions: Sexual entrapment is common on campus, affecting males and females, knowledge and perception influence experience of sexual entrapment, requiring the need for a holistic approach to reduce its prevalence.

Sexual Violence Victimization Among Youth Presenting to an Urban Emergency Department: The Role of Violence Exposure in Predicting Risk

Sexual violence (SV) is a widespread public health problem among adolescents and emerging adults with significant short- and long-term consequences. Young people living in urban, disadvantaged communities with high rates of violence may be especially at risk for SV victimization. Understanding interconnections between different forms of violence is critical to reducing SV risk among youth. Participants were youth ( N = 599) ages 14 to 24 years ( M = 20.05, SD = 2.42) presenting to an urban emergency department with a Level 1 trauma designation as part of a prospective cohort study and followed-up for 24 months. We used logistic regression to examine the probability of reporting SV during the 24-month follow-up based on baseline reports of community and peer violence exposure, accounting for previous SV victimization, substance use, and sociodemographic characteristics. Among youth presenting to an urban emergency department, 22% of youth not seeking care for a sexual assault reported any lifetime SV (forced and/or substance-induced sexual intercourse) at baseline. During the 24-month follow-up, 12% reported SV victimization. We found high community violence exposure (odds ratio [OR] = 2.96, 95% confidence interval [CI] [1.01, 8.68]) and peer violence exposure (OR = 1.58, 95% CI [1.19, 2.08]) were associated with increased odds of reporting SV during follow-up in addition to previous SV victimization (OR = 2.71, 95% CI [1.45, 5.09]). Sex, age, parent education, and alcohol or other drug use at baseline were not associated with odds of SV during follow-up. Investigating interconnections between SV victimization and other forms of violence across socioecological levels provides an opportunity to advance SV research and identify promising avenues for prevention based on other violence prevention research. Future strategies for SV prevention that incorporate community and peer components as well as SV-specific content may help reduce SV victimization among youth living in urban, disadvantaged communities.

Immigration Trauma among Hispanic Youth: Missed by Trauma Assessments and Predictive of Depression and PTSD Symptoms

Few quantitative studies have examined the rate of exposure to traumatic events during immigration among Hispanics or its relation to mental health outcomes. Failing to capture traumatic events that occur during immigration may impede investigations of trauma and related mental health disparities with Hispanics. In order to better understand the need for immigration-related trauma assessment, interviews were conducted with 131 immigrant Hispanic youth. First, youth completed a comprehensive trauma assessment interview. Items were added to the interview to assess if each traumatic event occurred during the process of immigration. An immigration-focused module was then added to the end of the assessment. A substantial minority of youths reported experiencing a traumatic event during immigration (n = 39; 29.8%). The majority of these were not captured by the standard trauma assessment (n = 32; 82.1% of those with in-transit trauma). Of these, the majority stated that the process of immigration itself was traumatic, but had not indicated experiencing any event assessed during the standard trauma assessment (n = 28; 87.5% of those with unidentified in-transit trauma). The traumatic events that were not captured during the standard trauma assessment significantly predicted both depression (p < .001) and PTSD symptoms (p = .012). Results suggest that standard trauma assessments may not capture traumatic events that occur during immigration for Hispanic youth. Failing to capture these events during trauma assessment may have large implications for research on trauma-related mental health disparities, as the events that were not captured overlapped significantly with depression and PTSD.

Sexual Violence against Women in Germany: Prevalence and Risk Markers

Previous research has repeatedly shown that gender-based violence affects a considerable proportion of women in any given population. Apart from providing current estimates of the prevalence of sexual violence against women in Germany, we identified specific risk markers applying an advanced statistical method. We analyzed data from a survey of N = 4450 women representative of the German population, conducted by the Criminological Research Institute of Lower Saxony in 2011. Lifetime prevalence for experiencing sexual violence was 5.4% for women aged 21–40 years (five-year prevalence: 2.5%). Non-parametric conditional inference tree (C-Tree) analyses revealed that physical and sexual abuse during childhood as well as being divorced, separated, or widowed was the most informative constellation of risk markers, increasing the five-year prevalence rate of experienced sexual violence victimizations up to 17.0%. Furthermore, knowing about the official penalization of marital rape was related to a lower victimization risk for women without a history of parental violence. Possible explanations for these findings as well as implications for future research are critically discussed.

Predictors and mental health outcomes of potentially traumatic event exposure

The aims were two-fold: to examine prevalence and correlates of lifetime potentially traumatic event (PTE) exposure and to explore the relationships between PTE exposure and mental health outcomes (i.e., trauma related distress, alcohol use quantity and frequency, depression symptoms, and anxiety symptoms) within a large sample of college freshmen. 6120 participants, consisting of three cohorts of incoming freshman at a large southeastern university, completed an online assessment battery measuring a multitude of factors including PTEs, personality, relationships (i.e., parental and peer), and mental health. The majority (81.8%) of participants endorsed experiencing at least one PTE within their lifetime and 39.0% reported at least one interpersonal trauma (i.e., physical assault, sexual assault, other unwanted or uncomfortable sexual situation). The average number of PTE categories endorsed was 1.71 (SD=1.30), and 8.7% of participants reported experiencing four or more separate PTE categories pre-college entry. Female gender and peer deviance were consistently associated with PTE exposure and symptoms of psychopathology. Furthermore, a history of interpersonal PTE exposure was associated with increased alcohol use (i.e., frequency and quantity), trauma related distress, depressive symptoms, and anxiety symptoms. The data demonstrate high prevalence PTE exposure among young adults and the clinical significance of a PTE history.

Early Sex Work Initiation and Violence against Female Sex Workers in Mombasa, Kenya

Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample included 816 FSWs in Mombasa, Kenya, recruited from HIV prevention drop-in centers who were 18 years or older and moderate-risk drinkers. Early initiation was defined as beginning sex work at 17 or younger. Logistic regression modeled recent violence as a function of early initiation, adjusting for drop-in center, age, education, HIV status, supporting others, and childhood abuse. Twenty percent of the sample reported early initiation of sex work. Although both early initiators and other FSWs reported commonly experiencing recent violence, early initiators were significantly more likely to experience recent physical and sexual violence and verbal abuse from paying partners. Early initiation was not associated with physical or sexual violence from non-paying partners. Many FSWs begin sex work before age 18. Effective interventions focused on preventing this are needed. In addition, interventions are needed to prevent violence against all FSWs, in particular, those who initiated sex work during childhood or adolescence.

The Association Between Unwanted Sexual Experiences and Early-Onset Cervical Cancer and Precancer by Age 25: A Case-Control Study

BACKGROUND

We examined the association between unwanted sexual experiences and cervical cancer, cervical intraepithelial neoplasia 3, adenocarcinoma in situ, diagnosed ≤25 years of age.

METHODS

A case-control study of women ≤55 years who attended gynecological hospitals in Australia between 1983 and 2007. Cases were ≤25 years when diagnosed with disease, control group 1 were "older women" >25 years at diagnosis; control group 2 were "well women" ≤25 years attending preventive health clinics. A self-administered postal survey was utilized. The main outcome measures were prevalence of childhood sexual abuse (<16 years) and unwanted adolescent sexual experiences (between 16 and 18 years) in cases compared to controls.

RESULTS

Of 400 contactable subjects, 251 participated (62.8%). Prevalence of childhood sexual abuse in cases (26.6% [25/94]) was similar to other groups. Prevalence of childhood genital contact abuse in cases with cervical cancer was 45.5% [5/11], compared to older women (20% [10/50], p = 0.08) and well women (13.8% [8/58], p = 0.01), and was marginally more common compared to well women when adjusted for other lifestyle factors (odds ratio [OR]: 4.7 [1.0-22.6], p = 0.05). Prevalence of unwanted adolescent sexual experiences in cases was 28.9% [33/114]. Prevalence of adolescent penile-genital contact experiences in cervical cancer cases was 46.7% [7/15], compared to older women (9.4%, [6/64], p < 0.001) and well women (13.7%, [10/73], p = 0.003), and was more common compared to well women when adjusted for lifestyle (OR: 5.9 [1.4-24.9], p = 0.02) and sexual health risk factors (OR: 5.6 [1.4-22.1] p = 0.01).

CONCLUSIONS

Unwanted sexual experiences with genital contact were a risk factor for invasive cervical cancer ≤25 years, likely due to a complex interplay of biological and environmental factors.

Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence

PURPOSE

The purpose of the present study was to investigate ethnic differences in trauma-related mental health symptoms among adolescents, and test the mediating and moderating effects of polyvictimization (i.e., number of types of traumas/victimizations experienced by an individual) and household income, respectively.

METHODS

Data were drawn from the first wave of the National Survey of Adolescents-replication study (NSA-R), which took place in the US in 2005 and utilized random digit dialing to administer a telephone survey to adolescents ages 12-17. Participants included in the current analyses were 3312 adolescents (50.2 % female; mean age 14.67 years) from the original sample of 3614 who identified as non-Hispanic White (n = 2346, 70.8 %), non-Hispanic Black (n = 557, 16.8 %), or Hispanic (n = 409, 12.3 %). Structural equation modeling was utilized to test hypothesized models.

RESULTS

Non-Hispanic Black and Hispanic participants reported higher levels of polyvictimization and trauma-related mental health symptoms (symptoms of posttraumatic stress and depression) compared to non-Hispanic Whites, though the effect sizes were small (γ ≤ 0.07). Polyvictimization fully accounted for the differences in mental health symptoms between non-Hispanic Blacks and non-Hispanic Whites, and partially accounted for the differences between Hispanics and non-Hispanic Whites. The relation between polyvictimization and trauma-related mental health symptoms was higher for low-income youth than for high-income youth.

CONCLUSIONS

Disparities in trauma exposure largely accounted for racial/ethnic disparities in trauma-related mental health. Children from low-income family environments appear to be at greater risk of negative mental health outcomes following trauma exposure compared to adolescents from high-income families.

Posttraumatic Coping and Distress

The current body of knowledge related to trauma and posttraumatic stress disorder (PTSD) is primarily based on research conducted in Western nations. Thus, Western clinicians and researchers may know little about whether people from non-Western societies have similar reactions or symptom manifestations to specific traumatic events. Traditional Chinese health beliefs with their roots in Taoism, Confucianism, and Buddhism influence illness perception and affect coping behaviors of Chinese exposed to traumatic events. This article discusses compatible and incompatible aspects of the traditional Chinese health beliefs with Western beliefs about PTSD and examines how culture-based motivations may possibly impact emotional responses to traumatic events between American and Chinese cultures. This article also reviews the literature on the prevalence and applications of Western diagnostic criteria and measures of PTSD in contemporary Chinese populations and proposes suggestions for developing a culturally sensitive framework for clinical management of Chinese trauma survivors.

Awareness of a rape crisis center and knowledge about sexual violence among high school adolescents

STUDY OBJECTIVE

This study examined awareness among adolescents of a local rape crisis center as well as their knowledge about sexual violence.

DESIGN

The Cleveland Rape Crisis Center (CRCC) conducts sexual violence prevention programs for high school students. A written, anonymous survey was distributed to students prior to the start of the program. Students were asked if they had heard of the CRCC; knowledge about sexual violence was assessed with a series of 7 statements (rape myths) that participants identified as true or false. Surveys were reviewed retrospectively. Analyses were carried out for individual questions and frequencies compared using chi-square analysis.

RESULTS

A total of 1633 surveys were collected; 1118 (68.5%) participants were female and 514 (31.5%) were male; ages ranged from 12 to 19 years. Respondents described themselves as being of European descent (45.9%), African descent (26.2%), or mixed race (17.7%). Just over half (863, 52.9%) of survey respondents had heard of the CRCC. Over half (950, 58.2%) of participants answered 5 or more questions correctly (range of correct answers 0 to 7). In general, more participants who were aware of the CRCC were able to identify statements about rape correctly (P < .01 for statements 1, 4, 5, 6, and 7, P < .001 for ≥ 5 correct). Age, gender, and race were all significantly associated with knowledge about rape. Females were consistently more likely to get an answer correct, as were participants of European descent.

CONCLUSION

Awareness of the CRCC was associated with increased knowledge about sexual violence.

Acute stress among adolescents and female rape victims measured by ASC-Kids: a pilot study

BACKGROUND

Rape is considered a stressful trauma and often with durable consequences. How the aftermath of rape is for young adolescents' girls considering acute stress is an overlooked field and remains to be studied.

AIMS

In this study, we wanted to investigate acute stress among adolescent victims of rape and the psychometric properties of the Acute Stress Checklist for Children (ASC-Kids).

METHODS

A clinical sample (n = 79) of raped girls, 13-17 years old who had turned to a special rape victim unit for treatment, answered the ASC-Kids. ASC-Kids was also given to a group of minor stressed, non-raped adolescents in the same age range (n = 154) together with the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI), and the Sense of Coherence Scale 13 (SOC-13).

RESULTS

The scores from the groups were compared and showed significant differences in mean values on all the diagnostic criteria of acute stress disorder. In the clinical group, 36.7% obtained full ASD criteria. ASC-Kids could discriminate well between groups. Cronbach's alpha was found to be excellent, and the correlation between the UCLA PTSD RI and ASC-Kids found to be good; both ASC-Kids and UCLA PTSD RI had a good and moderate negative correlation with SOC-13.

CONCLUSION

Adolescent female rape victims were shown to have a very high level of acute stress, and the ASC-Kids was found to have sound psychometrics and can be a valuable screening instrument to support clinicians in their assessments of an indication of adolescents after potentially stressful events such as rape.

Predictors of delayed disclosure of rape in female adolescents and young adults

BACKGROUND

Delayed disclosure of rape has been associated with impaired mental health; it is, therefore, important to understand which factors are associated with disclosure latency. The purpose of this study was to compare various demographics, post-rape characteristics, and psychological functioning of early and delayed disclosers (i.e., more than 1-week post-rape) among rape victims, and to determine predictors for delayed disclosure.

METHODS

Data were collected using a structured interview and validated questionnaires in a sample of 323 help-seeking female adolescents and young adults (12-25 years), who were victimized by rape, but had no reported prior chronic child sexual abuse.

RESULTS

In 59% of the cases, disclosure occurred within 1 week. Delayed disclosers were less likely to use medical services and to report to the police than early disclosers. No significant differences were found between delayed and early disclosers in psychological functioning and time to seek professional help. The combination of age category 12-17 years [odds ratio (OR) 2.05, confidence intervals (CI) 1.13-3.73], penetration (OR 2.36, CI 1.25-4.46), and closeness to assailant (OR 2.64, CI 1.52-4.60) contributed significantly to the prediction of delayed disclosure.

CONCLUSION

The results point to the need of targeted interventions that specifically encourage rape victims to disclose early, thereby increasing options for access to health and police services.

Sexual assault: a descriptive study of 2500 female victims over a 10-year period

OBJECTIVE

To describe the victims of sexual assault and the circumstances in which the assaults occur.

DESIGN

Descriptive case study.

SETTING

Centre for Victims of Sexual Assault (CVSA), Rigshospitalet, Copenhagen, Denmark.

POPULATION OR SAMPLE

A total of 2541 women attending CVSA from 2001 to 2010.

METHODS

All women attending CVSA underwent a standardised data collection procedure. Descriptive bivariate analysis and logistic regression analysis were performed.

MAIN OUTCOME MEASURES

Associations between different assault characteristics and (1) the age of the victim and (2) the relationship between victim and perpetrator.

RESULTS

Two-thirds of the victims were aged 15-24 years. Seventy-five percent had met the perpetrator before the sexual assault and 70% reported the assault to the police. A physical injury was found in 53, and 27% sustained an anogenital lesion. Alcohol was involved in 60% of the cases. One-third of the victims had experienced a previous sexual assault(s). Women were more likely to report to the police when they were assaulted by a stranger (odds ratio [OR] 1.9, 95% confidence interval [95% CI] 1.3-2.6) and sustained a physical injury (OR 1.7, 95% CI 1.4-2.2) or anogenital lesion (OR 1.5, 95% CI 1.1-2.0). Women aged 45 years or older were more likely to sustain a physical injury (OR 2.0, 95% CI 1.2-3.2) or an anogenital lesion (OR 2.1, 95% CI 1.4-3.2).

CONCLUSIONS

Our results challenge the typical stereotype of a violent rape attack by a stranger, which is important in creating an environment where women are not reluctant to seek help after a sexual assault. Young age and drinking alcohol were risk factors for sexual assault, and we need to address this when considering preventive strategies.

Strong association between earlier abuse and revictimization in youth

Background

Violence victimization among youth is recognized as a public health problem. The objective was to analyze the risk pattern of emotional, physical, and sexual abuse during the past 12 months by gender, sociodemographic factors, health risk behaviors, and exposure to abuse before the age of 15, among young men and women attending youth health centers in Sweden.

Methods

A cross-sectional survey was conducted using a nationally representative sample of youth health centers. A total of 2,250 young women and 920 young men aged 15–23 completed a self-administered questionnaire. Odds ratios (OR) and adjusted odds ratios (AOR) with 95% CI were calculated.

Results

A consistent and strong association was noted between exposure to all types of violence during the past year and victimization before the age of 15 for all types of violence for both women and men. The only exceptions were childhood sexual victimization and sexual violence during the past year for men. Younger age was associated with all violence exposure for the women and with emotional violence for the men. For the women, drug use was associated with all types of violence, while the association with hazardous alcohol use and not living with parents was restricted to physical and sexual violence exposure, present smoking was restricted to emotional and physical violence exposure, and partnership and living in urban areas were restricted to sexual violence. For men, not being partnered, hazardous alcohol consumption, and drug use meant increased risk for physical violence, while smoking and living in urban areas were associated with sexual violence. After adjustment, immigration had no association with violence exposure.

Conclusions

Violence victimization in young men and women is often not a single experience. Findings underline the importance of early interventions among previously abused youth.

Victims' use of professional services in a Dutch sexual assault centre

BACKGROUND

Prior research endorsed the establishment of sexual assault centres in the Netherlands because of the potential benefit for victims' mental recovery. In 2012, the first Dutch sexual assault centre was founded at the University Medical Center Utrecht. The aim of the centre is to provide 24/7 coordinated and integrated services (i.e., medical, forensic, and psychological) in one location.

OBJECTIVE

The purpose of the present study was to describe demographic, background, and assault characteristics of victims seen at the centre within one week post-assault, and their use of post-assault services in order to improve current services.

METHOD

From January 2012 to September 2013, prospective data of 108 patients were collected. To describe the population included, frequency counts and proportions were generated for categorical variables.

RESULTS

The mean age was 21.3 years (SD=9.8). Most victims were female (91.7%). A large proportion of victims reported background characteristics known to increase the risk for post-traumatic stress disorder (PTSD) and revictimisation such as prior sexual abuse (32.4%), pre-existing use of mental health services (45.4%), and not living with both biological parents (61.7%). Most patients (88.9%) consulted the centre within 72 hours post-assault. The uptake of services was high: 82.4% received emergency medical care, 61.7% underwent a forensic-medical exam, 34% reported to the police, and 82.4% utilised psychological services.

CONCLUSION

To prevent revictimisation and PTSD, current psychological services could be improved with immediate trauma-focused treatments. Current forensic services may be improved with the use of standard top to toe forensic-medical examinations for both children and adults.

Relationship of childhood trauma to depression and smoking outcomes in pregnant smokers

OBJECTIVE

We evaluated whether childhood trauma moderated the treatment effect on depression and smoking outcomes in pregnant smokers.

METHOD

The sample included pregnant smokers participating in a randomized trial evaluating the efficacy of a 10-session interpersonally focused therapy-cognitive behavioral analysis system of psychotherapy (CBASP)-versus a time-matched health and wellness control (HW) for smoking cessation and depression reduction. Women (N = 248) who completed the Childhood Trauma Questionnaire (CTQ) were included. On average, women were 25 years old (SD = 5.91) and smoked 10 (SD = 6.9) cigarettes per day. Depressive symptoms were assessed with the Center for Epidemiological Studies Depression Scale (CES-D), and women had an average score of 21 (SD = 11.03). Seventy-six percent of women had experienced some form of moderate to severe childhood trauma as assessed by the CTQ.

RESULTS

In women with a history of moderate to severe childhood trauma, there was a dose-response association of treatment on depression outcome through 6 months postpartum; those with increasing amounts of childhood trauma benefitted more from CBASP, whereas those in the HW condition did not. Childhood trauma did not moderate the treatment effect on abstinence, although increasing amounts of trauma were associated with reduced likelihood of abstinence at 6 months posttreatment.

CONCLUSIONS

An interpersonally focused therapy may be beneficial for the treatment of depression during the prenatal period in pregnant smokers with childhood trauma histories, and such treatment becomes increasingly more important with cumulative trauma experience. Childhood trauma increases risk for cessation failure in pregnant smokers. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

A comparative analysis of victims of sexual assault with and without mental health histories: acute and follow-up care characteristics

Sexual assault is a common and serious health issue that is underreported and has low follow-up rates. The myriad of psychological sequelae of sexual assault are well documented; however, there is a dearth of literature on the prevalence of preexisting mental health issues in survivors of sexual assault. This exploratory study compares victims seen at a sexual assault treatment center with and without preexisting self-reported mental health histories. The rates of preexisting mental illness in sexual assault victims are significant. Implications for clinical practice and research are discussed.

Forced intercourse, individual and family context, and risky sexual behavior among adolescent girls

PURPOSE

This study tested the hypothesis that individual and family factors associated with adolescent risky sexual behavior (RSB) operate differently in their relationship to RSB among girls who have experienced forced sexual intercourse (FSI), as compared to those girls who have not.

METHODS

Data were collected from 3,863 eighth-grade girls from a larger statewide sample. Different subgroups of participants received different sets of questions, so 655-2,548 students were included in each analysis. Multilevel modeling was used to examine relationships of individual (social negotiation skills, personal safety, depression, and sensation-seeking personality) and family factors (sibling deviance, parental monitoring, and quality of family relationships) to RSB. FSI was examined as a predictor of RSB and as a moderator of the relationship between individual and family variables and sexual risk.

RESULTS

In the case of individual predictors, social negotiation skills were associated with lower RSB for all girls, but these skills had a stronger relationship to RSB among girls who had experienced FSI. Depression and sensation-seeking tendencies had small positive relationships to RSB for all girls. In the case of family predictors, for girls without a history of FSI, parental monitoring was associated with lower RSB. However, among girls who had experienced FSI, parental monitoring was not significantly related to RSB, but sibling deviance was associated with lower RSB.

CONCLUSIONS

Results suggest that social negotiation skills and parental monitoring may warrant further attention in research and intervention.

Longitudinal examination of PTSD symptoms and problematic alcohol use as risk factors for adolescent victimization

The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.