1
|
Allison MK, Henderson H, Curran G, Zielinski MJ. Emergency Department Nurses' Perceptions of Patient Substance Use, Impact on Sexual Assault Care, and Access to Follow-up Behavioral Health Resources. J Emerg Nurs 2022; 48:698-708. [PMID: 36075768 PMCID: PMC9669220 DOI: 10.1016/j.jen.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 06/30/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patients may present to the emergency department for sexual assault care under the influence of drugs or alcohol. However, many emergency nurses are not prepared to meet their unique needs or aware of follow-up behavioral health resources. The purpose of this study was to (1) summarize current resources provided to patients and processes for referral to behavioral health services after sexual assault care, (2) explore emergency nurses' attitudes and behaviors toward patient substance use, and (3) explore nurses' perceptions of adjunct mobile health interventions for follow-up behavioral health care and describe anticipated barriers to use. METHODS Fifteen emergency nurses participated in semi-structured qualitative interviews. RESULTS Participants had mixed perceptions of patient intoxication during sexual assault care. They felt that conversations about substance use may be more appropriate after the ED visit. Participants recognized the opportunity to connect ED patients with substance use treatment or prevention resources but perceived that there are few local service providers. Most participants were not referring patients with substance use issues to behavioral health services after sexual assault care and said that their emergency departments did not have processes for referral to these services. Acceptability of mobile health for follow-up behavioral health care was high, but participants had concerns for patient privacy and internet access. Participants gave recommendations to improve referral practices and patient engagement with mobile health interventions. DISCUSSION This study highlights the need for emergency nurses to consider patient intoxication during sexual assault care and opportunities to connect patients with resources post-assault.
Collapse
Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Hannah Henderson
- Psychiatric Research Institute, University of Arkansas for Medical Sciences
| | - Geoffrey Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences
| | | |
Collapse
|
2
|
Bogen KW, Jones HR, Lorenz TK. Relational and Trait Factors Mediate the Associations between Women's Intoxication-Related Unwanted Sexual Experiences, Pleasure, and Desire. JOURNAL OF SEX RESEARCH 2022; 59:1175-1191. [PMID: 35262426 PMCID: PMC9458769 DOI: 10.1080/00224499.2022.2030661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Despite documented negative sexual health sequelae of unwanted sexual contact (USC), it is unclear why individuals who have experienced USC within the context of intoxication (intoxication-related USC) are at particular risk for poor sexual functioning. Intoxication-related USC may impact relational factors like relationship satisfaction, as trauma symptoms interfere with emotional closeness during sex. Additionally, although individual traits - such as sexual excitation and sensation seeking - affect the relationship between trauma and sexual functioning, it is unknown whether these factors differentially impact those who have experienced intoxication-related USC. Finally, because presence of a partner may evoke trauma-related symptoms during partnered (dyadic) sexual activity, mediators may differ across solitary versus dyadic sexual pleasure and desire. We tested relational and individual trait mediators of the association between intoxication-related USC and solitary and dyadic sexual pleasure and desire in a sample of heterosexual and sexual minority women. Trait factors consistently mediated the association between intoxication-related USC and both dyadic and solitary desire and pleasure, while relational factors such as emotional closeness were inconsistently related to sexual wellbeing. If replicated, these findings would suggest that trait factors may be useful targets for clinical sexual wellness interventions among sexuality-diverse women who have experienced intoxication-related USC.
Collapse
Affiliation(s)
- Katherine W. Bogen
- University of Nebraska – Lincoln, Department of Psychology; 238 Burnett Hall, Lincoln, NE 68588
- University of Nebraska – Lincoln, Center for Brain, Biology, and Behavior; C89 East Stadium, Lincoln, NE 68588
| | - Harper R. Jones
- University of Nebraska – Lincoln, Department of Psychology; 238 Burnett Hall, Lincoln, NE 68588
- University of Nebraska – Lincoln, Center for Brain, Biology, and Behavior; C89 East Stadium, Lincoln, NE 68588
| | - Tierney K. Lorenz
- University of Nebraska – Lincoln, Department of Psychology; 238 Burnett Hall, Lincoln, NE 68588
- University of Nebraska – Lincoln, Center for Brain, Biology, and Behavior; C89 East Stadium, Lincoln, NE 68588
| |
Collapse
|
3
|
ten Holt J, van Emmerik AA, Blanken P, Borgdorff JE, ten Holt PP, Kok RM, Mouthaan J, Pieterse B, Van den Berg JF. Direct and Indirect Exposure to Trauma, Posttraumatic Stress Disorder Symptoms, and Poor Subjective Sleep Quality in Patients with Substance Use Disorder. PSYCHIAT CLIN PSYCH 2022; 32:188-195. [PMID: 38766672 PMCID: PMC11099636 DOI: 10.5152/pcp.2022.22368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/22/2022] [Indexed: 05/22/2024] Open
Abstract
Background Despite the frequent co-occurrence of posttraumatic stress disorder and substance use disorder, screening for trauma exposure and posttraumatic stress disorder symptoms is not a routine practice in substance use disorder clinics. The aims of this study were to examine the prevalence of exposure to traumatic events, posttraumatic stress disorder symptoms, and subjective sleep quality in substance use disorder inpatients after detoxification. In addition, we analyzed associations of sociodemographics, direct and indirect exposure to traumatic events, and sleep quality with posttraumatic stress disorder symptom severity. Methods Adults diagnosed with substance use disorder (n = 188; 25% women, mean age 46.6 ± 12.3 years) from 2 inpatient addiction clinics were assessed at approximately 4 days post-admission for age, gender, educational level, self-reported substance use, trauma exposure, general and posttraumatic stress disorder-specific subjective sleep quality, and posttraumatic stress disorder symptom severity. Correlates of posttraumatic stress disorder symptom severity were identified with linear regression analyses. Results The prevalence of direct trauma exposure was high (89%), 51% of participants screened positive for posttraumatic stress disorder and 87% reported clinically significant poor sleep quality. Younger age, female gender, direct and indirect exposure to more traumatic events, and poor subjective sleep quality were associated with more severe posttraumatic stress disorder symptoms. Conclusion Nearly all substance use disorder patients admitted for detoxification in our study had been directly or indirectly exposed to 1 or more traumatic events, and many reported posttraumatic stress disorder symptoms and poor sleep quality. Younger and female substance use disorder patients were at higher risk of posttraumatic stress disorder symptoms. Our results emphasize the need for systematic screening for direct and indirect trauma exposure, posttraumatic stress disorder symptoms, and poor sleep quality in patients admitted for clinical substance use disorder treatment.
Collapse
Affiliation(s)
- Julia ten Holt
- Parnassia Addiction Research Centre (PARC), Parnassia Group, The Hague, Netherlands
| | | | - Peter Blanken
- Parnassia Group Academy, Parnassia Group, The Hague, Netherlands
| | - Jesse E. Borgdorff
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Pieter P.C. ten Holt
- Parnassia Addiction Research Centre (PARC), Parnassia Group, The Hague, Netherlands
| | - Rob M. Kok
- Brijder Addiction Treatment Clinic, Parnassia Group, Alkmaar, Netherlands
| | - Joanne Mouthaan
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Bouwe Pieterse
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Julia F. Van den Berg
- Brijder Addiction Treatment Clinic, Parnassia Group, Alkmaar, Netherlands
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
4
|
Nöthling J, Abrahams N, Jewkes R, Mhlongo S, Lombard C, Hemmings SMJ, Seedat S. Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape. J Affect Disord 2022; 309:151-164. [PMID: 35427719 DOI: 10.1016/j.jad.2022.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design. METHODS In a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape. RESULTS The incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores. LIMITATIONS We could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment. CONCLUSION Addressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.
Collapse
Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa.
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Carl Lombard
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| |
Collapse
|
5
|
Yeater EA, Witkiewitz K, Votaw VR, Ross R, Vitek K, Blackwell M, Sheffield A. Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault Among College Women With Higher Sexual Risk Alcohol Expectancies. J Stud Alcohol Drugs 2022; 83:556-564. [PMID: 35838433 PMCID: PMC9318703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/21/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE College women report high rates of sexual assault. Research focused on women's risk factors for sexual assault remains necessary to assist women in reducing their risk. Previous work has shown alcohol use and cannabis use to be associated with sexual assault. The current study examined whether individual difference variables moderated women's risk for sexual assault during occasions of alcohol use and cannabis use using ecological momentary assessment (EMA). METHOD Participants were 18- to 24-year-old first-year undergraduate women (N = 101) who were unmarried and interested in dating men, consumed three or more alcoholic drinks on one occasion in the month before baseline, and engaged in sexual intercourse at least once. Baseline individual difference variables included sex-related alcohol expectancies, alcohol problems, decision skills, and sexual attitudes. EMA reports, collected three times per day over 42 days, included items regarding alcohol and cannabis use and sexual assault experiences. RESULTS Among women who experienced sexual assault during the EMA period (n = 40), those with higher sexual risk expectancies had a higher probability of sexual assault during occasions when they were using alcohol or cannabis. CONCLUSIONS Several modifiable risk factors for sexual assault and individual differences factors may exacerbate risk. Ecological momentary interventions may be useful to reduce sexual assault risk for women with high sexual risk expectancies who use alcohol or cannabis.
Collapse
Affiliation(s)
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Victoria R. Votaw
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Ryan Ross
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Kristen Vitek
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Meredith Blackwell
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Alexis Sheffield
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| |
Collapse
|
6
|
Oulasmaa L, Riipinen P, Hakko H, Riala K, Kantojärvi L. Sex-Specific Predictors of Exposure to Hospital-Treated Assaults Among Former Adolescent Psychiatric Inpatients. VIOLENCE AND VICTIMS 2021; 36:751-769. [PMID: 34980584 DOI: 10.1891/vv-d-19-00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study examined the associations of psychiatric disorders, suicidal behavior and family-related characteristics during adolescence, to subsequent experiences of hospital-treated physical, or sexual assaults, among 508 young adults with a history of psychiatric inpatient care at adolescence (aged 13-17 years). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) based adolescent psychiatric disorders were assessed at index hospitalization using Schedule for Affective Disorder and Schizophrenia for School-Age children, Present and Lifetime version (K-SADS-PL). Treatment episodes for assaults were obtained from the health care register, provided by the Finnish National Institute for Health Welfare. About 14.4% of the participants had experienced physical or sexual assault during their lifetime. Results of logistic regression analysis indicated that anxiety disorder (odds ratio [OR] = 9.6) and nonsuicidal self-injury (OR = 3.7) in adolescence for males, and personality disorder (OR = 3.4) for females, were associated with increased likelihood for subsequent assault exposure leading to hospitalization. These findings can be used in targeting vulnerable adolescents and designing primary prevention strategies.
Collapse
Affiliation(s)
- Lauri Oulasmaa
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Pirkko Riipinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Kaisa Riala
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Liisa Kantojärvi
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
7
|
Dir AL, Hahn C, Jaffe AE, Stanton K, Gilmore AK. Depressive Symptoms Following Recent Sexual Assault: The Role of Drug and Alcohol Use, Acute Stress, and Assault Characteristics. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:5900-5913. [PMID: 30353780 PMCID: PMC6656621 DOI: 10.1177/0886260518803605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Sexual assault is a common traumatic experience that can have a wide-ranging impact on psychological functioning, including experience of depressive symptoms. Although many studies have examined lifetime rates of depression among those with sexual assault history, less is known regarding risk factors for depressive symptoms following recent sexual assault. The study examined whether drug use history is uniquely related to depressive symptoms following recent assault. N = 65 individuals, 95.4% female; 73.8% White; M(SD)age = 28.89 (10.29), who had recently experienced sexual assault (less than 60 days) and completed a SAMFE (sexual assault medical forensic examination) were interviewed via phone and completed questionnaires regarding depressive and acute/post-traumatic stress symptoms and substance use history. Demographic information as well as information related to the assault was also collected. 68.7% of the sample reported clinically significant levels of depressive symptoms (PHQ-9, Patient Health Questionnaire, scores ⩾ 12). In a linear regression adjusted for acute/post-traumatic stress (b = 0.26, p < .01) and other variables, polydrug use was significantly associated with depressive symptoms (b = 3.26, p = .04). Single-drug use (b = 0.96), physically forced sexual assault (b = -1.11), victim-perpetrator relationship (b = 0.15), prior sexual assault (b = -1.02), alcohol misuse (b = -0.09), age (b = 0.07), race (b = 2.78), and days since assault (b = -0.02) were not significantly associated with depressive symptoms (all ps > .05). Results highlight the potential role of drug use history in increasing risk of experiencing clinically significant depressive symptoms following recent assault.
Collapse
Affiliation(s)
- Allyson L. Dir
- Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Christine Hahn
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Anna E. Jaffe
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Kimberly Stanton
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Amanda K. Gilmore
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- College of Nursing, Medical University of South Carolina, Charleston, SC
| |
Collapse
|
8
|
Baiden P, Xiao Y, Asiedua-Baiden G, LaBrenz CA, Boateng GO, Graaf G, Muehlenkamp JJ. Sex differences in the association between sexual violence victimization and suicidal behaviors among adolescents. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
|
9
|
Brooker C, Hughes E, Lloyd-Evans B, Stefanidou T. Mental health pathways from a sexual assault centre: A review of the literature. J Forensic Leg Med 2019; 68:101862. [PMID: 31479796 DOI: 10.1016/j.jflm.2019.101862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/30/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022]
Abstract
The recent long-term NHS plan calls for improvements to the mental health of those attending a Sexual Assault Referral Centre (SARCs). The assessment of mental health is currently the subject of a systematic review being undertaken as part of the MiMoS project. However, there is a literature that examines mental health outcomes following attendance at a SARC. We review these studies and consider the implications for SARCs in England.
Collapse
Affiliation(s)
- C Brooker
- Royal Holloway, University of London, United Kingdom.
| | - E Hughes
- University of Leeds, United Kingdom
| | - B Lloyd-Evans
- Mental Health and Social Care, University College London, United Kingdom
| | - T Stefanidou
- Mental Health and Social Care, University College London, United Kingdom
| |
Collapse
|
10
|
Rabinovitz S, Goldman K, Rosca P, Barda J, Levine SZ. The role of substance use and adult sexual assault severity in the course of schizophrenia: An epidemiological catchment study of sexual assault victims. Schizophr Res 2019; 208:406-413. [PMID: 30654922 DOI: 10.1016/j.schres.2019.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 01/05/2019] [Accepted: 01/05/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Childhood trauma increases the risk of schizophrenia, yet the role of adult sexual assault in the course of schizophrenia is unknown. This study aims to examine the associations between substance use and sexual assault severity characteristics with the course of schizophrenia among adult sexual assault victims using an epidemiologic study design. METHODS Sexual assault data on all individuals received from 2000 to 2010 (N = 2147) at the Center for Care of Sexual Assault Victims at Wolfson Medical Center, the largest medical center for sexual assault victims in the country, were merged with the Israel National Psychiatric Case Registry, that consisted of lifetime psychiatric hospitalizations of schizophrenia (birth to 6 years post-assault). The associations between substance use and adult sexual assault severity characteristics with hospitalizations were quantified using recurrent events Cox modeling. RESULTS Schizophrenia with sexual assault survivors occurred in 117 persons. Cox modeling showed that recurrent psychiatric hospitalizations were associated with younger age, sexual assault at older age, previous diagnosis of psychosis, and drug use shortly before or during the assault. Other assault characteristics (number of assailants, means of subdual, penetration type, perpetrator violence, physical injury of the victim) and immediacy of seeking help had a null association with the course of psychiatric hospitalization. These results replicated in two sensitivity analyses. CONCLUSIONS Substance use among victims of sexual assault was associated with an exacerbated course of schizophrenia, pointing to a possibly modifiable risk factor that should be targeted in prevention, assessment, treatment formulation and implementation.
Collapse
Affiliation(s)
- Sharon Rabinovitz
- School of Criminology and The Unit for Excellence in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University of Haifa, Haifa, Israel.
| | - Keren Goldman
- School of Criminology and The Unit for Excellence in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University of Haifa, Haifa, Israel; Department for the Treatment of Substance Abuse, Ministry of Health, Jerusalem, Israel
| | - Paula Rosca
- Department for the Treatment of Substance Abuse, Ministry of Health, Jerusalem, Israel; The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Julia Barda
- Department of Obstetrics and Gynecology, The Center for Care of Sexual Assault Victims, Wolfson Medical Center, Holon, Israel
| | - Stephen Z Levine
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
11
|
Ceelen M, Dorn T, van Huis FS, Reijnders UJL. Characteristics and Post-Decision Attitudes of Non-Reporting Sexual Violence Victims. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:1961-1977. [PMID: 27402581 DOI: 10.1177/0886260516658756] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although the physical and psychological consequences of sexual violence can be severe, many victims do not report the violence to the police force. The current study examined the characteristics and the post-decisional attitude of the non-reporting sexual violence victims. In total, 287 victims of sexual violence completed an anonymous online questionnaire that assessed characteristics of the violence, whether or not the crime was reported, reasons for not reporting, and aspects that would have convinced non-reporters to report in retrospect. Eighty percent of the victims did not report the most recent sexual violence incident to the police ( n = 229). Nevertheless, 65% of the non-reporting victims ( n = 148) in retrospect would have reported to the police ("potential reporters"). Specific reasons for non-reporting and incident characteristics appear to relate to the post-decision attitude of non-reporting victims of sexual violence. "Lack of evidence" and "feelings of shame, guilt, and other emotions" appear to be more frequently mentioned by potential reporters as reasons for their decision to not report as compared with the definitive non-reporters. Likewise, being raped or sexually assaulted is predictive of potential reporting. Our findings are useful for policy makers to develop strategies to increase reporting rates of sexual violence victims.
Collapse
Affiliation(s)
- Manon Ceelen
- 1 Public Health Service, Amsterdam, The Netherlands
| | - Tina Dorn
- 1 Public Health Service, Amsterdam, The Netherlands
| | | | | |
Collapse
|
12
|
Vik BF, Nöttestad JA, Schei B, Rasmussen K, Hagemann CT. Psychosocial Vulnerability Among Patients Contacting a Norwegian Sexual Assault Center. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:2138-2157. [PMID: 27449896 DOI: 10.1177/0886260516659657] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this study, the objective was to assess the occurrence of specific vulnerability factors among adult and adolescent females attending a Norwegian sexual assault center (SAC). We also explored assault characteristics and investigated whether these characteristics differed between the group of patients with vulnerability factors compared with the group without such factors. We conducted a retrospective descriptive study of 573 women ≥ 12 years of age attending the SAC at St. Olavs Hospital, Trondheim, Norway, between July 1, 2003 and December 31, 2010. A patient was considered vulnerable if at least one of the following features was present: intellectual or physical disability; history of present/former mental health problems; history of present/former alcohol/substance abuse; or former sexual assault. At least one vulnerability factor was present in 59% of the cases. More than one vulnerability factor was present in 29%. Reporting at least one vulnerability factor was associated with a higher patient age, unemployment, a higher frequency of reported light/moderate physical violence, and the documentation of minor body injury. In contrast, those without vulnerability more often were students assaulted during night time, by a casual or stranger assailant and reporting a higher intake of alcohol prior to the assault. There are obvious patterns of differences in the nature of sexual assaults reported among victims with specific vulnerability factors compared with victims without these factors. Future research should address these differences and possible solutions for better protection of especially vulnerable individuals against sexual offenses, such as those with mental health and substance abuse difficulties.
Collapse
Affiliation(s)
- Bjarte Frode Vik
- 1 Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- 2 St. Olavs University Hospital, Trondheim, Norway
| | - Jim Aage Nöttestad
- 1 Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- 2 St. Olavs University Hospital, Trondheim, Norway
| | - Berit Schei
- 1 Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- 2 St. Olavs University Hospital, Trondheim, Norway
| | - Kirsten Rasmussen
- 1 Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- 2 St. Olavs University Hospital, Trondheim, Norway
| | - Cecilie Therese Hagemann
- 1 Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- 2 St. Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
13
|
Caravaca Sánchez F, Navarro Zaragoza J, Fearn NE, Vaughn MG. The Nexus of Trauma, Victimization, and Mental Health Disorders Among Incarcerated Adults in Spain. Psychiatr Q 2017; 88:733-746. [PMID: 28120281 DOI: 10.1007/s11126-017-9493-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Victimization and exposure to trauma, commonly linked to co-occurring mental health disorders, are prevalent among prison populations. The purpose of this study is to shed light on the prevalence of various kinds of victimization and trauma exposure at distinct life stages (childhood, adulthood and during prison) among incarcerated persons in Spain. The research team surveyed a random sample of 453 male and female inmates, serving time in two Spanish prisons, to gather information on experiences of physical and sexual victimization in both childhood and adulthood along with the presence or absence of in-prison treatment for a mental health disorder(s). More than 80% of participants reported experiencing some kind of traumatic/shocking life event - and this was significantly higher for those receiving in-prison mental health treatment than their non-treated counterparts (96.3 versus 83.3%, respectively). Logistic regression analyses revealed that inmates who were receiving in-prison treatment for a mental health disorder reported significantly higher rates of both physical and sexual victimization in prison, prior to prison, and during childhood. The results of this study strongly suggest the importance of comprehensive and accurate identification of inmates' traumatic, victimization, and mental health histories that necessitate treatment during incarceration. We discuss the implications of our study for correctional practice, policy and future research in order to reduce victimization in the Spanish Prison System.
Collapse
Affiliation(s)
| | - Javier Navarro Zaragoza
- Department of Forensic Medicine, School of Medicine, University of Murcia, Espinado, E-30100, Murcia, Spain
| | - Noelle E Fearn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| |
Collapse
|
14
|
Walsh K, Gilmore AK, Frazier P, Ledray L, Acierno R, Ruggiero KJ, Kilpatrick DG, Resnick HS. A Randomized Clinical Trial Examining the Effect of Video-Based Prevention of Alcohol and Marijuana Use Among Recent Sexual Assault Victims. Alcohol Clin Exp Res 2017; 41:2163-2172. [PMID: 28940320 DOI: 10.1111/acer.13505] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 09/12/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND This study examined whether a brief video intervention (Prevention of Post-Rape Stress [PPRS]) delivered in the emergency department to recent sexual assault (SA) victims reduced alcohol and marijuana use at 3 points over the course of a 6-month follow-up compared to treatment as usual (TAU) and an active control condition (Pleasant Imagery and Relaxation Instruction [PIRI]). Prior assault history, minority status, and pre-SA substance use also were examined as moderators of intervention efficacy. METHODS Women aged 15 and older (N = 154) who participated in a post-SA medical forensic examination were randomly assigned to watch the PPRS video (n = 54) or the PIRI video (n = 48) or receive TAU (n = 52) and completed at least 1 follow-up assessment targeted at 1.5 (T1), 3 (T2), or 6 (T3) months following the examination. RESULTS Regression analyses revealed that, relative to TAU, PPRS was associated with less frequent alcohol use at 6 months post-SA among women reporting pre-SA binge drinking and minority women. Relative to TAU, PPRS also was associated with fewer days of marijuana use at T1 among those who did not report pre-SA marijuana use and prior SA. Findings for pre-SA marijuana use were maintained at T3; however, findings for prior SA shifted such that PPRS was associated with fewer days of marijuana use at T3 for women with a prior SA. CONCLUSIONS PPRS may be effective at reducing substance use for some recent SA victims, including those with a prior SA history, a prior substance use history, and minority women.
Collapse
Affiliation(s)
- Kate Walsh
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Amanda K Gilmore
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Linda Ledray
- Sane Sart Resource Service, Minneapolis, Minnesota
| | - Ron Acierno
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina
| | - Dean G Kilpatrick
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina
| | - Heidi S Resnick
- Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
15
|
Parks KA, Frone MR, Muraven M, Boyd C. Nonmedical use of prescription drugs and related negative sexual events: Prevalence estimates and correlates in college students. Addict Behav 2017; 65:258-263. [PMID: 27567398 DOI: 10.1016/j.addbeh.2016.08.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/19/2016] [Accepted: 08/13/2016] [Indexed: 11/17/2022]
Abstract
The present study of college students investigated (a) the prevalence of nonmedical use of three classes of prescription drugs (stimulants, anxiolytics/sedatives, analgesics), (b) the prevalence of negative sexual events (NSE) associated with any nonmedical use of prescription drugs (NMUPD), and (c) a set of correlates of NSE. The specific NSE were sexual aggression victimization and perpetration, and regretted sex. The correlates of the NSE were sex, race/ethnicity, year in school, psychological symptoms, alcohol use, illegal drug use, and NMUPD. Participants were 509 (254 females, 255 males) randomly-selected college students who reported any NMUPD. The majority (76.2%) of the sample reported ever using stimulants, 38.9% reported ever using anxiolytics/sedatives, and 40.9% reported using analgesics. During NMUPD, 14.3% of the students reported regretted sex, 7.1% of female students reported sexual victimization, and 6.3% of male students reported perpetrating sexual aggression. Multiple logistic regression analyses indicated that anxiolytic/sedative use (Adj. OR=1.99; 95% CI=1.51-2.62) was positively associated with regretted sex, whereas anxiolytic/sedative use (Adj. OR=1.79; 95% CI=1.01-3.16) and psychological symptoms (Adj. OR=1.06; 95% CI=1.02-1.10) were positively associated with sexual victimization. Illegal drug use was positively associated with perpetrating sexual aggression (Adj. OR=4.10; 95% CI=1.21-13.86). These findings suggest that among these college students, NMUPD-associated NSE were not uncommon, and primarily associated with anxiolytic/sedative use. Given the academic, physical, and psychological implications associated with NSE, research needs to further explore the causal nature of these relations.
Collapse
Affiliation(s)
- Kathleen A Parks
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203, USA.
| | - Michael R Frone
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Mark Muraven
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY 12222, USA
| | - Carol Boyd
- UM Addiction Research Center, School of Nursing and Women's Studies Department, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48108, USA
| |
Collapse
|
16
|
Langdon KJ, Rubin A, Brief DJ, Enggasser JL, Roy M, Solhan M, Helmuth E, Rosenbloom D, Keane TM. Sexual Traumatic Event Exposure, Posttraumatic Stress Symptomatology, and Alcohol Misuse Among Women: A Critical Review of the Empirical Literature. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kirsten J. Langdon
- National Center for PTSD; Women's Health Sciences Division; VA Boston Healthcare System; Boston University School of Medicine
| | - Amy Rubin
- National Center for PTSD; VA Boston Healthcare System; Boston University School of Medicine
| | - Deborah J. Brief
- National Center for PTSD; VA Boston Healthcare System; Boston University School of Medicine
| | | | - Monica Roy
- VA Boston Healthcare System; Boston University School of Medicine
| | - Marika Solhan
- VA Boston Healthcare System; Boston University School of Medicine
| | - Eric Helmuth
- National Center for PTSD; Boston University School of Public Health
| | - David Rosenbloom
- National Center for PTSD; Boston University School of Public Health
| | - Terence M. Keane
- National Center for PTSD; VA Boston Healthcare System; Boston University School of Medicine
| |
Collapse
|
17
|
Stahlman S, Javanbakht M, Cochran S, Hamilton AB, Shoptaw S, Gorbach PM. Mental Health and Substance Use Factors Associated With Unwanted Sexual Contact Among U.S. Active Duty Service Women. J Trauma Stress 2015; 28:167-73. [PMID: 25976935 PMCID: PMC4522288 DOI: 10.1002/jts.22009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Many U.S. military women are exposed to unwanted sexual contact during military service, which can have important implications for mental health. Using data from the 2008 Department of Defense Survey of Health Related Behaviors, we employed multiple logistic regression methods to examine whether unwanted sexual contact was associated with stress, screening positive for mental disorders, or substance use, among active duty service women. The sample included 7,415 female military personnel, of whom 13.4% reported unwanted sexual contact (including any touching of genitals) since entering the military. After adjusting for potentially confounding variables, factors independently associated with unwanted sexual contact included military-related stress (adjusted odds ratio [AOR] = 2.44), family/personal life-related stress (AOR = 1.78), and gender-related stress (AOR = 1.98) in the past 12 months. In addition, screening positive for depression, anxiety, posttraumatic stress disorder, or psychological distress, and suicidal ideation or attempt were associated with unwanted sexual contact (AOR = 1.57-2.11). For drug/alcohol use, only misuse of tranquilizers/muscle relaxers (past 12 months) was associated with report of unwanted sexual contact (AOR = 1.35). Given the prevalence of unwanted sexual contact and corresponding adverse health outcomes in this sample of active duty women, strategies to create military structural/cultural changes and reduce gender-related stress and sexism are needed.
Collapse
Affiliation(s)
- Shauna Stahlman
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| | - Susan Cochran
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| | - Alison B. Hamilton
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Los Angeles California, USA,VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles; Los Angeles California, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| |
Collapse
|
18
|
Folgar MI, Rivera FF, Sierra JC, Vallejo-Medina P. Binge drinking: conductas sexuales de riesgo y drogas facilitadoras del asalto sexual en jóvenes españoles. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.sumpsi.2015.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Price M, Davidson TM, Ruggiero KJ, Acierno R, Resnick HS. Predictors of using mental health services after sexual assault. J Trauma Stress 2014; 27:331-7. [PMID: 24852357 PMCID: PMC4161950 DOI: 10.1002/jts.21915] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Sexual assault increases the risk for psychopathology. Despite the availability of effective interventions, relatively few victims who need treatment receive care in the months following an assault. Prior work identified several factors associated with utilizing care, including ethnicity, insurance, and posttraumatic stress disorder (PTSD) symptoms. Few studies, however, have examined predictors of treatment utilization prospectively from the time of assault. The present study hypothesized that White racial status, younger age, being partnered, having health insurance, having previously received mental health treatment, and having more PTSD and depression symptoms would predict utilization of care in the 6 months postassault. This was examined in a sample of 266 female sexual assault victims with an average age of 26.2 years, of whom 62.0% were White and 38.0% were African American assessed at 1.5 and 6 months postassault. Available information on utilizing care varied across assessments (1.5 months, n = 214; 3 months, n = 126; 6 months, n = 204). Significant predictors included having previously received mental health treatment (OR = 4.09), 1 day depressive symptoms (OR = 1.06), and having private insurance (OR = 2.24) or Medicaid (OR = 2.19). Alcohol abuse and prior mental health care were associated with a substantial increase in treatment utilization (OR = 4.07). The findings highlight the need to help victims at risk obtain treatment after sexual assault.
Collapse
Affiliation(s)
- Matthew Price
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Tatiana M. Davidson
- National Crime Victims Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kenneth J. Ruggiero
- National Crime Victims Center, Medical University of South Carolina, Charleston, South Carolina, USA,Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Ron Acierno
- National Crime Victims Center, Medical University of South Carolina, Charleston, South Carolina, USA,Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Heidi S. Resnick
- National Crime Victims Center, Medical University of South Carolina, Charleston, South Carolina, USA
| |
Collapse
|
20
|
Walsh K, Resnick HS, Danielson CK, McCauley JL, Saunders BE, Kilpatrick DG. Patterns of drug and alcohol use associated with lifetime sexual revictimization and current posttraumatic stress disorder among three national samples of adolescent, college, and household-residing women. Addict Behav 2014; 39:684-9. [PMID: 24370205 DOI: 10.1016/j.addbeh.2013.12.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 11/18/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
Abstract
Sexual revictimization (experiencing 2 or more rapes) is prevalent and associated with increased risk for posttraumatic stress disorder (PTSD) and substance use. However, no national epidemiologic studies have established the prevalence or relative odds of a range of types of substance use as a function of sexual victimization history and PTSD status. Using three national female samples, the current study examined associations between sexual revictimization, PTSD, and past-year substance use. Participants were 1763 adolescent girls, 2000 college women, and 3001 household-residing women. Rape history, PTSD, and use of alcohol, marijuana, other illicit drugs, and non-medical prescription drugs were assessed via structured telephone interviews of U.S. households and colleges in 2005-2006. Chi-square and logistic regression were used to estimate the prevalence and odds of past-year substance use. Relative to single and non-victims: Revictimized adolescents and household-residing women reported more other illicit and non-medical prescription drug use; revictimized college women reported more other illicit drug use. Past 6-month PTSD was associated with increased odds of drug use for adolescents, non-medical prescription drug use for college women, and all substance use for household-residing women. Revictimization and PTSD were associated with more deviant substance use patterns across samples, which may reflect self-medication with substances. Findings also could be a function of high-risk environment or common underlying mechanisms. Screening and early intervention in pediatric, primary care, and college clinics may prevent subsequent rape, PTSD, and more severe substance use.
Collapse
|
21
|
Cheney AM, Booth BM, Davis TD, Mengeling MA, Torner JC, Sadler AG. The role of borderline personality disorder and depression in the relationship between sexual assault and body mass index among women veterans. VIOLENCE AND VICTIMS 2014; 29:742-756. [PMID: 25905125 DOI: 10.1891/0886-6708.vv-d-12-00171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article examines lifetime sexual assault (LSA) and mental health history as risk factors associated with body mass index (BMI) in a population of women veterans. This cross-sectional study of a retrospective cohort of 948 Veterans Affairs (VA)-enrolled midwestern enlisted rank women veterans included computer-assisted telephone interviews. Findings show that 33.4% of the participants had a BMI of 30.0 or more meeting the criteria for obesity and 62.5% reported lifetime attempted or completed sexual assault. Greater BMI was positively associated with older age, less education, LSA, depression, and borderline personality disorder (BPD) and negatively associated with current substance use disorder in multivariate models. Mediation analysis found that the relationship between sexual assault and BMI was completely mediated by BPD and depression. Interventions should combine physical and mental health care in gender-specific services for overweight women veterans with trauma histories and mental health conditions.
Collapse
|