Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis

Effects of Social Acknowledgment and Interpersonal Shame on Complex Posttraumatic Stress Disorder Symptoms of Sexual Violence Survivors in South Korea

Sexual violence (SV) survivors face negative social reactions, which can affect their recovery. Based on the socio-interpersonal model of trauma, understanding how societal circumstances impact SV survivors' mental health is important. This study examined conditional indirect effects of interpersonal shame and social acknowledgment on the relationship between perceived SV event severity and complex post-traumatic stress disorder (CPTSD) symptoms. Cross-sectional data from 157 community-based adults who had previously experienced SV were collected from an online panel. Exploratory factor analysis of the Social Acknowledgment Questionnaire was conducted, followed by conditional indirect analyses using Models 1, 4, and 7 of PROCESS macro. First, results showed that a two-factor model of social acknowledgment consisting of "social disapproval" and "social recognition" was more suitable for this study than a three-factor model predominantly used by Western societies. Second, interpersonal shame partially mediated the relationship between perceived SV event severity and CPTSD symptoms. Third, the conditional indirect effect of social disapproval on the mediating effect of interpersonal shame was significant when the social disapproval level was high. This indicates that the indirect effect of interpersonal shame on CPTSD increases when the social disapproval level is high. This study supported the socio-interpersonal perspective of trauma and suggested that increasing social acknowledgment beyond personal-level intervention would be a critical step for recovery of SV survivors to decrease their interpersonal shame and CPTSD.

The Role of Shame in Associations with PTSD and Depression Symptoms and Hazardous Drinking Among Bisexual Women Who Experienced Sexual Violence

Bisexual (i.e. those with attraction to multiple genders) women experience disparities in sexual violence and mental health outcomes, including PTSD, depression, and hazardous drinking, compared to lesbian and heterosexual women. Unique stigma due to bisexual identity (antibisexual stigma), negative reactions to sexual violence (SV) disclosure (e.g. victim blaming), and prior child sexual abuse (CSA) may all contribute to shame. We tested whether shame explained the associations of antibisexual stigma, negative reactions to SV disclosure, and CSA severity with PTSD symptoms, depression, and hazardous drinking among young bisexual women. Participants who self-identified as bisexual women, between the ages of 18-35, residing in the US were recruited via Amazon's Mechanical Turk (MTurk) and completed online questionnaires. Women who reported SV since age 18 that they disclosed to someone were included in the current study, yielding a sample of 156 bisexual women (Mage = 25.7; 98.1% cisgender, 86.5% White). Path analysis with bias-corrected bootstrapping was conducted. There were significant direct effects of negative reactions on hazardous drinking and CSA on PTSD, and direct effects of shame on PTSD and depression symptoms. Shame explained the associations of antibisexual stigma, negative reactions, and CSA with PTSD symptoms, depression symptoms, and hazardous drinking. Shame may explain why stigmatizing experiences related to bisexual identity, sexual violence, and CSA history relate to distress among bisexual women. Shame is an important treatment target among bisexual survivors of SV.

The Psychosocial Consequences of Sexual Violence Stigma: A Scoping Review

Over the past decade, scholars have explored whether the stigma associated with sexual violence (SV) represents a risk factor for psychopathology and related comorbidities following SV. We conducted a scoping review to summarize and evaluate the state of this burgeoning literature. We included studies from Pubmed, APA PsychInfo, Embase, CINAHL Plus, Social Science Premium, and Web of Science that quantified stigma related to SV. Studies were screened and abstracted in accordance with the PRISMA-SCR guidelines for scoping reviews. Our final sample contained 62 studies. We address two key questions about SV stigma. First, is SV a stigmatized status? Articles (n = 14) provided evidence for SV stigma among potential stigmatizers (e.g., individuals who may perpetuate stigma) across a range of methods (e.g., vignettes) and outcomes (e.g., desire for social distance). Additional work (n = 20) corroborates perceptions of SV stigma among targets (i.e., SV survivors). Second, what are the psychosocial consequences of SV stigma? We reviewed studies (n = 28) demonstrating that SV stigma is correlated with a range of adverse psychosocial outcomes-including anxiety, depression, posttraumatic stress disorder, problematic drinking, and somatic symptoms-among individuals experiencing multiple types of SV (e.g., childhood sexual abuse and sexual assault). Thus, emerging evidence suggests that SV stigma may be a critical determinant of risk and recovery following SV exposure. However, a number of limitations were observed, including that SV stigma has not been consistently measured and that the literature has not fully incorporated stigma constructs, such as concealment and structural stigma. We offer several recommendations to advance this line of work.

A systematic review of individual, social, and societal resilience factors in response to societal challenges and crises

Societal challenges put public mental health at risk and result in a growing interest in resilience as trajectories of good mental health during stressor exposure. Resilience factors represent multilevel psychosocial resources that increase the likelihood of resilient responses. This preregistered systematic review aims at summarizing evidence on the predictive value of individual, social and societal resilience factors for resilient responses to societal challenges and crises. Eligible studies examined the predictive value of resilience factors in stressor-exposed populations in high-income countries by means of multinomial regression models based on growth mixture modeling. Five databases were searched until August 2, 2023. Data synthesis employed a rating scheme to assess the incremental predictive value of resilience factors beyond sociodemographic variables and other resilience factors. An adapted version of the Newcastle-Ottawa Scale was used for risk of bias assessment. Fifty studies (sample sizes: 360-65,818 participants) with moderate study quality reported on various stressors (e.g., pandemics, natural disasters, terrorist attacks). Higher income, socioeconomic status and perceived social support, better emotion regulation and psychological flexibility were related to more resilient responses. The association between resilience factors and resilient responses was stronger in samples with younger mean age and a larger proportion of women. Most studies used non-representative convenience samples and effects were smaller when accounting for sociodemographic variables and other resilience factors. For many factors, findings were mixed, supporting the importance of the fit between resilience factors and situational demands. Research into social and societal resilience factors and multilevel resilience interventions is needed. Preregistration-ID: 10.17605/OSF.IO/GWJVA. Funding source: Robert Koch Institute (ID: LIR_2023_01).

Reporting Rape: Stigmatizing Reactions to Survivors Who Seek Accountability

Rape survivors face stigma when disclosing their experiences. We hypothesized that a rape survivor who formally reports their rape would experience more stigma than one who does not, and that this effect will be stronger when the perceiver is a man or low in support for sexual consent. Across two studies using self-report, observational, and psychophysiological measures, we found that a reporting survivor was seen more negatively than an identical survivor who did not report their rape. Men and those low in support for sexual consent also responded more negatively to the survivor. Implications of these findings are discussed.

Validation of the Social Reactions-Online Questionnaire Among Adults Who Disclosed Online Victimization Via #MeToo

The #MeToo movement of 2017 ushered in a wave of online disclosure of sexual victimization. The ways in which people respond to the disclosure of sexual victimization can play an important role in a survivor's recovery process. This study conducted an exploratory structural equation model (ESEM) of a questionnaire aimed at characterizing the ways in which others respond to the disclosure of sexual victimization in online spaces. Participants (N = 767) were recruited via social media to participate in a study of disclosure of unwanted sexual experiences, with 25.4% (n = 195) endorsing disclosing an unwanted sexual experience online using the hashtag #MeToo and were included in analyses. Participants completed the Online Social Reactions Questionnaire (OSRQ). The questionnaire included all 16 original items from the Short Version of the Social Reactions Questionnaire (SRQ). An additional 8 items specific to online disclosure, not covered by the SRQ were added at the end, bringing the proposed OSRQ to a total of 24 items. The updated measure included the 16 original items of the Short Version of the SRQ as well as 8 additional items, for a total of 24 items. ESEM confirmed the OSRQ as a 23-item measure with a four-factor structure: (a) Turning Against+, (b) Unsupportive Acknowledgment, (c) Positive Support+, and (d) Online Sharing; model fit: χ2(186) = 387.125, p < .001, CFI = 0.976, RMSEA = 0.074 (90% CI [0.064, 0.085]), SRMR = 0.034. The OSRQ revealed excellent Cronbach's alpha (α = .93) and McDonald's Omega (ω = .93). The OSRQ represents a new measure that can be used to characterize the way in which others respond to online disclosure of sexual victimization.

The Process of Online Disclosures of Interpersonal Victimization: A Systematic Review

Theory and research on disclosure of interpersonal victimization, including intimate partner violence, sexual assault, and child abuse, has produced rich scholarship promoting a greater understanding of the challenges and implications of disclosure for survivors. However, in the last decade, social media platforms have opened new online disclosure opportunities that diverge from and overlap with offline disclosure. This highlights the need for adaptation and elaboration of theorizing in this growing area of study. Thus, the study aimed to systematically review the studies published in scientific literature. The following databases were accessed Criminal Justice Abstracts, Medline PsychInfo, Social Work Abstracts, Sociological Abstracts, Web of Science database, and Google Scholar. Twenty-seven studies met the inclusion criteria of peer-reviewed status and focused on the disclosure process. A thematic analysis revealed that online disclosure of interpersonal victimization is a multi-phase (decision-making and disclosure aftermath) and multifactorial (individual, interpersonal, social, and technological) experience for survivors. Specifically, survivors' motivation was related to therapeutic goals, social support, and a desire to advocate for social change. Survivors faced numerous facilitators (e.g., inspiration from other online disclosures) and barriers (e.g., fear of triggering other survivors) to disclosure. The impact of online disclosure was divided into benefits (e.g., empowerment) and risks (e.g., undermining survivors' security). The conceptual and empirical limitations of the current research are discussed, including a need for quantitative methods with larger samples and longitudinal designs to better understand how survivors can best benefit from processes of online disclosure, while avoiding harm or re-traumatization.

Child sexual abuse versus adult sexual assault: A review of psychological and neurobiological sequelae

Sexual trauma (ST) occurs with alarming frequency in the United States (U.S.) in the form of both childhood sexual abuse (CSA) and adulthood sexual assault (ASA). It is well-established that the effects of ST are pervasive, and that ST can be a risk factor for the development of several psychiatric disorders. However, the potential for distinct psychological consequences or neural correlates between CSA and ASA has received little attention. Furthermore, despite the high prevalence of sexual revictimization, the combinatorial effects of CSA and ASA are understudied in comparison to each form of ST on its own. In the current review, we present results from both clinical psychology and neuroscience research on the impacts of CSA and ASA, describing major psychological, biopsychosocial, and neuroimaging findings for each form of ST. We further highlight limitations in the current state of the research and needed areas of future research to better understand the distinct, overlapping, and cumulative effects of ST in both childhood and adulthood. The present study summarizes the state of the literature on this critical form of trauma and provides recommendations for future clinical research practices to mitigate the deleterious outcomes of ST.

Posttraumatic stress symptoms and risky alcohol use: The roles of negative social reactions to sexual assault disclosure and trauma-related shame

INTRODUCTION

Posttraumatic stress symptoms (PTS) and risky alcohol use (RAU) frequently co-occur among those with a history of sexual assault, and this co-occurrence has been linked to severe psychosocial and functional impairment.

OBJECTIVE

The current study examined the roles of negative social reactions to sexual assault disclosure and trauma-related shame in the association between PTS severity and RAU. This was tested by examining the separate and sequential indirect effects of negative social reactions and trauma-related shame in the PTSD-RAU relation among individuals with a history of sexual assault.

METHOD

Data were collected from 235 individuals who endorsed a history of sexual assault (Mage = 35.45, 70.5% women, 83.8% White).

RESULTS

Negative social reactions (b = .03, SE = .01, p < .05, 95% CI [.005, .06]) and trauma-related shame (b = .03, SE = .01, p < .05, 95% CI [.003, .06]), separately, and sequentially (b = .01, SE = .004, p < .05, 95% CI [.001, .02]) explained the relation between PTS severity and RAU.

CONCLUSIONS

Findings suggest that it may be valuable to assess and neutralize negative social reactions to reduce trauma-related shame and subsequent RAU among individuals with a history of sexual assault who experience more severe PTS severity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disclosing Sexual Victimization Online and In-Person: An Examination of Bisexual+ and Heterosexual Survivors

Bisexual+ (bisexual, pansexual, queer, attraction to more than one gender) people are at elevated risk for sexual victimization relative to their heterosexual counterparts. Disclosure of sexual victimization and social reactions received upon disclosure can play a major role in recovery following an assault. Using an online survey, the current study examined whether bisexual+ and heterosexual survivors of sexual victimization (N = 657) varied in disclosure of victimization, the type of disclosure (in-person vs. online via #MeToo), and receipt of various social reactions to disclosure in person and online. A chi-square test examined differences in disclosure and differences in types of disclosure (in-person only vs. MeToo across sexual identity). MANOVAS were used to examine whether in-person and online reactions varied across sexual identity. Bisexual+ survivors were more likely to disclose sexual victimization relative to heterosexual survivors. Among those who disclosed, bisexual+ survivors were more likely to disclose in person only whereas heterosexual survivors were more likely to disclose online via #MeToo. Whereas we did not find any significant differences for in-person reactions, we did find significant differences for online social reactions using #MeToo. Heterosexual survivors received higher turning against reactions (e.g., avoided talking to you or spending time with you) and more unsupportive acknowledgment relative to bisexual+ participants. Whereas bisexual+ participants received less turning against reactions and unsupportive acknowledgment during #MeToo/online disclosure, they were also less likely to disclose using #MeToo. Findings suggest that bisexual+ and heterosexual people vary in the way they disclose sexual victimization, and in how they are responded to when disclosing in person and online.

Empowerment Transformation Training Reduces Rape Among Girls and Young Women in South Sudan and the Kakuma Refugee Camp

PURPOSE

Rape occurs at high rates in South Sudan and Kakuma refugee camps, a region characterized by armed conflict, gender inequity, and economic crisis. To date, we know little about how to prevent rape in this region of the world. As such, the purpose of this study was to examine outcomes of Empowerment Transformation Training (ETT) (an adapted empowerment self-defense program; empowerment self-defense) among female participants in South Sudan and the Kakuma refugee camp.

METHODS

Schools were assigned to the treatment (ETT) condition (n = 7) or control (life skills) condition (n = 9) and used as the unit of analysis given the cluster-randomized design. Female participants anonymously completed a baseline (T1) and 12-month follow-up (T2) paper and pencil survey.

RESULTS

Annual rape victimization rates decreased from 10.7% to 5.5% in the ETT schools (risk ratio [RR] = 0.51); there was no change in the control schools (10.0%-9.0%). Empowerment Transformation Training (ETT) schools had increased confidence at T2 (T1: 42.4%; T2: 75.4%; RR = 1.79) and greater rates of confidence at T2 compared to control schools (54.3%; RR = 1.39). Knowledge of effective self-defense strategies (T2) was greater for ETT schools (47.4%) compared to control schools (30.1%) (RR = 1.57).

DISCUSSION

The ETT program reduced rates of rape, increased confidence, disclosures of rape (among victims), and knowledge of effective self-defense strategies. Empowerment self-defense programs are a critical component to rape prevention across global communities, including those characterized by armed conflict, gender inequity, and economic crisis.

Training Informal Supporters to Improve Responses to Victim-Survivors of Domestic Violence and Abuse: A Systematic Review

Informal supporters (friends, family, colleagues, and community members) play a crucial role in societal-wide responses to victim-survivors of domestic violence and abuse. Familial and social networks, however, report a sense of helplessness and difficulties in knowing how to respond. This mixed method systematic review examines the effectiveness, and perceived effectiveness, of training informal supporters to improve their responses to victim-survivors. A novel conceptual framework was developed to underpin the review. A systematic search of four electronic databases, specialist repositories, and websites were used to identify empirical research (in academic or gray literature). Eleven included studies examined educational interventions that aimed to improve responses from informal supporters. Quality appraisal was undertaken, and studies were judged to be "good enough" for synthesis. The studies in the review indicated that informal supporters recognized the value of training for building understanding and equipping them with the skills to respond to victim-survivors. The synthesis identified statistically significant improvements in the knowledge and attitudes of informal supporters in the immediate and short-term following training. Using a behavior change model to frame the evidence, the review found that training/educational activities prime informal supporters to respond to victim-survivors, as well as enhancing their capacity and motivation to do so. This increases the likelihood that informal supporters will take action to support victim-survivors of abuse. We don't know, however, what type of support they will provide and/or whether it would be judged to be helpful by victim-survivors.

Sources of Social Support and Trauma Recovery: Evidence for Bidirectional Associations from a Recently Trauma-Exposed Community Sample

Although the association between post-traumatic stress disorder (PTSD) and social support is well documented, few studies have tested the causal pathways explaining this association at several points in the acute post-trauma recovery period or examined whether the association varies for different sources of social support. To address these gaps, 151 community individuals (mean age = 37.20 years, 69.5% women) exposed to trauma within the previous 6 months were recruited to complete measures of PTSD and social support from intimate partners, friends, and relatives four times in 1 year. In line with recent recommendations for research on social support and PTSD symptoms, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine dynamic changes between PTSD severity and social support over time. The pattern of RI-CLPM cross-lagged coefficients indicated that positive deviations from one's expected stable level of total social support (across all sources) sped up the recovery of PTSD symptoms at the end of the post-trauma year, and more severe PTSD symptoms than expected based on one's expected stable level of PTSD started eroding social support midway through the assessment year. When specific sources of social support were analyzed separately, the association between within-person increases in social support from friends at any given time point accelerated the recovery from PTSD across the entire year. Among participants with intimate partners (n = 53), intimate partner support did not predict PTSD symptoms, but more severe PTSD symptoms at any given time point predicted less support at the following time point. Results from this longitudinal study provide additional support for the bidirectional relationship between PTSD and social support over time and suggest that perceived social support from friends may be especially helpful during trauma recovery.

How Helpful Is Bystander Intervention? Perspectives of Dating and Sexual Violence Survivors

While bystander intervention education has demonstrated promise as a strategy to reduce dating and sexual violence (DSV) on campus, little is known about whether survivors on whose behalf the interventions take place find these helpful. This paper uses qualitative, in-depth interviews with 33 DSV survivors to explore their perspectives on bystander intervention. Results indicate that while some interventions were identified as helpful, especially those that provided support to the survivor, many were not helpful enough or even harmful. Further work is needed to understand the consequences of bystander action.

Social Reactions to Disclosure of Sexual Violence Experienced by Sexual and Gender Minority Young Adults: Comparisons of Sexual and Gender Minority Recipients Versus Cisgender/Heterosexual Recipients

Sexual and gender minority (SGM) individuals are at an increased risk of experiencing sexual violence (SV). Social reactions received upon disclosure of SV impact survivors' mental health, and this may be more extreme when social reactions are provided by other SGM individuals. The purpose of the current study was to understand the SV disclosure experiences of SGM young adults, including the identity of disclosure recipients and the quality of the social reactions received by SGM and cisgender/heterosexual disclosure recipients. Additionally, the current study sought to examine how the SGM identity of the disclosure recipient and the quality of the social reactions received were associated with mental health outcomes (depression, post-traumatic stress disorder [PTSD], and alcohol use) among SGM SV survivors. SGM-identifying participants (N = 110) completed a 10-min survey on Qualtrics that was distributed through Prime Panels. Results revealed that 83% of participants (SGM survivors of SV) disclosed their SV experience to other SGM individuals. SGM disclosure recipients provided more positive social reactions and fewer negative social reactions than cisgender/heterosexual disclosure recipients. Regression models indicated that positive social reactions from cisgender/heterosexual recipients were associated with a decrease in depression scores. Negative social reactions from SGM recipients were associated with an increase in depression scores. Unexpectedly, positive social reactions from SGM recipients, while negative social reactions from cisgender/heterosexual recipients, were associated with an increase in PTSD scores. No associations were found between social reactions and alcohol use. Findings highlight the importance of social reactions and disclosure experiences on SGM survivors' mental health and mitigation opportunities to improve these disclosure experiences.

Associations Among Online Social Reactions to Disclosure of Sexual Victimization, Coping and Social Isolation

Social reactions to the disclosure of sexual victimization are critical to post-assault recovery. The popular social media hashtag "#MeToo" resulted in numerous survivors of sexual victimization disclosing their experience online. Whereas previous research has examined the association between social reactions to in-person disclosure of sexual victimization and factors commonly associated with adjustment among survivors - such as coping and social support - research is needed to examine correlates of social reactions to online disclosure of sexual victimization. Accordingly, the current study investigated the relationship between online social reactions to the disclosure of sexual victimization via #MeToo and engagement in various coping strategies (problem-focused coping, emotion-focused coping) and social isolation among a sample of 195 adults with a history of sexual victimization. Results indicated that the provision of online resources was associated with lower use of problem-focused and emotion-focused coping strategies. Receipt of online emotional and informational support was associated with increased use of emotion-focused coping strategies. Further, receipt of online social reactions that turned against the survivor and receipt of online social reactions that "made fun of you, insulted you, or said something to hurt you" were associated with higher levels of social isolation. Lastly, online unsupportive acknowledgment and "sharing your tweet with other people" were associated with lower levels of social isolation. Results highlight how online social reactions to disclosure of sexual victimization via #MeToo intersect with coping and social support among survivors of sexual victimization and help to give context to the experience of online disclosure of sexual victimization.

Associations of past-year overall trauma, sexual assault and PTSD with social support for young adult sexual minority women

Background: Young adult sexual minority women (SMW) are at elevated risk for sexual assault (SA), posttraumatic stress disorder (PTSD), and inadequate social support. While SA and PTSD can lead to reductions in social support from close significant others, the impact of SA and PTSD on SMWs' social support has not previously been assessed.Objective: This study examined the associations of past year SA and PTSD with SMW's social support from intimate partners, family, and friends. It was hypothesized that SA and PTSD would be negatively associated with support from partners, family and friends, and that PTSD would moderate the effect of SA on support in early adulthood.Method: Young adult SMW in the United States (N = 235) who were M = 23.93 (SD = 2.15) years old, primarily lesbian or bisexual (n = 186, 79.1%) and White (n = 176, 74.9%) completed measures on past year exposure to SA and non-SA trauma, PTSD, and social support from intimate partners, family and friends.Results: PTSD was associated with less social support from partners, (b  = -0.06, SE = 0.02, p = .010, R2change = .02), family, (b  = -0.06, SE = 0.03, p = .025, R2change = .02), and friends, (b  = -0.07, SE = 0.02, p = .008, R2change = .02). There was a significant interaction between PTSD and SA on social support from partners (b  = -0.01, SE = 0.01, p = .047, R2change = .01). Neither non-SA nor SA trauma was associated with support from family or friends.Conclusions: Results underscore the potential impact of recent SA on intimate partnerships for young adult SMW with more severe PTSD. Future work should explore how addressing PTSD and improving social support quality may help SMW recover from traumatic experiences and ameliorate the effects of SA on intimate partnerships.

Cross-sectional examination of correlates of sexual victimization disclosure via #MeToo

Background: Sexual victimization is a serious public health problem, with a range of negative impacts on mental and physical health. Responses that individuals get to disclosure of sexual victimization play an important role in recovery. With the increased use of social media, more survivors are talking about their experiences of sexual victimization online. Research is needed to document the correlates of online disclosure of sexual victimization.Objective: The current study examined the role of demographic characteristics, assault severity, coping strategies, and social isolation as putative correlates of disclosing sexual victimization online via the hashtag #MeToo.Methods: A sample of 637 adults recruited via social media who reported a history of sexual victimization since the age of 14 completed self-report surveys using online survey software to assess disclosure of sexual victimization, assault severity, coping strategies, and social isolation.Results: Multivariate analyses suggest that levels of emotion-focused coping were positively associated with the disclosure of sexual victimization online via #MeToo. Further, individuals who had experienced completed rape by verbal coercion were less likely to disclose via #MeToo, compared to individuals who experienced other forms of assault.Conclusion: Coping strategies and assault severity play an important role in determining whether survivors disclose sexual victimization online via #MeToo. Findings suggest that individuals may disclose via #MeToo to seek support or express their emotions. Further, individuals whose sexual victimization experiences do not conform to 'typical' sexual victimization experiences are less likely to disclose via #MeToo.

Social Reactions to Disclosures of Intimate Partner Stalking and Unwanted Pursuit Behaviors: Associations With PTSD, Academic Outcomes, and Empowerment

Among college survivors of unwanted pursuit behaviors (UPBs; 40.1%, n = 189) or intimate partner stalking (IPS, i.e., UPBs causing emotional distress; 32.1%, n = 151), the present study examined effects of social reactions to disclosures on post-traumatic stress disorder (PTSD) symptomatology, academic outcomes, and personal empowerment. Compared to UPB survivors, IPS survivors were more likely to disclose and reported higher positive and negative reactions to disclosure as well as greater frequency of UPBs/IPS, IPV, and PTSD symptoms. Among both groups, only negative social reactions were positively associated with PTSD symptoms. However, among IPS (but not UPB) survivors, only positive social reactions were related to academic outcomes and empowerment when controlling for PTSD and IPS frequency. Implications for research and practice are discussed.

Identification of Psycho-Socio-Judicial Trajectories and Factors Associated With Posttraumatic Stress Disorder in People Over 15 Years of Age Who Recently Reported Sexual Assault to a Forensic Medical Center: Protocol for a Multicentric Prospective Study Using Mixed Methods and Artificial Intelligence

BACKGROUND

Sexual assault (SA) can lead to a range of adverse effects on physical, sexual, and mental health, as well as on one's social life, financial stability, and overall quality of life. However, not all people who experience SA will develop negative functional outcomes. Various risk and protective factors can influence psycho-socio-judicial trajectories. However, how these factors influence trauma adaptation and the onset of early posttraumatic stress disorder (PTSD) is not always clear.

OBJECTIVE

Guided by an ecological framework, this project has 3 primary objectives: (1) to describe the 1-year psycho-socio-judicial trajectories of individuals recently exposed to SA who sought consultation with a forensic practitioner; (2) to identify predictive factors for the development of PTSD during the initial forensic examination using artificial intelligence; and (3) to explore the perceptions, needs, and experiences of individuals who have been sexually assaulted.

METHODS

This longitudinal multicentric cohort study uses a mixed methods approach. Quantitative cohort data are collected through an initial questionnaire completed by the physician during the first forensic examination and through follow-up telephone questionnaires at 6 weeks, 3 months, 6 months, and 1 year after the SA. The questionnaires measure factors associated with PTSD, mental, physical, social, and overall functional outcomes, as well as psycho-socio-judicial trajectories. Cohort participants are recruited through their forensic examination at 1 of the 5 participating centers based in France. Eligible participants are aged 15 or older, have experienced SA in the last 30 days, are fluent in French, and can be reached by phone. Qualitative data are gathered through semistructured interviews with cohort participants, individuals who have experienced SA but are not part of the cohort, and professionals involved in their psycho-socio-judicial care.

RESULTS

Bivariate and multivariate analyses will be conducted to examine the associations between each variable and mental, physical, social, and judicial outcomes. Predictive analyses will be performed using multiple prediction algorithms to forecast PTSD. Qualitative data will be integrated with quantitative data to identify psycho-socio-judicial trajectories and enhance the prediction of PTSD. Additionally, data on the perceptions and needs of individuals who have experienced SA will be analyzed independently to gain a deeper understanding of their experiences and requirements.

CONCLUSIONS

This project will collect extensive qualitative and quantitative data that have never been gathered over such an extended period, leading to unprecedented insights into the psycho-socio-judicial trajectories of individuals who have recently experienced SA. It represents the initial phase of developing a functional artificial intelligence tool that forensic practitioners can use to better guide individuals who have recently experienced SA, with the aim of preventing the onset of PTSD. Furthermore, it will contribute to addressing the existing gap in the literature regarding the accessibility and effectiveness of support services for individuals who have experienced SA in Europe. This comprehensive approach, encompassing the entire psycho-socio-judicial continuum and taking into account the viewpoints of SA survivors, will enable the generation of innovative recommendations for enhancing their care across all stages, starting from the initial forensic examination.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/46652.

Online Social Reactions to Disclosure of Sexual Victimization via #MeToo and Symptoms of Post-Traumatic Stress Disorder

Sexual victimization is a major public health concern with significant consequences for survivors, their families, and society at large. Studies examining in-person disclosure of sexual victimization suggest that the way others respond to disclosure has a significant impact on survivors' well-being. With the advent of social media, more survivors are choosing to disclose their experience online. Research is needed to understand how social reactions to online disclosure of sexual victimization impact survivors. Accordingly, the current study examined the association between online social reactions to the disclosure of sexual victimization and symptoms of post-traumatic stress disorder (PTSD) symptoms in a sample of 195 individuals who disclosed their experience online via the hashtag #MeToo. Symptoms of PTSD were positively associated with the level of assault severity reported by the survivor, as well as receipt of online social reactions to disclosure via #MeToo that made fun, insulted, or said something to hurt the survivor. Online social reactions to disclosure via #MeToo that involved turning away from the survivor or providing unsupportive acknowledgment of the experience were unrelated with PTSD symptoms. PTSD symptoms were also not associated with the receipt of positive online social reactions to disclosure via #MeToo. Like research addressing in-person social reactions to disclosure of sexual victimization, some forms of online negative social reactions to disclosure of sexual victimization via #MeToo appear to be associated with worse psychological outcomes among survivors. Thus, online disclosure of sexual victimization and its impact needs to be attended to in clinical and research settings.

Variations in Women's Attribution of Blame for Sexual Assault

In the United States, sexual assault (SA) is a significant problem that has adverse psychological impacts on women. Scholarship has shown that when survivors choose to disclose their experiences, the way their networks react has a powerful impact on their well-being, but literature on response to SA disclosure has not extensively explored variation among women, who are likely recipients of these disclosures. This study explored variation among perceptions of and blame attribution for SA within a geographically and politically diverse but primarily White sample of women. Participants were assigned one of four vignettes, each of which described a non-stereotypical SA. The vignettes differed in two ways: (1) the social status of the perpetrator of the assault and (2) the length of time the victim waited to report. Results showed that being older and more politically conservative was associated with assigning less blame to the perpetrator and more blame to the victim, but neither education level nor where the participant lived were linked with blame attribution. While women's own experiences of SA were unrelated to their responses, having a loved one who had experienced SA was associated with less victim blaming. With respect to attitudes, women endorsing higher levels of social dominance orientation (SDO) and sexism also reported higher levels of victim blame and lower levels of perpetrator blame. Further research should explore the role of specific personal experiences and knowledge of others' SA in assignment of blame, investigate the predictors and moderators of SDO, and should extend these findings to more racially/ethnically diverse samples of women.

Associations among posttraumatic growth, demographic characteristics, posttraumatic stress symptoms, and trauma type, with a focus on sexual violence

This study assessed posttraumatic growth (PTG) across multiple trauma types and by demographic characteristics (i.e., sex, age, education). Moreover, we examined the association between PTG and posttraumatic stress disorder (PTSD) symptoms as well as the characteristics and predictors of PTG after sexual violence. A phone survey was conducted in a nationally representative sample of 1,766 Icelandic adults. In total, 1,528 individuals reported having experienced some form of trauma and were included in the analysis, and 563 reported experiencing sexual violence. Interpersonal trauma (e.g., sexual violence, emotional abuse, and domestic violence) was associated with the highest levels of PTG. Moderate levels of PTSD symptoms were associated with the highest levels of PTG, whereas high- or low-level PTSD symptoms were related to less PTG. Women reported significantly more PTG than men, d = 0.16 and survivors of sexual violence reported significantly more PTG than individuals who reported other forms of trauma exposure, d = 0.28. Among sexual violence survivors, no demographic factors were associated with PTG, but cumulative trauma and positive social reactions were significantly related to higher levels of PTG. This study highlights that personal growth can result from aversive experiences and suggests a curvilinear association between PTG and PTSD symptoms.

Where do those experiencing sexual violence seek help and is routine enquiry acceptable within a sexual healthcare setting? Findings from a population-based survey

OBJECTIVES

Most sexual violence (SV) remains undisclosed to healthcare professionals. The aims of this study were to identify where support would be sought after SV and whether routine enquiry about SV was acceptable in a sexual healthcare setting.

DESIGN

An online population-based survey collected data on a history of SV and preferences on support after SV, in addition to sociodemographic data. Respondents' views on being routinely asked about SV were sought.

SETTING AND PARTICIPANTS

This online survey was based in England, UK. There were 2007 respondents.

RESULTS

The police were the most frequent first choice for support after experiencing SV (n=520; 25.9%); however, this was less common in individuals in younger age groups (p<0.001) and in those with a history of SV (17.2% vs 29.9%, p<0.001). For the 27.1% (532 of 1960) of respondents who reported a history of SV, the first choice of place for support was Rape Crisis or similar third-sector organisation. The majority of respondents supported routine enquiry about SV during Sexual and Reproductive Health Service (SRHS) consultations (84.4%), although acceptability was significantly lower in older age groups.

CONCLUSIONS AND STUDY IMPLICATIONS

A greater awareness of the influence of sociodemographic factors, including ethnicity, age, gender, disability and a history of SV, when planning and delivering services for those who have experienced SV is needed. A history of SV is common in the general population, and a 'one-size-fits-all' approach to encourage disclosure and access to support is unlikely to be optimal. Routine enquiry about SV is highly acceptable in an SRHS setting and likely to improve disclosure when appropriately implemented.

Development and Validation of the Disclosure Expectancy Scale

Although the disclosure of traumatic experiences is believed to influence trajectories of post-trauma recovery, less is known about individual differences that affect survivors' motivation to share. The current project describes the development and evaluation of the Disclosure Expectancy Scale (DExS), a novel instrument intended to assess survivors' expectations about the potential risks and benefits of disclosure. Items targeting both positive and negative expectancies were generated based on existing research and the authors' clinical experience with various survivor populations. Preliminary analyses in trauma-exposed undergraduates (N = 359) offer support for hypothesized positive and negative expectancy dimensions with evidence for the convergent and discriminant validity of scores. Subsequent evaluation in active-duty, help-seeking military personnel (N = 35) provides further evidence of validity based on correlations with relevant clinical measures. A final regression demonstrating unique effects of initial disclosure expectancies on post-traumatic stress disorder (PTSD) severity following trauma-focused treatment highlights the predictive validity of DExS scores.

The Influence of Deny, Attack, Reverse Victim and Offender and Insincere Apologies on Perceptions of Sexual Assault

DARVO (deny, attack, reverse victim and offender) is a response exhibited by perpetrators to deflect blame and responsibility. When using DARVO, perpetrators deny their involvement in wrongdoing, attack their victims' credibility, and argue that they are the real victims. The purpose of this study was to measure the influence of DARVO and another manipulative tactic-insincere perpetrator apologies-on observers' judgments of a victim and perpetrator in a fictional sexual violence scenario. Perpetrator DARVO was experimentally manipulated via fictional vignettes to measure their impact on perceived perpetrator and victim abusiveness, responsibility, and believability. Data from 230 undergraduate students revealed that participants who were exposed to perpetrator DARVO rated the perpetrator as less abusive (η p 2 = . 09 , 90% CI [0.04, 0.15]), less responsible for the sexual assault (η p 2 = . 02 , [0.001, 0.06]), and more believable compared (η p 2 = . 03 , [0.002, 0.07]) to participants who were exposed to a perpetrator who did not use DARVO. DARVO-exposed participants rated the victim as more abusive (η p 2 = . 09 , [0.04, 0.14]) and less believable (η p 2 = . 08 , [0.03, 0.14]), and also expressed less willingness to punish the perpetrator and greater willingness to punish the victim. Insincere apologies had minimal impact on ratings. By promoting distrust in victims and less punitive views of perpetrators, DARVO might contribute to rape-supporting outcomes such as victim blaming, greater victim distress, and low rates of rape reporting and perpetrator prosecution.

The Role of Unit and Interpersonal Support in Military Sexual Trauma and Posttraumatic Stress Disorder Symptoms

Military sexual trauma (MST) is strongly associated with posttraumatic stress disorder (PTSD). Among many potential factors explaining this association are unit and interpersonal support, which have been explored in few studies with veterans who have experienced MST. This project examines unit and interpersonal support as moderators and/or mediators of PTSD symptoms among post-9/11 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans who experienced MST. MST, unit support, and interpersonal support variables were collected at Time 1 (T1; N = 1,150, 51.4% women), and PTSD symptoms 1 year later at Time 2 (T2; N = 825; 52.3% women). Given gender differences in endorsed MST, models with the full sample (men and women) and women only were examined, while controlling for covariates related to PTSD, and a path model was examined among women veterans. Mediation was supported in the full model and women-only models, with the combination of both mediators demonstrating the strongest mediation effects (full-model: β = .06, 95% confidence interval [CI] [0.03, 0.10], p < .001; women-only model: β = .07, [0.03, 0.14], p = .002). Among the women-only model, MST was negatively associated with unit support (β = -.23, [-0.33, -0.13], p < .001) and interpersonal support (β = -.16, [-0.27, -0.06], p = .002) and both support types were negatively associated with PTSD symptoms (unit support: β = -.13, [-0.24, -0.03], p = .014; interpersonal support: β = -.25, [-0.35, -0.15], p < .001). Moderation was not supported in the full model nor in the women-only model. Experiencing MST is associated with receiving less unit and/or interpersonal support, which in turn is associated with greater PTSD symptoms. More work is needed to understand and improve the impact of unit and community responses to MST on service members who experience MST.

Evaluation of Multidimensional Functional Impairment in Adult Sexual Assault Survivors, with a Focus on Its Psychological, Physical, and Social Dimensions, Based on Validated Measurements: A PRISMA Systematic Review

Sexual violence (SV) is widely prevalent around the world: according to studies, 18 to 51% of women and 1 to 9% of men experience it at some point in their lives. Yet, experiences of SV are rarely disclosed outside the private sphere. Pathologies, acute or chronic, can be associated with SV. The study of the links between SV and health is often fragmented, viewed through the lens of a specific pathology, yet SV certainly has an impact on the different dimensions of the functioning of survivors (physical, psychological, social, and so on), whether or not there is an identified pathology at the origin of this impact. No synthesis of the knowledge on functional impairment in adult sexual assault survivors has been identified to date. Therefore, we conducted a systematic review according to the PRISMA recommendations, focusing on the assessment via validated scales or standardized measurements of the different dimensions of functional impairment in sexual assault survivors aged 15 and over, excluding abuse in childhood and polyvictimization. We searched the Medline database from its inception to October 2022, identifying 1130 articles. Two evaluators carried out their analysis, and fifty-one articles were retained. In the end, only 13 articles were included. Their quality was assessed by referring to their compliance with STROBE recommendations. Of these 13 articles, only 4 have a quality level deemed to be satisfactory, and they relate to 4 dimensions of functioning: psychological, sexual, physical (pain), and social. The main results were that survivors reported increased restrictions of activities, sexual dysfunctions such as vulvodynia or dyspareunia, decreased social satisfaction and functioning, and decreased self-esteem and quality of life compared to the general population. To date, evidence for functional impairment is very limited, preventing researchers and clinicians from gaining clear and well-established knowledge about the functioning of sexual assault survivors. Research in this area needs to evolve urgently.

Disclosure of Sexual Victimization: Effects of Invalidation and Shame on Re-Disclosure

Research on disclosure of sexual victimization has consistently demonstrated that the act of disclosure and the disclosure recipient have a synergistic effect in facilitating either positive or negative post-assault outcomes. While negative judgments such as victim blame have been argued to serve a silencing function, experimental investigations of this claim are lacking. The current study investigated whether invalidating feedback in response to self-disclosure of a personally distressing event produced feelings of shame, and whether shame influenced subsequent decisions around re-disclosure. Feedback type (validating, invalidating, no feedback) was manipulated in a sample of 142 college students. Results partially supported the hypothesis that shame resulted from invalidation, however shame was better predicted by individual perceptions of invalidation than the experimental manipulation. Although few participants opted to make changes to the content of their narrative for re-disclosure, those who did had higher levels of state shame. Results suggest that shame may be the affective mechanism by which invalidating judgments silence victims of sexual violence. The present study also supports the distinction previously made between Restore and Protect motivations in managing this shame. This study provides experimental support for the notion that an aversion to being shamed, communicated via an individual's perception of emotional invalidation, features in judgments of re-disclosure. Perceptions of invalidation, however, vary individually. Professionals working with victims of sexual violence should be mindful of the importance of shame attenuation in facilitating and encouraging disclosure.

Sexual Victimization Outcomes and Adjustment Among Bisexual Women: A Review of the Quantitative Literature

Bisexual women experience worse mental health outcomes than lesbian and heterosexual women, which may be explained by greater rates of sexual violence among bisexual women. The current comprehensive literature review aimed to synthesize research on mental health and substance use outcomes related to lifetime sexual violence among bisexual women. A comprehensive literature search was conducted within the PsycINFO and Medline databases (final search conducted in August, 2021). Inclusion criteria required articles to examine a mental health or substance use correlate/outcome of lifetime sexual victimization experiences among bisexual women. Fifteen studies met inclusion criteria and were reviewed. Results indicate that there are significant gaps in this literature, including limited research on psychological distress outcomes. Most notably, there is a limited focus on the experiences of bisexual women specifically and the role of bisexual minority stress. Findings indicate that lifetime sexual victimization experiences are linked with increased posttraumatic stress, depression, and alcohol (and other substance) use and consequences. It appears that bisexual women are vulnerable to cumulative victimization, which may further exacerbate outcomes. Clinicians working with bisexual women should provide bisexual-affirmative care, help bisexual women access positive social supports, and build more effective coping strategies for managing post-trauma distress. Future research on outcomes of violence among bisexual women would benefit from contextualizing adjustment following sexual assault within a bisexual minority stress-informed approach for a more comprehensive understanding of this process.

Disclosure of Sexual Assault Among Sexual and Gender Minorities: A Systematic Literature Review

Sexual assault is common in sexual and gender minority (SGM) individuals, but few studies have examined SGM victims' disclosure experiences. This systematic review identified 13 studies through searches of research databases on SGM populations with sexual victimization. These studies showed wide variation in disclosure rates, various barriers to disclosure, and psychological impacts of social reactions to disclosure on SGM individuals. Bisexual women were more likely to disclose to formal (e.g., police, healthcare providers) and informal (e.g., friends, family members) sources than other women, and SGM victims disclose to mental health professionals at particularly high rates. Sexual and gender minority victims also reported numerous barriers to disclosure, including those unique to SGM individuals (e.g., fear of being outed). Impacts of negative social reactions appear to be more negative on psychological symptoms of SGM victims, whereas positive reactions are helpful to recovery. Future research is needed taking an intersectional perspective to studying disclosure and social reactions to SGM individuals from both college and community samples, by examining both sexual minority and racial/ethnic identities in the context of intersectional minority stress theory. Studies are needed of both correlates and consequences of disclosures to both informal and formal support sources to better understand SGM individuals' reasons for telling and not telling various support sources and the impacts of their disclosure experiences on their recovery. Such data is also needed to inform interventions seeking to identify and intervene with support network members and professionals to reduce negative social reactions and their psychosocial impacts and to increase positive social reactions and general social support from informal support sources.

Attribution of Blame in an Intimate Partner Violence Situation: The Effect of Victim Sexuality and Observer Sex

Intimate partner violence (IPV) is an extensive public health concern, largely affecting women aged 20 to 24 years. Research suggests that bisexual women are more likely than heterosexual and homosexual women to be victims of IPV. Bisexual women are also more likely to be blamed for their abuse experiences after disclosing, a phenomenon known as victim blame attribution (VBA). However, very little VBA research recognizes bisexuality as a separate category. Therefore, the main aim of this quasi-experimental study was to investigate the role of female victim sexuality (bisexuality, homosexuality, and heterosexuality) and observer sex in the attribution of blame to the victim and perpetrator of IPV. Participants (N = 232; aged 18-24 years, M = 21.05, SD = 1.73) were randomly assigned into one of four conditions (heterosexual victim, bisexual victim with same-sex partner, bisexual victim with different-sex partner, homosexual victim), each containing a vignette portraying IPV within a relationship. Randomization checks were performed to ensure that participants in the four conditions did not differ significantly on underlying attitudes (institutional heterosexism (IH), aversive heterosexism (AH), heterosexual privilege (HP), sexist attitudes, just world beliefs) that may have affected their responses on outcome measures. Main analyses demonstrated that bisexual victims with a same-sex partner received the highest attribution of blame, whereas perpetrators in this condition received the lowest blame attribution. Male participants attributed significantly higher blame to victims than did female participants, regardless of victim sexuality. These findings substantiate the role of victim sexuality and observer sex in IPV blame attribution patterns. This research aimed to promote equality and rightful treatment to all victims of IPV regardless of their sexuality.

College students' perceptions of alcohol's role in disclosures of sexual assault and intimate partner violence

Objective: Much is known about how alcohol increases the risk of sexual assault or intimate partner violence victimization during college. This research qualitatively explores perceptions about how alcohol influences disclosures about these events to informal supports. Participants: Participants included college students who received a disclosure wherein they or the survivor were drinking during the disclosure (n = 81). Methods: Responses were coded with regard to who was drinking and whether the effect of drinking during the disclosure was perceived as positive, negative, mixed, or neutral/none. Results: Participants perceived alcohol to have both positive (e.g., increasing the likelihood of discussing difficult topics) and negative (e.g., cognitive impairment increased negative emotions) effects on disclosures. Conclusion: Prevention and intervention efforts should identify targeted strategies (e.g., remembering one or two easy and helpful phrases; revisiting the topic again while sober) to help survivors and disclosure recipients have constructive conversations in the presence of alcohol.

An ecological approach to understanding the impact of sexual violence: a systematic meta-review

Aim

A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence.

Methods

Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted.

Results

Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however.

Conclusion

Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.

A preliminary evaluation of the supportive other experiences questionnaire: Integrating the perspectives of SS providers after traumatic injury

BACKGROUND

Social support is a protective factor against the development of Posttraumatic Stress Disorder (PTSD). However, examinations of the social support after trauma have relied primarily on the self-reports of trauma survivors to the exclusion of their support providers. A new measure, the Supportive Other Experiences Questionnaire (SOEQ) was adapted from a well-established behavioral coding schema of support behaviors to capture social support experiences from the support provider perspective.

METHOD

513 Concerned Significant Others (CSOs) recruited on MTurk who had served as support providers to a traumatically injured romantic partner were recruited to respond to SOEQ candidate items and other relevant measures of psychopathology and relational factors. Factor analytic, correlational and regression analyses were conducted.

RESULTS

Confirmatory factor analytic results of SOEQ candidate items provide evidence for three support types (i.e., informational, tangible, and emotional) and two support processes (i.e., frequency, difficulty), producing a final 11-item version of the SOEQ. Evidence of convergent and discriminant validity provide good psychometric support for the measure. Evidence of construct validity was derived from support for two hypotheses: (1) difficulty providing social support is negatively associated with CSO perceptions of trauma survivor recovery, (2) social support provision frequency is positively associated with relationship satisfaction.

LIMITATIONS

Though factor loadings for support types were significant, several were small, limiting interpretability. Cross-validation in a separate sample is needed.

CONCLUSIONS

The final version of the SOEQ demonstrated promising psychometric properties, and can provide key information one the experiences of CSOs as social support providers for trauma survivors.

Initial testing of components of the cultural determinants of trauma recovery (CDTR) theory amongst American Gender-Based violence survivors: Structural equation modelling

AIM

We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample.

DESIGN

A cross-sectional study using anonymous online surveys.

METHODS

This study was conducted with 225 American survivors of gender-based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL-5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help-seeking (shame, frozen and problem management subscales: BHS-TR Internal) and the GBV healing (GBV-Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses.

RESULTS

The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help-seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers; the relationship between internal help-seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers and SOC.

CONCLUSIONS

This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups.

IMPACT

This study can help us focus on psychological interventions that enhance meaning and mitigate internal help-seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.

PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies

OBJECTIVE

Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault.

METHOD

Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity.

RESULTS

Meta-analysis of 22 unique samples (N = 2,106) indicated that 74.58% (95% confidence interval [CI]: [67.21, 81.29]) and 41.49% (95% CI: [32.36, 50.92]) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: [41.27, 54.61]) and 29.91% (95% CI: [23.10, 36.73]) of scales' maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed.

CONCLUSIONS

Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.

How Will I Be Perceived: The Role of Trauma-Related Shame in the Relationship Between Psychological Distress and Expectations of Disclosure Among Survivors of Sexual Victimization

Sexual assault is a serious physical and psychological concern worldwide. Various negative psychological outcomes are associated with survivor well-being, including depression, posttraumatic stress disorder (PTSD), depressive symptoms, and trauma-related shame. Opportunities for emotional expression and processing have been shown to be beneficial among survivors of trauma; however, survivors of sexual victimization may be reticent to disclose details of their traumatic experience, particularly to formal sources of support. Trauma-related shame (e.g., negative evaluations of self, feelings of worthlessness, and powerlessness) has been shown to negatively impact expectations of disclosure, as some survivors may fear being blamed or judged. Limited research exists on the impact of psychological distress on survivors' expectations of disclosure. The current study investigated whether psychological distress (i.e., depressive and PTSD symptoms) is associated with expectations of disclosure (positive vs. negative) through trauma-related shame among survivors of sexual victimization. Participants, recruited from a primarily Hispanic-serving institution, participated in the present study. Participants (N = 86) completed measures of PTSD and depression symptom severity, trauma-related shame, and expectations of disclosure. Results revealed that psychological distress severity was associated with negative expectations of disclosure through trauma-related shame (b = 0.682, p < .05, 95% confidence interval [CI] [0.197, 1.367]), but not positive expectation (b = -0.068, p = .417, 95% CI [-0.523, 0.155]). Our findings have implications for prognosis and treatment for survivors of sexual victimization, particularly among LatinX populations.

Cultural collectivism, intimate partner violence, and women's mental health: An analysis of data from 151 countries

Culture, defined as the distinctive, learned beliefs and patterns of behavior that are particular to a given group or community, is a key determinant of mental health. The cultural dimension of individualism-collectivism, which measures the extent to which a given society accords importance to individuals as opposed to larger groups, has been associated with cross-national variations in mental health outcomes such as depression and suicide. However, this cultural dimension is also associated with variations in the frequency of intimate partner violence (IPV), which has a significant and sustained adverse impact on women's mental health. This study examines the relationships between individualism-collectivism, the frequency of IPV, and rates of depression and suicide in women, based on data from 151 countries. In this data set, IPV was significantly associated with age-standardized rates of depression and suicide in women, even after adjusting for demographic variables. Cultural collectivism was positively correlated with IPV, but this relationship was significantly influenced by national income and women's educational attainment. In multivariate analyses, IPV, but not cultural collectivism, remained significantly associated with depression in women. These results highlight the importance of screening for and addressing IPV in women seeking mental health care, particularly in low- and middle-income countries where cultural and economic factors may both increase the risk of IPV and delay or impede its reporting.

Disrupting the cycle of youth violence: The role of social support for youth in a Northern Irish Youth Work Programme

Youth violence is a significant concern and previous research has found that violence is both trauma inducing and violence inducing. Meta-analyses have demonstrated that peri-trauma contextual factors such as the presence or absence of social supports following the onset of trauma may be predictive of the onset and duration of psychological stress. The aim of this study is to build upon the existing research evidence to clarify the links between social support, psychological stress and physical violence among a cross-section of youth living in high-violence areas of Northern Ireland. Participants were a sample of 10-25-year-olds (N = 635) who participated in a targeted youth work programme in Northern Ireland. This study conducted a mediation analysis, entering social support as the independent variable, psychological distress as the mediator and self-reported violence as the outcome variable. Violent victimisation was entered as a covariate in the analysis. After controlling for violent victimisation, social support operates through psychological stress to influence the risk of physical violence. Social support may contribute to reductions in psychological stress and thus buffer against the risks of living in areas of elevated community violence. Specialist youth work approaches may provide an opportunity to reduce psychological stress and thus help to mitigate the risk of further violence. Combined, these insights provide opportunities for harm reduction and prevention. At the same time, these findings advance our understanding of the distinct mechanisms of change involved in youth work-led violence prevention efforts.

Women Receive More Positive Reactions to Childhood Sexual Abuse Disclosure and Negative Reactions are Associated With Mental Health Symptoms in Adulthood for Men and Women

Although disclosure of sexual abuse has become more socially acceptable for both men and women in recent years, there is much yet to be understood about differences in the disclosure process and associated pathology between men and women. The current study aimed to (a) investigate differences in aspects of the childhood sexual abuse (CSA) disclosure process between adult men and women and (b) explore how timing of disclosure, perceived parental style, and negative social reactions to disclosure relate to various mental health symptoms. Using a cross-sectional, quasi-experimental design, adult men and women in the United States recruited through Amazon's Mechanical Turk (N = 299) completed self-report surveys. Women reported disclosing to a significantly greater number of people than men, and were more likely to disclose to parents, while men were more likely to tell friends. Results revealed that women reported receiving significantly more positive responses and emotionally supportive responses to their CSA disclosures than men. Negative reactions to disclosure were positively associated with internalizing symptoms and externalizing symptoms, while both negative reactions to disclosure and perceived parental dysfunction were positively associated with substance use symptoms. Results signify a need for resources to aid individuals in supporting survivors of CSA, as reactions have the potential to impact recovery trajectory and for clinicians to consider how disclosure experiences impact survivor cognitions and symptom exacerbation.

Disclosure Experiences for Transgender and Nonbinary Survivors of Intimate Partner Violence

While transgender individuals experience high rates of intimate partner violence (IPV), current gendered and heteronormative depictions of IPV in society may create unique barriers for transgender survivors who attempt to disclose their abuse, thus leaving survivors without access to support resources. This study sought to understand the barriers to disclosure transgender survivors face and how they overcome these barriers. Through in-depth interviews with transgender IPV survivors (n = 9), the researcher found that experiences of IPV were often inseparable from survivors' experiences of their gender identity. Both external and internalized transphobia served as barriers which framed how participants viewed their abuse and who they disclosed their abuse to. Conversely, transgender-affirming support helped participants overcome these barriers. These barriers and aids also took different forms and meanings based upon other intersecting identities, such as gender and ability status. Implications for researchers and service providers, as well as directions for future research are reviewed.

Crisis social support after work-related violence and threats and risk for depressive symptoms: a 3-months follow-up study

INTRODUCTION

Employees working at psychiatric wards are at risk for work-related threats and violence that may impact their physical and mental health. Studies have found that crisis social support may mitigate these adverse health effects.

PURPOSE

To examine the effects crisis social support on depressive symptoms 3 months after a violent or threating work incident and furthermore, to examine the effect of variations in prolonged social support on depressive symptoms during 3 months after a violent or threating incident.

METHODOLOGY

After exposure to work-related violence and threats at work, the employees received a questionnaire within the first month and after 3 months. Right after the incident, 374 employees answered both the depression and crisis support items and were included in the analyses. 3 months later 276 employees answered both the depression and social support items. Prospective associations between crisis social support and depression were calculated using stepwise regressions and linear mixed models.

RESULTS

Crisis social support at T1 was significantly and inversely associated with a lower level of depressive symptoms at T2, Std. Beta =  - 012, t (3) =  - 2.1, p = .040. Employees experiencing either a stable or increasing level of support from T1 to T2 had significantly lower levels of depressive symptoms compared to employees who experienced a decrease in support in the same period, mean difference_{Stable-Decreasing} = 4.0 t (190) = 5.2, p = 0.006 and mean difference_{Increasing-Decreasing} = 7.6, t (189) = 5.3, p < .001.

CONCLUSION

The study results indicate that depressive symptoms following work-related violence or threats can be mitigated by prolonged social support. We recommend that organizations continue to offer crisis social support in the subsequent months, and not just immediately after a violent or threating incident.

The Effect of Social Support on Depression among Economically Disadvantaged College Students: The Mediating Role of Psychological Resilience and the Moderating Role of Geography

The study examined the influence of social support on depression, including the mediating role of psychological resilience and the moderating role of geography. Questionnaires were completed by 424 economically disadvantaged college students in two provinces, X, a coastal province, and Y, an inland province. The results indicated that (1) the social support of economically disadvantaged college students was positively correlated to psychological resilience (β = 0.62, t = 11.22, p < 0.001); (2) the psychological resilience of economically disadvantaged college students was negatively correlated with depression (β = -0.24, t = -10.3, p < 0.001); (3) the social support of economically disadvantaged college students was negatively correlated with depression (β = -0.08, t = -2.85, p < 0.001); (4) the psychological resilience of economically disadvantaged college students played a partial mediating role between social support and depression; and (5) geography played a moderating role in the effect of social support on depression.

Public beliefs about trauma and its consequences: Profiles and correlates of stigma

Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N ₁ = 404; N ₂ = 502) and MTurk (N ₃ = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.

Correlates of Social Reactions to Victims' Disclosures of Sexual Assault and Intimate Partner Violence: A Systematic Review

Sexual assault and intimate partner violence (IPV) are common experiences in women, but few studies have examined correlates of social reactions experienced by victims telling others about assault. This systematic review identified 30 studies through searches of research databases on correlates of social reactions to disclosure of sexual assault or IPV in samples of adult victims or disclosure recipients. Studies showed evidence of greater negative social reactions for Black and Hispanic victims, less educated, and bisexual victims. More extensive trauma histories in victims were related to receipt of greater negative social reactions, whereas assault characteristics (e.g., victim-offender relationship, alcohol use, perpetrator violence during assault) were sometimes associated with negative reactions. In terms of postassault factors, more psychological symptoms, self-blame, avoidance coping, less perceived control, and less posttraumatic growth were related to more negative social reactions. Disclosure characteristics, telling informal sources, and telling more sources were related to more positive reactions, whereas telling both formal and informal sources was related to negative reactions. Demographic, attitudinal, and relational factors were related to disclosure recipients' intended social reactions. Future research needs to examine how various factors relate to social reactions in the context of theory, and clinical treatment and interventions should use this information to identify and intervene with victims to reduce negative social reactions and their psychological impacts and to increase positive social reactions particularly from informal support sources.

Nonconsensual Distribution of Sexually Explicit Images Within a Context of Coercive Control: Frequency, Characteristics, and Associations with Other Forms of Victimization

The present study examined the frequency and characteristics of nonconsensual distribution of sexually explicit images (NCD) among undergraduates (n = 496) and its co-occurrence with other forms of interpersonal violence (e.g., physical, sexual, and psychological abuse). Overall, 17.34% of participants reported NCD victimization; most were women (90.70%). Women who reported NCD from current/former partners (71.79%), compared to non-romantic acquaintances, reported more additional interpersonal violence from the same perpetrator and marginally higher threats of NCD, but were no more likely to receive NCD demands. NCD appears to occur within a pattern of elevated violence; prevention and intervention efforts are needed.

The Impact of Victim Blaming and Locus of Control on Mental Health Outcomes Among Female Sexual Assault Survivors

To elucidate individual differences in sexual assault survivor outcomes, we examined locus of control as a moderator of the relationship between victim blaming and both posttraumatic stress disorder (PTSD) symptoms and unhealthy alcohol use. The sample consisted of 82 female sexual assault survivors who had disclosed their victimization to at least one person. The results of this survey demonstrated that locus of control did not moderate the relationship between victim blaming and PTSD, or the relationship between victim blaming and unhealthy alcohol use. The findings further supported the direct relationship between victim blaming and a range of negative mental health outcomes among survivors.

Non-supportive responses to adolescents who have experienced sexual abuse: Relations with self-blame and trauma symptoms

BACKGROUND

Youth who have experienced sexual abuse sometimes also experience non-supportive responses, such as accusations of lying, from people in their family and social environment. Little is known about how such responses from different sources (caregivers, friends, other adults) correlate with one another and operate together in the prediction of youth problematic thinking, such as self-blame, and trauma symptoms.

OBJECTIVE

To better understand how non-supportive responses from different sources relate to one another and contribute to youth problems following sexual abuse.

PARTICIPANTS AND SETTING

Participants were 475 youths (M_age = 13.57, SD = 1.77) brought to a children's advocacy center in the southern United States.

METHODS

Participants completed measures of non-supportive responses from caregivers, friends, and other adults. They also completed measures of abuse-specific self-blame and trauma symptoms.

RESULTS

Non-supportive responses from caregivers, friends, and other adults correlated with each other and with abuse-specific self-blame and trauma symptoms (correlations ranged from 0.12 to 0.18; all p values <.001). Results of regression analyses indicated that only non-supportive responses from caregivers contributed independently to abuse-specific self-blame, whereas non-supportive responses from caregivers and friends contributed to trauma symptoms.

CONCLUSIONS

In the aftermath of sexual abuse, non-supportive responses from caregivers and friends relate to youth trauma symptoms. Assessing non-supportive responses broadly across the social network can be useful in understanding youth adjustment following sexual abuse.