Sexual assault in Virginia: A population-based study

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.

Sexual Assault and the Association With Health, Quality of Life, and Self-Efficacy in the General Norwegian Population

The lifetime prevalence of sexual assault was examined in a representative sample of the general Norwegian adult population (n = 1,792), in addition to the association between sexual assault and health, quality of life, and general self-efficacy. Respondents completed questionnaires assessing these factors. Overall, 6.7% (n = 120) of the respondents (10.9% of women and 1.9% of men) reported an experience of sexual assault. Respondents in the sexual assault group reported significantly worse mental and physical health as well as poorer quality of life and lower self-efficacy, compared with those without sexual assault experience. The most prevalent mental problems in the sexual assault group were depression (61.7%), sleep problems (58.3%), eating disorders (26.7%), and posttraumatic stress disorder symptoms at a clinical level (25.0%). The most prevalent physical problems were chronic pain (47.5%) and musculoskeletal disease (30.8%). The proportions of physical and mental health problems were not significantly different between male and female victims. Results indicated that having experienced sexual assault during one's life appears to be associated with lifetime occurrence of multiple health problems for both genders and reduces a person's perceived general self-efficacy and quality of life.

The Interplay Between Poly-Victimization and Sexual Assault in Late Life in the Context of Life Course Perspective

The aim of this article is to explore the interplay between poly-victimization and sexual assault against women in late life (SAWLL) according to the life-course perspective. Two themes emerged from qualitative interviews with 18 experienced welfare and health care professionals who intervened in cases of SAWLL: sexual assault by a spouse co-occurring with other types of abuse within marital relationships, and sexual assault and other types of abuse by two or more perpetrators along the life course. In many cases, SAWLL is an expression of a broader experience of poly-victimization, which relates to vulnerability in old age.

Breaking the Taboo: Sexual Assault in Late Life as a Multifaceted Phenomenon-Toward an Integrative Theoretical Framework

Sexual assault (SA) in late life has been receiving growing attention over the past two decades. It is directed primarily against older women and has been the least frequently reported form of abuse. Despite the growing awareness and body of knowledge on this phenomenon, the theoretical framework is still limited. Therefore, the aim of the present article is to suggest a theoretical conceptualization of the multifaceted phenomenon of sexual assault against women in late life (SAWLL). This conceptualization has been developed through several stages: (a) identification of three grounded fields of inquiry that are relevant to SAWLL: SA, elder mistreatment, and intimate partner violence; (b) classification of SAWLL along four paths: (1) ongoing SA in the context of lifelong IPV; (2) SA beginning in old age in the family within the community, involving spouses, family members, caregivers, dating mates, and so on; (3) ongoing SA, continuing in institutions, perpetrated by family members; and (4) SA in institutions, beginning in old age, relating to staff, residents, and family members; (c) We suggest three additional theoretical perspectives: trauma, a life-course perspective, and social constructionism, which provide further in-depth knowledge for understanding SAWLL. The combination of the three abovementioned stages composes an integrative theoretical framework, addressing SAWLL as a multifaceted phenomenon.

A cluster-randomized trial of a college health center-based alcohol and sexual violence intervention (GIFTSS): Design, rationale, and baseline sample

INTRODUCTION

Sexual violence (SV) on college campuses is common, especially alcohol-related SV. This is a 2-arm cluster randomized controlled trial to test a brief intervention to reduce risk for alcohol-related sexual violence (SV) among students receiving care from college health centers (CHCs). Intervention CHC staff are trained to deliver universal SV education to all students seeking care, to facilitate patient and provider comfort in discussing SV and related abusive experiences (including the role of alcohol). Control sites provide participants with information about drinking responsibly.

METHODS

Across 28 participating campuses (12 randomized to intervention and 16 to control), 2292 students seeking care at CHCs complete surveys prior to their appointment (baseline), immediately after (exit), 4months later (T2) and one year later (T3). The primary outcome is change in recognition of SV and sexual risk. Among those reporting SV exposure at baseline, changes in SV victimization, disclosure, and use of SV services are additional outcomes. Intervention effects will be assessed using generalized linear mixed models that account for clustering of repeated observations both within CHCs and within students.

RESULTS

Slightly more than half of the participating colleges have undergraduate enrollment of ≥3000 students; two-thirds are public and almost half are urban. Among participants there were relatively more Asian (10 v 1%) and Black/African American (13 v 7%) and fewer White (58 v 74%) participants in the intervention compared to control.

CONCLUSIONS

This study will offer the first formal assessment for SV prevention in the CHC setting. Clinical Trials #: NCT02355470.

Professionals' Awareness of Sexual Abuse in Late Life: An Exploratory Survey

BACKGROUND

The sexual abuse phenomenon is considered taboo. It has been discussed, to date, mainly in relation to children and young women, with insufficient attention to sexual abuse in a late-life context.

OBJECTIVES

The aim of this survey was to explore professionals' awareness of elder sexual abuse (ESA).

DESIGN

The survey was conducted among 161 Jewish and Arab professionals from health care and social services, who worked with older adults in Israel.

RESULTS

Of the entire sample, 70 professionals (only 43%) reported encountering at least one to three cases of ESA. A total of 98% of the victims were women, and the primary offender was the spouse (75%). In most cases (70%), the victim reported the abuse, which was mainly sexual assault (64%). All participants (100%) noted taking action.

CONCLUSION

This exploratory survey indicates that professionals are partially aware of the existence of and the need to address the ESA phenomenon.

Capturing sexual assault data: An information system designed by forensic clinicians and healthcare researchers

BACKGROUND

The Sexual Assault Resource Center (SARC) in Perth, Western Australia provides free 24-hour medical, forensic, and counseling services to persons aged over 13 years following sexual assault.

OBJECTIVE

The aim of this research was to design a data management system that maintains accurate quality information on all sexual assault cases referred to SARC, facilitating audit and peer-reviewed research.

METHODS

The work to develop SARC Medical Services Clinical Information System (SARC-MSCIS) took place during 2007-2009 as a collaboration between SARC and Curtin University, Perth, Western Australia. Patient demographics, assault details, including injury documentation, and counseling sessions were identified as core data sections. A user authentication system was set up for data security. Data quality checks were incorporated to ensure high-quality data.

RESULTS

An SARC-MSCIS was developed containing three core data sections having 427 data elements to capture patient's data. Development of the SARC-MSCIS has resulted in comprehensive capacity to support sexual assault research. Four additional projects are underway to explore both the public health and criminal justice considerations in responding to sexual violence. The data showed that 1,933 sexual assault episodes had occurred among 1881 patients between January 1, 2009 and December 31, 2015. Sexual assault patients knew the assailant as a friend, carer, acquaintance, relative, partner, or ex-partner in 70% of cases, with 16% assailants being a stranger to the patient.

CONCLUSION

This project has resulted in the development of a high-quality data management system to maintain information for medical and forensic services offered by SARC. This system has also proven to be a reliable resource enabling research in the area of sexual violence.

Athletic coaches as violence prevention advocates

Adolescent relationship abuse (ARA) is a significant public health problem. Coaching Boys Into Men (CBIM) is an evidence-based ARA prevention program that trains coaches to deliver violence prevention messages to male athletes. Assessing acceptability and impact of CBIM on coaches may inform prevention efforts that involve these important adults in health promotion among youth. As part of a two-armed cluster-randomized controlled trial of CBIM in 16 high schools in Northern California, coaches completed baseline and postseason surveys (n = 176) to assess their attitudes and confidence delivering the program. Coaches in the intervention arm also participated in interviews (n = 36) that explored program acceptability, feasibility, and impact. Relative to controls, intervention coaches showed increases in confidence intervening when witnessing abusive behaviors among their athletes, greater bystander intervention, and greater frequency of violence-related discussions with athletes and other coaches. Coaches reported the program was easy to implement and valuable for their athletes. Findings illustrate the value of exploring attitudinal and behavioral changes among ARA prevention implementers, and suggest that coaches can gain confidence and enact behaviors to discourage ARA among male athletes. Coaches found the program to be feasible and valuable, which suggests potential for long-term uptake and sustainability.

Analysis of sexual assault survivours in a tertiary care hospital in delhi: a retrospective analysis

INTRODUCTION

Rape and abuse of women are common occurrences, which, many a times go unspoken due to social stigma or fear of retribution. Rape is a crime not against a single human being but against the entire humanity. For granting justice to the rape survivor it becomes necessary that such matters are properly presented before the Courts of Law. Healthcare workers play an important role in this regard because they are the first person who examine the rape victims. They prepare a documented record of medical condition of rape victim and do relevant sample collection.

AIM

The objective of this study is to analyse demographic and event characteristics of rape victims who presented to the Emergency Department in tertiary care, Delhi after sexual assault.

MATERIALS AND METHODS

Data was retrospectively collected from the medico legal register of the Department of Obstetrics and Gynecology between June 2010 to December 2013.

RESULT

We noted a marked increase in the number of cases. Mean age of victims was 17 and most belonged to the lower socio-economic strata of the society. Use of sedatives and physical trauma was not common. Victims often knew the perpetrator of the event. Most (58%) of them reported within one day of the incident. Major degrees of perineal tears were seen in young victims.

CONCLUSION

By understanding the demography of the sexual assault victims, we need to train our doctors for proper evidence collection not just in a government set up but also in private clinics, to help rape victims get justice and proper medical treatment.

Emotional risks to respondents in survey research

Some survey research has documented distress in respondents with pre-existing emotional vulnerabilities, suggesting the possibility of harm. In this study, respondents were interviewed about a personally distressing event; mood, stress, and emotional reactions were assessed. Two days later, respondents participated in interventions to either enhance or alleviate the effects of the initial interview. Results indicated that distressing interviews increased stress and negative mood, although no adverse events occurred. Between the interviews, moods returned to baseline. Respondents who again discussed a distressing event reported moods more negative than those who discussed a neutral or a positive event. This study provides evidence that, among nonvulnerable survey respondents, interviews on distressing topics can result in negative moods and stress, but they do not harm respondents.

The relationship between assault and physical health complaints in a sample of female drinkers: roles of avoidant coping and alcohol use

Trauma exposure and PTSD are associated with poorer physical health. Psychological and behavioral mechanisms may help account for this relationship. In this study, we tested avoidant coping and alcohol use as mediators of the relationship between trauma exposure, PTSD, and self-reported physical health complaints in female drinkers. In 827 college women, we compared three groups: women with no trauma history, women with a sexual assault but no PTSD, and women with a sexual assault and PTSD, on avoidant coping, alcohol use, and physical health complaints. We found that PTSD was positively associated with alcohol use and that PTSD and trauma exposure were associated with increased avoidant coping. We also found that avoidant coping mediated the relationship between trauma, PTSD, and physical health complaints. Alcohol use did not predict physical health but was associated with PTSD. These results suggest that in female college students, coping may be more critical in the PTSD/physical health relationship than alcohol and have implications for targeting coping in young trauma-exposed women to improve physical health.

Barriers to the effective use of medico-legal findings in sexual assault cases worldwide

Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.

Minority women victims of recent sexual violence: disparities in incident history

AIMS

The aims of this descriptive study were to (1) describe assault and care characteristics and (2) determine differences in assault and care characteristics between black women and white women who sought emergency care following sexual violence.

METHODS

A retrospective, cross-sectional design was used to examine forensic examination data characterizing the incident history reported by women victims of sexual violence at the time of a forensic nurse examination. Examinations occurred at an urban university-affiliated hospital emergency department (ED) over a 2-year period.

RESULTS

Of the women (n = 173) seeking care in the ED, 58.4% were black and 41.6% were white. When compared with white women, black women were more likely to have weapons used in their assaults (42.6% vs. 16.7%, p < 0.00) and to be assaulted in the city rather than the suburbs (82.8% vs. 56.5%, p < 0.00). In general, substance use prior to the assault was reported to have occurred in 49.1% of the victims and 41% of the assailants; however, differences existed in the type and pattern of substance use by race/ethnicity. Black victims were more likely to report use of illicit drugs (28.7% vs. 12.5%, p = 0.01). White women were more likely than black women to report personal alcohol use prior to their assault, with significant differences for drinking by victims (47.2% vs. 23.8%, p = 0.01) or assailant use of alcohol (47.2% vs. 23.8%, p = 0.00). White women were more likely than black women to report both they and the assailant had used some type of substance (38.9 vs. 21.8, p = 0.01). Black women were more likely to arrive to the ED via EMS services (45.5% vs. 29.2%, p = 0.03). There were no reported differences in care characteristics by race.

CONCLUSIONS

Findings from this study suggest that differences exist in assault characteristics between black and white women. Use of substances, including alcohol, plays an important role in sexual violence in women and should be a focus of preventive intervention initiatives when conducting a forensic examination. Both coordinated responses and comprehensive, individualized care by specially trained providers are important in the emergency care of minority women who are victims of recent sexual violence.

A characterization of adult victims of sexual violence: results from the national epidemiological survey for alcohol and related conditions

Sexual violence can cause acute and persistent negative psychological outcomes among children and adults in a community. Previous studies have frequently reported high prevalence of prior child and adolescent sexual abuse among adult victims of sexual violence. This raises uncertainty over the specific contribution of sexual victimization in adulthood to the adverse psychological outcomes. The present study draws on a large nationally representative sample of adults without history of childhood sexual abuse, and applies diagnostic criteria of DSM-IV, in order to investigate the risk factors and psychiatric comorbidities correlated with sexual victimization in adulthood. In a large representative sample of U.S. adults without history of childhood sexual abuse, 2.5% reported sexual victimization in adulthood. Female gender, living alone, economic disadvantage, and a history of childhood adversities and parental psychopathology were identified as risk factors. Adult sexual victimization increased the risk of developing a variety of psychiatric disorders, especially PTSD (HR = 3.43, 95% CI [2.67, 4.41]) and drug abuse (HR = 3.38, 95% CI [2.49, 4.58]). Conversely, pre-existing psychiatric psychopathology, particularly PTSD (HR = 3.99, 95% CI [2.68, 5.94]) and dysthymia (HR = 2.26, 95% CI [1.42, 3.59]), increased the likelihood of sexual victimization in adulthood. Childhood experience and adulthood sociodemographic characteristics are important in affecting the risk of being sexually victimized in adulthood. Psychiatric disorders can act as both risk factors and outcomes of adult sexual victimization.

A case of a serial sexual offender: The first ever report from Turkey

There have been cases of serial sexual offenders and studies dealing with such cases in the literature. However, no serial sexual offender case was reported in Turkey, to the best of our knowledge. In this article, as the first report from Turkey, we present a serial sexual offender who assaulted 27 women. The assailant entered a total of 29 houses, and assaulted victims in 27 of them, and he failed to assault two individuals. The 'modus operandi' of the offender was identical in all assault cases and led the police towards a hypothesis that these assaults were all committed by the same individual. The offender did not admit the assaults and strictly refused a forensic psychiatric examination. Being an individual with a high level of education, having a respected position and profession, choosing women aged older than 18 years as victims were among distinctive features of the presented offender.

Sexual Victimization and Completed Suicide Among Danish Female Adults

Although sexual victimization has been associated with suicidal behaviors, its association with completed suicide has not been examined. We investigated this association among Danish women using longitudinal data and a conservative definition of victimization. This population-based case-control study included 476 suicide cases and 12,010 matched controls. Seven cases (1.5%) and 5 controls (0.04%) experienced sexual victimization that was reported to the police and resulted in a conviction. Sexual victimization was associated with a 14-fold increased rate of suicide, controlling for confounders and matching (95% CI: [3.4, 59]). Completed suicide is an important potential outcome of sexual victimization, warranting further examination.

Epidemiological characteristics of male sexual assault in a criminological database

Sexual assault among males, compared with females, is understudied, and may also be significantly underreported. Past studies have relied primarily on population-based survey data to estimate the prevalence of sexual assault and associated health outcomes. However, survey-based studies rely primarily on self-reports of victimization and may not accurately estimate the true prevalence of male sexual assault victimization. In order to obtain a detailed assessment of sexual assault among males, criminological databases like the National Incident Based Reporting System (NIBRS) may provide an important and unique source of information. The objective of the current study was to use data from the 2001-2005 NIBRS to construct an epidemiological profile of sexual assault among males. Our results suggest that the incidence of sexual assault was higher among young males (less than 19 years of age), with approximately 90% of all cases being reported among members of this age group. Among males of all ages, forcible fondling and sodomy were the most prevalent forms of sexual assault. Results from additional analyses include age- and race-specific rates of male sexual assault, the prevalence and severity of injury, and time trends detailing incidence by time of the day and location of the incident. Our analyses show that sexual assault is experienced by males of all age groups. However, the rate of sexual assault is higher among younger males. Despite some limitations, results from this study suggest that NIBRS data may provide a important complement to survey data for understanding breadth and consequences of male sexual assault.

Intimate violence among underrepresented groups on a college campus

Rape, sexual violence, psychological violence, and physical violence, among college students have been a concern. Lifetime events are often studied but not violence that specifically transpires while one is in college. Underrepresented groups such as Deaf and Hard of Hearing students, students who are gay, lesbian, and bisexual, and students who are members of racial and ethnic minorities have not been studied as extensively as White, heterosexual females. The authors used several measures to investigate the incidence of sexual violence, physical and psychological abuse among underrepresented groups in a random sample of 1,028 college students at a private, northeastern, technological campus in upstate New York, United States and analyzed victimization rates by gender, race/ethnicity, auditory status, and sexual orientation. Binary logistic regression analyses found that statistically significant differences are likely to exist between members of underrepresented groups and groups in the majority. The study found statistically significant associations between Deaf and Hard of Hearing students and students who were gay, lesbian, bisexual, or other sexual orientation with psychological abuse and physical abuse. Racial and ethnic minorities and gay, lesbian, bisexual, and other sexual orientation students were significantly more at risk for sexual abuse. Gay, lesbian, bisexual, and other sexual orientation students, students who were members of a racial or ethnic minority, and female students were significantly more likely to be raped. Female heterosexual students were more likely to be the victim of an attempted rape. Suggestions for further research and policy implications are provided.

Self-rated health in relation to rape and mental health disorders in a national sample of women

Overall health status is associated with long-term physical morbidity and mortality. Existing research on the correlates of mental health effects of rape suggests that rape victims are at higher risk for poor overall health status. Little is known, however, about how different rape tactics may relate to health status in rape victims. Our aim was to examine prevalence and correlates of self-rated health in a community sample of women, with particular emphasis on lifetime rape history (distinguishing between rape tactics), psychopathology, and substance use outcomes. A nationally representative sample of 3,001 U.S. women (age range: 18-86 years) residing in households with a telephone participated in a structured telephone interview. Poor self-rated health was endorsed by 11.4% of the sample. Final multivariable models showed that poor self-rated health was associated with older age (p<.001), lower educational attainment (p=.01), African American ethnicity (p=.03), lifetime posttraumatic stress disorder (PTSD; p<.001), lifetime major depressive episode (MDE; p=.01), and history of forcible rape (p=.01). Self-rated health was associated with three potentially modifiable variables (forcible rape, PTSD, and MDE). Therefore, trauma-focused interventions for rape victims should include collaboration on treatment or prevention modules that specifically address both mental and physical health.

Características das mulheres violentadas sexualmente e da adesão ao seguimento ambulatorial: tendências observadas ao longo dos anos em um serviço de referência em Campinas, São Paulo, Brasil

A violência sexual é um crime praticado contra a integridade e a liberdade sexual de uma pessoa. Atinge mulheres de todos os níveis socioeconômicos, e o agressor não escolhe a cor e nem a idade da vítima para agredi-las. É causa de elevado custo financeiro ao país e grave problema de saúde pública. Este estudo teve como objetivo avaliar a evolução da adesão de mulheres vítimas de violência sexual ao seguimento ambulatorial, as quais foram atendidas no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, entre janeiro de 2000 a dezembro de 2006. Observamos um aumento significativo no retorno às consultas agendadas. Em 2000, 41% das mulheres completavam o seguimento de seis meses, e, em 2006, o índice aumentou para 70%. Cerca de 70% das mulheres compareceram nas primeiras 24 horas após serem agredidas; a agressão por conhecidos triplicou ao longo dos anos. Houve mudanças na forma de intimidação e diminuição significativa na prescrição da anticoncepção de emergência.

Evaluation of an information processing model following sexual assault

There is growing recognition that individuals vary in their response to traumatic experiences. Resick and Schnicke (1992) developed an information processing model of trauma response patterns, theorizing that individuals vary in how they integrate the experience into their schematic beliefs. Specifically, individuals can respond to trauma by assimilation, altering the trauma to fit with extant schemas; accommodation, altering extant schemas; or over-accommodation, engaging in maladaptive schema change. Littleton (2007) supported that these response patterns are reflected in distinct coping patterns among rape victims. The current study utilized latent profile analysis (LPA) to replicate Littleton's (2007) findings in a sample of 340 college rape victims, as well as evaluated the extent to which these response patterns were related to distress, trauma-related schemas, re-victimization risk behaviors, and re-victimization. Results of the LPA supported the existence of the three response patterns. In addition, victims classified into the three response patterns differed in their distress, adherence to trauma-related schemas, and re-victimization risk behaviors. While no significant differences in re-victimization rates were found, re-victimization was common. Implications of the findings for future research and intervention are discussed.

Risk factors for suicidal ideation in a population of community-recruited female cocaine users

INTRODUCTION

Suicide, as the 11th leading cause of death in America, is a significant public health concern. Previous studies have shown that drug users are a population at especially high risk for suicidal ideation (SI). Although most people who think about killing themselves do not ultimately commit suicide, identifying those at risk for such thoughts is important.

METHODS

In this analysis, data from a sample of 462 cocaine-using women (87% African American) recruited using street outreach methods for a National Institute on Drug Abuse-funded study were examined to identify risk factors for lifetime SI. Sociodemographic factors, adverse childhood experiences, sexual behaviors, psychiatric comorbidities, and drug abuse and dependence were examined as potential risk factors using both bivariate and logistic regression analysis.

RESULTS

Fifty percent of the sample met at least one criterion for lifetime SI, and 32% of the sample reported a lifetime suicide attempt. In the final logistic regression model, childhood physical abuse, childhood sexual abuse, rape after the age of 15 years, posttraumatic stress disorder, and number of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, depression criteria met emerged as significant independent predictors of lifetime SI.

CONCLUSION

These findings identify important risk factors for SI among female substance abusers in community settings.

If she is not a victim, does that mean she was not traumatized? Evaluation of predictors of PTSD symptomatology among college rape victims

The issue of whether individuals can be traumatized by the experience of rape if they do not label the experience a victimization remains controversial. Indeed, there are conflicting findings with regard to the extent to which such unacknowledged victims experience posttraumatic symptoms. The goal of the current study was to evaluate acknowledgment status as a predictor of posttraumatic stress disorder symptomatology using structural equation modeling among a sample of 346 college rape victims. Results showed that whereas acknowledged victims reported more symptoms of posttraumatic stress disorder, acknowledgment status did not add to the prediction of posttraumatic stress disorder symptoms in a model including assault violence and other important predictors of these symptoms.

Adult sexual assault evaluations at Rhode Island emergency departments, 1995-2001

The objectives of this study were to estimate the incidence and identify the temporal patterns of visits to Rhode Island emergency departments (EDs) by adults who were sexually assaulted. Visits to all Rhode Island EDs from January 1995-June 2001 by adults who were sexually assaulted were identified using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9) codes. Medical records of these visits were reviewed. Frequency distributions of the assault characteristics and patient demographics were generated. Incidence rates (IRs) of ED visits after sexual assault were estimated using 2000 US Census data. Analyses of the temporal patterns of the ED visits after sexual assault were conducted. Of the 823 ED visits, 796 (96.7%) were by females and 27 (3.3%) were by males. The median age for females was 25 years (range, 18-96 years) and was 28 years (range, 18-87 years) for males. Among the female patients, 76.6% sustained a vaginal/anal assault. Among the male patients, 59.3% sustained an anal assault. The average annual IR of ED visits after sexual assault was 30.3/100,000/year for females and 1.2/100,000/year for males, which is a 25-fold greater incidence of these visits for females than males. ED visits after adult sexual assault were more frequent during warmer months and around 5 P.M. There was a gradual 43% increase in the IRs of ED visits after sexual assault over the 6.5-year period. These findings should help direct EDs to maximize supportive services when they are needed most often.

Characteristics of victims and assaults of sexual violence--improving inquiries and prevention

The purpose of our study was to provide descriptive data on victim and assault characteristics in sexual violence and to ascertain risk factors in the sequence of the assault events. Retrospective data were collected on all sexual assault victims presented to the sexual referral centre, the police and the Institute of Forensic Medicine in Aarhus, Denmark, during a five-year period. Four hundred and twenty-three victims were included. The annual incidence rate was 14.5 per 100,000 inhabitants aged 12-87 years and the "dark figure" was estimated to be 1.34. Median age was 21 years; 69% of the victims knew the assailant, and penile intercourse was reported in 59% of the cases. Young age and drinking alcohol were risk factors for the assault to take place in a public place. Information to high-risk groups identified by this study should be integrated in approaches of modifying sexual behaviour. Furthermore, the results from this study are useful in supporting staff and police investigators in the guidance of their efforts regarding treatment and inquiries.

Age at Sexual Assault And Posttraumatic Stress Disorder among Women: Prevalence, Correlates, And Implications for Prevention

BACKGROUND

Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that can occur in people who experience extremely stressful or traumatic life events. Sexual assault is one of the most traumatic stressors in life. Although several studies have investigated the association between history of sexual assault and PTSD, studies on the impact of age at first sexual assault on PTSD are limited.

METHODS

A cross-sectional telephone survey was conducted among 1,769 adult female residents of Virginia. A detailed screening questionnaire was used to ascertain the occurrence and age at first sexual assault. The DSM-IV diagnostic criteria were used to define PTSD.

RESULTS

The prevalences of PTSD among women with no history of sexual assault, those victimized for the first time before the age of 18, and those assaulted for the first time at >or=18 were 8.1%, 35.3%, and 30.2%, respectively. Multivariate logistic regression model showed an increased risk of PTSD among women assaulted at a younger age. Compared with women reporting no history of sexual assault, women who were victimized before age 18 were 3.8 times more likely to suffer from PTSD (OR = 3.75, 95% CI 2.33-6.53). The risk of PTSD among women victimized as adults was 2.9 times higher compared with women who reported no history of sexual assault (OR = 2.89, 95% CI 1.46-5.74).

CONCLUSIONS

The risk of PTSD is slightly higher among those assaulted before the age of 18 compared with those who were assaulted at age >or=18. The adverse effect of sexual assault as a risk for PTSD is a major public health concern. Primary prevention strategies should be in place to detect sexual assault victims and prevent the occurrence of PTSD.