Predictors of PTSD symptom severity and social reactions in sexual assault victims

Gender differences in the associations of psychosocial trauma and acute medical stressors with immune system activation and dementia risk

Objective: The purpose of this article is to provide a narrative review synthesizing the literature on differences between women and men in relationships among certain stressors associated with immune system activation and their relationship to cognitive dysfunction and dementia. Method: We review the cycle of stress leading to neuroinflammation via cortisol and neurochemical alterations, cell-mediated immune system activation, and pro-inflammatory cytokines, and how this is implicated in the development of dementia. We follow this by discussing sex differences in stress physiology and immune function. We then review the work on early life adversity (ELA) and adverse childhood experiences (ACEs), post-traumatic stress disorder, acute medical stressors, and their associations with cognitive dysfunction and dementia. Throughout, we emphasize women's presentations and issues unique to women (e.g. trauma disorder prevalence). Conclusions: There is a need for more mechanistic and longitudinal studies that consider trauma accumulation, both physical and emotional, as well as a greater focus on traumas more likely to occur in women (e.g. sexual abuse), and their relationship to early cognitive decline and dementia.

Logistics and Interdisciplinary Expertise of a Sexual Assault Response Team: A Case Study Through Observations and Interviews

To more effectively respond to sexual assault in the United States, some jurisdictions have created sexual assault response teams (SARTs). SARTs involve members of multiple agencies tasked with responding to sexual assault within a jurisdiction, such as law enforcement, advocates, prosecutors, and sexual assault nurse examiners (SANEs). Despite hundreds of jurisdictions utilizing SARTs, and the Department of Justice establishing guidelines, SARTs vary across jurisdictions in their form and function. To clarify this, the current research outlines two studies to better understand the logistics and functioning of one SART. In Study 1, for over nearly 2 years, SART meetings were observed and notes were taken on representation of agencies, time spent on cases, and possible challenges. Overall, the SART met consistently, with representation of major stakeholders at each meeting. Stakeholder agencies remained consistent and most time spent in the meetings was on case review. In Study 2, 10 members of SART were interviewed to assess perceptions of SART. These interviews were independently qualitatively coded for both factual and thematic codes. Areas of focus included perceived logistics of the SART and expertise of members that make up an effective SART. Overall, on average, members had been part of the SART for 3.5 years, felt required to attend the meetings as part of their role, and shared that all members (i.e., law enforcement, district attorney, victim advocates, and SANEs) had expertise on differing subjects that effectively made the SART work well. Importantly, qualitative perceptions from members of the SART (Study 2) lined up with the independent observation of SART meetings (Study 1). Ultimately, the results from this body of research could delineate specific actions that a jurisdiction implementing a SART could utilize.

Acute Stress Symptoms, Intolerance of Uncertainty and Coping Strategies in Reaction to the October 7 War

BACKGROUND

On 7 October 2023, hundreds of armed Hamas fighters breached the security border fence and entered Israel from the Gaza Strip. More than 1400 Israeli citizens were murdered, and 239 individuals were kidnapped. Many Israeli citizens experienced these occurrences as psychologically traumatic events that caused stress and uncertainty.

OBJECTIVES

The present study aimed to examine the relationship between exposure to war (in more distant circles), intolerance of uncertainty (IU) and disengaged coping on acute stress symptoms (ASS). First, we examined whether exposure to war and IU were directly associated with ASS. Second, we tested the mediating role of disengaged coping in the relationship among war exposure, IU and ASS.

METHODS

This cross-sectional study involved 393 Israeli citizens. Participants answered questionnaires on exposure to war, IU, coping strategies and ASS.

RESULTS

The study results indicate that higher exposure and higher levels of IU were directly associated with more intensive ASS, and this association was partially mediated by higher use of disengaged coping strategies.

CONCLUSIONS

Individuals during wartime are at risk of experiencing high levels of ASS and developing ASD. However, degree of exposure to war alone was not associated with ASS, but it was related to personal resources and coping strategies.

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).

The self-perceived impact of sexual abuse on daily life and general health - an issue to consider in dental care

BACKGROUND/AIM

To analyse, from the perspective of adults with a history of sexual abuse, the impact of the experience on their general health and well-being.

MATERIAL AND METHODS

The participants comprised 12 strategically selected informants (10 women), aged 19-56; all sexually abused during child- and/or adulthood. They were interviewed in-depth and encouraged to describe the impact of the sexual abuse on their daily lives. The consequences of sexual abuse on oral health have previously been reported. The interviews were recorded digitally, transcribed verbatim and analysed according to qualitative content analysis with an inductive approach.

RESULTS

The overall theme illustrating the latent content was Sexual abuse experience-limiting long-term consequences, always present in body and mind. The first category covering the manifest content was 'A lost foothold', with two subcategories: (i) emotional repercussions and (ii) physical health repercussions. The second category was 'The significance of distance to trauma', with two subcategories (i) keeping a distance and tending to escape and (ii) processing the trauma experience-a struggle towards balance.

CONCLUSIONS

A history of sexual abuse cannot be understood in isolation: the long-term repercussions pervade daily life. However, after disclosure of the abuse and processing the trauma, it is possible to ameliorate some of the negative effects. In this context, the dental setting emerges as a potentially important venue for disclosure as almost every person, sooner or later, visits the dentist.

Aspects of Selective Sexual Assault Disclosure: Qualitative Interviews With Survivors and Their Informal Supports

Two-thirds of survivors typically disclose their experience to informal supports (e.g., friends, family, partners) at some point following sexual assault, but little in-depth research has addressed specific aspects of disclosure. In the current study, a diverse sample of 45 sexual assault survivors and their informal support providers (SP; e.g., family, friends, romantic partners) were interviewed separately about experiences of disclosure, social reactions, and help-seeking following the assault. Narrative data on the overarching thematic category of selective disclosure were analyzed using thematic analysis methods. Several subthemes emerged specific to (a) the circumstances of disclosure (prompted or coerced), (b) withholding details (framing disclosures to avoid rape myths and blame, strategic use of language, protecting others by not disclosing or limiting details), and (c) sharing details (selecting who was told, selecting trusted others for disclosure, selective details told to specific people, sharing with strangers easier). Implications are drawn for future research on aspects of selective disclosure of sexual assault and clinical practice implications for supporting survivors and their informal support networks.

The Relationship Between Rape Myths, Revictimization by Law Enforcement, and Well-Being for Victims of Sexual Assault

Relationships between rape myths, revictimization, and postassault well-being were examined in a sample of adult victims of sexual assault (n = 88). Correlation, multiple regression, and path analyses investigated whether conformity to stereotypes of "real rape" or "real victim" was associated with revictimization and well-being. A possible mediating effect of revictimization on the relationship between rape myth conformity and well-being was assessed. The relationship between specific revictimization behaviors and emotions was also analyzed. Questioning victims' resistance to the assault was correlated with revictimization emotions. "Real victim" characteristics were associated with well-being, but no mediating effect of revictimization was observed.

Sexual Violence Disclosure in #Notokay: Disclosure Goals, Disclosure-Facilitating Resources, and Overall Disclosure Trajectory

This study investigated the disclosure goals, disclosure-facilitating resources, and overall disclosure trajectory of 16 women who participated in the 2016 #notokay antisexual violence campaign. Findings indicate that most participants' disclosure goals were approach focused. Factors that facilitated disclosure were social media affordances and psychological, professional, and financial resources. Participants' overall disclosure trajectory was upward, but not linear, and disclosure outcomes included self-growth and awareness of the intersectional nature of violence. The findings suggest that the disclosure processes model can be strengthened by considering goal-relevant resources as a structural or environmental factor that influences the choice of approach versus avoidance goals, and consequently, beneficial or harmful disclosure outcomes. Further, by investigating how participants' #notokay disclosure was situated in their other online and offline disclosure episodes, this study provides a contextualized perspective of online hashtagged disclosures of sexual violence.

(Non-)disclosure of lifetime sexual violence in maternity care: Disclosure rate, associated characteristics and reasons for non-disclosure

BACKGROUND

In maternity care, disclosure of a past sexual violence (SV) experience can be helpful to clients to discuss specific intimate care needs. Little evidence is available about the disclosure rates of SV within maternity care and reasons for non-disclosure.

AIM

The aim of this study was to examine (1) the disclosure rate of SV in maternity care, (2) characteristics associated with disclosure of SV and (3) reasons for non-disclosure.

METHODS

We conducted a descriptive mixed method study in the Netherlands. Data was collected through a cross-sectional online questionnaire with both multiple choice and open-ended items. We performed binary logistic regression analysis for quantitative data and a reflexive thematic analysis for qualitative data.

RESULTS

In our sample of 1,120 respondents who reported SV, 51.9% had disclosed this to a maternity care provider. Respondents were less likely to disclose when they received obstetrician-led care for high-risk pregnancy (vs midwife-led care for low-risk pregnancy) and when they had a Surinamese or Antillean ethnic background (vs ethnic Dutch background). Reasons for non-disclosure of SV were captured in three themes: 'My SV narrative has its place outside of my pregnancy', 'I will keep my SV narrative safe inside myself', and 'my caregiver needs to create the right environment for my SV narrative to be told'.

CONCLUSIONS

The high level of SV disclosure is likely due to the Dutch universal screening policy. However, some respondents did not disclose because of unsafe care conditions such as the presence of a third person and concerns about confidentiality. We also found that many respondents made a positive autonomous choice for non-disclosure of SV. Disclosure should therefore not be a goal in itself, but caregivers should facilitate an inviting environment where clients feel safe to disclose an SV experience if they feel it is relevant for them.

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.

Sexual Violence-Related Stigma, Mental Health, and Treatment-Seeking: A Multimodal Assessment in a Population-Based Study of Young Adults

Sexual violence (SV) is a stigmatized form of trauma, yet the stigma experiences of those reporting SV are often assumed rather than explicitly measured. We adapted a measure that quantified three key features of SV stigma across three levels: negative self-image (individual), disclosure concerns (interpersonal), and concerns about public attitudes (structural). We administered this measure to a population-based sample of Swedish young adults (N = 453) who reported a history of either sexual assault (SA) or intimate partner sexual violence (IPSV). Among both groups, 89% endorsed at least one item on the stigma scale. Experiences of SV-related stigma were associated with significantly higher symptoms of generalized anxiety, depression, and posttraumatic stress disorder, with greater perceived need for mental health treatment, and with more shame (measured implicitly via a reaction-time task). Experiences of stigma were negatively associated with symptoms of alcohol misuse. Results suggest that exposure to SV stigma may be a critical, but often overlooked, correlate of post-assault recovery.

The Role of Coping Behaviors and Intoxication in Trauma Symptomology Subsequent to Sexual Victimization

College women are at an elevated risk for sexual victimization (SV) and secondary physical and psychological consequences. While some women experience negative outcomes such as posttraumatic stress disorder (PTSD), others experience reduced or complete absence of distress following SV. The variation in outcomes may be associated with the victim's level of intoxication, which may in turn affect their processing of and coping with the event. We examined the effects of SV severity on PTSD via coping and intoxication using a moderated mediation analysis among female college students (N = 375). Results demonstrate that coping mediates the association between SV severity and PTSD symptomology; however, intoxication did not moderate these associations. Results suggest that regardless of intoxication, SV severity influences various coping styles and plays an important role in a victim's adjustment post-victimization.

Reacting to Non-Prototypical Victims: Blame, Empathy, and Willingness to Label Sexual Assaults of Men and Sexual Minority Victims

Sexual assault is prevalent in the U.S. society, with an estimated 16% of women and 8% of men experiencing some form of sexual violence during their lifetime (Breiding, 2014). Sexual violence crosses all identity lines; however, legislation, cultural representation, and academic scholarship on sexual violence has historically been limited to assaults against women perpetrated by men. This dominant analysis of sexual assault focuses on the impact of sexism on sexual violence, neglecting the impact off other forms of oppression and attitudes related to sexuality and gender. This dominant representation leaves non-prototypical victims, such as men, people of other genders, and sexual minorities of all genders, less visible and less understood. This underrepresentation may lead to negative reactions toward these victims including blame, exoneration of the perpetrator, and reluctance to acknowledge assaults. In the current study, I explored the impact of both victim gender and sexual orientation on reactions to a hypothetical intimate partner sexual assault victim. Results indicated that perpetrators who assaulted a man were blamed less than those who assaulted a woman. Furthermore, study participants had more empathy for women who were assaulted than they did for men. There were no differences in participants' negative reactions to victims by sexual orientation. Results suggest that, while some advances have been made in public support for sexual assault victims, these advances may not extend yet to men as victims.

A qualitative analysis of the context and characteristics of trauma exposure among sexual minority survivors: Implications for posttraumatic stress disorder assessment and clinical practice

OBJECTIVE

Sexual minority individuals are exposed to traumatic harms unique to the shared cultural experience of living under conditions of identity-based stigma, discrimination, and marginalization. However, the context and characteristics by which this culture shapes traumatic experiences among sexual minority people are poorly specified in the research literature, leaving even well-intentioned mental health professionals inadequately prepared to treat sexual minority trauma survivors in a culturally affirming, tailored, and evidence-based manner.

METHOD

To begin to address this gap, we conducted a thematic analysis of descriptions of 52 Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Criterion A (traumatic) events described by sexual minority participants during administration of the Clinician-Administered PTSD Scale for DSM-5.

RESULTS

Probing for identity relatedness of Criterion A trauma produced a rich and reliable (κ = .83-.86) coding scheme reflecting the cultural context and characteristics of these experiences.

CONCLUSIONS

Clinicians working with sexual minority and other marginalized trauma survivors should specifically assess for the role of culture in traumatic experiences to inform case conceptualization and treatment plans supporting recovery of the whole survivor. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Predictors of college women's disclosure of sexual assault prior to and during college

Talking to others about experiences of sexual assault can facilitate recovery. The present study explored associations between assault characteristics, attitudes, coping strategies, social support, and the college women's disclosure of adolescent sexual victimization (N = 134), as well as sexual victimization over a 7-month interim during college (N = 67). A sample of first-year college women completed pencil and paper assessments of sexual victimization, assault characteristics, tendency to disclose, self-concealment, attributions of blame, likelihood to report sexual victimization, social support., and coping strategies. A series of bivariate and multivariate analyses examined predictors of sexual assault disclosure. Whereas acknowledgment of the sexual assault as victimization predicted disclosure of adolescent sexual assault, less acquaintance with the perpetrator and strong social attachments predicted disclosure of sexual assault occurring during women's first year of college. Data suggest that the factors that influence disclosure of sexual assault may vary across periods of adolescent and young adult development.

A Comparison of Sexual Minority and Heterosexual College Students on Gendered Sexual Scripts and Sexual Coercion Perpetration

Prior work has identified endorsement of gendered sexual script beliefs as predictive of sexual coercion perpetration among heterosexual individuals, primarily men. This research is lacking among sexual minority individuals and may be important in informing inclusive and effective sexual coercion prevention efforts. The current study sought to (1) assess the level of adherence to gendered sexual script beliefs, (2) report relative rates of general sexual coercion and sexual intimate partner violence (IPV), and (3) examine the relationship between gendered sexual script beliefs and self-reported sexually coercive behavior among sexual minority and heterosexual college men and women. Undergraduate students (n = 1,199; 182 sexual minorities) completed self-report measures assessing gendered sexual script beliefs, sexual coercion perpetration, and sexual IPV. Results from Gender × Sexual Minority group ANOVAs and logistic regression analyses indicated similar rates of perpetration across sexual orientation groups, with men overall reporting the most perpetration. Furthermore, men and heterosexual individuals adhered more strongly to gendered sexual scripts than women and sexual minority individuals, respectively. Results of path models revealed no moderation by sexual orientation, and that adherence to gendered sexual scripts was positively related to sexual IPV perpetration among the full sample of heterosexual and nonheterosexual individuals, though this effect was small. Gendered sexual scripts did not significantly relate to general sexual coercion perpetration among the full sample, suggesting that traditional sexual script beliefs may not be as relevant to perpetration in a contemporary college sample. This study adds to limited literature on sexual coercion perpetration among sexual minority individuals and is an important step in understanding relationships between endorsement of gendered sexual script beliefs and sexual coercion perpetration among sexual minority and heterosexual college students.

Reassessing the Confluence Model of Men's Risk for Sexual Aggression

Reassessing the confluence model of men's risk for sexual aggression-the confluence model of sexual aggression has been widely used to study men's risk for perpetrating sexual violence. Over time, researchers have attempted to expand this model to improve its predictive utility. Unfortunately, this work has continued to produce similar results with only slight improvements in prediction at best. One explanation for the inability to enhance the model could be due to changes in the dating landscape and shifts in beliefs about gender roles. Therefore, the current study aims to reassess the confluence model using a more contemporary construct, hostile sexism, in an effort to improve the predictive utility of the confluence model of sexual aggression. Participants were 258 college men recruited from a medium-sized public university in the northeastern United States, using an online participant pool of students who volunteered to participate as part of a requirement for a psychology course. Structural equation modeling using mean- and variance-adjusted weighted least squares estimation indicated that the confluence of hostile sexism and impersonal sex appears to be a better predictor of sexual aggression in comparison to the confluence of hostile masculinity and impersonal sex. The results suggest that replacing hostile masculinity with hostile sexism may produce a model that is better able to predict men's risk for perpetrating sexual aggression. These results can provide insight for future iterations of the confluence model, which may include hostile sexism as a core construct. Attitudes that stem from hostile sexism may be a beneficial target for future interventions designed to decrease the frequency of perpetration.

Patterns of Violence Victimization and Disclosure Among Transgender/Gender Nonconforming and Cisgender Latinx College Students

Although research on sexual violence experiences of minoritized college students has increased in recent years, little is known about the experiences of Latinx students. Even less knowledge is available on whether such violence and disclosure experiences vary by gender identity. The present study addressed this gap by exploring the rates of sexual violence and disclosure patterns after experiences of sexual violence among Latinx college students. Using data from the 2019-2020 Healthy Minds Study, a national sample of Latinx college students was analyzed (n = 6,690). Descriptive statistics, χ² tests, and one-way analyses of variance were conducted to explore differences in gender identity, sexual violence victimization, and disclosure type. Multiple logistic regression analyses were used to estimate the association between (1) gender identity and sexual violence victimization and (2) gender identity and sexual violence disclosure while controlling for various sociodemographic measures. Results indicated sexual violence victimization occurred at significantly higher rates among transgender/gender nonconforming and cisgender women Latinx students, compared to cisgender men. Transgender/gender nonconforming students who experienced sexual violence were significantly less likely to make any disclosure of sexual violence when compared to cisgender men. These findings highlight the extent to which experiences of sexual violence among Latinx students differ based on their gender identity. It also brings attention to the need for campus programming to attend to students who often face structural barriers because of their intersecting identities, specifically transgender/gender nonconforming Latinx students.

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.

Beyond Sexual Assault Prevention: Targeted Outcomes for Empowerment Self-Defense

Empowerment Self-Defense (ESD) has been shown to be effective in reducing risk of sexual assault victimization among women, but because research in this area is still in its infancy, less is known about additional intervention outcomes that may explain how and why the intervention is effective and about other ways that ESD affects students. The purpose of this study was to examine ESD instructor perspectives about intervention outcomes they perceive to be most important for their students. Using qualitative case-study methodology, interviews from 15 ESD instructors from the United States and Canada were conducted and analyzed using thematic analysis, which yielded six themes: Agency, boundaries, core beliefs, health and healing, somatic experiences, and gender and intersectionality, with each theme having two or more subthemes. Although some of these outcomes have been quantitatively evaluated in previous ESD studies, over half (n = 10) have not yet been empirically measured and are the focus of this article. These 10 outcomes include enactment, self-determination, nonverbal communication, relationship quality, self-worth, healing, physical strength and power, downregulation, support and solidarity, and societal-level changes. In addition to developing standardized tools to measure these outcomes, future research should quantitatively evaluate these outcomes across diverse student populations and explore their effect on producing the profound outcome associated with ESD, which is reduced risk for sexual assault victimization.

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.

Rape Victim Advocates' Perceptions of the #MeToo Movement: Opportunities, Challenges, and Sustainability

Awareness of the frequency of sexual victimization has been promoted through the #MeToo movement that opened the floodgates for survivors of sexual harassment, victimization, and violence to disclose their victimization. This research explores 41 rape victim advocates' perceptions of the #MeToo movement and concludes that they recognize its strengths and weaknesses. They credit the movement for: empowering survivors to disclose their experience possibly due to reduced stigma surrounding sexual victimization given the number of disclosures, providing support through social media from other survivors, and increasing societal awareness of the prevalence of sexual victimization. Those interviewed fault the movement for: giving the false perception that since so many survivors are stepping forward then reports must be fabricated, pressuring victims to support the movement through disclose and criticizing those who do not disclose, and hindering survivors' ability to escape media and social media coverage of sexual victimization. Advocates perceived #MeToo to be more of a "movement" rather than a "moment." However, to sustain its progress advocates suggested that action must be taken to create change for survivors and to reduce the occurrence of sexual victimization through policy/legal change and perpetrator accountability.

The Role of Social Reactions to Disclosures in the Relationship Between Sexual Assault Acknowledgment and Psychological Symptoms

Following a sexual assault, women experience a host of negative psychological consequences. While some survivors label their sexual assault experience as such (i.e., are acknowledged survivors), other survivors do not. The effect of acknowledgment of sexual assault on postassault outcomes has yielded mixed findings. It was hypothesized that social reactions may account for the relationship between acknowledgment status and psychological symptoms. Results indicated that acknowledged survivors reported more severe posttraumatic stress disorder symptoms, which were partially accounted for by turning against social reactions. Future studies should explore the mechanisms responsible for these relationships and analyze the individual social reactions.

Explaining the Why in #WhyIDidntReport: An Examination of Common Barriers to Formal Disclosure of Sexual Assault in College Students

Within the current study, we examined themes of college students' reasons for choosing not to formally disclose (report) sexual assault. To complete this objective, we examined tweets (n = 1,297) that used the WhyIDidntReport hashtag in which a user also made reference (within the same thread) to being enrolled at a college or university during the time (and aftermath) of the assault. We deemed Twitter a particularly valuable platform, offering insight into the hidden figure of crime, as users described events, feelings, and perceptions after the event that led to them not formally disclosing. Further, it provides a large sample of cases of women and men who recognize their assault as an assault (at least in hindsight), while also providing open-ended, unstructured explanations of their rationales and motivations. Using an inductive approach, we established broad themes that were then refocused into common barriers of formal disclosure or the continuation of formal disclosure. Subthemes included anticipated social reactions (stemming from vicarious and direct experiences), internalized emotions, often stemming from social reactions (normalization, shame, and blame), victim and offender status, and victim-offender relationship. Three overarching premises were developed from the analysis including (a) victims' internalizations of experiences and observations, (b) the interaction of social factors of the victim, offender, and the victim-offender relationship, and (c) the continual and compounded decision-making process of formal disclosure. These conclusions were then examined within theoretical models, including Black's Behavior of Law Theory (specifically morphology and stratification), Overstreet and Quinn's intimate partner violence stigmatization model, and Chaudoir and Fisher's disclosure process model. Lastly, we provide programmatic recommendations, which includes retailoring current bystander intervention curricula to include more focus on social reactions and social support in anticipation of college students being recipients of sexual assault disclosures by friends and acquaintances.

Exploring Correlates of Social Reactions to Disclosure Among Latina Sexual Assault Survivors

Social reactions to sexual assault (SA) disclosure are well-documented in the literature, but less is known about disclosure and reactions received by Latina survivors. The current study analyzed correlates of positive and negative social reactions to sexual assault disclosure in a community sample of Latina survivors (n = 239). Compared to White survivors, Latina survivors were more likely to report turning against and acknowledgement without support reactions. Among Latina survivors, contrary to hypotheses, both "stereotypical" (e.g. more violent assaults) and "non-stereotypical" (e.g. pre-assault substance use) assault characteristics were associated with acknowledgement without support negative social reactions. Furthermore, total number of sources Latina survivors disclosed to were associated with turning against social reactions. Implications for future research on disclosure/social reactions and Latina survivors are discussed.

Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape

INTRODUCTION

The prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design.

METHODS

In a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape.

RESULTS

The incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores.

LIMITATIONS

We could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment.

CONCLUSION

Addressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.

Reactions to the disclosure of intrafamilial childhood sexual abuse: Findings from the National Sexual Assault Online Hotline

INTRODUCTION

For child sexual abuse (CSA) victims, disclosure can be helpful or harmful depending on how recipients respond. Despite a growing body of literature examining reactions to disclosure, little is known about the experiences of current CSA victims, particularly those abused by family.

OBJECTIVE

We aimed to describe and explore the initial disclosure experiences of intrafamilial CSA victims, and whether reactions varied based on the type of disclosure recipient.

PARTICIPANTS AND SETTING

This study utilized anonymous, archival data from the US-based National Sexual Assault Online Hotline (NSAOH), and focused on a sample of 224 intrafamilial CSA victims who had previously disclosed to one type of recipient.

METHODS

NSAOH staff summarized children's disclosure experiences via an open-ended survey field. Data were independently coded using the Social Reactions Questionnaire.

RESULTS

Nearly three-fourths (73%) of children described receiving a negative reaction to disclosure. Negative reactions included distracting or dismissing the victim (33%), not believing the victim (29%), or retaliating or responding violently following disclosure (10%). Children most frequently disclosed abuse to non-offending family (66%), friends (17%), and formal support providers (12%). Relative to friends and intimate partners, victims were more likely to discuss negative reactions from family (49% v 87%, respectively, Cramer's V = 0.33, p < 0.001).

CONCLUSIONS

Disclosing to non-offending family may be unproductive and potentially harmful for some children. This study has implications for disclosure-related planning protocols on anonymous hotlines. Findings underscore the importance of educating the public, and parents in particular, about how to respond to CSA disclosures.

Lonely in the Dark: Trauma Memory and Sex-Specific Dysregulation of Amygdala Reactivity to Fear Signals

Loneliness exacerbates psychological distress and increases the risk of psychopathology after trauma exposure. However, it is still unclear whether a lack of social connectedness affects trauma-related intrusions and the neural processing of fear signals. Moreover, it is uncertain, whether loneliness plays a different role in women and men. A prestratification strategy is used and n = 47 (n = 20 women) healthy lonely individuals and n = 35 controls (n = 18 women) are recruited. Participants are exposed to an experimental trauma and evoked intrusive thoughts in daily life are monitored for three consecutive days. Functional magnetic resonance imaging is used to assess neural habituation to fearful faces and fear learning (conditioning and extinction) prior to trauma exposure. The results reveal a significant interaction between loneliness and sex such that loneliness is associated with more intrusions in men, but not in women. A similar pattern emerges at the neural level, with both reduced amygdala habituation to repeated fearful faces and amygdala hyperreactivity during the conditioning of fear signals in lonely men. The findings indicate that loneliness may confer vulnerability to intrusive memories after trauma exposure in healthy men and that this phenotype relates to altered limbic processing of fear signals.

Responding to Disclosure of Sexual Assault: The Potential Impact of Victimization History and Rape Myth Acceptance

Victims of sexual assault often disclose their victimization experiences to friends and family members in the hope of gaining support. However, a number of factors may influence the manner in which these confidants respond to the disclosure (e.g., severity of the victim's assault). The purpose of this study was to examine the role of two unique factors-the disclosure recipient's sexual victimization history and endorsement of rape myths-in predicting responses to disclosure. Participants were 114 undergraduate students who indicated that a close friend or family member had previously disclosed a sexual victimization experience to them. The participants' responses to that disclosure, personal sexual victimization history, and rape myth attitudes were assessed via a self-report. Results indicated that a history of victimization predicted increased emotionally supportive responses to disclosure. Lower rape myth acceptance predicted increased supportive responses (i.e., emotionally supporting the victim and aiding the victim) and decreased unsupportive responses (i.e., treating the victim differently after the abuse, distracting the victim from the abuse, and blaming the victim). These results have implications for prevention efforts and those working with sexual assault survivors.

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

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

Latent Profiles of Social Reactions to Sexual Assault Disclosure Among Undergraduate Women

The types of social reactions that victims receive when they disclose experiences of sexual assault are important for post-trauma recovery. Using a person-centered analytic approach, we identified latent profiles based upon the nature of two types of negative (turning against and unsupportive acknowledgment) and two types of positive (emotional support and informational/tangible aid) reactions received by 300 undergraduate women who disclosed sexual assault. Analyses identified four latent profiles characterized by (a) moderate emotional support/low negative reactions, (b) moderate emotional support/moderate negative reactions, (c) high positive/some unsupportive acknowledgment reactions, and (d) moderate positive/high negative reactions. Differences between the profiles in sexual assault acknowledgment, self- and perpetrator-blame, and some assault-related characteristics (victim injury but not victim or perpetrator intoxication) were identified. Group comparisons revealed that the two profiles characterized by greater negative reactions reported greater posttraumatic stress, whereas the profile characterized by moderate support/moderate negative reactions reported greater depression. No differences were identified for hazardous alcohol use. Findings highlight the importance of addressing negative reactions to sexual assault disclosure as potential barriers to recovery. Colleges may benefit from programming targeted at disclosure recipients as part of violence prevention efforts. A broader societal shift is also imperative to eliminate stigmatization of victims. Additional online materials for this article are available on PWQ’s website at: http://journals.sagepub.com/doi/suppl/10.1177/03616843211038924 .

Differences in Women's Substance-Related Sexual Assaults: Force, Impairment, and Combined Assault Types

This study furthers previous research on sexual assaults (SAs) involving substances and/or force by examining effects of perpetrator behaviors of alcohol and/or drug impairment level (none, impaired, incapacitated) and/or force during SA in relationship to various assault and recovery outcomes. A diverse sample of 632 women from a large Midwestern city participated in a study on women's experiences with SA. Of this sample of substance-involved SAs, 37.3% (n = 236) reported a forcible-only unimpaired assault, 50.6% (n = 320) reported a combined impairment/incapacitation and force assault, and 12% (n = 76) reported an impaired/incapacitated-only assault. Multivariate analyses of covariance (MANCOVAs) and chi-square analyses compared assault types as defined by combined alcohol and/or drug impairment level and/or force to determine how these assaults differed in demographics, other assault characteristics, and post-assault experiences. Assault types differed on several demographic, assault, and post-assault factors with most differences showing that the combined assault type was related to worse outcomes than forcible-type assaults, including greater reexperiencing, avoidance, and numbing post-traumatic stress disorder (PTSD) symptoms. Implications for clinical intervention include recognizing that assaults involving substance use and force are traumatic and warrant individualized treatment.

The Role of Anger in Traumatic Harm and Recovery for Sexual Violence Survivors

Sexual violence is a strong predictor of posttraumatic stress disorder (PTSD). Sexual violence survivors presenting for PTSD treatment may experience and express a range of distressing emotions. An extensive body of research guides clinical conceptualization and targeting of fear responses in PTSD treatment. Models to guide clinicians in working with posttraumatic anger, in contrast, are scarce. To address this gap, we: 1) provide a review of the theoretical and empirical literature on sexual violence, anger, and trauma recovery among sexual violence survivors; 2) integrate this literature with social functionalist theories of anger; and 3) discuss implications of this integration for adaptively leveraging anger in psychological treatment.

Prevalence and risk factors for acute stress disorder in female victims of sexual assault

Sexual assault is one of the most traumatic events a person can experience. Despite this, information regarding the risk factors associated with the development of Acute Stress Disorder (ASD) in sexual assault victims is scarce. A follow-up prospective cohort study was designed to examine the prevalence and risk factors of ASD in women exposed to a recent sexual assault. A total of 156 women were treated at the Emergency Department of a university general hospital shortly after sexual assault. Sociodemographic, clinical and sexual assault-related variables were collected. The Acute Stress Disorder Interview was used to estimate the prevalence of ASD at three weeks post-SA. From the 156 victims, 66.6% (N = 104) met ASD diagnosis using DSM-5 criteria, whereas 59.6% (N = 93) met ASD diagnosis using DSM-IV criteria. The risk factors associated with the development of ASD were nationality, psychiatric history, peritraumatic dissociation and type of assault. In conclusion, the prevalence of ASD in female victims of recent sexual assault was high, affecting approximately two thirds of them. The recognition of the risk factors associated with ASD development, like peritraumatic dissociation or type of assault, may aid in the prompt detection of vulnerable women that require early and specific interventions shortly after trauma.

Mediating role of avoidance of trauma disclosure and social disapproval in ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder: cross-sectional study in a Lithuanian clinical sample

Background

ICD-11 includes a new diagnosis of complex post-traumatic stress disorder (CPTSD), resulting predominantly from reoccurring or prolonged trauma. Previous studies showed that lack of social support is among the strongest predictors of PTSD, but social factors have been sparsely studied in the context of the ICD-11 definition of PTSD and CPTSD.

Aims

To analyse the factor structure of the International Trauma Questionnaire (ITQ) in a Lithuanian clinical sample and to evaluate the mediating role of social and interpersonal factors in the relationship between trauma exposure and ICD-11 PTSD and CPTSD.

Method

The sample comprised 280 adults from out-patient mental health centres (age, years: mean 39.48 (s.d. = 13.35); 77.5% female). Trauma-related stress symptoms were measured with the ITQ. Social disapproval was measured with the Social Acknowledgment Questionnaire (SAQ) and trauma disclosure using the Disclosure of Trauma Questionnaire (DTQ).

Results

ICD-11 PTSD and CPTSD prevalence among the participants in this study was 13.9% and 10.0% respectively. Results indicated that avoidance of trauma disclosure mediated the relationship between trauma exposure and PTSD as well as CPTSD, whereas social disapproval mediated only the relationship between trauma exposure and CPTSD.

Conclusions

The findings suggest that disclosure of traumatic experiences and support from closest friends and family members might mitigate the effects of traumatic experiences, potentially reducing the risk of developing CPTSD.

Sexual Victimization Disclosure: A Cluster Analysis Approach to Understanding Victimization Experiences in Disclosers and Non-Disclosers

Research has used cluster analysis to identify clusters, or groups, of sexual victimization survivors who share similar assault experiences. However, researchers have not investigated whether disclosure status is a key component of the survivors' experience. The current study identified two clusters among 174 disclosing and non-disclosing sexual victimization survivors. Cluster One (n = 74) included an incapacitated assault by a lesser-known perpetrator and disclosure of the event. Cluster Two (n = 100) included a verbally instigated assault by a well-known perpetrator and nondisclosure of the event. Follow up independent t-tests revealed that women in Cluster One had significantly higher depression and posttraumatic stress disorder (PTSD) symptoms than women in Cluster Two. Results support prior research identifying clusters of victimization based on assault characteristics and suggest that disclosure status is a key variable in the recovery process. Specific implications for clinicians, policy makers, and the community are discussed.

Disclosing Unwanted Pursuit Victimization: Indirect Effects of Negative Reactions on PTSD Symptomatology Among Undergraduate Women

A growing literature has documented that negative social reactions to disclosures of sexual and intimate partner violence (IPV), such as victim blaming or disbelief, can negatively affect survivors' recovery. However, despite growing recognition of the frequency of unwanted pursuit behaviors (UPBs; for example, stalking, excessive or threatening contact) following romantic relationships and their negative effects on survivors, research to date has not explored disclosures, social reactions, or their impacts among victims of UPBs. The purpose of the present study was to assess the frequency of disclosures of UPB victimization to various sources, social reactions received, and their associations with symptoms of posttraumatic stress disorder (PTSD). Among a sample of 318 undergraduate women (ages 18-24) who reported a breakup within the past 3 years, 59.7% (n =190) reported experiencing UPBs. Nearly all of the women (92.6%; n =176) who experienced UPBs disclosed their victimization to others. Among women who disclosed, the most frequent recipient of disclosure was a female friend (93.2%, n = 164) and women reported receiving higher mean positive than negative social reactions (p < .001). Results supported the hypothesized indirect effect of UPB victimization on PTSD symptoms through increases in negative social reactions (p < .001); these results suggest that negative social reactions to UPB victimization may increase the risk for PTSD symptomatology. By contrast, there was no indirect effect via positive social reactions (p = .205). Implications for research and clinical practice will be discussed.

Sexual Assault Among Women in College: Immediate and Long-Term Associations With Mental Health, Psychosocial Functioning, and Romantic Relationships

The current study sought to examine immediate and long-term consequences of college sexual assault (C-SA) among women with no prior sexual assault history. While much is known regarding the short-term negative impact of C-SA, the current study examines whether C-SA is associated with immediate academic and psychosocial consequences as well as long-term poorer mental health (depression, posttraumatic stress [PTS], anxiety) and interpersonal functioning (relationship quality, sexual and emotional intimacy). In addition, the current study explores potential moderators of these associations, including race, the nature of the assault, resulting injury, relation to perpetrator, and whether the assault was reported. A stratified design was used comparing women who experienced C-SA (n = 201) to women with no C-SA history (n = 203) controlling for age, education, race, and ethnicity. Results from a series of repeated-measures analyses of variance (ANOVAs) demonstrated that across race and ethnicity, women with a history of C-SA reported lower grade-point averages, more missed classes, and fewer serious romantic relationships in college following the assault. Furthermore, results from a series of linear and logistic regression revealed that approximately 9 years later, women who experienced C-SA reported greater symptoms of depression, anxiety, and PTS as well as lower emotional and sexual intimacy. These associations differed by a number of assault variables (assault type, relation to perpetrator, amount of fear reported, physical injuries sustained, whether the assault was reported, whether medical treatment was sought). The current study further confirms the significant and pervasive impact of C-SA associated with women's health and functioning, warranting further intervention to both reduce the incidence of C-SA and expand the reach of existing mental health interventions to survivors.

The Impact of Campus-Level Factors on Peers' Perceived Ability to Support a Survivor

Campus sexual violence is a complex issue that has led to a proliferation of federal legislation and best practices with the intent to better support student survivors. Despite these efforts, research suggests that many survivors do not disclose to formal resources on campus, but rather, to their peers. While there is growing theoretical and empirical support for the role of peer-level influences on both preventing and responding to sexual violence on college campuses, our understanding of students' confidence in knowing how to respond is limited. Furthermore, disclosure research has yet to assess the impact of broader campus-level factors on students' confidence in being able to support survivors. In the present exploratory study, undergraduate students responded to a survey, which included questions about receiving disclosures and perceived ability to respond as well as measures of individual-level correlates (gender, race, prior victimization) and campus community factors (perceptions of the university's responsiveness, exposure to information, awareness of resources). Bivariate analyses were conducted to examine whether certain students were more likely to receive a disclosure on campus. To look at the impact of individual- and community-level factors, a series of hierarchical logistic regression models were estimated. Ability to respond to a disclosure was measured using three separate dichotomous variables. Findings show that 34% of our sample has received at least one disclosure of sexual violence from a peer since coming to campus. In addition, results show that above and beyond individual correlates, campus-level factors impacted students' confidence in their roles as disclosure recipients. These results have significant implications for sexual violence programs on campus. Suggestions for future research are also discussed.

Factors Associated With Posttraumatic Stress Disorder Symptomology Among Women Who Have Experienced Sexual Assault in Canada

There is a dearth of information about the association of victim-related and assailant-related characteristics and posttraumatic stress disorder (PTSD) among sexually assaulted women. Recently, Statistics Canada included items measuring the possible presence of PTSD symptoms in their 2014 nationally representative General Social Survey on Victimization (GSS-V), for the purpose of improving the understanding of mental health impacts associated with sexual victimization. The present study used the GSS-V to examine the association of sociodemographic, health, and assailant characteristics and prior traumatic experiences in the form of physical or sexual dating violence, physical assault, stalking, childhood abuse, and witnessing of violence between parents with PTSD symptomology among sexually assaulted women. Among 319 women who reported experiencing at least one incident of sexual assault in the 12 months prior to the survey, 68.6% had experienced at least one negative emotional impact as a result, among whom, 43.6% reported past-month PTSD symptoms. Logistic regression modeling revealed that prior traumatic events in the form of physical or sexual dating violence, stalking, and having witnessed violence between parents were associated with higher odds of experiencing PTSD symptoms, as was having been sexually assaulted by a known assailant. In contrast, the odds of experiencing PTSD symptoms was lower for Aboriginal or visible minority women. The results suggest that PTSD symptoms in the near aftermath of sexual victimization are common, and there are a range of factors that contribute to the likelihood of developing these symptoms. Implications for future research are discussed.

Talking to Others About Sexual Assault: A Narrative Analysis of Survivors' Journeys

Previous research suggested the benefits for sexual assault survivors to talk about their trauma and its mental health implications, but it remained unclear what steps sexual assault survivors need to take to be able to have these conversations. To address this gap in the literature, this study aims to explore the journeys of sexual assault survivors with the use of narrative interviews to retain the richness of the data. This study reports the findings of a narrative analysis of the accounts of six female sexual assault survivors aged between 20 and 38. The analysis provides an individual case profile for each participant, the core aspects and tone of each narrative, and a cross-case analysis. The cross-case analysis reveals an overarching theme of "the bumpy journey" within which the individual difficulties encountered are examined. The analysis also reveals the two main factors that motivated the participant to strive to make a difference for other sexual violence survivors and to improve their mental health through talking about their experiences. The implications for services providing continuous and long-term support to sexual assault survivors and clinical practices are discussed.

Personal and Political: Post-Traumatic Stress Through the Lens of Social Identity, Power, and Politics

Post-traumatic stress disorder (PTSD) has always been controversial and highly politicized. Here, using a social identity approach, we review evidence that trauma and its aftermath are fundamentally linked to social position, sociopolitical capital, and power. We begin this contribution by demonstrating how a person's group memberships (and the social identities they derive from these memberships) are inherently linked to the experience of adversity. We then go on to consider how it is through group memberships that individuals are defined by their trauma risk and trauma histories-that is, a person's group memberships and their trauma are often inherently linked. Considering the importance of group memberships for understanding trauma, we argue that it is important to see these, and group processes more generally, as more than just "demographic" risk factors. Instead, we argue that when groups are defined by their trauma history or risk, their members will often derive some sense of self from this trauma. For this reason, attributes of group memberships are important in developing an understanding of adjustment and adaptation to trauma. In particular, groups' status, their recourse to justice, and the level of trust and solidarity within the group are all central to the impact of traumatic events on individual-level psychological resilience. We review evidence that supports this analysis by focusing on the exacerbating effects of stigma and social mistrust on post-traumatic stress, and the value of solidarity and strong identities for resilience. We conclude that because of these group-related processes, trauma interweaves the personal with the political and that post-traumatic stress is fundamentally about power, positionality, and politics.

Perceived Social Support and Life Satisfaction in Infertile Women Undergoing Treatment: A Moderated Mediation Model

Perceived social support is positively related to life satisfaction in infertile women. Whereas, the underlying mechanism of this relationship is unclear. The present study aimed to investigate whether self-compassion mediated the relationship of perceived social support with life satisfaction and whether infertility self-efficacy moderated the relationship between perceived social support and self-compassion in infertile women. A total of 290 infertile women in mainland China undergoing treatment completed an online survey assessing perceived social support, life satisfaction, self-compassion, and infertility self-efficacy. The results supported the mediation model that perceived social support was associated with life satisfaction via self-compassion. Besides, infertility self-efficacy moderated the relationship between perceived social support and self-compassion. Specifically, perceived social support displayed a stronger predictive effect on self-compassion when infertile women had higher level of infertility self-efficacy.

Bidirectional associations between alcohol use and intimate partner violence and sexual assault victimization among college women

Whereas some prior studies have explored whether alcohol increases the risk for victimization and/or whether distress resulting from victimization increases the risk for alcohol use, few studies have simultaneously tested these bidirectional hypotheses among a high-risk sample (i.e., undergraduate women), while including both sexual assault (SA) and intimate partner violence (IPV) victimization, and exploring potential moderating effects of PTSD symptoms on these paths. Among 631 college women, the present study tested these bidirectional associations using cross-lagged panel models across two measurement periods (i.e., Time 1 [T1] and Time 2 [T2], six months later). Results suggested that T1 alcohol use increased risk for T2 SA (but not T2 IPV victimization), and PTSD symptoms moderated this association; at lower levels of PTSD symptoms, there were no significant associations between alcohol use and subsequent SA victimization, whereas at higher levels of PTSD symptoms, alcohol use predicted subsequent SA victimization. By contrast, the opposite directional hypothesis was not supported; neither T1 lifetime SA nor IPV were associated with T2 drinking, regardless of the level of their PTSD symptoms. Prevention and intervention efforts should simultaneously address risk factors for alcohol use and victimization using trauma-informed practices.

What's in a Label? The Impact of Media and Sexual Assault Characteristics on Survivor Rape Acknowledgment

Media coverage of sexual assault has increased since 2017 due to high-profile cases and social media campaigns designed to increase awareness of sexual assault. The purpose of this study was to examine whether media coverage of the Harvey Weinstein allegations and the onset of the 2017 viral #MeToo movement impacted the likelihood of college women acknowledging their own victimization as rape. Participants were 207 female rape survivors who completed an online survey that included assessments of survivor acknowledgment and characteristics of the sexual assault. Some participants completed the study prior to the Harvey Weinstein allegations and onset of the #MeToo movement, and some participants completed the study after these events. The likelihood of survivors labeling their experience as rape did not differ based on when participants completed the study, odds ratios (ORs) = 0.61-3.92, ps = .127-.604. Use of both nonforceful verbal resistance, OR = 2.63, p = .001, and assertive resistance, OR = 3.05, p < .001, were positively associated with the likelihood of survivor acknowledgment. The effects of both perpetrators' use of force and experiencing immobility on survivor acknowledgment were moderated by the timing of study completion, ORs = 4.22 and 0.11, respectively, ps = .023-.040. These findings suggest that media coverage may impact how certain sexual assault characteristics influence how survivors label their victimization experiences.

Profile Analysis of Sexual Assault Experiences among Adult Women and Their Implications for Mental Health

OBJECTIVE

Extant studies indicate that just one characteristic of sexual assault cannot properly represent the whole experience of sexual assault and, especially, the severity of sexual assault. This study aimed to understand the totality of sexual assault experiences and elucidate subtypes of sexual assault victims based on the detailed characteristics of their sexual assault experiences and those relationships with mental health.

METHODS

A total of 255 adult sexual violence victims who used intervention services and a comparison group were included. Information on their sexual assault experiences was gleaned from case records data.

RESULTS

The following four distinctive profile groups were identified: "Sexual Touching" (19.6%), "Rape/Social Relation" (30.4%), "Intimate Partner Violence (IPV)" (18.8%), and "Rape/Stranger" (31.3%). The subgroups differed in terms of secondary victimization and adverse childhood experiences. The Rape/Social Relation and IPV subgroups most frequently experienced secondary victimization and childhood adversity. The four profile subgroups demonstrated different relationships with mental health outcomes, with a complicated pattern. The Rap/Social Relation and IPV subgroups scored higher on mental health problem screening measures compared to other groups. However, a considerable proportion of victims in the Sexual Touching subgroup also reported suicidal behaviors and self-injury.

CONCLUSION

Based on the results, theoretical and clinical implications were discussed.