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Widanaralalage BK, Murphy AD, Loughlin C. Support or justice: a triangulated multi-focal view of sexual assault victim support in a UK sexual assault referral centre (SARC). Int J Ment Health Syst 2024; 18:15. [PMID: 38589935 PMCID: PMC11000339 DOI: 10.1186/s13033-024-00631-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Despite vast levels of underreporting, sexual assault remains an issue at scale in the UK, necessitating the presence of statutory and voluntary organisations in the support of victims. Understanding the experiences of all parties within this context is important for the resilience of support that can be provided at a systems level. This study examines the barriers faced by service providers when working with victims of sexual assault. METHODS Semi-structured interviews took place with eleven professionals working in or in conjunction with a Sexual Assault Referral Centre (SARC) in Southeast England, which were subsequently analysed using inductive thematic analysis. RESULTS Five themes were identified exploring SARC staff's experiences with (i) communication breakdowns with external services; (ii) delivering support in an underfunded system; (iii) tailoring support to survivors' needs; (iv) the Criminal Justice System fails victims of sexual assault; and (v) reckoning with burnouts and vicarious trauma. CONCLUSION Significant gaps in UK service provision for sexual assault victims are identified, particularly within the criminal justice system, where legal and investigative processes are cited as retraumatizing. The results emphasize the urgency of enhanced training, coordination, resources, and trauma-informed practices across organizations to better serve victims and support overwhelmed providers. Prioritizing systemic improvements is crucial to address the complex needs of both victims and service professionals.
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Affiliation(s)
| | | | - Casey Loughlin
- King's College London, London, UK
- University of Westminster, London, UK
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2
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Waltzman D, Daugherty J, Haarbauer-Krupa J, Zheng X, Jorge C, Basile KC. Association Between Lifetime Sexual Violence and Recent Traumatic Brain Injury Among Adults: 2017 Connecticut Behavioral Risk Factor Surveillance System. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1351-1367. [PMID: 37804158 PMCID: PMC10962142 DOI: 10.1177/08862605231203962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Sexual violence (SV) is a critical public health problem that is associated with numerous negative health consequences, including immediate- and long-term physical and mental health conditions and health-risk behaviors. Some of these health-risk behaviors (e.g., substance use, unsafe driving practices, poor mental health, lower impulse control, and abnormal brain circuitry) might increase the risk for sustaining a traumatic brain injury (TBI). A TBI causes neurological or neuropsychological changes and may also lead to various symptoms that affect a person's cognition, mobility, behavior, and mental health. Determining if those who have experienced SV are at increased risk of sustaining a TBI in their lifetime is critical given the high prevalence and health impacts of SV, the potential vulnerability to TBI after SV, and the known detrimental effects of TBI. This exploratory study examined data from the 2017 Connecticut behavioral risk factor surveillance system and found that lifetime SV victimization (controlling for age and sex) was associated with increased odds of reporting a recent TBI in the past 12 months (adjusted odds ratio [AOR] = 2.1; 95% confidence interval [CI] [1.03, 4.21]). Further research is needed to better understand how SV history is related to the risk of sustaining a TBI. Healthcare professionals can support patients who experience SV by providing resources to help reduce associated physical and mental health conditions and health-risk behaviors.
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Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Juliet Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xi Zheng
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Celeste Jorge
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Kathleen C. Basile
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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3
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Mellen EJ, Hatzenbuehler ML. Sexual Violence-Related Stigma, Mental Health, and Treatment-Seeking: A Multimodal Assessment in a Population-Based Study of Young Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11243-11271. [PMID: 37491905 DOI: 10.1177/08862605231179715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
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.
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Ullman SE. Facilitators of Sexual Assault Disclosure: A Dyadic Study of Female Survivors and Their Informal Supports. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:615-636. [PMID: 37249345 PMCID: PMC10330913 DOI: 10.1080/10538712.2023.2217812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
Two-thirds of survivors typically disclose their experience to others at some point following sexual assault, but little in-depth research has addressed factors facilitating disclosure. In the current study, a diverse sample of 45 female sexual assault survivors (75% racial/ethnic minorities) and their 45 informal support providers (SP; e.g., family, friends, romantic partners) were interviewed separately about experiences of disclosure, social reactions, and help-seeking following assault. Disclosure facilitation was expressed by 40 survivors and 31 SPs, of which 28 were matched S/SP dyadic pairs. Narrative data on the overarching thematic category of sexual assault disclosure facilitation was analyzed using descriptive thematic analysis methods. Several themes emerged from the analysis of quotes specific to the facilitation of disclosure, including: individual (e.g., survivor psychological, behavioral, and disclosure recipient factors), interpersonal (e.g., SP-solicited disclosures, helping others, mutual disclosures), and societal (e.g., lack of barriers, formal supports, media). Implications are drawn for future research on facilitators of sexual assault disclosure. Clinical practice implications are provided for professionals supporting survivors and their informal support networks.
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5
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Channell I, Thomas ED, Forkus SR, Salvatore G, Vieira M, Weiss NH. Religiosity and hazardous substance use: The moderating role of trauma-related shame. Am J Addict 2023; 32:274-282. [PMID: 36571570 PMCID: PMC10121753 DOI: 10.1111/ajad.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Hazardous substance use is a major public health concern among individuals with a history of sexual victimization. Although increased religiosity has been known to serve as a protective factor against hazardous substance use, religious individuals with a history of sexual victimization may be at a greater risk for hazardous substance use due to difficulties reconciling sexual victimization with their religious beliefs. Individuals with greater trauma-related shame may engage in hazardous substance use as a means of coping with the traumatic event. METHOD The present study consisted of 614 participants (Mage = 34.57, 50% women). RESULTS Results suggested that organizational, nonorganizational, and intrinsic religiosity were positively associated with hazardous alcohol use at higher, but not lower, levels of trauma-related shame. Organizational and intrinsic religiosity were positively associated with hazardous drug use at higher, but not lower, levels of trauma-related shame. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This is the first study to examine the role of trauma-related shame in the relationship between religiosity and hazardous substance use. The findings underline the importance of targeting trauma-related shame in religious individuals with a history of sexual victimization.
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Affiliation(s)
- Isabella Channell
- Department of Psychology, University of Rhode Island, Rhode Island, Kingston, USA
| | - Emmanuel D Thomas
- Department of Psychology, University of Rhode Island, Rhode Island, Kingston, USA
| | - Shannon R Forkus
- Department of Psychology, University of Rhode Island, Rhode Island, Kingston, USA
| | - Gianna Salvatore
- Department of Psychology, University of Rhode Island, Rhode Island, Kingston, USA
| | - Monica Vieira
- Department of Psychology, University of Rhode Island, Rhode Island, Kingston, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Rhode Island, Kingston, USA
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Yucel E, Angelone DJ, Jones MC. Reassessing the Confluence Model of Men's Risk for Sexual Aggression. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6062-6084. [PMID: 36218144 DOI: 10.1177/08862605221127376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
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.
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Wright EN, Miyamoto S, Anderson J. "Having One Person Tell Me I Didn't Do the Wrong Thing": The Impact of Support on the Post-Sexual Assault Exam Experience. Violence Against Women 2023:10778012231156153. [PMID: 36794461 DOI: 10.1177/10778012231156153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Social support following a sexual assault (SA) may help minimize or prevent the myriad of negative sequelae impacting individuals who experience SA. Receiving a SA exam may provide initial support during the SA exam and set up individuals with needed resources and supports post-SA exam. However, the few individuals who receive a SA exam may not stay connected to resources or support post-exam. The purpose of this study was to understand individuals' post-SA-exam social support pathways including individuals' ability to cope, seek care, or accept support following a SA exam. Interviews were conducted with individuals who experienced SA and then received a SA exam through a telehealth model. The findings revealed the importance of social support during the SA exam and in the months that followed. Implications are discussed.
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Affiliation(s)
| | - Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
- The Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA
| | - Jocelyn Anderson
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
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Shroff FMC. Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans. Front Glob Womens Health 2023; 4:1126934. [PMID: 36860346 PMCID: PMC9968936 DOI: 10.3389/fgwh.2023.1126934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023] Open
Abstract
COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.
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Affiliation(s)
- Farah Mahrukh Coomi Shroff
- Department of Family Practice and School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,Maternal and Infant Health Canada, Vancouver, BC, Canada,Correspondence: Farah Mahrukh Coomi Shroff
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9
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Schuler MS, Wong EC, Ramchand R. Military service branch differences in alcohol use, tobacco use, prescription drug misuse, and mental health conditions. Drug Alcohol Depend 2022; 235:109461. [PMID: 35487079 DOI: 10.1016/j.drugalcdep.2022.109461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 03/16/2022] [Accepted: 04/09/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Rates of substance use and mental health conditions vary across military service branches, yet branches also differ notably in terms of demographics and deployment experiences. This study examines whether branch differences in substance use and mental health outcomes persist after adjustment for a comprehensive set of demographic and deployment-related factors. METHODS Data on 16,699 Armed Forces Active Duty service members were from the 2015 Department of Defense Health Related Behaviors Survey. Service branch-specific prevalences were estimated for self-reports of heavy episodic drinking (HED), possible alcohol use disorder (AUD), current smoking, e-cigarette use, smokeless tobacco use, prescription drug misuse, probable post-traumatic stress disorder (PTSD), probable depression, and probable anxiety. Using logistic regression, we assessed whether branch differences persisted after adjusting for an extensive array of demographic factors (among full sample) and deployment/combat factors (among ever-deployed subgroup). RESULTS HED, AUD, smoking, e-cigarette use, smokeless tobacco use, depression, and anxiety were highest in the Marine Corps; prescription drug misuse and PTSD were highest in the Army. HED, AUD, smoking, smokeless tobacco use, PTSD, depression, and anxiety were lowest in the Air Force; e-cigarette use and prescription drug misuse were lowest in the Coast Guard. Demographics and deployment/combat experiences differed across branches. After adjustment, service members in the Army, Marine Corps and Navy exhibited nearly 2-3 times the odds of multiple mental health conditions and substance use behaviors relative to the Air Force. CONCLUSION Service branch differences were not fully explained by variation in demographics and deployment/combat experiences.
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Affiliation(s)
- Megan S Schuler
- RAND Corporation, 1200 S Hayes St, Arlington, VA 22202, USA.
| | - Eunice C Wong
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA
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10
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Brewer G, Lyons M, Perry A, O'Brien F. Dark Triad Traits and Perceptions of Sexual Harassment. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP7373-NP7387. [PMID: 30724687 DOI: 10.1177/0886260519827666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Those high on Dark Triad traits (narcissism, Machiavellianism, primary and secondary psychopathy) are more likely to engage in sexual harassment and less likely to empathize with others. Few studies have, however, considered the impact of Dark Triad traits on perceptions of sexually aggressive behavior performed by others. The present study investigated the relationship between Dark Triad traits and perceptions of sexual harassment. Heterosexual women (N = 142) aged 18 to 50 years (M = 20.86, SD = 5.62) completed the NPI-16 (Narcissistic Personality Inventory), Mach IV, Levenson Self-Report Psychopathy Scale, and Sexual Harassment Attitudes Questionnaire. Standard multiple regressions were conducted to investigate the extent to which Dark Triad traits predicted victim and perpetrator blame and attitudes toward victim responses to sexual harassment. Primary psychopathy was the only significant individual predictor such that women with higher levels of the trait were more likely to blame the victim and less likely to blame the perpetrator. In addition, primary psychopathy was related to higher endorsement of victim compliance, and lower likelihood of supporting confrontation of the perpetrator.
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11
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Tan RKJ, Phua K, Tan A, Gan DCJ, Ho LPP, Ong EJ, See MY. Exploring the role of trauma in underpinning sexualised drug use ('chemsex') among gay, bisexual and other men who have sex with men in Singapore. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 97:103333. [PMID: 34175526 DOI: 10.1016/j.drugpo.2021.103333] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexualised drug use (SDU) has been identified as a major risk factor for HIV, as well as other mental health comorbidities among gay, bisexual and other men who have sex with men (GBMSM). While multiple studies have been conducted on the topic, few have explored the role of trauma in underpinning experiences of SDU among substance use treatment-experienced GBMSM. This qualitative study investigates life histories of trauma, and proposes a framework to better situate the factors driving SDU among treatment-experienced GBMSM. METHODS We conducted semi-structured in-depth interviews with 33 purposively-sampled GBMSM with a history of SDU, and seeking treatment for it in Singapore. Interview topics included participants' experiences and life histories of SDU, substance use, incarceration, trauma, as well as stories of resilience and ongoing recovery from SDU. Interviews were audio-recorded, transcribed, coded, and analysed using inductive thematic analysis, from which a trauma-informed framework was developed. RESULTS Participants firstly articulated the positive and desired aspects of SDU, such as its utility in allowing them to achieve positive emotional states, sexual enhancement, and feelings of connectedness and intimacy. Participants also described how SDU, in contrast, was used as a coping mechanism to deal with emotional and situational 'precipitants', including dealing with loneliness and a low self-esteem, sexual shame and social anxiety, as well as general stressful situations. Participants also articulated how such precipitants were underpinned by experiences of trauma, including those relating to HIV-related stigma, racism, sexual violence, death and loss, neglect, as well as internalised homophobia. Next, participants illustrated how such trauma were in turn reinforced by several 'preconditions', including the accessibility of substances, emphasis on sexual capital, and lack of access to mainstream support structures in the gay male community, alongside general sociolegal barriers to accessing care. CONCLUSIONS This study proposes the role of trauma and the preconditions underpinning them in motivating SDU among a sample of largely substance use treatment-experienced GBMSM in Singapore. Interventions that provide support for GBMSM seeking treatment for SDU should provide trauma-informed care to address the complex barriers to treatment effectiveness.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Tahir Foundation Building #10-01, 117549, Singapore; The Greenhouse Community Services Limited, 531A Upper Cross Street #04-98 Hong Lim Complex, 051531, Singapore.
| | - Krish Phua
- The Greenhouse Community Services Limited, 531A Upper Cross Street #04-98 Hong Lim Complex, 051531, Singapore
| | - Alaric Tan
- The Greenhouse Community Services Limited, 531A Upper Cross Street #04-98 Hong Lim Complex, 051531, Singapore
| | - David Chong Jin Gan
- The Greenhouse Community Services Limited, 531A Upper Cross Street #04-98 Hong Lim Complex, 051531, Singapore
| | - Lai Peng Priscilla Ho
- Care and Counselling, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Eleanor J Ong
- The Greenhouse Community Services Limited, 531A Upper Cross Street #04-98 Hong Lim Complex, 051531, Singapore
| | - Maha Yewtuck See
- The Greenhouse Community Services Limited, 531A Upper Cross Street #04-98 Hong Lim Complex, 051531, Singapore
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12
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Schuler MS, Collins RL. Sexual minority substance use disparities: Bisexual women at elevated risk relative to other sexual minority groups. Drug Alcohol Depend 2020; 206:107755. [PMID: 31810051 PMCID: PMC6980764 DOI: 10.1016/j.drugalcdep.2019.107755] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/02/2019] [Accepted: 11/18/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prior studies characterizing sexual minority substance use disparities have primarily compared lesbian/gay and bisexual individuals, respectively or in combination, to heterosexual individuals. In light of emerging evidence that bisexual individuals may have particularly elevated substance use risk, we examine differences in recent substance use between bisexual and lesbian/gay individuals using national survey data. METHODS Data on 126,463 adults (including 8241 LGB adults) were from the 2015-2017 National Survey on Drug Use and Health. Substance use outcomes included binge drinking, cigarette smoking, cigar smoking, marijuana use, illicit drug use, opioid misuse, alcohol use disorder, nicotine dependence, and substance use disorder. Logistic regression was used to estimate sexual identity- and gender-specific odds ratios, controlling for demographic characteristics. Of particular interest were estimates comparing bisexual and lesbian/gay individuals of the same gender. RESULTS Both male and female sexual minority adults had significantly elevated rates of substance use compared to heterosexual adults. Furthermore, relative to lesbian/gay women, bisexual women had significantly elevated odds of binge drinking (aOR = 1.29), marijuana use (aOR = 1.42), illicit drug use (aOR = 1.55), opioid misuse (aOR = 1.53), and alcohol use disorder (aOR = 1.48). Relative to gay men, bisexual men had significantly elevated cigar use (aOR = 1.64). CONCLUSIONS Bisexual women were at significantly greater risk for multiple substance use behaviors relative to lesbian/gay women. We did not observe any substance use behaviors for which bisexual individuals had significantly lower risk than their lesbian/gay peers. These disparities may be explained, in part, by unique risk factors for substance use experienced by bisexual individuals, particularly bisexual women.
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Ullman SE, O'Callaghan E, Lorenz K. Women's Experiences of Impairment and Incapacitation During Alcohol/Drug-Related Sexual Assaults: Toward a Survivor-Informed Approach to Measurement. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2105-2116. [PMID: 31327108 PMCID: PMC6788449 DOI: 10.1007/s10508-019-1441-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/13/2019] [Accepted: 03/20/2019] [Indexed: 06/10/2023]
Abstract
Researchers have categorized level of impact of drinking during alcohol/substance facilitated sexual assaults as unimpaired (perceived no effect of drinking), impaired (conscious, but impacted by substance use), or incapacitated (unconscious due to substance use). However, researchers have not always agreed on what constitutes these categories, and no qualitative research has been done to date to explore those discrepancies. Such work is needed in order to listen to survivors' voices, using their perspectives and experiences to develop trauma-informed practices specific to survivors of alcohol-involved assaults. The current study sought to shed light on impaired/incapacitated sexual assault experiences presenting 141 qualitative written responses of women who were drinking and/or using substances at the time of their assault. Results showed that while some responses aligned with previous researcher-defined quantitative impaired/incapacitated categories, most responses coded could be considered both impaired and incapacitated, or neither of these categories. Implications for further research, particularly qualitative work, are discussed specifically challenging previous research on impaired/incapacitated sexual assault experiences.
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Affiliation(s)
- Sarah E Ullman
- Department of Criminology, Law and Justice, University of Illinois at Chicago, 1007 West Harrison Street, Chicago, IL, 60607-7140, USA.
| | - Erin O'Callaghan
- Department of Criminology, Law and Justice, University of Illinois at Chicago, 1007 West Harrison Street, Chicago, IL, 60607-7140, USA
| | - Katherine Lorenz
- Department of Criminology and Justice Studies, California State University, Northridge, Los Angeles, CA, USA
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Dworkin ER, Brill CD, Ullman SE. Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis. Clin Psychol Rev 2019; 72:101750. [PMID: 31260816 DOI: 10.1016/j.cpr.2019.101750] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 06/12/2019] [Accepted: 06/22/2019] [Indexed: 10/26/2022]
Abstract
Public attention has been increasingly paid to how friends, family members, and others can best support survivors of sexual assault and other forms of violence. The broader social support literature posits that perceiving social support positively is more important to mental health than the degree to which social support is actually received, and that negative interactions with social supporters are more harmful than positive interactions are helpful (potentially because negative reactions violate survivors' expectations of their social supporters). This may be especially true after a crisis, such as interpersonal violence. Thus, this systematic review and meta-analysis summarizes the literature on social reactions to interpersonal violence. Meta-regression analyses were performed on 1871 correlations from 51 studies reflecting the degree to which receiving specific reactions more frequently, or perceiving reactions more positively, was associated with psychopathology. Results indicated that negative social reactions to disclosure-especially reactions involving controlling, distracting, and treating survivors differently-were associated with worse psychopathology, whereas positive social reactions did not appear to be protective. Perceiving reactions more positively was associated with less severe psychopathology, but (although causation cannot be concluded) positive perceptions' potential benefit appeared to be smaller than the potential risk conveyed by negative reactions. These findings indicate that interventions which reduce the degree to which survivors receive negative social reactions are needed.
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Affiliation(s)
- Emily R Dworkin
- University of Washington School of Medicine, 1100 NE 45(th) St., Ste. 300, Seattle, WA 98105, USA.
| | - Charlotte D Brill
- University of Washington, 119A Guthrie Hall Box 351525, Seattle, WA 98195-1525, USA.
| | - Sarah E Ullman
- University of Illinois, Chicago, 1007 West Harrison Street (MC 141), 4050B Behavioral Sciences Building, Chicago, IL 60607-7140, USA.
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15
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Ullman SE, Lorenz K, O'Callaghan E. Risk Avoidance Strategies after Sexual Assault: A Dyadic Study of Survivors and Informal Support Providers. VICTIMS & OFFENDERS 2018; 13:814-833. [PMID: 31080377 PMCID: PMC6510513 DOI: 10.1080/15564886.2018.1479910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Interview data from 45 matched pairs of survivors disclosing sexual assaults and their primary informal support provider (friend, family, significant other) were used to explore survivor-support provider perspectives on self-protective behaviors survivors and those close to them take to protect themselves from future assaults. Strategies for reducing risk taken by survivors included behavioral changes, security measures, self-defense strategies, avoiding alcohol/drugs, and protecting others. Support providers play critical roles by encouraging survivors to pursue risk avoidance strategies, and employing these strategies themselves. Counseling and prevention implications are drawn in the context of risks facing survivors trying to avoid further sexual victimization.
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Affiliation(s)
- Sarah E Ullman
- Department of Criminology, Law, & Justice, University of Illinois at Chicago
| | - Katherine Lorenz
- Department of Criminology, Law, & Justice, University of Illinois at Chicago
| | - Erin O'Callaghan
- Department of Criminology, Law, & Justice, University of Illinois at Chicago
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