The Impact of Questionnaire Administration Mode on Response Rate and Reporting of Consensual and Nonconsensual Sexual Behavior

A qualitative study on how intimate partner violence against women changes, escalates, and persists from pre- to postseparation

Research has focused on intimate partner violence (IPV) against women either before or after separation, but little attention has been paid to the changes in and persistence of violent behaviors from one situation to the next. This study contributes to the literature by comparing the changes in types and frequencies of abusive behaviors of women's former husbands. This allows us to understand how mechanisms of power are enacted through IPV both before and after separation. We interviewed 19 women in the Midwestern United States who had experienced IPV by their former husbands and had subsequently divorced them. Data were analyzed using qualitative content analysis. The findings suggest that verbal abuse and using children were the most common forms of IPV both pre- and postseparation. Many preseparation behaviors were replaced by other forms of abuse; for example, physical abuse was not experienced after separation. Some forms of IPV, such as stalking and economic abuse, escalated after separation. This reveals that exerting control over women through nonphysical forms of IPV was more common after separation. In particular, using axial and selective coding approach, our findings present three composite narratives of women's experiences of the changes in, and the escalation and persistence of, the violence they faced. The three composite narratives show how abusive behaviors are situated within patriarchal notions of dominance, power, and control over women and their children. The implications of the findings are discussed in terms of healthcare services, advocacy-based victim assistance, school officials, and the courts.

Altered sexual function after central neurological system trauma is reflective of region of injury; brain vs spinal cord

OBJECTIVE

To compare and contrast the contributory effects of traumatic brain injury (TBI) and spinal cord injury (SCI) on sexual function and social relationship opportunities, hypothesizing that patterns of change in sexual function would follow etiology.

DESIGN

Cross-sectional, case-matched survey of community living individuals with TBI, SCI or both (termed dual diagnosis).

PARTICIPANTS

Consecutive sample of participants with TBI (n = 25), SCI (n = 24) and dual diagnosis (n = 28), an average 3.6 years post-rehabilitation discharge.

METHODS

Participants were interviewed using a modified version of the 'Sexuality after Spinal Injury Questionnaire.'

RESULTS

Almost all respondents (97%) perceived adverse post-injury change in their experience of neurosexual function and/or social relationships. Physiological aspects of sexual function (e.g., erection, orgasm) were most affected by SCI whereas social relationships appeared more affected by TBI. People with dual diagnoses exhibited a combination of features. Participants with SCI (with or without TBI) were significantly more likely to have their concerns about sexual function discussed during rehabilitation than the TBI group.

CONCLUSION

TBI and SCI produce predictable impacts upon sexual function following injury, the impact of which were less frequently addressed during inpatient rehabilitation for those with TBI.

Reliability and Findings From an Instrument Examining Sexual Assault Disclosure Content and Context: The Sexual Assault Inventory of Disclosure

Compared to the depth of research examining the impact of sexual assault disclosure and related responses from others, little is known about the content shared during disclosures. Categorizing survivors as disclosers or nondisclosers disregards the nuanced and complex nature of disclosure. To address this gap, the current studies examined the reliability and preliminary results of the Sexual Assault Inventory of Disclosure (SAID), an inventory of content shared during disclosures and the context in which it was shared. The SAID proved reliable and preliminary findings suggest that perceptions of disclosures as positive or negative are predicted by differences in content and context, above and beyond disclosure recipients' response. The current study also explored gender differences in disclosure. Additional findings, implications, and suggestions for future studies using the SAID are discussed.

Maximizing New Technologies to Treat Depression

In an era of rapid technological evolution, mental healthcare providers are tapping into technology that offers feasible and effective alternatives to reach patients who suffer from depression. This paper provides a brief history and description of current technologies, frequently used taxonomies, and specific applications for the assessment and treatment of depression. These include online healthcare communities and social media, automated screening, wearable technology, and virtual reality therapy. A review of a secondary analysis that incorporated technology used with patients experiencing depressive symptoms is provided and future trends in mHealth or cellular-based technologies to treat depression are explored.

Women's Self-Report of Sexual Victimization: An Experimental Examination of the Influence of Race, Mode of Inquiry, Setting, and Researcher Contact

Female college students ( N = 255) provided self-report of adult sexual assault (ASA) and child sexual abuse (CSA) in one of eight randomly assigned conditions which manipulated three methodological variables (level of researcher contact, setting, and inquiry mode). The impact of methodology on reporting was examined, with race as a moderator. Non-White participants reported significantly more CSA than White participants out of lab, but differences were not observed in lab. White participants reported significantly more ASA than non-White participants on pencil-and-paper surveys, but there were no differences on computer surveys. Interpretation of race-related differences in self-reported victimization may require consideration of methodological effects.

Revising the SES: A Collaborative Process to Improve Assessment of Sexual Aggression and Victimization

The Sexual Experiences Survey (SES) assesses victimization and perpetration of unwanted sexual experiences (e.g., Koss, Gidycz, & Wisniewski, 1987 ). Revised versions of the SES that resulted from the work of the SES Collaboration are now available. This article reviews weaknesses of the SES that were identified, strengths that were preserved, and methodological considerations in the measurement of unwanted sexual experiences that informed the revisions. The primary changes include: more behavioral specificity; conversion to gender neutrality; full crossing of unwanted acts and coercive tactics; and revised and updated wording for assessing consent, alcohol-related incidents, unwanted acts, and coercive tactics. For illustration, the full text of the revised victimization version and its scoring rules are provided. The article concludes with suggestions for future research. These suggestions aim to involve researchers in a coordinated agenda to develop data that clarify methodological questions and contribute to continued improvement in assessing sexual victimization and perpetration.

Effects of Experimenter Contact, Setting, Inquiry Mode, and Race on Women's Self-Report of Sexual Attitudes and Behaviors: An Experimental Study

Factors related to the research context, such as inquiry mode, setting, and experimenter contact, may affect participants' comfort with and willingness to disclose certain sexual attitudes or admit to engaging in sensitive sexual behaviors. In this study, 255 female undergraduates (42.7 % non-White) completed a survey containing measures of sexual behavior and attitudes. The level of experimenter contact (high vs. low contact), setting (in lab vs. out of lab), and inquiry mode (pencil-and-paper vs. computer) were manipulated and participants were randomly assigned to conditions. We hypothesized that low-contact, out-of-lab, computer conditions would be associated with more liberal sexual attitudes and higher rates of reported sexual behaviors than high-contact, in-lab, and paper-and-pencil conditions, respectively. Further, we hypothesized that effects would be moderated by race, such that differences would be greater for non-White participants because of concerns that reporting socially undesirable behavior might fuel racial stereotypes. For attitudinal measures, White participants endorsed more liberal attitudes toward sex in high-contact conditions and non-White participants endorsed more liberal attitudes in low-contact conditions. For behavioral measures, non-White participants reported more behaviors on pencil-and-paper surveys than on computers. White participants demonstrated no significant mode-related differences or reported more sexual behaviors in computer conditions than paper-and-pencil conditions. Overall, results suggest that experimenter contact and mode significantly impact sexual self-report and this impact is often moderated by race.

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as "rape" or "abuse" as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general "label" questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.

Impact of different privacy conditions and incentives on survey response rate, participant representativeness, and disclosure of sensitive information: a randomized controlled trial

BACKGROUND

Anonymous survey methods appear to promote greater disclosure of sensitive or stigmatizing information compared to non-anonymous methods. Higher disclosure rates have traditionally been interpreted as being more accurate than lower rates. We examined the impact of 3 increasingly private mailed survey conditions-ranging from potentially identifiable to completely anonymous-on survey response and on respondents' representativeness of the underlying sampling frame, completeness in answering sensitive survey items, and disclosure of sensitive information. We also examined the impact of 2 incentives ($10 versus $20) on these outcomes.

METHODS

A 3X2 factorial, randomized controlled trial of 324 representatively selected, male Gulf War I era veterans who had applied for United States Department of Veterans Affairs (VA) disability benefits. Men were asked about past sexual assault experiences, childhood abuse, combat, other traumas, mental health symptoms, and sexual orientation. We used a novel technique, the pre-merged questionnaire, to link anonymous responses to administrative data.

RESULTS

Response rates ranged from 56.0% to 63.3% across privacy conditions (p = 0.49) and from 52.8% to 68.1% across incentives (p = 0.007). Respondents' characteristics differed by privacy and by incentive assignments, with completely anonymous respondents and $20 respondents appearing least different from their non-respondent counterparts. Survey completeness did not differ by privacy or by incentive. No clear pattern of disclosing sensitive information by privacy condition or by incentive emerged. For example, although all respondents came from the same sampling frame, estimates of sexual abuse ranged from 13.6% to 33.3% across privacy conditions, with the highest estimate coming from the intermediate privacy condition (p = 0.007).

CONCLUSION

Greater privacy and larger incentives do not necessarily result in higher disclosure rates of sensitive information than lesser privacy and lower incentives. Furthermore, disclosure of sensitive or stigmatizing information under differing privacy conditions may have less to do with promoting or impeding participants' "honesty" or "accuracy" than with selectively recruiting or attracting subpopulations that are higher or lower in such experiences. Pre-merged questionnaires bypassed many historical limitations of anonymous surveys and hold promise for exploring non-response issues in future research.

Epidemiology of Traumatic Experiences in Childhood

The epidemiology of traumatic experiences in childhood is a key context for research, clinical treatment, program management, and policy development. This article discusses the conceptual, methodological, and programmatic challenges in precisely answering even relatively simple questions concerning the basic prevalence and incidence of important trauma types among American youth. Findings from studies using nationally representative samples and directly interviewing youth about their trauma histories are reviewed, and lifetime prevalence rates for various types of traumatic experience presented. Clinical application of this information and future directions are discussed.

Sexual victimization among Spanish college women and risk factors for sexual revictimization

Sexual revictimization is frequent among victims of child sexual abuse. Several variables, such as sexual experience, substance abuse, and sexual assertiveness, have been proposed to explain the link between child sexual abuse and adolescent and adult sexual victimization, although they have typically been tested separately. The main objective of this study was to analyze which of these variables better explains the revictimization phenomenon using a multiple mediation analysis. The study also tested the frequency of sexual victimization experiences in a Spanish sample of college women. Four hundred and two women were interviewed. Results showed that 30.4% of them engaged in undesired sexual contact while almost 4% were victims of rape. The most frequent perpetrators were partners or ex-partners, acquaintances, or dating partners, but not strangers. Finally, the relationship between child sexual abuse and adolescent and adult sexual victimization was mediated by number of consensual sexual partners and sexual assertiveness. Results reflect some cultural differences from previous research.

Sexual violence and pregnancy-related physical symptoms

Background

Few studies have investigated the impact of sexual violence on health during pregnancy. We examined the association between sexual violence and the reporting of physical symptoms during pregnancy.

Methods

A population-based national cohort study conducted by The Norwegian Mother and Child Cohort study (MoBa) collected data from pregnant women through postal questionnaires at 17 and 32 weeks gestation. Three levels of sexual violence were measured: 1) mild (pressured into sexual relations), 2) moderate (forced with violence into sexual relation) and 3) severe (rape). Differences between women reporting and not reporting sexual violence were assessed using Pearson’s X² test and multiple logistic regression analyses.

Results

Of 78 660 women, 12.0% (9 444) reported mild, 2.8% (2 219) moderate and 3.6% (2 805) severe sexual violence. Sexual violence was significantly associated with increased reporting of pregnancy-related physical symptoms, both measured in number of symptoms and duration/degree of suffering. Compared to women not reporting sexual violence, the probability of suffering from ≥8 pregnancy-related symptoms estimated by Adjusted Odds Ratio (AOR) was 1.49 (1.41–1.58) for mild sexual violence, 1.66(1.50–1.84) for moderate and 1.78 (1.62–1.95) for severe. Severe sexual violence both previously and recently had the strongest association with suffering from ≥8 pregnancy-related symptoms, AOR 6.70 (2.34–19.14).

Conclusion

A history of sexual violence is associated with increased reporting of pregnancy-related physical symptoms. Clinicians should consider the possible role of a history of sexual violence when treating women who suffer extensively from pregnancy-related symptoms.

Investigating the impact of inquiry mode on self-reported sexual behavior: theoretical considerations and review of the literature

Measurement of sexual behaviors is typically reliant on retrospective self-reports of behaviors. Historically, self-reported sexual behavior data were primarily collected through face-to-face interviews or paper-and-pencil questionnaires, as these were the only modes of inquiry available. In recent decades, technological innovations such as telephones, computers, and the Internet have expanded the self-report inquiry modes available. The addition of these new inquiry modes further complicates the ability of sex researchers to evaluate the quality of research results and compare findings across studies. Self-report sexual behavior data are vulnerable to participation biases, as well as to sources of bias in individual responses, such as recollection and social desirability bias. This is true regardless of the inquiry mode being used, but some modes may be more vulnerable to bias than others. This review examines the available research regarding self-report sexual behavior research, inquiry mode, and relative bias across modes. The review also provides recommendations for advancing the current understanding of inquiry mode effects within sexual behavior research. Specifically, by shifting the focus away from evaluating specific modes of inquiry toward examination of factors common across all modes, researchers will be better able to interpret existing research and improve the designs of future studies as well.

Adolescent Girls' Assessment and Management of Sexual Risks: Insights from Focus Group Research

We conducted focus groups with girls ages 14 to 17 (N = 43) in order to study how the dominant discourse of sexual risk shapes young women's understanding of the sexual domain and their management of these presumably pervasive threats. Through inductive analysis, we developed a coding scheme focused on three themes: (a) types of sexual risk; (b) factors that moderate sexual risk; and (c) strategies for managing sexual risk. Collectively, participants identified many risks but distanced themselves from these by claiming that girls' susceptibility is largely a function of personal factors and therefore avoidable given the right traits, values, and skills. We consider this reliance on other-blaming and self-exemption, as well as instances in which individual participants diverged from this group discourse, in the context of neoliberalism.

Emerging issues in the measurement of rape victimization

We provide an overview of emerging directions in the measurement of rape, the most extreme form of sexual victimization. The context for our overview is how operational definitions of rape have evolved, where consensus has emerged, and where it eludes the field. We discuss two approaches to the detection of rape victimization in survey methods, namely behaviorally specific questions and a new, two-stage approach, and how each can be evaluated in terms of validity. We point out promises and pitfalls of the two-stage approach and make suggestions for its implementation and evaluation. We conclude that all empirical research to date supports the use of behaviorally specific compared to broad questions, that a standard definition of rape and its components of act, tactics, and nonconsent is imperative to move the field forward, and that research to systematically validate methods of detecting rape victimization is needed. To that end, we propose an agenda.

DOES ALCOHOL CONTRIBUTE TO THE CONFLUENCE MODEL OF SEXUAL ASSAULT PERPETRATION?

The confluence model of sexual assault provides a useful theoretical integration of factors that influence men's likelihood of committing sexual assault (Malamuth, Sockloskie, Koss, & Tanaka, 1991). This study replicates and extends the confluence model by including alcohol at multiple levels. Participants' usual alcohol consumption and alcohol consumption in sexual situations were included as predictor variables. The number of sexually aggressive acts that participants committed after consuming alcohol and the number of sexually aggressive acts participants committed when sober were separately calculated so that the predictors of each could be distinguished. Participants were 356 men who completed a survey that included measures that assessed the key components of the confluence model. Results of path analyses indicated that the expanded model fit the data well, with both general and situational measures of alcohol use predicting frequency of sexual assault when drinking alcohol. These findings highlight the importance of developing universal and targeted prevention programs for young men.

Modeling response rates in surveys of female sexual difficulty and dysfunction

INTRODUCTION

Studies that address sensitive topics, such as female sexual difficulty and dysfunction, often achieve poor response rates that can bias results. Factors that affect response rates to studies in this area are not well characterized.

AIM

To model the response rate in studies investigating the prevalence of female sexual difficulty and dysfunction. Methods. Databases were searched for English-language, prevalence studies using the search terms: sexual difficulties/dysfunction, woman/women/female, prevalence, and cross-sectional. Studies that did not report response rates or were clinic-based were excluded. A multiple linear regression model was constructed.

MAIN OUTCOME MEASURES

Published response rates.

RESULTS

A total of 1,380 publications were identified, and 54 of these met our inclusion criteria. Our model explained 58% of the variance in response rates of studies investigating the prevalence of difficulty with desire, arousal, orgasm, or sexual pain (R(2) = 0.581, P = 0.027). This model was based on study design variables, study year, location, and the reported prevalence of each type of sexual difficulty. More recent studies (beta = -1.05, P = 0.037) and studies that only included women over 50 years of age (beta = -31.11, P = 0.007) had lower response rates. The use of face-to-face interviews was associated with a higher response rate (beta = 20.51, P = 0.036). Studies that did not include questions regarding desire difficulties achieved higher response rates than those that did include questions on desire difficulty (beta = 23.70, P = 0.034).

CONCLUSION

Response rates in prevalence studies addressing female sexual difficulty and dysfunction are frequently low and have decreased by an average of just over 1% per anum since the late 60s. Participation may improve by conducting interviews in person. Studies that investigate a broad range of ages may be less representative of older women, due to a poorer response in older age groups. Lower response rates in studies that investigate desire difficulty suggest that sexual desire is a particularly sensitive topic.

Prospective prediction of women's sexual victimization by intimate and nonintimate male perpetrators

Although behavioral risk factors such as substance use have been hypothesized to increase women's vulnerability to sexual victimization, prospective studies provide mixed empirical support. In the current prospective study, the authors considered substance use, sexual activity, and sexual assertiveness as predictors of sexual victimization from intimate partners and nonintimate perpetrators. Among a representative community sample of women ages 18-30 years (N = 927), 17.9% reported sexual victimization over 2 years, the majority by an intimate partner. Low sexual refusal assertiveness, drug use, and prior intimate partner victimization predicted intimate partner sexual victimization. Heavy episodic drinking and number of sexual partners predicted victimization from nonintimates. The finding that there are different risk factors for sexual victimization from intimates versus nonintimates suggests the need for tailored prevention strategies.

Childhood sexual abuse, relationship satisfaction, and sexual risk taking in a community sample of women

Childhood sexual abuse (CSA) has been proposed to influence both women's adult sexual risk behaviors and the quality of their intimate relationships. Among a household sample of women (n = 732), good fit was obtained for a model in which CSA predicted Wave 1 male partner sexual risk and aggression characteristics, resulting in lower relationship satisfaction, and ultimately in higher numbers of Wave 2 sexual partners. The model was generally replicated among women who entered new relationships at Waves 2 and 3. Partner sexual risk characteristics also were associated with women's risk of sexually transmitted infection from current partner. Elevated sexual risk behaviors among CSA survivors reflect difficulty in establishing stable and safe relationships and may be reduced by interventions aimed at improving intimate relationships.