The impact of sociocultural contexts on mental health following sexual violence: A conceptual model

OBJECTIVE

Sexual violence has substantial mental health effects on survivors around the globe. Although there has been increasing attention to the ways that sociocultural environments can affect survivors' recovery, there has been no review to our knowledge of the specific factors within sociocultural environments that offer risk or protection, or the mechanisms by which these factors affect recovery.

METHOD

To address this gap, we present a conceptual model supported by a theoretical and empirical review that prioritizes research conducted with ethnic minority and global samples.

RESULTS

We identify three components of global sociocultural settings-norms, structures, and environmental stressors-that may affect mental health following sexual violence. We propose that these components may affect survivors' mental health by (1) influencing how survivors themselves, survivors' social contexts, and the systems with which survivors come into contact think about and respond to sexual violence, and (2) creating additional sources of stress, burden, or protection for survivors.

CONCLUSIONS

We argue that future research, practice, and policy could have a greater effect on survivors by attending to sociocultural factors in recovery.

An Exploration of the Relationship Between Culture and Resilience Capacity in Trauma Survivors

Resilience capacity has been found to be associated with individuals’ flexibility and adaptability when dealing with adversity-related stress. Previous research suggested that resilience capacity may play an important role in moderating the relationships between exposure to traumatic events and severity of post-traumatic stress disorder (PTSD) symptoms and cultural factors may be associated with that process. However, adequate research of the mechanisms on how culture may relate to the relationship between resilience and PTSD is still lacking. The present study attempted to explore potential mediators associated with the relationship between culture and resilience capacity among trauma survivors and focused on the potential mediating associations of cultural variables (independent/interdependent self-construal, dialectical thinking, and familism). Levels of culture-related variables among three cultural regions (America, Hong Kong, and Mainland China) were assessed and analyzed. The results of a bootstrapping analysis indicated that independent self-construal and dialectical thinking each significantly mediated the relationship between culture and resilience capacity. Cultural and clinical implications of these findings and suggestions for future research were explored.

Prolonged Grief Disorder and Positive Affect Improved by Chinese Brush Painting Group in Bereaved Parents: A Pilot Study

Traditional Chinese art practices such as brush painting and calligraphy are thought to promote self-development through holistically engaging both physical and mental health. This pilot study investigated the beneficial effects of a community-based self-help group incorporating Chinese art practices as a culturally adapted bereavement intervention. Twenty-six Chinese parents aged over 49 years and who had lost their only child participated in a 20-session Chinese brush painting group over a 6-month period. Ten bereaved parents from the same community who did not participate in the art course but received living support were recruited as a control group. Compared with the control group, the art practice group exhibited a pre-post intervention effect in terms of promoting positive affect and preventing deterioration of prolonged grief symptoms, particularly through the improvement of accessory grief symptoms (e.g., "emotional numbness due to the loss", and "feeling that life is unfulfilling, empty or meaningless after the loss"). No effect was found on negative affect. These findings indicate that a culturally adapted community-based art group may be an effective means of improving grief-related health.

Representation of low and middle income countries in traumatic stress journals from 2006 to 2015

Although the majority of trauma survivors reside in low and middle income countries, these regions have historically been poorly represented in traumatic stress research. However, a recent review of geographic representation within traumatic stress journals is lacking. This study reviewed all articles published between 2006 and 2015 in six leading traumatic stress journals. When articles ( n = 2530) were categorised by region, less than one tenth (9.76%; n = 247) were representative of low and middle income countries. All articles categorised as being from a low and middle income country were then coded for the regional and country representations of samples, author affiliations, and funding sources, and for type of research methodology. The majority of primary author teams (56.28%) and funding sources (55.87%) for articles based in low and middle income countries were located in high-income countries. The majority of low and middle income country articles (71.66%) used structured symptom questionnaires of which more than two thirds (70.6%) assessed symptoms of posttraumatic stress disorder. These findings indicate that knowledge production about traumatic stress in domain-specific journals reflects a state of ongoing geographic inequality and that research published from low and middle income countries reflects predominantly etic methodologies centred on measuring posttraumatic stress disorder. The implications are discussed and recommendations are offered for developing a research base in domain-specific journals that better represents the experiences and needs of trauma survivors in low and middle income countries.

Asian American Women Sexual Assault Survivors' Choice of Coping Strategies: The Role of Post-Assault Cognitive Responses

Even though approximately one in three Asian American (AA) and Pacific Islander women experience sexual assault victimization, there is a dearth of literature examining how AA women sexual assault survivors cope with this traumatic experience. This study examined AA female sexual assault survivors' choice of coping strategies post-assault and how their cognitive responses toward sexual assault victimization (e.g., attributions of self-blame, perceived control over the recovery process) relate to their use of coping strategies. Using the AA subsets of two large community studies, a total of 64 AA women ages 18 to 58 with unwanted sexual experiences after the age of 14 years were included in the analyses. Results indicated that AA survivors used Acceptance and Self-Distraction the most to cope with sexual assault. In addition, those who perceived they had less control over their recovery process tended to use more maladaptive coping strategies, such as substance abuse and behavioral disengagement (e.g., giving up). Discussions include clinical implications and recommendations for using language, modalities, and foci of interventions that are consistent with clients' and their families' worldviews (e.g., indirect inquiries, solution-focused).