Psychological management of victims of sexual assault

Crime Reporting Behavior: Do Attitudes Toward the Police Matter?

Police researchers have long argued that favorable evaluations of the police eventually lead to citizens' willingness to cooperate with the police. However, this assumption has barely been studied empirically. The current study examines the association between attitudes toward the police and crime reporting behavior of victims. Furthermore, the study explores the influence of victims' characteristics on their decisions to report crime to the police. Using field data originally collected in Ghana, the study found that victims' levels of confidence in the police and satisfaction with police work positively predict their decisions to report sexual assault and robbery to the police. Moreover, findings revealed that age, marital status, and employment status are important predictors of victims' reporting behavior. Several practical and theoretical implications of the results are discussed.

Post-traumatic stress symptoms in pathological gambling: Potential evidence of anti-reward processes

Background Excessive gambling is considered to be a part of the addiction spectrum. Stress-like emotional states are a key feature both of pathological gambling (PG) and of substance addiction. In substance addiction, stress symptomatology has been attributed in part to "anti-reward" allostatic neuroadaptations, while a potential involvement of anti-reward processes in the course of PG has not yet been investigated. Methods To that end, individuals with PG (n = 22) and mentally healthy subjects (n = 13) were assessed for trauma exposure and post-traumatic stress symptomatology (PTSS) using the Life Events Checklist and the Civilian Mississippi Scale, respectively. Results In comparison with healthy subjects, individuals with PG had significantly greater PTSS scores including greater physiological arousal sub-scores. The number of traumatic events and their recency were not significantly different between the groups. In the PG group, greater gambling severity was associated with more PTSS, but neither with traumatic events exposure nor with their recency. Conclusions Our data replicate prior reports on the role of traumatic stress in the course of PG and extend those findings by suggesting that the link may be derived from the anti-reward-type neuroadaptation rather than from the traumatic stress exposure per se.

The Integrated Problem-Solving Model of Crisis Intervention: Overview and Application

Crisis intervention is a role that fits exceedingly well with counseling psychologists' interests and skills. This article provides an overview of a new crisis intervention model, the Integrated Problem-Solving Model (IPSM), and demonstrates its application to a specific crisis, sexual assault. It is hoped that this article will encourage counseling psychologists to become more involved in crisis intervention itself as well as in research and training in this important area.

Fear of the perpetrator: a major reason why sexual assault victims delayed presenting at hospital

OBJECTIVE

To identify the reasons for presentation of sexual assault more than 72 h after the incidents at Newcastle Hospital, South Africa.

METHODS

A retrospective analysis of 534 medical records of victims seen between 2005 and 2009 at the hospital's sexual assault service centre.

RESULTS

Overall, 219 (41%) of the victims presented at the hospital more than 72 h after the alleged sexual assault, mainly for fear of the perpetrator (37.4%). Females constituted 87%, and rape with vaginal penetration was the most common form of sexual assault reported (74%). Tests of significance showed a positive association between fear of the perpetrator and delayed presentation at hospital. Age under 9 years and being scared of what relatives would say about alleged sexual assault were also associated with delayed presentation.

CONCLUSIONS

Attention needs to be focused on educating society on the importance of reporting sexual assault incidents promptly in order for victims to benefit from appropriate medical treatment.

Risk of Sexual Dysfunction in a Randomly Selected Nonclinical Sample of the Swedish Population

OBJECTIVE

To investigate the risk of sexual dysfunction as a result of childhood sexual abuse or sexual assault in a randomly selected nonclinical sample of men and women.

METHODS

In 1996, a randomly selected sample of 2,810 Swedish males and females completed a 322-item interview and questionnaire. Age-adjusted odds ratios (ORs) were calculated to assess risk of sexual dysfunction and analysis of variance was employed to test differences by gender and abuse or assault history in regard to seeking assistance for sexual dysfunction.

RESULTS

For females with a history of childhood sexual abuse, an increased risk of anorgasmia for more than 12 months was found for women aged between 31 and 45 years (OR 1.21, P=.009). For females with a history of sexual assault; an increased risk for hypoactive sexual desire disorder was found for women who between the ages of 16 and 30 years (OR 1.51, P=.03), 31 and 45 years (OR 1.28; P=.02), 46 and 60 years (OR 1.21, P=.03), and 61 and 84 years (OR 1.62, P=.04); lubrication problems in the past year for women between 46 and 60 years (OR 1.28, P=.02) and for more than 12 months (OR 1.38, P=.02). No statistically significant increased risk of sexual dysfunction was found for males with a history of childhood sexual abuse. Males who reported a history of sexual assault as an adult had a significant increased risk of retarded ejaculation in the last 12 months if they were between the ages of 31 and 45 years (OR 2.00, P=.008) or 46 and 60 years (OR 2.11, P=.02). Women most often reported sexual dysfunction to their gynecologists (18%) or midwives (8.4%), whereas men reported their sexual dysfunction to their physicians (5.6%) or urologists (4.3%).

CONCLUSION

Future research should focus on predictors of sexual dysfunction and resilience subsequent to childhood sexual abuse and sexual assault as an adult.

LEVEL OF EVIDENCE

III.

[Victims of sexual assault: a routine protocol for better management]

Caring for victims of sexual assault is a difficult situation where the physician has to simultaneously evaluate the psychological impact and conduct a complete and precise physical examination. To make sure every step of the examination is completed and all samplings are done in the correct order by all physicians, it is useful to have a written routine protocol. We describe step-by-step management procedures for victims of sexual assault, taking into consideration the psychological aspect, the physical examination, the different samplings, and the different emergency treatments. Free download of the entire protocol, with the booklet containing examples of prescriptions, is available at http://www.agof.net/constatviol/.

Caring for adolescents and families in crisis

Nurses are likely to see adolescents and their families in a variety of practice settings. Recognizing the youth and family at risk is significant in helping them resolve a stressful situation by mobilizing resources and strengthening coping and problem-solving skills. This article has focused on several areas, including suicide and depression, sex-related issues, substance abuse, and poor academic performance. Helping the youth and family in crisis challenges the nurse to use astute assessment skills that support a patient-centered crisis intervention model. During a time when cost-effective mental health care is a necessity, this model offers nurses an opportunity to provide quality health care.

Sexual victimization and perceptions of close relationships in adolescence

An attachment perspective is proposed as a framework for conceptualizing the impact of sexual victimization on close relationships. Two studies were conducted to empirically examine the links between sexual victimization and perceptions of romantic, parental, and peer relationships. Study One included 154 undergraduate women, and Study Two included 48 high school seniors. In both studies, approximately half the women reported having experienced some form of coerced sexual experience. The majority were victimized by an acquaintance, and most victims had experienced multiple incidents. The first study found that victimized women had significantly more preoccupied romantic views than nonvictimized women. Retrospective reports indicated that women victimized in college were significantly more dismissing with their fathers in high school. In Study Two, victims reported more negative interactions with romantic partners, but no differences were found for romantic styles. Victims also reported more dismissing parental styles and more negative interactions with their fathers than nonvictims.

Correlates of psychological distress following armed robbery

Although mental health professionals have long been aware of the impact of traumatic events, it was not until 1980 that the term posttraumatic stress disorder (PTSD) was introduced into the DSM-III. Since then, one major goal of research has been to identify factors associated with distress following trauma; as yet, few reliable indicators have emerged. Within the population of armed robbery victims, this is particularly true. The purpose of this study was to investigate possible correlates of posttrauma distress in armed robbery victims, and to assess the overall level of distress within this group. A questionnaire was mailed out of 57 robbery victims, aged 15 to 65, who were recruited as study volunteers via community outreach. Severity of the trauma, vulnerability attributions, and avoidant coping were significantly related to distress level, and victims exhibited a high level of distress.

Post-traumatic stress disorder: an overview

An overview of post-traumatic stress disorder, including a brief historical survey, and its epidemiology, nosology, etiology, clinical presentation, treatment, prognosis as well as a short vignette, highlights the fact that this disorder prevails in times of war and peace. Early intervention is emphasized as the key to successful treatment. The timeliness for Canadian mental health professionals to review this disorder is also mentioned.