Violence against women: outcome complexity and implications for assessment and treatment

Rapport Building in Written Crisis Services: Qualitative Content Analysis

BACKGROUND

Building therapeutic relationships and social presence are challenging in digital services and maybe even more difficult in written services. Despite these difficulties, in-person care may not be feasible or accessible in all situations.

OBJECTIVE

This study aims to categorize crisis counselors' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers.

METHODS

The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations.

RESULTS

Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation.

CONCLUSIONS

Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.

Longitudinal Associations Between Adolescent Dating Violence Victimization and Adverse Outcomes: A Systematic Review

Evidence on the outcomes of adolescent dating violence (ADV) victimization mainly derives from cross-sectional studies, which have limitations in suggesting causal relationships. Furthermore, the complexity of factors and overlapping dimensions in dating violence research, such as the forms of violence experienced, may have contributed to the variability of findings across the literature. To address these gaps and provide a more comprehensive understanding of the impact of ADV, this study reviews findings from prospective cohort studies, with a focus on the type of violence experienced and the gender of the victim. A systematic search was conducted in nine electronic databases and additional relevant journals. Prospective longitudinal studies were included if dating violence victimization occurred during adolescence and chronologically preceded the outcomes. A quality assessment was conducted using the Mixed Methods Appraisal Tool. A narrative approach was used to synthesize findings. After screening 1,838 records, 14 publications met the selection criteria and were included in this review. Our findings suggest that experiencing ADV is longitudinally associated with many adverse outcomes, including higher internalizing symptoms and externalizing behaviors, poorer well-being, increased substance use, and increased revictimization. However, the associations are not consistently reported across studies when considering the type of ADV experienced and the gender of the victim. This review highlights the limited number of longitudinal studies examining the outcomes of ADV victimization, the unbalanced approach in investigating different forms of violence, and the lack of diverse samples examining this subject. Implications for research, policy, and practice are outlined.

'I'm not the mother I wanted to be': Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers

A paucity of research has been conducted within South Africa on abused women's experiences of motherhood, even though abused women tend to be at increased risk of negative physical and mental health difficulties, which can interfere with their ability to take care of themselves and their children. The aim of this qualitative study was to explore women's experiences of mothering in the context of an abusive relationship. Data was collected via individual, telephonic, semi-structured, in-depth interviews with 16 mothers from three South African provinces, and analyzed according to the principles of grounded theory. Our findings highlight the mothers' experiences of: a simultaneous increased sense of responsibility with regards to their children and a loss of control over their mothering; as well as experiencing abuse aimed at either the mother or the child, which is simultaneously meant to affect the other; and lastly, mothers' assessing themselves negatively through normative paradigms of 'good mothering', regardless that they often mother in the best way they know how to, given challenging circumstances. Therefore, this study highlights that the motherhood institution continues to create 'good mothering' benchmarks against which women themselves evaluate their mothering, often leading to feelings of inadequacy. Our findings also emphasize that the environment created by men's abuse is in conflict with the great expectations placed upon mothers in abusive relationships. Thus, mothers may experience huge pressure, which may lead to feelings of failure, self-blame, and guilt. This study has demonstrated that the abuse mothers' encounter adversely impacted on their mothering. We therefore emphasize the need to better understand how mothering is influenced by and responsive to violence. This is important as understanding abused women's experiences can assist us to further develop appropriate support mechanisms needed to ensure minimal impact on both women and their children.

Feeling Guilt and Shame Upon Psychological Dating Violence Victimization in College Women: The Further Role of Sexism

Dating violence is manifested in different forms between romantic partners. Psychological violence, the most common form of dating violence, is more likely to affect women, eliciting feelings such as shame and guilt. The robust relationship of sexism to psychological dating violence victimization (PDVV) is well-documented but whether PDVV serves as a mechanism linking sexism to guilt and shame remains unexplored. This study, therefore, investigated the potential mediating role of PDVV in the association between sexist attitudes and feelings of guilt and shame. Dating college women (N = 219) from Turkey, an honor culture in which one's self-worth lies on one's evaluation as well as the assessment of what others think, participated in the study. High rates of PDVV were found in this culture, and structural equation modeling revealed that PDVV mediated the relationship between sexism and feelings of guilt and shame. These findings are discussed in terms of their implications for future research and how sexist attitudes might be challenged to reduce the adverse emotional effects experienced by women who are victims of psychological dating violence.

The Impacts of Working With Victims of Sexual Violence: A Rapid Evidence Assessment

AIM

Supporting clients who have experienced trauma can lead to trauma symptoms in those working with them; workers in the sexual violence field are at heightened risks of these. This article collated and critically appraised papers, published from 2017 onward, in the area of people assisting victims of sexual violence. It explores the impacts and effects the work has on them, their coping and self-care mechanisms, and organizational support offered to them.

DESIGN

A question-based rapid evidence assessment with a triangulated weight of evidence approach was used. Academic and nonacademic databases were searched. Twenty-five papers were included for analysis based on the inclusion/exclusion criteria.

RESULTS

Most studies were of medium to high methodological quality. Negative impacts included trauma symptoms, disrupted social relationships, behavioral changes, and emotional and psychological distress. Ability to manage negative impacts was influenced by overall organizational support, availability of training, supervision and guidance, workloads and caseload characteristics, individual characteristics, and their coping and self-care mechanisms. Positive impacts included empowering feelings, improved relationships, compassion satisfaction, and posttraumatic growth.

CONCLUSIONS

Impacts are significant. Support at work and in personal life increases staff's ability to cope and find meaning in their role. Implications for research and practice are discussed.

Understanding Discussions of Sexual Assault in Young Women on a Peer Support Mental Health App: A Content Analysis

Trauma narratives may have been influenced by the Me Too movement, with thousands of individuals disclosing sexual violence stories online. Youth, the largest demographic of online users, may prefer the anonymity of the Internet to discuss experiences of sexual assault. Understanding the ways that young women, especially those experiencing mental health difficulties, discuss their experiences is important as they are at higher risk of revictimization and continued poor mental health. We searched for terms related to acts of sexual assault on a mental health peer-support app, TalkLife, and compared the number of posts during the initial wave of the Me Too movement (October 2017-March 2018) to the same time period in the previous year (October 2016-March 2017). We found a significant increase in posts related to sexual assault of 49.7% between the Pre and Post Me Too time periods (p < .001), controlling for a general increase in posts. A content analysis of 700 randomly selected posts found that a substantial number of young women used TalkLife to discuss their experiences of sexual assault, and these self-disclosures were mostly hopeless or depressing in tone. Additionally, neither the nature nor the number of self-disclosures varied across time points. The negative tone of the self-disclosures in the current study is worrying because the way women talk about their trauma can shape how they understand it, which could lead to negative self-appraisal and continued mental health difficulties. Online spaces have the potential to support young women and facilitate help-seeking, but we must be attentive to how they are used.

"They Aren't Going to Do Jack Shit": Text-Based Crisis Service Users' Perceptions of Seeking Child Maltreatment-Related Support From Formal Systems

Many of the children reported to child protective services (CPS) exhibit signs and symptoms that allow others to recognize their abuse or neglect and intervene; others, especially adolescents, must disclose their experiences to be identified. Relatively little is known about young people's disclosure experiences, but individual, interpersonal, and cultural factors appear to influence when and how young people disclose. Technology-facilitated approaches, such as text- or chat-based hotlines or crisis services, may be one way to help young people share their maltreatment experiences and seek help. The current study contributes to the small body of literature that includes nonsexual maltreatment disclosures and sheds some light on how to support young people during their disclosures. We conducted a qualitative content analysis of all conversations from a text-based crisis service that resulted in a report to CPS (n = 244). Many of the texters had previously sought support from their peers or parents, and some had engaged with more formal systems. Many young people were hesitant to reach out to formal systems in the future, in part because of negative experiences during past disclosure experiences. Young people may be more likely to seek support through their preferred communication medium, so providing text- and chat-based communication may be one way to encourage and facilitate disclosure. As these resources become increasingly available, determining best practices for receiving disclosures through technology-facilitated platforms will be critical.

Social Reactions to Disclosure of Sexual Violence in Adulthood and Women's Sexuality: The Mediating Role of Shame and Guilt

This study examined the mediating role of emotions related to sexual violence in adulthood in the associations between social reactions to sexual violence disclosure and sexual outcomes. Self-reported data were collected from 324 women reporting sexual violence and path analyses were conducted among the 264 women (81.5%) who disclosed their most recent sexual violence experience. Results showed that emotional support was associated with higher sexual satisfaction. Victim blame was associated with greater guilt related to the sexual violence, which, in turn, was associated with higher sexual compulsivity. Stigmatization was associated with greater shame related to the sexual violence, which, in turn, was associated with higher sexual distress and avoidance, and lower sexual satisfaction and function. Our findings highlight the importance of social reactions to sexual violence disclosure in women's sexuality.

Hate Crimes and Race-Based Trauma on Latinx Populations: A Critical Review of the Current Research

Traditionally, the literature has sought to understand the impact of racial minority status and trauma as it relates to interpersonal violence, domestic violence, and sexual assault. What has not been as extensively reviewed and summarized is how racially or ethnically motivated hate crimes impact the mental health of minorities-particularly Latinx/Hispanic groups. This review aims to summarize the current body of literature on the intersection of race-motivated hate crime and trauma responses within Latinx community. To do so, the theoretical foundation for this inquiry will build from a race-based trauma perspective. Specifically, this review connects existing frameworks for race and trauma and integrates literature that examines Latinx or Hispanic populations that have experienced discrimination, bias, or hate crime as a result of their identity or perceived identity. The importance of situating bias or hate events within the trauma literature stems from a lack of overall formal evaluation of these events, and how these occurrences are historically overlooked as a traumatic stressor. The findings of this review suggest that (1) experiencing racially motivated victimization can cause adverse mental and physical health outcomes in Latinxs and (2) currently, there is only one study that has examined the impact of hate crime on Latinxs in the United States. This leaves the field with unanswered questions about the impact of hate crime victimization among Latinxs, which is an ever-growing area in need of attention.

Attachment, Trauma, and Mentalization in Intimate Partner Violence: A Preliminary Investigation

Intimate partner violence (IPV) has been examined from a range of theoretical perspectives, including attachment theory, with the aim of assessing psychosocial risk factors. Previous research has shown that a child's exposure to violence in the family is a major predictor of IPV victimization later in life. Furthermore, research on abused and traumatized adult samples has shown high frequencies of unresolved/disorganized attachment styles. In particular, disorganized attachment is associated with major problems of affect regulation and deficits in mentalizing ability. The present research had three aims: (a) to assess the childhood traumatic experiences of female victims of IPV; (b) to investigate and identify the attachment patterns of female victims of IPV; and (c) to examine reflective functioning and prementalistic modes in female victims of IPV, in relation to attachment and trauma. A sample of 31 women, recruited through anti-violence centers, were administered the Adult Attachment Interview (AAI) and the Reflective Functioning Questionnaire. The Complex Trauma Questionnaire and the Reflective Functioning Scale (RFS) were also applied to the AAI transcripts. Interviews were audio recorded and transcribed verbatim. Coding was conducted by two trained coders and certified as reliable for the AAI and RFS. Clinicians completed the Modes of Mentalization Scale (MMS) to assess participants' mentalization style. The data showed a high percentage of women with insecure attachment and lower reflective functioning. The results are discussed in terms of their clinical and theoretical implications-particularly their application to psycho-forensics, through the development of preventive programs and interventions for IPV. Efforts to understand the etiology of IPV and to intervene to prevent recidivism are fundamental in reducing this public health threat.

Married Women's Attitude toward Intimate Partner Violence Is Influenced by Exposure to Media: A Population-Based Spatial Study in Bangladesh

This study estimated the attitudes of women toward accepting IPV at district level in Bangladesh and examined its relationship with sociodemographic predictors including exposure to media (e.g., newspaper, radio and television) using the Multiple Indicator Cluster Survey-2019 with a sample of 63,689 women. Around 25.6% women accepted IPV that geographically varied from 1.78% (Pirojpur) to 57.14% (Kurigram). Women regularly exposed to media were 17% less likely to accept IPV. Attitude toward accepting IPV was found to be higher among the illiterate women in disadvantaged circumstances, patriotically from poorer households living in remote areas, which suggest that planned interventions are needed for this vulnerable group of women to improve their living status by providing access to education and media. Further research is necessary to assess the impact of women's empowerment on their attitude toward acceptance of IPV.

Violence Against Incarcerated Women: Predicting Risk Through the Lens of Childhood Harm

Victimization is common inside prisons and much remains unknown about the predictors of violence against incarcerated women. A sample of 564 incarcerated women was used to examine the link between in-prison victimization, childhood (physical, sexual, and emotional) harm, and mental illness. Nearly half or more of women reported childhood harm and over one-quarter experienced in-prison victimization. Childhood harm fell into four latent classes and low sexual abuse and high abuse classes predicted resident-on-resident sexual victimization, as did single types of childhood harm. Current depressive symptoms and perceptions of overcrowding predicted physical and sexual victimization perpetrated by residents and correctional staff.

A Comparison of Intimate Partner Homicide With Intimate Partner Homicide-Suicide: Evidence From a Norwegian National 22-Year Cohort

Homicide-suicide incidents make up a relatively small proportion of homicides overall, but occur more frequently in certain subtypes of homicide, such as men who kill their female partners. This study investigates aspects of intimate partner homicide-suicide (IPHS) by comparing it with intimate partner homicide (IPH). All IPHs in Norway from 1990 to 2012 (N = 177) were included. Quantitative data were extracted from court documents. Qualitative data were collected by interviews with bereaved. Multivariate logistic regression analyses and systematic text condensation were conducted. Nearly one fourth of IPHs were identified as IPHS. Perpetrators of IPHS were less likely to have a previous criminal record, even having a history of disregard and violations of the law. Perpetrators of IPHS were mainly native-born citizens and were more educated than IPH perpetrators. The motive of IPHS was more often jealousy than a dispute, but the motive was most often recorded as "other" or "unknown." IPHS was perceived as intentional, and the bereaved did not unambiguously support the interpretation that the IPHS had been triggered by stressful situations. The bereaved pointed to the loss of hope or loss of a future combined with an inability to cope with severe disappointments as an important risk factor. Within the framework of an interactional perspective, our findings indicate that IPHS shares more characteristics with IPH than it does with other categories of homicide and other violent deaths in general.

Lifetime prevalence of polyvictimization among older adults in Sweden, associations with ill-heath, and the mediating effect of sense of coherence

Background

Experiences of violence and abuse is a prominent part of the life history of many older adults and is known to have negative health effects. However, the importance of multiple victimization over the life course, e.g., lifetime polyvictimization, is not well investigated in this age group. The objective of this study was to investigate the prevalence of lifetime physical, emotional, and sexual victimization as well as polyvictimization among older adults in Sweden. We explored background characteristics associated with polyvictimization and hypothesized that violence victimization and especially polyvictimization would be associated with lower health status. To better understand factors that promote health in the aftermath of victimization, we also explored the effect of two resilience factors, sense of coherence (SOC) and social support, on the association between victimization and ill-health.

Method

Cross-sectional data from a random population sample in Sweden (women n = 270, men n = 337) aged 60–85 was used. Respondents answered questions about exposure to violence, health status, social support, and SOC. Conditional process analysis was used to test if SOC mediates the association between victimization and health outcome, and if social support moderates the association.

Results

Overall, 24.8% of the women and 27.6% of the men reported some form of lifetime victimization and 82.1% of the female and 62.4% of the male victims were classified as polyvictims, i.e., reported experiences of more than one episode of violence. As hypothesized, we found a negative association between victimization and health status and the association was most prominent for polyvictims. We found moderated mediation for the association between polyvictimization and health status, i.e., polyvictimization was associated with lower SOC and SOC had a positive correlation with health status. Social support moderated the association, i.e., victims without social support had lower health scores.

Conclusions

Lifetime polyvictimization was common among older adults and associated with lower health status. To help victims of violence recover, or preferably never develop ill-health, a better understanding of what fosters resilience is warranted. This study implies that social support, and especially SOC may be factors to consider in future interventions concerning older adults subjected to violence.

Sexual Assault, Sexual Orientation, and Reporting Among College Students

Research has demonstrated significantly higher rates of sexual assault victimization among lesbian, gay, bisexual and queer (LGBQ) students than heterosexual students, and the overwhelming majority of assaults are not reported to any official system. Given the potential for support services to provide valuable assistance and promote well-being after an assault, the present study explores whether LGBQ students report assaults at similar rates to heterosexual students. As part of the 2015 College Student Health Survey, 10,646 male and female college students at 2- and 4-year colleges in Minnesota provided data regarding sexual assault victimization; reporting to a health care provider, campus authority, police, or social contact; and sexual orientation (two items, including write-in). Chi-square tests were used to detect associations between sexual assault victimization and five sexual orientation groups; and between sexual orientation and assault reporting (for 523 assault incidents). Almost 6% of students reported that they had experienced sexual assault in the previous 12 months. Significant differences in assault experience were seen by sexual orientation groups, for both males and females. For example, rates of sexual assault were 2.5 to over 5 times higher among bisexual and queer/pansexual/other females than among heterosexual females. Reporting of sexual assault to health care providers, campus authorities or police was rare for both heterosexual and sexual minority students, and there were no significant differences in reporting across sexual orientation. LGBQ students and heterosexual students appear to be similarly comfortable accessing health care providers, police, and campus resources, suggesting that these services are not overtly biased or unwelcoming to sexual minorities. However, rates of sexual assault were considerably higher among sexual minority groups, suggesting a need for primary prevention that is appropriate and sensitive to the experiences of LGBQ students.

Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood

BACKGROUND

Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals' health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood.

METHODS

Data from a nationally representative survey of household residents (adults aged 16 to 59 years; n = 21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes.

RESULTS

Most individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16 years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA.

CONCLUSIONS

Prevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.

Sexual Revictimization: A Routine Activity Theory Explanation

Research has shown that victims of sexual assault are at a significant risk of revictimization. We use routine activity theory to predict how sexual victimization in adolescence relates to depression, substance use, and ultimately revictimization as a young adult. We frame our research within routine activity theory and predict that sexual victimization increases substance use and depressive symptoms, both of which increase the likelihood of revictimization. We test the hypotheses with three waves of data from the Longitudinal Study of Violence Against Women. Using structural equation modeling, we examine the direct and indirect effects of previous sexual victimization, depressive symptoms, and substance use on the odds of victimization during the sophomore year of college. Results suggest that sexual victimization during the sophomore year of college is predicted directly by previous sexual victimization and also indirectly through depressive symptomology, though not substance use. Although understudied in the literature, depression is shown to mediate the relationship between victimization and revictimization, and this finding is consistent with routine activity theory, as well as the state dependence perspective on revictimization. Our findings suggest that depressive symptoms, a long acknowledged consequence of sexual victimization, should also be understood as a source of revictimization risk, indicating the importance of depression screening and intervention for decreasing sexual victimization.

High rate of partner violence during pregnancy in eastern Ethiopia: Findings from a facility-based study

INTRODUCTION

Intimate partner violence during pregnancy can contribute to maternal mortality and morbidity by limiting women's ability to receive maternal health services including antenatal care and skilled delivery care. In Ethiopia, evidence regarding intimate partner violence during pregnancy is limited, and no previous studies have been conducted in the Harari region. Therefore, this study aimed to investigate the prevalence and associated factors of intimate partner violence during pregnancy among women who had given birth in public hospitals in Harari regional state, eastern Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted from November 2018 to April 2019 among women who had given birth in public hospitals in Harari regional state, East Ethiopia. A systematic random sampling method was employed to select 648 participants. Data were collected using an interviewer-administered standardized questionnaire based on the World Health Organization Multi-Country Study on Women's Health and Domestic Violence against Women survey. Crude and adjusted odds ratios with respective confidence intervals were computed. Variables with a p-value of ≤0.05 were considered to have a significant association with intimate partner violence during pregnancy.

RESULTS

The prevalence of intimate partner violence during the most recent pregnancy was found to be 39.81%. Furthermore, the prevalence of physical, emotional and sexual violence were found to be 25.93%, 25.62% and 3.7%, respectively. Longer duration of marriage (adjusted odds ratio = 1.68, 95% confidence interval = 1.01-2.79), most recent pregnancy being unplanned (adjusted odds ratio = 1.55, 95% confidence interval = 1.03-2.34), experiencing controlling behaviour by a partner, (adjusted odds ratio = 2.23, 95% confidence interval = 1.46-3.40) and having an attitude that justifies intimate partner violence (adjusted odds ratio = 1.60, 95% confidence interval = 1.09-2.36) were associated with experiencing intimate partner violence.

CONCLUSION

The prevalence of intimate partner violence during pregnancy was found to be high. Pregnancy monitoring programs, which can detect and intervene with regard to partner's controlling behaviors and women's perception regarding justification of intimate partner violence, especially in those women with an unplanned pregnancy, could help to reduce intimate partner violence during pregnancy. Further, changing social norms that condone violence through advocacy and awareness creation might help in preventing partner violence.

"I'm here to listen and want you to know I am a mandated reporter": Understanding how text message-based crisis counselors facilitate child maltreatment disclosures

BACKGROUND

Emerging research suggests technology-facilitated crisis services are a promising method to support young people during child maltreatment disclosure. Little is known about how employees/volunteers respond to child maltreatment disclosure in these platforms and how they may support young victims through the disclosure process.

OBJECTIVES

We sought to determine how crisis counselors respond to child maltreatment disclosures using a content analysis of all conversations within a text-based crisis organization that resulted in a mandatory report.

METHODS

We conducted an iterative team-based content analysis of 244 conversations (24,730 text messages) between a young person and a crisis counselor from an anonymous text-based crisis service. All conversations included in the sample resulted in a mandatory report to child protective services.

RESULTS

There were two crucial points in maltreatment disclosure conversations. The first occurred immediately after the disclosure. At this point, crisis counselors most often provided sympathy and affirmation. The second crucial point after disclosure was the discussion of mandatory reporting. In many cases, crisis counselors confirmed both parties understood mandatory reporting and encouraged young people to consider the repercussions of their decision to share identifiable information that would permit a mandatory report.

CONCLUSION

Understanding how crisis counselors responded to young people in one text-based crisis service, particularly characteristics of well-received conversations, may inform the policies and processes for other organizations. Continued exploration of crisis text-based services may improve the disclosure process for young victims.

Immediate and Long-Term Mental Health Outcomes in Adolescent Female Rape Survivors

Rape is considered a stressful trauma and often has long-lasting health consequences. Compared with adult females, limited data exist on the psychological impact of rape in adolescents. The aim of this study was to assess the prevalence and associated factors of emotional distress in a cohort of adolescent rape survivors in Cape Town. Participants in this prospective longitudinal study were 31 adolescent female rape survivors recruited from a rape clinic in Cape Town and assessed within 2 weeks of the assault. Assessment measures included a sociodemographic questionnaire and initial screening with the Child and Adolescent Trauma Survey (CATS), the patient-rated Children's Depression Inventory (CDI), and the Multidimensional Anxiety Scale for Children (MASC). The CATS, CDI, and MASC were repeated at 1, 3, 6, 9, and 12 months post enrollment. Psychiatric diagnoses were made with the clinician-administered Mini International Neuropsychiatric Interview-Child and Adolescent version (MINI-Kid). At baseline, on the MINI-Kid, a definitive diagnosis of major depressive episode was endorsed in 22.6% of the participants. Stress-related disorders were found in 12.9%, whereas 16.1% had anxiety disorders. There was no diminution of symptoms on self-reported psychopathology measures at follow-up assessment over the five follow-up time points, suggesting persistent psychopathology over a 1-year period despite repeated clinical assessments and supportive counseling. Symptoms of anxiety, depression, and posttraumatic stress disorder in this sample of adolescent female rape survivors were high at enrollment and found to be persistent, underlining the need for long-term support, screening, and evidence-based follow-up care.

The Social and Individual Characteristics of Women Associated With Engagement With Multiple Intimate Violent Partners

Intimate partner violence (IPV) is a serious public health problem with known negative physical and mental health outcomes for women exposed. Studies have shown that with increased violence exposure, there are increased risks of negative outcomes for women. Likewise, chronicity of IPV across multiple partners is linked to more profound psychological suffering than acute exposure. However, little is known about the social- and individual-level characteristics of women that are correlated with engagement with multiple abusive partners. The current study (N = 164) identifies the characteristics of women that are associated with the number of violent partners with which they have been involved, with 35% of the sample reporting multiple IPV relationships. Participants reported on the number of violent partners, demographic characteristics, trauma history, current trauma and depressive symptoms, and exposure to IPV, including physical, sexual, and psychological violence. Results of multiple regression analysis indicate that trauma history (childhood sexual abuse, being held hostage, and torture) and current psychological violence were associated with women's engagement with multiple violent partners. Additional findings reveal that identification as African American and White was associated with greater re-engagement compared with identification as Latina. Finally, current exposure to sexual violence was associated with fewer violent partners. The clinical implications of these findings for treatment for women at risk for engagement with multiple partners in IPV relationships are discussed.

Women’s Experiences of Nature as a Pathway to Recovery From Sexual Assault

Given the serious challenges faced by female survivors of sexual assault, an understanding of how they heal after such an experience is vital. Yet little is known about how being in nature may be helpful in this regard. The purpose of this qualitative study was to develop an in-depth understanding of how nature helps women heal from sexual assault. A narrative analysis of semi-structured interview data provided by four female sexual assault survivors generated four main themes. These themes point to how nature served as a source of emotion regulation and spiritual connection, as well as how it facilitated greater acceptance and reduced dissociation. Themes also indicated reduced negative thinking and rumination, and increased attention to the here and now. Findings are contextualized within the existing literature on sexual assault, and implications for counselling and psychotherapeutic practice with survivors are provided.

Do outcomes of cognitive-behaviour therapy for co-occurring alcohol misuse and depression differ for participants with symptoms of posttraumatic stress?

BACKGROUND

Although post-traumatic stress disorder (PTSD) often co-occurs with depression and alcohol use disorder (AUD), treatment settings may not screen for PTSD symptoms.

AIMS

To explore the effects of PTSD symptoms in participants seeking treatment for depression and alcohol misuse by capitalising on the DAISI (Depression and Alcohol Integrated and Single focussed Interventions) project.

METHODS

Participants (N = 220) with current depressive symptoms and alcohol misuse were recruited from the DAISI project, a randomised controlled trial with four treatment arms. PTSD symptoms were assessed at baseline by the Posttraumatic Stress Diagnostic Scale and again at the 3-month assessment.

RESULTS

McNemars t-test assessed for changes in PTSD symptom severity and PTSD symptom clusters at the 3-month assessment. Repeated measures multivariate analysis of variance assessed for changes in PTSD symptoms, by DAISI treatment allocation. At the 3-month assessment, participants with PTSD reported significant reductions in PTSD symptoms (except intrusion) and a lower rate of PTSD, and responded better to integrated depression-alcohol misuse CBT than to the alcohol/depression single-focussed or brief interventions.

CONCLUSION

Integrated depression and alcohol misuse CBT may be effective for PTSD symptoms, but intrusions may need to be addressed specifically.

The weWomen and ourCircle randomized controlled trial protocol: A web-based intervention for immigrant, refugee and indigenous women with intimate partner violence experiences

Intimate partner violence (IPV), including homicides is a widespread and significant public health problem, disproportionately affecting immigrant, refugee and indigenous women in the United States (US). This paper describes the protocol of a randomized control trial testing the utility of administering culturally tailored versions of the danger assessment (DA, measure to assess risk of homicide, near lethality and potentially lethal injury by an intimate partner) along with culturally adapted versions of the safety planning (myPlan) intervention: a) weWomen (designed for immigrant and refugee women) and b) ourCircle (designed for indigenous women). Safety planning is tailored to women's priorities, culture and levels of danger. Many abused women from immigrant, refugee and indigenous groups never access services [WHY?] and research is needed to support interventions that are most effective and suited to the needs of abused women from these populations in the US. In this two-arm trial, 1250 women are being recruited and randomized to either the web-based weWomen or ourCircle intervention or a usual safety planning control website. Data on outcomes (i.e., safety, mental health and empowerment) are collected at baseline and at 3, 6, and 12 months post- baseline. It is anticipated that the findings will result in an evidence-based culturally tailored intervention for use by healthcare and domestic violence providers serving immigrant, refugee and indigenous survivors of IPV. The intervention may not only reduce risk for violence victimization, but also empower abused women and improve their mental health outcomes.

The Child-Centered EMDR Approach: A Case Study Investigating a Young Girl’s Treatment for Sexual Abuse

This article seeks to address the underrepresented area of eye movement desensitization and reprocessing (EMDR) treatment for sexually abused children. It presents the child-centered EMDR approach–a new protocol derived from Klaff (2016). This approach is built on Shapiro’s Adaptive Information Processing model and assumes that a successful outcome can be achieved without directly processing memories of the abuse since children have the ability to open channels of association to uncover, process, and resolve emotional trauma relating to the abuse. Instead of focusing on traumatic memories, the treatment targets whatever current concerns the child presents, as it is thought that these concerns may provide a pathway to covert and possibly unconscious issues. This approach is tested with a case study, which explores its use with a 9-year-old girl who presented with emotional triggers originating from sexual abuse by her biological father. She received six sessions addressing memories of being taunted by other children and of her father using drugs, but her memories of the sexual abuse were not directly addressed. Following treatment, her scores on the Child Report of Post-Traumatic Symptoms (CROPS) and Parent Report of Post-Traumatic Symptoms (PROPS) decreased to nonclinical levels, with results maintained 2 months later at follow-up. The promising results suggest the value of future research to further test this approach.

Intimate partner violence, trauma, and mental health need among female community college students

OBJECTIVE

The impact of interpersonal violence on college students has received considerable attention, yet no studies have been conducted among community college students, who comprise 40% of all American college students, and have unique risk factors and needs. Community College students are more likely to be women, people of color, working, parenting, and first generation college students.

PARTICIPANTS

Data were collected from a simple random sample from four community colleges (n=435).

METHODS

A cross-sectional quantitative survey was used to assess the extent of intimate partner violence, trauma exposure, sexual violence, and associated mental health consequences among female students.

RESULTS

Over 27% of participants reported IPV in the past year, while 25% reported sexual assault and 34% reported other uncomfortable sexual experiences in their lifetime. Nearly 20%of participants were currently reporting PTSD symptoms.

CONCLUSIONS

Community Colleges should work with service providers to build their capacity to respond to students' needs.

Self-Compassion and Psychological Flexibility in a Treatment-Seeking Sample of Women Survivors of Interpersonal Violence

Interpersonal violence is pervasive and is related to numerous negative psychological outcomes. This study examines self-compassion and psychological flexibility as potential protective factors for the range of diverse problems associated with interpersonal trauma. A community sample of 27 women (mean age = 37.74, SD = 16.16) participated in a larger pilot intervention study for psychological distress related to interpersonal violence. In this treatment-seeking sample, self-compassion was positively associated with psychological flexibility and negatively linked to higher levels of trauma-related distress, including posttraumatic stress disorder (PTSD) symptoms as well as problems related to the self and relations with others. The results suggest that self-compassion and psychological flexibility may function as protective factors in the development of problems in survivors of interpersonal violence.

Effects of Assault Type on Cognitive Behaviour Therapy for Coexisting Depression and Alcohol Misuse

Although assault exposure is common in mental health and substance misusing populations, screening for assaults in treatment settings is frequently overlooked. This secondary analysis explored the effects of past sexual (SA) and physical (PA) assault on depression, alcohol misuse, global functioning and attrition in the Depression and Alcohol Integrated and Single focussed Intervention (DAISI) project, whose participants (N = 278) received cognitive behaviour therapy (CBT) for their depression and/or alcohol misuse. Of the 278 DAISI participants, 220 consented to screening for past assault (either by a stranger or non-stranger) at baseline. Depression, alcohol, and global functioning assessments were administered at baseline and 3, 12, 24, and 36 months post baseline. A between-group analysis was used to assess differences between SA and No SA, and PA and No PA groupings, on adjusted mean treatment outcomes across all assessment periods. SA and PA participants had similar mean symptom reductions compared to No SA and No PA participants except for lower depression and global functioning change scores at the 12-month follow-up. People with coexisting depression and alcohol misuse reporting SA or PA can respond well to CBT for depression and alcohol misuse. However, follow-up is recommended in order to monitor fluctuations in outcomes.

Childhood Victimization, Attachment, Coping, and Substance Use Among Victimized Women on Probation and Parole

Justice-involved women report high rates of victimization across their life span, and these experiences contribute to their involvement in the criminal justice (CJ) system. Within this population, research has identified an overlap among victimization and substance use, a high-risk coping mechanism. Furthermore, research indicates attachment style is related to coping and high-risk behaviors. Research is needed to understand the relationship among these mechanisms as they relate to intimate partner violence (IPV). To address this gap, this study investigated the relationship between attachment, coping, childhood victimization, substance use, and IPV among 406 victimized women on probation/parole. Results of 6 multivariate regression analyses were statistically significant, accounting for 8%-13% of the variance in IPV. Particularly, childhood sexual victimization and negative coping were significant in all analyses. Findings provide practitioners, administrators, and policymakers information about the specific needs of justice-involved women.

Associations between adolescent experiences of violence in Malawi and gender-based attitudes, internalizing, and externalizing behaviors

Little is known about adolescent exposure to and factors associated with violence in Malawi. The aim of this research was to describe the prevalence of exposure to violence among adolescents in Malawi, and test the hypotheses that such exposures are associated with gender-based violent attitudes, and with internalizing and externalizing problems. In 2014, 561 primary school pupils were interviewed (50% girls), and logistic regression analysis was performed on gender-stratified data, adjusting for sociodemographic differences. Both girls and boys had witnessed domestic violence (28.5% & 29.6%), experienced emotional abuse at home (23.1% & 22.9%), physical abuse at home (28.1% & 30.4%), physical abuse at school (42.4% & 36.4%), and been bullied (33.8% & 39.6%). Among girls, internalized violent attitudes towards women were associated with emotional abuse at home (OR 2.1) and physical abuse at school (OR 1.7). Condoning rape was associated with physical abuse at school (OR 1.9). Bullying perpetration was associated with emotional abuse at home (OR 4.5). Depression was associated with emotional abuse at home (OR 3.8) and physical abuse at school (OR 2.4). Among boys, violent attitudes towards women and condoning rape were not associated with violence exposure. Bullying perpetration was associated with having been a victim of bullying (OR 2.9) and physical abuse at school (OR 2.7). Depression was associated with emotional abuse at home (OR 2.9), domestic violence (OR 2.4) and physical abuse at school (OR 2.5). These findings can inform programs designed to reduce violence victimization among Malawian girls, both in homes and schools.

Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis

The aim of the study was to explore the pathways by which childhood sexual abuse (CSA), psychological and physical intimate partner violence (IPV) during pregnancy, and other covariates relate to each other and to posttraumatic stress disorder (PTSD) symptoms in the postpartum period. The sample comprised 456 women who gave birth at a maternity service for high-risk pregnancies in Rio de Janeiro, Brazil, interviewed at 6-8 weeks after birth. A path analysis was carried out to explore the postulated pathways between exposures and outcome. Trauma History Questionnaire, Conflict Tactics Scales and Posttraumatic Stress Disorder Checklist were used to assess information about exposures of main interest and outcome. The link between CSA and PTSD symptoms was mediated by history of trauma, psychiatric history, psychological IPV, and fear of childbirth during pregnancy. Physical IPV was directly associated with postnatal PTSD symptoms, whereas psychological IPV connection seemed to be partially mediated by physical abuse and fear of childbirth during pregnancy. The role of CSA, IPV, and other psychosocial characteristics on the occurrence of PTSD symptoms following childbirth as well as the intricate network of these events should be acknowledged in clinic and intervention approaches.

Mental Pain and Suicidal Tendencies in Sexual and Physical Abuse Victims

We examine differential effects of mental pain and suicidal tendencies in female victims who have been sexually and physically abused, hypothesizing that sexual abuse victims report more mental pain and suicidal tendencies than physical abuse victims. A group of 98 women completed questionnaires that measured mental pain, suicidal tendencies and thoughts, and demographic details. Sexual abuse victims suffered more mental pain than physical abuse victims while the physical abuse victims demonstrated more repulsion by life than sexual abuse victims. Only sexual abuse victims demonstrated less attraction to life and only physical abuse victims showed more attraction to death.

A 6-Week School Curriculum Improves Boys' Attitudes and Behaviors Related to Gender-Based Violence in Kenya

This study investigated the effects of a gender-based violence (GBV) educational curriculum on improving male attitudes toward women and increasing the likelihood of intervention if witnessing GBV, among adolescent boys in Nairobi, Kenya. In total, 1,543 adolescents participated in this comparison intervention study: 1,250 boys received six 2-hr sessions of the "Your Moment of Truth" (YMOT) intervention, and 293 boys comprised the standard of care (SOC) group. Data on attitudes toward women were collected anonymously at baseline and 9 months after intervention. At follow-up, boys were also asked whether they encountered situations involving GBV and whether they successfully intervened. Compared with baseline, YMOT participants had significantly higher positive attitudes toward women at follow-up, whereas scores for SOC participants declined. At follow-up, the percentage of boys who witnessed GBV was similar for the two groups, except for physical threats, where the intervention group reported witnessing more episodes. The percentage of boys in the intervention group who successfully intervened when witnessing violence was 78% for verbal harassment, 75% for physical threat, and 74% for physical or sexual assault. The percentage of boys in the SOC group who successfully intervened was 38% for verbal harassment, 33% for physical threat, and 26% for physical or sexual assault. Results from the logistic regression demonstrate that more positive attitudes toward women predicted whether boys in the intervention group would intervene successfully when witnessing violence. This standardized 6-week GBV training program is highly effective in improving attitudes toward women and increasing the likelihood of successful intervention when witnessing GBV.

The Association Between Maternal Early Life Forced Sexual Intercourse and Offspring Birth Weight: The Role of Socioeconomic Status

BACKGROUND

This study utilizes a life-course framework to investigate whether maternal early life forced sexual intercourse operates in conjunction with health behaviors during adolescence, young adulthood, and the prenatal period to influence offspring birth weight.

METHODS

Using data from the 1994-2009 National Longitudinal Study of Adolescent Health (Add Health), we examined whether early life forced sexual intercourse predicted offspring birth weight through a mediated pathway, including depressive symptoms, substance use, and prenatal cigarette smoking. We stratify our analysis by socioeconomic status (SES) to determine whether the proposed pathways operate similarly, or differently, according to SES.

RESULTS

Our findings suggest that the pathways through which forced sexual intercourse affects offspring birth weight differ by SES. Among middle-to-high SES women, we found a mediated pathway linking forced sexual intercourse to offspring birth weight with prenatal cigarette smoking predicting lower offspring birth weight. Among low SES women, however, we did not find a mediated pathway linking forced sexual intercourse to birth weight. Findings suggest that prenatal cigarette smoking was not a mechanism of influence in the pathway between maternal early life forced sexual intercourse and offspring birth weight for low SES women.

CONCLUSIONS

Our findings suggest that forced sexual intercourse may influence infant birth weight in the next generation. Infants born with a low birth weight are at increased risk for a myriad of adverse outcomes across the life-course. Study results suggest the importance of interventions designed to reduce behavioral risks and to support health promoting behaviors among survivors in the short term, in an effort to prevent long-term consequences among later-born offspring.

Examining the Relationship Between Childhood Victimization, High-Risk Behaviors, and Health Among Criminal Justice-Involved Women

The purpose of this study was to develop and test a conceptual model of the pathways through which childhood victimization influences adult health outcomes. Specifically, measures of high-risk behaviors, tobacco use, alcohol use, illegal substance use, and HIV risk behaviors were hypothesized to mediate the relationship between childhood victimization and adult physical health. The sample consisted of 406 women on probation and parole with a history of childhood victimization in Jefferson County, Kentucky. Structural equation modeling was used to examine the relationship between childhood victimization, high-risk behaviors, and physical health outcomes. The findings indicate partial mediation, with health risk behaviors accounting for 12.5% of the variance in the relationship between childhood victimization and health outcomes. Implications for policy and treatment practice in the health and criminal justice arena are discussed.

Sexual Violence Among College Students: An Examination of Individual and Institutional Level Factors Associated With Perpetration

BACKGROUND

Sexual violence incidents involving college students have received media attention and increased awareness of this public health problem in the United States; prevention efforts are needed that target potential perpetrators. We examined characteristics of self-reported perpetrators of sexual violence on campuses.

METHODS

This study used a secondary data analysis of the 2015 College Student Health Survey, an annual survey, which was completed by students attending 17 colleges/universities in Minnesota. The analytic sample included 6,548 18-to 24-year-old college students who answered at least one of two questions assessing perpetration in the past 12 months (i.e., sex/sexual touch without consent). Chi-square tests were used to detect associations between perpetration and individual (e.g., age, race, substance use, victimization) and institutional (e.g., school type, location) level characteristics. Multiple logistic regression analyses identified predictive models for being a perpetrator of sexual violence.

RESULTS

Fifty-two students reported perpetration of sexual violence in the past year, including 29 rapes. Overall, self-reported perpetrators of sexual violence are more likely to be men, to have been a victim in his or her lifetime, to have smoked marijuana in the past 12 months (but not the past month), and to be younger (18 or 19 years old). Institutional level characteristics, including school type and location, did not yield significant associations with perpetration.

DISCUSSION

Sexual violence prevention and response efforts toward college students need to be inclusive, especially targeting individual level factors, and considerate of the victimization-perpetration comorbidity experienced by many students.

Effectiveness of a Group Intervention Program for Female Victims of Intimate Partner Violence

Group intervention has been widely used with female victims of intimate partner violence (IPV). However, efficacy studies are scarce due to several research limitations. This study evaluates the effectiveness of an 8-week group intervention program, with a cognitive-behavioral orientation and attended by 23 female victims of IPV. Self-report psychological assessment was conducted at pre-test, post-test, and follow-up. Results revealed that the group intervention had a positive impact on participants, showing a decrease in re-victimization and in beliefs toward legitimizing IPV. A decrease in levels of depression and a significant improvement in general clinical symptoms were also evident. Self-esteem and social support were enhanced throughout group intervention. The changes were confirmed through follow-up after 3 months, suggesting that this group intervention has important effects on female victims. The implications of the findings for practice are also discussed.

Forensic implications of changes in DSM-5 criteria for responses to trauma and stress

DSM-5 significantly changed the diagnostic criteria for Posttraumatic Stress Disorder (PTSD) relative to DSM-IV/DSM-IV-TR. These changes do not alter its basic approach to diagnosing mental disorders, which treats each disorder as a separate category. This article analyzes the strengths and weaknesses of the categorical approach, and reviews empirical evidence regarding the impact of changes within it on the ease or difficulty of receiving the PTSD diagnosis. It especially analyzes the impact of newly included symptoms that are meant to identify cases in which trauma exposure was associated with changes in more serious PTSD cases, known as Complex PTSD (C-PTSD). It proposes some effects that the changes could have on psychological injury claims. Many changes could support plaintiffs' claims while others could support defense claims. Some changes could support either. Overall, DSM-5 PTSD diagnosis is more responsive to individual differences in symptom presentations and appears able to diagnose some C-PTSD cases. The thesis throughout the article is that PTSD diagnostic accuracy could be improved further, especially for C-PTSD cases, by complementing its current exclusive reliance on behavioral symptoms that are characteristic of victims in general with assessment of the meaning that the symptoms have for individual victims. The article proposes some principles to guide interpretation of the individualized meaning of victims' symptoms, which help make the reasoning behind the interpretations explicit.

What Do Domestic Violence and Sexual Assault Service Providers Need to Know About Survivors to Deliver Services?

Using survey data, we investigate perspectives of 80 program directors of domestic violence and/or sexual assault agencies regarding whether gathering specific information at intake is helpful in determining survivors' needs for five service areas: legal advocacy, medical advocacy, support group, counseling, and shelter. We explore whether directors' opinions of information-type usefulness differ by type of service agency (single- or dual-focus). Findings show directors perceive the information most helpful to early service provision includes survivors' goals, experiences of violence and trauma, and health status. MANOVA results show no significant differences among directors from single- or dual-focus agencies.

Traumatic Events Associated With Posttraumatic Stress Disorder: The Role of Race/Ethnicity and Depression

This study sought to examine specific types of potentially traumatic experiences as predictors of posttraumatic stress disorder (PTSD) and the moderating effect of race/ethnicity and major depressive disorder (MDD) among non-Hispanic White, non-Hispanic Black, and Hispanic U.S. women. The study sample was drawn from two waves of the National Epidemiologic Surveys of Alcohol and Related Conditions. Sexual assault, intimate partner violence, and childhood trauma were the strongest predictors of PTSD compared with the reference group (indirect/witnessed trauma). Similar patterns were revealed across racial/ethnic groups, although the estimates were most robust among White women. Findings also suggest that MDD moderates the effect of traumatic experiences on PTSD.

Patterns of cumulative abuse among female survivors of intimate partner violence: links to women's health and socioeconomic status

Drawing on the Women's Health Effects Study, a community sample of women (N = 309) who recently left an abusive partner, this study examines patterns of cumulative abuse experiences over the life course, their socioeconomic correlates, and associations with a range of health outcomes. Latent class analysis identified four groups of women with differing cumulative abuse profiles: Intimate Partner Violence (IPV) Dominant, Child Abuse and IPV, All Forms, and All Forms Extreme. We find a relationship pattern between cumulative abuse and socioeconomic circumstances, and significantly worse health outcomes among women with the All Forms Extreme profile. Implications for research and practice are discussed.

A trip down memory lane about sex differences in the brain

Scientific studies funded by the United States government must now include both males and females as experimental subjects. This is a welcomed change for those of us who have been reporting on sex differences for decades. That said, there are some issues to consider; I focus on one in this review: females used in animal models of mental illness and health are almost always virgins and yet most adult females around the world, irrespective of species, are not virgins. I am not advocating that all scientists include non-virgin females in laboratory studies, but rather to consider the dynamic nature of the female brain when drawing conclusions through discovery. Stressful life experiences, including those related to sexual aggression and trauma, can have a lasting impact on processes of learning related to mental health and plasticity in the female brain. Her response to stress can change rather dramatically as she emerges from puberty to become pregnant and produce offspring, as she must learn to care for those offspring. The inclusion of females in scientific research has been a long time coming but it comes with a history. Going forward, we should take advantage of that history to generate hypotheses that are both reasonable and meaningful.

Campus Sexual Violence Resources and Emotional Health of College Women Who Have Experienced Sexual Assault

Institutional characteristics may help mitigate trauma associated with sexual assault. This study examines associations between resources on college campuses for sexual violence prevention and the emotional well-being of female students who have experienced sexual assault. There were 495 female college students who have experienced sexual assault who provided survey data in 2010-2011. Sexual violence resource data from 28 college campuses were combined with student survey data in multilevel analysis. Dependent variables include diagnosis with anxiety, depression, panic attacks, and PTSD, and models adjust for covariates and clustering of students within colleges. Participants attending colleges with more sexual violence resources had lower rates of mental health conditions than those attending colleges with fewer resources. Colleges are encouraged to expand their array of sexual violence resources to create a supportive environment for victims of sexual assault and to connect affected students with appropriate services.