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Campbell R, Engleton J, Gregory K, Goodman-Williams R, Javorka M. "It Made Me Feel Like Someone Wasn't Doing Their Job:" Sexual Assault Kit (SAK) Victim Notifications and Institutional Betrayal by the Criminal Legal System. J Trauma Dissociation 2024; 25:99-112. [PMID: 37401798 DOI: 10.1080/15299732.2023.2231914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 07/05/2023]
Abstract
In the United States, sexual assault survivors are advised to have a medical forensic exam and the collection of a sexual assault kit (SAK) to preserve biological evidence (e.g. semen, blood, saliva, hair) if they are considering reporting the assault to the police. Law enforcement personnel are supposed to submit the SAK (also known as a "rape kit") to a crime laboratory for forensic DNA testing, which can help identify or confirm the identity of the offender. However, police do not routinely submit SAKs for testing, and large stockpiles of untested kits have been found in police storage throughout the United States. Public outrage has prompted many cities to submit these older rape kits for DNA analysis, and this testing has identified thousands of suspected perpetrators. Police and prosecutors are re-opening these older sexual assault cases, which requires reestablishing contact with survivors who made the initial report years ago - a process referred to as "victim notification." In this study, we conducted qualitative interviews with survivors who received a SAK victim notification and participated in the re-investigation and prosecution of their cases. We explored how survivors reacted to this de facto admission of an institutional betrayal and the emotions they felt during and after the notification. Participants experienced considerable emotional distress (e.g. PTSD, anxiety, fear), anger and betrayal, and hope after they were recontacted by the police. Implications for making victim notifications more trauma informed are discussed.
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Affiliation(s)
- Rebecca Campbell
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Jasmine Engleton
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Katie Gregory
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | | | - McKenzie Javorka
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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2
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Campbell R, Gregory K, Goodman-Williams R, Engleton J, Javorka M. Victim Notification Protocols for Untested Sexual Assault Kits: Survivors' and Advocates' Perspectives on Law Enforcement-Led Outreach Methods. Violence Against Women 2023; 29:3101-3125. [PMID: 37700717 DOI: 10.1177/10778012231200479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Current estimates suggest there are 300,000-400,000 untested sexual assault kits (SAKs) in police department storage facilities throughout the United States. As these kits are being discovered and then submitted for forensic DNA testing, legal system personnel may recontact victims. These "victim notifications" involve informing survivors their kits were previously untested, sharing the results of new DNA testing, and asking for their engagement in reinvestigating and prosecuting the case. Typically, victim notifications are conducted by police, and survivors are connected with victim advocates soon thereafter. In this study, we interviewed survivors about their experiences of being notified by the police. We also interviewed about their work supporting survivors. Both survivors and advocates expressed strong concerns about police conducting notifications without an advocate present.
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Affiliation(s)
| | | | | | | | - McKenzie Javorka
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, MT, USA
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3
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Mhlongo S, Seedat S, Jewkes R, Myers B, Chirwa E, Nöthling J, Lombard C, Peer N, Kengne A, Garcia-Moreno C, Dunkle K, Abrahams N. Depression and post-traumatic stress symptoms two years post-rape and the role of early counselling: Rape Impact Cohort Evaluation (RICE) study. Eur J Psychotraumatol 2023; 14:2237364. [PMID: 37642373 PMCID: PMC10467520 DOI: 10.1080/20008066.2023.2237364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 03/16/2023] [Accepted: 06/06/2023] [Indexed: 08/31/2023] Open
Abstract
Background: Survivors of sexual violence are at higher risk of adverse mental health outcomes compared to those exposed to other interpersonal traumas.Objective: To examine the trajectory of both post-traumatic stress disorder (PTSD) and depression as well as the role of early counselling over 24 months among rape survivors.Method: The South African Rape Impact Cohort Evaluation (RICE) study enrolled women aged 16-40 years attending post-rape care services within 20 days of a rape incident (n = 734), and a comparison group (n = 786) was recruited from primary health care. Women were followed for 24 months; the main study outcomes were depression and PTSD. Reports of early supportive counselling by the exposed group were also included. The analysis included an adjusted joint mixed model with linear splines to account for correlated observations between the outcomes.Results: At 24 months, 45.2% of the rape-exposed women met the cut-off for depression and 32.7% for PTSD. This was significantly higher than levels found among the unexposed. Although a decline in depression and PTSD was seen at 3 months among the women who reported a rape, mean scores remained stable thereafter. At 24 months mean depression scores remained above the depression cut-off (17.1) while mean PTSD scores declined below the PTSD cut-off (14.5). Early counselling was not associated with the trajectory of either depression or PTSD scores over the two years in rape-exposed women with both depression and PTSD persisting regardless of early counselling.Conclusion: The study findings highlight the importance to find and provide effective mental health interventions post-rape in South Africa.
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Affiliation(s)
- S. Mhlongo
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - S. Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Research Chair in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - R. Jewkes
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- Office of the Executive Scientist, South African Medical Research Council, PretoriaSouth Africa
| | - B. Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - E. Chirwa
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - J. Nöthling
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - C. Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - N. Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - A.P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - C. Garcia-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization (WHO)Geneva, Switzerland
| | - K. Dunkle
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - N. Abrahams
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine: Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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4
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Anderson KM, Karris MY, DeSoto AF, Carr SG, Stockman JK. Engagement of Sexual Violence Survivors in Research: Trauma-Informed Research in the THRIVE Study. Violence Against Women 2022:10778012221125501. [PMID: 36148910 PMCID: PMC10387722 DOI: 10.1177/10778012221125501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Given the potential for retraumatization among survivors of sexual violence engaged in research, we aimed to provide pertinent knowledge and exemplification of the integration of trauma-informed practice to research with survivors. Grounded in trauma-informed care, we discuss the need for trauma-informed research, drawing upon experiences and data from a longitudinal case-control study on sexual violence. Through trauma-informed research settings, we can improve research experiences for survivors of sexual violence, as demonstrated by positive experiences of participants in The THRIVE Study. By meeting the needs of survivors, researchers can increase participation while maximizing the research quality and advancement of research.
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Affiliation(s)
- Katherine M Anderson
- Department of Medicine, Division of Infectious Diseases and Global Public Health, 12220University of California San Diego, La Jolla, CA, USA.,Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Maile Y Karris
- Department of Medicine, Division of Infectious Diseases and Global Public Health, 12220University of California San Diego, La Jolla, CA, USA
| | - Alexandra Fernandez DeSoto
- Department of Medicine, Division of Infectious Diseases and Global Public Health, 12220University of California San Diego, La Jolla, CA, USA
| | - Sara Giovanna Carr
- Department of Medicine, Division of Infectious Diseases and Global Public Health, 12220University of California San Diego, La Jolla, CA, USA
| | - Jamila K Stockman
- Department of Medicine, Division of Infectious Diseases and Global Public Health, 12220University of California San Diego, La Jolla, CA, USA
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5
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Nöthling J, Abrahams N, Jewkes R, Mhlongo S, Lombard C, Hemmings SMJ, Seedat S. Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape. J Affect Disord 2022; 309:151-164. [PMID: 35427719 DOI: 10.1016/j.jad.2022.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design. METHODS In a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape. RESULTS The incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores. LIMITATIONS We could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment. CONCLUSION Addressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.
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Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa.
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Carl Lombard
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
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6
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Lomax J, Meyrick J. Systematic Review: Effectiveness of psychosocial interventions on wellbeing outcomes for adolescent or adult victim/survivors of recent rape or sexual assault. J Health Psychol 2022; 27:305-331. [PMID: 32838568 PMCID: PMC8777327 DOI: 10.1177/1359105320950799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Sexual assault and rape are common forms of sexual violence/abuse. The psychological/health consequences represent significant and ongoing harm. It seems imperative that victim/survivors receive evidence-based support within first response settings. To assess what psychosocial interventions work for victim/survivors of a recent sexual assault. Twenty-seven electronic databases were systematically searched. Narrative data synthesis was used to read across studies. Reporting format follows PRISMA checklist. Ten studies were identifed including range of interventions. The evidence is sparse and scientifically weak, common flaws are reviewed. There is some weak evidence for the impact of video and cognitive behavioural therapy (CBT) based interventions, especially trauma processing. There is a gap in the evidence base on psychosocial interventions for victim/survivors of sexual assault and higher quality research is required.
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Affiliation(s)
| | - Jane Meyrick
- University of the West of England
Bristol, Bristol, UK
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7
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Campbell R, Javorka M, Hetfield M, Gregory K, Vollinger L, Ma W. Developing Trauma-Informed Research Methods: Using Proxy Respondents to Assess Sexual Assault Survivors' Experiences Seeking Medical Forensic Exams. VIOLENCE AND VICTIMS 2021; 36:793-807. [PMID: 34980586 DOI: 10.1891/vv-d-20-00221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In research on sexual assault victims' help-seeking, proxy data sources are often utilized because outreach to survivors immediately postassault may increase a study's risk-to-benefit ratio. Victim advocates and services providers are common proxy respondents, but empirical research comparing the accuracy of their information is needed. We collaborated with seven sexual assault nurse examiner (SANE) programs to collect de-identified, paired data from nurses and advocates regarding the help-seeking experiences of N = 744 adult victims. Using pairwise McNemar tests, we found statistically significant agreement on victim demographics, assault characteristics, and victims' decisions regarding medical forensic exams, sexual assault kit (SAK) collection, and release of SAKs for forensic DNA testing. Nurses and advocates had different information regarding victims' disclosure histories and their reasons for seeking SANE care.
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Affiliation(s)
- Rebecca Campbell
- Department of Psychology, Michigan State University, East Lansing, MI
| | - McKenzie Javorka
- Department of Psychology, Michigan State University, East Lansing, MI
| | | | - Katie Gregory
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Lauren Vollinger
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Wenjuan Ma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI
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8
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Draughon Moret JE, Sheridan DJ, Wenzel JA. "Reclaiming Control" Patient Acceptance and Adherence to HIV Post-Exposure Prophylaxis Following Sexual Assault. Glob Qual Nurs Res 2021; 8:23333936211046581. [PMID: 35187201 PMCID: PMC8851138 DOI: 10.1177/23333936211046581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
Sexual assault is an irrefutable trauma; an insult to the autonomy of the person forced into sexual acts. Sexual assault sequelae range from physical injury and acute traumatic stress, to pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). HIV post-exposure prophylaxis (HIV PEP) following sexual assault may decrease the likelihood of HIV transmission. Many patients seeking healthcare post-sexual assault either do not initiate HIV PEP or do not complete the 28-day medication regimen. In this qualitative interpretive description, we interviewed sexual assault patients (N=11) about HIV PEP discussions/reactions, attitudes and understanding related to HIV and PEP, and barriers and facilitators of HIV PEP acceptance and adherence. Participants described a process of losing and reclaiming control throughout post-assault care and follow-up; and how this affected HIV PEP-related decision-making. Most HIV PEP decisions were described as a process of reclaiming control over one outcome while simultaneously losing control of another.
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Affiliation(s)
- Jessica E Draughon Moret
- Faculty of the Betty Irene Moore School of Nursing in Sacramento, University of California Davis, Davis, CA, USA
| | - Daniel J Sheridan
- Faculty of the School of Nursing in Baltimore, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer A Wenzel
- Faculty of the School of Nursing in Baltimore, Johns Hopkins University, Baltimore, MD, USA
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9
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MacGregor KE, Villalta L, Clarke V, Viner R, Kramer T, Khadr SN. A systematic review of short and medium-term mental health outcomes in young people following sexual assault. J Child Adolesc Ment Health 2020; 31:161-181. [PMID: 31805838 DOI: 10.2989/17280583.2019.1665533] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: Sexual assault peaks in adolescence, yet sequelae at this age are not well understood. This systematic review aimed to describe mental health outcomes following sexual assault in young people. Method: Two reviewers independently searched databases, screening publications from 1990 to 2018. Inclusion criteria included: longitudinal studies, systematic reviews, and meta-analyses with ≥50% participants aged ten to 24 years; baseline mental health assessment prior to/or <8 weeks post-assault with follow-up ≥ 3 months after the initial assessment.Results: 5 124 titles and abstracts were screened, with 583 papers examined in full. Ten studies met inclusion criteria (sample size 31 to 191). Five studies examined rates of post-traumatic stress disorder (PTSD), reporting rates of up to 95% within one month and up to 60% at 12 months post-assault. Studies evaluating post-traumatic (n = 5) and anxiety (n = 3) symptom scores showed symptoms were highest in the immediate aftermath of the trauma, generally reducing over four to 12 months post-assault. Depressive symptomology appeared to vary between studies (n = 5). However, the majority showed symptoms decreasing over the same time period.Conclusions: Psychopathology is common following sexual assault in young people. Most studies observed reduced rates over time, but there is a paucity of longitudinal research. Psychopathology during the first year after sexual assault is an important treatment target to consider.
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Affiliation(s)
- Kirsten E MacGregor
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Laia Villalta
- Centre for Psychiatry, Imperial College London, London, UK
| | | | - Russell Viner
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Tami Kramer
- Centre for Psychiatry, Imperial College London, London, UK
| | - Sophie N Khadr
- University College London Great Ormond Street Institute of Child Health, London, UK.,The Havens, Sexual Assault Referral Centres, London, UK
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10
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Villalta L, Khadr S, Chua KC, Kramer T, Clarke V, Viner RM, Stringaris A, Smith P. Complex post-traumatic stress symptoms in female adolescents: the role of emotion dysregulation in impairment and trauma exposure after an acute sexual assault. Eur J Psychotraumatol 2020; 11:1710400. [PMID: 32002143 PMCID: PMC6968575 DOI: 10.1080/20008198.2019.1710400] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/17/2019] [Accepted: 12/04/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Adolescents are at high risk of sexual assault compared to any other age group. The pattern of post-traumatic stress symptoms plus life-impairing disturbances in self-organization (emotion dysregulation, negative self-concept and interpersonal problems) is termed Complex Post-Traumatic Stress Disorder (CPTSD). Research about CPTSD after sexual assault in adolescents is limited owing to the challenges associated with assessing this group. This study aims to determine the frequency and structure of CPTSD, and the relationship of emotion dysregulation with impairment and additional trauma exposure among adolescents who have been sexually assaulted. Method: Prospective cohort study of adolescents attending the Sexual Assault Referral Centres serving London over a 2-year period. We conducted cross-sectional analyses (n = 99) on data collected 4-5 months after sexual assault, and Confirmatory Factor Analyses (CFA) and Latent Class Analyses (LCA) to determine the CPTSD profile. CTPSD was defined according to the ICD-11, selecting symptom indicators from the following measures: Strengths and Difficulties Questionnaire (SDQ), Children's Revised Impact of Event Scale (CRIES-13), Short version of the Mood and Feelings Questionnaire (S-MFQ), The Development and Well-Being Assessment (DAWBA). We analysed the association of CPTSD symptom domains with impairment (measured with the SDQ, and the Children's Global Assessment Scale; C-GAS) and with additional trauma exposure. Results: The frequency of ICD-11 PTSD was 59%, and of ICD-11 CPTSD was 40%. CPTSD symptoms showed a strong fit for a correlated 4-factor model, and LCA distinguished a class of participants with high levels of CPTSD symptoms. Emotion dysregulation was associated with impairment in functioning and exposure to trauma beyond other self-organization disturbances and core PTSD symptoms. Conclusions: Disturbances in self-organization are frequent in sexually assaulted adolescents, and emotion dysregulation is associated with impairment and further exposure to trauma. Emotion dysregulation should be considered in preventive and treatment strategies for these vulnerable youth.
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Affiliation(s)
- Laia Villalta
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, University of Barcelona (UB), Barcelona, Spain
| | - Sophie Khadr
- Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, UK.,The Havens Sexual Assault Referral Centres, King's College Hospital, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kia-Chong Chua
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tami Kramer
- The Centre for Mental Health, Imperial College London, London, UK
| | - Venetia Clarke
- The Havens Sexual Assault Referral Centres, King's College Hospital, London, UK
| | - Russell M Viner
- Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, UK
| | - Argyris Stringaris
- Mood Brain & Development Unit, Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Patrick Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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11
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Abstract
Sexual assault is a widespread problem in US communities, affecting about one in every three women and one in every eight men. These assaults reverberate through the lives of survivors and their loved ones, often for decades or even a lifetime. Healthcare providers must be empowered and equipped to contribute to the medical and mental health of survivors. This article provides a framework for that knowledge and empowerment.
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12
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Campbell R, Goodman-Williams R, Javorka M. A Trauma-Informed Approach to Sexual Violence Research Ethics and Open Science. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:4765-4793. [PMID: 31514606 DOI: 10.1177/0886260519871530] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The practice of ethics in social science research is a reflexive process of self-review to define a profession's collective responsibility in the face of changing norms and expectations. In recent years, we have seen transformative changes in how society thinks about supporting sexual assault survivors, and how the scientific community thinks about our obligations to society. Decades of research on trauma and its impact has raised awareness about the needs of victimized individuals, giving rise to the trauma-informed practice movement, which emphasizes that service providers must center survivors' well-being in all interactions, decisions, and program practices. The field of sexual assault research helped give rise to this movement and provides empirical support for its guiding tenets, and in this article, we explore how to bring these ideas full circle to begin articulating trauma-informed principles for research. A trauma-informed perspective on research challenges scientists to go beyond the requirements of the Belmont Report (1979) and institutional review boards' (IRB) regulations to develop research procedures that fully support survivors' choice, control, and empowerment. Such reflection on participants' rights is particularly important given the open science movement sweeping academia, which calls on scientists to share their data publicly to promote transparency, replication, and new discoveries. Disseminating data could pose significant safety, privacy, and confidentiality risks for victims of sexual assault, so we need to evaluate what open science means within a trauma-informed framework. In this article, we examine three key stages of the research process-participant recruitment, data collection, and dissemination-and consider how trauma-informed principles could help, but also could complicate, research practices. We explore these tensions and offer potential solutions so that research on sexual trauma embodies trauma-informed practice.
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13
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Rodgers M, Meisel Z, Wiebe D, Crits-Christoph P, Rhodes KV. Wireless Participant Incentives Using Reloadable Bank Cards to Increase Clinical Trial Retention With Abused Women Drinkers: A Natural Experiment. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:2774-2796. [PMID: 27503325 PMCID: PMC5589513 DOI: 10.1177/0886260516662849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Retaining participants in longitudinal studies is a unique methodological challenge in many areas of investigation, and specifically for researchers aiming to identify effective interventions for women experiencing intimate partner violence (IPV). Individuals in abusive relationships are often transient and have logistical, confidentiality, and safety concerns that limit future contact. A natural experiment occurred during a large randomized clinical trial enrolling women in abusive relationships who were also heavy drinkers, which allowed for the comparison of two incentive methods to promote longitudinal retention: cash payment versus reloadable wireless bank cards. In all, 600 patients were enrolled in the overall trial, which aimed to incentivize participants using a reloadable bank card system to promote the completion of 11 weekly interactive voice response system (IVRS) phone surveys and 3-, 6-, and 12-month follow-up phone or in person interviews. The first 145 participants were paid with cash as a result of logistical delays in setting up the bank card system. At 12 weeks, participants receiving the bank card incentive completed significantly more IVRS phone surveys, odds ratio (OR) = 2.4, 95% confidence interval (CI) = [0.01, 1.69]. There were no significant differences between the two groups related to satisfaction or safety and/or privacy. The bank card system delivered lower administrative burden for tracking payments for study staff. Based on these and other results, our large medical research university is implementing reloadable bank card as the preferred method of participant incentive payments.
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Affiliation(s)
- Melissa Rodgers
- Perelman School of Medicine, University of Pennsylvania
- College of Education, The University of Texas at Austin
| | | | - Douglas Wiebe
- Perelman School of Medicine, University of Pennsylvania
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Mental and sexual health outcomes following sexual assault in adolescents: a prospective cohort study. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:654-665. [PMID: 30119759 DOI: 10.1016/s2352-4642(18)30202-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Young people are disproportionately affected by sexual assault, yet longitudinal data are sparse. This paper examines the characteristics of adolescents presenting to sexual assault services and mental and sexual health outcomes after an assault. METHODS This was a prospective cohort study in adolescents aged 13-17 years attending the Sexual Assault Referral Centres serving Greater London, UK, over 2 years. Baseline interviews (T0) were done less than 6 weeks after an assault to collect data on sociodemographic and assault characteristics and psychological symptoms, with follow-up interviews (T1) at 4-5 months after the assault. Four psychological symptom questionnaires were used at T0 and T1: The Child Revised Impact of Events Scale, the Short Mood and Feelings Questionnaire, the Screen for Child Anxiety Related Disorders, and the Strengths and Difficulties Questionnaire. The primary outcome was prevalence of any psychiatric disorder at T1, assessed using the Development and Wellbeing Assessment. Secondary outcomes at T1 were pregnancy, sexually transmitted infections, and sexual health screening since the assault. FINDINGS Between April 15, 2013, and April 20, 2015, 141 (29%) of 491 eligible young people were recruited to the study (134 females; mean age 15·6 years [SD 1·27]), and 106 (75%) of 141 participants had T1 interviews (99 female). At T0, psychological symptom scores showed that 115 (88%) of 130 females were at risk for depressive disorder, 90 (71%) of 126 were at risk for anxiety disorders, and 116 (91%) of 128 were at risk for post-traumatic stress disorder, with symptoms largely persisting at T1. 68 (80%) of 85 females who had a diagnostic assessment at T1 had a psychiatric disorder, with multiple disorders in 47 (55%) of 85. Anxiety, post-traumatic stress, and major depressive disorders were the commonest diagnoses. Presence of a psychiatric disorder was associated with baseline psychosocial vulnerability (previous social services involvement, mental health service use, self-harm, or sexual abuse), but not assault characteristics. At T1, four (4%) of 105 females had been pregnant since the assault, 14 (12%) of 119 had a sexually transmitted infection diagnosed between T0 and T1, and nine (8%) of 107 reported re-victimisation since the assault. INTERPRETATION Vulnerable adolescents have the double disadvantage of being at risk for both sexual assault and associated psychiatric disorders, highlighting the need for comprehensive support after an assault. Feasibility and effectiveness of prevention programmes should be investigated. FUNDING National Institute for Health Research Policy Research Programme grant (115/0001).
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Combs JL, Riley EN, Peterson SJ, Jordan CE, Smith GT. Pre-Assault Personality Predicts the Nature of Adverse Outcomes Among Sexual Assault Victims. J Stud Alcohol Drugs 2018; 79:258-268. [PMID: 29553355 PMCID: PMC6019766 DOI: 10.15288/jsad.2018.79.258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Exposure to sexual assault results in ongoing harms for women. After an assault, some women engage in higher levels of externalizing behaviors, such as problem drinking, and others experience higher levels of internalizing dysfunction, such as symptoms of anxiety and depression. We sought to understand the role of premorbid factors on the different post-assault experiences of women. METHOD We studied 1,929 women prospectively during a period of high risk for sexual assault (the first year of college): women were assessed in July before arriving at college and in April near the end of the school year. RESULTS A premorbid personality disposition to act impulsively when distressed (negative urgency) interacted positively with sexual assault experience to predict subsequent increases in drinking behavior; a premorbid personality disposition toward internalizing dysfunction positively interacted with sexual assault experience to predict increased symptoms of anxiety and depression. CONCLUSIONS Women with different personalities tend to experience different forms of post-assault consequences.
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Affiliation(s)
- Jessica L. Combs
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Elizabeth N. Riley
- Department of Psychology, University of Kentucky, Lexington, Kentucky,Correspondence may be sent to Elizabeth N. Riley or Gregory T. Smith at the Department of Psychology, 105 Kastle Hall, University of Kentucky, Lexington, KY 40506, or via email at: or . At the time the research was conducted, Jessica L. Combs was with the Department of Psychology, University of Kentucky, Lexington, KY
| | - Sarah J. Peterson
- Department of Psychology, University of Kentucky, Lexington, Kentucky
| | - Carol E. Jordan
- Office for Policy Studies on Violence Against Women, University of Kentucky, Lexington, Kentucky
| | - Gregory T. Smith
- Department of Psychology, University of Kentucky, Lexington, Kentucky,Correspondence may be sent to Elizabeth N. Riley or Gregory T. Smith at the Department of Psychology, 105 Kastle Hall, University of Kentucky, Lexington, KY 40506, or via email at: or . At the time the research was conducted, Jessica L. Combs was with the Department of Psychology, University of Kentucky, Lexington, KY
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dos Reis MJ, Lopes MHBDM, Osis MJD. ‘It's much worse than dying’: the experiences of female victims of sexual violence. J Clin Nurs 2016; 26:2353-2361. [DOI: 10.1111/jocn.13247] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Maria José Duarte Osis
- CEMICAMP (Center for Maternal-Child Research of Campinas); University of Campinas; Campinas SP Brazil
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Westmarland N, Alderson S. The health, mental health, and well-being benefits of rape crisis counseling. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:3265-82. [PMID: 23926218 DOI: 10.1177/0886260513496899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
There is very little research on interventions to alleviate the distress experienced following rape. This action research project developed and piloted the "Taking Back Control" tool that measured the impact of rape crisis counseling over time. Five rape crisis centers in the North of England agreed to pilot the tool, which was administered by the client's counselor, either on Week 1 or 2, and then repeated every 6 weeks until the end of counseling. Eighty-seven clients completed at least two questionnaires. This allowed us to measure change from their first compared with their last data collection point. The most change was made in relation to the statement "I feel empowered and in control of my life," where 61% strongly/disagreed at the first data collection point compared with 31% at the last data collection point. Large shifts were also seen in relation to "I have 'flashbacks' about what happened" and "I have panic attacks." Overall, some degree of positive change was seen for all measures. This research, despite some limitations, begins to develop an evidence base for rape crisis centers to demonstrate their benefits and to assess and develop their own practice.
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Backes BL. Building a solid foundation for sexual violence research: applying lessons learned to inform research priorities. Violence Against Women 2013; 19:737-55. [PMID: 23833250 DOI: 10.1177/1077801213494704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The extant research on sexual violence has developed into a substantial body of knowledge, in large part supported by federal funds from agencies such as the Centers for Disease Control and Prevention (CDC), the National Institute of Justice (NIJ), and National Institutes of Health (NIH) components. Overall, NIJ has dedicated over US$20 million in research funds to study sexual violence resulting in more than 60 studies and multiple topic-specific research-to-practice meetings. From an initial study on the criminal justice response to rape in 1973 to present-day initiatives on multidisciplinary responses, forensic sciences, and methodological queries, NIJ has made a significant contribution to current knowledge in the field of sexual violence. A strength of the program is its use of an interdisciplinary approach, encompassing the perspectives of those within the field of research and practice to guide the development of its research program. This article details the history and development of NIJ's program of research, highlighting key studies and their contribution to the field, and provides a framework for the continued study of sexual violence.
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