A systematic qualitative review of risk and protective factors for sexual violence perpetration

Differentiating Between Sexual Offending and Violent Non-sexual Offending in Men With Schizophrenia Spectrum Disorders Using Machine Learning

Forensic psychiatric populations commonly contain a subset of persons with schizophrenia spectrum disorders (SSD) who have committed sex offenses. A comprehensive delineation of the features that distinguish persons with SSD who have committed sex offenses from persons with SSD who have committed violent non-sex offenses could be relevant to the development of differentiated risk assessment, risk management and treatment approaches. This analysis included the patient records of 296 men with SSD convicted of at least one sex and/or violent offense who were admitted to the Centre for Inpatient Forensic Therapy at the University Hospital of Psychiatry Zurich between 1982 and 2016. Using supervised machine learning, data on 461 variables retrospectively collected from the records were compared with respect to their relative importance in differentiating between men who had committed sex offenses and men who had committed violent non-sex offenses. The final machine learning model was able to differentiate between the two types of offenders with a balanced accuracy of 71.5% (95% CI = [60.7, 82.1]) and an AUC of .80 (95% CI = [.67, .93]). The main distinguishing features included sexual behaviours and interests, psychopathological symptoms and characteristics of the index offense. Results suggest that when assessing and treating persons with SSD who have committed sex offenses, it appears to be relevant to not only address the core symptoms of the disorder, but to also take into account general risk factors for sexual recidivism, such as atypical sexual interests and sexual preoccupation.

Development of a Measure of Anti-Rape Attitudes as a Potential Protective Factor Against Rape Perpetration

The role of attitudes toward women and sexual violence in predicting men's perpetration of rape has been well documented in the literature. While research on rape perpetration has primarily focused on identifying risk factors, the limited understanding of protective factors has hindered the development of psychometric measures to assess attitudinal protective factors. However, comprehending these protective factors is essential for a comprehensive understanding of the risk of rape perpetration and the advancement of strength-based approaches. This research describes the development of a new scale designed to measure anti-rape attitudes (ARA) in young heterosexual men. To generate the initial item pool, relevant information was gathered from sexual violence support service websites and academic literature. This item pool underwent an external expert review for further item generation and cognitive interviews for content validation. This qualitative phase was followed by four quantitative studies for item reduction and scale validation. The resulting 19-item scale demonstrates good internal consistency (Cronbach's α = .84). The ARA scale exhibits strong negative correlations with rape myth acceptance (RMA) and hostile sexism, and strong positive correlations with positive consent attitudes (PCA), supporting the scale's construct validity. We further conducted hierarchical regression analyses to test the unique relationship of ARA with those constructs while controlling for RMA. These showed that ARA have significant, unique associations with PCA and ambivalent sexism. The development of this new scale enables a more comprehensive assessment of the risk of rape perpetration and opens up new avenues for research on protective factors against rape. Ultimately, this study constitutes an important step toward fostering strength-based approaches to combat sexual violence.

Social Connections as a Protective Factor for Sexual Violence-Related Attitudes

Endorsing problematic sexual violence-related attitudes including rape myth acceptance (RMA), hostile sexism, and disapproval of sexual consent is associated with negative outcomes, including the perpetration of sexual violence. This study examined social connections as a protective factor for sexual violence-related attitudes among a sample of 770 participants. Results indicate that in the full sample, connections to a workplace were protective for RMA and hostile sexism while family connections were protective for disapproval of sexual consent, RMA, and hostile sexism. Patterns of other social connections differed in separate models for men and women. Unexpected findings indicating that connections to a religious social group are a risk, not a protective, factor are discussed.

Risk factors of sexual violence perpetration and victimization among adolescents: A study of Norwegian high school students

Sexual violence among adolescents represents a significant problem in society. In this study, we aimed to examine risk factors for sexual violence perpetration in adolescent men and victimization in adolescent women among a community sample of Norwegian high school students. The participants (560 men and 751 women, aged between 16 and 21 years) responded to online questionnaires covering physical and non-physical forms of sexual harassment and possible risk factors identified in the literature. Last year's prevalence rate of physical sexual perpetration reported by adolescent men was 7%. Comparably, the prevalence of physical sexual victimization reported by adolescent women was 30%. Path analyses suggest that sociosexuality was associated with adolescent men's sexual perpetration indirectly through sexual risk taking, alcohol intoxication, porn exposure, and sexual underperception that in turn was positively associated with undesirable non-physical solicitation from and toward women. In addition, rape stereotypes were associated with perpetration behavior in adolescent men. For adolescent women, sociosexuality was associated with being sexually victimized primarily through sexual risk behavior, alcohol intoxication, and sexual overperception. These factors were again positively associated with sexual derogation from adolescent women and solicitation from adolescent men. Prior sexual abuse victimization was only indirectly associated with victimization. The factors associated with adolescent men's perpetration and adolescent women's victimization were highly similar. Future work aimed at reducing sexual violence in adolescence within the educational context might find it more effective to specifically target non-physical forms of sexual harassment.

Evidence That Pervasive Body Gaze Behavior in Heterosexual Men Is a Social Marker for Implicit, Physiological, and Explicit Sexual Assault Propensities

Deliberate and effortful attempts to gaze at the bodies of women is emerging as a valuable marker of sexual objectification in men. Some preliminary evidence suggests that pervasive body gaze behavior may also accompany insidious attitudes which can facilitate sexual assault. The present study aimed to further explore this potential by examining pervasive body gaze associations with explicit, implicit, and physiological sexual assault propensity measures. We presented 110 heterosexual male participants with images of fully and partially dressed women with and without injuries while measuring their skin conductance responses. We also captured implicit and explicit sexual assault measures in addition to self-reported pervasive body gaze behavior. Pervasive body gaze behavior was significantly correlated with rape myth acceptance attitudes, prior perpetration of sexual assault, a stronger implicit association between erotica and aggression, and lower physiological reactivity during exposure to partially dressed injured women. These findings suggest that body gaze towards women could be a behavioral marker for inclinations to victim blame, preferences for rough sexual conduct, and a physiological desensitization towards female victims. This study further validates a five item self-reported body gaze measure as a valuable tool for detecting deviant sexual objectification attitudes and affective states. As such, measurement and observation of body gaze behavior could be useful for developing risk assessments, estimating intervention efficacy, and enhancing public awareness.

Patterns of Gender Equitable Attitudes and Behaviors Among Young Men: Relationships With Violence Perpetration and Masculinity Ideologies

This study used latent profile analysis with data from 481 U.S. men to examine patterns of men's attitudes toward gender equity and their engagement in gender-equitable (GE) behaviors. Five resulting profiles included groups with (a) high endorsement of both GE attitudes and behaviors, (b) low endorsement of both, (c) mid-range endorsement of both, (d) strong endorsement of GE attitudes, but low engagement in action, and (e) low endorsement of GE attitudes but high participation in GE behavior. Worryingly, this last group reported higher rates of violence perpetration than other groups, while simultaneously reporting higher rates of participation in gender-based violence prevention actions.

Developmental Trajectories Leading to Hostility Toward Women: A Structural Equation Modeling Study

Hostility toward women is frequently examined as a risk factor for violence against women, but research on its antecedents is sparse. The aim of this study was to explore the developmental and psychological antecedents associated with hostility toward women in a Canadian sample of sexual aggressors of women. Drawing on Malamuth's confluence model of sexual aggression, we developed a multifactorial model of hostility toward women, using structural equation modeling. The results indicate the presence of three trajectories, all starting from childhood victimization and leading to hostility toward women, involving antisocial characteristics, emotional negativity, anxiety, and depression.

Campus climate impacts on sexual violence: a Bayesian comparison of undergraduate and community colleges

OBJECTIVE

Sexual violence is endemic on college campuses. Four-year campuses present high-risk environments for sexual violence and heavy episodic drinking is a robust risk factor for victimization. However, limited literature exists on sexual violence at two-year institutions, with most research focused on four-year campuses. We examined whether campus climates affect sexual violence prevalence rates.

PARTICIPANTS

Sexual misconduct campus climate data from two-year and four-year campus students.

METHODS

We used Bayesian logistic regressions to compare sexual victimization odds between two- and four-year campuses.

RESULTS

Four-year students were twice as likely to have experienced sexual victimization and 2.5 times more likely to engage in heavy episodic drinking compared to two-year students. The risk of sexual victimization associated with heavy episodic drinking was reliably similar across campus types.

CONCLUSIONS

Campus climates reliably impact student's risk of sexual victimization. Based on these findings, two- and four-year campuses may need to implement distinct prevention services.

The Reintegration of Men into Society after a Sexual Offense: A Hermeneutic Phenomenology Study

The purpose of this study was to describe the lived experience and meaning of being a 'sex offender' for the individual who is reintegrating into society, considering issues associated with self-perception, perception of others, stigma and humanization. Fourteen male adults were invited to participate in this hermeneutic phenomenological study. Data analysis was completed using an iterative process as described by van Manen. Five major themes were identified: exposed secret leads to humiliation; being considered a sex offender is living in fear of the unknown; stigma and shame consume the identity of the individual charged with a sexual offense; reframing and "leveling" of the crime are coping strategies; and the path toward healing and forgiveness is complex. Contextualizing individuals' experiences and examining barriers and motivators post-charge are essential to minimize stigma and risk factors linked to recidivism, as well as to facilitate recovery and healing.

Perils and Possibilities: Sexual Violence Preventionists' Perspectives on Gathering Community Input on Prevention Practice

There is relatively little research unpacking provider processes or tensions (e.g., leadership decision-making) when attempting to gather and incorporate community feedback into gender-based violence work. Across focus groups with 18 sexual violence preventionists, we explored experiences collecting information and perspectives from or with community members; barriers, and facilitators; and how they navigate possibilities of community-informed sexual violence prevention. We learned that preventionists want to gather input, and they gather it in nonsystematic ways; they face barriers familiar to many community-informed processes; and the topic of sexual violence complicates community-informed processes. Determining boundaries of possibility is central to navigating practice. Further, organizational settings are influential in determining boundaries.

Community-Level Factors As Positive and Negative Correlates of Sexual Aggression Perpetration Among Adolescent Boys

Often, perpetrators of sexual violence first aggress in their teens. Presently, very little is known about environmental factors that may influence adolescents' engagement in sexual aggression. Drawing upon data collected at 27 high schools in the Northeast United States, this study is the first to test the association between community-level factors and male adolescents' sexual aggression. A series of backward linear regressions determined that 10 of 19 community variables were associated with males' sexual aggression, which were then used to generate a ratio of positive to negative correlates of sexual aggression for each high school. In multilevel analyzes, as hypothesized, the ratio of positive to negative correlates was positively associated with schools' sexual aggression perpetration rates. We discuss the study's implications for future sexual assault research and prevention interventions.

Protective Factors for Sexual Violence Perpetration Among High School and College Students: A Systematic Review

To prevent sexual violence (SV), it is important to understand both risk and protective factors for SV perpetration. Although considerable research has examined risk factors for perpetration of SV among high school and college students, less research is dedicated to investigating protective factors which might mitigate the risk of perpetration. This review summarizes existing research on protective factors for perpetration of SV among high school and college students. Thirteen articles were included in this study after reviewing 5,464 citations. Inclusion criteria included peer-reviewed scholarly journals, written in English, and published between 2010 and 2021. The included articles indicate that 11 factors were significantly related to less SV perpetration. Key protective factors identified in this study include empathy, impulse control, social support, parental factors, peers, church attendance/ religiosity, and school connections. In addition to protective factors, this review also examined study characteristics for the included articles and found that most participants were White and just over half of the studies were longitudinal. Overall, these findings indicate a lack of research focused on protective factors for SV perpetration, and a need for more research on the identified protective factors and to investigate additional protective factors. Such studies should include longitudinal designs and more diverse samples to understand the range of protective factors that can be bolstered through interventions to prevent SV among high school and college students.

Empirically Assessing the Effectiveness of the Pathways Programme: An Online Self-Help Intervention for Male Sexual Aggression at UK Universities

Though contemporary evidence suggests that upwards of one-in-nine UK male university students engage in sexually violent behaviors (Hales and Gannon in Sexual Abuse 34:744-770, 2022), few evidence-based primary prevention strategies have been developed to prevent their perpetration. To help contribute to this evidence gap, this study evaluated the short and longer-term effectiveness of a novel psychoeducation-based online self-help intervention for university male sexual aggression called The Pathways Programme. Designed around current empirical understanding of university-based sexual harm in the UK, the program contains six modules that correspond with known risk factors for perpetration. Data were collected as part of a randomized control trial from 254 self-identified heterosexual male students enrolled at a UK university who reported a proclivity towards sexual aggression. Results showed that participants who took part in the program displayed moderate reductions in their self-perceived likelihood of sexual aggression (our primary treatment target) across testing points, as well as reductions in their self-reported levels of hostility towards women, rape myth acceptance, and problematic sexual fantasies (our secondary treatment targets). Control participants also displayed reductions in some domains over time, albeit to a lesser degree. Additional analyses probed the factors associated with participant drop-out, clinical and reliable change, and user feedback. Overall, our study provides preliminary evidence for the efficacy of The Pathways Programme at reducing UK university males' risk of sexual aggression; however, we caution readers that more robust evaluation is necessary to support intervention rollout. We discuss our findings alongside the limitations of our study and provide suggestions for future research.

Socioecological Risk and Protective Factors for Sexual Victimization in Post-Secondary Students in Ireland: A Brief Report

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV.

Acceptability of RealConsent: A Sexual Violence Web-Based Risk Reduction Program for College Women

Acceptability of a sexual violence (SV) risk reduction program called RealConsent designed for first-year female college students was conducted as part of a larger, randomized controlled trial. RealConsent uses web-based and mobile technology to deliver four 45-minute theoretically and empirically derived modules designed to increase knowledge, affect attitudes and normative beliefs, increase bystander and other protective behaviors, and reduce alcohol misuse. Educational entertainment is used throughout the program to achieve these aims. A total of 444 first-year female college students recruited from three Southeastern universities who were eligible and provided informed consent were randomized to RealConsent. Acceptability was ascertained both quantitatively and qualitatively through a survey administered following the completion of each of four modules. Results suggest that overall, RealConsent was viewed as relatable, realistic, and relevant. Most participants rated modules as good/excellent in quality, in organization, and in the conveying of a high degree of knowledge regarding alcohol misuse, consent for sex, sexual communication, defense strategies, protective strategies, and intervening to prevent SV. Suggestions to improve RealConsent centered on having more content inclusive of sexual and gender-minoritized students. Results suggest that RealConsent is an acceptable SV risk reduction program among first-year female college students and may have advantages for dissemination over in-person programs due to its web-based and mobile technology.

Measuring Sexual and Gender-Based Violence at the University of Cape Coast: Developing and Deploying a Campus Climate Survey

AIMS

Sexual and gender-based violence (SGBV) is a global public health crisis, impacting university youth around the world. The purpose of this study was twofold: (a) determine the best methodology for conducting a campus climate survey at the University of Cape Coast (UCC) in Ghana and (b) gather data on SGBV knowledge, attitudes, and behaviors from a representative sample of students.

METHODS

This descriptive study included three phases: (a) develop a campus climate survey unique to UCC, (b) develop a sampling methodology, and (c) deploy the first ever campus climate survey at UCC.

RESULTS

A 71-item survey was developed and then administered via a student portal to 2,000 students. Of those students, 1,381 (69.1%) responded. Although most students (63.2%) know the university has a sexual harassment policy, fewer have seen it (25.9%) or read it (22.3%). Students held generally positive views of how the university would respond to reports of sexual harassment, although 50.2% of participants believed the reporter would be labeled a troublemaker. More participants reported seeking and giving verbal than nonverbal consent, and more men than women reported both seeking and giving verbal consent. More men than women reported they "always" sought verbal consent (61.2% vs. 47.7%, p = 0.001). Most students ( n = 316, 56.5%) sought verbal consent all of the time, and an additional 99 (17.7%) sought it most of the time.

CONCLUSIONS

Accurate data about students' knowledge, attitudes, and experiences with SGBV policy, prevention, and response are needed globally to better inform locally appropriate practices.

POTENTIAL IMPACT OF CAMPUS INTIMATE PARTNER VIOLENCE AND SEXUAL ASSAULT ON FORENSIC NURSING

Forensic nursing is currently localized in high-income countries. University students' knowledge, attitudes, and experiences with SGBV can support the expansion of forensic nursing research and practice to low- and middle-income countries.

Advancing a Comprehensive Multilevel Approach to Sexual Violence Prevention Using Existing Efficacious Programs

ABSTRACT

Sexual violence (SV) is a serious and long-standing public health problem on college campuses. At institutions of higher education, campus administrators, activists, and practitioners have worked for decades to address campus SV. Despite federally mandated campus SV prevention programming, rates of campus SV remain unchanged. The purpose of this commentary is to outline a strategy for enhancing campus SV prevention efforts using a comprehensive multilevel approach utilizing existing efficacious programs. The following three strategies for implementing optimal campus SV prevention are proposed, which include (a) the need to prioritize efficacy, (b) targeting multiple levels of the social ecology, and (c) leveraging the benefits of in-person programming and technology-driven prevention. A call to action is included for both institutions of higher education administrators and practitioners to implement and invest in comprehensive multilevel interventions using existing, efficacious SV programs, ideally combining a technology-based program with an in-person component. Furthermore, a coordinated effort between prevention and response is needed to achieve successful prevention of campus SV and revictimization, including a connection with the community for postassault interventions. Thus, implementing multilevel interventions on college campuses using existing evidence-based programs in combination with a coordinated community response of postassault interventions can bring the campus community together and is optimal to moving the needle on rates of campus SV.

Defining and Measuring Sexual Consent within the Context of University Students' Unwanted and Nonconsensual Sexual Experiences: A Systematic Literature Review

Lack of sexual consent forms the foundation of unwanted (and nonconsensual) sexual experiences (USEs), yet research suggests it is not well understood amongst university students. While the prevalence of USEs has been well documented within the university context, less is known about how sexual consent is defined or measured. This review aims to identify a consistent sexual consent definition and how current research examining USEs defines and measures sexual consent amongst university students. A systematic review of nine electronic databases (2000-2022) was conducted, and the results were assessed against inclusion criteria (e.g., studies had to focus exclusively on university students). Thirty-three articles were identified and reviewed against the study aims. Sexual consent was more often implicitly defined across measures and articles. Four themes were identified (incapacitation, use of force, use of threats, and lack of wantedness) across the implicit definitions but varied by study with some implicitly defining sexual consent within the context of a relationship. Only three studies explicitly defined sexual consent, referring to it as a willingness to engage in sexual behavior. Measures assessed sexual consent communication or, attitudes and behaviors that might predict sexual aggression. Two studies examined students' individual sexual consent conceptualizations. Sexual consent appears to be contextual so future research should examine the variability of sexual consent in student samples. Students may indeed rely on implicit sexual consent definitions (rather than explicit) but more research is needed. Lastly, researchers should take care to be clear on their sexual consent definitions, both in text and within measures.

Empirically-based dynamic risk and protective factors for sexual offending

This review provides an overview and update of empirical evidence for psychologically meaningful dynamic risk factors and protective factors for sexual offending. Using the review by Mann et al. (2010) as a starting point, we reviewed relevant literature that has appeared since this publication, focusing on meta-analyses, systematic and scoping reviews of dynamic risk factors, recent evaluations of commonly used dynamic assessment tools, and studies of dynamic risk and protective factors in community samples in addition to clinical or forensic samples. Two risk factors previously deemed promising by Mann et al. (2010), hostility towards women and dysfunctional coping (conceptualized as hostile masculinity and emotional regulation deficits, respectively, in this review), could now be considered supported using this review's criteria of three or more studies demonstrating an effect size of 0.15 or greater. No new risk factors were identified. We conducted a broader search of protective factors in recognition of the relative newness of this literature: Positive social support was the only protective factor identified as empirically supported. We also discuss situational risk and protective factors.

Evaluating a Theory-Based Online Program for Preventing Sexual Aggression: An Experimental-Longitudinal Study With German University Students

This pre-registered study evaluated an intervention designed to reduce sexual aggression perpetration and victimization by changing risky scripts for consensual sexual interactions and corresponding risky sexual behavior, and by improving sexual self-esteem, refusal assertiveness, and initiation assertiveness. In a four-wave longitudinal study covering 23 months, 1181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six weekly modules addressing the targeted theory-based risk and vulnerability factors of sexual aggression perpetration and victimization. Controlling for baseline levels (T1), the intervention group showed less risky sexual scripts one week post-intervention (T2), which predicted less risky sexual behavior nine months later (T3), which predicted lower odds of sexual aggression perpetration and victimization 12 months later (T4). No direct intervention effects on rates of sexual aggression perpetration and victimization at T3 and T4 were found. No indirect intervention effect on sexual aggression was found via sexual self-esteem and sexual assertiveness. However, sexual self-esteem at T2, which was higher in the intervention group, predicted lower odds of sexual aggression victimization at T3 via higher initiation assertiveness at T3. Implications for reducing sexual aggression and conceptualizing risk and vulnerability factors of sexual aggression are discussed.

Integrated Alcohol Use and Sexual Assault Prevention Program for College Men Who Engage in Heavy Drinking: Randomized Pilot Study

BACKGROUND

Sexual assault is prevalent on college campuses and most commonly is perpetrated by men. Problematically, there is a dearth of evidence-based prevention programs targeting men as perpetrators of sexual aggression. The Sexual Assault and Alcohol Feedback and Education (SAFE) program is an integrated alcohol and sexual assault prevention intervention for college men who engage in heavy drinking that aims to address sexual aggression proclivity and alcohol use outcomes by incorporating social norms theory, bystander intervention, and motivational interviewing.

OBJECTIVE

This study aims to examine the initial feasibility-, acceptability-, and efficacy-related outcomes of a randomized pilot trial of an integrated alcohol and sexual assault prevention program for college men who engage in heavy drinking.

METHODS

This study included 115 college men who engaged in heavy drinking, who were randomly assigned to the SAFE program or a mindfulness-based control condition (MBCC). The feasibility of implementation, adequacy of participant retention, fidelity and competency of program administration, and satisfaction and utility of the intervention were evaluated. The primary outcomes of alcohol use and sexual aggression were evaluated at 2 and 6 months after baseline. The secondary outcomes of perceived peer norms, risks for sexual aggression, and bystander intervention were also assessed. The extent to which the motivational interviewing session with personalized normative feedback facilitated changes in the proximal outcomes of drinking intentions, motivation to change, and self-efficacy was also examined.

RESULTS

The study procedures resulted in high program completion and retention (>80%), high fidelity to the program manual (>80% of the content included), high competency in program administration, and high ratings of satisfaction and program utility in addressing sexual relationships and alcohol use. Both groups reported declines in the number of drinks per week and number of heavy drinking days. Compared with the MBCC participants, the SAFE participants reported higher motivation to change alcohol use after the program, as well as greater use of alcohol protective behavioral strategies at 6 months. Compared with the MBCC participants, the SAFE participants also reported lower perceived peer engagement in sexual coercion, perceived peer comfort with sexism, and peer drinking norms at 2 and 6 months. However, no group differences were observed in sexual aggression severity, rape myth acceptance, or the labeling of sexual consent. Results regarding bystander intervention intentions were mixed, with the MBCC group showing decreased intentions at 2 months and the SAFE group reporting increased intentions at both 2 and 6 months.

CONCLUSIONS

The findings provide promising evidence for the feasibility, acceptability, utility, and preliminary efficacy of the SAFE program in reducing alcohol use and positively influencing perceived peer norms and intentions for bystander intervention among college men who drink.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05773027; https://clinicaltrials.gov/study/NCT05773027.

Improving Sexual Assault and Sexual Harassment Prevention from the Bottom-up: a Pilot of Getting To Outcomes in the US Military

While the Department of Defense (DoD) has given increased attention and priority to preventing sexual assault and sexual harassment (SA/SH), it remains a problem. To build its prevention capacity, DoD piloted Getting To Outcomes® (GTO®) from 2019 to 2022 at 10 military installations. GTO is an evidence-based planning and implementation support that has been used in many civilian contexts but has only recently been adapted for military SA/SH. The purpose of this study was to describe GTO use, identify its benefits and challenges, and discuss lessons the GTO effort yielded for prevention more broadly using a framework of organizational and program-level capacities needed for successful prevention in the military context, called the Prevention Evaluation Framework (PEF). GTO was piloted with 10 military installations ("sites") representing all Military Services, plus the Coast Guard and National Guard. GTO is comprised of a written guide, training, and ongoing coaching. The pilot's goal was for each site to use GTO to implement a SA/SH prevention program twice. Participants from each site were interviewed and data was collected on GTO steps completed, whether GTO spurred new evaluation activities and collaborations, and the degree of leadership support for GTO. Most sites completed all GTO steps at least once. Interviews showed that DoD participants believe GTO improved prevention understanding, planning, and evaluation capacity; strengthened confidence in chosen programs; and helped sites tailor programs to the military context. Barriers were the complexity of GTO, DoD personnel turnover, and the disruption that the COVID pandemic caused in sexual assault prevention program delivery. Many respondents were unsure if they would continue all of GTO after the coaching ended, but many believed they would continue at least some parts. According to the PEF, the GTO pilot revealed several additional prevention system gaps (e.g., need for leadership support) and changes needed to GTO (e.g., stronger leader and champion engagement), to support quality prevention. The military and other large organizations will need to focus on these issues to ensure prevention implementation and evaluation are conducted with quality.

Risk Markers for Male Perpetration of Sexual Assault on College Campuses: A Meta-Analysis

Sexual assault (SA) on college campuses remains a prominent public health issue. This meta-analysis focuses on identifying all potential risk markers for college male SA perpetration. Using standard search procedures, a total of 25 studies yielding 89 unique effect sizes were included in the study. Significant risk markers were related to hegemonic masculinity (e.g., peer approval of SA, rape myth acceptance, sexist beliefs, hostility towards women), other forms of dating violence perpetration (e.g., physical and psychological dating violence perpetration), and the college party culture (e.g., binge drinking, alcohol and substance use, frequency of hook-ups). Psychological dating violence victimization, athletic team membership, race/ethnicity, relationship status, and religiosity were not significant risk markers for SA perpetration. Findings support potential benefits of SA prevention efforts prioritizing peer education/student leaders modeling SA disapproval, challenging hegemonic masculinity, healthy relationship and sexual education, as well as alcohol and substance use awareness.

Does Athlete Status Explain Sexual Violence Victimization and Perpetration on College Campuses? A Socio-Ecological Study

In the United States, college students have been identified as a high-risk group for sexual violence (SV) victimization and perpetration, with one in three women and one in four men experiencing SV in their lifetimes. Therefore, studies investigating both perpetration and victimization across genders are pertinent. Additionally, in the context of higher education, athletics is often viewed as a high-risk environment for SV. Despite established relationships between SV and intercollegiate athletics, research on this topic is not conclusive due to the heterogeneous nature of college sports, as well as a dearth of research on recreational athletes. The primary purpose of this study was to examine the differences in SV victimization and perpetration among intercollegiate, recreational, and non-athlete populations. Additional context was provided by exploring variables at multiple levels of the socio-ecological model for violence prevention, as these factors can be important aspects of a person's development and may inform behavior. Utilizing a sample of 62,996 students from 199 institutions of higher education in the United States, multilevel logistic regression analyses were conducted to assess individual- (i.e., personal demographics), relationship- (i.e., athlete status), and community-level (i.e., institutional characteristics) predictors of SV victimization and perpetration. The results indicated that recreational athletes are the most at-risk group, experiencing and perpetrating SV at higher rates than non-athletes. Results on institutional status and individual characteristics, as well as implications for practitioners and future research is discussed.

A Theory-Based Intervention to Reduce Risk and Vulnerability Factors of Sexual Aggression Perpetration and Victimization in German University Students

The current study evaluated an intervention program, designed by the authors and based on the theory of sexual scripts and social learning theory, to reduce empirically established risk and vulnerability factors of sexual aggression. A sample of 1,181 university students in Germany (762 female) were randomly assigned to an intervention and a no-intervention control group. The intervention group completed six modules addressing established antecedents of sexual aggression perpetration and victimization: risky sexual scripts, risky sexual behavior, low sexual self-esteem, low sexual assertiveness, acceptance of sexual coercion, and perceived realism of pornography. After baseline (T1), intervention effects were measured one week after the last module (T2), nine months later (T3), and another 12 months later (T4). The intervention group showed significantly less risky sexual scripts and higher sexual self-esteem at T2, T3, and T4. The intervention indirectly reduced risky sexual behavior at T3 and T4 via less risky sexual scripts at T2 and increased sexual assertiveness at T3 and T4 via higher sexual self-esteem at T2. No intervention effects were found on the acceptance of sexual coercion and pornography realism. The implications of the findings for reducing the prevalence of sexual aggression perpetration and victimization are discussed.

Contradictions in change: Ecological factors in the implementation of outer layer sexual violence prevention

This study examined the adoption and implementation process in early efforts to implement ecological ("outer layer") sexual violence (SV) prevention strategies. Interviews with 28 preventionists from 26 local sites within a large, midwestern state, were conducted to examine individual preventionists' problem definitions of SV and ecological factors surrounding implementation. Findings suggest that SV prevention in the state is primarily implemented at the individual-level; when preventionists described engaging in or anticipating outer layer interventions, they were often tertiary (i.e., responding after perpetration; e.g., Sexual Assault Response Teams). A majority expressed problem definitions rooted within the individual (e.g., perpetration due to a lack of consent education), and a majority of implemented efforts matched this individual-level conceptualization. Yet, contradictions between problem definitions (e.g., SV stemming from oppression) and implemented activities (e.g., single-session educational interventions) emerged. Such contradictions may be best understood in light of contextual implementation influences: diverse preventionist job responsibilities, less training/support for outer layer prevention, preventionist autonomy, leadership messaging, time requirements, partner reticence, and extensive work with schools. Inner layer influences, including identification with job roles, preference for, and a sense of urgency toward inner layer work, appeared to interact with contextual factors. Implications across community psychology domains are discussed.

Impulsivity and Reactive-Proactive Aggression as Mechanisms of Alcohol-Related Sexual Intimate Partner Violence Perpetration among Romantic Partners

Background: Sexual intimate partner violence (S-IPV) commonly occurs within the contexts of committed romantic relationshops. Prior research has demonstrated the existence of a robust link between alcohol use and S-IPV. Despite this, few research studies have explored the etiological underpinnings of alcohol-related S-IPV perpetration, specifically. The present study examines the role of several key factors (i.e., problematic drinking, negative and positive urgency, proactive and reactive aggression) on S-IPV perpetration. Methods: Participants were 337 heavy drinking men and women in intimate relatinships who reported perpetrating some form of IPV toward their current partner within the past-year. A moderated-mediation model was used to determine how the key study variables interacted to predict S-IPV perpetration. Results: Results indicated that problematic drinking was positively correlated with both negative urgency and positive uregency. Findings also revealed that negative urgency, positive urgency, proactive aggression, and reactive aggression were all positively related to S-IPV perpetration. The indirect relationship between problematic drinking and S-IPV perpetration was mediated by positive urgency. Additionally, a significant main effect of proactive aggression on S-IPV perpetration was also detected. Conclusions: These findings suggest that impulsivity, specifically positive urgency, and proactive aggression may be under-appreciated constructs within the existing sexual aggression literature, and future research examining these variables as mechanisms explaining the association between the alcohol and S-IPV is warranted.

Researcher-Practitioner Partnerships to Implement and Evaluate Sexual and Relationship Violence Prevention Programs for Boys and Men

Although male-focused sexual and relationship violence (SRV) prevention programs are widely promulgated, limited guidance concerning how programs should be implemented for rigorous evaluation exists. To help develop evidence for such guidance, this paper reports on 20 interviews with leaders at youth-serving community-based organizations (CBOs) and educational institutions, which are sites for male-focused SRV prevention programs. This study examined: (1) how programs can be designed to engage male participants; and (2) how youth-serving CBOs and educational institutions can partner with researchers for evaluations. Findings underscore the importance of attending to the unique needs of program participants, their parents/guardians, and host organizations.

Pornography Use, Perceived Peer Norms, and Attitudes Toward Women: A Study of College Men

Men's negative attitudes toward women is a known risk factor for sexual aggression perpetration. Sexual aggression is a widespread public health concern, especially among emerging adults, and is associated with a multitude of negative consequences. The current study evaluated whether pornography-related perceived peer norms, own approval, and self-reported use are associated with negative attitudes towards women in a sample of college men. Types of pornography examined included: pornography (in general), pornography that included portrayals of bondage, whipping, and spanking but without explicit dissent (i.e., pornography that depicted bondage/physical aggression), as well as pornography consisting of sexually explicit rape depictions in which force is used. Self-report measures assessing the frequency of pornography exposure, self-acceptance of pornography use, and perceived peer norms were collected from 283 college men. A multiple linear regression model revealed that only perceived peer norms for acceptance of pornography that depicted rape was positively associated with negative attitudes toward women. Findings highlight the importance of better understanding and addressing perceived peer norms in sexual assault prevention programs for college men.

An Application of the Confluence Model of Sexual Aggression Among Young Adult Male Soldiers

Sexual violence in the U.S. military is a serious concern. Whereas numerous studies document the prevalence of sexual violence among service members, far less research has examined etiological risk factors for sexual aggression perpetration among service members. The present study sought to evaluate the applicability of the Confluence Model of Sexual Aggression among a sample of young adult men engaged in active-duty military service within the U.S. Army. Anonymous surveys were completed by 326 male soldiers between the ages of 18 and 24 at a large military installation in the Southeastern region of the United tStates. Men's likelihood to engage in sexual aggression was operationalized as men's perceived likelihood to persist with sexual activity despite a partner's resistance. Aligning with the Confluence Model of Sexual Aggression, two composite variables reflecting hostile masculinity and tendency toward impersonal sex were created. A linear regression indicated that the main effects of hostile masculinity and impersonal sex were significantly associated with greater perceived likelihood of sexual aggression perpetration. Results also revealed that while the interaction term between hostile masculinity and impersonal sex was significant, the direction of the relationship suggests that the effect of impersonal sex is weaker at higher levels of hostile masculinity. These findings lend evidence to help identify those at elevated risk for perpetrating sexual aggression, as well as informing programmatic efforts to prevent sexual assault within the military.

Open pilot trial of an interactive digital application for campus sexual violence prevention

Digital applications, or "serious games" for health address learning goals in a cognitively active, interactive manner, with the potential for widespread dissemination. This study used a mixed methods approach to develop and conduct a formative evaluation of a digital application for sexual assault prevention. Make a change is a digital application that uses the principles of games for health to foster learning, engagement, and skill-building around risk and protective factors for sexual victimization, sexual aggression, and bystander intervention. The digital application includes four narrative chapters, six embedded activities, as well as a user-derived change plan in which individuals establish goals for behavior change following program completion. This multisite study at a 2- and a 4-year college utilized student interviews (n = 14), stakeholder interviews (n = 10), and focus groups with students (n = 40) to inform intervention development. A total of 41 college students then participated in an open trial and completed self-report surveys (pre, post, and 1-month follow-up) to evaluate the feasibility, acceptability, utility, and preliminary outcomes. Most of the sample reported enjoyment, usefulness, and perceived competence after completing the application. Data evidenced a trend to reduce the frequency of heavy drinking, and perceptions of social norms evidenced change over time. Findings support the feasibility and effectiveness of this novel format for the delivery of sexual assault prevention programming.

Risk factors for perpetrating sexual aggression among adolescents: Differences by gender and sexual orientation

Although anyone-regardless of gender or sexual orientation-can perpetrate sexual aggression, most studies examining risk factors for engaging in sexual aggression include samples of boys and men, and do not consider the sexual orientation of the respondent. The current study addresses this gap in the literature by examining how risk factors for sexual aggression vary as a function of gender and sexual orientation in a sample of 1782 high school youth. Participants completed surveys evaluating engagement in consent behaviors, rape myth acceptance, perception of peer rape myth acceptance, perceived peer engagement in violence, and perceived peer support for violence. A one-way MANOVA found that constructs varied as a function of gender and sexual orientation. Specifically, heterosexual boys reported lower engagement in consent behaviors, higher rape myth acceptance, and higher perceived peer support for violence compared to heterosexual girls and sexual minority girls. The results highlight the importance of considering gender and sexual orientation when designing sexual aggression prevention programs.

Ntombi Vimbela! Sexual violence risk reduction intervention: pre and one-year post assessments from a single arm pilot feasibility study among female students in South Africa

BACKGROUND

The extremely high prevalence of sexual violence victimisation reported among female students in South African public higher education demands urgent action to develop, rigorously evaluate and scale effective prevention interventions. This article details findings from a pilot feasibility study of Ntombi Vimbela! a campus sexual violence risk reduction intervention developed to tackle the high burden of sexual violence in higher education institutions in South Africa.

METHODS

Ntombi Vimbela! (NV!) is a sexual violence risk reduction intervention that comprises sexuality empowerment, gender and social norm change, early-risk identification, self-defence, resistance and mental wellbeing components. NV! is comprised of ten workshop sessions running for 3.5 h each. Workshops are co-delivered by two trained peer facilitators per group of at most 20 first-year female students. One-year post-intervention quantitative outcome assessments were remotely completed by 98 participants who participated in the NV! pilot workshops. Qualitative assessments were conducted with 35 participants through in-depth telephone interviews (IDTIs).

FINDINGS

One year after attending NV! workshops, most participants reported improved awareness of sexual rights, assertive communication, shifts in gender equitable beliefs, reductions in rape myth acceptance, improved expressed sexual relationship power sexual decision-making, and improved negotiation within their intimate relationships. Participants' depressive symptoms also significantly decreased. Many participants improved awareness of sexual assault risk and vigilance, including using self-protection strategies such as removing themselves from environments where alcohol intoxication posed sexual assault risks. Some participants used assertive communication to withstand peer pressure to engage in risky sexual behaviours. Most participants scored highly on the self-defence efficacy scale. Some participants were exposed to and successful in using verbal and physical resistance strategies in potential sexual assault risky situations.

CONCLUSION

These findings indicate the potential beneficial effects of NV! as a campus sexual violence risk reduction intervention at one-year post-intervention, which must be evaluated in a future rigorous randomised control trial.

PILOT TRIAL REGISTERED AT

ClinicalTrials.gov NCT04607564 on 29/10/2020.

Youth sexual offending in Hong Kong: examining the role of self-control, risky sexual behaviors, and paraphilic interests

Introduction

Little is known about the nature and prevalence of sexual offending among youth in Hong Kong.

Methods

Testing self-control theory and sexual health risk factors (i.e., risky sexual behaviors [general and two subtypes] and paraphilic interests [general and 14 subtypes]), the prevalence of self-reported sexual offending behaviors (i.e., threat of sexual assault, penetrative sexual assault, and nonpenetrative sexual offense) was examined in a community-based sample of 863 young people (aged 17 to 20) in Hong Kong.

Results

In this study, men reported significantly higher levels of threat of sexual assault and of general and 12 subtypes of paraphilic interests than women; and women reported a significantly higher level of a specific paraphilic interest subtype (i.e., transvestic fetishism) than men. Logistic regressions found that, in general, a low level of self-control and high levels of risky sexual behaviors and paraphilic interests were important factors in the participants' likelihood of issuing threats of sexual assault and engaging in penetrative and nonpenetrative sexual assault.

Discussion

Important practical implications for reducing the tendency of young people to engage in sexual offending behavior can be derived from this study.

The effects of bilateral stimulation using eye movements on sexual fantasies with follow-up

BACKGROUND AND OBJECTIVES

Sexual fantasies represent a common aspect of human sexuality that can support sexual well-being but also contribute to psychopathology. The latter warrants intervention and bilateral stimulation with eye movements (EMs) may be a suitable intervention for impairing mental imagery of sexual fantasies. This study aimed to evaluate the effect of multiple rounds of EMs on sexual fantasies, gauge the effect over time with a one-week follow-up, and assess how impaired sexual imagery may influence behaviour and behavioural intention.

METHODS

Twenty-eight participants (14 male, Mage = 44.10, SDage = 9.77) selected a favoured sexual fantasy and engaged in five repeated rounds of an EM task, either face-to-face or via telehealth. Baseline phenomenological characteristics of sexual fantasies were compared against repeated measures after each round of EMs and at one-week follow-up, as well as hypothetical behavioural intention and frequency of fantasy masturbation.

RESULTS

All sexual fantasy characteristics (e.g., vividness, sensations, arousal, believability) diminished progressively between each round of EMs. These characteristics increased from round five to follow-up. However, they remained significantly reduced compared to baseline. Participants' hypothetical behavioural intention and frequency of masturbation associated with their sexual fantasies also reduced post-EM task.

LIMITATIONS

Use of self-report measures; participants' mental imagery could not be measured directly; and no comparison groups were included.

CONCLUSIONS

As an imagery impairing task, bilateral stimulation with EMs is effective for diminishing the phenomenological properties of sexual fantasies, extending upon extant literature. Collectively, the progressive research regarding EMs and sexual fantasies encourages replication in specific populations (e.g., individuals with problematic or harmful sexual fantasies).

Sexual Fantasies and Harmful Sexual Interests: Exploring Differences in Sexual Memory Intensity and Sexual Fantasy Characteristics

The perpetration of harmful sexual behavior is a global concern, with deviant sexual fantasies identified as a prominent etiological risk factor. However, the concepts of state sexual fantasy characteristics (e.g., vividness and emotionality) and associated trait sexual memory intensity have received minimal investigation concerning harmful sexual interests, formulating the impetus for this research. Two online surveys were conducted in community populations. Study 1 (N = 414) aimed to validate the psychometric properties of a trait sexual memory intensity scale (SMIS) through principal components analysis, confirmatory factor analysis, and evaluation of concurrent validity. Study 2 (N = 820) endeavored to explore associations between state sexual fantasy characteristics and cognitive-behavior variables (e.g., frequency of masturbation to a reported fantasy), and evaluate differences in fantasy characteristics and SMIS scores between participants with and without harmful sexual interests. Collectively, results supported the factor structure, concurrent validity, and internal consistency of the SMIS, while revealing significant associations between the SMIS, sexual fantasy characteristics, and several variables. Significant differences in sexual fantasy characteristics and SMIS scores were evident but variable among harmful sexual interests. Findings encourage the consideration and research of interventions focused on impairing mental imagery and memory in the management of harmful sexual interests.

Violent Victimization During Childhood in the United States: Associations With Revictimization and Health

Childhood violence victimization is a serious adverse childhood experience with lasting health impacts. This study examined the prevalence and characteristics of five forms of childhood violence victimization and their association with revictimization and negative health conditions among adults. Data are from the 2010-2012 National Intimate Partner and Sexual Violence Survey. Age at first victimization and perpetrator sex were assessed; adjusted odds ratios assessed associations with revictimization and health. Ages 14-17 were the most common age at first victimization for most violence types; almost half of male (46.7%) and a quarter of female (27.0%) rape victims reported first victimization before age 10. Most victimization was associated with revictimization and negative health, controlling for adult victimization. Primary prevention of childhood violence may reduce later health risks.

Event Characteristics of Sexual Violence Perpetration Against Romantic Partners Versus Non-Romantic Partners

Tactics used to perpetrate sexual violence may be crucial to understanding when and why sexual violence occurs. Moreover, most sexual violence occurs between people who know each other-including in the context of dating or sexual relationships. Little is known about the context of sexual violence that occurs with non-romantic partners. To address these research gaps, we examined online survey data from 786 young adults (weighted n = 763) aged 19 to 27 years, living across the United States. Findings suggest that 60% of sexual assault, 40% of attempted rape, 42% of rape, and 67% of coercive sex were perpetrated against a romantic partner, defined as a current or ex-boyfriend, girlfriend, spouse, or domestic partner. Contextual differences were noted by relationship type: Those who perpetrated against romantic partners were more likely than those who targeted non-romantic partners to report that it occurred because they were feeling sad or angry. They were also more likely to say that the other person was completely responsible for what happened. Conversely, those who aggressed against non-romantic partners were more likely to say that someone else found out about what happened. Making the other person feel guilty was the most common tactic for both groups. The most frequently endorsed reason for perpetrating sexual violence was "feeling really horny," although feeling "good" or being drunk/high were also common reasons noted by aggressors. Afterward, many said they felt guilty or ashamed and were worried about the other person's feelings. Fear of getting caught was universally absent. Findings support the importance of building emotion regulation and emotional awareness skills in sexual violence prevention programming. Prevention programs should also discuss coercion as a violence tactic, since perpetrators may not always recognize this to be sexual violence. More generally, violence prevention programs should also address healthy relationships, consent, and taking responsibility.

The Role of Alexithymia and Impulsivity in Male Victims and Perpetrators of Intimate Partner Violence

(1) Background: Alexithymia and impulsivity appear to represent risk factors for violence perpetration, while mixed results are present with respect to victimization experience. In light of this, the purpose of this study was to compare the roles of both alexithymia and impulsivity among three different samples of men: men who experienced partner victimization (IPVV); male intimate partner violence perpetrators (IPVP); and men from the general population (CG). (2) Methods: Participants were recruited from specialized centers in Italy. A profile analysis was conducted. (3) Results: The results showed that IPVV presented alexithymia and impulsivity comparable to the CG. Furthermore, differences were found between victims and perpetrators in terms of impulsivity and alexithymia. The IPVP group had higher levels of both impulsivity and alexithymia in comparison to IPVV. Moreover, the perpetrators exhibited significantly higher levels of alexithymia compared to the CG. However, despite the medium Cohen's d (d = 0.441) resulting from the analyses, IPVP's level of impulsivity was not statistically different from the CG. (4) Conclusion: Alexithymia and impulsivity appear to play a key role in violent behaviors and should be the focus of psychological interventions with perpetrators.

Profiles of Men's Rape Myth Beliefs and the Association With Rape Proclivity

The two constructs of rape myth acceptance (RMA) and rape proclivity are associated with sexual violence (SV) perpetration. Further understanding these constructs can help improve prevention efforts aimed at reducing SV perpetration. Latent profile analysis was conducted to examine typologies of RMA among 474 incoming college men and found that male college students can be categorized into four profiles. Some groups endorsed lower or mid-levels of rape myths (RMs) and others endorsed higher levels of some or all RMs, indicating the heterogeneity of RM beliefs. And within each subgroup of college men's RMA, intention to join an all-male sports team and/or a fraternity (two risk factors) and bystander attitudes (a protective factor) were examined as covariates in the model. Bystander attitudes appear to act as a protective factor as they are higher among profiles of men with lower RMA. Furthermore, this study examined the four subgroups (latent profiles) of college men based on their RMA to examine whether membership within each subgroup/profile is differentially associated with rape proclivity. The findings indicate that subgroups of men with high levels of RMA have higher mean rape proclivity scores compared to the subgroup of men with the lowest level of RMA. Implications for prevention programming tailored for high-risk groups of men, based on their RMA beliefs, as well as possible future research within this area are discussed.

A Comparison of Sexual Minority and Heterosexual College Students on Gendered Sexual Scripts and Sexual Coercion Perpetration

Prior work has identified endorsement of gendered sexual script beliefs as predictive of sexual coercion perpetration among heterosexual individuals, primarily men. This research is lacking among sexual minority individuals and may be important in informing inclusive and effective sexual coercion prevention efforts. The current study sought to (1) assess the level of adherence to gendered sexual script beliefs, (2) report relative rates of general sexual coercion and sexual intimate partner violence (IPV), and (3) examine the relationship between gendered sexual script beliefs and self-reported sexually coercive behavior among sexual minority and heterosexual college men and women. Undergraduate students (n = 1,199; 182 sexual minorities) completed self-report measures assessing gendered sexual script beliefs, sexual coercion perpetration, and sexual IPV. Results from Gender × Sexual Minority group ANOVAs and logistic regression analyses indicated similar rates of perpetration across sexual orientation groups, with men overall reporting the most perpetration. Furthermore, men and heterosexual individuals adhered more strongly to gendered sexual scripts than women and sexual minority individuals, respectively. Results of path models revealed no moderation by sexual orientation, and that adherence to gendered sexual scripts was positively related to sexual IPV perpetration among the full sample of heterosexual and nonheterosexual individuals, though this effect was small. Gendered sexual scripts did not significantly relate to general sexual coercion perpetration among the full sample, suggesting that traditional sexual script beliefs may not be as relevant to perpetration in a contemporary college sample. This study adds to limited literature on sexual coercion perpetration among sexual minority individuals and is an important step in understanding relationships between endorsement of gendered sexual script beliefs and sexual coercion perpetration among sexual minority and heterosexual college students.

Components of Hostile Masculinity and Their Associations With Male-Perpetrated Sexual Aggression Toward Women: A Systematic Review

Hostile masculinity and its components (i.e., sexual dominance, hostility toward women, adversarial sexual beliefs, rape myth acceptance, and acceptance of interpersonal violence) have received considerable research attention as predictors of male-perpetrated sexual aggression toward women. The current systematic review sought to synthesize and organize the extant literature. Studies were included in the systematic review if they were published in a peer-reviewed journal between the years 1990 and 2020, contained a male sample within the United States, analyzed quantitative data, and examined at least one component of hostile masculinity and its association with sexual aggression. Literature searches were conducted in three academic databases, and additional records were identified through references sections from known hostile masculinity research. A total of 95 articles met inclusion criteria and were integrated into the overview of results. The reviewed literature provided broad support for the association between hostile masculinity and sexual aggression, including evidence for the theoretical framework posited by the confluence model of sexual aggression. Prevention efforts are likely to find success by modifying hostile masculine characteristics among men, particularly within problematic environmental contexts. However, the review also highlighted the need for a uniform conceptualization and operational definition of hostile masculinity. Additionally, empirical work with diverse samples is necessary to determine the scope of generalizability and potential subcultural distinctions. Future research that addresses these limitations will contribute to the understanding and prevention of sexual aggression beyond what is provided by the extant literature.

The Role of Sexual Scripts in the Relationship Between Pornography Use and Sexual Coercion

Decades of research have examined the association between pornography use and sexual coercion, with the most significant relationships found between more deviant genres of pornography use and sexual violence. However, researchers have yet to provide a comparable body of research examining the theoretical mechanism of this association. One theory that has shown promise in explaining the association between certain variables of pornography use and sexual coercion is the sexual script theory. In this theory, scripts can best be understood as a mechanism through which society defines and disseminates what is acceptable, desirable, and pleasurable sexual conduct. Studies examining the application of the sexual script theory to the association between pornography use and sexual coercion have found that pornography use has a significant indirect effect on sexual coercion and correlates of sexual coercion through sexual scripts. The current study sought to extend this line of inquiry by examining the relationship between pornography use, sexual scripts, and sexual coercion. A structural equation model examining direct and indirect effects of sexual scripts and pornography use on sexually coercive behaviors was run using a sample of 390 college-aged males. Results of the study indicated there were significant direct and indirect effects in the model. Specifically, pornography use, while not directly related to sexually coercive behaviors, had a significant indirect effect on sexual coercion through sexual scripts. These results further support the use of the sexual scripts theory to help explain the relationship between pornography use and sexual coercion.

Reassessing the Confluence Model of Men's Risk for Sexual Aggression

Reassessing the confluence model of men's risk for sexual aggression-the confluence model of sexual aggression has been widely used to study men's risk for perpetrating sexual violence. Over time, researchers have attempted to expand this model to improve its predictive utility. Unfortunately, this work has continued to produce similar results with only slight improvements in prediction at best. One explanation for the inability to enhance the model could be due to changes in the dating landscape and shifts in beliefs about gender roles. Therefore, the current study aims to reassess the confluence model using a more contemporary construct, hostile sexism, in an effort to improve the predictive utility of the confluence model of sexual aggression. Participants were 258 college men recruited from a medium-sized public university in the northeastern United States, using an online participant pool of students who volunteered to participate as part of a requirement for a psychology course. Structural equation modeling using mean- and variance-adjusted weighted least squares estimation indicated that the confluence of hostile sexism and impersonal sex appears to be a better predictor of sexual aggression in comparison to the confluence of hostile masculinity and impersonal sex. The results suggest that replacing hostile masculinity with hostile sexism may produce a model that is better able to predict men's risk for perpetrating sexual aggression. These results can provide insight for future iterations of the confluence model, which may include hostile sexism as a core construct. Attitudes that stem from hostile sexism may be a beneficial target for future interventions designed to decrease the frequency of perpetration.

Power-Related Emotions, Alcohol Intoxication, and Nonconsensual Sex Intentions: The Role of Fear of Intimacy

The problem of alcohol-involved sexual assault against women highlights the need to identify how the presence of alcohol interacts with risk factors associated with sexual assault perpetration. One risk factor for sexual assault perpetration is fear of intimacy, the inhibited capacity to exchange vulnerable thoughts and emotions with a valued individual. Men who have perpetrated sexual violence report higher fear of intimacy and alcohol use than those who have not. However, little research has investigated how fear of intimacy may contribute to sexual assault perpetration in the context of alcohol intoxication. This study examined alcohol intoxication, fear of intimacy, proximal power-related emotions, and nonconsensual sex intentions. Non-monogamous, male social drinkers (N = 94) completed measures and were randomly assigned to an alcohol condition (alcohol [BrAC = .10%] versus control). Participants then read a sexual assault analogue scenario depicting sexual assault against a hypothetical woman and reported power-related emotions and nonconsensual sex intentions. Self-reported fear of intimacy differed across types of past perpetration. Results found that for intoxicated men only, fear of intimacy was positively associated with power-related emotions, and power-related emotions were positively associated with nonconsensual sex intentions. These associations were not observed for men in the control condition who did not consume alcohol. Future research should examine intimacy-related interventions for sexual assault prevention programming.

Epidemiology of Injuries to Early Adolescents from Family Violence Evaluated in an Urban Pediatric Emergency Department

BACKGROUND

Exposure to family violence during childhood and adolescence increases the risk for experiencing or perpetrating future violence. Social distancing protocols combined with reduction in access to youth/family services during the COVID-19 pandemic may have intensified the risk of exposure to familial violence.

OBJECTIVES

This study describes the epidemiology of violence-related injuries to 10- to 15-year-old children from family violence, including child maltreatment and physical fighting, resulting in emergency department (ED) evaluation.

METHODS

This retrospective cohort study located in an urban academic pediatric ED in the mid-Atlantic region is a review of electronic medical records between January 2019 and March 2020 (prepandemic period) and March to December 2020 (pandemic period). This review focused on visits for youth aged 10 to 15 years who presented for evaluation of an injury due to a violent event involving a family member. Demographic and clinical data were abstracted, including circumstances of the event. Descriptive statistics were used to summarize data and compare prepandemic to postpandemic proportions.

RESULTS

Of 819 youth aged 10 to 15 years evaluated for a violence-related injury, 448 (54.7%) involved a family member. Of these, most involved parents/guardians, 343 (76.6%), and occurred at home (83.9%). Most patients were girls (54.0%), Black/African American (84.4%), and were enrolled in a public insurance plan (71.2%). Most youth were transported to the hospital by police (66.7%). Overall, alcohol, drugs, and weapons were involved in 10.0%, 6.5%, and 10.7% of events, respectively, and their involvement significantly increased during the pandemic period to 18.8%, 14.9%, and 23.8% ( P < 0.001). Most patients (98.7%) were discharged from the ED.

CONCLUSIONS

More than half of violence-related injuries treated in the ED in this population resulted from family violence. Family violence is a prevalent and possibly underrecognized cause of injuries during adolescence. Further research should explore the potential of the ED as a setting for preventive interventions.

Risky Sexual Behavior, Paraphilic Interest, and Sexual Offending: The Study of a Community Sample of Young Adults in Hong Kong

Limited information is available on the prevalence and nature of sexual offending in Hong Kong. This cross-sectional study seeks to explore the role of risky sexual behavior (RSB) and paraphilic interests in self-reported sexual offending behavior (i.e., nonpenetrative-only, penetrative-only, and nonpenetrative-plus-penetrative sexual assault) in a community sample of young adults in Hong Kong. Using a large sample (N = 1885) of university students, the lifetime prevalence of self-reported sexual offending was 18% (n = 342; 23% males (n = 166), 15% females (n = 176)). Based on the study subsample of 342 participants who self-reported sexual offending (aged 18-35), the findings indicated that males reported significantly higher levels of general, penetrative-only, nonpenetrative-plus-penetrative sexual assault; and paraphilic interest in voyeurism, frotteurism, biastophilia, scatophilia, and hebephilia than females; while females reported a significantly higher level of transvestic fetishism than males. No significant difference was found in RSB between males and females. Logistic regressions found that the participants who possessed a higher level of RSB, particularly penetrative behaviors, and paraphilic interest in voyeurism and zoophilia were less likely to engage in a nonpenetrative-only sexual offense. Conversely, the participants who possessed higher levels of RSB, especially penetrative behaviors, and paraphilic interest in exhibitionism and zoophilia, were more likely to engage in nonpenetrative-plus-penetrative sexual assault. The implications for practice in areas such as public education and offender rehabilitation are discussed.

Impacts of GlobalConsent, a Web-Based Social Norms Edutainment Program, on Sexually Violent Behavior and Bystander Behavior Among University Men in Vietnam: Randomized Controlled Trial

BACKGROUND

Sexual violence against women is prevalent worldwide. Prevention programs that treat men as allies and integrate a bystander framework are emerging in lower income settings, but evidence of their effectiveness is conflicting.

OBJECTIVE

This study aimed to test the impact of GlobalConsent on sexually violent behavior and prosocial bystander behavior among university men in Vietnam.

METHODS

We used a double-blind, parallel intervention versus control group design with 1:1 randomization at 2 universities. A total of 793 consenting heterosexual or bisexual men aged 18-24 years who matriculated in September 2019 were enrolled and assigned randomly to GlobalConsent or an attention-control adolescent health education (AHEAD) program. GlobalConsent is an adapted, theory-based, 6-module web-based intervention with diverse behavior change techniques and a locally produced serial drama. AHEAD is a customized, 6-module attention-control program on adolescent health. Both the programs were delivered to computers and smartphones over 12 weeks. Self-reported sexually violent behaviors toward women in the prior 6 months and prosocial bystander behaviors in the prior year were measured at 0, 6, and 12 months.

RESULTS

More than 92.7% (735/793) of men in both study arms completed at least 1 program module, and >90.2% (715/793) of men completed all 6 modules. At baseline, a notable percentage of men reported any sexually violent behavior (GlobalConsent: 123/396, 31.1%; AHEAD: 103/397, 25.9%) in the prior 6 months. Among men receiving GlobalConsent, the odds of reporting a high level (at least 2 acts) of sexually violent behavior at the endline were 1.3 times the odds at baseline. Among men receiving AHEAD, the corresponding odds ratio was higher at 2.7. The odds of reporting any bystander behavior at endline were 0.7 times the odds at baseline for GlobalConsent, and the corresponding odds ratio for AHEAD was lower at 0.5.

CONCLUSIONS

Compared with a health attention-control condition, GlobalConsent has sustained favorable impacts on sexually violent behavior and prosocial bystander behavior among matriculating university men in Vietnam, who would otherwise face increasing risks of sexually violent behavior. GlobalConsent shows promise for national scale-up and regional adaptations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04147455; https://clinicaltrials.gov/ct2/show/NCT04147455.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1186/s12889-020-09454-2.

Social Media Communication About Sexual Violence May Backfire: Online Experiment with Young Men

Sexual violence harms millions of individuals each year in the United States. Survivors of sexual violence endure long-term hardships such as significant financial setbacks, physical and mental health consequences, academic challenges, and stunted career achievement. Digital feminist activism (DFA) has created space online where women can disclose experiences of sexual violence. Research thus far has been limited to documenting the existence and value of DFA for those who participate and has not addressed whether DFA can influence a key demographic for prevention, young men. We conducted an experiment to examine the impact of DFA on college-aged men's reactance to messaging, rape myth acceptance, knowledge about severity, and susceptibility to perpetrate sexual violence. University men (n=230, 18-29 years old) were randomized to one of three conditions: (1) tweets from women challenging rape myths, (2) tweets from women providing information about sexual violence harms, or (3) no exposure control. Tweets challenging rape myths or providing information did not impact rape myth perceptions, knowledge, or susceptibility. Participants had greater reactance (unintended outcome) to tweets challenging rape myths, and subsequently higher rape myth acceptance and lower knowledge about the severity of sexual violence. Rape myth acceptance was associated with susceptibility to perpetrate sexual violence overall. Our finding that some forms of DFA have a negative, indirect influence among college-aged males highlights important unintended consequences and the need for more efficacious communication to prevent sexual violence perpetration.