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Hahn C, Tilstra-Ferrell E, Salim S, Goodrum N, Rheingold A, Gilmore AK, Barber S, Moreland A. Web-Based Screening, Brief Intervention, and Referral to Treatment for Traumatic Stress and Alcohol Misuse Among Survivors of Sexual Assault and Intimate Partner Violence: Usability and Acceptability Study. JMIR Form Res 2024; 8:e49557. [PMID: 38358791 PMCID: PMC10905344 DOI: 10.2196/49557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 12/14/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Recent survivors of intimate partner violence (IPV) and sexual assault (SA) are at a high risk for traumatic stress and alcohol misuse. IPV and SA survivors face barriers to services for traumatic stress and alcohol misuse and have low service utilization rates. One way to increase access to services for this population is the use of web-based screening, brief intervention, and referral to treatment (SBIRT), an evidence-informed approach for early identification of traumatic stress and alcohol and drug misuse and connecting individuals to treatment. OBJECTIVE This study aims to assess the usability and acceptability of a web-based SBIRT called CHAT (Choices For Your Health After Trauma) tailored to address traumatic stress and alcohol misuse following past-year IPV, SA, or both. METHODS Phase 1 involved gathering feedback about usability and acceptability from focus groups with victim service professionals (22/52, 42%) and interviews with past-year survivors of IPV, SA, or both (13/52, 25%). Phase 2 involved gathering feedback about the acceptability of an adapted version of CHAT in an additional sample of recent survivors (17/52, 33%). Survey data on history of IPV and SA, posttraumatic stress disorder symptoms, alcohol and drug use, and service use were collected from survivors in both phases to characterize the samples. Qualitative content and thematic analyses of the interviews and focus group data were conducted using a coding template analysis comprising 6 a priori themes (usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance). RESULTS Six themes emerged during the focus groups and interviews related to CHAT: usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance. Phase 1 providers and survivors viewed CHAT as acceptable, easy to understand, and helpful. Participants reported that the intervention could facilitate higher engagement in this population as the web-based modality is anonymous, easily accessible, and brief. Participants offered helpful suggestions for improving CHAT by updating images, increasing content personalization, reducing text, and making users aware that the intervention is confidential. The recommendations of phase 1 participants were incorporated into CHAT. Phase 2 survivors viewed the revised intervention and found it highly acceptable (mean 4.1 out of 5, SD 1.29). A total of 4 themes encapsulated participant's favorite aspects of CHAT: (1) content and features, (2) accessible and easy to use, (3) education, and (4) personalization. Six survivors denied disliking any aspect. The themes on recommended changes included content and features, brevity, personalization, and language access. Participants provided dissemination recommendations. CONCLUSIONS Overall, CHAT was acceptable among victim service professionals and survivors. Positive reactions to CHAT show promise for future research investigating the efficacy and potential benefit of CHAT when integrated into services for people with traumatic stress and alcohol misuse after recent IPV and SA.
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Affiliation(s)
- Christine Hahn
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Emily Tilstra-Ferrell
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Selime Salim
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Nada Goodrum
- Department of Psychology, University of South Carolina, Charleston, SC, United States
| | - Alyssa Rheingold
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Amanda K Gilmore
- Department of Health Policy & Behavioral Sciences, Georgia State University, Atlanta, GA, United States
| | - Sara Barber
- South Carolina Coalition Against Domestic Violence and Sexual Assault, Columbia, SC, United States
| | - Angela Moreland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
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Baert S, Fomenko E, Machiels A, Bicanic I, Van Belle S, Gemmel P, Gilles C, Roelens K, Keygnaert I. Mental health of sexual assault victims and predictors of their use of support from in-house psychologists at Belgian sexual assault care centres. Eur J Psychotraumatol 2023; 14:2263312. [PMID: 37819370 PMCID: PMC10569350 DOI: 10.1080/20008066.2023.2263312] [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: 11/16/2022] [Accepted: 08/05/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Sexual assault (SA) can induce a negative impact on victims' mental health. Specialised SA services generally offer medical care and a forensic examination to SA victims. However, there is a large variation in how these services provide mental health support. OBJECTIVE This study aims to assess mental health problems of SA victims attending the Belgian Sexual Assault Care Centres (SACCs) and identify predictors for victims' use of support from in-house psychologists. METHOD Health records of victims ≥ 16 years who presented within one week post-SA to one of the three Belgian SACCs between 25 October 2017 and 31 October 2019 were reviewed. An AIC-based stepwise backward binary logistic regression was used to analyse the association between victim, assault, service use and mental health characteristics and follow-up by a SACC-psychologist. RESULTS Of the 555 victims, more than half had a history of mental health problems. Of those assessed, over 70% showed symptoms of posttraumatic stress disorder (PTSD), depression and/or anxiety disorder. One in two victims consulted a SACC-psychologist. Victims with a mental health history (OR 1.46, p = .04), victims accompanied by a support person during acute care (OR 1.51, p = .04), and victims who were assaulted by an acquaintance in comparison to those assaulted by a stranger (OR 1.60, p = .039) were more likely to attend their appointment with the SACC-psychologist. CONCLUSION The study reaffirms the high mental health burden among victims attending specialised SA services, stressing the need to provide effective mental health interventions at these services and improve their longer-term use by victims. Prescheduling of appointments with an in-house psychologist in combination with phone reminders may improve the uptake of such services. Health care providers must be vigilant about potential barriers faced by victims without a mental health history or social support in attending appointments with mental health professionals.
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Affiliation(s)
- Saar Baert
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Elizaveta Fomenko
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Aurélie Machiels
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Iva Bicanic
- National Psychotrauma Centre for Children and Youth, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sara Van Belle
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Paul Gemmel
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | | | - Kristien Roelens
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Ines Keygnaert
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
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Koçtürk N. Psychological symptoms of adolescent survivors of sexual abuse and characteristics of survivors displaying suicidal and/or self-harming behaviors. Health Care Women Int 2023; 44:1136-1154. [PMID: 35133950 DOI: 10.1080/07399332.2021.2021204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
We examine the psychological symptoms and suicide attempts and/or self-injury behaviors of survivors of childhood sexual abuse (CSA) according to individual and familial characteristics. The participants of this study included 80 adolescents aged 14-17 years. We show that high psychological symptom scores may indicate that the perpetrator was a family member and that penetration occurred. In addition, most of the participating survivors have experienced numerous problems, largely related to psychological symptoms. Considering the results regarding survivors who had previously attempted suicide, we demonstrate that the perpetrators in these cases were mostly reliable/loved people, while these survivors generally hid the events and were exposed to penetration more often. We conclude that survivors exposed to CSA by a reliable/loved person, blaming themselves, having low social support, and displaying certain symptoms should be followed closely and necessary psychosocial interventions for suicide should be applied.
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Affiliation(s)
- Nilüfer Koçtürk
- Faculty of Education, Department of Psychological Counseling and Guidance, Hacettepe University, Beytepe, Ankara, Turkey
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Rajkumar RP. Biomarkers of Neurodegeneration in Post-Traumatic Stress Disorder: An Integrative Review. Biomedicines 2023; 11:biomedicines11051465. [PMID: 37239136 DOI: 10.3390/biomedicines11051465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Post-Traumatic Stress Disorder (PTSD) is a chronic psychiatric disorder that occurs following exposure to traumatic events. Recent evidence suggests that PTSD may be a risk factor for the development of subsequent neurodegenerative disorders, including Alzheimer's dementia and Parkinson's disease. Identification of biomarkers known to be associated with neurodegeneration in patients with PTSD would shed light on the pathophysiological mechanisms linking these disorders and would also help in the development of preventive strategies for neurodegenerative disorders in PTSD. With this background, the PubMed and Scopus databases were searched for studies designed to identify biomarkers that could be associated with an increased risk of neurodegenerative disorders in patients with PTSD. Out of a total of 342 citations retrieved, 29 studies were identified for inclusion in the review. The results of these studies suggest that biomarkers such as cerebral cortical thinning, disrupted white matter integrity, specific genetic polymorphisms, immune-inflammatory alterations, vitamin D deficiency, metabolic syndrome, and objectively documented parasomnias are significantly associated with PTSD and may predict an increased risk of subsequent neurodegenerative disorders. The biological mechanisms underlying these changes, and the interactions between them, are also explored. Though requiring replication, these findings highlight a number of biological pathways that plausibly link PTSD with neurodegenerative disorders and suggest potentially valuable avenues for prevention and early intervention.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
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Dworkin ER, Schallert M, Lee CM, Kaysen D. Pilot randomized clinical trial of an app-based early intervention to reduce PTSD and alcohol use following sexual assault. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2023-60287-001. [PMID: 37011153 PMCID: PMC10545809 DOI: 10.1037/tra0001460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Sexual assault is associated with high risk for posttraumatic stress disorder (PTSD), and PTSD often co-occurs with alcohol misuse. Most sexual assault survivors do not access early preventative interventions for such conditions. App-based interventions are a promising means to extend the reach of early interventions and thereby reduce risk of chronic PTSD and alcohol misuse. METHOD This study was a pilot randomized clinical trial of an app-based early intervention with phone coaching (THRIVE) for survivors of past-10-week sexual assault (NCT#: NCT03703258). Intended active components of the THRIVE app are daily cognitive restructuring, daily activity scheduling, and as-needed relationally focused exercises, supported by coaching calls. Forty-one adult female survivors of recent sexual assault with elevated posttraumatic stress and drinking were randomized to intervention or control (symptom-monitoring app with phone coaching). Participants in both conditions were encouraged to use their respective app for 21 days and completed self-report symptom assessments at baseline, postintervention, and 3-month follow-up. RESULTS At 3-month follow-up, the between-group effect size favored intervention for posttraumatic stress (d = -0.70), intoxication frequency (d = -0.62), and drinking hours per week (d = -0.39). More participants evidenced reliable change in intervention versus control for posttraumatic stress (OR = 2.67) and alcohol problems (OR = 3.05) at 3 months. CONCLUSIONS The general direction of effects indicates that THRIVE, coupled with coaching, reduces risk for PTSD and alcohol outcomes beyond coached monitoring. These findings suggest that apps like THRIVE may provide an option for early intervention for sexual assault survivors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Emily R Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Macey Schallert
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
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Acosta LA, Morris McEwen M. Post-Rape Experiences of Undocumented Mexican Women in the U.S.-Mexico Border Region: A Critical Ethnography. HISPANIC HEALTH CARE INTERNATIONAL 2023; 21:30-37. [PMID: 35611489 DOI: 10.1177/15404153221102797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Introduction: Numerous undocumented immigrant women in the United States have survived rape, and many have experienced physical and psychological consequences. Although rape disclosure can facilitate early intervention and improve health outcomes, most undocumented immigrant women do not disclose rape, and little is known about their post-rape experiences. Methods: This critical ethnography explored the post-rape experiences of undocumented immigrant women of Mexican (UIWM) origin living in the U.S. Mexico border region. Data collection and analysis were guided by Carspecken's framework for critical qualitative research. Six women, who identified as UIWM participated in the study. Each was interviewed using a semistructured approach. Results: Interview data revealed three domains: Glimpses of Support, Barrier After Barrier, and Overcoming. In accordance with Carspecken's framework, a theoretical lens was applied to these domains. The application of Feminist Intersectional Theory and Standpoint Theory united the domains into the theme Struggling to Heal. Conclusion: This study suggests that the marginalization of these survivors detrimentally impacts their post-rape experiences and describes the intersections of multiple forces on their experiences, including the cultural and sociopolitical context of the border region. This study lays the foundation for future research aimed at mitigating disclosure and help-seeking barriers for this marginalized group.
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Affiliation(s)
- Lauren A Acosta
- 8041The University of Arizona, College of Nursing, Tucson, AZ, USA
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Manor-Binyamini I, Schreiber-Divon M. Exposing the Secret: Listening to Bedouin Men Who Have Experienced Sexual Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3468-3488. [PMID: 35658742 DOI: 10.1177/08862605221107054] [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: 06/15/2023]
Abstract
There are few indigenous men's voices regarding sexual violence against them, particularly concerning Bedouin men's views. How do Bedouin men who have experienced SV describe, perceive, and interpret their experiences in their cultural context? Seventeen Bedouin men, residents of either recognized or unrecognized Bedouin settlements in the Negev, Israel. Phenomenological semi-structured interviews were recorded, transcribed verbatim, and then translated into English. Themes were generated using thematic analysis. Three main themes were found: descriptions of the incidents, reactions to the experiences, and the need for keeping incidents of SV secret due to the stigma involved as a result of patriarchal, political (i.e., tribal hierarchy), and private (i.e., family loyalty) norms, and the matrix of multiple and often conflicting roles and identities that Bedouin men must assume despite their experiences. The incidence of SV against men in the Bedouin community is alarming and must be acknowledged by the research community and public health practitioners as a serious health issue that requires more holistic research to better understand the men's experiences. More efforts are needed on the local, regional, and global levels to provide post-violence care for survivors and to prevent SV. In particular, there is a need to reduce the stigma associated with SV so that young men will be willing to speak up about their trauma without shame and receive help.
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Hahn CK, Kilimnik CD, Brady KT, Marx BP, Rothbaum BO, Saladin ME, Gilmore AK, Metts CL, Back SE. Early intervention using written exposure therapy for PTSD and AUD symptoms following sexual assault: Description of design and methodology. Contemp Clin Trials 2023; 125:107002. [PMID: 36436732 PMCID: PMC9989773 DOI: 10.1016/j.cct.2022.107002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/31/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common following sexual assault and associated with more severe symptomology and increased likelihood of sexual revictimization. Integrated interventions aimed at reducing PTSD and AUD symptoms following recent sexual assault are needed and should address barriers to care and early treatment termination. The proposed study will test a novel, brief (5 to 7 sessions) intervention that integrates Written Exposure Therapy for PTSD and Cognitive Behavioral Therapy for AUD, and is initiated within the first six weeks post-assault. In Phase 1, qualitative analysis of content gathered during focus groups with treatment providers will be conducted to inform intervention development. In Phase 2, a proof-of-concept pilot study (n = 10) of the intervention, Substance Use Skills Training and Exposure Post-Sexual Assault (STEPS), will be conducted. In Phase 3, a pilot randomized controlled trial (RCT) among 54 recent sexual assault survivors will be implemented using the updated manualized STEPS intervention to evaluate feasibility and preliminary efficacy in reducing PTSD and AUD symptoms. Ecological momentary assessments will be used to assess daily alcohol use, craving, affect, intrusions and avoidance. The effects of STEPS on commonly associated symptoms (e.g., depression, substance use) will be examined. The proposed study has the potential to make a significant public health impact by advancing knowledge on the link between sexual assault and co-occurring PTSD and AUD and informing early intervention efforts for this high-risk population.
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Affiliation(s)
- Christine K Hahn
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA.
| | - Chelsea D Kilimnik
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA.
| | - Kathleen T Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA.
| | - Brian P Marx
- Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118, USA.
| | - Barbara O Rothbaum
- Emory School of Medicine, Emory University, 01 Dowman Dr., Atlanta, GA 30322, USA.
| | - Michael E Saladin
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA
| | - Amanda K Gilmore
- Department of Health Policy and Behavioral Sciences, Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA 30303, USA.
| | - Christopher L Metts
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA.
| | - Sudie E Back
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., 2nd Fl. S., MSC 861, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, 109 Bee St. Charleston, SC 29401, USA.
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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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Lovett J, Hales G, Kelly L, Khan A, Hardiman M, Trott L. What Can We Learn from Police Data About Timeliness in Rape and Serious Sexual Offence Investigations in England and Wales? INTERNATIONAL CRIMINOLOGY 2022. [PMCID: PMC9558038 DOI: 10.1007/s43576-022-00067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The issue of timeliness in rape and other serious sexual offence investigations has been raised in a number of inspections and reviews, and there are policy imperatives to decrease delays, but there has been little exploration of police data to understand what contributes to them and enable practical recommendations or options. This paper explores what official data from two police forces participating in Operation Soteria Bluestone tell us about the timelines of these investigations, what this reveals about the gaps in policing data, and what additional knowledge can be gained from qualitative methodologies, in this instance case file analysis and case reviews.
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Affiliation(s)
- Jo Lovett
- grid.23231.310000 0001 2221 0023London Metropolitan University, London, UK
| | - Gavin Hales
- grid.23231.310000 0001 2221 0023London Metropolitan University, London, UK
| | - Liz Kelly
- grid.23231.310000 0001 2221 0023London Metropolitan University, London, UK
| | - Aneela Khan
- grid.449668.10000 0004 0628 6070University of Suffolk, Ipswich, UK
| | | | - Louise Trott
- grid.17236.310000 0001 0728 4630Bournemouth University, Poole, UK
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Murphy-Oikonen J, Egan R. Sexual and Gender Minorities: Reporting Sexual Assault to the Police. JOURNAL OF HOMOSEXUALITY 2022; 69:773-795. [PMID: 33722182 DOI: 10.1080/00918369.2021.1892402] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual assault is defined as any type of forced or coerced sexual contact or behavior that happens without consent. Victims seeking justice and personal safety must report their assaults to police, however few survivors report their victimization. Sexual and gender minorities, inclusive of the LGBTQI2-S population, are at an increased risk for experiencing sexual assault yet the vast majority of empirical research on sexual victimization has been conducted through a hetero-cisnormative lens. Sexual and gender minorities likely have a unique experience of sexual assault compared to heterosexual, cisgender survivors, especially as it relates to their help-seeking behaviors post-assault. Through the use of Sexual and Gender Script Theory, this review explores barriers that sexual and gender minorities may experience when reporting sexual assault to the police, thereby impeding their access to equitable justice. Opportunities for future policy, practice, and research among sexual and gender minorities are presented.
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Affiliation(s)
| | - Rachel Egan
- School Services Division, Children's Centre Thunder Bay, Thunder Bay, Ontario, Canada
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12
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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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13
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Lovett J, Hales G, Kelly L, Khan A, Hardiman M, Trott L. What can We Learn from Police Data About Timeliness in Rape and Serious Sexual Offence Investigations in England and Wales? INTERNATIONAL CRIMINOLOGY 2022. [PMCID: PMC9527390 DOI: 10.1007/s43576-022-00069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The issue of timeliness in rape and other serious sexual offence investigations has been raised in a number of inspections and reviews, and there are policy imperatives to decrease delays, but there has been little exploration of police data to understand what contributes to them and enable practical recommendations or options. This paper explores what official data from two police forces participating in Operation Soteria Bluestone tell us about the timelines of these investigations, what this reveals about the gaps in policing data, and what additional knowledge can be gained from qualitative methodologies, in this instance case file analysis and case reviews.
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Affiliation(s)
- Jo Lovett
- London Metropolitan University, London, UK
| | | | - Liz Kelly
- London Metropolitan University, London, UK
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14
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Chana SM, Wolford-Clevenger C, Faust A, Hemberg J, Ramaswamy M, Cropsey K. Associations among betrayal trauma, dissociative posttraumatic stress symptoms, and substance use among women involved in the criminal legal system in three US cities. Drug Alcohol Depend 2021; 227:108924. [PMID: 34333280 PMCID: PMC8464486 DOI: 10.1016/j.drugalcdep.2021.108924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Betrayal trauma, as defined by (Freyd, 1996), refers to a subcategory of trauma characterized by a significant violation of trust surrounding interpersonal maltreatment (physical, sexual, or emotional). Previous research has shown that people with betrayal trauma histories experience greater dissociative symptoms of posttraumatic stress disorder and co-morbid substance use disorder symptoms. Women in the criminal legal system commonly have significant histories of betrayal trauma and related posttraumatic stress symptoms and substance use. However, no studies have specifically explored the impact of dissociative posttraumatic stress symptoms on substance use outcomes in this population. Additionally, no studies have explored whether betrayal trauma relates to nonfatal overdoses. METHODS This cross-sectional survey study of N = 508 women with criminal legal system involvement examined the indirect effects of betrayal trauma history on substance use outcomes through dissociative posttraumatic stress symptoms. RESULTS Multivariate analyses supported an indirect effect of betrayal trauma on substance use severity, daily substance use, and history of overdose, but not alcohol use severity, through dissociative symptoms. CONCLUSIONS Women in the criminal legal system with betrayal trauma and dissociative symptoms may be at risk for substance use and related outcomes (i.e., overdose). Future work is needed to examine whether targeting such symptoms may improve substance use treatment and prevention of serious outcomes in this population.
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Affiliation(s)
- Sofía Mildrum Chana
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
| | - Caitlin Wolford-Clevenger
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
| | - Alexandra Faust
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
| | - Jordana Hemberg
- Community Health and Implementation Research Program, RTI International, 2150 Shattuck Avenue, Suite 800, Berkeley, California 94704 USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas School of Medicine, 3901 Rainbow Blvd, MS 1008, Kansas City, Kansas 66160
| | - Karen Cropsey
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
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15
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Paquette G, Martin-Storey A, Bergeron M, Dion J, Daigneault I, Hébert M, Ricci S, Castonguay-Khounsombath S. Trauma Symptoms Resulting From Sexual Violence Among Undergraduate Students: Differences Across Gender and Sexual Minority Status. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9226-NP9251. [PMID: 31195873 DOI: 10.1177/0886260519853398] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Experiencing sexual violence is an important risk factor for trauma symptoms, and these symptoms significantly impair psychosocial functioning. Sexual and gender minority university students are more likely than their heterosexual and cisgender peers to experience sexual violence (e.g., sexual harassment, unwanted sexual contact, or sexual coercion) while attending university, but research on the consequences of these experiences is needed to inform service provision to these vulnerable populations. Using a large-scale study of university-based sexual violence in Quebec, the current study examined how gender and sexual minority status were associated with the severity of trauma symptoms among students who experienced sexual violence (N = 1,196). Findings indicated that compared with their cisgender peers, gender minority students experienced significantly higher levels of trauma symptoms as a result of sexual violence, controlling for the severity of sexual violence behaviors experienced and other variables. Among cisgender women, but not cisgender men, sexual minority identity was also associated with higher levels of trauma symptoms, controlling for severity of sexual violence behaviors experienced and other variables. Furthermore, gender of perpetrator and amount of sexual violence moderated the associations between sexual identity and trauma symptoms among cisgender women. These findings not only suggest that gender minority and some sexual minority university students are more likely to experience sexual violence, but that they are also more likely to experience negative psychological sequelae as a consequence of these experiences. Ultimately, these findings may suggest the need for services that are more supportive of the specific needs of gender and sexual minority students with regard to sexual violence.
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Affiliation(s)
- Geneviève Paquette
- Groupe de recherche sur les inadaptations sociales de l'enfance de l'Université de Sherbrooke (Québec), Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Québec, Canada
| | - Alexa Martin-Storey
- Groupe de recherche sur les inadaptations sociales de l'enfance de l'Université de Sherbrooke (Québec), Canada
| | | | - Jacinthe Dion
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Québec, Canada
- Université du Québec à Chicoutimi, Québec, Canada
| | - Isabelle Daigneault
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Québec, Canada
- Université de Montréal, Québec, Canada
| | - Martine Hébert
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Québec, Canada
- Université du Québec à Montréal, Québec, Canada
| | | | - Sonn Castonguay-Khounsombath
- Groupe de recherche sur les inadaptations sociales de l'enfance de l'Université de Sherbrooke (Québec), Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Québec, Canada
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16
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Yuen B, Billings J, Morant N. Talking to Others About Sexual Assault: A Narrative Analysis of Survivors' Journeys. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9714-NP9737. [PMID: 31288608 DOI: 10.1177/0886260519861652] [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: 06/09/2023]
Abstract
Previous research suggested the benefits for sexual assault survivors to talk about their trauma and its mental health implications, but it remained unclear what steps sexual assault survivors need to take to be able to have these conversations. To address this gap in the literature, this study aims to explore the journeys of sexual assault survivors with the use of narrative interviews to retain the richness of the data. This study reports the findings of a narrative analysis of the accounts of six female sexual assault survivors aged between 20 and 38. The analysis provides an individual case profile for each participant, the core aspects and tone of each narrative, and a cross-case analysis. The cross-case analysis reveals an overarching theme of "the bumpy journey" within which the individual difficulties encountered are examined. The analysis also reveals the two main factors that motivated the participant to strive to make a difference for other sexual violence survivors and to improve their mental health through talking about their experiences. The implications for services providing continuous and long-term support to sexual assault survivors and clinical practices are discussed.
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17
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Dworkin ER. Risk for Mental Disorders Associated With Sexual Assault: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2020; 21:1011-1028. [PMID: 30585128 PMCID: PMC6707905 DOI: 10.1177/1524838018813198] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Sexual assault (SA) is a common form of trauma that is associated with numerous deleterious outcomes. Understanding the relative prevalence of psychiatric diagnoses in people who have been sexually assaulted versus people who have not been assaulted could help to prioritize assessment and intervention efforts, but there has been no quantitative review of this topic. A search of PsychINFO, ProQuest Digital Dissertations and Theses, and Academic Search Premier for articles dated between 1970 and 2014 was conducted, and unpublished data were obtained. Eligible studies used diagnostic interviews to assess Diagnostic and Statistical Manual of Mental Disorders diagnoses in both individuals experiencing adolescent/adult and/or lifetime SA and unassaulted individuals. The search yielded 171 eligible effects from 39 studies representing 88,539 participants. Meta-regression was used to aggregate the prevalence of psychiatric diagnoses in sexually assaulted and unassaulted samples as well as calculate odds ratios reflecting the difference between these prevalence estimates. Results indicated that most disorders were more prevalent in survivors of SA, and depressive disorders and posttraumatic stress disorder (PTSD) were especially prevalent. Disorder-specific differences in odds ratios were observed as a function of sample type, type of comparison group, and time frame of SA. Service providers should be prepared to address depressive disorders and PTSD in survivors of SA, and interventions that prevent the development of these disorders are especially needed.
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Affiliation(s)
- Emily R Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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18
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Short NA, Morabito DM, Gilmore AK. Secondary prevention for posttraumatic stress and related symptoms among women whohave experienced a recent sexual assault: A systematic review and meta-analysis. Depress Anxiety 2020; 37:1047-1059. [PMID: 32442345 PMCID: PMC7680285 DOI: 10.1002/da.23030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/23/2020] [Accepted: 04/19/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Women who have experienced a recent sexual assault (SA) are at high risk for posttraumatic stress disorder (PTSD) and related conditions, with approximately half of women experiencing SA meeting criteria for PTSD. There are no guidelines for the prevention of PTSD and other common mental health disorders after SA. Thus, the purpose of this systematic review and meta-analysis is to synthesize research on secondary preventions for PTSD after SA, determine efficacy whether any intervention seems promising, and ascertain when, how, and to whom interventions should be delivered. METHODS After searching electronic databases for secondary preventions for PTSD and related conditions among women who have experienced a recent SA, 17 studies were reviewed, their quality was rated on the clinical trial assessment measure, and 10 studies were meta-analyzed (7 were excluded, as they were not randomized controlled trials or due to the absence of heterogeneity). RESULTS Results suggested a small-to-moderate effect of prevention on reducing PTSD and related symptoms. There was no moderating effect of medication versus psychosocial interventions, timing, treatment modality, or targeted versus universal prevention. Half of the studies were of high quality. CONCLUSION Cognitive-behavioral secondary preventions for PTSD appear to be safe and effective among women who have experienced a recent SA. Future research should identify best practices and mechanisms of treatment, and once identified, it should move toward implementation science.
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Affiliation(s)
- Nicole A. Short
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Amanda K. Gilmore
- Department of Health Policy & Behavioral Sciences and Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA
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19
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Miller E, Jones KA, McCauley HL, Rofey DL, Clark DB, Talis JM, Anderson JC, Chugani CD, Coulter RWS, Abebe KZ. Cluster Randomized Trial of a College Health Center Sexual Violence Intervention. Am J Prev Med 2020; 59:98-108. [PMID: 32362510 PMCID: PMC7360347 DOI: 10.1016/j.amepre.2020.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Sexual violence, particularly in the context of drinking, is prevalent on college campuses. This study tested a brief intervention to prevent sexual violence among students receiving care from college health centers. STUDY DESIGN This study was a two-arm, unblinded cluster RCT. SETTING/PARTICIPANTS On 28 campuses with health/counseling centers (1:1 randomization allocation; 12 intervention and 16 control), from September 2015 to March 2018, a total of 2,291 students seeking care at college health centers completed surveys before the appointment, immediately after, 4 months later, and 12 months later. INTERVENTION Intervention college health center staff received training on delivering sexual violence education to all students seeking care. Control sites provided information about drinking responsibly. MAIN OUTCOME MEASURES The primary outcome was students' change in recognition of sexual violence. Additional outcomes included sexual violence disclosure and use of services among students with a history of sexual violence at baseline. Generalized linear mixed models accounting for campus-level clustering assessed intervention effects. Data were analyzed from September 2018 to June 2019. RESULTS Half (55%) of students seeking care at college health centers reported any history of sexual violence exposure. No between-group differences in primary (β=0.001, 95% CI= -0.04, 0.04) or secondary outcomes emerged between intervention and control students. Post-hoc analyses adjusting for the intensity of intervention delivery (intensity-adjusted) revealed an increase in self-efficacy to use harm reduction strategies (β=0.09, 95% CI=0.01, 0.18) among intervention participants. Among those who reported sexual violence at baseline, intervention students had increased odds of disclosing violence during the visit (AOR=4.47, 95% CI=2.25, 8.89) in intensity-adjusted analyses compared with control. No between-group differences emerged for remaining outcomes. CONCLUSIONS Sexual violence exposure is high among students seeking care in college health centers. A brief provider-delivered sexual violence intervention, when implemented with fidelity, was associated with improved self-efficacy to use harm reduction and increased disclosure of sexual violence during clinical encounters but no increased use of services. More interventions that are stronger in intensity are needed to connect students to sexual violence services. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02355470.
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Affiliation(s)
- Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Heather L McCauley
- School of Social Work, Michigan State University, East Lansing, Michigan
| | - Dana L Rofey
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychiatry, Western Psychiatric Hospital, Pittsburgh, Pennsylvania
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Janine M Talis
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jocelyn C Anderson
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; College of Nursing, Pennsylvania State University, State College, Pennsylvania
| | - Carla D Chugani
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert W S Coulter
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kaleab Z Abebe
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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20
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Bedard-Gilligan M, Masters NT, Ojalehto H, Simpson TL, Stappenbeck C, Kaysen D. Refinement and Pilot Testing of a Brief, Early Intervention for PTSD and Alcohol Use Following Sexual Assault. COGNITIVE AND BEHAVIORAL PRACTICE 2019; 27:470-486. [PMID: 34168421 DOI: 10.1016/j.cbpra.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Experiencing a sexual assault can have long-lasting negative consequences including development of posttraumatic stress disorder (PTSD) and alcohol misuse. Intervention provided in the initial weeks following assault can reduce the development of these chronic problems. This study describes the iterative treatment development process for refining a brief intervention targeting PTSD and alcohol misuse for women with recent sexual assault experiences. Experts, treatment providers, and patients provided feedback on the intervention materials and guided the refinement process. Based on principles of cognitive change, the final intervention consists of one in-person session and four coaching calls targeting beliefs about the assault and about drinking behavior. Initial feasibility and acceptability data are presented for patients enrolled in an open trial (N = 6). The intervention was rated as helpful, not distressing, and interesting by patients and all patients completed the entire treatment protocol. A large decrease in PTSD symptoms pre- to post-intervention was observed. A small effect on decreasing alcohol consequences also emerged, although drinks consumed per week showed a slight increase, not a decrease, over the course of the intervention. Applications of this intervention and next steps for testing efficacy are presented.
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Affiliation(s)
| | | | | | - Tracy L Simpson
- University of Washington and Center of Excellence in Substance Addiction, Treatment, and Education, VA Puget Sound, Seattle
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21
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Catabay CJ, Stockman JK, Campbell JC, Tsuyuki K. Perceived stress and mental health: The mediating roles of social support and resilience among black women exposed to sexual violence. J Affect Disord 2019; 259:143-149. [PMID: 31445340 PMCID: PMC6791774 DOI: 10.1016/j.jad.2019.08.037] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/01/2019] [Accepted: 08/17/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Black women disproportionately suffer from violence and its subsequent mental health outcomes. Increasing levels of perceived stress are associated with greater symptoms of depression and post-traumatic stress disorder (PTSD). Social support and resilience can potentially mediate the negative consequences of perceived stress on women's mental health. This study assesses the association between perceived stress and mental health outcomes among Black women. In addition, this study examines social support and resilience as mediators of association between perceived stress and mental health. METHODS Black women residing in Baltimore, MD (n = 310) were recruited from STD clinics into a retrospective cohort study (2013-2018) on sexual assault and HIV risk. Social support and resilience served as coping variables and were assessed as mediators in the associations between perceived stress and mental health. Analyses were stratified by exposure to sexual violence in adulthood. RESULTS Almost half of our sample (46%) experienced severe depression and about one-third (27%) experienced severe PTSD. Resilience partially mediated the association between perceived stress and severe depressive symptoms among exposed women. Social support partially mediated the association between perceived stress and severe PTSD symptoms among exposed women. LIMITATIONS Since this is a cross-sectional analysis, we are unable to determine the temporal relationship between outcome and exposure variables. The CES-D-10 and NSESSS are scales that measure the severity of depressive and PTSD symptoms, respectively, and are not clinical diagnoses. CONCLUSION There is a critical need to develop interventions focused on reducing the burden of stress on mental health.
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Affiliation(s)
- Christina J Catabay
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, United States
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, United States
| | - Jacquelyn C Campbell
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD 21205-2110, United States
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, United States.
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22
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Chung H, Kim JW, Kwon J, Kim K, Ryou B, Ryu HJ. Development of Brief Post-Traumatic Stress Disorder Rating Scale for Sexual Violence Victims. Psychiatry Investig 2019; 16:868-871. [PMID: 31648424 PMCID: PMC6877460 DOI: 10.30773/pi.2019.0168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/16/2019] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study was to develop a brief rating scale of post-traumatic stress disorder (PTSD) symptoms among sexual violence victims. We analyzed the data from 195 victims and 220 non-victims to select meaningful items from the original PTSD rating scales. We also examined the validity of the brief scale by assessing internal consistency and ROC curves. The optimal cutoff scores for each brief scales were obtained. The results showed that a different approach may be required for early intervention in different age groups.
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Affiliation(s)
- Halin Chung
- Counseling Psychology Program, College of Education, University of Iowa, IA, USA
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Kihyun Kim
- Department of Social Welfare, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea
| | - Bee Ryou
- Social Welfare Research Institute, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hee Jeong Ryu
- Department of Social Welfare, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea
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23
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Oosterbaan V, Covers MLV, Bicanic IAE, Huntjens RJC, de Jongh A. Do early interventions prevent PTSD? A systematic review and meta-analysis of the safety and efficacy of early interventions after sexual assault. Eur J Psychotraumatol 2019; 10:1682932. [PMID: 31762949 PMCID: PMC6853210 DOI: 10.1080/20008198.2019.1682932] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/30/2019] [Accepted: 10/07/2019] [Indexed: 12/19/2022] Open
Abstract
Objective: To review the safety and efficacy of early interventions after sexual assault in reducing or preventing posttraumatic stress disorder (PTSD). Method: Systematic searches were performed on studies (1980-2018) that examined the efficacy of interventions for PTSD within 3 months after sexual assault. Results: The review identified 7 studies (n = 350) with high risk of bias that investigated 5 interventions. Only two studies reported on safety. Contact with the authors of six studies provided no indications for the occurrence of adverse events. Two studies reported the efficacy using PTSD diagnosis as dependent variable but found no difference between groups. All studies reported on efficacy using PTSD severity as dependent variable. For the meta-analysis, 4 studies (n = 293) were included yielding significantly greater reductions of PTSD severity than standard care at 2 to 12 months follow-up (g = -0.23, 95% CI [-0.46, 0.00]), but not at 1 to 6 weeks post-intervention (g = -0.28, 95% CI [-0.57, 0.02]). The heterogeneity of the interventions precluded further analyses. Discussion: Findings suggest that early interventions can lead to durable effects on PTSD severity after sexual assault. However, due to limited availability of data, it is impossible to draw definite conclusions about safety and efficacy of early interventions, and their potential to prevent PTSD.
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Affiliation(s)
- Veerle Oosterbaan
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Milou L V Covers
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iva A E Bicanic
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rafaële J C Huntjens
- Department of Experimental Psychotherapy & Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Ad de Jongh
- Department of Social Dentistry and Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Psychotrauma Expertise Center (PSYTREC), Bilthoven, The Netherlands.,Institute of Health and Society, University of Worcester, Worcester, UK.,Queen's University Belfast, Belfast, Northern Ireland, UK
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24
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Walsh WA, Meunier-Sham J, Re C. Using Telehealth for Sexual Assault Forensic Examinations: A Process Evaluation of a National Pilot Project. JOURNAL OF FORENSIC NURSING 2019; 15:152-162. [PMID: 31436683 DOI: 10.1097/jfn.0000000000000254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
INTRODUCTION This project describes the first time live sexual assault nurse examiner (SANE) services were provided via telehealth to support site clinicians conducting sexual assault forensic medical examinations for adult and adolescent patients. It involved six sites in three states, including rural, tribal, military, and community hospitals. The purpose of this process evaluation was to determine the extent to which patients consent to telehealth technology, examine how the technology worked, and explore the types of assistance. METHODS We reviewed information for sexual assault patients who presented at emergency departments (N = 215) and conducted telephone and online surveys with 178 clinicians who provided or received telehealth services. RESULTS Between May 1, 2015, and March 31, 2018, 129 patients and site clinicians received services via telehealth and an additional 86 site clinicians received consultation advice via telehealth. Most patients consented and accepted SANE services via telehealth (86% overall and 97% in non-U.S. Navy sites). No significant technology problems were experienced for most interactions (92%). The assistance provided remotely by SANEs to site clinicians included guiding clinicians through history taking and documentation, forensic examination and evidence collection techniques, identifying and documenting injuries, and guiding clinical practice. Site clinicians reported, on average, a positive impact of the assistance on their confidence in providing an effective examination, their ability to provide their patient with the best care, and their sense of feeling supported. IMPLICATION Results of this pilot suggest that using live telehealth services for sexual assault forensic examinations is a promising practice.
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Affiliation(s)
- Wendy A Walsh
- Author Affiliations: Crimes Against Children Research Center, University of New Hampshire
| | | | - Cheryl Re
- Massachusetts SANE Program, MA Department of Public Health
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