A comparison of Indigenous and non-Indigenous survivors of sexual assault and their receipt of and satisfaction with specialized health care services

Child sexual abuse survivors: Differential complex multimodal treatment outcomes for pre-COVID and COVID era cohorts

BACKGROUND

Child sexual abuse (CSA) is a form of early-life trauma that affects youth worldwide. In the midst of the current COVID-19 pandemic, it is imperative to investigate the potential impact of added stress on already vulnerable populations.

OBJECTIVE

The aim of this study was to evaluate the effectiveness of a multimodal treatment program on mental health outcomes for youth CSA survivors aged 8-17. Secondary to this, we explored the potential impact of the COVID-19 on treatment outcomes.

PARTICIPANTS AND SETTING

Participants of this study were children and youth aged 8-17 who were engaged in a complex multimodal treatment program specifically designed for youth CSA survivors.

METHODS

Participants were asked to complete self-report surveys at baseline and at the end of two subsequent treatment rounds. Surveys consisted of measures pertaining to: (1) PTSD, (2) depression, (3) anxiety, (4) quality of life, and (5) self-esteem.

RESULTS

Median scores improved for all groups at all timepoints for all five domains. For the pre-Covid participants, the largest improvements in the child program were reported in depression (36.6 %, p = 0.05); in the adolescent program anxiety showed the largest improvement (-35.7 %, p = 0.006). Improvements were generally maintained or increased at the end of round two. In almost every domain, the improvements of the pre-COVID group were greater than those of the COVID-I group.

CONCLUSIONS

A complex multimodal treatment program specifically designed for youth CSA survivors has the capacity to improve a number of relevant determinants of mental health and well-being. The COVID-19 pandemic may have retraumatized participants, resulting in treatment resistance.

Sexual Violence at University: Are Indigenous Students More at Risk?

University-based sexual violence prevalence is worryingly high and leads to many serious consequences for health and academic achievement. Although previous work has documented greater risk for sexual violence among Indigenous Peoples, little is known about university-based sexual violence experienced by Indigenous students. Using a large-scale study of university-based sexual violence in Canada, the current study aims to (1) examine the risk of sexual violence against Indigenous students compared to non-Indigenous students, and (2) to document sexual violence experiences of Indigenous students. Undergraduate students from six universities (N = 5,627) completed online questionnaires regarding their experience and consequences of university-based sexual violence (e.g., forms of sexual violence experiences, gender, and status of the perpetrator, context of the violence, PTSD, disclosure). Findings indicated that compared with their non-Indigenous peers, Indigenous students experienced significantly higher levels of sexual harassment. However, no difference was found for unwanted sexual behaviors, nor for sexual violence contexts. Among Indigenous students, those having experienced sexual violence after age 18 (outside university) were more likely to report university-based sexual violence. Overall, findings highlight that Indigenous students, as well as non-Indigenous students, experience university-based sexual violence. Given their history, Indigenous students may have different needs, so sustainable policies that foster cultural safety on all campuses are clearly needed.

Psicología y Pueblos Indígenas

La pregunta sobre la existencia de características comunes inherentes a la psicología de los pueblos Indígenas de todo el mundo ha sido objeto de mucho debate. Nosotros argumentamos que los pueblos Indígenas comparten la experiencia de la colonización, así como sus consecuencias sociales y psicológicas. Desarrollamos este argumento en cuatro secciones: ( a) La historia global de la colonización y las desigualdades sociales; ( b) aspectos relativos a la identidad y los procesos grupales, incluidas la transmisión intergeneracional de valores compartidos, la conexión con la naturaleza y la promoción del cambio social; ( c) el prejuicio y la discriminación hacia los pueblos Indígenas y el rol que juegan los procesos psicológicos para promover relaciones positivas entre los pueblos Indígenas y no-Indígenas; y ( d) el impacto del trauma histórico y del colonialismo en la cognición, la salud mental y el bienestar de los pueblos Indígenas, así como la base para el desarrollo de intervenciones exitosas que integran los conocimientos Indígenas. Por último, abordamos los desafíos futuros de la investigación sobre estos temas.

Ready for Anything: A Holistic Approach to Training Sexual Assault Nurse Examiners

Although numerous training options exist for sexual assault nurse examiner certification, most focus on specific certification-related content rather than on creating a holistic preparation for sexual assault nurse examiner (SANE) practice. Holistic preparation may be preferable for SANE trainees who are early in their nursing careers or who have practiced in limited clinical environments. This article describes a holistic training approach implemented at a SANE training site funded by the Advanced Nursing Education initiative of the Health Resources and Services Administration. Training covers hands-on pelvic and anal examinations, community education, underserved communities, self-care, and other topics that support newly trained SANEs in establishing and maintaining practice. This content has prepared trainees for a wide variety of patient encounters as well as for engaging with the community. With this approach, our trainees have the opportunity to enhance their ability to provide SANE care and to provide additional resources within their primary practice environments.

Prevalence of sexual abuse and its association with health-risk behaviors among Brazilian adolescents: A populational study

BACKGROUND

Analysis of sexual abuse has usually been neglected in research at developing countries despite its everlasting consequences. This study examined the prevalence of sexual abuse among Brazilian adolescents according to data from the National School Health Survey (PeNSE) and analyzed it based on Brazilian regions, sociodemographic aspects, health information, and health-risk behaviors among Brazilian adolescents who reported having experienced sexual abuse previously.

PARTICIPANTS AND SETTING

The PeNSE data were utilized, and the sample included 102,072 students from all over Brazil, aged between 11 and 19 years.

METHODS

Data were collected by questionnaires and were analyzed by multivariate analysis using the Poisson regression model.

RESULTS

The results denoted a relation between sexual abuse, social determinants of health variables (i.e., black, indigenous, and mixed skin color/ethnicity; Brazilian region public school, age between 15 and 18 years, and low education level of the mother), and health-risk behaviors (i.e., early sexual intercourse, having multiple sexual partners, unprotected sexual intercourse, use of tobacco, alcohol, and illicit drugs).

CONCLUSION

Therefore, reports of sexual abuse are associated with risky behaviors. Given these findings, targeted interventions on sexual abuse are essential for the health of adolescents and the prevention of risky behaviors, and can also facilitate programs to prevent sexual abuse.

Psychology and Indigenous People

Whether there are common features inherent to the psychology of Indigenous peoples around the globe has been the subject of much debate. We argue that Indigenous peoples share the experience of colonization and its social and psychological consequences. We develop this argument across four sections: (a) the global history of colonization and social inequalities; (b) aspects concerning identity and group processes, including the intergenerational transmission of shared values, the connection with nature, and the promotion of social change; (c) prejudice and discrimination toward Indigenous peoples and the role of psychological processes to improve relations between Indigenous and non-Indigenous peoples; and (d) the impact of historical trauma and colonialism on dimensions including cognition, mental health, and the well-being of Indigenous peoples as well as the basis for successful interventions that integrate Indigenous knowledge. Finally, we address future challenges for research on these topics. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Sexual Assault: Indigenous Women's Experiences of Not Being Believed by the Police

Rates of sexual victimization among Indigenous women are 3 times higher when compared with non-Indigenous women. The purpose of this secondary data analysis was to explore the experiences and recommendations of Indigenous women who reported sexual assault to the police and were not believed. This qualitative study of the experiences of 11 Indigenous women reflects four themes. The women experienced (a) victimization across the lifespan, (b) violent sexual assault, (c) dismissal by police, and (d) survival and resilience. These women were determined to voice their experience and make recommendations for change in the way police respond to sexual assault.

Sexual assault: women's voices on the health impacts of not being believed by police

Background

Sexual assault is a prevalent crime against women globally with known negative effects on health. Recent media reports in Canada indicate that many sexual assault reports are not believed by police. Negative reporting experiences of sexual assault have been associated with secondary victimization and trauma among survivors. However, little is known about the impact that being sexually assaulted and not believed by police has on a survivor’s health and well-being. The purpose of this study was to explore women’s experiences of not being believed by police after sexual assault and their perceived impact on health.

Methods

We conducted open-ended and semi-structured interviews with 23 sexual assault survivors who were sexually assaulted and not believed by police. The interviews explored the self-reported health impacts of not being believed by police and were conducted from April to July, 2019. All interviews were audio-recorded, transcribed, and entered into NVIVO for analysis. Data were analyzed using Colaizzi’s analytic method.

Results

Analysis revealed three salient themes regarding the health and social impact of not being believed by police on survivors of sexual assault: (1) Broken Expectations which resulted in loss of trust and secondary victimization, (2) Loss of Self, and (3) Cumulative Health and Social Effects. The findings showed that not being believed by police resulted in additional mental and social burdens beyond that of the sexual assault. Many survivors felt further victimized by police at a time when they needed support, leading to the use taking of alcohol and/or drugs as a coping strategy.

Conclusion

Reporting a sexual assault and not being believed by police has negative health outcomes for survivors. Improving the disclosure experience is needed to mitigate the negative health and social impacts and promote healing. This is important for police, health, and social service providers who receive sexual assault disclosures and may be able to positively influence the reporting experience and overall health effects.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01358-6.

Putting the Patient First: A Scoping Review of Patient Desires in Canada

Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments.

Percepção das mulheres em situação de violência sobre o apoio formal: Scoping review

RESUMO Objetivo Examinar e mapear as evidências científicas acerca das percepções das mulheres em situação de violência quanto aos serviços de apoio social formal. Método Scoping Review, conforme Joanna Briggs Institute e a questão norteadora: “Qual a percepção das mulheres em situação de violência ao buscar atendimento profissional nos serviços de apoio?”. Inclusos estudos nacionais, internacionais, primários, abordagens qualitativas, quantitativas, métodos mistos, idiomas inglês, português e espanhol, no espaço temporal de 2014 a 2019. Realizadas buscas em sete bases de dados, encontrados 1557 artigos e selecionados 16 como amostra final. Resultados Os atendimentos evidenciaram a escuta ativa, criação de vínculo e articulação dos serviços. Como também a falta de acolhimento; sentimento de insegurança, medo e humilhação. O processo de capacitação foi estabelecido pelos artigos como ferramenta aos profissionais, na promoção de abordagem direcionada e individualizada. Conclusões e considerações para a prática O acolhimento e vínculo propiciado por alguns serviços de apoio resultou em propostas de mudanças e suscitou nas mulheres reflexão, confiança e busca para saída do ciclo da violência. O contrário gerou afastamento dos serviços e consequente permanência junto ao agressor.

The Mental Health and Well-Being of Canadian Indigenous and Non-Indigenous Women Abused by Intimate Partners

Intimate partner violence (IPV), mental health, disabilities, and child abuse history were examined for 292 Indigenous compared with 295 non-Indigenous Canadian women. IPV was assessed by the Composite Abuse Scale and mental health by the Symptom Checklist-10, Center for Epidemiological Studies-Depression 10, the Posttraumatic Stress Disorder (PTSD) Checklist, and Quality of Life Questionnaire. Scores did not differ nor were they in the clinical ranges for the two groups. In a MANCOVA on the mental health/well-being scales, with IPV severity as a covariate, only disability was significantly associated with more severe mental health symptoms. Suggestions for service providers are presented.