A Short Measure of Social Reactions to Sexual Assault: The Social Reactions Questionnaire-Shortened

Latent Profiles of Co-occurring Sexual Problems and Posttraumatic Stress Symptoms Among Young Women Exposed to Sexual Violence

Sexual dysfunctions (SDs) have been noted to occur following exposure to sexual violence although how these conditions covary with other mental health conditions, particularly posttraumatic stress disorder symptoms (PTSS), is relatively understudied. The current study examined patterns of co-occurring SDs and PTSS in a sample of 328 college-aged, female-identified survivors of adolescent/early adulthood sexual assault (ASA). Latent profile analysis was used to examine patterns of symptom endorsement of various types of SDs and PTSS at the symptom cluster level. Four profiles were identified: asymptomatic (41.2% of sample), sexually distressed + intrusions (24.7%), co-occurring (21%), and PTSS (13.1%). Profiles were compared to one another on various characteristics of sexual assault and social reactions from others following assault disclosure. Results indicated that those in the co-occurring symptom and PTSS profiles reported more severe ASA and more unsupportive social responses relative to the sexually distressed + intrusions and asymptomatic profiles. The asymptomatic profile was significantly less likely to have experienced rape relative to the other three profiles and was less likely to report instances where a close other treated them in a negative manner following assault disclosure. Results are discussed in light of mental health needs for young women who have experienced ASA, with implications discussed for future research and clinical services for university students.

Posttraumatic stress symptoms and risky alcohol use: The roles of negative social reactions to sexual assault disclosure and trauma-related shame

INTRODUCTION

Posttraumatic stress symptoms (PTS) and risky alcohol use (RAU) frequently co-occur among those with a history of sexual assault, and this co-occurrence has been linked to severe psychosocial and functional impairment.

OBJECTIVE

The current study examined the roles of negative social reactions to sexual assault disclosure and trauma-related shame in the association between PTS severity and RAU. This was tested by examining the separate and sequential indirect effects of negative social reactions and trauma-related shame in the PTSD-RAU relation among individuals with a history of sexual assault.

METHOD

Data were collected from 235 individuals who endorsed a history of sexual assault (Mage = 35.45, 70.5% women, 83.8% White).

RESULTS

Negative social reactions (b = .03, SE = .01, p < .05, 95% CI [.005, .06]) and trauma-related shame (b = .03, SE = .01, p < .05, 95% CI [.003, .06]), separately, and sequentially (b = .01, SE = .004, p < .05, 95% CI [.001, .02]) explained the relation between PTS severity and RAU.

CONCLUSIONS

Findings suggest that it may be valuable to assess and neutralize negative social reactions to reduce trauma-related shame and subsequent RAU among individuals with a history of sexual assault who experience more severe PTS severity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disclosing Sexual Victimization Online and In-Person: An Examination of Bisexual+ and Heterosexual Survivors

Bisexual+ (bisexual, pansexual, queer, attraction to more than one gender) people are at elevated risk for sexual victimization relative to their heterosexual counterparts. Disclosure of sexual victimization and social reactions received upon disclosure can play a major role in recovery following an assault. Using an online survey, the current study examined whether bisexual+ and heterosexual survivors of sexual victimization (N = 657) varied in disclosure of victimization, the type of disclosure (in-person vs. online via #MeToo), and receipt of various social reactions to disclosure in person and online. A chi-square test examined differences in disclosure and differences in types of disclosure (in-person only vs. MeToo across sexual identity). MANOVAS were used to examine whether in-person and online reactions varied across sexual identity. Bisexual+ survivors were more likely to disclose sexual victimization relative to heterosexual survivors. Among those who disclosed, bisexual+ survivors were more likely to disclose in person only whereas heterosexual survivors were more likely to disclose online via #MeToo. Whereas we did not find any significant differences for in-person reactions, we did find significant differences for online social reactions using #MeToo. Heterosexual survivors received higher turning against reactions (e.g., avoided talking to you or spending time with you) and more unsupportive acknowledgment relative to bisexual+ participants. Whereas bisexual+ participants received less turning against reactions and unsupportive acknowledgment during #MeToo/online disclosure, they were also less likely to disclose using #MeToo. Findings suggest that bisexual+ and heterosexual people vary in the way they disclose sexual victimization, and in how they are responded to when disclosing in person and online.

Social Reactions to Disclosure of Sexual Violence Experienced by Sexual and Gender Minority Young Adults: Comparisons of Sexual and Gender Minority Recipients Versus Cisgender/Heterosexual Recipients

Sexual and gender minority (SGM) individuals are at an increased risk of experiencing sexual violence (SV). Social reactions received upon disclosure of SV impact survivors' mental health, and this may be more extreme when social reactions are provided by other SGM individuals. The purpose of the current study was to understand the SV disclosure experiences of SGM young adults, including the identity of disclosure recipients and the quality of the social reactions received by SGM and cisgender/heterosexual disclosure recipients. Additionally, the current study sought to examine how the SGM identity of the disclosure recipient and the quality of the social reactions received were associated with mental health outcomes (depression, post-traumatic stress disorder [PTSD], and alcohol use) among SGM SV survivors. SGM-identifying participants (N = 110) completed a 10-min survey on Qualtrics that was distributed through Prime Panels. Results revealed that 83% of participants (SGM survivors of SV) disclosed their SV experience to other SGM individuals. SGM disclosure recipients provided more positive social reactions and fewer negative social reactions than cisgender/heterosexual disclosure recipients. Regression models indicated that positive social reactions from cisgender/heterosexual recipients were associated with a decrease in depression scores. Negative social reactions from SGM recipients were associated with an increase in depression scores. Unexpectedly, positive social reactions from SGM recipients, while negative social reactions from cisgender/heterosexual recipients, were associated with an increase in PTSD scores. No associations were found between social reactions and alcohol use. Findings highlight the importance of social reactions and disclosure experiences on SGM survivors' mental health and mitigation opportunities to improve these disclosure experiences.

Associations Among Online Social Reactions to Disclosure of Sexual Victimization, Coping and Social Isolation

Social reactions to the disclosure of sexual victimization are critical to post-assault recovery. The popular social media hashtag "#MeToo" resulted in numerous survivors of sexual victimization disclosing their experience online. Whereas previous research has examined the association between social reactions to in-person disclosure of sexual victimization and factors commonly associated with adjustment among survivors - such as coping and social support - research is needed to examine correlates of social reactions to online disclosure of sexual victimization. Accordingly, the current study investigated the relationship between online social reactions to the disclosure of sexual victimization via #MeToo and engagement in various coping strategies (problem-focused coping, emotion-focused coping) and social isolation among a sample of 195 adults with a history of sexual victimization. Results indicated that the provision of online resources was associated with lower use of problem-focused and emotion-focused coping strategies. Receipt of online emotional and informational support was associated with increased use of emotion-focused coping strategies. Further, receipt of online social reactions that turned against the survivor and receipt of online social reactions that "made fun of you, insulted you, or said something to hurt you" were associated with higher levels of social isolation. Lastly, online unsupportive acknowledgment and "sharing your tweet with other people" were associated with lower levels of social isolation. Results highlight how online social reactions to disclosure of sexual victimization via #MeToo intersect with coping and social support among survivors of sexual victimization and help to give context to the experience of online disclosure of sexual victimization.

Social Reactions to Disclosures of Intimate Partner Stalking and Unwanted Pursuit Behaviors: Associations With PTSD, Academic Outcomes, and Empowerment

Among college survivors of unwanted pursuit behaviors (UPBs; 40.1%, n = 189) or intimate partner stalking (IPS, i.e., UPBs causing emotional distress; 32.1%, n = 151), the present study examined effects of social reactions to disclosures on post-traumatic stress disorder (PTSD) symptomatology, academic outcomes, and personal empowerment. Compared to UPB survivors, IPS survivors were more likely to disclose and reported higher positive and negative reactions to disclosure as well as greater frequency of UPBs/IPS, IPV, and PTSD symptoms. Among both groups, only negative social reactions were positively associated with PTSD symptoms. However, among IPS (but not UPB) survivors, only positive social reactions were related to academic outcomes and empowerment when controlling for PTSD and IPS frequency. Implications for research and practice are discussed.

Identification of Psycho-Socio-Judicial Trajectories and Factors Associated With Posttraumatic Stress Disorder in People Over 15 Years of Age Who Recently Reported Sexual Assault to a Forensic Medical Center: Protocol for a Multicentric Prospective Study Using Mixed Methods and Artificial Intelligence

BACKGROUND

Sexual assault (SA) can lead to a range of adverse effects on physical, sexual, and mental health, as well as on one's social life, financial stability, and overall quality of life. However, not all people who experience SA will develop negative functional outcomes. Various risk and protective factors can influence psycho-socio-judicial trajectories. However, how these factors influence trauma adaptation and the onset of early posttraumatic stress disorder (PTSD) is not always clear.

OBJECTIVE

Guided by an ecological framework, this project has 3 primary objectives: (1) to describe the 1-year psycho-socio-judicial trajectories of individuals recently exposed to SA who sought consultation with a forensic practitioner; (2) to identify predictive factors for the development of PTSD during the initial forensic examination using artificial intelligence; and (3) to explore the perceptions, needs, and experiences of individuals who have been sexually assaulted.

METHODS

This longitudinal multicentric cohort study uses a mixed methods approach. Quantitative cohort data are collected through an initial questionnaire completed by the physician during the first forensic examination and through follow-up telephone questionnaires at 6 weeks, 3 months, 6 months, and 1 year after the SA. The questionnaires measure factors associated with PTSD, mental, physical, social, and overall functional outcomes, as well as psycho-socio-judicial trajectories. Cohort participants are recruited through their forensic examination at 1 of the 5 participating centers based in France. Eligible participants are aged 15 or older, have experienced SA in the last 30 days, are fluent in French, and can be reached by phone. Qualitative data are gathered through semistructured interviews with cohort participants, individuals who have experienced SA but are not part of the cohort, and professionals involved in their psycho-socio-judicial care.

RESULTS

Bivariate and multivariate analyses will be conducted to examine the associations between each variable and mental, physical, social, and judicial outcomes. Predictive analyses will be performed using multiple prediction algorithms to forecast PTSD. Qualitative data will be integrated with quantitative data to identify psycho-socio-judicial trajectories and enhance the prediction of PTSD. Additionally, data on the perceptions and needs of individuals who have experienced SA will be analyzed independently to gain a deeper understanding of their experiences and requirements.

CONCLUSIONS

This project will collect extensive qualitative and quantitative data that have never been gathered over such an extended period, leading to unprecedented insights into the psycho-socio-judicial trajectories of individuals who have recently experienced SA. It represents the initial phase of developing a functional artificial intelligence tool that forensic practitioners can use to better guide individuals who have recently experienced SA, with the aim of preventing the onset of PTSD. Furthermore, it will contribute to addressing the existing gap in the literature regarding the accessibility and effectiveness of support services for individuals who have experienced SA in Europe. This comprehensive approach, encompassing the entire psycho-socio-judicial continuum and taking into account the viewpoints of SA survivors, will enable the generation of innovative recommendations for enhancing their care across all stages, starting from the initial forensic examination.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/46652.

Online Social Reactions to Disclosure of Sexual Victimization via #MeToo and Symptoms of Post-Traumatic Stress Disorder

Sexual victimization is a major public health concern with significant consequences for survivors, their families, and society at large. Studies examining in-person disclosure of sexual victimization suggest that the way others respond to disclosure has a significant impact on survivors' well-being. With the advent of social media, more survivors are choosing to disclose their experience online. Research is needed to understand how social reactions to online disclosure of sexual victimization impact survivors. Accordingly, the current study examined the association between online social reactions to the disclosure of sexual victimization and symptoms of post-traumatic stress disorder (PTSD) symptoms in a sample of 195 individuals who disclosed their experience online via the hashtag #MeToo. Symptoms of PTSD were positively associated with the level of assault severity reported by the survivor, as well as receipt of online social reactions to disclosure via #MeToo that made fun, insulted, or said something to hurt the survivor. Online social reactions to disclosure via #MeToo that involved turning away from the survivor or providing unsupportive acknowledgment of the experience were unrelated with PTSD symptoms. PTSD symptoms were also not associated with the receipt of positive online social reactions to disclosure via #MeToo. Like research addressing in-person social reactions to disclosure of sexual victimization, some forms of online negative social reactions to disclosure of sexual victimization via #MeToo appear to be associated with worse psychological outcomes among survivors. Thus, online disclosure of sexual victimization and its impact needs to be attended to in clinical and research settings.

Social Reactions and Trauma Symptoms Among Gender and Sexual Minority Students Disclosing Sexual Violence

Addressing the higher rates of sexual violence experienced by gender and sexual minority students in university contexts requires an understanding of responses to disclosures of sexual violence. Using data from a large-scale study of sexual violence in university contexts, the current study examined (1) whether gender and sexual minority status was associated with responses to sexual violence disclosure and (2) how disclosure responses were associated with trauma symptoms among these students. Linear regression indicated that university students' (n = 1,464) reports of responses to disclosures of sexual violence did not differ across gender or sexual minority status. Focusing on gender and sexual minority participants (n = 327), linear regression linked turning against the victim and positive responses to higher levels of trauma symptoms.

Correlates of Social Reactions to Victims' Disclosures of Sexual Assault and Intimate Partner Violence: A Systematic Review

Sexual assault and intimate partner violence (IPV) are common experiences in women, but few studies have examined correlates of social reactions experienced by victims telling others about assault. This systematic review identified 30 studies through searches of research databases on correlates of social reactions to disclosure of sexual assault or IPV in samples of adult victims or disclosure recipients. Studies showed evidence of greater negative social reactions for Black and Hispanic victims, less educated, and bisexual victims. More extensive trauma histories in victims were related to receipt of greater negative social reactions, whereas assault characteristics (e.g., victim-offender relationship, alcohol use, perpetrator violence during assault) were sometimes associated with negative reactions. In terms of postassault factors, more psychological symptoms, self-blame, avoidance coping, less perceived control, and less posttraumatic growth were related to more negative social reactions. Disclosure characteristics, telling informal sources, and telling more sources were related to more positive reactions, whereas telling both formal and informal sources was related to negative reactions. Demographic, attitudinal, and relational factors were related to disclosure recipients' intended social reactions. Future research needs to examine how various factors relate to social reactions in the context of theory, and clinical treatment and interventions should use this information to identify and intervene with victims to reduce negative social reactions and their psychological impacts and to increase positive social reactions particularly from informal support sources.

The Role of Social Reactions to Disclosures in the Relationship Between Sexual Assault Acknowledgment and Psychological Symptoms

Following a sexual assault, women experience a host of negative psychological consequences. While some survivors label their sexual assault experience as such (i.e., are acknowledged survivors), other survivors do not. The effect of acknowledgment of sexual assault on postassault outcomes has yielded mixed findings. It was hypothesized that social reactions may account for the relationship between acknowledgment status and psychological symptoms. Results indicated that acknowledged survivors reported more severe posttraumatic stress disorder symptoms, which were partially accounted for by turning against social reactions. Future studies should explore the mechanisms responsible for these relationships and analyze the individual social reactions.

Binegativity Exacerbates the Effects of Sexual Victimization Disclosure on Posttraumatic Stress and Drinking Among Bisexual Women

Bisexual women experience higher rates of sexual victimization and mental health problems compared to heterosexual and lesbian women. Bisexual women also receive more unsupportive or overtly negative reactions when they disclose experiences of sexual victimization. The current study aimed to examine the interaction of negative social reactions and binegativity (i.e., experiences of stigma due to bisexual identity) in predicting posttraumatic stress, depression, and hazardous drinking among bisexual women. The sample consisted of 161 young adult bisexual women (ages 18-35) who disclosed a sexual victimization experience to at least one person. Moderation analyses were conducted via the PROCESS macro for SPSS. "Turning against" reactions to disclosure (e.g., victim blame and avoidance of the victim) predicted increased posttraumatic stress and hazardous drinking in the presence of binegativity. In addition, reactions to disclosure that acknowledged the experience but were unsupportive predicted increased drinking in the context of binegativity. Depression was not associated with either type of negative reactions, regardless of binegativity. Thus, findings suggest that binegativity in combination with negative responses to disclosure of sexual victimization are important factors in specific types of distress related to sexual violence among bisexual women. Implications for research, clinical intervention, and policy are discussed.

Supporter-focused early intervention for recent sexual assault survivors: Study protocol for a pilot randomized clinical trial

INTRODUCTION

Sexual assault is a common form of trauma that is associated with elevated risk for negative psychosocial outcomes. Although survivors' social relationships could serve as a major protective factor against negative outcomes, survivors' supporters often lack knowledge regarding effective responses and may inadvertently respond in ways that are detrimental to healing. Communication and Recovery Enhancement (CARE) is a 2-session early intervention for survivors of a past-10-week sexual assault and their supporters that aims to improve supporters' ability to respond effectively.

OBJECTIVE

In this paper, we present a study protocol for a pilot randomized clinical trial of CARE (NCT05345405). The goal of this pilot trial is to understand the feasibility, acceptability, and preliminary efficacy of two versions of CARE: a version in which survivors and supporters attend sessions together (dyadic version) and a version in which supporters attend sessions alone (supporter-only version).

METHODS

Survivors aged 14+ with elevated posttraumatic stress will enroll with a supporter of their choosing. Dyads will be randomized to dyadic CARE, supporter-only CARE, or waitlist control, and will complete self-report assessments at baseline, post-session-1, and follow-ups (1, 2, and 3 months post-baseline). We will use descriptive statistics, effect sizes, and exploratory statistical tests to characterize the acceptability of both CARE versions, impact on knowledge change from baseline to 1 month, impact on disclosure experiences at 1 month, and impact on functional outcomes at 3 months.

DISCUSSION

Results will be used to inform future changes to CARE and determine whether a fully-powered randomized controlled trial is warranted.

A Mixed-Method Process Evaluation of an Intervention to Improve Social Reactions to Disclosures of Sexual Assault and Partner Abuse

Because of the high rates and deleterious consequences of sexual assault (SA) and partner abuse (PA) on college campuses, there is a proliferation of programming to both prevent and respond to these issues. Most research to date, however, presents outcome evaluation data on these programs and neglects to present process evaluation data which are critical for program refinement and dissemination. The purpose of this study was to present process evaluation data (i.e., acceptability and feasibility) specific to a program that endeavored to increase positive and decrease negative social reactions from disclosure recipients to individuals disclosing SA and PA. Participants were 303 students who completed the program and participated in postintervention surveys and a subset of students (n = 18) who completed exit interviews. Results documented that the program was both feasible and acceptable, as evidenced by high satisfaction ratings. Important suggestions were also provided for how to improve the program, such as reducing repetition and making scenarios more realistic. Finally, participants who reported higher program engagement and more program usage generally reported more intentions to provide positive social reactions, less intentions to provide negative social reactions, and less actual negative social reactions. This information is useful not only for adapting the current program discussed herein but also for program developers and preventionists wishing to create similar programming to effectively prevent and improve response to SA and PA.

How, why, for whom and in what context, do sexual health clinics provide an environment for safe and supported disclosure of sexual violence: protocol for a realist review

INTRODUCTION

Supporting people subjected to sexual violence includes provision of sexual and reproductive healthcare. There is a need to ensure an environment for safe and supported disclosure of sexual violence in these clinical settings. The purpose of this research is to gain a deeper understanding of how, why, for whom and in what circumstances safe and supported disclosure occurs in sexual health services.

METHODS AND ANALYSIS

To understand how safe and supported disclosure of sexual violence works within sexual health services a realist review will be undertaken with the following steps: (1) Focussing of the review including a scoping literature search and guidance from an advisory group. (2) Developing the initial programme theories and a search strategy using context-mechanism-outcome (CMO) configurations. (3) Selection, data extraction and appraisal based on relevance and rigour. (4) Data analysis and synthesis to further develop and refine programme theory, CMO configurations with consideration of middle-range and substantive theories.

DATA ANALYSIS

A realist logic of analysis will be used to align data from each phase of the review, with CMO configurations being developed. Programme theories will be sought from the review that can be further tested in the field.

ETHICS AND DISSEMINATION

This study has been approved by the ethics committee at University of Birmingham, and has Health Research Authority approval. Findings will be disseminated through knowledge exchange with stakeholders, publications in peer-reviewed journals, conference presentations and formal and informal reports. In addition, as part of a doctoral study, the findings will be tested in multisite case studies.

PROSPERO REGISTRATION DETAILS

CRD4201912998. Dates of the planned realist review, from protocol design to completion, January 2019 to July 2020.