1
|
Jaffe AE, Blayney JA, Jones HR, Stappenbeck CA, George WH, Davis KC. Sexual Decision Making When Intoxicated: Women's Reasons for and Against Having Sex in a Laboratory-Based Scenario. J Sex Res 2024; 61:767-782. [PMID: 37651745 PMCID: PMC10902182 DOI: 10.1080/00224499.2023.2249774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Young adult women report high condom use intentions, but inconsistent condom use. Cognitive appraisals during sexual encounters are important determinants of condom use decisions, but a nuanced understanding of what cognitions emerge during women's "hot states" (e.g., sexual arousal, alcohol intoxication) remains lacking. To address this gap, we examined women's heat of the moment cognitions in their own words using mixed methods. Young adult women (N = 503; Mage = 25.01, SDage = 2.66) were randomized to a beverage condition (alcohol or control), then read and responded to questions about an eroticized sexual scenario. The nature and strength of reasons for and against having sex were reported before and after learning no condom was available. Multilevel models revealed intoxicated participants were more likely to let the partner decide how far to go sexually than sober participants at both timepoints, but the strength of cognitive appraisals (reasons for, reasons against, and feeling conflicted) only differed between beverage conditions after knowledge of no condom. These results suggest alcohol myopia was evident in the presence of inhibition conflict. Content analysis of these reasons revealed multifaceted cognitions that changed upon learning there was no condom. Findings highlight cognitions to target through interventions and underscore the importance of both alcohol and situational context in decision making.
Collapse
Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Harper R Jones
- Department of Psychology, University of Nebraska-Lincoln
| | | | | | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
| |
Collapse
|
2
|
George WH, Blayney JA, Davis KC. Impact of Acute Alcohol Consumption on Sexuality: A Look at Psychological Mechanisms. Annu Rev Clin Psychol 2024; 20. [PMID: 38346294 DOI: 10.1146/annurev-clinpsy-080921-075423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Alcohol's link with sexuality is long-standing and prominent. While research continues to document robust associations between drinking and sexual behavior, attention now centers primarily on evaluating mechanisms and attendant theoretical frameworks to advance our understanding of how alcohol exerts a causal impact. We describe four domains with reliable evidence of alcohol effects: sexualized social perceptions, sexual arousal, sexual risk taking, and sexual assault. We consider three contextual frames: distal factors associated with encountering opportunities for alcohol-involved sex, proximal factors associated with alcohol's acute effects, and distal-proximal interactions. We then examine the empirical support for mechanisms embedded within four theoretical frameworks: alcohol disinhibition, alcohol expectancy, alcohol myopia, and emotion regulation. Support for disinhibition mechanisms is evident with sexual arousal only. Expectancy and myopia mechanisms enjoy support across domains and make up bases for integrative expectancy-myopia causal explanations. Emotion regulation mechanisms evidence preliminary support in risk taking and sexual assault. Implications and future directions are considered. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- William H George
- Department of Psychology, University of Washington, Seattle, Washington, USA;
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| |
Collapse
|
3
|
Neilson EC, Gulati NK, Stappenbeck CA, George WH, Davis KC. Emotion Regulation and Intimate Partner Violence Perpetration in Undergraduate Samples: A Review of the Literature. Trauma Violence Abuse 2023; 24:576-596. [PMID: 34551642 PMCID: PMC8938307 DOI: 10.1177/15248380211036063] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Intimate partner violence (IPV) perpetration increases throughout young adulthood and is particularly widespread among college students, resulting in mental health and academic consequences. Deficits in emotion regulation (ER) are an important factor associated with IPV perpetration; the developmental tasks and challenges associated with college, including relationship stressors and hazardous alcohol use, implicate ER as a particularly relevant risk factor for IPV perpetration. Thus, college presents an important opportunity for intervention in order to change the trajectories of IPV perpetration across young adulthood. The purpose of this review was to synthesize findings regarding ER and psychological, physical, and sexual IPV perpetration among college students. Twenty-one articles met inclusion criteria. Studies were organized into five categories: (a) direct associations of ER with IPV perpetration, (b) qualitative assessment of ER and IPV, (c) ER in indirect effects models, (d) ER in moderation models, and (e) experiments with ER instructional sets. Overall, ER emerged as an important inhibiting factor for IPV perpetration, particularly impulse control and access to ER strategies. ER deficits in the context of impelling (e.g., negative affect, trauma history) and instigating (e.g., provocation) factors emerged as consistent predictors of psychological and physical IPV perpetration for both male and female students. Deficits in ER were associated with sexual IPV perpetration among men; however, very few studies examined sexual IPV. Experimental paradigms suggest cognitive reappraisal may reduce IPV perpetration, while suppression may, in some contexts, increase perpetration. Methodological strengths and weaknesses and implications for IPV prevention and interventions programming for college students are discussed.
Collapse
Affiliation(s)
| | - Natasha K. Gulati
- University of Washington, Department of Psychology, Seattle, WA 98195
| | | | - William H. George
- University of Washington, Department of Psychology, Seattle, WA 98195
| | - Kelly Cue Davis
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004
| |
Collapse
|
4
|
Neilson EC, Maitland DWM, George WH. Power-Related Emotions, Alcohol Intoxication, and Nonconsensual Sex Intentions: The Role of Fear of Intimacy. Sex Abuse 2023; 35:313-339. [PMID: 35537465 PMCID: PMC9646925 DOI: 10.1177/10790632221096420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The problem of alcohol-involved sexual assault against women highlights the need to identify how the presence of alcohol interacts with risk factors associated with sexual assault perpetration. One risk factor for sexual assault perpetration is fear of intimacy, the inhibited capacity to exchange vulnerable thoughts and emotions with a valued individual. Men who have perpetrated sexual violence report higher fear of intimacy and alcohol use than those who have not. However, little research has investigated how fear of intimacy may contribute to sexual assault perpetration in the context of alcohol intoxication. This study examined alcohol intoxication, fear of intimacy, proximal power-related emotions, and nonconsensual sex intentions. Non-monogamous, male social drinkers (N = 94) completed measures and were randomly assigned to an alcohol condition (alcohol [BrAC = .10%] versus control). Participants then read a sexual assault analogue scenario depicting sexual assault against a hypothetical woman and reported power-related emotions and nonconsensual sex intentions. Self-reported fear of intimacy differed across types of past perpetration. Results found that for intoxicated men only, fear of intimacy was positively associated with power-related emotions, and power-related emotions were positively associated with nonconsensual sex intentions. These associations were not observed for men in the control condition who did not consume alcohol. Future research should examine intimacy-related interventions for sexual assault prevention programming.
Collapse
Affiliation(s)
| | - Daniel W. M. Maitland
- Morehead State University, Department of Psychology, Morehead, KY, USA
- Bowling Green State University, Department of Psychology, Bowling Green, OH, USA
| | - William H. George
- University of Washington, Department of Psychology, Seattle, WA, USA
| |
Collapse
|
5
|
Gleason N, Smith G, Canning JR, George WH, Larimer ME, Jennings TL, Coleman E, Miner MH. The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior. AIDS Behav 2023; 27:2317-2327. [PMID: 36633765 PMCID: PMC10399619 DOI: 10.1007/s10461-022-03961-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/13/2023]
Abstract
Men who have sex with men (MSM) are disproportionately impacted by HIV in the United States, and substance use and compulsive sexual behavior (CSB) are contributors to HIV risk behavior. This study sought to examine the direct and interactive effects of concurrent substance use and CSB on condomless anal sex (CAS) in a community sample of MSM (N = 200) utilizing a 90-day timeline follow-back assessment. Results indicated CSB did not directly increase risk for CAS when controlling for substance use and age. There was limited evidence for a direct effect of concurrent alcohol use on CAS, and no evidence for an interaction effect with CSB. The relationship between concurrent drug use and CAS was moderated by CSB, such that concurrent drug use was positively associated with CAS for those who screened positive for CSB, while the association was non-significant for those who screened negative. Implications and limitations of these findings are discussed.
Collapse
Affiliation(s)
- Neil Gleason
- Department of Psychology, University of Washington, Seattle, WA, USA.
| | - Gabriel Smith
- Department of Psychology, St. Olaf College, Northfield, MN, USA
| | - Jessica R Canning
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - William H George
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Mary E Larimer
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Todd L Jennings
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, Institute for Sexual and Gender Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael H Miner
- Department of Family Medicine and Community Health, Institute for Sexual and Gender Health, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
6
|
Stappenbeck CA, Jaffe AE, Blayney JA, Kirwan M, George WH, Davis KC. An event-level evaluation of women's self-medicated drinking: The role of sexual assault severity, affect, and drinking motives. Psychol Trauma 2023; 15:110-120. [PMID: 35617256 PMCID: PMC10914019 DOI: 10.1037/tra0001278] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Women with sexual assault (SA) histories report heavier and more frequent drinking. Consistent with the motivational model of alcohol use, women with SA histories may consume alcohol to both downregulate negative emotions and upregulate positive ones. The present event-level study used a Bayesian multilevel moderated mediation approach to examine the extent to which women's alcohol use and intoxication was influenced by coping and enhancement drinking motives to downregulate or upregulate affect, respectively. METHOD Women ages 21-30 were recruited from the community to participate in a larger study that included a 32-day daily diary assessment of affect, drinking motives, and alcohol use. RESULTS We found consistent support for women's tendencies to be motivated to drink to cope or enhance negative or positive affect, respectively, and those drinking motives were associated with indicators of increased drinking. Becoming intoxicated to downregulate negative emotion was common and this pathway was particularly strong for women who reported more severe SA histories. Although women with more severe SA histories were generally more likely to drink more, they were not likely to do so as a way to enhance positive experiences. CONCLUSIONS Alcohol interventions that provide adaptive regulatory strategies are needed for women who experience increased negative or positive affect, with a particular focus on self-medication for young women with more severe SA histories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
|
7
|
Neilson EC, Schraufnagel TJ, George WH, Davis KC. The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women. J Child Sex Abus 2023; 32:3-21. [PMID: 36515168 PMCID: PMC9911360 DOI: 10.1080/10538712.2022.2155284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.
Collapse
Affiliation(s)
- Elizabeth C Neilson
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | | | - William H George
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| |
Collapse
|
8
|
Angelone DJ, Mitchell D, Yucel E, Davis KC, George WH. An Evaluation of the Methodological Underpinnings of a Laboratory Paradigm for the Study of Sexual Violence. J Interpers Violence 2022; 37:NP22092-NP22113. [PMID: 35042375 DOI: 10.1177/08862605211068081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Ethically constructed laboratory paradigms can provide behaviorally based opportunities to study sexual violence as an addition to questionnaires. One such paradigm invites male participants to watch and show sexual materials to a female confederate as an analog of sexual perpetration. However, there has been inconsistency in the confederate's presentation, such that she either expresses a dislike of sexual material or her preferences are omitted. Some researchers have also questioned whether an expressed dislike is analogous to an expressed nonconsent. As such, the primary goal of the current study was to determine whether confederate expressions of dislike, nonconsent, or the omission of a preference, differentially affect male participants' behavior within a well-established paradigm. That is, we attempted to clarify the appropriate methodology for future researchers (i.e., the validity of the paradigm) and determine the impact of such a situational manipulation on laboratory-based sexual violence. Participants were 276 adult men, who were randomly assigned to one of three conditions: (1) dislike, (2) nonconsent, or (3) said nothing (the omission of a preference) and then asked to show a brief video clip to the female confederate who expressed these preferences. Overall, exposure to experimental condition predicted sexual video-showing over and above that of social desirability, hostile sexism (HS), and sexual violence history, suggesting that situational variables can play a significant role in laboratory-based sexual violence. Greater HS was associated with greater likelihood of sexual video-showing in the nonconsent condition relative to the dislike condition. Sexual video-showing was most frequent in the said nothing condition. In sum, researchers should be mindful of the confederate expression (or lack thereof) of preferences for sexual materials when using the sexual imposition paradigm.
Collapse
Affiliation(s)
| | - Damon Mitchell
- Central Connecticut State University, New Britain, CT, USA
| | | | | | | |
Collapse
|
9
|
Bird ER, Stappenbeck CA, Blayney J, Kaysen D, George WH. Examination of Sex-Related Distress and Self-Medication Drinking Model in U.S. College Women. J Sex Res 2022; 59:1192-1200. [PMID: 35275036 DOI: 10.1080/00224499.2022.2044444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adult sexual assault (ASA) in college remains a concern. Consequently, many college-aged women experience negative emotions surrounding sexual activity (sex-related distress). Consistent with self-medication theory, some drink to cope with sex-related distress, which may reduce distress, but lead to greater drinking quantity before sex and negative sexual consequences. How women with ASA histories navigate sexual situations and cope with sex-related distress is under researched. We examined ASA, sex-related distress, and drinking to cope motives to understand correlates of drinking before sex. First and second year college women (n = 300) reported on a recent sexual experience in the past six weeks. In the full sample, ASA severity was associated with a greater likelihood of drinking before sex, while general sex-related distress was associated with a lower likelihood. General sex-related distress was associated with event-specific sex-related distress and sexual consequences. There were no differences in number of pre-sex drinks or subjective intoxication during sexual activity based on ASA. In a subsample of women who drank before sexual activity (n = 179), drinking to cope with sex-related distress motives mediated the association between sex-related distress and sexual consequences. Interventions can draw on these findings to target self-medication drinking in consensual sexual situations.
Collapse
Affiliation(s)
| | | | - Jessica Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center
| | | |
Collapse
|
10
|
Kirwan M, Davis KC, Stappenbeck CA, George WH. The Effect of State, Trait, and Situational Factors on Young Men's Coercive Condom Use Resistance. Psychol Men Masc 2022; 23:374-383. [PMID: 36776223 PMCID: PMC9910211 DOI: 10.1037/men0000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coercive Condom Use Resistance (CUR) is a significant problem, associated with increases in STIs, unplanned pregnancy, feelings of betrayal, and a loss of sexual autonomy. Furthermore, young men are much more likely to perpetrate coercive CUR than young women. Thus, the present study sought to examine the past experiences, trait characteristics, and state emotions which may precede coercive CUR perpetration intentions, including alcohol intoxication, childhood emotional abuse, trait impulsivity, sexual sensation seeking, state impulsivity, and state anxiety, using an alcohol administration procedure. Young, single, non-problem drinking, and sexually active men who have sex with women from the United States (N = 297; 66% White, 9.4% Black, 10.7% Multi-racial, 5.1% Asian, 1.0% Native American, 1.0% Pacific Islander, and 10.4% Hispanic or Latino) were recruited for participation. They were randomly assigned to either receive alcohol or remain sober before projecting themselves into a hypothetical sexual scenario with a woman who asked to use a condom. Results showed that greater levels of childhood emotional abuse were associated with increased trait impulsivity and sexual sensation seeking, and that sexual sensation seeking was associated with increased state impulsivity and subsequent anxiety during the scenario. Finally, alcohol intoxication moderated the relationship between state anxiety and coercive CUR such that state anxiety was positively associated with coercive CUR among intoxicated men only. Findings suggest that interventions targeting coercive CUR behavior may be improved by focusing on men who have experienced childhood trauma, as well as their alcohol consumption and in-the-moment experiences of impulsivity and anxiety.
Collapse
Affiliation(s)
- Mitchell Kirwan
- Edson College of Nursing and Health Innovation, Arizona State University
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | | |
Collapse
|
11
|
Eakins DR, Neilson EC, Stappenbeck CA, Nguyen HV, Cue Davis K, George WH. Alcohol intoxication and sexual risk intentions: Exploring cultural factors among heavy drinking women. Addict Behav 2022; 131:107314. [PMID: 35381432 PMCID: PMC9271756 DOI: 10.1016/j.addbeh.2022.107314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Sexually Transmitted Infections (STI) rates are the highest of the last 20 years, with people of color and women particularly affected. Ongoing research has identified risk factors (e.g., alcohol intoxication) and protective factors (e.g., risk perception) for sexual risk behaviors, such as inconsistent condom use. Depending on behavioral norms within a group, ethnic identity (EI) - the exploration and sense of belonging to one's ethnicity - may be a risk or protective factor. This study examined the relations between EI, alcohol intoxication, and STI risk perception on sexual risk intentions among women of color (WOC) and white women (WW). METHODS Cisgender women (N = 390; 35% WOC; 65% WW) completed measures and were randomly assigned to an alcohol condition (0.10% BrAC vs control). They projected themselves into an eroticized scenario and self-reported two aspects of STI risk perception (personal, partner) and two sexual risk behaviors (condomless sex intentions, condom decision abdication intentions). RESULTS Path analysis indicated that intoxicated women endorsed higher sexual risk intentions compared to women in the control group. Personal STI risk perception was negatively associated with sexual risk intentions. Indirect effects indicated that race was indirectly associated with both indicators of sexual risk, such that WOC reported higher perceived personal STI risk and subsequently endorsed lower sexual risk intentions compared to WW. Surprisingly, EI was associated with higher perceived partner risk for WW only. CONCLUSIONS Prevention initiatives that address STI risk perception, condom assertion behaviors, and alcohol may be effective for mitigating women's sexual risk behaviors.
Collapse
|
12
|
Davis KC, Neilson EC, Kirwan M, Bird ER, Eldridge N, George WH, Stappenbeck CA. The Interplay of Sexual Arousal and Power-Related Emotions in Men's Alcohol-Involved Sexual Aggression Intentions. J Sex Res 2022; 59:765-779. [PMID: 34520295 PMCID: PMC8918440 DOI: 10.1080/00224499.2021.1972923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Research has identified power/dominance and sexual arousal as key motivators of men's sexual aggression; however, little research has examined the interplay of these two factors in alcohol-involved sexual aggression. Two alcohol administration experiments investigated the roles of power-related sex motives and power- and sexual arousal-related emotions on men's sexual aggression intentions. In Study 1, participants (N = 96) read a sexual aggression scenario after random assignment to consume either an alcoholic (target peak BrAC = .10%) or nonalcoholic beverage. Results indicated that power-related sex motives indirectly predicted stronger sexual aggression intentions through greater in-the-moment power-related emotions but not through sexual arousal-related emotions. Intoxicated men with more severe perpetration histories reported stronger sexual aggression intentions. In Study 2, participants (N = 203) completed similar measures after random assignment to receive either a brief emotion regulation-focused intervention (cognitive restructuring or mindfulness) or a control, followed by either alcohol (target peak BrAC = .08%) or nonalcoholic beverage consumption. Results demonstrated that greater power-related sex motives indirectly predicted stronger sexual aggression intentions through greater feelings of power and sexual arousal. Additionally, findings suggest that cognitive restructuring approaches may mitigate these relationships in sober men, while mindfulness approaches may exacerbate these relationships in intoxicated men.
Collapse
Affiliation(s)
- Kelly Cue Davis
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004
| | | | - Mitchell Kirwan
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004
| | - Elizabeth R. Bird
- Seattle VA Medical Center, VA Puget Sound Healthcare System, Seattle, WA 98108
| | - Nolan Eldridge
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004
| | - William H. George
- University of Washington, Department of Psychology, Seattle, WA 98195
| | | |
Collapse
|
13
|
Kirwan M, Davis KC, Stappenbeck CA, George WH. The Roles of Emotion Regulation, Alcohol Consumption, and Women's Condom Request Style in Men's Coercive Condom Use Resistance Intentions. J Aggress Maltreat Trauma 2022; 31:1187-1205. [PMID: 36686317 PMCID: PMC9857612 DOI: 10.1080/10926771.2022.2089862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 04/14/2022] [Accepted: 05/22/2022] [Indexed: 06/17/2023]
Abstract
Condom use resistance (CUR) remains a significant problem, and many men employ coercive CUR strategies to avoid using condoms with partners who do not consent to unprotected sex. To assess the decision-making process underlying men's coercive CUR, the present study administered alcohol to assess the effects of alcohol intoxication, condom request style, and emotion regulation (ER) strategies (i.e., cognitive reappraisal, expressive suppression) on intentions to use coercive CUR to have unprotected sex during a hypothetical sexual scenario. Sexually active, male social drinkers (N = 297) were randomly assigned to either consume alcohol or remain sober, and to project themselves into a hypothetical sexual scenario during which they received either indirect, direct, or insistent condom requests. Results showed that, although cognitive reappraisal had no relationship with coercive CUR or unprotected sex intentions, expressive suppression's relationship with intentions to have unprotected sex was mediated by coercive CUR and moderated by alcohol intoxication and condom request. Specifically, suppression was positively associated with coercive CUR among sober individuals who received an indirect condom request only. Such results suggest that sober men with suppressive tendencies may use coercive CUR to regulate negative emotions, such as frustration at not being able to have unprotected sex.
Collapse
Affiliation(s)
- Mitchell Kirwan
- Edson College of Nursing and Health Innovation, Arizona State University
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | | |
Collapse
|
14
|
Neilson EC, Smith L, Davis KC, George WH. Acute Alcohol Intoxication, State Anger, and Sexual Assault Perpetration: The Role of State Emotion Regulation. Psychol Violence 2022; 12:42-51. [PMID: 35509850 PMCID: PMC9060544 DOI: 10.1037/vio0000381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Alcohol-involved sexual assault remains a pervasive problem, with extensive individual- and societal-level costs. Emotion regulation (ER), the process through which an individual modulates emotional states, remains an understudied predictor of sexual assault perpetration, with past research focusing on general ER tendencies (e.g., trait ER) as predictors of sexual assault perpetration. This study sought to examine the associations between state ER on sexual assault perpetration in the context of state anger and acute alcohol intoxication. METHOD Single, male social drinkers aged 21-30 with a history of sexual risk-taking (N = 92) participated in an alcohol administration paradigm and were randomly assigned to an alcohol condition [sober control vs. intoxicated (BrAC = .10%)]. Intoxicated and sober participants completed a sexual assault analogue that assessed state anger, state ER, and sexual assault perpetration intentions against a hypothetical female partner. RESULTS Path analysis demonstrated interactive effects of state ER and state anger on sexual assault perpetration intentions. Relative to men with low and moderate levels of anger, state ER was associated with lower intentions to perpetrate sexual assault for men with high levels of anger. Alcohol intoxication did not directly predict state ER, state anger, or sexual assault perpetration intentions. CONCLUSIONS The results suggested that state ER may be protective against sexual assault perpetration for men who experience anger in response to a partner's expression of non-consent. Because replication is necessary, the results carry tentative implications for state ER as an intervention target for sexual assault prevention programming.
Collapse
Affiliation(s)
- Elizabeth C. Neilson
- Morehead State University, Department of Psychology, Morehead, KY 40351
- University of Washington, Department of Psychology, Seattle, WA 98195
| | - Lauren Smith
- University of Washington, Department of Psychology, Seattle, WA 98195
| | - Kelly Cue Davis
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004
| | - William H. George
- University of Washington, Department of Psychology, Seattle, WA 98195
| |
Collapse
|
15
|
George WH, Blayney JA, Stappenbeck CA, Davis KC. The Role of Alcohol-Related Behavioral Risk in the Design of HIV Prevention Interventions in the Era of Antiretrovirals: Alcohol Challenge Studies and Research Agenda. AIDS Behav 2021; 25:347-364. [PMID: 34244871 DOI: 10.1007/s10461-021-03351-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/29/2022]
Abstract
HIV/AIDS remains a significant health threat and alcohol is a robust contributing factor. After 25 years of alcohol challenge studies investigating alcohol-related behavioral risk (ARBR), much has been learned delineating how drinking influences sexual transmission. We examine this research and consider its relevance for interventions in the era of antiretrovirals. We consider prototypic alcohol challenge methods, illustrative findings, and prevention/intervention implications, noting three perspectives: (a) scale up/extend existing interventions, including identifying under-targeted risk groups and intersecting with PrEP/PEP interventions; (b) modify existing interventions by cultivating psychoeducational content related to alcohol expectancies, alcohol myopia, sexual arousal, risk perception, sexual abdication, and condom use resistance; and (c) innovate new interventions through Science of Behavior Change approaches and repurposing ARBR paradigms. Finally, we suggest research directions concluding that until HIV incidence diminishes significantly, psychosocial interventions addressing the nexus of alcohol use, sexual transmission, and adherence to biomedical protocols will be an important priority.
Collapse
Affiliation(s)
- William H George
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195-1525, USA.
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Cynthia A Stappenbeck
- Department of Psychology, Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| |
Collapse
|
16
|
Neilson EC, Gilmore AK, Stappenbeck CA, Gulati NK, Neilon E, George WH, Davis KC. Psychological Effects of Abuse, Partner Pressure, and Alcohol: The Roles of in-the-Moment Condom Negotiation Efficacy and Condom-Decision Abdication on Women's Intentions to Engage in Condomless Sex. J Interpers Violence 2021; 36:NP9416-NP9439. [PMID: 31246143 PMCID: PMC6933097 DOI: 10.1177/0886260519857160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Women's experiences of intimate partner violence (IPV) from their male partners can include psychological, physical, and sexual control and abuse. The psychological effects of abuse (PEA) include terror, shame, and loss of power and control in relationships. While women's experiences of IPV are associated with decreased condom use, limited research has examined the impact of PEA on women's condom use. Intoxicated (breath alcohol content [BrAC] = .10%) versus sober women were evaluated to test the hypothesis that PEA would interact with intoxication and scenario-context partner pressure to forgo condom use and be associated with intentions to engage in condomless sex. After beverage administration, community women (N = 405) projected themselves into a computerized scenario depicting a male partner exerting high or low pressure for condomless sex. In-the-moment condom negotiation self-efficacy and condom-decision abdication-letting the man decide on condom use-were assessed. Path analysis examined the direct and indirect effects of PEA, alcohol, and partner pressure conditions on condomless sex intentions. PEA increased condomless sex intentions indirectly through decreased condom negotiation self-efficacy. Intoxication increased condomless sex intentions indirectly through decreased condom negotiation self-efficacy and increased condom-decision abdication. Intoxicated women in the low pressure condition were more likely to abdicate the condom decision than women in the high pressure condition. Women who have experienced greater PEA may benefit from interventions focusing on how condom negotiation self-efficacy, condom-decision abdication, and intoxication influence sexual decision-making.
Collapse
Affiliation(s)
- Elizabeth C Neilson
- Department of Psychology, University of Washington, Seattle, WA, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Amanda K Gilmore
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, SC, USA
| | - Cynthia A Stappenbeck
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Natasha K Gulati
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Erin Neilon
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - William H George
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Kelly C Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| |
Collapse
|
17
|
Nguyen HV, Schacht RL, Yang JP, George WH, Pantalone DW. Asian American Women's Victimization History and In-The-Moment Responses to Partner Violence. J Interpers Violence 2021; 36:NP3080-NP3103. [PMID: 29673304 DOI: 10.1177/0886260518770186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Between 20% and 50% of Asian American women report experiencing partner violence (PV). Furthermore, nearly half of PV victims experience their first assault between the age of 18 and 24 years, suggesting that Asian American college women may be particularly at risk of PV. Experiencing childhood abuse (CA) may impair women's capacity to perceive risk during a potential PV situation, increasing their risk for revictimization. The purpose of the current study was to examine differences among Asian American college women's (N = 324) in-the-moment behavioral intention, risk perception, and likelihood to stay in an abusive relationship during a progressively threatening PV scenario, based on victimization history and posttraumatic stress disorder (PTSD) symptoms. We tested three path models, each assessing the relations among CA, PV, PTSD, current and future risk perception, likelihood of staying in the relationship, and one of three behavioral intentions (soothe the perpetrator, escape, and escalation/resistance). As hypothesized, CA history positively predicted PV history and PTSD symptoms. Furthermore, CA and PV predicted more in-the-moment soothe behavioral intentions and fewer escape behavioral intentions which, in turn, predicted diminished current and future risk perception. CA and PV also predicted stronger escalation/resistance behavioral intentions, such that escalation/resistance intentions were associated with higher risk perception during a more violent part of the scenario but lower risk perception during a less violent part of the scenario. Finally, higher risk perception predicted lower likelihood of staying in the relationship. Findings indicate that victimization history is associated with increased risky behavioral intentions among Asian American college women and suggest that targeted interventions to improve assault-exposed Asian American women's awareness of risk cues may be warranted.
Collapse
Affiliation(s)
| | | | - Joyce P Yang
- VA Palo Alto Health Care System, CA, USA
- Stanford University, CA, USA
| | | | - David W Pantalone
- University of Massachusetts Boston, USA
- Fenway Health, Boston, MA, USA
| |
Collapse
|
18
|
Gulati NK, Stappenbeck CA, George WH, Davis KC. Predicting rape events: The influence of intimate partner violence history, condom use resistance, and heavy drinking. Aggress Behav 2021; 47:69-77. [PMID: 32864752 DOI: 10.1002/ab.21927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 08/03/2020] [Accepted: 08/14/2020] [Indexed: 11/11/2022]
Abstract
Sexual aggression perpetration is a public health epidemic, and burgeoning research aims to delineate risk factors for individuals who perpetrate completed rape. The current study investigated physical and psychological intimate partner violence (IPV) history, coercive condom use resistance (CUR), and heavy episodic drinking (HED) as prospective risk factors for rape perpetration. Young adult men (N = 430) ages 21-30 completed background measures as well as follow-up assessments regarding rape events perpetrated over the course of 3 months. Negative binomial regression with log link function was utilized to examine whether these risk factors interacted to prospectively predict completed rape. There was a significant interaction between physical IPV and HED predicting completed rape; men with high HED and greater physical IPV histories perpetrated more completed rapes during follow-up than men with low HED at the same level of physical IPV. Moreover, psychological IPV and coercive CUR interacted to predict completed rape such that men with high coercive CUR and greater psychological IPV histories perpetrated more completed rapes throughout the follow-up period than men with low coercive CUR at the same level of psychological IPV. Findings suggest targets for intervention efforts and highlight the need to understand the topography of different forms of aggression perpetration.
Collapse
Affiliation(s)
- Natasha K. Gulati
- Department of Psychology University of Washington Seattle Washington
| | | | - William H. George
- Department of Psychology University of Washington Seattle Washington
| | - Kelly C. Davis
- Edson College of Nursing and Health Innovation Arizona State University Phoenix Arizona
| |
Collapse
|
19
|
Davis KC, Neilson EC, Kirwan M, Eldridge N, George WH, Stappenbeck CA. Alcohol-involved sexual aggression: Emotion regulation as a mechanism of behavior change. Health Psychol 2020; 40:940-950. [PMID: 33252964 DOI: 10.1037/hea0001048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Sexual aggression remains a significant public health problem, with the majority of sexual assaults involving alcohol. Founded upon an experimental medicine approach to behavior change, the current study used a proximal change experiment to target and test emotion regulation (ER) as a mechanism underlying alcohol-involved sexual aggression. METHOD Heavy episodic drinking men aged 21-30 with a sexual assault perpetration history (N = 209) were randomly assigned to a brief, online, ER-focused cognitive restructuring or mindfulness intervention or to control. Intervention effects were evaluated during sober and intoxicated states through laboratory-based alcohol administration (target BrAC = .08%). Intoxicated and sober participants completed a proximal change protocol that included implementing ER skills during a sexual aggression analogue that assessed relevant emotions and intentions. RESULTS Path analysis demonstrated that relative to control, the cognitive restructuring intervention improved emotional modulation and emotional clarity, resulting in lower sexual arousal and anger, respectively, followed by decreased sexual coercion intentions. The mindfulness intervention yielded mixed results, predicting decreased sexual aggression intentions compared to control but also predicting stronger coercive tactic intentions in intoxicated men with more severe sexual aggression histories. Both interventions improved emotional acceptance relative to control, but only for sober men. CONCLUSIONS Overall, the current study demonstrated that ER-focused interventions improved proximal ER skills associated with reduced sexual aggression intentions, signifying ER as an important mechanism for changing sexually aggressive behavior. Because intervention efficacy varied by intoxication state, further research is needed to assess the effectiveness of ER interventions targeting real-world alcohol-involved sexual aggression. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | - Mitchell Kirwan
- Edson College of Nursing and Health Innovation, Arizona State University
| | - Nolan Eldridge
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | | |
Collapse
|
20
|
Stappenbeck CA, Norris J, Wegner R, Bryan AEB, Davis KC, Zawacki T, Abdallah DA, George WH. An Event-Level Investigation of Factors Associated With Young Women's Experiences of Coerced Consensual Sex. J Interpers Violence 2020; 35:384-402. [PMID: 29294628 PMCID: PMC5756142 DOI: 10.1177/0886260516683178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Little is known about instances of coerced consensual sex in which women report both that they consented to have sex and that their partner used coercive tactics (e.g., made threats) to get them to have sex when they did not want to. Yet, these experiences are frequently reported by young sexually active women. We examined the relationship between sexual victimization history and the woman's level of alcohol intoxication in the likelihood of experiencing coerced consensual sex using event-level data collected over a 1-year period from 548 young adult nonproblem drinking women who engaged in sexual activity with men. Twenty percent (n = 112) reported at least one incident of coerced consensual sex. A generalized estimating equation model revealed main effects of daily estimated blood alcohol content (eBAC) and sexual victimization severity. The more women increased their alcohol consumption above their own average and the more severe their sexual victimization history, the more likely they were to experience coerced consensual sex. Our findings highlight the fact that coercion and consent are not mutually exclusive in some situations and shed light on this important yet understudied coercive sexual experience.
Collapse
|
21
|
Abstract
Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women's sexual victimization history and men's condom use resistance. Limitations and implications associated with this body of research are also discussed.
Collapse
|
22
|
Davis KC, Stappenbeck CA, Masters NT, George WH. Young Women's Experiences with Coercive and Noncoercive Condom Use Resistance: Examination of an Understudied Sexual Risk Behavior. Womens Health Issues 2019; 29:231-237. [PMID: 30826133 DOI: 10.1016/j.whi.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/21/2018] [Accepted: 01/24/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate young women's engagement in and receipt of condom use resistance (CUR; attempts to avoid condom use with a partner who wants to use one), including nonconsensual condom removal ("stealthing"), with male partners. METHODS Participants were 503 women aged 21-30 years with increased sexual risk characteristics recruited from 2013 to 2017. Participants completed measures assessing sexual victimization history and CUR experiences. RESULTS Findings indicated that 87% of women experienced noncoercive CUR from a partner and 49% experienced coercive CUR. Of these women, 58% and 19% reported having engaged in noncoercive and coercive CUR, respectively. Twelve percent of women had a partner engage in stealthing; none of the women engaged in stealthing. The severity of sexual victimization history was positively associated with both use and receipt of coercive and noncoercive CUR. Diagnoses of sexually transmitted infections were positively associated with receipt of, but not engagement in, CUR. CONCLUSIONS Findings demonstrate that sexual victimization and both the use and receipt of CUR are positively related for young women, suggesting that prevention efforts focusing on women's sexual health would benefit from joint consideration of sexual violence and risk behaviors and that such efforts should target victims of sexual violence.
Collapse
Affiliation(s)
- Kelly Cue Davis
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona.
| | - Cynthia A Stappenbeck
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - N Tatiana Masters
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, Washington
| | - William H George
- Department of Psychology, University of Washington, Seattle, Washington
| |
Collapse
|
23
|
Bird ER, Stappenbeck CA, Neilson EC, Gulati NK, George WH, Cooper ML, Davis KC. Sexual Victimization and Sex-Related Drinking Motives: How Protective is Emotion Regulation? J Sex Res 2019; 56:156-165. [PMID: 30247943 PMCID: PMC6368457 DOI: 10.1080/00224499.2018.1517206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
One in five college women experience sexual victimization (SV), and SV severity is associated with subsequent psychological distress, including sex-related distress. SV severity may also be associated with drinking motives to cope with sex-related distress and to enhance sex (sex-related drinking motives [SRDMs]), particularly if individuals suffer from emotion regulation (ER) difficulties. College women (N = 151) completed a survey assessment of ER, SV history, childhood sexual abuse (CSA), and SRDMs. Twelve regression models assessed six facets of ER as moderators between SV severity and SRDMs. Among women with no or low levels of prior SV severity, women with greater access to ER strategies were less likely to endorse drinking to cope SRDMs. At higher levels of SV severity, women at all levels of access to ER strategies were equally likely to endorse drinking to cope SRDMs, suggesting that access to ER strategies did not mitigate motivations to drink to cope with sex-related distress for these women. Women with severe SV histories may benefit from interventions that build on existing ER strengths or address other factors. However, greater access to ER strategies may serve as a protective factor against SRDMs when SV severity is low.
Collapse
Affiliation(s)
| | | | | | | | | | - M. Lynne Cooper
- University of Missouri, Department of Psychological Sciences
| | - Kelly Cue Davis
- Arizona State University, College of Nursing and Health Innovation
| |
Collapse
|
24
|
Abstract
Transgender (trans) individuals have historically been left out of research, and previous work has often conflated gender identity with sexual orientation. Furthermore, language used in psychology measures is often heteronormative and uses binary gendered language (e.g., "him"/"her"). The aim of the current study was to provide empirically derived guidance on conducting culturally sensitive research with transgender participants using qualitative data. We recruited trans individuals, ages 18 to 44, to participate in an anonymous, qualitative, national online survey as part of a quantitative study on the relationships among minority stress, sexual behavior, and mental health. The qualitative portion included four open-ended feedback questions. We identified four overarching themes regarding experiences with our survey: (a) emotional reaction; (b) insight gained; (c) being outside the box; and (d) value of the work. Research with trans adults should be more inclusive of diverse gender identities, sexual identities, and sexual behaviors. Steps in this direction may include soliciting feedback from community members regarding survey language and response options, allowing participants to contextualize their responses using open-ended questions, and clarifying language to distinguish between sexual behavior and sexual identity. A list of seven preliminary guidelines was proposed to aid scientists in conducting culturally sensitive research with trans individuals.
Collapse
|
25
|
Bird ER, Seehuus M, Heiman JR, Davis KC, Norris J, George WH. Sexual vs. Nonsexual Currently Most Upsetting Trauma: A Fresh Look at Attenuation of Sexual Response, Alcohol Intoxication, and Post-Traumatic Stress. J Sex Res 2018; 55:915-926. [PMID: 29023137 PMCID: PMC6195219 DOI: 10.1080/00224499.2017.1380159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined the dependence of sexual response (vaginal pulse amplitude [VPA] and subjective sexual arousal) on alcohol intoxication (.10% breath alcohol concentration [BrAC] versus no alcohol) and the nature of a woman's currently most upsetting traumatic event (C-MUTE), whether it was sexual (e.g., rape) or nonsexual (e.g., combat). Self-reported sexual outcomes were also compared by C-MUTE type. A total of 117 women completed background measures and either drank alcoholic or nonalcoholic beverages. They were shown erotic films and their VPA was assessed. A two (sexual versus nonsexual C-MUTE) by two (.10% BrAC versus no alcohol) analysis of variance (ANOVA) showed that, controlling for post-traumatic stress (PTS) symptoms, women with a sexual C-MUTE showed lower percent VPA change than women with a nonsexual C-MUTE. No significant effects were found for subjective sexual arousal. A multivariate analysis of variance (MANOVA) showed that women with a sexual C-MUTE reported more frequent anxiety and inhibition during partnered sex and more frequent lack of vaginal lubrication versus women with a nonsexual C-MUTE. There was no significant interaction between C-MUTE and alcohol intoxication. Whether a woman is currently upset by past sexual victimization may influence current sexual difficulties. Attenuated VPA may be attributable to the sexual nature of a C-MUTE as opposed to general trauma exposure.
Collapse
Affiliation(s)
| | | | - Julia R Heiman
- c Psychological and Brain Sciences , Indiana University
- d The Kinsey Institute , Indiana University
| | | | - Jeanette Norris
- f Alcohol and Drug Abuse Institute , University of Washington
| | | |
Collapse
|
26
|
Gilmore AK, Maples-Keller JL, Pinsky HT, Shepard ME, Lewis MA, George WH. Is the Use of Protective Behavioral Strategies Associated With College Sexual Assault Victimization? A Prospective Examination. J Interpers Violence 2018; 33:2664-2681. [PMID: 26856359 PMCID: PMC4977210 DOI: 10.1177/0886260516628808] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Sexual assault protective behavioral strategies (PBS) may be negatively associated with sexual assault victimization. However, no studies to date have prospectively examined whether the use of sexual assault PBS is negatively associated with subsequent sexual assault experiences. The current study examined the association between the use of sexual assault PBS and subsequent sexual assault victimization severity. College women who reported engaging in heavy episodic drinking ( n = 77) were assessed online for their use of sexual assault PBS and history of sexual assault victimization. In addition, a 3-month follow-up survey was given assessing sexual assault victimization severity in the past 3 months. The use of sexual assault PBS was negatively associated with sexual assault severity in the 3-month follow-up period. Future research should further examine these PBS to create more college-specific PBS and to determine whether they are useful as risk-reduction strategies.
Collapse
Affiliation(s)
- Amanda K. Gilmore
- Medical University of South Carolina, Charleston, USA
- University of Washington, Seattle, USA
| | | | | | | | | | | |
Collapse
|
27
|
Gilmore AK, Bountress KE, Selmanoff M, George WH. Reducing Heavy Episodic Drinking, Incapacitation, and Alcohol-Induced Blackouts: Secondary Outcomes of a Web-Based Combined Alcohol Use and Sexual Assault Risk Reduction Intervention. Violence Against Women 2018; 24:1299-1313. [PMID: 30078370 DOI: 10.1177/1077801218787934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Heavy episodic drinking, alcohol-induced blackouts, and incapacitation are associated with sexual assault among college women. Therefore, reducing heavy episodic drinking, alcohol-induced blackouts, and incapacitation among college women may reduce sexual assault victimization risk. The current study examined the indirect effect of a combined alcohol use and sexual assault risk reduction program on sexual assault severity through heavy episodic drinking, alcohol-induced blackouts, and incapacitation ( n = 264). An alcohol use reduction program, sexual assault risk reduction program, and combined alcohol use and sexual assault risk reduction program were compared with a control condition. The sexual assault risk reduction content reduced alcohol-induced blackouts and incapacitation, and the combined alcohol use and sexual assault risk reduction program reduced alcohol-induced blackouts. Only incapacitation was associated with reduced sexual assault severity at follow-up. Reducing incapacitation and alcohol-induced blackouts is possible with a brief, web-based intervention, and reducing incapacitation may be one viable strategy within larger sexual assault prevention programming efforts.
Collapse
Affiliation(s)
- Amanda K Gilmore
- 1 College of Nursing, Medical University of South Carolina, Charleston, SC, USA.,2 Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kaitlin E Bountress
- 3 Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Mollie Selmanoff
- 2 Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - William H George
- 4 Department of Psychology, University of Washington, Seattle, WA, USA
| |
Collapse
|
28
|
Jaffe AE, Bountress KE, Metzger IW, Maples-Keller JL, Pinsky HT, George WH, Gilmore AK. Student engagement and comfort during a web-based personalized feedback intervention for alcohol and sexual assault. Addict Behav 2018; 82:23-27. [PMID: 29477903 DOI: 10.1016/j.addbeh.2018.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/16/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate individual engagement and comfort during a web-based intervention for alcohol and sexual assault risk reduction. METHODS Participants were 264 college women (aged 18-20) who reported engaging in heavy episodic drinking in the past month. Participants were randomized to either an intervention condition (alcohol, sexual assault risk reduction, or combined) or a control condition (full or minimal assessment). Participants rated their experiences during the procedures following the assessment or receipt of the intervention depending on condition. Survey usage information (e.g., time data, completion of intervention) was automatically recorded. RESULTS Most participants completed the intervention as intended (in a reasonable amount of time, in private, without consuming substances). Women with a sexual assault history were most comfortable in the sexual assault risk reduction intervention, whereas women who frequently engaged in heavy episodic drinking were least comfortable in the alcohol intervention condition. Self-reported distraction was not impacted by personal relevance of the intervention, but was associated with setting of participation. CONCLUSIONS Results suggest that most college women completed web-based personalized feedback interventions as designed, despite minimal discomfort.
Collapse
|
29
|
Staples JM, Neilson EC, Bryan AEB, George WH. The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults. J Sex Res 2018; 55:591-603. [PMID: 29148860 DOI: 10.1080/00224499.2017.1393651] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity-internalization of negative societal attitudes about one's trans identity-in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.
Collapse
|
30
|
Davis KC, Masters NT, Casey E, Kajumulo KF, Norris J, George WH. How Childhood Maltreatment Profiles of Male Victims Predict Adult Perpetration and Psychosocial Functioning. J Interpers Violence 2018; 33:915-937. [PMID: 26590221 PMCID: PMC4874905 DOI: 10.1177/0886260515613345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study used latent class analysis to empirically identify subgroups of men based on their exposure to childhood maltreatment (i.e., emotional neglect and abuse, physical neglect and abuse, and sexual abuse). It then examined subgroups' differential perpetration of adult intimate partner violence (IPV; both psychological and physical), violence against peers, and sexual assault. Finally, we compared sociodemographic variables and psychosocial functioning across profiles to characterize the adult experiences of men in different maltreatment groups. The community sample consisted of 626 heterosexually active 21- to 30-year-old men. We identified four subgroups: Low Maltreatment (80% of the sample), Emotional and Physical Maltreatment (12%), Emotional and Sexual Maltreatment (4%), and Poly-Victimized (4%). The Low Maltreatment group had significantly lower IPV perpetration rates than the Emotional and Physical Maltreatment group, but groups did not significantly differ on peer violence or sexual assault perpetration rates. Overall, Poly-Victimized men were significantly worse off than the Low Maltreatment group regarding income, education level, and incarceration history. Their rates of recent anxiety and depression symptoms were also higher than those of Low Maltreatment men. Findings support the use of person-oriented techniques for deriving patterns of childhood maltreatment and how these patterns relate to psychological, behavioral, and social factors in adulthood.
Collapse
Affiliation(s)
| | | | - Erin Casey
- 1 University of Washington, Seattle, WA, USA
| | | | | | | |
Collapse
|
31
|
Neilson EC, Bird ER, Metzger IW, George WH, Norris J, Gilmore AK. Understanding sexual assault risk perception in college: Associations among sexual assault history, drinking to cope, and alcohol use. Addict Behav 2018; 78:178-186. [PMID: 29179154 DOI: 10.1016/j.addbeh.2017.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/12/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Sexual assault history and alcohol use are associated with higher likelihood of subsequent sexual assault. Alcohol use and drinking to cope are associated with re-assault, but it is unclear whether these factors are associated with malleable constructs like sexual assault risk perception. This study examined typical weekly drinking and drinking to cope motive as factors underlying the association between sexual assault history and risk perception. METHODS Both perceived likelihood of experiencing incapacitated sexual assault and when to leaving a hypothetical sexual assault scenario were assessed as indicators of sexual assault risk perception. 660 female college students recruited from psychology courses completed questionnaires online. RESULTS Results revealed that sexual assault history severity was positively associated with perceived incapacitated sexual assault likelihood and when to leave a risky scenario. Drinking to cope with anxiety was positively associated with perceived incapacitated sexual assault likelihood. Among women who reported regular drinking, typical weekly drinking was positively associated with when to leave a risky scenario, such that women who reported more weekly drinks stayed in a potentially risky scenario longer than women who reported fewer weekly drinks. CONCLUSIONS These findings suggest that alcohol use and drinking to cope with anxiety are associated with risk perception. Sexual assault history was associated with both perceived incapacitated sexual assault likelihood and when to leave a hypothetical scenario. Alcohol use and drinking to cope are two potential points of intervention for sexual assault risk reduction programs, but further examination is needed.
Collapse
|
32
|
Staples JM, Neilson EC, George WH, Flaherty BP, Davis KC. A descriptive analysis of alcohol behaviors across gender subgroups within a sample of transgender adults. Addict Behav 2018; 76:355-362. [PMID: 28903090 DOI: 10.1016/j.addbeh.2017.08.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 06/10/2017] [Accepted: 08/17/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Transgender (trans) adults are identified as an at-risk group for problem alcohol use. Descriptive empirical data examining alcohol behaviors among trans adults is limited. The present study investigates alcohol behaviors - quantity, frequency, alcohol-related problems, and drinking to cope motives - across sex assigned at birth, gender expression, and gender identity subgroups within a sample of trans adults. METHOD A total of 317 trans participants were recruited to complete a cross-sectional battery of online measures assessing alcohol use behaviors, alcohol-related problems, and drinking to cope. Gender identity was assessed through two methods: (1) an open-ended question in which participants wrote-in their primary gender identity; and (2) participants rated the extent to which they identified with 14 gender identity categories. RESULTS This sample had high rates of alcohol use, alcohol-related problems, and drinking to cope motives relative to the general population. Significant and meaningful differences in drinking frequency, alcohol-related problems and drinking motives were found according to gender expression, but not sex assigned at birth or gender identity. CONCLUSIONS Future work should examine alcohol behaviors among trans individuals, including investigation of predictors and causal pathways, to inform prevention and intervention work aimed at reducing trans people's risk for alcohol-related problems.
Collapse
Affiliation(s)
- Jennifer M Staples
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - Elizabeth C Neilson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - William H George
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - Brian P Flaherty
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - Kelly Cue Davis
- College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ 85004, United States.
| |
Collapse
|
33
|
Wegner R, Davis KC, Stappenbeck CA, Kajumulo KF, Norris J, George WH. The Effects of Men's Hostility Toward Women, Acute Alcohol Intoxication, and Women's Condom Request Style on Men's Condom Use Resistance Tactics. Psychol Violence 2017; 7:593-601. [PMID: 29242755 PMCID: PMC5724380 DOI: 10.1037/vio0000069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To extend previous research demonstrating that intoxicated men high in hostility toward women report stronger intentions to use coercive condom use resistance (CUR) tactics to have unprotected sex by examining the role of women's condom request style. METHODS Community, non-problem drinking men, ages 21-30 (N = 296) completed standard alcohol administration procedures and read an eroticized story of a casual sexual interaction. Following the woman's request to use a condom, intentions to engage in coercive CUR tactics were assessed. Generalized linear models with gamma distributions assessed the 3-way interaction of men's hostility toward women, beverage condition (alcohol or sober), and the woman's condom request style (indirect, direct, or insistent). RESULTS The 3-way interaction between hostility toward women, beverage condition, and indirect condom request (vs. direct) significantly predicted men's coercive CUR intentions. Men high in hostility toward women reported stronger CUR intentions after experiencing an indirect condom request, when sober or intoxicated, and after a direct condom request when intoxicated. Men high in hostility toward women reported the weakest CUR intentions when sober following an insistent or direct condom request. CONCLUSIONS Men high in hostility toward women pose a threat to women's sexual safety, particularly when intoxicated or following an indirect condom request. Hostility toward women and alcohol consumption should be addressed in sexual risk prevention programs. Pending further replication, women should be informed of the relative effectiveness of using insistent condom requests.
Collapse
Affiliation(s)
- Rhiana Wegner
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | | | | | | | | |
Collapse
|
34
|
Neilson EC, Eakins DR, Davis KC, Norris J, George WH. Depressive Symptoms, Acute Alcohol Intoxication, and Risk Rationale Effects on Men's Condom Use Resistance. J Sex Res 2017; 54:764-775. [PMID: 27547862 PMCID: PMC5526205 DOI: 10.1080/00224499.2016.1217500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the role of depressive symptoms, acute intoxication, and risk rationale in men's use of condom use resistance (CUR) tactics in an experimental study. Participants included 313 heterosexual male, nonproblem drinkers, ages 21 to 30. Participants were randomized to one of four beverage conditions: no alcohol, placebo, low (.04%) alcohol dose, or high (.08%) alcohol dose. They read an eroticized scenario depicting a consensual sexual encounter with a female partner who requested a condom to prevent either pregnancy or sexually transmitted infections (STIs) (risk rationale) and then indicated their intentions to use 10 different CUR tactics. Hypotheses related to the pharmacological, dosage, and expectancy effects of alcohol were tested in a generalized linear model. In intoxicated (.04% and .08%) men who were given a pregnancy risk rationale, depressive symptoms were associated with stronger intentions to use CUR tactics than in sober (control and placebo) men. Men who received a high alcohol dose (.08%) and who were given a pregnancy risk rationale reported higher intentions to use CUR tactics than those who received a lower alcohol dose (.04%). Findings suggest that the pharmacological effects of alcohol on men's likelihood to resist condoms vary by the saliency of the risk rationale and mood-related variables.
Collapse
Affiliation(s)
- Elizabeth C. Neilson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195
| | | | | | | | | |
Collapse
|
35
|
Bird ER, Gilmore AK, Stappenbeck CA, Heiman JR, Davis KC, Norris J, George WH. Women's Sex-Related Dissociation: The Effects of Alcohol Intoxication, Attentional Control Instructions, and History of Childhood Sexual Abuse. J Sex Marital Ther 2017; 43:121-131. [PMID: 26735683 PMCID: PMC4935630 DOI: 10.1080/0092623x.2015.1124304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study examined influences of alcohol intoxication, attentional control, and childhood sexual abuse (CSA) severity on sex-related dissociation. Sex-related dissociation is defined here as dissociation (e.g., feeling as if the world is unreal and feeling disconnected from one's body) during sexual activity or in the presence of sexual stimuli. Women (N = 70) were randomized to a 2 (alcohol condition: none,.10% peak breath alcohol concentration) X 2 (attentional control instructions: none, "relax and maximize" sexual arousal) experiment and exposed to sexual stimuli. Alcohol intoxication was positively associated with sex-related dissociation. CSA severity and sex-related dissociation were positively associated in the no-instruction condition but not in the "relax and maximize" condition. For some women, efforts to relax and maximize sexual arousal may buffer the association between CSA and sex-related dissociation.
Collapse
Affiliation(s)
- Elizabeth R Bird
- a Department of Psychology, University of Washington , Seattle , Washington , USA
| | - Amanda K Gilmore
- b Department of Psychiatry and Behavioral Science, Medical University of South Carolina , Charleston , South Carolina , USA
| | | | - Julia R Heiman
- d Department of Psychological and Brain Sciences, Indiana University and the Kinsey Institute , Bloomington , Indiana , USA
| | - Kelly Cue Davis
- e School of Social Work, University of Washington , Seattle , Washington , USA
| | - Jeanette Norris
- f Alcohol and Drug Abuse Institute, University of Washington , Seattle , Washington , USA
| | - William H George
- a Department of Psychology, University of Washington , Seattle , Washington , USA
| |
Collapse
|
36
|
George WH, Davis KC. Does Alcohol Really Contribute to College Men’s Sexual Assault Perpetration? A Commentary on Testa and Cleveland (2017). J Stud Alcohol Drugs 2017; 78:16-17. [DOI: 10.15288/jsad.2017.78.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
37
|
Masters NT, Stappenbeck CA, Kaysen D, Kajumulo KF, Davis KC, George WH, Norris J, Heiman JR. A person-centered approach to examining heterogeneity and subgroups among survivors of sexual assault. J Abnorm Psychol 2016; 124:685-96. [PMID: 26052619 DOI: 10.1037/abn0000055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M = 24.78, SD = 2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across 2 cohorts of women using multiple-group LCA: contact or attempted assault (17% of the sample), incapacitated assault (52%), and forceful severe assault (31%). Groups did not differ in their sexual risk/safety behavior. Women in the forceful severe category had higher levels of anxiety, depression, and trauma symptoms; higher proportions of incarceration and transactional sex; and more experiences with controlling and violent partners than did women in the other 2 groups. Women in the forceful severe category also reported a higher frequency of HED than women in the incapacitated category. Different types of assault experiences appear to be differentially associated with negative outcomes. Understanding heterogeneity and subgroups among sexual assault survivors has implications for improving clinical care and contributing to recovery.
Collapse
Affiliation(s)
| | | | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | | | | | | | - Julia R Heiman
- The Kinsey Institute Research in Sex, Gender, and Reproduction, Psychological & Brain Sciences, Indiana University
| |
Collapse
|
38
|
|
39
|
Abstract
Using explicit, self-report measures, past research has found that heterosexual men, relative to heterosexual women, often attribute more sexuality to women's behaviors. In the present studies, the Implicit Association Test was used to determine if these findings held at the automatic processing level. The results of Study 1 were consistent with past research: Men, compared to women, had more sexual and less friendly automatic associations with the concept of women. Gender differences, however, were not observed in associations with the concept of self or men. Study 2 investigated how exposure to a dating context affected these associations. Associations about the self became more sexualized after reading about a first date, regardless of the participants' gender. However, for opposite-sex others, men's associations became less sexualized whereas women's associations became more sexualized. Collectively, these studies shed light on chronic and temporarily activated automatic processes relevant to sexual perception and contexts in which women are oversexualized.
Collapse
|
40
|
Norris J, Davis KC, George WH, Martell J, Heiman JR. Victim's Response and Alcohol-Related Factors as Determinants of Women's Responses to Violent Pornography. Psychology of Women Quarterly 2016. [DOI: 10.1111/j.1471-6402.2004.00123.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Women suffer a variety of detrimental effects from exposure to violent pornography. This study examined the role of specific situational cues embedded within a violent pornographic story, as well as alcohol consumption and alcohol expectancies, to determine potential mechanisms through which these effects occur. Female social drinkers ( N = 123), recruited from the community at large, participated in a between-subjects factorial experiment varying two situational cues—victim response (pleasure vs. distress) and story character beverage consumption (alcohol vs. mineral water)—and participant beverage consumption (alcohol vs. placebo vs. tonic). Results indicate that participants' identification with the victim plays a key role in affecting their responses and that alcohol-related factors appear to exacerbate the negative impact of pornography.
Collapse
Affiliation(s)
| | | | | | - Joel Martell
- Department of Psychology, University of Washington
| | | |
Collapse
|
41
|
Stappenbeck CA, George WH, Staples J, Nguyen H, Davis KC, Kaysen D, Heiman JR, Masters NT, Norris J, Danube CL, Gilmore AK, Kajumulo KF. In-The-Moment Dissociation, Emotional Numbing, and Sexual Risk: The Influence of Sexual Trauma History, Trauma Symptoms, and Alcohol Intoxication. Psychol Violence 2016; 6:586-595. [PMID: 28239507 PMCID: PMC5321660 DOI: 10.1037/a0039978] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Prior research on the effects of sexual trauma has examined dissociation but not emotional numbing during sex and has relied exclusively on retrospective surveys. The present experiment examined associations among distal factors of childhood sexual abuse (CSA), adolescent/adult sexual assault (ASA), and trauma symptoms and the proximal factor of acute alcohol intoxication on in-the-moment dissociation, emotional numbing, and sexual risk intentions. METHOD Young adult female drinkers (N = 436) at elevated sexual risk were randomized to receive alcohol (target peak breath alcohol concentration = .10%) or no alcohol. They then read an eroticized sexual scenario and reported on their dissociation and emotional numbing experiences, unprotected sex refusal self-efficacy, and unprotected sex intentions. RESULTS Path analysis revealed that CSA was indirectly associated with increased unprotected sex intentions through increased ASA severity, increased trauma-related symptoms, increased emotional numbing, and decreased unprotected sex refusal self-efficacy. Further, alcohol intoxication was indirectly associated with increased unprotected sex intentions through increased emotional numbing and decreased unprotected sex refusal self-efficacy. CONCLUSIONS Emotional numbing, but not dissociation, was associated with unprotected sex intentions and may be one potential target for interventions aimed at reducing HIV/STI-related risk among women with a history of sexual trauma.
Collapse
Affiliation(s)
| | | | | | - Hong Nguyen
- Department of Psychology, University of Washington
| | | | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Julia R Heiman
- Department of Psychological and Brain Sciences, Indiana University
| | | | | | - Cinnamon L Danube
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | | |
Collapse
|
42
|
Bryan AEB, Norris J, Abdallah DA, Zawacki T, Morrison DM, George WH, Davis KC, Danube CL, Stappenbeck CA. Condom-Insistence Conflict in Women's Alcohol-Involved Sexual Encounters with a New Male Partner. Psychol Women Q 2016; 41:100-113. [PMID: 29720782 DOI: 10.1177/0361684316668301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
First-time sexual intercourse with a new male partner, relative to other sexual encounters, is associated with heightened risk to women for contracting sexually transmitted infections. Little is known, however, about women's condom-related decision-making processes during these first-time sexual encounters. In the present study, we surveyed a community sample of 179 women aged 18-30 about their alcohol consumption, desire to use a condom, perception of their partner's desire to use a condom, condom-insistence conflict, and condom-decision abdication and use during their most recent alcohol-involved first-time sexual encounter with a new partner. With structural equation modeling we tested a cognitive mediation model with various configurations of alcohol effects on abdication and condom use (direct, indirect, moderator). A moderated mediation model fit the data best. Women experienced elevated condom-insistence conflict when they wanted to use a condom and perceived their partner did not; conflict, in turn, was associated with higher likelihood of abdication and lower likelihood of condom use. Higher alcohol intoxication attenuated the associations of desire to use a condom, and perceived partner's desire to use a condom, with conflict. Results support an alcohol myopia-conflict inhibition-reduction model and emphasize the importance of sex education programs that teach young women not only about condom-related assertiveness and the effects of alcohol, but also prepare them to respond to experiences of conflict that arise during sexual encounters.
Collapse
Affiliation(s)
| | | | | | - Tina Zawacki
- Department of Psychology, University of Texas at San Antonio
| | | | | | | | - Cinnamon L Danube
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | |
Collapse
|
43
|
Staples JM, Eakins D, Neilson EC, George WH, Davis KC, Norris J. Sexual Assault Disclosure and Sexual Functioning: The Role of Trauma Symptomatology. J Sex Med 2016; 13:1562-9. [PMID: 27590187 DOI: 10.1016/j.jsxm.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 07/25/2016] [Accepted: 08/03/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Previous research has demonstrated that a history of adult sexual assault (ASA) is associated with negative outcomes, including trauma symptomatology and fear of sexual intimacy. Disclosing sexual assault might be protective against such negative outcomes. AIM To examine the indirect effect of trauma symptomatology on the association between disclosing ASA and current sexual functioning. METHODS Participants included 652 women 21 to 30 years old with a history of ASA recruited from the community. Participants completed self-report measurements on a computer. MAIN OUTCOME MEASURES Separate models were performed, with sexual functioning divided into sexual desire, orgasm, and pain during sex. RESULTS ASA disclosure was indirectly associated with sexual orgasm and pain during sex by trauma symptomatology. However, there was no indirect effect of trauma symptomatology on the relation between ASA disclosure and sexual desire. CONCLUSION Disclosing experiences of ASA could serve a protective function by lessening trauma symptomatology, thereby mitigating impacts on aspects of sexual functioning, such as orgasm and pain.
Collapse
Affiliation(s)
| | - Danielle Eakins
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - William H George
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Kelly Cue Davis
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Jeanette Norris
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
| |
Collapse
|
44
|
Parkhill MR, Norris J, Gilmore AK, Hessler DM, George WH, Davis KC, Zawacki T. The Effects of Sexual Victimization History, Acute Alcohol Intoxication, and Level of Consensual Sex on Responses to Sexual Assault in a Hypothetical Scenario. Violence Vict 2016; 31:938-956. [PMID: 27523958 DOI: 10.1891/0886-6708.vv-d-14-00042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Assertive resistance to sexual assault can decrease the likelihood of completed rape and its subsequent aftermath; however, this relationship may be influenced by situational characteristics. This study examined how 2 manipulated variables, level of consensual sex during an encounter and acute alcohol intoxication, along with sexual victimization history, affected women's responses to a hypothetical sexual assault scenario. Female participants were assigned to a drink condition (alcohol/control) and to a consent history condition (low/high). Path analysis found that women who were previously victimized, consumed alcohol, and who were in the high consent condition endorsed greater immobility intentions during the assault; only level of consent predicted likelihood of assertive resistance. Resistance strategies were related to subsequent responding. Results suggest that interventions should seek to decrease negative consequences by empowering women to assertively resist unwanted sexual advances.
Collapse
|
45
|
Pinsky HT, Shepard ME, Bird ER, Gilmore AK, Norris J, Davis KC, George WH. Differences in Mental Health and Sexual Outcomes Based on Type of Nonconsensual Sexual Penetration. Violence Against Women 2016; 23:1039-1054. [PMID: 27486127 DOI: 10.1177/1077801216655624] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Little is known based on the stratification and localization of penetration type of rape: oral, vaginal, and/or anal. The current study examined associations between type of rape and mental and sexual health symptoms in 865 community women. All penetration types were positively associated with negative mental and sexual health symptoms. Oral and/or anal rape accounted for additional variance in anxiety, depression, some trauma-related symptoms, and dysfunctional sexual behavior than the association with vaginal rape alone. Findings suggest that penetration type can be an important facet of a rape experience and may be useful to assess in research and clinical settings.
Collapse
Affiliation(s)
- Hanna T Pinsky
- 1 Department of Psychology, University of Washington, Seattle, WA, USA.,2 University of Massachusetts, Amherst, MA, USA
| | - Molly E Shepard
- 1 Department of Psychology, University of Washington, Seattle, WA, USA.,3 Palo Alto University, Palo Alto, CA, USA
| | - Elizabeth R Bird
- 1 Department of Psychology, University of Washington, Seattle, WA, USA
| | - Amanda K Gilmore
- 1 Department of Psychology, University of Washington, Seattle, WA, USA.,4 Medical University of South Carolina, Charleston, SC, USA
| | - Jeanette Norris
- 1 Department of Psychology, University of Washington, Seattle, WA, USA.,5 Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
| | - Kelly Cue Davis
- 6 School of Social Work, University of Washington, Seattle, WA, USA
| | - William H George
- 1 Department of Psychology, University of Washington, Seattle, WA, USA
| |
Collapse
|
46
|
Gilmore AK, Granato HF, Wilson SM, George WH. Sexual Assault and Heavy Episodic Drinking Among Women of Asian/Pacific Islander Ancestry and Women of European Ancestry. Psychology of Women Quarterly 2016. [DOI: 10.1177/0361684316648312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Amanda K. Gilmore
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Hollie F. Granato
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Sarah M. Wilson
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - William H. George
- Department of Psychology, University of Washington, Seattle, WA, USA
| |
Collapse
|
47
|
Abstract
In this study we investigated how alcohol consumption affects women's responses to unwanted sexual advances in a hypothetical dating situation. Sixty female social drinkers participated in a 2 × 2 between-subjects experiment, which examined the effects of moderate alcohol intoxication and relationship characteristics on behavioral responses to unwanted sexual advances. Hypotheses were tested regarding the influence of inhibition conflict on intoxicated participants. As predicted, intoxicated women were more likely than sober women to consent to their dating partner's sexual advances in high conflict situations. Additionally, alcohol consumption increased women's estimated likelihood of responding passively. These findings aid in explicating the relationship between alcohol consumption and women's increased vulnerability to sexual assault.
Collapse
Affiliation(s)
| | | | - Jeanette Norris
- The Alcohol and Drug Abuse Institute, University of Washington
| |
Collapse
|
48
|
Abstract
This study investigated how 165 female college students appraised their sexual-assault risk in a hypothetical dating situation. A 2 × 2 × 2 between-subjects experiment investigating the effects of male-dating-partner characteristics, story character beverage consumption, and perspective on women's risk appraisals was conducted. Multivariate analyses of variance were performed to test hypotheses regarding the feelings of the dating woman and the occurrence of sexual behaviors. Although the dating woman was rated as feeling more vulnerable on dates when alcohol was consumed, alcohol consumption did not influence ratings regarding the dating man committing nonconsensual sexual acts. Nonconsensual sexual behaviors were rated as more probable when the man had rape-congruent characteristics and when the participants were judging another woman rather than themselves. These findings suggest that women are partially accurate in making sexual-assault risk appraisals and thus may benefit from rape prevention education that specifically targets their inaccuracies.
Collapse
|
49
|
Abstract
Stereotypes about Black sexuality fostered hypotheses that racial factors and racism influence rape victim blaming. Predominantly White and Asian college students (170 men, 162 women) completed the Modern Racism Scale and evaluated a rape vignette varying victim race, perpetrator race, and rape type. As predicted, racial factors determined victim blaming. Compared to intraracial rapes, interracial rapes were less uniformly judged as “definitely rape” and were judged as having more culpable and less credible victims, and less culpable perpetrators. For men, racism scores positively predicted victim blaming in all rapes. For women, racism scores moderated victim blaming in interracial acquaintance rapes. In our conclusions, we emphasize the durability of racial stereotypes about rape and their influence on discriminatory adjudication outcomes.
Collapse
|
50
|
Stoner SA, Norris J, George WH, Davis KC, Masters NT, Hessler DM. Effects of Alcohol Intoxication and Victimization History on Women's Sexual Assault Resistance Intentions: The Role of Secondary Cognitive Appraisals. Psychology of Women Quarterly 2016. [DOI: 10.1111/j.1471-6402.2007.00384.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study used an experimental paradigm to investigate the role of secondary cognitive appraisals in women's sexual assault resistance and whether these appraisals mediated influences of alcohol and prior victimization. After consuming a beverage (control, placebo, moderate, or high dose), 351 women projected themselves into a simulated interaction with a sexually aggressive man. Four types of secondary appraisals (shock at the man's behavior, concern about his feelings, uncertainty in the situation, conflict about what to do) and three resistance strategies (assertive, polite, passive) were examined. Path modeling revealed that, as expected, intoxication and prior sexual victimization influenced secondary appraisals, which in turn influenced intended resistance. Prior adult sexual assault (ASA) and childhood sexual abuse (CSA) also had direct effects: ASA negatively predicted assertive resistance and CSA positively predicted passivity. Findings suggest that secondary appraisals are key targets for intervention to facilitate effective resistance, thereby reducing the risk of adult sexual victimization.
Collapse
Affiliation(s)
| | | | | | - Kelly Cue Davis
- Department of Psychology, University of Washington
- Tatiana Masters and Kelly Davis are now at the School of Social Work, University of Washington
| | - N. Tatiana Masters
- Department of Psychology, University of Washington
- Tatiana Masters and Kelly Davis are now at the School of Social Work, University of Washington
| | | |
Collapse
|