Gender Minority Stress and Resilience Measure: A Meta-Analysis of the Associations with Mental Health in Transgender and Gender Diverse Individuals

Transgender and gender diverse (TGD) individuals are more likely to experience mental health difficulties than cisgender individuals due to unique stressors related to their stigmatized gender identity and/or expression. This meta-analysis examined the associations between gender minority stressors and resilience factors, as measured by the Gender Minority Stress and Resilience Measure (GMSR; Testa et al., 2015), and two types of mental health symptoms (i.e., depression and anxiety). A comprehensive literature search and study inclusion process following PRISMA guidelines identified 69 sources, representing 47 unique samples. Mean effect sizes revealed significant positive associations between all GMSR minority stress subscales and anxiety and depression symptoms (rs = .22 to .40) with larger correlations for proximal stressors compared to distal stressors. The GMSR resilience subscales were significantly negatively correlated with anxiety and depression symptoms (rs = -.07 to -.16). These findings highlight the robust relationship between gender minority stressors and mental health symptoms among TGD individuals and indicate a need for addressing these stressors both by reducing exposure to external stressors and by addressing the internalization of those stressors in clinical settings. The small effects for the resilience subscales suggest a need to examine additional resilience factors that may be more pertinent to mental health among TGD individuals.

The Prevalence of Nonsuicidal Self-Injury in Military Personnel: A Systematic Review and Meta-Analysis

Military service members and veterans (SMVs) are at risk for self-directed violence, including nonsuicidal self-injury (NSSI). While NSSI is an important construct worthy of independent study, it is understudied among SMVs and, when included in research, typically examined in the context of suicide risk. Consequently, lifetime prevalence rate estimates of NSSI among SMVs vary. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review and meta-analysis estimated the average lifetime NSSI prevalence among SMVs and explored demographic and methodological factors that may account for observed variability. Based on a search of Ovid MEDLINE, Embase, PsycINFO, and Web of Science, 47 samples from 42 articles across five countries met inclusion criteria. Results revealed an average NSSI lifetime prevalence rate of 15.76% among SMVs. Significantly higher prevalence rates were observed among clinical (28.14%) versus community (11.28%) samples and studies using interviews to assess NSSI (23.56%) versus self-report (13.44%) or chart review (7.84%). Lifetime prevalence increased as publication year increased and decreased as sample size increased. In contrast to prior literature, prevalence rates were comparable between active-duty SMVs, and studies collecting data anonymously versus those that did not. Lifetime prevalence was not moderated by age, gender, race, country, primary research focus, quality of NSSI operationalization, or whether NSSI methods were assessed. Findings suggest NSSI is a pervasive problem among military personnel, particularly within clinical settings, highlighting the need for systematic assessment of this important but understudied clinical phenomenon among SMVs. Further research is necessary to elucidate additional risk factors for NSSI among SMVs, including trauma exposure.

Sexual assault characteristics and posttraumatic stress symptoms among collegiate women: The role of posttraumatic cognitions

Although it is well-established that sexual assault is a risk factor for posttraumatic stress symptoms (PTSS) and other negative mental health outcomes, research is needed to help identify which individuals are most likely to experience ongoing distress following sexual assault. Negative cognitions following trauma may be influenced by sexual assault characteristics and have been shown to be associated with PTSS. The present study examined whether sexual assault characteristics were associated with PTSS by way of posttraumatic cognitions in a sample of 475 female college students who had experienced a sexual assault since the age of 14 years. Participants completed an online survey that included questions about sexual assault characteristics (i.e., whether the perpetrator used force, whether they experienced a freeze response), posttraumatic cognitions, and PTSS. Path analysis revealed that survivors who indicated they froze during the assault reported higher levels of PTSS, total effect = .28, p < .001, direct effect = .19, p < .001; posttraumatic cognitions regarding others, indirect effect = .02, p = .047, and other-safety, indirect effect = .05, p = .003, partially accounted for this association. Only the direct effect of perpetrator use of force on PTSS was statistically significant, total effect = .23, p = .090, direct effect = .16, p = .009; none of the indirect effects were statistically significant, ps = .063-.669. The results support that assault characteristics are associated with postassault outcomes and are consistent with the cognitive model of posttraumatic stress disorder.

The Role of Gender, Sexual Assault History, and Sexism in Endorsement of Rape Myths Among College Students

The present study examined the roles of sexual victimization history, sexism toward women, and sexism toward men in the gender difference in rape myth acceptance. The data were obtained from 2,011 male and female college students who completed an online survey. The results suggested that gender had a significant indirect effect on rape myth acceptance via sexual assault history and several forms of sexist beliefs. The findings supported the importance of considering additional antecedents of rape myths in research, as well as in programming geared toward preventing sexual assault and improving support for survivors.

The Impact of Victim Blaming and Locus of Control on Mental Health Outcomes Among Female Sexual Assault Survivors

To elucidate individual differences in sexual assault survivor outcomes, we examined locus of control as a moderator of the relationship between victim blaming and both posttraumatic stress disorder (PTSD) symptoms and unhealthy alcohol use. The sample consisted of 82 female sexual assault survivors who had disclosed their victimization to at least one person. The results of this survey demonstrated that locus of control did not moderate the relationship between victim blaming and PTSD, or the relationship between victim blaming and unhealthy alcohol use. The findings further supported the direct relationship between victim blaming and a range of negative mental health outcomes among survivors.

Attitudes Toward Men and Rejection of Rape Myths: The Impact on Survivor Rape Acknowledgment

Because unacknowledged rape survivors (i.e., those who do not conceptualize their victimization as rape) are less likely to report the crime to police or seek formal services, a better understanding of factors that contribute to rape acknowledgment is a key step to improving access to care and assault reporting on college campuses. To contribute to this line of research, this study examined the indirect effect of sexist attitudes toward men on rape acknowledgment via rejection of rape myths among female rape survivors. The analyzed sample included 250 college female rape survivors (M age = 22.49 years, SD = 7.27) who completed measures of sexual assault history, sexist beliefs toward men, and rejection of rape myths. Among these women, 49.6% were classified as acknowledged rape survivors and 50.4% of the sample was classified as unacknowledged rape survivors. Indirect effects of sexist beliefs on rape acknowledgment via rape myth rejection were supported for four types of sexist beliefs, including resentment of paternalism, compensatory gender differentiation, maternalism, and complementary gender differentiation. Specifically, the findings supported that people with greater levels of these particular types of sexist beliefs toward men rejected rape myths less, and lower rejection of rape myths was associated with increased likelihood of unacknowledged rape. The indirect effects were not supported for the heterosexual hostility or heterosexual intimacy subscales of sexist beliefs. By identifying antecedents of rape acknowledgment, the findings from this study can be used to inform programming geared toward encouraging survivors to seek services, which ultimately improves survivor outcomes.

The Effect of Social Anxiety on the Risk of Sexual Victimization via Assertiveness in an Ethnically Diverse Sample

Preliminary evidence suggests social anxiety may increase the risk of sexual victimization via decreased sexual assertiveness. A sample of 2,043 undergraduate students completed an online survey. Analyses of moderated indirect effects examined whether gender or ethnicity moderated the indirect effect of social anxiety on sexual victimization via sexual assertiveness. No moderation effects were found, but the indirect effect of social anxiety on sexual victimization via sexual assertiveness was significant for all five types of sexual victimization. Clinically, the findings suggest that sexual assault risk reduction programs may be improved by including assertive resistance strategies and behavioral rehearsals.

What's in a Label? The Impact of Media and Sexual Assault Characteristics on Survivor Rape Acknowledgment

Media coverage of sexual assault has increased since 2017 due to high-profile cases and social media campaigns designed to increase awareness of sexual assault. The purpose of this study was to examine whether media coverage of the Harvey Weinstein allegations and the onset of the 2017 viral #MeToo movement impacted the likelihood of college women acknowledging their own victimization as rape. Participants were 207 female rape survivors who completed an online survey that included assessments of survivor acknowledgment and characteristics of the sexual assault. Some participants completed the study prior to the Harvey Weinstein allegations and onset of the #MeToo movement, and some participants completed the study after these events. The likelihood of survivors labeling their experience as rape did not differ based on when participants completed the study, odds ratios (ORs) = 0.61-3.92, ps = .127-.604. Use of both nonforceful verbal resistance, OR = 2.63, p = .001, and assertive resistance, OR = 3.05, p < .001, were positively associated with the likelihood of survivor acknowledgment. The effects of both perpetrators' use of force and experiencing immobility on survivor acknowledgment were moderated by the timing of study completion, ORs = 4.22 and 0.11, respectively, ps = .023-.040. These findings suggest that media coverage may impact how certain sexual assault characteristics influence how survivors label their victimization experiences.

Psychological outcomes following sexual assault: Differences by sexual assault setting

Sexual assault is associated with increased psychological distress. It is possible that military sexual assault (MSA) is associated with heightened psychological distress compared to adult sexual assault that occurs pre- or postmilitary service due to the nature of the military setting. Veterans and service members (N = 3,114; 19.6% women) who participated in the Post-Deployment Mental Health Study completed self-report measures of sexual assault history, symptoms of posttraumatic stress disorder (PTSD), symptoms of depression, hazardous alcohol use, drug use, and suicidal ideation. Women who reported a history of MSA endorsed higher levels of all types of psychological distress than women who did not experience adult sexual assault. Women who reported a history of MSA also endorsed higher levels of PTSD and depression symptoms than women who experienced pre- or postmilitary adult sexual assault. Men who reported a history of adult sexual assault, regardless of setting, reported higher levels of PTSD and depression symptoms than individuals who did not experience adult sexual assault. MSA was associated with higher psychological distress than pre- or postmilitary adult sexual assault among women. Among men, distress associated with MSA was comparable to sexual assault outside the military. Women may face unique challenges when they experience sexual assault in the military, and men may face additional stigma (compared to women) when they experience sexual assault, regardless of setting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Self- and Other-Directed Violence as Outcomes of Deployment-Based Military Sexual Assault in Iraq/Afghanistan-era Veteran Men and Women

Although military sexual assault (MSA) has been well-established as a risk factor for psychopathology (e.g., PTSD, depression), little research has examined the association between MSA and self- and other-directed violence. Furthermore, there has been a growing empirical focus on potential gender differences in the effects of MSA, but few of these studies have examined gender differences in self- and other-directed violence. In a sample of 1571 Iraq/Afghanistan-era veterans (21.0% women), we examined the effect of MSA on difficulty controlling violent behavior and attempting suicide among veteran men and women, above and beyond the influence of childhood sexual abuse, combat trauma, PTSD, and major depressive disorder. Results of a logistic regression revealed that MSA increased risk of attempting suicide and difficulty controlling violence among women but not men. Thus, the results suggest that MSA may be a risk factor for both types of violence in women. Furthermore, because PTSD was associated with both types of violence in both men and women, MSA may also confer risk of violence via PTSD.

Global REACH 2018: The influence of acute and chronic hypoxia on cerebral haemodynamics and related functional outcomes during cold and heat stress

KEY POINTS

Thermal and hypoxic stress commonly coexist in environmental, occupational and clinical settings, yet how the brain tolerates these multi-stressor environments is unknown Core cooling by 1.0°C reduced cerebral blood flow (CBF) by 20-30% and cerebral oxygen delivery (CDO₂ ) by 12-19% at sea level and high altitude, whereas core heating by 1.5°C did not reliably reduce CBF or CDO₂ Oxygen content in arterial blood was fully restored with acclimatisation to 4330 m, but concurrent cold stress reduced CBF and CDO₂ Gross indices of cognition were not impaired by any combination of thermal and hypoxic stress despite large reductions in CDO₂ Chronic hypoxia renders the brain susceptible to large reductions in oxygen delivery with concurrent cold stress, which might make monitoring core temperature more important in this context ABSTRACT: Real-world settings are composed of multiple environmental stressors, yet the majority of research in environmental physiology investigates these stressors in isolation. The brain is central in both behavioural and physiological responses to threatening stimuli and, given its tight metabolic and haemodynamic requirements, is particularly susceptible to environmental stress. We measured cerebral blood flow (CBF, duplex ultrasound), cerebral oxygen delivery (CDO₂ ), oesophageal temperature, and arterial blood gases during exposure to three commonly experienced environmental stressors - heat, cold and hypoxia - in isolation, and in combination. Twelve healthy male subjects (27 ± 11 years) underwent core cooling by 1.0°C and core heating by 1.5°C in randomised order at sea level; acute hypoxia ( P ET , O 2  = 50 mm Hg) was imposed at baseline and at each thermal extreme. Core cooling and heating protocols were repeated after 16 ± 4 days residing at 4330 m to investigate any interactions with high altitude acclimatisation. Cold stress decreased CBF by 20-30% and CDO₂ by 12-19% (both P < 0.01) irrespective of altitude, whereas heating did not reliably change either CBF or CDO₂ (both P > 0.08). The increases in CBF with acute hypoxia during thermal stress were appropriate to maintain CDO₂ at normothermic, normoxic values. Reaction time was faster and slower by 6-9% with heating and cooling, respectively (both P < 0.01), but central (brain) processes were not impaired by any combination of environmental stressors. These findings highlight the powerful influence of core cooling in reducing CDO₂ . Despite these large reductions in CDO₂ with cold stress, gross indices of cognition remained stable.

The Prevalence of Sexual Revictimization: A Meta-Analytic Review

The literature consistently demonstrates evidence that child sexual abuse survivors are at greater risk of victimization later in life than the general population. This phenomenon is called sexual revictimization. Although this finding is robust, there is a large amount of variability in the prevalence rates of revictimization demonstrated in the literature. The purpose of the present meta-analysis was to calculate an average prevalence rate of revictimization across the literature and to examine moderators that may potentially account for the observed variability. Based on a review of PsycINFO and PILOTS, 1,412 articles were identified and reviewed for inclusion. This process resulted in the inclusion of 80 studies, which contained 12,252 survivors of child sexual abuse. The mean prevalence of sexual revictimization across studies was 47.9% (95% confidence intervals [43.6%, 52.3%]), suggesting that almost half of child sexual abuse survivors are sexually victimized in the future. The present study failed to find support for any of the examined moderators. Potential explanations of and implications for the results are offered, including suggestions for therapists.

The Prevalence of Military Sexual Trauma: A Meta-Analysis

Due to methodological heterogeneity, the exact prevalence of military sexual trauma (MST) is unknown. To elucidate our understanding of the pervasiveness of this important social issue, a meta-analysis was conducted. A computerized database search in PsycINFO, PubMed, and PILOTS revealed 584 unique citations for review. Of these identified studies, 69 met the inclusion criteria for the meta-analysis. The results revealed that 15.7% of military personnel and veterans report MST (3.9% of men, 38.4% of women) when the measure includes both harassment and assault. Additionally, 13.9% report MST (1.9% of men, 23.6% of women) when the measure assesses only assault and 31.2% report MST (8.9% of men, 52.5% of women) when the measure assesses only harassment. Regardless of the type of victimization incident (i.e., harassment or assault), women evidenced significantly larger prevalence rates compared to men. Self-report measure and interviews were associated with higher prevalence rates than the review of veterans affair (VA) medical records when measuring both harassment and assault and only harassment. No significant differences were observed among prevalence rates based on VA, non-VA, or both VA and non-VA recruitment. Ultimately, the findings suggest that MST is a pervasive problem, among both men and women in the military, highlighting the importance of this line of research.

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.

Rape myth acceptance and rape acknowledgment: The mediating role of sexual refusal assertiveness

Unacknowledged rape, defined as when an individual experiences an event that meets a legal or empirical definition of rape but the individual does not label it as such, is prevalent. Research examining predictors of rape acknowledgment is needed. Sexual assertiveness may be an important variable to consider, as an individual's typical behavior during sexual situations may influence rape acknowledgment. To assess the indirect effect of rape myth acceptance on rape acknowledgment through sexual refusal assertiveness, an online survey of 181 female rape survivors was conducted. The indirect effects of two types of rape myths (He didn't mean to and Rape is a deviant event) were significant and positive. Specifically, acceptance of these two rape myths was negatively related to sexual refusal assertiveness, which was negatively associated with likelihood of rape acknowledgment. The results of this study indicate that sexual refusal assertiveness is associated with lower likelihood of rape acknowledgment among rape survivors. As a result, it appears that, under certain circumstances, women high in rape myth acceptance may be more likely to acknowledge rape when it results in decreased sexual refusal assertiveness.

Bone health and SATB2-associated syndrome

SATB2-associated syndrome (SAS) is a rare disorder caused by alterations in the special AT-rich sequence-binding protein 2 (SATB2). Skeletal abnormalities such as tibial bowing, osteomalacia, osteopenia or osteoporosis have been reported suggesting a higher frequency of skeletal complications in SAS. The optimal timing, necessity, and methodology for routine assessment of bone health in individuals with SAS, however, remain unclear. We report molecular and phenotypic features of 7 individuals with SAS documented to have low bone mineral density (BMD) ascertained by dual-energy X-ray absorptiometry (DXA), often preceded by tibial bowing. The lowest BMD Z-scores ranged -2.3 to -5.6. In 4 individuals, total alkaline phosphatase levels were elevated (2 with elevated bone fraction) around the time of low BMD documentation. A clinically significant fracture history and a diagnosis of pediatric osteoporosis were present in 4 individuals. Pamidronate treatment in 2 children improved BMD. In conclusion, low BMD, fractures, and tibial bowing are relatively common skeletal complications in individuals with SAS. DXA is a useful tool when evaluating a child with SAS suspected to have low BMD and the results might alter clinical management.

Independent and interactive effects of incremental heat strain, orthostatic stress, and mild hypohydration on cerebral perfusion

The purpose of this study was to identify the dose-dependent effects of heat strain and orthostasis [via lower body negative pressure (LBNP)], with and without mild hypohydration, on systemic function and cerebral perfusion. Eleven men (means ± SD: 27 ± 7 y; body mass 77 ± 6 kg), resting supine in a water-perfused suit, underwent progressive passive heating [0.5°C increments in core temperature (T_c; esophageal to +2.0°C)] while euhydrated (EUH) or hypohydrated (HYPO; 1.5-2% body mass deficit). At each thermal state, mean cerebral artery blood velocity (MCAv_mean; transcranial Doppler), partial pressure of end-tidal carbon dioxide ([Formula: see text]), heart rate (HR) and mean arterial blood pressure (MAP; photoplethysmography) were measured continuously during LBNP (0, -15, -30, and -45 mmHg). Four subjects became intolerant before +2.0°C T_c, unrelated to hydration status. Without LBNP, decreases in [Formula: see text] accounted fully for reductions in MCAv_mean across all T_c. With LBNP at heat tolerance (+1.5 or +2.0°C), [Formula: see text] accounted for 69 ± 25% of the change in MCAv_mean. The HYPO condition did not affect MCAv_mean or any cardiovascular variables during combined LBNP and passive heat stress (all P > 0.13). These findings indicate that hypocapnia accounted fully for the reduction in MCAv_mean when passively heat stressed in the absence of LBNP and for two- thirds of the reduction when at heat tolerance combined with LBNP. Furthermore, when elevations in T_c are matched, mild hypohydration does not influence cerebrovascular or cardiovascular responses to LBNP, even when stressed by a combination of hyperthermia and LBNP.

The unique associations between rape acknowledgment and the DSM-5 PTSD symptom clusters

It is well documented in the sexual assault literature that more than half of rape survivors do not label their experience as rape. This is called unacknowledged rape. Although this phenomenon is common and undoubtedly has huge implications for psychotherapy, the impact of acknowledgment status on psychological adjustment is unclear. The present study aimed to delineate the unique impact of rape acknowledgment on psychopathology by examining PTSD symptoms at the cluster level. To examine this, 178 female college students who reported rape completed an online survey, including an assessment of PTSD symptoms in the past month. The results suggested that, after accounting for several covariates, acknowledged rape survivors reported significantly greater levels of intrusion and avoidance symptoms compared to unacknowledged rape survivors. The findings suggest that examining PTSD symptoms at the cluster level may provide more insight into the process of recovery following rape and therefore may better inform treatment decisions.

ADHD and nonsuicidal self-injury in male veterans with and without PTSD

The objective of the present research was to examine the association between ADHD symptoms and nonsuicidal self-injury (NSSI) in male Iraq/Afghanistan-era veterans with and without PTSD. Approximately 25% of veterans screened positive for clinically-significant levels of ADHD. Male veterans with PTSD were significantly more likely to report ADHD symptoms than male veterans without PTSD. In addition, as expected, ADHD was strongly associated with NSSI, even after accounting for the effects of demographic variables, PTSD, depression, and alcohol use disorder. Future work aimed at replicating and extending these findings in longitudinal studies of veterans is needed.

Meta-Analysis of the Prevalence of Unacknowledged Rape

Many sexual violence survivors do not label their experiences as rape but instead use more benign labels, such as "bad sex" or "miscommunication." A meta-analysis was conducted to estimate the mean prevalence of unacknowledged rape and to inform our understanding of methodological factors that influence the detection of this phenomenon. Studies were identified using PsycINFO, PubMED, and PILOTS and were required to report the percentage of unacknowledged rape that had occurred since the age of 14 among female survivors. Moderator variables included mean participant age, recruitment source, rape definition, and unacknowledged rape definition. Twenty-eight studies (30 independent samples) containing 5,917 female rape survivors met the inclusion criteria. Based on a random effects model, the overall weighted mean percentage of unacknowledged rape was 60.4% (95% confidence interval [55.0%, 65.6%]). There was a large amount of heterogeneity, Q(29) = 445.11, p < .001, and inconsistency (I(2) = 93.5%) among included studies. The prevalence was significantly higher among college student participants compared to noncollege participants. The findings supported that over half of all female rape survivors do not acknowledge that they have been raped. The results suggest that screening tools should use behaviorally descriptive items about sexual contact, rather than using terms such as "rape."

A systematic review of probable posttraumatic stress disorder in first responders following man-made mass violence

The current study was a systematic review examining probable posttraumatic stress disorder (PTSD) in first responders following man-made mass violence. A systematic literature search yielded 20 studies that fit the inclusion criteria. The prevalence rates of probable PTSD across all 20 studies ranged from 1.3% to 22.0%. Fifteen of the 20 articles focused on first responders following the September 11th terrorist attacks and many of the studies used the same participant recruitment pools. Overall, the results of the systematic review described here suggest that our understanding of PTSD in first responders following man-made mass violence is based on a very small set of articles that have focused on a few particular events. This paper is meant to serve as a call for additional research and to encourage more breadth in the specific incidents that are examined.

Does military sexual trauma moderate the impact of critical warzone experiences?

The present research sought to replicate the finding that military sexual trauma (MST) moderates the effect of critical warzone experiences on mental health outcomes in a sample of male veterans. One-hundred eighty-one male veterans completed measures of MST, critical warzone experiences, and mental health symptoms. The hypothesized interaction was not significant, nor was a significant main effect observed for MST. In contrast, both critical warzone experiences and childhood maltreatment had significant main effects.

Sexual victimization history, depression, and task physiology as predictors of sexual revictimization: results from a 6-month prospective pilot study

The current study examined depression and physiological reactivity to a sexual threat task as longitudinal predictors of sexual revictimization in women with sexual victimization histories. The sample included 14 young adult women (M(age) = 19.15) who reported child sexual abuse. Heart rate and root mean square of the successive differences were measured at baseline and during the presentation of sexual victimization-related words during an Emotional Stroop task. Results indicated that women who reported a greater history of childhood sexual abuse and adult sexual victimization were at increased risk for sexual revictimization 6 months after initial data collection. Furthermore, even after accounting for their childhood and adult sexual victimization histories and depression symptoms, women who exhibited reduced, or blunted, physiological activity during the sexual victimization stimuli of the Stroop task were more likely to report sexual revictimization during the 6-month follow-up. The findings suggest that sexual victimization survivors may benefit from interventions that address physiological blunting and the recognition of sexual threat cues in their environment.

Sexual victimization history, depression, and task physiology as predictors of sexual revictimization: results from a 6-month prospective pilot study

The current study examined depression and physiological reactivity to a sexual threat task as longitudinal predictors of sexual revictimization in women with sexual victimization histories. The sample included 14 young adult women (M(age) = 19.15) who reported child sexual abuse. Heart rate and root mean square of the successive differences were measured at baseline and during the presentation of sexual victimization-related words during an Emotional Stroop task. Results indicated that women who reported a greater history of childhood sexual abuse and adult sexual victimization were at increased risk for sexual revictimization 6 months after initial data collection. Furthermore, even after accounting for their childhood and adult sexual victimization histories and depression symptoms, women who exhibited reduced, or blunted, physiological activity during the sexual victimization stimuli of the Stroop task were more likely to report sexual revictimization during the 6-month follow-up. The findings suggest that sexual victimization survivors may benefit from interventions that address physiological blunting and the recognition of sexual threat cues in their environment.

Unacknowledged Rape: The Influences of Child Sexual Abuse and Personality Traits

Evidence supports that the majority of young women who experience sexual victimization that meets the legal definition of rape do not label their experiences as rape--this has been termed unacknowledged rape. In a sample of 77 young adult women, the odds of unacknowledged rape significantly increased as a function of less severe child sexual abuse histories and greater levels of dysfunctional personality traits. Potential explanations for these findings as well as clinical implications are discussed. Because of the potential psychological and societal consequences of unacknowledged rape, it is vital that researchers continue to examine this phenomenon.

Interpersonal difficulties mediate the relationship between child sexual abuse and depression symptoms

This study examined the influence of interpersonal functioning as a mediator in the relationship between child sexual abuse and depression symptoms, after accounting for the influence of child physical abuse. The research questions build on the existing knowledge base by examining mechanisms of adult adjustment among child sexual abuse survivors. In the current study, 2,892 young adult women (18-29 years old; M = 19.06) reported on child sexual and physical abuse, 5 domains of interpersonal functioning, and depression symptoms. The results supported aggression, sensitivity, ambivalence, and lack of sociability as mediators in the relationship between child sexual abuse and depression symptoms. These results suggest that interpersonal difficulties related to hostility, emotional reactivity, inability to collaborate, and isolation may be of particular interest when understanding depression in child sexual abuse survivors. The findings support interpersonal problems as a key mechanism of depression symptoms following child sexual abuse and is even demonstrated when examining long-term outcomes and controlling for child physical abuse. The hypotheses and findings are discussed in the context of interpersonal psychotherapy for depression.

Do child abuse and maternal care interact to predict military sexual trauma?

OBJECTIVE

The present research tested the hypothesis that maternal care moderates the relationship between childhood sexual abuse and subsequent military sexual trauma (MST).

METHOD

Measures of childhood sexual abuse, maternal care, and MST were administered to 197 Iraq and Afghanistan war veterans.

RESULTS

After accounting for gender, age, and the main effects of maternal care and childhood sexual abuse, the maternal care x childhood sexual abuse interaction was a significant predictor of MST (odds ratio = .28, β = -1.26, 95% confidence intervals of .10, .80). As hypothesized, rates of MST were higher among veterans who reported childhood sexual abuse and low levels of maternal care (43%) compared with veterans who reported childhood sexual abuse and high levels of maternal care (11%).

CONCLUSION

These findings suggest that high levels of maternal care may act as a protective factor against future revictimization among military service members. These findings have the potential to inform both prevention and intervention efforts.

Mass shootings: a meta-analysis of the dose-response relationship

A meta-analysis was conducted to examine the dose-response theory as it relates to posttraumatic stress symptoms (PTSSs) following mass shootings. It was hypothesized that greater exposure to a mass shooting would be associated with greater PTSSs. Trauma exposure in the current study was broadly defined as the extent to which a person experienced or learned about a mass shooting. The meta-analysis identified 11 qualifying studies that included 13 independent effect sizes from a total of 8,047 participants. The overall weighted mean effect size, based on a random effects model, was r = .19, p < .001, 95% CI [.13, .25]. Maximum likelihood meta-regressions revealed no significant linear effects of participant gender, participant age, or time elapsed since the shooting on the relationship between exposure and PTSSs. Because so few studies satisfied the inclusion criteria, the present study also documents that this area of the literature is underresearched.

Aggressive behavior: an alternative model of resting heart rate and sensation seeking

Low resting heart rate is a well-replicated biological correlate of aggression, and sensation seeking is frequently cited as the underlying causal explanation. However, little empirical evidence supports this mediating relationship. Furthermore, the biosocial model of violence and social push theory suggest sensation seeking may moderate the relationship between heart rate and aggression. In a sample of 128 college students (82.0% White; 73.4% female), the current study tested a moderation model as an alternative relationship between resting heart rate and sensation seeking in regard to aggression. Overall, the findings partially supported an interaction effect, whereby the relationship between heart rate and aggression was moderated by sensation seeking. Specifically, the oft-noted relationship between low resting heart rate and increased aggression was found, but only for individuals with low levels of sensation seeking. If replication supports this finding, the results may better inform prevention and intervention work.

Baseline heart rate, sensation seeking, and aggression in young adult women: a two-sample examination

Although substantial literature discusses sensation seeking as playing a role in the relationship between baseline heart rate and aggression, few published studies have tested the relationships among these variables. Furthermore, most prior studies have focused on risk factors of aggression in men and have largely ignored this issue in women. Two samples (n = 104; n = 99) of young adult women completed measures of resting heart rate, sensation seeking, and aggression. Across the two samples of females there was no evidence for the relationships of baseline heart rate with sensation seeking or with aggression that has been consistently shown in males. Boredom susceptibility and disinhibition subscales of sensation seeking were consistently significantly correlated with aggression. The lack of significance and the small effect sizes indicate that other mechanisms are also at work in affecting aggression in young adult women. Finally, it is important to consider the type of sensation seeking in relation to aggression, as only boredom susceptibility and disinhibition were consistently replicated across samples.

Mutations in CUL7, OBSL1 and CCDC8 in 3-M syndrome lead to disordered growth factor signalling

3-M syndrome is a primordial growth disorder caused by mutations in CUL7, OBSL1 or CCDC8. 3-M patients typically have a modest response to GH treatment, but the mechanism is unknown. Our aim was to screen 13 clinically identified 3-M families for mutations, define the status of the GH-IGF axis in 3-M children and using fibroblast cell lines assess signalling responses to GH or IGF1. Eleven CUL7, three OBSL1 and one CCDC8 mutations in nine, three and one families respectively were identified, those with CUL7 mutations being significantly shorter than those with OBSL1 or CCDC8 mutations. The majority of 3-M patients tested had normal peak serum GH and normal/low IGF1. While the generation of IGF binding proteins by 3-M cells was dysregulated, activation of STAT5b and MAPK in response to GH was normal in CUL7(-/-) cells but reduced in OBSL1(-/-) and CCDC8(-/-) cells compared with controls. Activation of AKT to IGF1 was reduced in CUL7(-/-) and OBSL1(-/-) cells at 5 min post-stimulation but normal in CCDC8(-/-) cells. The prevalence of 3-M mutations was 69% CUL7, 23% OBSL1 and 8% CCDC8. The GH-IGF axis evaluation could reflect a degree of GH resistance and/or IGF1 resistance. This is consistent with the signalling data in which the CUL7(-/-) cells showed impaired IGF1 signalling, CCDC8(-/-) cells showed impaired GH signalling and the OBSL1(-/-) cells showed impairment in both pathways. Dysregulation of the GH-IGF-IGF binding protein axis is a feature of 3-M syndrome.

The link between sensation seeking and aggression: a meta-analytic review

Substantial empirical evidence supports low resting heart rate (HR) as the best replicated psychophysiological correlate of aggression [Ortiz and Raine, 2004]; however, researchers continue to debate the explanatory mechanisms of the phenomenon. Sensation seeking has been proposed as a possible outcome of low resting HR that may lead to aggressive tendencies but findings have been inconsistent in terms of showing a relationship between sensation seeking and aggression. A meta-analysis was conducted on 43 independent effect sizes, from studies with a total of 32,217 participants, to test the hypothesis that sensation seeking would be positively related to aggression across studies. A significant overall effect size was found (d = .1935, P<.001), supporting the hypothesis. Moderator analyses revealed that the relationship differed based on participant and methodological characteristics, such as participant age and the nature of the aggression measurement; however, these conclusions are limited by the uneven number of studies in many of the moderator classes. Overall, the findings provide support for higher levels of aggression in high sensation seekers and have theoretical implications for arousal theory. Further research on the links between arousal, sensation seeking and aggression can inform clinicians about potential interventions.

Therapists as Trauma Survivors: A Case Study Detailing Cognitive Processing Therapy for Rape Victims With a Psychology Graduate Student

This case study describes the treatment of a female psychology graduate student, referred to as Mary, who presented with complaints of “mild symptoms of depression and a lack of motivation.” It was revealed that Mary had been sexually assaulted 4 years before presenting for therapy and was diagnosed with depression and posttraumatic stress disorder. Because of the timing of the symptom onset and the nature of her symptomatology, it is likely that she was experiencing a form of vicarious traumatization that further complicated her own difficulties. The primary purpose of the current article is to draw attention to the importance of self-care for mental health professionals and to provide recommendations for the promotion of well-being in professionals working with trauma survivors. The secondary aim of the current study is to discuss Mary’s progress through 12 sessions of manualized cognitive processing therapy for rape victims as further support for its efficacy.

Test of recrudescence hypothesis for overwintering of West Nile virus in gray catbirds

West Nile virus is a pathogen of concern for both human and wildlife health. Although many aspects of the ecology of West Nile virus are well understood, the mechanisms by which this and similar mosquito-borne viruses overwinter and become reinitiated each spring in temperate regions is not known. A thorough understanding of this mechanism is crucial to risk assessment and development of control strategies. One of the hypotheses to explain the mechanism by which this virus persists from year to year is the spring recrudescence of latent virus in avian reservoir hosts. Stress-related immunosuppression is implicated in the recrudescence of latent viruses in birds. We tested the spring recrudescence hypothesis in a controlled laboratory experiment using hatching-year gray catbirds (Dumatella carolinensis) captured in northern Ohio (July-August 2006). Catbirds (n = 60) were experimentally infected (September 2006) and later examined for the effects of immunosuppression through exogenous hormones and artificially induced migratory disposition. We found no effect of either testosterone or migratory behavior on infection status in any of the treatment birds. Moreover, we detected no viral RNA in the kidney, spleen, brain, or liver upon necropsy at 24 wk postinfection.

Thought control strategies as mediators of trauma symptoms in young women with histories of child sexual abuse

The current retrospective study examined thought control strategies, or cognitive techniques individuals use to deal with unpleasant thoughts following stressful events, as potential mediators of adjustment in young women with histories of child sexual abuse (CSA). In a sample of 76 undergraduate women who self-reported on abuse experiences, thought control strategies, and current trauma symptoms, several key findings emerged: (i) Greater severity of the CSA event was associated with greater reported use of worry and punishment strategies and less use of social control strategies; (ii) Increased use of worry and punishment strategies following the CSA event was associated with greater levels of trauma symptoms, while increased use of social control strategies following the CSA event was associated with lower levels of trauma symptoms; and (iii) Worry, punishment, and social control strategies served as mediators between CSA severity and trauma symptoms. The results suggest that thought control strategies, specifically increased worry and punishment, and decreased social control, play a vital role in understanding adjustment after CSA. Future research should examine the roles of these cognitive control strategies as possible avenues of intervention following CSA.