"That is Not Behavior Consistent With a Rape Victim": The Effects of Officer Displays of Doubt on Sexual Assault Case Processing and Victim Participation

Despite the prevalence and severity of sexual violence, case attrition has been identified as a significant issue. Of the cases that are reported to police, only a small portion result in arrest, prosecution, or conviction. Research has revealed that much of this attrition occurs early in the process and that a number of theoretically supported legal (e.g., physical evidence, victim participation) and extralegal (e.g., demographics, victim credibility) factors influence how and whether a case progresses through the criminal justice system. However, few researchers have directly examined the impact of officer doubt on case processing. Whereas legal and extralegal factors represent case characteristics, doubt represents officer cognition about these characteristics. These perceptions can affect how victims are treated, how police investigate the case, and ultimately, the case's progression through the system. A random sample of sexual assault reports from one police department in a medium-sized jurisdiction in the western U.S. was drawn to examine the expression of officer doubt, as well as its impact on victim participation, arrest, and referral for prosecution while controlling for relevant legal and extralegal factors. The findings suggest that officer doubt is an important consideration in sexual assault case processing, independent of other legal and extralegal factors, and that it significantly impacts the likelihood of arrest and referral for prosecution. Consistent with previous research, police decision-making was also impacted by certain legal factors. Victim participation was not directly affected by officer doubt but it was predicted by extralegal factors. Implications for future sexual assault research and practitioner training are discussed.

Labeling Victimization Experiences and Self as Predictors of Service Need Perceptions and Talking to Police

Theoretical frameworks suggest that how victims of violence against women (VAW) label their experiences and selves shapes their help-seeking intentions and behaviors. Quantitative studies assessing this relationship have focused on sexual assault and have neglected self-labels, thus this study adds to the research by including multiple forms of VAW and both experience-labels (e.g., "abuse") and self-labels (e.g., "victim"). Data came from a community-based sample of 1,284 adult, female victims of physical intimate partner violence, sexual assault, and/or stalking. These women participated in a state-wide phone survey in 2020 to determine victimization prevalence and were selected for the present analyses based on their victimization experiences. Bivariate analyses and multivariate logistic regression models were used to determine whether experience- and self-labels predicted the likelihood of perceiving the need for legal services, victim services, shelter or safe housing, and/or medical care, as well as talking to police. Both applying a label to one's experiences with VAW and applying a label to oneself in relation to those experiences approximately doubled the odds of perceiving a need for formal services. The significance of self-labels seemed to be driven by the "survivor" label, as using a "victim" label was not related to need perceptions, but a "survivor" label doubled or tripled the odds of perceiving a need for formal services. Applying a label to one's experiences with VAW almost doubled the odds of talking to the police, and, again, use of the "survivor" self-label significantly increased the odds of talking to the police. These findings confirm the importance of labeling one's victimization experiences and self, and indicate that greater attention be paid to the labels that victims use and how the use of labels might be improved so that they are more likely to seek and attain meaningful help and services.

The influence of attachment style on support and feedback seeking and depression severity among mothers during the COVID-19 pandemic

OBJECTIVES

The ways that people seek support during times of stress influence their mental health outcomes, including depression. Insecure attachment is a risk factor for depression and may also interfere with adaptive support and feedback-seeking behaviour during stress. The purpose of the present study was to test theorized associations between insecure attachment, support and feedback seeking, and changes in depression symptoms over 1 year, in a sample of mothers of school-age children in the context of stress elicited by the COVID-19 pandemic.

METHODS

Participants (N = 70 mothers) completed self-report measures of anxious and avoidant attachment and depression severity at baseline in spring 2020 and then completed measures of past-year engagement in direct and indirect support seeking and excessive reassurance seeking (ERS), preference for negative feedback, and depression severity at a follow-up assessment in summer 2021.

RESULTS

Greater attachment anxiety at baseline predicted more frequent direct support seeking, indirect support seeking, and ERS during the 1-year follow-up period. In turn, greater indirect support seeking predicted greater increases in depression from baseline to follow-up. Greater attachment avoidance at baseline predicted less direct support seeking during the 1-year follow-up period. Greater attachment avoidance at baseline also predicted depression severity at follow-up, particularly among mothers with moderate to high levels of attachment anxiety, although none of the examined support and feedback-seeking behaviours mediated this association.

CONCLUSIONS

These results provide support for the role of activated attachment systems in determining support and feedback-seeking behaviour during stress, as well as the role of support and feedback-seeking behaviour in the maintenance and exacerbation of depression.

Help-Seeking Patterns Among Students Experiencing Sexual Harassment: A Latent Class Analysis

Sexual harassment continues to be a pervasive problem in institutes of higher education. Despite this, there are significant gaps in research and our understanding related to students' help-seeking associated with sexual harassment. Understanding students' help-seeking patterns is critical in improving and streamlining campus-wide resources. The following study uses a latent class analysis to examine whether unique patterns of help-seeking exist among students experiencing sexual harassment and whether there are meaningful differences between help-seeking groups with respect to incident characteristics, campus climate, and demographic profiles. Data used in this analysis are from an anonymous, web-based campus climate survey across a university system that included 7,318 undergraduate and 3,484 graduate students. Of these, 704 undergraduates and 229 graduate students reported experiencing sexual harassment. Our results indicated four help-seeking groups: Comprehensive help-seeking group (engaged in multiple types of formal and informal help-seeking), Informal help-seeking group (relied exclusively on friends as sources of support), Low help-seeking group (individuals in this group told virtually no one about their experience, including friends or family), and Unsure group (reached out to friends in large numbers but universally characterized themselves as not knowing what to do). Across classes, findings highlight significant differences related to incident characteristics (offender identity and incident location), student status, and racial identity. Our results point to the heterogeneity of patterns and responses in help-seeking for students experiencing sexual harassment. Variations in help-seeking across different classes highlight that students' perceptions and preferences for formal and informal support depend on their specific type. Our study is a reminder that survivors access support through diverse ways; understanding these distinct patterns in help-seeking behaviors based on specific subgroups will help universities tailor programs that better align with students' contextual needs and realities.

Parent-Child Communication About Potentially Traumatic Events: A Systematic Review

Social support plays an important role in children's well-being after experiencing a potentially traumatic event (PTE). One such source of support is the parent-child relationship, specifically by discussing the event. However, current literature provides no consensus on whether parents and children communicate about PTEs, in what way they might communicate and how this affects the child. Hence the goal of the current study is threefold, to explore: (a) whether parents and children communicate about PTEs, (b) what this communication looks like, and (c) how this affects children's well-being. These questions are answered by means of a systematic literature review. Articles were eligible for inclusion if it was an empirical study on communication between parents and children about a PTE that the child (under 18 years) had experienced. Initial searches in electronic databases provided 31,233 articles, of which 26 were deemed eligible for inclusion. Results show that most parents and children have discussed PTEs, but that this may depend on cultural background. What the parent-child communication looks like depends on various factors such as, age of the child, tone, and child's initiation of discussion. Parental post-traumatic stress symptoms seem to negatively impact communication. The results of the impact of communication are less clear-cut, but it seems to have a predominantly positive effect on the child's well-being, depending on parental sensitivity. Clinicians should be watchful for parental symptoms of post-traumatic stress disorder and can focus on promoting parental sensitivity and responsiveness when discussing PTEs with their child or on creating a joint narrative within families.

Variations in Women's Attribution of Blame for Sexual Assault

In the United States, sexual assault (SA) is a significant problem that has adverse psychological impacts on women. Scholarship has shown that when survivors choose to disclose their experiences, the way their networks react has a powerful impact on their well-being, but literature on response to SA disclosure has not extensively explored variation among women, who are likely recipients of these disclosures. This study explored variation among perceptions of and blame attribution for SA within a geographically and politically diverse but primarily White sample of women. Participants were assigned one of four vignettes, each of which described a non-stereotypical SA. The vignettes differed in two ways: (1) the social status of the perpetrator of the assault and (2) the length of time the victim waited to report. Results showed that being older and more politically conservative was associated with assigning less blame to the perpetrator and more blame to the victim, but neither education level nor where the participant lived were linked with blame attribution. While women's own experiences of SA were unrelated to their responses, having a loved one who had experienced SA was associated with less victim blaming. With respect to attitudes, women endorsing higher levels of social dominance orientation (SDO) and sexism also reported higher levels of victim blame and lower levels of perpetrator blame. Further research should explore the role of specific personal experiences and knowledge of others' SA in assignment of blame, investigate the predictors and moderators of SDO, and should extend these findings to more racially/ethnically diverse samples of women.

The Role of Unit and Interpersonal Support in Military Sexual Trauma and Posttraumatic Stress Disorder Symptoms

Military sexual trauma (MST) is strongly associated with posttraumatic stress disorder (PTSD). Among many potential factors explaining this association are unit and interpersonal support, which have been explored in few studies with veterans who have experienced MST. This project examines unit and interpersonal support as moderators and/or mediators of PTSD symptoms among post-9/11 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans who experienced MST. MST, unit support, and interpersonal support variables were collected at Time 1 (T1; N = 1,150, 51.4% women), and PTSD symptoms 1 year later at Time 2 (T2; N = 825; 52.3% women). Given gender differences in endorsed MST, models with the full sample (men and women) and women only were examined, while controlling for covariates related to PTSD, and a path model was examined among women veterans. Mediation was supported in the full model and women-only models, with the combination of both mediators demonstrating the strongest mediation effects (full-model: β = .06, 95% confidence interval [CI] [0.03, 0.10], p < .001; women-only model: β = .07, [0.03, 0.14], p = .002). Among the women-only model, MST was negatively associated with unit support (β = -.23, [-0.33, -0.13], p < .001) and interpersonal support (β = -.16, [-0.27, -0.06], p = .002) and both support types were negatively associated with PTSD symptoms (unit support: β = -.13, [-0.24, -0.03], p = .014; interpersonal support: β = -.25, [-0.35, -0.15], p < .001). Moderation was not supported in the full model nor in the women-only model. Experiencing MST is associated with receiving less unit and/or interpersonal support, which in turn is associated with greater PTSD symptoms. More work is needed to understand and improve the impact of unit and community responses to MST on service members who experience MST.

Rape Crisis Victim Advocacy: A Systematic Review

While rape crisis center (RCC) advocacy is generally regarded as valuable, there are no prior systematic reviews of the advocacy literature. This review examined RCC advocacy service provision, perceptions and impact of advocacy, and challenges and facilitators to effective service provision. Databases related to health and social sciences were searched including Academic Search Complete, PsychINFO, PubMed, CINAHL, ProQuest, Science Direct, OAlster, WorldCat, and MEDLINE. Empirical articles written in English that examined RCC advocacy service provision and/or impact in the US were included. The researchers reviewed abstracts and titles, and then full texts. Forty-five articles met criteria, were summarized, and double checked. Findings demonstrate advocacy is multi-faceted, beneficial, and challenging. Advocates work directly with survivors and interact with other responders on behalf of survivors. Specifically, advocates provide emotional support, safety plan, support survivors in making decisions, and assist them in navigating other systems. While advocates are generally regarded positively by survivors and responders, some responders have concerns about advocates. In addition, advocates sometimes report victim-blaming and being ill-equipped to meet survivors' needs. Finally, advocates face specific challenges in their work with survivors and responders. Future research using diverse methodological approaches is needed to understand advocacy utilization and reach; survivors' perceptions of advocacy; marginalized survivors' experiences; connections between specific services, implementation, and outcomes; and effective strategies for advocates' interactions with other responders. Additional resources to help advocates serve all survivors effectively and equitably; to support evaluator-practitioner partnerships; and to share unpublished data on advocacy may help contribute to improvements in advocacy practice.

"Sometimes It Seems Easier to Push It Away": A Study Into the Barriers to Help-Seeking for Victims of Sexual Violence

Experiencing sexual violence may have serious long-term consequences for victims. Seeking help may decrease the chances of developing long-term physical and psychosocial problems. Still not every victim seeks help, and especially with victimization of sexual violence, there may be several reasons as to why. The barriers to help-seeking are diverse and may depend on several contextual factors. This study, as part of a larger research project, aimed to determine the barriers that victims of sexual violence experience in their decision to seek help in a non-college setting. This mixed-methods study included an online survey (N = 133) and open-ended survey (N = 207) amongst victims of 18 years and older. The online survey data were analyzed using chi-square tests for independence and t-tests; the open-ended survey data were analyzed using a descriptive approach. The online survey data showed that minimization of the incident was higher for non-help-seekers, whilst distrust toward support providers and issues with the accessibility of help were higher for help-seekers. No further significant associations were found between the decision to seek help and the barriers to help-seeking. From the open-ended survey data, three categories of barriers were distinguished: (a) individual barriers, such as feelings of shame, (b) interpersonal barriers, such as the fear of negative social reactions and (c) sociocultural barriers, such as societal stereotypes regarding sexual violence. The findings suggest that victims experience various, but primarily individual, barriers to help-seeking and that these barriers do not strongly differ between help-seekers and non-help-seekers. This study highlights the importance of addressing barriers to help-seeking on an organizational and societal level to encourage help-seeking.

The Role of Structural Factors in Support-Seeking Among Women Experiencing Intimate Partner Violence (IPV) in Mwanza, Tanzania: Findings From a Qualitative Study

In this qualitative study of women participating in an intimate partner violence (IPV) prevention trial, experiences of IPV and the context that shapes support-seeking were explored through in-depth interviews and focus groups discussions. Decisions to seek support were influenced by a range of factors including fear of further abuse, shame, acceptance of IPV as normal, belief that IPV is a private matter between the couple, economic dependence on male partners, and a poorly responsive legal and justice system. Gender empowerment programs need to intervene at the social, cultural, political, and economic levels that shape justification and meanings attached to IPV and women's decisions in seeking support.

Faculty-Student Consensual Sexual Relationship Policies: Examining Prevalence and Content using a Nationally Representative Sample of Institutions of Higher Education in the United States

The current study uses a nationally representative sample of institutions of higher education (IHEs) in the United States (n = 448) to estimate the prevalence rate of consensual sexual relationship policies (CSRPs) and to examine variation in CSRPs across sectors of IHEs. The concepts of consent and power differentials in CSRPs are also explored. Findings show that the majority of IHEs do not have a CSRP, that there are no significant differences in the prevalence rate or type of CSRPs across IHE sectors, and the most common type of CSRP is a limited ban. The concepts of consent and power differentials underpin the majority of CSRPs.

Mandatory Reporting and Adolescent Sexual Assault

Adolescents experience alarmingly high rates of sexual violence, higher than any other age-group. This is concerning as sexual violence can have detrimental effects on teens' personal and relational well-being, causing long-term consequences for the survivor. Still, adolescents are hesitant to report the assault or seek out services and resources. When an adolescent survivor does seek out services, they may interact with a provider who is a mandatory reporter. This scoping review sought to synthesize the current U.S.-based research on the role, challenges, and impact of mandatory reporting (MR) in the context of adolescent sexual assault. Database searches using key words related to MR, sexual assault, and adolescence identified 29 peer-reviewed articles. However, none of these articles reported on empirical investigations of the phenomenon of interest and instead consisted of case studies, commentaries, and position papers. The scoping review was expanded to provide a lay of the land of what we know about the intersection of adolescent sexual assault and MR. Results of the review indicate that though implemented broadly, MR policies vary between individuals, organizations, and states and have historically been challenging to implement due to this variation, conflicts with other laws, tension between these policies and providers' values, and other factors. Based on the available literature, the impact of MR in the context of adolescent sexual assault is unknown. There is a critical need for research and evaluation on the implementation and impact of MR policies, especially in the context of adolescents and sexual violence.

Factors Influencing Recovery and Well-Being Among Asian Survivors of International Criminal Sex Trafficking in an Urban U.S. City

Sex trafficking is serious form of gender-based violence that results in profound adverse health outcomes, yet one that is poorly understood. New York City is a major hub for sex trafficking, with a significant but unquantified number of victims originating from East Asian countries and trafficked via illicit massage businesses. Peer-reviewed studies among Asian survivors of international criminal sex trafficking do not exist. The aim of this study is to qualitatively examine the factors at various levels of influence that impact the recovery and reintegration process of Asian criminal sex trafficking survivors in the United States from the perspective of survivors and front-line service providers. The study was guided by community-based participatory research and trauma-informed approaches, leveraging a collaboration with a well-established service provider organization. Ten in-depth interviews were conducted between 2018 and 2019 with three Korean survivors and seven key informants who were anti-trafficking service providers working with East Asian clients. Data were analyzed using a grounded theory approach. Survivors and service providers vocalized factors at multiple levels that either facilitate or impede recovery and well-being. Levels of influence included structural (e.g., poverty/debt bondage, immigration status, limited English proficiency), cultural (e.g., fatalism, collectivism), institutional (e.g., lack of culturally appropriate, trauma-informed care), interpersonal (e.g., exploitation, social support), and individual (e.g., resilience). Stigma was a crosscutting factor that spanned all levels of influence. This study highlights the voices of survivors and front-line service providers to understand the lives of an under-researched population of Asian sex trafficking survivors. Ultimately, the root, structural causes of survivor marginalization need to be addressed, which stem from the intersection of class-, gender-, and race-related inequities. While survivors continue to experience exploitation and marginalization post-trafficking, they also carry an enormous amount of resilience that must be leveraged in their path to recovery from trauma.

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

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

"I Am the One That Needs Help": The Theory of Help-Seeking Behavior for Survivors of Intimate Partner Violence

African American women survivors of intimate partner violence disproportionately experience homicide due, in part, to the racism and racial discrimination they experience during their help-seeking process. Yet, existing scholarship neglects to examine how this multiply-marginalized population of women navigate sociocultural barriers to obtain crisis services and supports from the domestic violence service provision system. Fundamental to developing culturally-salient interventions is more fully understanding their help-seeking behavior. We conducted 30 in-depth, semi-structured interviews with women who self-identified as African American. Constructivist grounded theory methodology was employed. Sensitizing concepts from the Transtheoretical Model of Change and Intersectionality theories, along with Agency framework were conceptually bound. The Theory of Help-Seeking Behavior emerged from the data. This nascent theory provides practitioners and researchers with a theoretical model to examine African American women's nuanced help-seeking efforts.

Rape Victim Advocates' Perceptions of the #MeToo Movement: Opportunities, Challenges, and Sustainability

Awareness of the frequency of sexual victimization has been promoted through the #MeToo movement that opened the floodgates for survivors of sexual harassment, victimization, and violence to disclose their victimization. This research explores 41 rape victim advocates' perceptions of the #MeToo movement and concludes that they recognize its strengths and weaknesses. They credit the movement for: empowering survivors to disclose their experience possibly due to reduced stigma surrounding sexual victimization given the number of disclosures, providing support through social media from other survivors, and increasing societal awareness of the prevalence of sexual victimization. Those interviewed fault the movement for: giving the false perception that since so many survivors are stepping forward then reports must be fabricated, pressuring victims to support the movement through disclose and criticizing those who do not disclose, and hindering survivors' ability to escape media and social media coverage of sexual victimization. Advocates perceived #MeToo to be more of a "movement" rather than a "moment." However, to sustain its progress advocates suggested that action must be taken to create change for survivors and to reduce the occurrence of sexual victimization through policy/legal change and perpetrator accountability.

Post-Assault Health Care for Sexual Assault Survivors During COVID-19: A Mixed Methods Analysis of Service Rates in a Predominately African American Community

This study examined how the COVID-19 pandemic affected sexual assault healthcare services in a predominately African American U.S. city. In mixed methods research design, we used quantitative interrupted time series modeling to evaluate changes in service rates for three core post-assault healthcare services-medical forensic exams (MFEs), medical advocacy MFE accompaniment, and counseling-from January 2019 through June 2021. We also conducted qualitative interviews with 12 sexual assault advocates to understand how their clients were impacted by COVID and how their agency adapted services to respond to the needs of their community. Both the quantitative and qualitative data revealed marked disruptions in service provision. The number of MFEs, medical advocacy accompaniments, and counseling sessions significantly decreased during the pandemic's initial surge, and survivors feared seeking hospital-based health care due to concerns that they might contract COVID-19 in hospital emergency departments. The number of MFEs performed by program staff did not return to pre-pandemic levels during this study's observation period, but the number of medical advocacy accompaniments and counseling sessions did significantly rebound. Counseling services eventually exceeded pre-pandemic levels as agency staff supported clients with both assault- and COVID-related trauma and loss. These results underscore the need for community-based sexual assault healthcare services, so that if public health emergencies limit the availability, accessibility, and safety of hospital emergency department care, sexual assault survivors have other settings for obtaining post-assault health care.

Help-Seeking and Barriers to Care in Intimate Partner Sexual Violence: A Systematic Review

Intimate partner sexual violence (IPSV) is a prevalent phenomenon, yet an under-researched topic. Due to the complex nature of balancing love and fear, individuals who experience IPSV have unique needs and face unique barriers to seeking care. The purpose of this systematic review was to examine the literature on help-seeking and barriers to care in IPSV. Articles were identified through PubMed, CINAHL, PsycINFO, and Web of Science. Search terms included terms related to IPSV, intimate partner violence (IPV), domestic violence, sexual assault, and rape. The review was limited to the United States, and articles that were included needed to specifically measure or identify sexual violence in an intimate relationship and analyze or discuss IPSV in relation to help-seeking behaviors or barriers to care. Of the 17 articles included in this review, 13 were quantitative studies and four were qualitative studies. Various definitions and measurements of IPSV across studies included in this review make drawing broad conclusions challenging. Findings suggest that experiencing IPSV compared to experiencing nonsexual IPV (i.e., physical or psychological IPV) may increase help-seeking for medical, legal, and social services while decreasing help-seeking for informal support. Help-seeking can also reduce risk of future IPSV and decrease poor mental health outcomes. Barriers to seeking care in IPSV included social stigma, fear, and difficulty for individuals in identifying IPSV behaviors in their relationships as abuse. More inclusive research is needed among different populations including men, non-White individuals, nonheterosexual, and transgender individuals. Suggestions for research, practice, and policies are discussed.

Healing After Gender-Based Violence: A Qualitative Metasynthesis Using Meta-Ethnography

Gender-based violence (GBV) is a significant violation of human rights, requiring specific understanding of how individuals heal and recover after these experiences. This article reports on findings of a qualitative metasynthesis that examined the nature of healing after GBV through the perspectives of female-identifying survivors. Empirical studies were identified by a search of peer-reviewed articles via electronic databases. Studies were included for review if they were available in the English language, reported on qualitative studies that directly engaged female-identifying survivors of GBV, and were aiming to understand the GBV healing journey, process, or goals. After our initial search, 1,107 articles were reviewed by title and abstract and 47 articles were reviewed for full text. Twenty-six peer-reviewed articles were included for the review and were analyzed using meta-ethnography. Key findings included the recovery journey as a nonlinear, iterative experience that requires active engagement and patience. Healing was composed of (1) trauma processing and reexamination, (2) managing negative states, (3) rebuilding the self, (4) connecting with others, and (5) regaining hope and power. "Shifts" or "turning points" are also mentioned which catalyzed healing prioritization. This article aggregates and examines the scientific literature to date on GBV healing and provides articulation of the limitations, gaps in evidence, and areas for intervention. The article considers implications for future research, policy, and practice and, in particular, focuses our attention on the need to expand our knowledge of alternative recovery pathways and mechanisms for healing.

Bringing Shame Out of the Shadows: Identifying Shame in Child Sexual Abuse Disclosure Processes and Implications for Psychotherapy

Child sexual abuse (CSA) has been described as a highly stigmatizing experience. Despite the recognition of shame as a significant contributor to psychological distress following CSA, an inhibitor of CSA disclosure, and a challenging emotion to overcome in therapy, limited research has explored the experience of shame with young people who have been sexually abused. This study is unique in examining the transcripts of 47 young people aged 15-25 years from a large-scale study conducted in Ireland and Canada and exploring manifestations of shame in CSA disclosure narratives. Using a thematic analysis of both inductive and deductive coding, the data were examined for implicit, as distinct from explicit, manifestations of shame. Three key themes were identified in this study: languaging shame, avoiding shame, and reducing shame. The study supports previous authors in highlighting the need for nuanced measures of shame in research that takes account of the complexity of this emotion. Conceptualizations in the literature of the distinction between shame and guilt are challenged when these emotions are explored in the context of CSA. Finally, recommendations for working therapeutically with young people who have experienced CSA are offered with a view to addressing shame in therapeutic work.

Experiences of Women Survivors of Childhood Sexual Abuse in Relation to Nonsupportive Significant Adults: A Scoping Review

Childhood sexual abuse (CSA) is a complex trauma with devastating long-term, negative effects on survivors. This study extended the understanding of experiences of women survivors of CSA in relation to nonsupportive significant adults documented in literature, as to date, there exists no summary in literature on this particular topic. As such, a scoping review was conducted on publications between 1980 and January 2020. A total of 26 733 were selected for analysis in accordance with the search terms. After duplicates were removed and the exclusion criteria were applied, a total of 58 articles were selected for inclusion in the review. Thematic analysis was conducted on the studies included, and three themes were developed pertaining to the experiences of women survivors of CSA in relation to nonsupportive significant adults. Theme 1 identified nonsupportive behaviors experienced before disclosure or discovery of abuse. Theme 2 identified nonsupportive behaviors experienced during or after disclosure or discovery of abuse. Theme 3 identified the long-term negative consequences of nonsupportive experiences. These three themes support the findings of Freyd's betrayal trauma theory and Bowlby's attachment theory, extend on the global knowledge base of this topic, and identify gaps for further exploration.

What Characterizes Vulnerability? Interdisciplinary Perspectives on Service Provision for Survivors of Sexual Assault

Although research indicates that specialized sexual assault (SA) services are effective in terms of promoting postassault recovery and improving legal outcomes, little is known about how to best support survivors facing co-occurring difficulties and inequalities (e.g., preexisting mental health issues, substance abuse, poverty). This deficiency in knowledge was also expressed by service providers at Danish SA centers (SACs), who described this using the term "vulnerable survivors." Therefore, the present study aims to address this knowledge gap by exploring (a) how service providers understand vulnerability in the context of SA and (b) how service provision is currently approached for these survivors. Interviews were conducted with 18 service providers representing five professional groups (psychologists, social workers, forensic doctors, nurses, police) and analyzed using Interpretative Phenomenological Analysis. A total of eight themes emerged from the analysis, including service providers' descriptions of what characterizes vulnerability in survivors and broader perspectives on service provision for these survivors. Survivors considered least likely to attain desired supports were also those perceived to be most vulnerable with regards to risk and experiences surrounding sexual victimization (e.g., individuals with preexisting mental health issues). Service providers also believed that a large proportion of those served experience ongoing vulnerabilities that are difficult to manage within existing support models. The results thus suggest that survivors' needs cannot be met if vulnerabilities are overlooked or ignored. At the same time, the concept of vulnerability warrants caution since vulnerabilities are often placed within individual survivors, but the formal support system also appears vulnerable in its ability to meet the diverse needs and priorities of those served. The implications for SA services across the globe are discussed, including a need for more individually tailored and trauma-informed responses to SA that simultaneously address co-occurring difficulties and inequalities in survivors.

Student-Athletes', Coaches', and Administrators' Perspectives of Sexual Violence Prevention on Three Campuses with National Collegiate Athletic Association Division I and II Athletic Programs

Research has found associations between intercollegiate athletics and risk for sexual violence, and that sexual violence is more pervasive at colleges and universities with National Collegiate Athletic Association (NCAA) Division I athletic programs, relative to NCAA Division II, NCAA Division III and no athletic programs. Simultaneously, sports involvement is linked with prosocial values and there are documented developmental benefits of sports participation. College athletic programs hold promise for fostering sexual violence prevention but there is limited knowledge about how student-athletes conceptualize sexual violence and how athletes, coaches, and administrators perceive available prevention and response programs. We conducted seven Focus Group Discussions (FGDs) and 21 In-Depth Interviews (IDIs) with student-athletes, athletic directors, and coaches from public university Division I (n = 2) and Division II (n = 1) campuses. We assessed perceptions of sexual violence, knowledge and opinions of available prevention and response programs, and sought input on how to bridge gaps in campus sexual violence policies. Student-athletes associated sexual violence with alcohol in their relationships with peers and asymmetrical power dynamics in relationships with coaches and faculty. Athletes felt strong connections with teammates and sports programs but isolated from the larger campus. This created barriers to students' use of services and the likelihood of reporting sexual violence. Athletes felt the mandatory sexual violence prevention training, including additional NCAA components, were ineffective and offered to protect the university and its athletic programs from legal complications or cultural ridicule. Athletic staff were aware of policies and programs for reporting and referring sexual violence cases but their knowledge on how these served students was limited. Student-athletes were uncomfortable disclosing information regarding relationships and sexual violence to coaches and preferred peer-led prevention approaches.

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

One in four women will experience sexual assault in their lifetime. Although less than 5% of sexual assaults are reported to law enforcement, one in five cases reported to police are deemed baseless (by police) and therefore coded as "unfounded." Police officers are in a unique position to act as gatekeepers for justice in sexual assault cases, given their responsibility to investigate sexual assault reports. However, high rates of unfounded sexual assaults reveal that dismissing sexual violence has become common practice amongst the police. Much of the research on unfounded sexual assault is based on police perceptions of the sexual assault, as indicated in police reports. Women's perspectives about their experiences with police are not represented in research. This qualitative study explored women's experiences when their sexual assault report was disbelieved by the police. Data collection included open-ended and semi-structured interviews with 23 sexual assault survivors. Interviews covered four areas including the sexual assault, the experience with the police, the experience of not being believed, and the impact on their health and well-being. Interviews were audio-recorded, transcribed, and entered into NVIVO for analysis. Data were analyzed using Colaizzi's analytic method, resulting in the identification of four themes, including, (a) vulnerability, (b) drug and alcohol use during the assault, (c) police insensitivity, and (d) police process. The women in this study who experienced a sexual assault and reported the assault to police were hopeful that police would help them and justice would be served. Instead, these women were faced with insensitivity, blaming questions, lack of investigation, and lack of follow-up from the police, all of which contributed to not being believed by the institutions designed to protect them. The findings from this research demonstrate that police officers must gain a deeper understanding of trauma and sensitive communication with survivors of sexual assault.

From Offline to Online: Understanding Chinese Single Mothers' Uncertainty Management in Interpersonal and Online Contexts

Divorced and unwed single motherhood is heavily stigmatized in Chinese cultural context, preventing Chinese single mothers from actively seeking the information and support needed and negatively impacting their wellbeing. Drawing on the theory of motivated information management (TMIM), this study tested how perceived stigma and cultural norms influenced Chinese single mothers’ search for information and social support from families, friends as well as from online communities. Using two-wave data collected from 226 single mothers, findings support the utility of the TMIM in explaining information management and support seeking behaviors and contribute to situating the TMIM process within larger socio-cultural contexts. Practical implications regarding how to facilitate more effective uncertainty management and enhance Chinese single mothers’ wellbeing in interpersonal vs. online contexts are discussed.

"If You Report Your Dad, How are You Going to Survive": Health Practitioner Perspectives on Quality of Care for Survivors of Sexual Violence and the Challenge of Family Interference

This study examined the experiences and perspectives of health practitioners facing the challenges of providing services to female survivors of sexual violence. Interviews were conducted with 28 health practitioners, from eight post-rape care facilities located in Nairobi, Kenya. Data were analyzed using the Colaizzi's 1978 analytical model. The analysis of the results was guided by four domains of the ecological framework: individual, interpersonal, community/cultural, and public policy. The study documented a myriad of detail about the challenges faced by women before reporting the crime as well as the actual process of reporting. One key finding from this study was that health practitioners perceived family interference as a barrier to reporting, access to care, and to the pursuit of justice for survivors, particularly if the perpetrator was a relative. Family interference was also identified as a factor with implications for health practitioners' ability to ensure quality of care as it resulted in patients loss to follow-up and added to the negative emotional toll on health practitioners providing post-rape care. Three main themes emerged in practitioner responses related to this issue: (a) fear of consequences of reporting and care seeking, including economic vulnerability, family conflict, and retaliation such as divorce or further violence, (b) the trend toward out-of-court settlements rather than intervention through formal health and criminal justice sector challenges, and (c) attitudes toward sexual violence and survivors, normalization of rape, and victim-blaming attitudes. The study adds to our understanding of the obstacles faced by health practitioners providing post-rape care and provides a unique set of insights from the front lines on underlying factors contributing to these challenges.

Responding to Disclosure of Sexual Assault: The Potential Impact of Victimization History and Rape Myth Acceptance

Victims of sexual assault often disclose their victimization experiences to friends and family members in the hope of gaining support. However, a number of factors may influence the manner in which these confidants respond to the disclosure (e.g., severity of the victim's assault). The purpose of this study was to examine the role of two unique factors-the disclosure recipient's sexual victimization history and endorsement of rape myths-in predicting responses to disclosure. Participants were 114 undergraduate students who indicated that a close friend or family member had previously disclosed a sexual victimization experience to them. The participants' responses to that disclosure, personal sexual victimization history, and rape myth attitudes were assessed via a self-report. Results indicated that a history of victimization predicted increased emotionally supportive responses to disclosure. Lower rape myth acceptance predicted increased supportive responses (i.e., emotionally supporting the victim and aiding the victim) and decreased unsupportive responses (i.e., treating the victim differently after the abuse, distracting the victim from the abuse, and blaming the victim). These results have implications for prevention efforts and those working with sexual assault survivors.

Helpful and Hurtful Empathy: How the Interplay of Empathy, Shame, and Anger Predicts Responses to Hypothetical Rape Disclosures

Responses to rape victims, although often helpful, can be hurtful and hinder victims' health and recovery. Adopting a multidimensional approach to dispositional empathy, this research investigated how different subfacets of empathy predict responses to hypothetical rape victims. Before reading a sexual assault scenario, 282 participants completed measures of cognitive and emotional empathy. Participants' subsequent emotional arousal was measured by self-report, as were their intentions to help, avoid, or blame the victim. A path model demonstrated that dispositional empathy predicted behavioral intentions toward hypothetical rape victims by altering their vulnerability to experience shame or anger. People who tended to feel personal distress were more likely to mirror rape victims' assumed shame. Due to its antisocial nature, experiencing shame, in turn, led to hurtful behaviors such as blaming or distancing oneself from the victim. On the other hand, people who tended to feel empathic concern were more likely to feel anger on behalf of the victim following a rape disclosure. Anger is a motivating force for action and promotes helping behavior. A second study demonstrated that these results appear unique to rape disclosure, namely, participants reactions to nonsexual assault were unsuccessfully captured by this model. Understanding how empathetic arousal of shame can lead to hurtful intentions toward rape victims has important implications for future interventions: Programs that draw attention to the shame or humiliation experienced by rape victims may do more harm than good. For instance, some anti-rape campaigns portray pictures of women covering their faces. These campaigns, however well intentioned, may discourage people from helping victims because they may evoke feelings of shame in the perceiver. On the other hand, societal movements, such as the #Metoo movement, may be particularly effective by reducing the shame surrounding sexual assault and promote helpful behaviors.

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.

Measuring online health-seeking behaviour: Construction and initial validation of a new scale

OBJECTIVES

Online health-seeking behaviour (OHSB) such as information- and support-seeking encompasses a range of motivations and outcomes, but few studies consider the nuances of OHSB. The current study aimed to (1) develop and provide an initial validation of an OHSB measure, and (2) explore the role of demographic variables in OHSB among adult Internet users.

DESIGN

The study was a quantitative, cross-sectional online survey.

METHODS

The study consistent of two data collection waves, including 451 general Internet users (aged 18-73) and 204 online health groups users (aged 19-78) who completed online questionnaires.

RESULT

Exploratory Factor Analysis and Item Analysis in the two samples resulted in a final 37-item measure. The scale comprises three distinct factors: Support seeking (α = .97); information seeking (α = .89); and the Internet as a supplement or alternative to offline medical care (α = .88). Multiple regression analyses indicated that younger age, a higher number of people living in the household, and presence of a chronic condition significantly predicted all three aspects of OHSB. Poorer perceived health also predicted support-seeking online, while being male, employed and a general Internet user (vs. online health group member) also predicted using the Internet as a supplement or alternative to offline medical care.

CONCLUSION

The study presents a useful scale for future research to explore more complex psychosocial, contextual and health-related variables as potential contributors to health-seeking in the online domain.

Sexual Assault, Campus Resource Use, and Psychological Distress in Undergraduate Women

Undergraduate women are at high risk of experiencing sexual assault during their college years. Research has established a strong link between sexual victimization and psychological distress. Although the relationship between sexual victimization and distress has been established, little is known about how the use of university-affiliated sexual assault resources influences mental health outcomes for survivors. The aims of this cross-sectional study were to describe the characteristics of women who used campus survivor resources following a sexual assault during college, examine correlates of campus resource use, and examine correlates and predictors of mental health of women who have been sexually assaulted during college. An online anonymous survey was sent to undergraduate women at two public universities in a mid-Atlantic state. Participants were female, undergraduate students (N = 362) who had been sexually assaulted during their time at college. Few women (n = 98, 27.1%) used campus resources following a sexual assault. We found significant relationships between participants' use of campus survivor resources and experiencing a sexual assault prior to entering college, experiencing more severe sexual assaults, acknowledging the assault as a rape, feeling more self-blame, and experiencing more psychological distress. Campus resource use was significantly associated with poorer mental health outcomes. The cross-sectional nature of this study limited our ability to explore the reason for this. Further research is needed to explore the role campus resources play in supporting survivors during the recovery process. Given the high rate of sexual assaults on college campuses and the known negative psychological impact of sexual assault, it is imperative that campuses offer resources that are effective in meeting the needs of survivors.

The Impact of Campus-Level Factors on Peers' Perceived Ability to Support a Survivor

Campus sexual violence is a complex issue that has led to a proliferation of federal legislation and best practices with the intent to better support student survivors. Despite these efforts, research suggests that many survivors do not disclose to formal resources on campus, but rather, to their peers. While there is growing theoretical and empirical support for the role of peer-level influences on both preventing and responding to sexual violence on college campuses, our understanding of students' confidence in knowing how to respond is limited. Furthermore, disclosure research has yet to assess the impact of broader campus-level factors on students' confidence in being able to support survivors. In the present exploratory study, undergraduate students responded to a survey, which included questions about receiving disclosures and perceived ability to respond as well as measures of individual-level correlates (gender, race, prior victimization) and campus community factors (perceptions of the university's responsiveness, exposure to information, awareness of resources). Bivariate analyses were conducted to examine whether certain students were more likely to receive a disclosure on campus. To look at the impact of individual- and community-level factors, a series of hierarchical logistic regression models were estimated. Ability to respond to a disclosure was measured using three separate dichotomous variables. Findings show that 34% of our sample has received at least one disclosure of sexual violence from a peer since coming to campus. In addition, results show that above and beyond individual correlates, campus-level factors impacted students' confidence in their roles as disclosure recipients. These results have significant implications for sexual violence programs on campus. Suggestions for future research are also discussed.

Crime Victim Service Providers' Needs and Barriers: Rurality and "High Need"

The crime victims' rights movement has led to the development of advocacy, rights, and services for crime victims. A growing body of research has examined victim service provision using victim/client samples and complementary research has utilized service provider samples. The latter have focused on crime victim service providers' (VSPs) perceptions regarding clients' needs and barriers, as well as perceptions of service provision, needs, and barriers pertaining to their agency's operations. Although relatively small, the body of provider-focused victim services research has commonly considered the influence of rurality on service provision. The present study adds to this body of research by examining reported needs and barriers of VSPs (N = 94) in a Mountain West state, considering the influence of rurality and concentrated need. Three research questions informed the descriptive analyses: (a) What are the most commonly identified needs and barriers for providers in the state? (b) Are there differences in identified needs and barriers between rural and urban providers? (c) Do certain agencies report more needs and barriers than others, and if so, what are the differences? Findings indicate that many of the needs and barriers identified by VSPs mirror those identified by previous research and that agencies serving rural communities report significantly more needed services than those who do not serve rural communities. Furthermore, approximately 30% of the sample was designated as "high need" due to reported needs and/or barriers exceeding the average of the rest of the sample. The high-need agencies were not exclusively rural in terms of agency location or population served. The potential nuances of rurality's influence on VSPs in an overwhelmingly rural state are discussed.

Trauma Recovery Is Cultural: Understanding Shared and Different Healing Themes in Irish and American Survivors of Gender-based Violence

Little research has focused on the trauma healing processes of survivors of gender-based violence (GBV) worldwide. Even less research has utilized cross-cultural comparison to understand shared or culturally-distinct healing goals, creating a gap in understanding how to provide adequate, culturally relevant, and trauma-informed care to survivors. The purpose of this study was to cross-culturally compare shared healing influences and themes of the trauma recovery process in samples of Irish and American female survivors of GBV. To gather healing data, an ethnographic narrative interview was used with 19 American and 12 Irish female survivors who self-identified as having experienced GBV. Thematic analysis was used to examine and compare desired healing outcomes, focusing on the definitions, influences, and meanings of healing experiences. Our analysis revealed shared healing objectives of reconnecting to the self, others, and the world. Within reconnecting with the self, shared themes included regaining control and feelings of competency. Within reconnecting to others, shared themes included building and maintaining relationships, living one's life authentically, and feeling heard and understood. Within reconnecting to the world, shared themes included feelings of serenity, finding fulfillment, and having hope for a brighter future. Although these themes were shared, the way they manifested in each culture was often different. A vital component of the healing dynamic in the Irish sample was survivors' mothering responsibilities and feelings of unconditional devotion to their children. Conversely, the American sample focused on personal growth and resolving feelings of weakness. This information reveals shared as well as cultural nuances of important healing objectives following GBV. The present study's results can be used to create culturally sensitive and relevent healing spaces for survivors. These results can also inform intervention and messaging strategies aimed at promoting healing in these populations.

Transformative or Functional Justice? Examining the Role of Health Care Institutions in Responding to Violence Against Women in India

With the growing salience of ideas and reforms concerning women's human rights and gender equality, violence against women (VAW) has received heightened policy attention. Recent global calls for ending VAW identify health care systems as having a crucial role in a multisector response to tackle this social injustice. Scholars emphasize the transformative potential of such response in its ability to not only address the varied health consequences but also prevent future recurrence by enabling wider access to support and justice. This wider consensus on the role of health systems, however, demands stronger empirical basis. This article reports findings from an exploratory research developed around the core question: What are the perceived strengths and challenges confronting health systems in offering a comprehensive response to VAW in India? Drawing on site visits, observations, and interviews with front-line staff and program managers of an integrated intervention to tackle violence in Kerala and nongovernment organisation staff in Delhi and Mumbai, the article presents its historical context and key barriers to effective implementation. While promising in terms of outreach and incremental changes in attitudes, barriers include deficits in infrastructure and institutional practices that reinforce inequities in gender-power relations, hostile attitudes, and limited capacities of health workforce to tackle the complex and diverse needs of women experiencing abuse. Locating these experiences in relation to other models rooted in feminist approach, I argue how conventional intervention models of provisioning fail to challenge institutional contexts and structural inequalities that underpin violence and compound vulnerabilities experienced by women, thereby serving a functional response. Health systems are social institutions embedded in prevailing gender norms and power relations that must be tackled alongside addressing imminent needs of women victims of abuse. To this end, feminist approaches to counselling and relational perspectives to social justice can strengthen responsiveness (and transformative potential) of integrated sector-wide interventions.

"Why Did She Talk to Him Again?" The Effects of the Justice Motive, Relationship Type, and Degree of Postassault Contact on Perceptions of Sexual Assault

Victim blaming attitudes are prevalent within the criminal justice system where survivor behavior before, during, and following an assault is heavily scrutinized. Although dispositional characteristics (e.g., strength of one's justice motive) and characteristics of the assault (e.g., the type of relationship between a survivor and an offender) have been found to predict the degree of victim blaming, the effects of these variables on sexual assault myth endorsement are unclear. In addition, a variable that has not been examined in past literature is the degree of contact maintained between a survivor and offender after the assault. The purpose of the current study was to examine the extent to which the justice motive (strong vs. weak), the relationship between a fictional survivor and an offender (strangers vs. intimate partners), and contact between a survivor and offender postassault (contact vs. no contact) influenced endorsement of sexual assault myths. Undergraduate students read a vignette depicting a fictional sexual assault that varied with respect to the relationship and the amount of postassault contact between the survivor and offender and completed measures of the strength of their justice motive and their endorsement of sexual assault myths. Results indicated that participants (N = 419) who held a strong justice motive showed higher endorsement of sexual assault myths. Participants were also more likely to endorse sexual assault myths when there was postoffense contact between the survivor and offender. The implications of these findings and their relevance to the criminal justice system are discussed, including the need for further research into the creation of survivor-oriented education and training capable of counteracting bias toward survivors of sexual violence and producing sustained attitudinal changes.

Sexual Assault Disclosure: The Effect of Victim Race and Perpetrator Type on Empathy, Culpability, and Service Referral for Survivors in a Hypothetical Scenario

The aftermath of sexual assault warrants further attention surrounding the responses provided by those to whom survivors disclose, especially when perpetrator type or victim race may affect whether the bystander response is supportive or attributes culpability to the victim. Disclosure responses have significant consequences for survivors' posttrauma mental health and formal help-seeking behavior. The current study used a sample of 348 self-report, paper-and-pencil surveys administered during the fall 2015 semester to a purposive sample of undergraduate students with a mean age of 20.94 years old at a midsized, Southern public university. Survey design included a randomly assigned 2 × 2 hypothetical sexual assault disclosure vignette. The objective of the study was to assess the effect of perpetrator type (stranger vs. acquaintance) and victim race (White vs. Black) on empathic concern, culpability attributions, and resource referral. Between-subjects factorial ANOVA and multivariate ordinary least squares (OLS) regression models were estimated to identify the role of vignette manipulations, participant-sexual victimization history, and rape myth acceptance on empathy, culpability, and resource referral for the sexual assault survivor portrayed in the vignette. Multivariate analyses included main effects and moderation models. Findings revealed increased culpability and decreased resource referral for victims of acquaintance rape as compared with stranger rape, independent of victim race. Although no direct victim race effects emerged in the multivariate analyses, race moderated the effect of culpability on resource referral indicating culpability attributions decreased resource referral, but only when the victim was Black . Implications from the results presented here include a continued focus on bystander intervention strategies, empathy-building techniques, and educational programming targeting potential sexual assault disclosees and race stereotypes that disadvantage victims of color.

"Don't Ever Give Up!" Resisting Victimhood Through Self-Defense

Whether or not women should physically resist a male attacker has been a long-contested issue. This article enters this debate drawing on findings from an evaluation of a feminist self-defense course. It locates these data within a broader historical context to question dominant discourses around ideal femininity and explore the potential for empowerment such courses can offer, particularly for women deemed at high risk. It draws on qualitative data from interviews with course participants (n = 15), community stakeholders (n = 15), and self-defense instructors (n = 7), as well as quantitative data from pre-post course evaluations (n = 115). Findings are presented to demonstrate how participants and stakeholders from a diverse range of women's groups experienced the program. Evidence is presented that the participation not only resulted in increased self-defense skills but importantly also the confidence and attitude to put these skills into action, if required. Factors identified as critical to the success of these courses are explored, and the implications are assessed in relation to both prevention and empowerment.

Recommendations for Responding to Survivors of Sexual Assault: A Qualitative Study of Survivors and Support Providers

Empirical research has repeatedly examined the social reactions survivors receive from informal and formal support providers. This research has also provided an understanding of social reactions survivors perceive as helpful and hurtful. Advocacy agencies provide supplemental information instructing support providers how to respond to survivors in a positive way. However, these sources-to our knowledge-have not specifically asked survivors how they want to be responded to when disclosing assault and what they need in the aftermath of assault. Furthermore, studies have not asked support providers about how to respond to survivors in a positive way. Thus, the information provided to survivors and support providers on positive support may not be "survivor informed." This study examined recommendations for responding to survivors from two methods. First, as a broader approach, open-ended survey responses from N = 1,863 survivors were examined for unprompted recommendations on what survivors need following assault. Second, in a sample of 45 informal support dyads, survivors and support providers were specifically asked to provide recommendations on responding to survivors in a positive way. Results include recommendations from survivors to informal supporters, formal service providers, and other survivors on what is needed in the aftermath of sexual assault. Results also include recommendations on responding to survivors in a positive way from interviewed support providers to other supporters.

An Integrative Review of Safety Strategies for Women Experiencing Intimate Partner Violence in Low- and Middle-Income Countries

Intimate partner violence (IPV) is prevalent and a leading source of morbidity and mortality to women worldwide. Safety planning is a cornerstone of harm reduction and violence support in many upper income countries. Far less is known about safety strategies used by women in low- and middle-income countries (LMICs) where the IPV support service infrastructure may be more limited. This study aimed to review the literature regarding safety strategies in LMICs. A PubMed search was conducted using search terms "safety," "coping," "harm reduction," and "intimate partner violence." Inclusion criteria comprised IPV studies mentioning characterization and utilization of safety strategies that were written in English and conducted in an LMIC. Our search yielded 16 studies (in-depth interviews, n = 5; focus group discussions, n = 2; case study, n = 2; mixed qualitative methods, n = 4; mixed methods, n = 1; and semi-structured quantitative survey, n = 2). Four distinct themes of strategies emerged: engaging informal networks, removing the stressor/avoidance, minimizing the damage to self and family through enduring violence, and building personal resources. IPV-related safety strategies literature primarily emerged from site-specific qualitative work. No studies provided effectiveness data for utilized strategies. Across geoculturally diverse studies, results indicate that women are engaging in strategic planning to minimize abuse and maximize safety. Women highlighted that safety planning strategies were feasible and acceptable within their communities. Further research is needed to test the effectiveness of these strategies in decreasing revictimization and increasing health and well-being. Further adoption of safety strategies into violence programming could increase monitoring and evaluation efforts.

Multiple Traumas, Maternal Depression, Mother-Child Relationship, Social Support, and Young Children's Behavioral Problems

This study examined whether maternal depression, mother-child relationships, and maternal perceived social support mediate the associations between child's exposure to multiple traumatic events and behavioral problems. We recruited a representative sample of 904 Israeli (Jewish and Arab) mothers and their 2- to 6-year-old children. Data collection was conducted through structured face-to-face interviews with the mothers between July and November 2011. All measures were completed by the mothers. We used the child's and mother's exposure to political violence questionnaires, Child Behavior Checklist (CBCL), a short version of the Parental Acceptance-Rejection Questionnaire (PARQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Medical Outcomes Study (MOS) Social Support Survey. The research study model was tested using path analysis. The model showed a very good fit to the data, suggesting that maternal rejection, maternal depression, and social support play an important role in child's behavioral problems in the context of multiple traumatic events. Higher levels of maternal rejection were significantly associated with greater children behavior problems. Maternal rejection mediated the associations between maternal depressive symptoms and child's behavioral problems. Maternal perceived social support mediated the associations between child's exposure to multiple traumatic events and child's behavioral problems; child's exposure to multiple traumatic events was associated with lower levels of maternal perceived social support. In turn, lower levels of perceived social support were associated with higher levels of behavioral problems. In conclusion, in accordance with the "social stress framework," social support has a mediation role in the association between exposure to traumatic events and child's behavioral problems. Thus, enhancing social support to mothers to young children in the context of multiple traumatic events is essential for children resiliency.

Knowing you are there makes the difference: perceived social support, preferences for using support, and health

Using cluster analysis, we investigated whether perceived social support and individual differences in preferences to use support combined to form distinct profiles. Self-report data were collected from U.S. adults (N = 454; aged 40-90, M_age = 55.37, SD = 9.73). Four profiles were identified: disengaged, interpersonally connected, isolated independent, and connected independent. Profiles characterized by high perceived support were associated with better overall health, even among those who preferred not to use support; men and those not married or cohabiting were less likely to be in these profiles. Implications for understanding associations between social support and health and the identification of at-risk groups are discussed.

Factors Related to College Students' Decisions to Report Sexual Assault

Sexual assault is a serious problem on college campuses. Using a sample of 266 survivors of sexual assault during their college years, results from a multinomial regression identified factors linked with the odds of making either a formal report to university officials, an informal disclosure, or telling no one of the assault. Survivors were more likely to formally report the sexual assault to university officials if they had received sexual assault training, if the assault included vaginal or anal penetration, and if the survivor had a positive perception of the overall campus climate. Survivors were less likely to formally report the assault to university officials if the perpetrator was an acquaintance, friend, or dating partner compared with a stranger. Racial or ethnic minorities were less likely to formally report or informally disclose the assault. Our findings suggest that universities can aid survivors in reporting their sexual assault through education, training, and improving the overall campus climate.

Insecure Attachment and Other Help-Seeking Barriers among Women Depressed Postpartum

When untreated, postpartum depression (PPD) can severely, negatively affect maternal health, child development, and the wellbeing and functioning of the entire family. Yet, despite screening and treatment programs for PPD, many women who experience depression with onset in the postpartum year do not communicate their symptoms. Negative relational experiences early in life, such as not receiving sensitive help and support when needed, often result in so-called insecure attachment styles, and there is evidence that these may contribute to the development and maintenance of PPD. However, the role of insecure attachment styles in non-help-seeking is unknown for this group. Using mixed quantitative and qualitative methodology, we identified help-seeking barriers of women who experienced depression with onset in the postpartum year but who had not sought help for their depression (N = 37), and explored links to their attachment orientations as assessed through both self-reported attachment style and narrative based attachment script assessment. The sample was non-normative regarding attachment, with an over-representation of avoidant attachment styles. Help-seeking barriers varied systematically with the mother's adult attachment style. Specifically, convictions of a strong self and lack of trust in healthcare professionals constituted a common barrier among women with avoidant attachment styles, while unrealistic expectations about motherhood constituted a barrier for women with secure attachment styles. This new knowledge on how barriers to communicating symptoms and seeking help when suffering from PPD vary systematically with attachment orientation can help formulate individualized, and therefore more efficient, approaches to addressing non-help-seeking behavior in women who suffer in silence.

A Trauma-Informed Approach to Sexual Violence Research Ethics and Open Science

The practice of ethics in social science research is a reflexive process of self-review to define a profession's collective responsibility in the face of changing norms and expectations. In recent years, we have seen transformative changes in how society thinks about supporting sexual assault survivors, and how the scientific community thinks about our obligations to society. Decades of research on trauma and its impact has raised awareness about the needs of victimized individuals, giving rise to the trauma-informed practice movement, which emphasizes that service providers must center survivors' well-being in all interactions, decisions, and program practices. The field of sexual assault research helped give rise to this movement and provides empirical support for its guiding tenets, and in this article, we explore how to bring these ideas full circle to begin articulating trauma-informed principles for research. A trauma-informed perspective on research challenges scientists to go beyond the requirements of the Belmont Report (1979) and institutional review boards' (IRB) regulations to develop research procedures that fully support survivors' choice, control, and empowerment. Such reflection on participants' rights is particularly important given the open science movement sweeping academia, which calls on scientists to share their data publicly to promote transparency, replication, and new discoveries. Disseminating data could pose significant safety, privacy, and confidentiality risks for victims of sexual assault, so we need to evaluate what open science means within a trauma-informed framework. In this article, we examine three key stages of the research process-participant recruitment, data collection, and dissemination-and consider how trauma-informed principles could help, but also could complicate, research practices. We explore these tensions and offer potential solutions so that research on sexual trauma embodies trauma-informed practice.

Dealing With Death in Custody: Psychosocial Consequences for Correctional Staff

This study investigated experiences of trauma and psychosocial mediators in correctional staff who had dealt with a death in custody within the previous year. A total of 211 participants completed the Trauma Symptom Index as well as measures of self-efficacy, optimism, problem-solving style, social support, and growth. The data showed that around 32% of participants were exhibiting symptoms at a clinical level. Prior experience with suicide and level of involvement in the incident were direct predictors of symptom level. Support, optimism, self-efficacy, and confidence in problem-solving seemed to be potential protective factors and were also predictive of trauma-related growth. Although the study was cross sectional, the data suggest that it may be possible to predict factors that are protective and therefore offer some hope in terms of developing preventive strategies.

Reporting Crimes to the Police Depends on Relationship Networks: Effects of Ties Among Victims, Advisors, and Offenders

A victim's decision to report a crime to the police is typically made after talking with someone else, usually a friend or relative, but sometimes a stranger. The advice this person gives depends primarily on the seriousness of the crime, and to some extent on the gender and age of the victim. The present research, which used experimental vignettes, examined the role of social networks in reporting: How do the relationships among a victim, the advisor, and the offender affect the advice to report or not to report a violent or nonviolent crime? Results from Study 1 indicated that relationships matter: Crimes are least likely to be reported if the offender is part of the same triad as the victim and the advisor, and crimes are most likely to be reported if the victim, the advisor, and the offender are all strangers. Study 1 also found that males are more likely to protect friends who are offenders (by advising against reporting), while females are more likely to protect friends who are victims (by advising them to report). Study 2 found that the effect of these relationships on reporting is conditioned by the nature of the organization to which the offender belongs, such that males are particularly likely to protect their friends in athletic organizations and fraternities when accused of minor property crimes. Both studies found that gender differences in the advice to report are moderated by characteristics of the crime and triad structure.

Beyond Advocacy: Mapping the Contours of Victim Work

In contrast to works on victim advocacy in specific organizational contexts, this article introduces the term "victim work" to capture the vast array of victim-related roles and tasks that have proliferated in recent decades. Data are derived from in-depth interviews with 30 "victim workers" in public and private agencies in two Midwestern states. The interviews revealed diverse work experiences that spanned hotlines, crisis response, legal proceedings, and postconviction support. Three themes emerged that characterize "victim work": flexibility, emotions, and the challenge of "fit"-the multifaceted difficulties of interacting with victims and agents of the justice system. Based on the findings, we offer a revised model of criminal justice vis-à-vis victims and implications for practice and future research.

Adolescents' Daily Worries and Risky Behaviors: The Buffering Role of Support Seeking

With worries and risky behaviors becoming more prominent in adolescence, this study investigated bidirectional temporal connections between these two important adolescent concerns, that is, whether change in one concern is linked to change in the other either within the same day or during the next day. We also tested whether the coping strategy of seeking support from family and friends moderated the link between worries and risky behaviors. For 10 days, an ethnically and racially diverse sample of adolescents (N = 103; M age = 18.0) reported on 26 common worries, 18 risky behaviors, and the impact of seeking support from others. Multilevel models showed that worries and risky behaviors covaried on the same day and that worries predicted next-day risky behavior for male but not female participants. In contrast, risky behaviors did not predict next-day worries. For adolescents reporting negative experiences of support seeking, worries led to next-day risky behaviors and risky behaviors led to next-day worries. Female adolescents' positive support-seeking experiences buffered the association between risky behaviors and next-day worries. These results were significant beyond any influence of daily negative mood or depressive and anxiety symptoms. The data demonstrate that worries and risky behaviors may be situational triggers for each other and highlight the importance, from intervention perspectives, of adolescents' communication of concerns to others.

Preventing Posttraumatic Stress Related to Sexual Assault Through Early Intervention: A Systematic Review

Sexual assault survivors come into contact with a variety of community responders after assault, and these interactions may play an important role in mitigating distress. Given theoretical understandings of the importance of early experiences in the development of posttraumatic stress (PTS), early contact with formal systems (e.g., health care, criminal justice, social services) and informal responders (e.g., friends, family) might be particularly important in preventing PTS. However, the effectiveness of these early interventions is unclear. Understanding the key elements of early interventions, both formal and informal, that successfully prevent the development of PTS could help to improve community responses to sexual assault and ultimately promote survivor well-being. In this systematic review, we investigate the types of experiences with responders in the early aftermath of assault that are associated with PTS, the duration of effects on PTS, and the role of the timing of these responses in the development of PTS. Findings indicate that responder contact alone is not typically associated with significant differences in PTS, and there is insufficient evidence to indicate that the timing of seeking help is associated with PTS, but the quality of services provided and perceptions of interactions with certain responders appear to be associated with PTS. Although many effects were short-lived, interventions that were perceived positively may be associated with lower PTS up to a year postassault. These findings support the importance of offering best practice interventions that are perceived positively, rather than simply encouraging survivors to seek help.