The development of a brief acceptance and mindfulness-based program aimed at reducing sexual revictimization among college women with a history of childhood sexual abuse

Women with a history of childhood sexual assault (CSA) are more likely to be revictimized; however, most existing programs aimed at reducing sexual victimization do not expressly address the issue of revictimization. The present study examined the efficacy of a brief mindfulness-based program in reducing rates of sexual assault and revictimization in college women over the course of an academic semester. Although the results were not statistically significant, a large-magnitude effect was noted, whereby women with a history of CSA who participated in the program were less likely to be sexually assaulted and raped at 2-month follow-up.     

Social support and risk of sexual assault revictimization

Limited research on revictimization has examined the role of social support, which is known to affect sexual assault survivors' psychological recovery. Measuring social support also provides a more ecological approach to understanding revictimization, as it assesses the possible role of those in the survivors' environment. The current study examined how social support and disclosure experiences of 625 community‐based survivors related to their revictimization status over a 12‐month period. Results showed differences between revictimized and nonrevictimized survivors in terms of who they disclosed to about their assault. In addition, revictimized survivors received less informational and emotional support and more blaming reactions. Implications for future research regarding using an ecological approach to better understand revictimization risk are discussed. © 2008 Wiley Periodicals, Inc.     

The role of childhood sexual abuse sequelae in the sexual revictimization of women: an empirical review and theoretical reformulation

There is now widespread empirical evidence that child sexual abuse (CSA) survivors are at greater risk for sexual revictimization in adulthood, but less is known of the mechanisms underlying this relationship. Despite the lack of a conceptual framework to guide research, there has been a recent influx of studies examining explanatory variables, with most focusing on the psychological sequelae of CSA: alcohol and drug use, sexual behavior, dissociation, posttraumatic symptomatology, poor risk recognition, and interpersonal difficulties. With the exception of sexual behavior, the studies reviewed here provide limited or mixed support for the role of intrapersonal factors in revictimization. Future research may benefit from a focus on the function of psychological distress that is expressed as psychological vulnerability, as opposed to individual forms of psychopathology or maladaptive behavior. An ecological framework may be useful as a guide to future investigations, as this model focuses on factors outside of the victim, including childhood factors such as family environment, contextual factors including the behavior of the perpetrator, and societal and cultural factors that impact revictimization. Future investigations should focus on the interaction between victim vulnerability and perpetrator behavior. Implications for prevention programming, clinical intervention, and future research are discussed.     

Differential effects of women's child sexual abuse and subsequent sexual revictimization.

This study examines the differential effects of sexual revictimization in a community sample of 248 African-American and White American women, ages 18 to 36. Two classifications of sexual revictimization over the life course were used to assess the effects on later sexual and psychological functioning. The findings suggest that unintended pregnancies and abortions were significantly associated with sexual revictimization. Women who reported more than one incident in both childhood and adulthood were also likely to have multiple partnerships and brief sexual relationships. The findings are discussed within the context of the dynamics of sexual revictimization and its effects. Suggestions are offered for therapeutic strategies with survivors in order to minimize the effects of sexual revictimization.     

The evaluation of a sexual assault risk reduction program: a multisite investigation.

This article summarizes the results of the Ohio University Sexual Assault Risk Reduction Project, which is a program designed to reduce college women's risk for sexual assault. The program was evaluated at 2 separate universities with 762 women. Participants were randomly assigned either to the program or to the no-treatment comparison group, and they completed measures that assessed sexual victimization, dating behaviors, sexual communication, and rape empathy at the pretest and at the 2-month and 6-month follow-ups. At the 2-month follow-up, there were no differences between the groups on any of the outcome measures. However, those women who were moderately victimized during the 2-month follow-up were significantly less likely to be revictimized during the 6-month follow-up period if they participated in the program.     

Exploring Revictimization Risk in a Community Sample of Sexual Assault Survivors

Previous research points to links between risk detection (the ability to detect danger cues in various situations) and sexual revictimization in college women. Given important differences between college and community samples that may be relevant to revictimization risk (e.g., the complexity of trauma histories), the current study explored the link between risk detection and revictimization in a community sample of women. Community-recruited women (N = 94) reported on their trauma histories in a semistructured interview. In a laboratory session, participants listened to a dating scenario involving a woman and a man that culminated in sexual assault. Participants were instructed to press a button “when the man had gone too far.” Unlike in college samples, revictimized community women (n = 47) did not differ in terms of risk detection response times from women with histories of no victimization (n = 10) or single victimization (n = 15). Data from this study point to the importance of examining revictimization in heterogeneous community samples where risk mechanisms may differ from college samples.     

Impact of mindfulness-based cognitive therapy on counseling self-efficacy: A randomized controlled crossover trial

ObjectiveTo investigate the impact of a structured eight-week mindfulness-based cognitive therapy (MBCT) program on counseling self-efficacy among counseling trainees.MethodsUndergraduate counseling trainees were randomized to an MBCT group (n = 25) or a waitlist control group (n = 25) with a crossover trial design. Psychological measurements regarding mindfulness, empathy, self-compassion, psychological distress, counseling self-efficacy as well as neuro-physiological measures including frontal midline theta activity, respiration rate, and skin conductance were taken at baseline (T1), after intervention (T2), and six-month follow-up (T3).ResultsMindfulness training could make significant positive changes in empathy, self-compassion, stress reduction, and counseling self-efficacy with this being backed up by both psychological and neuro-physiological evidence at T2. However, such differences between the two groups had greatly subsided after crossover in which carry-over effect and marked improvement were noted in the study and control group, respectively, at T3. In addition, mindfulness was the most significant determinant that contributed to counseling self-efficacy, followed by psychological distress reduction and self-compassion according to the regression models.ConclusionIntegrating mindfulness into counseling training is beneficial for helping profession trainees.Practice implicationIncorporating mindfulness into counseling training can enhance the necessary “being mode” qualities in counseling and address self-care issues during training.     

Predictors of bystander behaviors and sexual assertiveness among college women attending a sexual assault prevention program

Identifying predictors of bystander behaviors and sexual assertiveness can help to inform sexual assault prevention programs on college campuses. College sorority members (N = 141) completed measures of sexual assault history, rape myth acceptance, bystander self‐efficacy, sexual assertiveness, and bystander behaviors before attending The Women's Program, which is a bystander‐based sexual assault prevention program. Regression analyses were conducted. Lower rape myth acceptance and greater bystander self‐efficacy predicted more engagement in bystander behaviors and higher sexual assertiveness. A total of 28 participants completed a 2‐week follow‐up survey that included measures of rape myth acceptance, bystander self‐efficacy, and sexual assertiveness. T‐test analyses were conducted. Rape myth acceptance was significantly lower among participants at 2‐week follow‐up compared to baseline. Implications for sexual assault prevention on college campuses are discussed.     

Online psychoeducational support for infertile women: a randomized controlled trial

BACKGROUND: The study goal was to develop and test the effectiveness of a brief online education and support program for female infertility patients. METHODS: A randomized-controlled trial was conducted. Using a Solomon-four group design, 190 female patients were recruited from three US fertility centers and were randomized into two experimental and two no-treatment control groups. The psychological outcomes assessed included infertility distress, infertility self-efficacy, decisional conflict, marital cohesion and coping style. Program dosage and satisfaction were also assessed at four weeks follow-up. RESULTS: Women exposed to the online program significantly improved in the area of social concerns (P = 0.038) related to infertility distress, and felt more informed about a medical decision with which they were contending (P = 0.037). Trends were observed for decreased global stress(P = 0.10), sexual concerns (P = 0.059), distress related to child-free living (P = 0.063), increased infertility self-efficacy (P = 0.067) and decision making clarity (P = 0.079). A dosage response was observed in the experimental groups for women who spent >60 min online for decreased global stress (P = 0.028) and increased self efficacy (P = 0.024). CONCLUSIONS: This evidence-based eHealth program for women experiencing infertility suggests that a web-based patient education intervention can have beneficial effects in several psychological domains and may be a cost effective resource for fertility practices.     

Effects of a parenting sexual education program for immigrant parents: A cluster randomized trial

ObjectivesThe aim was to assess the effects of a parental sex education program on knowledge, attitudes, self-efficacy, and practices among immigrant parents.MethodsA cluster randomized trial was conducted at immigrant activity centers in northern Taiwan. Recruited participants were randomly assigned to an experimental (four centers, n = 86) or control (four centers, n = 67) group. A practical booklet and a booster session were delivered. In total, 132 participants’ knowledge, attitudes, self-efficacy, and practice of parenting sexual education were examined at the baseline and 6 weeks after the intervention.ResultsAfter controlling for possible confounders, the posttest scores of self-efficacy of the experimental group were higher than those of the control group. The Johnson-Neyman procedure indicated that the intervention was effective for participants who had pretest knowledge, attitude, and practice scores of <14.62, <110.27, and <41.5, respectively.ConclusionsAn intervention with both practical booklet and booster session can improve knowledge, attitudes, self-efficacy and practices of parental sex education among immigrant parents.Practice implicationsIn addition to practical booklets, health care professionals should provide booster sessions that meet the needs of immigrant parents to prevent sexual problems among children and adolescents at an early age.     

Effects of a rape awareness program on college women: increasing bystander efficacy and willingness to intervene

An experimental study evaluated the efficacy of a sexual assault risk‐reduction program on 279 college women that focused on learning characteristics of male perpetrators and teaching bystander intervention techniques. After seeing The Women's Program, participants reported significantly greater bystander efficacy and significantly greater willingness to help than before seeing the program. Participants outperformed a control group. Rape myth acceptance also declined among program participants. Implications for rape awareness programming are discussed. © 2010 Wiley Periodicals, Inc.     

What factors predict women's disclosure of sexual assault to mental health professionals?

Although many sexual assault survivors seek support from mental health sources for adverse psychological symptoms due to sexual assault, many do not. A diverse sample of adult sexual assault survivors was surveyed about their sexual assault experiences, social reactions received when disclosing assault, attributions of blame, coping strategies, and psychological symptomatology. Statistical analyses were run to identify demographic, assault, and postassault factors differentiating women who disclosed from those who did not disclose sexual assault to mental health sources. Both demographic (race, sexual orientation, and age) and postassault factors (posttraumatic stress disorder [PTSD] symptom severity, number of informal support sources told, receipt of tangible aid/information support) significantly predicted assault disclosure. Implications of the results are discussed. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 619–638, 2007.     

时间管理心理干预对医学院新生学业自我效能感的影响

目的探讨时间管理心理干预对医学院新生学业自我效能感的影响。方法采用对照研究,以团体心理干预技术,对24名医学院新生进行为期8周的时间管理心理干预。结果在学业自我效能感总分及各维度上,实验组前后测差值显著高于对照组(t=2.690,2.707,2.155;P<0.05)。在学业自我效能感总分和学习能力自我效能感得分上,实验组的追踪测试结果与前测差值显著高于对照组(t=2.56,2.97;P<0.05)。结论时间管理心理干预可以有效提高医学院新生的学业自我效能感,并且后效显著。     

Child Sexual Abuse and Sexual Revictimization

Research identifying rates and effects of adult/adolescent sexual revictimization among child sexual abuse victims was reviewed. Approximately one-third of child sexual abuse victims report experiencing repeated victimization. Child sexual abuse victims have a 2 to 3 times greater risk of adult revictimization than women without a history of child sexual abuse. Physical contact in abuse and revictimization in adolescence were found to lead to the greatest risk of revictimization. Repeated victims had more symptoms of Post Traumatic Stress Disorder (PTSD) and dissociation than women with a history of child sexual abuse alone. Theories of revictimization and mediating variables were also reviewed. Clearer definitions of repeated victimization are needed and future research should include studies that follow child sexual abuse victims prospectively.     

基于优势的大学生乐观干预训练

目的:以优势的发现和实现理论以及期望模型理论为基础,探讨乐观倾向训练方案对乐观、悲观的各自改变效果及效果的稳定性;同时进一步分析该训练对相关消极、积极心理变量的影响效果。方法:采用实验组、控制组对比训练实验法。结果:实验组的乐观、自尊、内控性、一般自我效能感、正性情感、一般生活满意度和主观幸福感等指标都得到显著提升,而悲观、抑郁和负性情感等显著降低,并且追踪测量效果更为显著,表现出本训练方案的长期效果不但稳定而且还表现为后期效应扩大的现象。结论:基于优势的乐观干预训练效果显著且稳定。     

The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: a mediational model of posttraumatic stress disorder and physical health outcomes

This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms; the 3rd, sexual revictimization across the lifespan with adult sexual harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed.     

Revictimization rates and method variance: a meta-analysis

The present meta-analytic review examined revictimization rates and sources of variance among rates provided by 19 empirical studies of adult females. In this review, revictimization refers to the occurrence of at least one incident of childhood sexual abuse followed by a subsequent incident of adult sexual victimization. Studies were included in the review if they provided rates of revictimization and had a comparison sample of nonrevictimized women. The overall effect size for revictimization was .59, a moderate effect, suggesting a definite relationship between childhood victimization and adult victimization experiences. The overall effect size was heterogeneous and various study characteristics and definition issues were examined to determine their effect on revictimization rates. The most striking, although not surprising finding, was that studies in which more inclusive definitions of abuse were utilized yielded smaller effect sizes than studies that used more restrictive definitions of abuse. Studies that examine victimization or revictimization are often concerned with learning more about the phenomenon with the expectation that by understanding the underlying mechanism, prevention and treatment can be better focused. The interpretation given to results from past and future studies should take into account those factors found to influence estimations of revictimization rates.     

Emergency evaluation and intervention with female victims of rape and other violence

Given the high prevalence of crime within the general population and the increased rates of victimization among those seeking medical care, professionals who work in emergency departments, primary care medical facilities, or mental health settings need to be prepared to address physical and psychological problems related to sexual and physical assault. In this paper, interpersonal violence prevalence studies are reviewed in terms of study design and findings for sexual assault and physical assault. Common injuries following both forms of assault are documented, followed by a review of long-term medical outcomes. In addition to a review of physical health outcomes, primary psychological effects of violence are also reviewed. Strategies with which to screen for interpersonal violence in the medical setting are offered, and issues related to mandatory reporting are summarized. Interventions for assault victims that can be implemented in the medical setting are outlined, and a new hospital-based treatment for victims of rape is described.     

Planning and self-efficacy can increase fruit and vegetable consumption: a randomized controlled trial

Fruit and vegetable consumption represents a nutritional goal to prevent obesity and chronic illness. To change dietary behaviors, people must be motivated to do so, and they must translate their motivation into actual behavior. The present experiment aims at the psychological mechanisms that support such changes, with a particular focus on dietary self-efficacy and planning skills. A randomized controlled trial compared a theory-based psychological intervention with a health education session in 114 participants. Dependent variables were fruit and vegetable consumption, intention to consume more fruit and vegetables, planning to consume more, and dietary self-efficacy, assessed before the intervention, 1 week afterwards, and at 6-week follow up. Significant group by time interactions for all four dependent variables documented superior treatment effects for the psychological intervention group, with substantially higher scores at posttest and follow-up for the experimental group, although all students benefited from participation. To identify the contribution of the main intervention ingredients (self-efficacy and planning), regression analyses yielded mediator effects for these two factors. A social-cognitive intervention to improve fruit and vegetable consumption was superior to a knowledge-based education session. Self-efficacy and planning seem to play a major role in the mechanisms that facilitate dietary changes.     

Evaluation of an Intervention to Increase Self-Efficacy for Independent Exercise in Cardiac Rehabilitation

Adherence to independent exercise is an essential outcome of cardiac rehabilitation (CR), yet limited theory-based interventions to improve adherence exist. This study tested the effects of an intervention based on Bandura's conceptualization of self-efficacy. The self-efficacy coaching intervention (SCI), a supplement to standard care, was designed to increase self-efficacy for independent exercise and independent exercise behavior in CR. We examined whether the SCI vs. attention control (AC) resulted in improved exercise self-efficacy (ESE), barriers self-efficacy (BARSE), and minutes of independent exercise for CR participants (n = 65). While between-group differences did not reach significance (p > .10) for any of the outcome measures, significant within-group changes were noted in BARSE scores and independent exercise (p < .001) for the SCI group. Change in independent exercise for the AC group was also significant (p =. 006). Further study is needed to explore whether short-term changes translate into maintenance of independent exercise participation after program completion.