Prevalence and consequences of adult sexual assault of men: review of empirical findings and state of the literature

Male victims of adult sexual assault (ASA) are understudied as compared with female victims. Further, commonly-held myths about sexual assault suggest that men cannot be victims or that, if men are victims, they are relatively physically and emotionally unharmed by sexual assault. The goal of this paper was to systematically review the empirical literature on ASA among men to evaluate the veracity of these myths. This paper also sought to examine the methodological quality of the body of research in this area, identify limitations and gaps in the current literature, and suggest directions for future research. Eighty-seven relevant studies were identified through a systematic review of the literature. The reported prevalence of men's sexual aggression varied widely depending on the methods used and the population studied; some populations (e.g., veterans, prison inmates, and gay and bisexual men) reported higher rates of ASA than men in the general population. Few studies have systematically examined the consequences of male ASA; however, those that have suggest that ASA can have notable adverse physical and psychological consequences for some men.     

A sex difference in features that elicit genital response

Previous research suggests that women's genital arousal is an automatic response to sexual stimuli, whereas men's genital arousal is dependent upon stimulus features specific to their sexual interests. In this study, we tested the hypothesis that a nonhuman sexual stimulus would elicit a genital response in women but not in men. Eighteen heterosexual women and 18 heterosexual men viewed seven sexual film stimuli, six human films and one nonhuman primate film, while measurements of genital and subjective sexual arousal were recorded. Women showed small increases in genital arousal to the nonhuman stimulus and large increases in genital arousal to both human male and female stimuli. Men did not show any genital arousal to the nonhuman stimulus and demonstrated a category-specific pattern of arousal to the human stimuli that corresponded to their stated sexual orientation. These results suggest that stimulus features necessary to evoke genital arousal are much less specific in women than in men.     

Sexual assault of men in the community

Sexual assault of men in the community, a hidden and unacknowledged crime, has recently become the subject of medical and psychological literature. The present research, conducted in 1992, was designed to determine the nature and existence of this crime in the United States through victim reports to agencies servicing the needs of sexual assault victims. Out of the 336 surveys returned, one hundred and seventy two agencies reported contact with 3,635 men who had sought treatment for sexual assault occurring in their adulthood. Most assaults occurred between the ages of 16 and 30 in which the vast majority of these men experienced symptoms of Posttraumatic Stress Disorder. The presentation of these figures should alert health professionals to the existence of adult male rape and inspire further research to assess this hidden form of sexual victimization. © 1997 John Wiley & Sons, Inc.     

Sex and diabetes: a thematic analysis of gay and bisexual men's accounts

Around 50 per cent of men with diabetes experience erectile dysfunction. Much of the literature focuses on quality of life measures with heterosexual men in monogamous relationships. This study explores gay and bisexual men's experiences of sex and diabetes. Thirteen interviews were analysed and three themes identified: erectile problems; other 'physical' problems; and disclosing diabetes to sexual partners. Findings highlight a range of sexual problems experienced by non-heterosexual men and the significance of the cultural and relational context in which they are situated. The personalized care promised by the UK government should acknowledge the diversity of sexual practices which might be affected by diabetes.     

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.     

Sexual assault and physical health: findings from a population-based study of older adults

OBJECTIVE: Prior reports have pointed to an adverse effect of sexual assault on subsequent health, particularly depression and obesity, in women. The objective of this study was to determine whether there is an association between self-reported sexual assault history and objective parameters of physical health in a sample of older men and women. METHODS: We conducted a cross-sectional study of white, middle to upper middle class, older (median age 75 years) men (N = 533) and women (N = 826) within a defined community setting. Sex-specific, age-adjusted risks were calculated for 11 common chronic medical conditions (10 for each sex: coronary heart disease, hypertension, diabetes, osteoporosis, obesity, asthma, migraine, thyroid disease, and arthritis in all subjects; breast cancer in women; and prostate cancer in men) and confirmed by physical or laboratory examination or review of medical records. RESULTS: Sexual assault was reported by 5.4% of men and 12.7% of women; repeated exposure was reported by 10.3 and 21.9% of sexually assaulted men and women, respectively. In women, a history of sexual assault was associated with an increased risk of 2 of 10 conditions: arthritis (OR = 1.76, 95% CI = 1.13-2.76) and breast cancer (OR = 2.21, 95% CI = 1.12-4.33). A "dose-response" effect was observed: Multiple episodes of sexual assault carried a two- to three-fold increased risk of these diseases compared with a single episode. In men, the only statistically significant association was between sexual assault and thyroid disease (OR = 4.68, 95% CI = 1.08-20.3). CONCLUSIONS: These data partially replicate findings from other studies of adverse effects of sexual trauma on health, although the specific diseases are different. Causal mechanisms cannot be inferred from these data. Studies in other cohorts are warranted.     

Risk recognition and trauma-related symptoms among sexually revictimized women.

This study used experimental methodology to investigate the differential impact of various levels of sexual victimization on women's perceptions of risk and evaluative judgments of sexual assault within a dating interaction. Single- and multiple-incident victims were compared with nonvictims. Results supported the hypothesis that revictimized women would exhibit longer latencies than either single-incident victims or nonvictims in signaling that an audiotaped date rape should be halted. Revictimized women with greater posttraumatic stress disorder (PTSD) symptoms, arousal symptoms in particular, exhibited latencies similar to those of nonvictims, whereas revictimized women with lower levels of PTSD symptoms had significantly longer latencies. Dissociative symptoms were not related to latency. These findings suggest that PTSD-related arousal symptoms may serve a buffering effect, increasing sensitivity to threat cues that portend a sexually coercive interaction.     

无性防卫能力强奸案的犯罪学特点

目的：探讨精神发育迟滞女性被奸案特征及性防卫能力问题。方法：采用自编性罪错调查表对50例经司法鉴定为无性防卫能力的强奸案，与50例以正常女性为性侵害对象的强奸案进行比较。结果：无性防卫能力女性被奸案在案犯年龄、犯罪动机、是否熟人、犯罪时间地点、被奸次数，以及案发时案发后受害人的反应等方面均存在显著性差异。结论：无性防卫能力女性被奸案存在一定特征。     

A longitudinal examination of male college students' perpetration of sexual assault

Self-administered surveys were completed by 197 men in college at 2 time points, 1 year apart. Men who committed sexual assault at multiple time points (repeat assaulters) had the most extreme scores on measures of hostility toward women, past sexual experiences, drinking in sexual situations, and adolescent delinquency. Nonassaulters had the least extreme scores and men who committed sexual assault at only 1 time point had scores that tended to fall in between. Repeat assaulters also expressed significantly less remorse when they described their sexual assault at Time 1 than did past assaulters who committed sexual assault only at the initial time point. These findings demonstrate the importance of initiating prevention and treatment programs in early adolescence, before longstanding attitudes and behaviors tolerant of sexual assault are established.     

The relationship of male self-report of rape supportive attitudes,sexual fantasy,social desirability and physiological arousal to sexually coercive stimuli

Studies have supported the finding that sexually coercive behavior exists between males and females on college campuses and that when women say “no” to sexual behavior, men do not believe them. This study utilized penile plethysmography to investigate male sexual arousal to rape myth scenarios in a college population. The scenarios portrayed a woman who said “no” to sexually coercive intercourse behavior by a male. Results indicated that a low level of social desirability, sexual fantasies involving group sexual activity, as well as hurting and being hurt by a partner were associated with greater levels of physiological responding to coercive stimuli. Supportive attitudes about rape showed no relationship with physiological responding, yet did correlate with the sexual fantasy of being hurt by a partner, which was itself related to increased sexual arousal to sexually coercive audio stimuli. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53: 935–942, 1997     

Uncovering category specificity of genital sexual arousal in women: The critical role of analytic technique

Based on analytic techniques that collapse data into a single average value, it has been reported that women lack category specificity and show genital sexual arousal to a large range of sexual stimuli including those that both match and do not match their self‐reported sexual interests. These findings may be a methodological artifact of the way in which data are analyzed. This study examined whether using an analytic technique that models data over time would yield different results. Across two studies, heterosexual (N = 19) and lesbian (N = 14) women viewed erotic films featuring heterosexual, lesbian, and gay male couples, respectively, as their physiological sexual arousal was assessed with vaginal photoplethysmography. Data analysis with traditional methods comparing average genital arousal between films failed to detect specificity of genital arousal for either group. When data were analyzed with smoothing regression splines and a within‐subjects approach, both heterosexual and lesbian women demonstrated different patterns of genital sexual arousal to the different types of erotic films, suggesting that sophisticated statistical techniques may be necessary to more fully understand women's genital sexual arousal response. Heterosexual women showed category‐specific genital sexual arousal. Lesbian women showed higher arousal to the heterosexual film than the other films. However, within subjects, lesbian women showed significantly different arousal responses suggesting that lesbian women's genital arousal discriminates between different categories of stimuli at the individual level. Implications for the future use of vaginal photoplethysmography as a diagnostic tool of sexual preferences in clinical and forensic settings are discussed.     

Victimization among homeless women: Implications for service delivery

This article focuses on the experience of victimization among a representative sample of 141 homeless women interviewed in a single-adult shelter in New York City. The frequency of victimization experiences, specifically aggressive sexual and physical assault, was high. Twenty-one women reported being raped, 42 women reported both rape and physical abuse, and 62 women reported physical abuse without sexual abuse. Shelter women reporting frequent experiences were likely to experience high levels of depressive symptoms; psychotic symptoms; and hospitalization for psychiatric, medical, alcohol, and drug problems. These results further indicate that assault experiences cluster in specific ways and are associated with different clinical outcomes. These findings are seen as underscoring the need for service delivery programs to respond to the experience of vicitimization among homeless women and suggest some future research directions.     

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.     

Increased male responsibility and participation: a key to improving the reproductive health

This article examines the role of male responsibility and participation in the enhancement of reproductive health in India. Men are recognized to be responsible for the large proportion of reproductive ill health suffered by their female partners. Lack of knowledge, nonavailability of acceptable contraceptives and lack of services with quality of care deter men from sharing the responsibility in reproductive health matters. Misinformation regarding male sexuality and limited availability of scientific data contributed men's less involvement in reproductive health. Thus, various strategies are implemented to increase men's awareness of reproductive health and the accessibility of products and services. These strategies include: 1) increasing contraceptive options for men; 2) supporting women's contraceptive use; 3) improving sexual behavior and safe sex practices; and 4) narrowing the gender gap for better fertility control. Moreover, extensive research is required in order to understand men's perceptions and needs about fertility regulation and sexual behavior as well as services development.     

Cognitive-behavior therapy for PTSD in rape survivors

In recent years, new data have appeared, further suggesting the utility of cognitive-behavioral interventions for posttraumatic stress disorder (PTSD) subsequent to sexual assault. In this article, we present a model of cognitive-behavioral treatment (CBT) for PTSD in rape survivors. Emotional-processing theory, which proposes mechanisms that underlie the development of disturbances following rape, is reviewed. A CBT-based therapy (Prolonged Exposure) is presented that entails education about common reactions to trauma, relaxation training, imaginal reliving of the rape memory, exposure to trauma reminders, and cognitive restructuring. Current research regarding the use of prolonged exposure is discussed. The case example of a young female rape survivor is described in detail, and her prior substance dependence and intense shame are highlighted. The therapy was successful in reducing the client's symptoms of PTSD, as well as her depressive symptoms, and these gains were maintained at a one-year follow-up assessment.     

The impact of men's alcohol consumption on perpetration of sexual aggression

Epidemiological and experimental literature examining the link between men's alcohol consumption and perpetration of sexual aggression is reviewed. The following are included in the review: (1) associational studies that examine the correlation between typical alcohol consumption and history of sexual aggression perpetration; (2) event-level studies that examine the impact of alcohol consumption at the time of sexual assault; and (3) experimental studies that consider the impact of administered alcohol on men's responses to a sexual aggression analog. Associational studies suggest a modest correlation between typical alcohol consumption and history of sexual aggression perpetration, but spurious effects may account for much of the relationship. Event-level studies offer mixed evidence in support of a relationship between alcohol consumption at the time of the sexually aggressive incident and severity of outcome. Experimental analog studies provide evidence of a proximal, pharmacological effect of alcohol on the likelihood of sexual aggression perpetration and more modest evidence supporting an alcohol expectancy effect. An integrative heuristic model of alcohol's distal and proximal effects on sexual aggression perpetration is proposed. Priorities for future research include greater specificity in measurement of sexual aggression, examination of alcohol's indirect effects on aggression through context, and consideration of mechanisms other than alcohol myopia in understanding alcohol's proximal effects.     

Sexual arousal patterns of bisexual men revisited

Men who identify themselves as bisexual report feeling sexually aroused by both men and women. However, past research has not demonstrated that such men exhibit substantial genital arousal to both male and female erotic stimuli, suggesting that they identify as bisexual for reasons other than their genital arousal pattern. The purpose of the present study was to examine arousal patterns among bisexual men who were recruited using stringent criteria involving sexual and romantic experience with both men and women in order to increase the likelihood of finding a bisexual arousal pattern. Bisexual men in the present study demonstrated bisexual patterns of both subjective and genital arousal. It remains unclear which pattern is most typical of contemporary bisexual men: the present results supporting a bisexual arousal pattern, or previous results not finding one. In either case, understanding men with bisexual arousal patterns could help illuminate the etiology and development of male sexual orientation.     

Offense type and two-point MMPI code profiles: discriminating between violent and nonviolent offenders

Offense data and MMPI profiles were examined for 67 men who had been remanded by the courts to a psychiatric hospital forensic unit for pretrial assessment. They were classified as violent or nonviolent offenders based upon the nature of their offenses. Violent offenders were those charged with assault, robbery, sexual assault, and all degrees of homicide. Nonviolent offenders were those charged with break, enter and commit, uttering threats, and fraud. The controversial issue of two-point MMPI code types (4-3, 4-8/8-4) was addressed. Neither of these commonly employed two-point types successfully discriminated between violent and nonviolent offenders.