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.     

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.     

城市女性遭遇性侵犯的风险因素

目的:探索城市女性遭遇性侵犯的发生率及风险因素。方法:采用方便取样,在广东省3城市随遇选取1023名17～45岁女性,匿名填写人口学信息统计表、艾森克人格问卷(EPQ)、特质应付方式问卷(TCSQ)、社会支持自评量表(SSRS)、应激史问卷(THQ)。结果:在有效回应的946人中,报告有被性侵犯经历的有223人,占23.57%。创伤事件数量、受教育程度、神经质、消极应对方式、婚姻状况与性侵事件正相关(r=0.07～0.51,均P<0.05),而主观支持和支持利用度与性侵事件负相关(r=-0.12,-0.08,均P<0.05)。Logistic多因素回归分析表明,较多的创伤事件数量(OR=1.85～2.80)、较多受教育年数(OR=1.11～1.54)、主观支持水平较低(OR=0.86～0.99)的女性有较高的被性侵犯风险,这3个因素可共同解释40.24%的城市女性被性侵风险。结论:较高的教育水平、较多经历创伤事件及较低的主观支持程度可能是城市女性遭遇性侵犯的风险因素。     

Prevention of sexual and physical assault toward women: A program for male athletes

This article presents a sexual and physical violence prevention program designed for college student athletes. The program has been in place for approximately 10 years and has demonstrated several uniquely positive results. Implications for prevention programs designed for high-risk groups and athletes in particular are presented as are the components and philosophy felt necessary for such programs. © 2000 John Wiley & Sons, Inc.     

The effects of sexual assault on men: a survey of 22 victims

Twenty-two men, who had been forcibly sexually assaulted, participated in a study to determine the circumstances of the attacks and the effects on the victims. The immediate and long-term responses were very similar to those described in female victims of rape.     

Acute management of the sexual assault victim.

Sexual assault victims usually seek emergency medical care at urban hospitals. The incidence of over 52,000 cases a year reported by the FBI does not include instances in which the victim died, cases of statutory rape (victim below the age of consent), or cases not confirmed by the police. It is well known that sexual assault is one of the most unreported crimes. The incidence of this crime in affluent communities is unknown. Rape occurs in any community but nonhospital professional services may be more easily available in some.     

Cognitive processing therapy for sexual assault victims.

Cognitive processing therapy (CPT) was developed to treat the symptoms of posttraumatic stress disorder (PTSD) in rape victims. CPT is based on an information processing theory of PTSD and includes education, exposure, and cognitive components. Nineteen sexual assault survivors received CPT, which consists of 12 weekly sessions in a group format. They were assessed at pretreatment, posttreatment, and 3- and 6-month follow-up. CPT subjects were compared with a 20-subject comparison sample, drawn from the same pool who waited for group therapy for at least 12 weeks. CPT subjects improved significantly from pre- to posttreatment on both PTSD and depression measures and maintained their improvement for 6 months. The comparison sample did not change from the pre- to the posttreatment assessment sessions.     

Medical and social aspects of sexual assault of males: a survey of 100 victims.

Sexual assault of males is an infrequently reported and a poorly understood phenomenon. Details of 100 victims who sought assistance from a nationwide agency set up specifically to provide help for such individuals are reported here. Twenty eight victims were aged 16 years or over at the time of assault. The assailants were known by 72 of the victims and were perceived by the victim to have a heterosexual orientation in 72% of these cases. Attacks were often multiple and in 33 cases involved disruption of skin or mucous membranes. Twenty victims received threats about the possibility of transmission of the human immunodeficiency virus and 17 victims sought medical advice following the assault, most commonly from their general practitioner. It is suggested that greater opportunities for medical and psychological support should be given to male victims of sexual assault.     

Positive and negative life changes following sexual assault.

A longitudinal study was conducted to investigate (a) the timing and course of posttraumatic growth and (b) the relations between positive and negative life changes and posttraumatic distress among recent female sexual assault survivors (N = 171). Most survivors reported positive change even at 2 weeks postassault. Positive changes generally increased over time and negative changes decreased, although change in different domains followed different courses and there was significant individual variability in change patterns. Both positive and negative changes were associated with distress in expected ways, although the relations with negative changes were stronger. The least distress at 12 months was reported by those who noted positive life changes at both 2 weeks and 12 months postassault. Implications for theory and research on posttraumatic growth are discussed.     

Results of a multifactor cardiovascular risk reduction program in the czech republic: The healthy dubec project

Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the world. A 2-year community-based project was designed to increase CVD awareness and knowledge and behavior change skills, thus stimulating change in CVD-related behaviors. Dubec, a Czech town located just outside Prague, was the study community. Risk-factor surveys were conducted before and after the intervention (1992 and 1994). The intervention combined communitywide health education and intensive medical treatment of individuals at high risk for CVD. At baseline, 55% of the eligible population (n = 1,119) participated in the survey; however, the dropout rate in 1994 was high (46%). After taking those factors associated with dropout into consideration, regression analyses revealed significant increases in CVD knowledge, reductions in blood pressure, non-high-density lipoprotein cholesterol (non-HDL-C), and dietary intake of fat in both the high-risk CVD group and the community sample. In addition, the community sample had significant reductions in total cholesterol and a positive shift in their attitudes about changing CVD risk. There were no significant changes in percentage of smokers, body mass index (BMI), or dietary intake of high-fiber foods. This study demonstrates the feasibility of addressing CVD risk-related behaviors in Central Europe and supports additional efforts to address this significant public health problem. This program was supported by the U.S. Agency for International Development (US AID) under the Partnerships in Health Care Program (EUR 00037-G-00-2026-00). The authors wish to acknowledge the considerable support of Julia Terry, US AID program officer for the Central and Eastern European Partnerships.     

Cognitive behavioural strategies for HIV sexual risk reduction

Unprotected sexual intercourse is the principal means of transmission for HIV; the virus associated with AIDS. In the absence of effective medical treatment, the modification of sexual behaviour remains the most important method of containment. A cognitive behavioural model of risky sexual behaviour is described. Intervention strategies suggested by the model are discussed in some detail. These include a novel procedure that potentiates state dependent memory effects. Finally, three cases are presented in order to underscore key points.     

Adolescent sexual risk behavior: a multi-system perspective.

Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, including infection with human immunodeficiency virus, other sexually transmitted diseases, and unintended pregnancy. As a result, researchers have attempted to identify those factors that influence adolescent sexual risk behavior so that meaningful prevention and intervention programs may be developed. We propose that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with the adolescent sexual experience. In this article, we review the recent literature (i.e., 1990-1999) pertaining to the correlates of adolescent sexual risk-taking, and organize the findings into a multisystemic perspective. Factors from the self, family, and extrafamilial systems of influence are discussed. We also consider several methodological problems that limit the literature's current scope, and consider implications of the adoption of a multisystemic framework for future research endeavors. We conclude with a discussion of the implications of the available research for practitioners working to reduce sexual risk behavior among adolescents.     

Vaginocervical cytology in victims of sexual assault

To investigate the role of vaginocervical smears in alleged victims of rape, we reviewed the findings in 4,220 consecutive rape victims between the years 1982 and 1989. These rape victims showed a slight increase in cellular abnormalities (1.18% vs. .93%) when compared to a group of 17,187 routine smears from an indigent population in 1989. While the differences in the spectrum of cellular abnormalities were not statistically significant, the increase in abnormal smears is remarkable because of the younger age distribution and lower risk factors for cervical cancer in this group of rape victims (41% of the victims were never seen at our institution before their evaluation for alleged rape and were most probably of higher socioeconomic status and at lower risk for cervical cancer than the indigent population served at our hospital). This finding may reflect the low incidence of vaginocervical cytology screening among the general population of which rape victims are a random sample. Fifty-seven percent of the rape victims with cellular abnormalities who were also regular patients at our hospital returned for follow-up by appropriate repeat smears or biopsies. This was lower than the 95% general follow-up rate of vaginocervical smear abnormalities among the rest of the population screened at our hospital. We detected spermatozoa in 56% of the smears from victims who were examined within three days of the alleged sexual assault. Cytology adds to the criminal investigation of rape cases as we detected spermatozoa in four of 16 semen-negative cases from a random sample of 53 cases evaluated by the state crime lab.     

Diagnostic efficiency and material specificity of the Warrington Recognition Memory Test: a collaborative multisite investigation.

Two studies examined the Warrington Recognition Memory Test (RMT) discrepancy index (Words-Faces) in a large sample of patients heterogeneous with respect to age, education, gender, and neurological diagnosis. In Study 1 (N = 504) we used cutoffs from the Words-Faces discrepancy scores derived from Warrington's original validation sample to attempt to accurately classify patients with left, right, or diffuse brain damage. Sensitivity for left hemisphere patients (Faces > Words) was 10% with a specificity of 88%, whereas sensitivity for right hemisphere patients (Words > Faces) was 48% with a specificity of 86%. For patients with diffuse brain damage (Words = Faces) sensitivity was 69% and specificity was 38%. In Study 2 (N = 263), we examined the relationship between the Words-Faces discrepancy score and Wechsler Memory Scale-Revised (WMS-R; Wechsler, 1981) Logical Memory and Visual Reproduction subtests. Contrary to predictions, patients with Words > Faces performed better on both WMS-R subtests; the Faces > Words discrepancy was not related to Visual Reproduction performance. Potential reasons for these negative findings are discussed, as well as cautions for future RMT discrepancy index use.     

An experimental evaluation of a school-based program for children at risk: Wisconsin early intervention

This article describes the nature and effectiveness of Wisconsin Early Intervention (WEI), a social development program for rural elementary school children. Incorporating a social learning formulation of child and family dysfunction, program services included social skill groups and parent/teacher consultation for referred kindergarten through 4th-grade students at two schools. Services were evaluated experimentally with random assignment of 78 children from School A to Full Service (parent/teacher consultation, social skills groups) or Partial Service (parent/teacher consultation) and 49 children from School B to Partial Service or No Service conditions. Full services resulted in decreased depression relative to partial services, based on standardized interview data. However, multidimensional ratings obtained from parents, teachers, and WEI staff consistently indicated that children's competencies and behavior, regardless of service group, improved during the course of the program. Explanations for these results and the importance of experimentally evaluating community-level interventions are discussed.     

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.     

Cardiovascular risk reduction in men: a nine-year cohort study.

Cardiovascular risk scores improved in a cohort of 500 males aged 20 to 50 years over a nine-year period. The major component of the risk improvement was a reduction in smoking habits. A disappointing finding is the increased number of obese subjects and those not participating in regular exercise. Altering these trends must now be a priority for all health professionals. The effects of community-based and primary care health promotion are likely to be synergistic with those of national mass media campaigns.