Universal mandatory reporting policies show null effects in a statewide college sample.

OBJECTIVE: It is widely assumed that universal mandatory reporting policies (MRPs) for sexual misconduct are important for campus safety, but there is little evidence to support these assumptions. HYPOTHESES: Given the exploratory nature of this research, no formal hypotheses were tested. We did not expect universal MRPs to be significantly associated with increased reporting or postreporting outcomes. METHOD: Data on MRPs and sexual misconduct reporting in annual security reports and to Title IX coordinators at institutions of higher education in New York (N = 188) were used to examine the prevalence of universal MRPs as well as the relationship between MRPs and reporting and postreporting outcomes. RESULTS: Descriptives showed that 44% of institutions of higher education have a universal MRP. Multivariate linear regression models indicated that universal MRPs were not significantly related to reporting in annual security reports; reports to Title IX coordinators, campus police, campus safety or security officers; or rates of referrals to additional services, no-contact orders, access to the judicial conduct process for sexual misconduct, or findings of student responsibility for sexual misconduct. CONCLUSIONS: Our findings raise concerns about the widespread implementation of MRPs and highlight the need for future research on their impact on student-survivor reporting and access to remedies and resources. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does the affirmative consent standard increase the accuracy of sexual assault perceptions? It depends on how you learn about the standard.

OBJECTIVE: Colleges and universities are increasingly adopting affirmative consent standards of sexual assault, in which consent is defined as conscious and voluntary "yeses" given throughout a sexual interaction. We examined the impact of affirmative consent standards on perceptions of assault and consent. HYPOTHESES: We hypothesized that in sexual assault scenarios involving physical force or verbal coercion, exposure to the consent standard would increase perceptions of assault and decrease perceptions of consent relative to not being exposed to the standard. We then explored whether dehumanization of the perpetrator or the victim mediates the association between assault type and sexual assault perceptions and how this relation changes on the basis of exposure to the affirmative consent standard. METHOD: We exposed 909 participants (predominantly women: n = 574; predominantly White: n = 677; age: M = 28.61 years, SD = 11.10; students: n = 363, Mechanical Turk workers: n = 546) to an affirmative consent standard in a written policy, a video using a "cup-of-tea" metaphor to describe the consent standard, or no information on the standard. Participants rated perceptions of assault, consent, and dehumanization of a man and woman involved in a sexual interaction involving physical force, verbal coercion, or a consensual agreement. RESULTS: Participants who saw the affirmative consent video were more likely to perceive physical assault as assault compared with participants in the no-exposure control condition. Participants who read the affirmative consent definition were no more or less likely to perceive physical assault as sexual assault compared with participants in the control condition. Participants exposed to the text definition perceived the consensual interaction as more assaultive than did participants in the video and control conditions. Perpetrator dehumanization also emerged as a mediator of the relation between assault type and assault perceptions. CONCLUSIONS: These results suggest that exposure to consent standards sometimes aids sexual assault decision-making but also leads to confusion, even in scenarios in which consent is normally discernable. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants.

Latinx immigrants experience substantial disparities in mental health treatment access, particularly for posttraumatic stress disorder (PTSD). The availability of brief, flexible interventions in Spanish may assist in reducing these disparities. Written Exposure Therapy (WET) is a five-session PTSD intervention that appears as effective as longer, gold-standard interventions, but has yet to be tested among Latinx immigrants. To test the acceptability and preliminary effectiveness of WET, 20 Spanish-speaking, Latinx immigrants conducted structured interviews at pretreatment, were offered WET, and completed posttreatment structured interviews. Open thematic coding of pre- and posttreatment interview questions examined perceived barriers and benefits of WET. Quantitative components examined symptom change across PTSD (PCL-IV-C) and depression (PHQ-9). Quantitative results indicated clinically meaningful and statistically significant change in PTSD symptoms using intent-to-treat analyses (Mdiff = 17.06, SDdiff = 9.97, range = 0-29, t(15) = 6.84, p < .001). Open thematic coding identified four barrier-related themes and three benefit-related themes at pretreatment. At posttreatment, three barrier-related themes and two benefit-related themes were identified. Qualitative results largely suggested that perceived barriers were common to other PTSD interventions (e.g., exposure components). Only one participant identified barriers specific to WET. Results suggested WET may reduce PTSD symptoms among Latinx immigrants. WET also appeared to be acceptable and primarily viewed as beneficial among this population. WET is a promising intervention with Latinx immigrants and warrants further testing larger trials, including testing implementation strategies that may improve access to care.

Examining Support for University-to-Police Reporting Policies for Sexual Assault: The Role of Survivors' Consent.

In several states, bills have been introduced that require universities to report sexual assaults to law enforcement. Opponents argue that such policies can compel survivors to disclose against their will, stripping survivors of autonomy and harming campus communities. We used a mixed method approach to examine people's support for reporting policies that do and do not consider survivor consent: compelled police disclosure (requires a report regardless of victim consent) and consented police disclosure (requires a report if the victim consents). We examined individual characteristics and attitudes associated with support for these approaches (i.e., had experienced sexual assault, trust in police). Participants (1,045 adults in the United States) were randomly assigned to read one of three policy statements, and we collected quantitative and qualitative survey data. Participants were less supportive of compelled police disclosure than consented police disclosure. People who supported compelled disclosure frequently focused on the crime and potential social benefits, were more likely to be non-victims, and held greater trust in the police. People who supported consented disclosure focused on the victim's needs, were more likely to be survivors, and held less trust in the police. Survivor consent should be considered in the discussion of university-to-police reporting policies for sexual assault.

Bystander Response to Sexual Assault Disclosures in the U.S. Military: Encouraging Survivors to use Formal Resources.

Experiencing military sexual assault (MSA) results in serious mental health consequences. Sexual assault survivors often disclose to informal sources of support, and how these individuals respond can have a significant effect on survivors' wellbeing. Bystander intervention is one mechanism through which institutions, such as the U.S. Military, aim to teach informal support providers to respond positively and effectively to sexual assaults. One bystander response that survivors may find helpful is the discussion of formal resources (e.g., counseling options, reporting options). The current study examined factors associated with U.S. Service members' intentions to encourage sexual assault survivors to report and seek mental health counseling, including individual characteristics (rank, gender, personal experience of MSA) and perceptions of military sexual assault response efforts (exposure to sexual assault training, leader response to sexual assault, service barriers). The study also examined contextual factors (branch) and interactions between individual and contextual predictors. We analyzed survey data from 27,505 active duty Service members collected by the U.S. Department of Defense. As expected, rank, gender, experience of MSA, training exposure, leader response, and service barriers were associated with Service members' intentions to encourage MSA survivors to report and seek-help. Bystander responses to disclosures can have a significant effect on survivors' response to the assault, and these findings can help in identifying why bystanders may or may not encourage the use of formal resources after receiving a sexual assault disclosure.

The evolving landscape of Title IX: Predicting mandatory reporters' responses to sexual assault disclosures.

Approximately 1 in 4 women is sexually assaulted in college, a problem that federal law has attempted to address with recent changes. Under the evolving landscape of Title IX, and related law, universities nationwide have overhauled their sexual assault policies, procedures, and resources. Many of the new policies designate undergraduate resident assistants (RAs) as Responsible Employees-requiring them to provide assistance and report to the university if a fellow student discloses sexual assault. We investigated factors that predict the likelihood of RAs enacting their policy mandate, that is, reporting sexual assault disclosures to university authorities and referring survivors to sexual assault resources. Based on data from 305 Responsible Employee RAs, we found that likelihood to report and refer varied, depending on RAs' knowledge of reporting procedures and resources, trust in these supports, and perceptions of mandatory reporting policy. Understanding mandatory reporter behavior is crucial, because help-providers' responses can have serious implications for the recovery of sexual assault survivors. Our findings elucidate some effects of changes in the interpretation and implementation of Title IX, with potential to inform the development of more theoretically and empirically informed policies. (PsycINFO Database Record

"It Happens to Girls All the Time": Examining Sexual Assault Survivors' Reasons for Not Using Campus Supports.

Sexual assault is a prevalent problem in higher education, and despite the increasing availability of formal supports on college campuses, few sexual assault survivors use them. Experiencing sexual assault can have devastating consequences on survivors' psychological and educational wellbeing, which may intensify if survivors do not receive adequate care. Drawing from existing theoretical frameworks and empirical research, this study used a mixed methodological approach to examine why survivors did not use three key campus supports-the Title IX Office, the sexual assault center, and housing staff-and if these reasons differed across the three supports. Using data from 284 women who experienced sexual assault in college, our qualitative findings identified four overarching themes, including logistical issues (e.g., lacking time and knowledge), feelings, beliefs, and responses that made it seem unacceptable to use campus supports, judgments about the appropriateness of the support, and alternative methods of coping. Quantitative findings revealed that survivors' reasons for not seeking help differed across supports. Collectively, our findings suggest that community norms and institutional policies can make it challenging for survivors to use campus supports. We propose several suggestions for institutional change (e.g., taking a stronger stance against "less serious" forms of sexual assault, reducing a quasi-criminal justice approach to investigation and adjudication, limiting mandated reporting).

(Missing) Knowledge About Sexual Assault Resources: Undermining Military Mental Health.

In 2005, the Department of Defense reformed military sexual assault (MSA) prevention and response efforts. However, research suggests that some Service members may not be informed of MSA resources. We examined how lacking such knowledge may undermine psychological well-being (i.e., symptoms of depression and posttraumatic stress) among MSA survivors as well as Service members who feel unsafe from MSA. The data were collected by the DoD in 2010 and sampled active duty Service women and men. Experiencing MSA, feeling unsafe from MSA, and lacking knowledge of MSA resources predicted greater psychiatric symptoms. Service members who felt unsafe from MSA reported greater psychiatric symptoms as a function of lacking knowledge of MSA resources. Findings suggest that education about sexual assault resources may be critical for the protection of mental health-among survivors and nonvictims alike.

See Something, Do Something: Predicting Sexual Assault Bystander Intentions in the U.S. Military.

Sexual assault is a pervasive problem in the U.S. military, especially against women. Bystander intervention is increasingly promoted as important for reducing sexual violence, and it may be particularly helpful in contexts with high rates of sexual violence. Bystander training encourages and enables people to intervene safely and stop sexual violence. In this study, we drew from an ecological model to investigate intrapersonal, microsystem, and exosystem factors that predicted Service members' assumption of personal responsibility to intervene in an alcohol-involved sexual assault. Moreover, we examined how these predictors played a role in decisions about how to intervene: confronting the perpetrator, assisting the victim, or finding someone to help. We analyzed data from 24,610 active duty personnel collected by the Department of Defense. Several factors significantly related to Service members' bystander intentions: gender, rank, morale, attitudes about sexual assault, training, and trust in the military sexual assault system predicted the likelihood and method of bystander intervention. These findings help identify how and why people intervene (or fail to intervene) when they witness situations that could develop into sexual violence.

Quality of life and metastatic breast cancer: the role of body image, disease site, and time since diagnosis.

PURPOSE: Too little is understood about the quality of life (QoL) concerns of patients diagnosed with advanced disease. While body image has been found to be consistently important for women with early-stage breast cancer, the impact of body image on women with metastatic breast cancer (MBC) is less frequently studied. This cross-sectional study aimed to identify factors affecting QoL in a sample of patients diagnosed with MBC, with particular attention to body image, disease site, and time since diagnosis. METHODS: In total, 113 women diagnosed with MBC completed two QoL scales (EORTC QLQ30; EORTC BR23) as part of a larger study. Clinical characteristics were obtained via medical record review. Demographics, disease characteristics, and clinical factors were examined. RESULTS: Time since diagnosis and location of metastases were found to affect patients' QoL, and most strikingly, this effect often differed for those with higher and lower body image. Body image appears to remain highly influential even for those living with a shortened life expectancy. CONCLUSIONS: These findings indicate that the development of QoL support should more carefully consider patients diagnosed with MBC and the unique sets of body concerns that affect this population.

Sexual assault training in the military: evaluating efforts to end the "invisible war".

Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members' training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD's 2010 annual report on military sexual assault concluded that "most Active Duty members receive effective training on sexual assault" (p. 104). Our results cast doubt on that assertion.

Student Experiences Reporting Sexual and Gender-Based Misconduct to the Title IX Office at a Public State University.

Twenty-five survivors completed anonymous surveys about reporting sexual and gender-based misconduct to their public university's Title IX office, including case characteristics, perceptions of the reporting and response process (e.g., helpfulness, respect), and experiences of institutional betrayal and support. Measures and open-ended responses described varied misconduct incidents, reporting behaviors, case outcomes, process issues, and negative process consequences. Additionally, process perceptions correlated with institutional betrayal and support. Findings illuminate how survivors' Title IX process perceptions relate to experiencing harm or support from larger institutions, and offer insights into developing a Title IX process which maintains student rights and dignity regardless of outcome.

The Rothman Index predicts unplanned readmissions to intensive care associated with increased mortality and hospital length of stay: a propensity-matched cohort study.

BACKGROUND: Patients with unplanned readmissions to the intensive care unit (ICU) are at high risk of preventable adverse events. The Rothman Index represents an objective real-time grading system of a patient's clinical condition and a predictive tool of clinical deterioration over time. This study was designed to test the hypothesis that the Rothman Index represents a sensitive predictor of unanticipated ICU readmissions. METHODS: A retrospective propensity-matched cohort study was performed at a tertiary referral academic medical center in the United States from January 1, 2022, to December 31, 2022. Inclusion criteria were adult patients admitted to an ICU and readmitted within seven days of transfer to a lower level of care. The control group consisted of patients who were downgraded from ICU without a subsequent readmission. The primary outcome measure was in-hospital mortality or discharge to hospice for end-of-life care. Secondary outcome measures were overall hospital length of stay, ICU length of stay, and 30-day readmission rates. Propensity matching was used to control for differences between the study cohorts. Regression analyses were performed to determine independent risk factors of an unplanned readmission to ICU. RESULTS: A total of 5,261 ICU patients met the inclusion criteria, of which 212 patients (4%) had an unanticipated readmission to the ICU within 7 days. The study cohort and control group were stratified by propensity matching into equal group sizes of n = 181. Lower Rothman Index scores (reflecting higher physiologic acuity) at the time of downgrade from the ICU were significantly associated with an unplanned readmission to the ICU (p < 0.0001). Patients readmitted to ICU had a lower mean Rothman Index score (p < 0.0001) and significantly increased rates of mortality (19.3% vs. 2.2%, p < 0.0001) and discharge to hospice (14.4% vs. 6.1%, p = 0.0073) compared to the control group of patients without ICU readmission. The overall length of ICU stay (mean 8.0 vs. 2.2 days, p < 0.0001) and total length of hospital stay (mean 15.8 vs. 7.3 days, p < 0.0001) were significantly increased in patients readmitted to ICU, compared to the control group. CONCLUSION: The Rothman Index represents a sensitive predictor of unanticipated readmissions to ICU, associated with a significantly increased mortality and overall ICU and hospital length of stay. The Rothman Index should be considered as a real-time objective measure for prediction of a safe downgrade from ICU to a lower level of care.

"I Could Never Tell My Parents": Barriers to Queer Women's College Sexual Assault Disclosure to Family Members.

Queer women are at high risk of college sexual victimization, but they face barriers to formal support services. As a result, informal support is critical. This study uses data from 40 open-ended interviews to explore family members' reactions to queer women's disclosures and examine whether their family is a reliable source of informal support. Findings indicate that family reactions are often more harmful than helpful. In comparison to research focused on heterosexual survivors, we find family reactions to be more extreme and disparaging of queer survivors' sexual identities. In fact, family members' negative reactions may pose barriers to accessing formal services.

Alcohol Use Before Sexual Violence and Cognitive Appraisals: Differential Associations With Barriers to Help-Seeking.

The current study examined two cognitive appraisals-labeling (identifying an unwanted sexual experience as sexual violence) and self-blame-as potential mechanisms between survivor alcohol use before sexual violence and three help-seeking barriers (minimization, negative treatment, and social-emotional barriers) among non-service-seeking sexual violence survivors. Participants were 141 undergraduate women who completed self-report measures. Three parallel mediation models were tested. Survivors who were drinking were more likely to label their victimization as sexual violence and, in turn, perceived fewer minimization and greater social-emotional barriers. Further, survivors who were drinking blamed themselves more and, in turn, perceived greater negative treatment and social-emotional barriers.

Analyzing the shifting state of college sexual violence compelled disclosure policies: National trends, empirical findings, and implications.

Following federal and state law, institutions of higher education (IHE) have implemented mandatory reporting (MR) policies, requiring some employees to report sexual violence they learn about to university officials regardless of victim/survivor consent (i.e., compelled disclosure). Proponents argue that MR policies are beneficial (e.g., provide survivors with support), while critics argue that MR policies that limit survivor autonomy can be harmful. Given the tension between purported goals of MR policies and potential risks to survivors, the current work provided a comprehensive analysis of IHE MR policies in the United States. First, we reviewed laws shaping MR policies. Second, we analyzed MR policies from a nationally representative sample of Title IV eligible IHEs in the United States. Third, we discussed the findings in connection to extant research on MR policies, identifying key patterns and remaining gaps. Our analysis suggested that federal and state policymaking has increasingly expanded reporting mandates for IHE employees. The majority of IHEs designated all or nearly all employees as mandatory reporters, but there was more variability in the breadth of MR policies compared to the previous research. The content of MR policies mostly offered minimal instructions for employees (e.g., to whom to report) and rarely mandated trauma-informed responses (e.g., how to respond to disclosures). In light of empirical evidence, which finds that those who are most knowledgeable about survivors' needs and the process of reporting to the university (including survivors) are less supportive of MR policies, our findings further indicate that current MR policies focus on compliance over victim/survivor support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).