Atendimento psicossocial à mulher que comete ofensa sexual / Psychosocial attention for women that commit sexual offenses / Atención psicosocial para mujeres que cometen delitos sexuales

Objetivamos apresentar uma proposta de atendimento psicossocial grupal oferecida para mulheres adultas que cometeram ofensa sexual, cuidadoras e mães. A experiência está sendo desenvolvida no Distrito Federal, Brasil, com pessoas do gênero feminino provenientes de encaminhamento judicial. Carece que os profissionais das áreas da justiça, saúde, serviço social e psicologia avancem no estudo e na compreensão desta temática, de modo a pensarem a atuação e o apoio terapêutico a essas mulheres. O modo de atendimento é focal e breve, com ênfase na criação de um ambiente lúdico como facilitador das interações grupais e da discussão sobre os temas: identidade; confiança nas relações afetivas e sociais; vivência pessoal com violência física e sexual; configuração de gênero; e expressão da sexualidade e futuro. A abordagem individual também se baseia no enfoque dos temas mencionados. O oferecimento de ajuda à mulher cuidadora ou à mãe tem participação ativa na interrupção do circuito abusivo sexual, pois essa violência é extremamente ocultada, ocasionando uma prolongada vulnerabilidade para as vítimas. Ressalta-se o valor do texto indicando a descrição de ação voltada para uma população permanentemente não estudada e evitada em seu reconhecimento. Os limites desta proposta encontram-se na falta de outras iniciativas que possibilitem uma discussão sobre essa experiência.(AU)

We aim to present a proposal of a group psychosocial intervention offered for adult female sexual offenders, caregivers, and mothers. The intervention is being developed at Federal District, Brazil, with female people coming from judicial referrals. Professionals in the areas of justice, health, social work, and psychology need to advance in the study and understanding this theme to think about action and therapeutic support for these women. The intervention is a focal and brief approach, with emphasis on the creation of a ludic environment as a facilitator of group interactions and discussion about the themes: identity; trust in affective and social relationships; personal experience with physical and sexual violence; gender configuration; and sexuality expression and future. The individual approach is also based on focusing on these themes. The offering of help to the female caregiver or the mother has an active participation in the interruption of the sexual offense circuit, since this violence is extremely hidden, bringing a prolonged condition of vulnerability to the victims. The value of this text is highlighted indicating the description of an action directed to a population that is permanently not studied and whose recognition is avoided. The limits of this proposal are found in the absence of other initiatives that would allow a discussion about this experience.(AU)

Este texto presenta una propuesta de atención psicosocial grupal destinada a mujeres adultas que han cometido delito sexual, a cuidadoras y madres. La intervención se está desarrollando en el Distrito Federal (Brasil), con personas del género femenino provenientes de remisiones judiciales. Es necesario que los profesionales de las áreas de justicia, salud, trabajo social y psicología avancen en el estudio y comprensión de esta temática para pensar en el desempeño y apoyo terapéutico de estas mujeres. El servicio es enfocado y breve, con énfasis en la creación de un ambiente lúdico como facilitador de interacciones grupales y discusión sobre los temas: identidad; confianza en las relaciones afectivas y sociales; experiencia personal con violencia física y sexual; configuración de género; y expresión de la sexualidad y el futuro. El enfoque individual también se centra en estos temas. La oferta de ayuda a la mujer cuidadora o a la madre es importante para la interrupción del circuito de abuso sexual, ya que esta violencia es extremadamente oculta y provoca una vulnerabilidad prolongada a las víctimas. Se destaca el valor del texto con la descripción de la acción dirigida a una población que no es objeto de estudios ni reconocida. Los límites de esta propuesta se encuentran en la ausencia de otras iniciativas que permitan un debate sobre esta experiencia.(AU)

Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

"Was I asking for it?": An experimental investigation of perceived responsibility, mental contamination and workplace sexual harassment.

BACKGROUND AND OBJECTIVES: Mental contamination (i.e., contamination concerns that arise in the absence of direct contact with a contaminant) is a common symptom in obsessive-compulsive disorder (OCD). Cognitive theories suggest that it results from individuals' misinterpretations of perceived violations. Cognitive theories of OCD also highlight the importance of appraisals of inflated responsibility in the maintenance of other OCD symptoms. However, the role of responsibility in mental contamination has not yet been examined experimentally. The present study examined the role of perceived responsibility and violation in the relationship between workplace sexual harassment imagery and subsequent mental contamination. METHODS: One hundred and forty-nine participants listened to a workplace sexual harassment imagery task, wherein responsibility was manipulated. Participants were randomly assigned to one of three conditions (high responsibility (HR), low responsibility (LR), no responsibility (NR)). Participants completed questionnaires assessing mental contamination and completed a hand washing task. RESULTS: Those in the NR condition reported significantly lower levels of responsibility than those in the LR or HR conditions. Accordingly, those in the NR condition also reported significantly lower levels of anxiety and dirtiness than in the LR condition. There were no significant differences between the LR and HR condition on variables of interest. LIMITATIONS: The nature of the victim blaming used for the responsibility induction may have elicited compensatory responses from participants. CONCLUSIONS: Findings may highlight the central role of perceptions of violation in the understanding and treatment of mental contamination.

Poly-Strengths and Peer Violence Perpetration: What Strengths Can Add to Risk Factor Analyses.

Adolescence is a high-risk time for perpetration of different forms of peer-based violence including harassment, bullying, and sexual assault. Research documents a number of important risk factors but less understood are protective factors like sense of mattering or how combinations of strengths may reduce perpetration risk. The current study examined how protective factors (i.e., positive social norms), including a diversity of strengths (termed poly-strengths), influenced the perpetration of harassment, bullying, and sexual assault for young people, while accounting for the use of alcohol both cross-sectionally and over time. Youth (N = 2232, 52.6% female) in grades 7-10 enrolled in a study using active parental consent (53% response rate) and completed online surveys in school that asked about bullying and harassment, alcohol use, positive social norms related to violence prevention, and a composite of intra-personal strengths. Follow-up surveys took place 6 months later (N = 2150). Logistic regression analyses examined how social norms and poly-strengths influenced odds of perpetration after accounting for demographic variables and the risk factor of alcohol use. Use of alcohol increased the odds of perpetrating all forms of violence. Strengths were significantly related to lower perpetration at Time 1 but not Time 2. Positive social norms reduced perpetration at both time points. The findings suggest adolescent perpetration of bullying, harassment, and sexual violence is lower in the presence of positive social norms over time and more proximally, in the presence of a diverse strengths portfolio. Prevention efforts that incorporate positive social norms and alcohol reduction strategies may reduce peer violence.

Sexual Trauma Screening for Men and Women: Examining the Construct Validity of a Two-Item Screen.

The Veterans Health Administration (VHA), the largest integrated healthcare system in the United States, has conducted universal screening for military sexual trauma (MST) to facilitate MST-related care since 2002. VHA defines MST as sexual assault or repeated, threatening sexual harassment that occurred during military service. Evidence of construct validity, the degree to which the screen is measuring what it purports to measure (i.e., MST), was examined using the 23-item Sexual Experiences Questionnaire-Department of Defense (SEQ-DoD). Results showed individuals who endorsed no SEQ-DoD items screened MST negative. Those who had experienced more SEQ-DoD behaviors with greater frequency, and across all four SEQ-DoD domains, were more likely to screen MST positive. Findings were similar for men and women. These findings contribute to the validity evidence for the VHA MST screen.

Violence at work: determinants & prevalence among health care workers, northwest Ethiopia: an institutional based cross sectional study

BACKGROUND: Workplace violence is the intentional use of power, threatened or actual, against another person or against a group, in work-related circumstances, that either results in or has a high degree of likelihood of resulting in injury, death, psychological harm, mal development, or deprivation. The aim of this study is to assess magnitude and predictors of workplace violence among healthcare workers in health facilities of Gondar city. METHODS: Institutional based cross sectional study design was employed to conduct this study. The study conducted in Gondar town from February 21 to march 21, 2016. Five hundred fifty three health care workers selected from health facilities of Gondar City administration. A stratified sampling technique was used for selecting the study subjects through simple random sampling. Data was collected by structured self administered questionnaire which is adapted from ILO/ICN/WHO/PSI after it is pretested & prepared in Amharic. The data was coded and entered in to EPI info version 7 and exported to SPSS version 20 software for analysis. The degree of association for variables was assessed using odds ratios with 95% confidence interval and p-value ≤0.05. RESULTS: The prevalence of workplace violence was found to be 58.2% with [95% confidence interval (CI): (53.7, 62.3)] in which verbal abuse 282(53.1%) followed by physical attack 117(22.0%) and 38(7.2%) sexual harassment. Working at emergency departments [AOR = 3.99,95% CI:(1.49,10.73)], working at shifts [AOR = 1.98,95%, CI: (1.28,3.03)],short experiences [AOR = 3.09,95% CI: (1.20,7.98)], being nurse or midwife [AOR = 4.06, 95% CI: (1.20,13.74)] were positively associated with workplace violence. The main sources of violence are visitors/patient relatives followed by colleagues and patients. CONCLUSION: workplace violence is major public health problem across health facilities and the Ministry of Health should incorporate interventions in its different health sector development & management safety initiative.

Estrategias de persuasión percibidas por adolescentes en situaciones de engaño pederasta por Internet (online grooming) / Persuasion strategies perceived by adolescents in situations of online grooming

El engaño pederasta por Internet (online grooming) es el proceso por el cual un adulto consigue victimizar sexualmente a un menor valiéndose de los medios que ofrece Internet. El objetivo de este estudio fue analizar la prevalencia de las estrategias de persuasión e influencia utilizadas por adultos para manipular e involucrar a menores en el engaño pederasta por Internet, así como las diferencias atendiendo al sexo. Inicialmente, 2731 adolescentes de entre 12 y 15 años (50,6% chicas) completaron un cuestionario sobre solicitudes e interacciones sexuales con adultos y otro sobre persuasión basado en los principios de influencia de Cialdini (2001). 408 Menores (14,9%) se vieron implicados en el engaño pederasta durante el último año (61,3% mujeres; edad media= 14,23; DT= 0,92). Se encontró una utilización altamente frecuente de los principios de influencia, siendo el más experimentado el principio de simpatía (hasta un 50,9%). Las chicas experimentaron más frecuentemente todos los principios excepto el de autoridad, en el que no hubo diferencias. Estos hallazgos proporcionan información útil para entender y prevenir la victimización sexual de los menores en Internet

Online grooming is the process by which an adult sexually victimizes a minor using the means offered by the Internet. The objective of this study was to analyze the prevalence of persuasion and influence strategies used by aggressors to manipulate and involve minors in online grooming, as well as gender differences. The initial sample consisted of 2731 adolescents between 12 and 15 years of age (50.6% girls) who completed a questionnaire on sexual solicitations and interactions with adults and another on persuasion based on the principles of influence of Cialdini (2001). 408 Minors (14.9%) were involved in grooming during the previous year (61.3% girls, mean age= 14.23, DT= 0.92). It was found a highly frequent use of the principles of influence, being the principle of sympathy the most experienced (up to 50.9%). Girls experienced more frequently all the principles of influence except the principle of authority, in which there were no gender differences. These findings provide useful information for understanding and preventing sexual victimization of minors on the Internet

Predicting the Emergence of Sexual Violence in Adolescence.

This study aims to report the epidemiology of sexual violence (SV) perpetration for both female and male youth across a broad age spectrum. Additionally, the etiology of SV perpetration is examined by identifying prior exposures that predict a first SV perpetration. Six waves of data were collected nationally online, between 2006 and 2012, from 1586 youth between 10 and 21 years of age. Five types of SV were assessed: sexual harassment, sexual assault, coercive sex, attempted rape, and rape. To identify how prior exposures may predict the emergence of SV in adolescence, parsimonious lagged multivariable logistic regression models estimated the odds of first perpetrating each of the five types of SV within the context of other variables (e.g., rape attitudes). Average age at first perpetration was between 15 and 16 years of age, depending on SV type. Several characteristics were more commonly reported by perpetrators than non-perpetrators (e.g., alcohol use, other types of SV perpetration and victimization). After adjusting for potentially influential characteristics, prior exposure to parental spousal abuse and current exposure to violent pornography were each strongly associated with the emergence of SV perpetration-attempted rape being the exception for violent pornography. Current aggressive behavior was also significantly implicated in all types of first SV perpetration except rape. Previous victimization of sexual harassment and current victimization of psychological abuse in relationships were additionally predictive of one's first SV perpetration, albeit in various patterns. In this national longitudinal study of different types of SV perpetration among adolescent men and women, findings suggest several malleable factors that need to be targeted, especially scripts of inter-personal violence that are being modeled by abusive parents in youths' homes and also reinforced by violent pornography. The predictive value of victimization for a subsequent first SV perpetration highlights the inter-relatedness of different types of violence involvement. Universal and holistic prevention programming that targets aggressive behaviors and violent scripts in inter-personal relationships is needed well before the age of 15 years.

Neurobiology of Sexual Assault and Osteopathic Considerations for Trauma-Informed Care and Practice.

Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and emotional health. Sexual assault is associated with gastrointestinal, neurologic, and reproductive symptoms, as well as obesity, diabetes, and chronic pain. With 1 in 3 women and 1 in 6 men experiencing some form of unwanted sexual violence in their lifetime, sexual assault is a significant public health problem that necessitates attention in the medical community. This review discusses relevant literature on the neurobiologic changes that occur as a consequence of sexual assault, such as how the brain responds during a traumatic experience and the impact of trauma on memory. Osteopathic considerations for trauma-informed care and practice and how all physicians can better serve patients with a history of sexual assault are also discussed.

Identifying cases of violence against women and children: An essential skill set in family medicine

INTRODUCTION: Child abuse, sexual and domestic violence are among the most destructive experiences afflicting women and children that result to physical, behavioral, psychological and economic consequences. Physicians in the front line need to be sensitive and vigilant in identifying both overt and subtle signs of these violations. As such, identification of victims is vital to prevent further abuse and injury, as well as to manage the patient holistically.OBJECTIVE: To assess the skill of Family Medicine (FM) residents in detecting cases of violence against women and children (VAWC).METHODS: Eight case scenarios were presented to 48 resident trainees from government and private hospitals in Metro Manila. They were tasked to identify cases pertaining to VAWC, and distinguish the case type.RESULTS: Red flags that were easily detected by more than 80% of trainees were cases of physical abuse towards men, and neglect. Circumstances with moderate challenge were sexual harassment, rape, and abandonment, in that order. On the other hand, respondents had inadequacy in detecting cases of sexual abuse and physical abuse towards children; while the most difficult to recognize was emotional abuse.CONCLUSION: Acquisition of this new skill set may prove beneficial in providing the ideal environment for proper management and support provision for the VAWC subjects. Lack of knowledge and training in this rising societal and health threat may cause underdiagnosis of common VAWC presentations. Consequently, this leads to failure of identification, assessment, documentation, and management of such patients.

Identifying cases of violence against women and children: An essential skill set in family medicine

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Child abuse, sexual and domestic violence are among the most destructive experiences afflicting women and children that result to physical, behavioral, psychological and economic consequences. Physicians in the front line need to be sensitive and vigilant in identifying both overt and subtle signs of these violations. As such, identification of victims is vital to prevent further abuse and injury, as well as to manage the patient holistically.<br /><strong>OBJECTIVE:</strong> To assess the skill of Family Medicine (FM) residents in detecting cases of violence against women and children (VAWC).<br /><strong>METHODS:</strong> Eight case scenarios were presented to 48 resident trainees from government and private hospitals in Metro Manila. They were tasked to identify cases pertaining to VAWC, and distinguish the case type.<br /><strong>RESULTS:</strong> Red flags that were easily detected by more than 80% of trainees were cases of physical abuse towards men, and neglect. Circumstances with moderate challenge were sexual harassment, rape, and abandonment, in that order. On the other hand, respondents had inadequacy in detecting cases of sexual abuse and physical abuse towards children; while the most difficult to recognize was emotional abuse.<br /><strong>CONCLUSION:</strong> Acquisition of this new skill set may prove beneficial in providing the ideal environment for proper management and support provision for the VAWC subjects. Lack of knowledge and training in this rising societal and health threat may cause underdiagnosis of common VAWC presentations. Consequently, this leads to failure of identification, assessment, documentation, and management of such patients.</p>

Mindfulness-based stress reduction for veterans exposed to military sexual trauma: rationale and implementation considerations.

Military sexual trauma (MST) represents a significant public health concern among military personnel and Veterans and is associated with considerable morbidity and suicide risk. It is estimated that 22% of Veteran women and 1% of Veteran men experienced sexual assault or repeated, threatening sexual harassment during their military service. Exposure to traumatic stress has detrimental effects on emotion regulation, which refers to a set of strategies used to modulate different components of emotion at different points on the trajectory of an emotional response. Mindfulness-based interventions offer approaches to health that focus on mind and body practices that can help regulate the experience and expression of difficult emotions. Mindfulness-based stress reduction (MBSR) is an evidence-based therapy shown to be effective for depression, anxiety, and post-traumatic stress disorder. This article discusses the rationale for providing MBSR to Veterans who have been exposed to MST. The article also discusses ways to facilitate implementation of this practice in the U.S. Department of Veterans Affairs health care system. We address potential barriers to care and ways to facilitate implementation at the patient, provider, organization/local, and policy levels. MBSR is likely to be an important component of a comprehensive approach to care for Veterans exposed to MST.

Faecal incontinence with transitory absence of anal contraction in two sexually or physically abused women.

OBJECTIVE: To report two cases of faecal incontinence caused by transitory absence of anal voluntary contraction without anal anomalies. PATIENTS: Two women referred to our gastroenterology department with faecal incontinence. One patient had been sexually abused by her father; the other had been physically abused by her husband. RESULTS: Clinical and manometric anal contraction was absent despite normal anal endosonography and normal electrophysiological perineal study. Anal contraction was completely normalized after biofeedback, and the patients recovered from the faecal incontinence. CONCLUSION: Transitory absence of anal contraction is very uncommon as the origin of faecal incontinence. It was observed in two abused women.

The development and evaluation of a sexual harassment contact person training package.

The effectiveness of a training package to teach listening and helping skills to three pairs of sexual harrassment contact person trainees was evaluated, using a multiple probe design. The training package comprised five components: behavioral specifications, rationales, situational examples, study guides, and role-play exercises, provided in a written instructional format based on guidelines developed by Fawcett and Fletcher. Evaluation involved pre- and posttraining measures of target behavior occurrence, relevant knowledge, and self-rated confidence level. Ratings of performance were also provided by potential consumers as a measure of social validity. Findings indicated that the package was effective in increasing listening and helping skills, knowledge, and confidence of trainees and that skills generalized to new simulated cases and were maintained over time.