The Prevalence of Sexual Violence Perpetration in Sexual Minority Men: A Secondary Analysis of Systematic Review Data.

Prior literature illustrates that sexual minority people (e.g., bisexual, gay, queer) are at increased vulnerability for sexual violence victimization compared to heterosexual peers, including while in college. However, the study of sexual violence perpetration in sexual minority populations, much less specifically sexual minority college men, has been neglected. This article reviews the literature and presents a secondary data analysis of a systematic review on college men's sexual perpetration rates and associated methodology. We also conducted analyses to summarize available literature regarding publishing dates, authors, and data inclusivity. METHODS: We downloaded the dataset and associated materials from Mendeley.com's data archive. RESULTS: To our surprise, we could not analyze sexual perpetration prevalence rates in sexual minority men using the systematic review data due to absence of reported data across all 77 independent samples including over 5,500 male participants. We found no significant relationship between inclusion of sexual minority men and the use of measurement strategies specialized to assess sexual minority needs. We did find a positive relationship between recency of publication and the inclusion of sexual minority men, r(76) = .24, p = .03, and that most authors/co-authors were women (72%). CONCLUSIONS: Preventing perpetration is central to ending sexual violence; therefore, future research should include sexual minority people and use appropriate methodology in the investigation of sexual perpetration characteristics and patterns.

The Frequency of Sexual Perpetration in College Men: A Systematic Review of Reported Prevalence Rates From 2000 to 2017.

BACKGROUND: The prevalence of sexual perpetration in college men is unknown. Prior reviews of sexual violence prevalence rates have produced wide-ranging estimates, likely due to wide variation in measurement strategies. OBJECTIVES: This article systematically reviewed research findings (from 2000 to 2017) regarding prevalence rates of sexual perpetration in college men and measurement strategies. Data Sources: PsycINFO and Web of Science databases. Eligibility Criteria: Empirical reports published between 2000 and 2017 that included male participants, available in English, and reported lifetime prevalence findings in Canadian or American college students. Participants: Data from 78 independent samples including 25,524 college men. RESULTS: The average prevalence rate of any sexual perpetration was 29.3% (SD = 16.8), and the average rate of rape was 6.5% (SD = 6.3). Studies that used non-Sexual Experiences Survey (SES)-based questionnaires recorded higher prevalence rates (41.5%) than SES-using studies (26.2%). At least 16 different sexual perpetration questionnaires were identified. Modifying standardized questionnaires was extremely common; this was reported in over half of the studies. Studies using modified standardized questionnaires found higher prevalence rates of sexual perpetration than studies using nonmodified standardized questionnaires. LIMITATIONS: This report focused exclusively on college men in the United States and Canada. CONCLUSIONS AND IMPLICATIONS: On average, 29% of college males report engaging in behaviors defined as sexual perpetration; however, there was a strong influence of measurement strategy on reported rates.

Pilot evaluation of horticultural therapy in improving overall wellness in veterans with history of suicidality.

OBJECTIVES: Novel approaches to mental health and suicide prevention are lacking. Converging evidence has shown the effectiveness of horticultural therapy (HT) in improving mental health symptoms, but whether it would reduce suicide risk and contributing risk factors is unknown. DESIGN: Using a cohort model, HT was delivered 3.5 h over four weekly, sessions administered by a registered horticultural therapist to veterans with history of suicide ideation or attempt who felt isolated and experienced ongoing environmental stressors with interest in learning new coping strategies. SETTING: HT delivery occurred in an urban garden, through a community partnership between the VA (Veterans Administration) and the New York Botanical Garden. Guided by principles of biophilia, participating veterans took part in nature walks, self-reflection and journaling, and planting activities. OUTCOME MEASURES: Stress, mood, pain, and social isolation levels were measured weekly pre-post HT sessions using thermometer scales, with concordant validity to validated clinical instruments. RESULTS: Of the 20 men and women with a history of suicide attempts/ideation, HT demonstrated immediate improvements after each session across all symptom domains in magnitude of reduction in stress, pain, mood, and loneliness. The effect sizes were in medium to large range (Cohen's d>.5). Additionally, a single HT session showed a sustained effect over subsequent 2-to-4 weeks as observed by the significantly decreased pre-session thermometer scores in subsequent weeks. Reductions in mood symptoms correlated with decline in suicidal ideation (rs = 0.63). CONCLUSION: HT intervention maybe a promising therapeutic modality for improving overall wellness in suicide prevention in at-risk veteran populations.

Effectiveness of Complementary and Integrative Approaches in Promoting Engagement and Overall Wellness Toward Suicide Prevention in Veterans.

Objective: Suicide is a major public health problem, specifically among U.S. veterans, who do not consistently engage in mental health services, often citing stigma as a barrier. Complementary and Integrative Health (CIH) interventions are promising alternatives in promoting patient engagement and further, they may play a critical role in transitioning people into mental health care. Toward this goal, the Resilience and Wellness Center (RWC) was developed to break through the stigma barrier by addressing risk factors of suicide through multimodal CIH interventions via cohort design, promoting social connectedness and accountability among participants. Design: This is a program evaluation study at a large urban VA medical center, where assessments were evaluated from pre- to post-program completion to determine the effectiveness of an intensive multimodal CIH 4-week group outpatient intervention for suicide prevention. Outcome measures: Primary outcomes measured included group connectedness, severity of depression and hopelessness symptoms, suicidal ideation, sleep quality, and diet. Secondary outcomes included measures of post-traumatic stress disorder (PTSD), generalized anxiety severity stress/coping skills, pain, and fatigue. Results: The RWC showed high participant engagement, with an 84%-95% attendance engagement rate depending on suicide risk history. Data from 15 cohorts (N = 126) demonstrate favorable outcomes associated with participation in this comprehensive program, as evidenced by a reduction in suicidal ideation, depression, and hopelessness, but not sleep quality and diet. In addition, in a subset of veterans with a history of suicidal ideation or attempt, significant improvements were noted in pain, PTSD/anxiety symptoms, and stress coping measures. Conclusions: The RWC shows that an intensive complement of CIH interventions is associated with a significant improvement with high veteran engagement. Findings from this program evaluation study can be used to aid health care systems and their providers in determining whether or not to utilize such multimodal CIH integrated interventions as an effective treatment for at-risk populations as a part of suicide prevention efforts.

The association of childhood trauma with sleep disturbances and risk of suicide in US veterans.

BACKGROUND: Sleep dysregulation is prevalent among veterans and is associated with increased risk of suicidal ideation and behaviors. A confluence of risk factors have been identified to date that contribute to increase risk for suicidal behavior. How these risk factors including childhood trauma, comorbid psychopathology, impulsivity, and hostility together with sleep disturbance contribute to suicide risk remains an open question. These factors have never been examined simultaneously in a unified mediation model, as investigated in the present study, to determine their relative contribution to suicide risk. METHODS: Veterans (N = 105) were recruited across 3-groups, including Major Depressive Disorder (MDD) with/without a history of a suicide attempt (n = 35 and n = 37, respectively), and non-psychiatric controls, who had no history of mental illness or suicidal behavior (n = 33). The participants were assessed using validated self-report assessments with in-depth phenotyping for relevant risk factors associated with suicidal behavior including childhood adversity, depression severity, impulsivity, hostility, and sleep quality. These factors were included in mediation models using path analysis. RESULTS: Across all subjects including those with MDD and non-psychiatric controls, mediation analysis showed that higher levels of childhood trauma had an indirect effect on poor sleep quality (p = 0.001). This effect was orthogonal, being independently mediated by both MDD psychopathology (p = 0.003), and higher traits of impulsivity (p = 0.001) and hostility (p = 0.015). Amongst MDD veterans, childhood trauma was directly associated with increased suicide risk (p = 0.034), irrespective of their severity of depression, or their degree of hostility and impulsivity. LIMITATIONS: include use of self-report data, and the inability to establish causal inferences with cross-sectional design. CONCLUSION: Childhood adversity as a significant pre-deployment risk factor for disturbed sleep and elevated suicide risk, potentially important for incorporation in clinical practice for suicide.