Coping with sexual violence as a post-assault formed couple: A dyadic phenomenological interview analysis.

Increasing evidence shows that survivors of sexual violence frequently experience relationship difficulties following their victimization. Little is known regarding how couples which formed post-assault cope with the impact of the prior assault. Hence, the aim of the current study was to gain insight into post-assault formed couples' experiences in coping with the impact of sexual violence. To this end, an interview study was conducted with five female survivors and their male partners who began their romantic relationship post-assault. A dyadic phenomenological interview analysis revealed that sexual victimization is a dyadic stressor but is not always considered as such by the couple. In addition, disclosure is described as a potential bonding experience. Flexibility and creativity from both partners are required as they adapt to the post-assault impact. In addition, meaningful communication and considering the perspective of one's partner seemed to be key to dyadically cope successfully. The current study also identified challenges couples had to manage, including caregiver burden and role confusion. Results suggest that interventions supporting couples in their continuous efforts toward mutual understanding can foster trust and growth.

Recovery and adjustment trajectories among Hurricane Florence survivors: Analysis utilizing nonlinear dynamic system modeling.

Self-regulation shift theory (SRST) argues that most individuals are able to successfully recover from trauma via engagement in self-regulation processes as well as the effective utilization of internal and environmental resources. However, a minority of individuals may instead experience a self-determination violation as a result of their self-regulatory capacity being overwhelmed. This self-determination violation is marked by chaotic and shifting adjustment, maladaptive regulation attempts, and, ultimately, a shift to an impaired self-state and the development of persistent psychopathology, such as posttraumatic stress disorder (PTSD). The current study utilized nonlinear dynamic system (NDS) analysis to identify adjustment trajectory dynamics among rural hurricane survivors in North Carolina (N = 131) who completed daily ecological momentary assessments (EMAs) regarding their distress (i.e., negative mood and PTSD symptoms), regulation efforts (e.g., coping), and appraisals (e.g., coping self-efficacy) over a 6-week period. Four adjustment trajectories were identified, including two largely adaptive trajectories (69.0% and 5.7%), a less stable adjustment trajectory (6.9%), and a fourth trajectory (18.4%) marked by shifting adjustment states and more frequent maladaptive regulation and negative appraisals, suggesting possible self-determination violation. Consistent with this possibility, this final trajectory was also associated with more severe PTSD symptoms relative to the other three trajectories at enrollment and 6-month follow-up. Future work should utilize NDS to model posttrauma adjustment dynamics from within a SRST framework to identify patterns of positive and negative adjustment dynamics at different time points in the trauma recovery process.

Institutional Betrayal: A Mixed Methods Study of College Women's Experiences With On-Campus Help-Seeking Following Rape.

In a given year, between 3 and 10% of women attending college will experience a completed rape. Unfortunately, when college survivors seek help following rape, representatives from their university may respond inadequately or harmfully, such as by blaming them, failing to provide adequate support and accommodations, or by minimizing the assault. The failures of an institution to protect its members from harm has been termed institutional betrayal (IB). The present study sought to examine college women rape survivors' (n = 28) experiences with disclosing to three types of campus resources: confidential sources (e.g., counselor), mandated reporters (e.g., faculty member), and Title IX and/or police via examination of their quantitative ratings of IB and institutional support, as well as via thematic analysis of their written help seeking narratives (n = 19). Results support that those who disclosed to Title IX and/or police reported the greatest amount of IB, and there was a trend for those who disclosed to a confidential source to report more support. Thematic analysis revealed four IB themes and two institutional support themes. Implications of findings for university sexual assault prevention and response efforts are discussed.

Patterns of Sexual Risk Behaviors among College Women: A Latent Profile Analysis.

Sexual risk behavior is common among college women, but little work has identified risk patterns or correlates. The current study utilized latent profile analysis to identify sexual risk patterns among 1,534 college women. Results supported four classes: low sexual risk (68.2%), moderate sexual risk: party hookups (11.0%), moderate sexual risk: risky partners (17.6%), and high sexual risk (3.1%). Membership in the moderate and high-risk classes were associated with coping motives, drinking, and risky peer norms, while membership in the low risk class was associated with sexual satisfaction and low peer approval of risky sex. Implications of the findings are discussed.

Sexual Risk Behavior and Sexual Satisfaction among Rape Victims: Examination of Sexual Motives as a Mediator.

Rape survivors engage in more risky sexual behavior and report more sexual dissatisfaction and dysfunction than those without a rape history. However, little research has examined possible mechanisms to explain the relation between rape and sexual health outcomes. Therefore, the current study examined sexual motives as one mechanism to explain why survivors engage in more risk behavior and report lower sexual satisfaction. We hypothesized that rape survivors would be more likely to report engaging in sex for a variety of potentially maladaptive motives, including to reduce their negative affect, improve their self-esteem, and obtain approval or avoid censure from their peers and sexual partners. Engaging in sex for these reasons was then hypothesized to mediate the relation between rape history and sexual risk behavior as well as sexual satisfaction. These hypotheses were tested among 1,534 sexually active college women. Results supported that all four sexual motives mediated the relation between rape history and risky sexual behavior and sexual satisfaction. In both cases, the size of the standardized indirect effect was larger for the models including the two affect regulation motives as mediators, as compared to the models including peer and partner approval motives as mediators. Thus, survivors who endorse affect regulation motives for sex are more likely to engage in risky sexual behavior and more likely to report feeling dissatisfied with their sex lives. This suggests that sexual motives may be an important area to target for future sexual health research and intervention programs targeting survivors.

Resilience, Self-compassion, and Mental Health Outcomes: Rebuilding Eastern North Carolina After Natural Disasters.

Natural disasters have occurred more frequently in Eastern North Carolina in recent years. Evidence supports that repeated exposure to natural disasters may have lasting mental health impacts among vulnerable populations. Greater access to mental health services may aid in ensuring equitable access to needed care and promote resilience.

Evaluation of an Internet-based intervention for ICD patients with elevated symptoms of posttraumatic stress disorder.

BACKGROUND: To date, treatment to reduce posttraumatic stress disorder (PTSD) symptoms in implantable cardioverter defibrillator (ICD) patients has been limited by lack of symptom recognition, lack of provider referrals, barriers to treatment access, and inadequate evidence base of treatment effectiveness in this population. METHODS: Participants were 46 patients with ICDs (17 paired) with elevated PTSD symptoms who were recruited in electrophysiology clinics at community and university hospitals as well as ICD support forums. Participants were provided the Web-based, brief psychosocial intervention, which was tailored to ICD patients and contained elements of evidence-based cognitive-behavioral protocols for PTSD. Pretest and posttest measurement assessed participants' trauma experiences, mental health, and device-specific distress (device acceptance and shock anxiety). RESULTS: Postintervention scores on the PTSD Checklist (PCL; M = 35.5, SD = 10.09) were significantly lower than preintervention scores (M = 46.31, SD = 9.88), t (16) = 3.51, P = 0.003, d = 1.08. CONCLUSIONS: Preliminary results indicate that future research with a more robust design is warranted. Given limitations in accessibility of mental health providers to manage cardiac-related psychological sequelae, brief, Web-based intervention may be an effective, supplemental, clinical modality to offer treatment to this population.

Changes in Coping and Negative Cognitions as Mechanisms of Change in Online Treatment for Rape-Related Posttraumatic Stress Disorder.

Cognitive behavioral therapy (CBT)-based interventions, including those administered via telepsychology, represent efficacious posttraumatic stress disorder (PTSD) treatments. Despite demonstrated efficacy, limited research has examined mechanisms of change for CBT. We examined trauma-related cognitions and coping as treatment mechanisms among 46 women who completed a randomized clinical trial of a CBT-based, telepsychology-delivered interactive program for rape survivors. The results indicated that both the interactive program, d = 1.5, and the active control condition, a psychoeducational website, d = 1.4, resulted in large reductions in posttest PTSD symptoms. Analysis of residual gain scores showed that reductions in the three types of assessed trauma-related cognitions were strongly related to reductions in PTSD symptoms among women assigned to the interactive program, rs = .60-.79, but only weakly related to symptom reduction among those assigned to active control, rs = .06-.31. The results also suggest that increases in trauma-related approach coping were weakly related to reductions in PTSD symptoms among participants in the interactive program, rs = -.16 and -.17, but, conversely, decreases in trauma-related approach coping were weakly related to reductions in PTSD symptoms among those in the active control group, rs = .07 and .28. Reductions in avoidance coping were modestly related to reductions in PTSD symptoms among women in the interactive program, rs = .38 and .38, but unrelated to changes in PTSD symptoms among those assigned to the active control, rs = .03 and .05. Implications for future work examining mechanisms of change for PTSD treatments are discussed.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Cambios en el afrontamiento y las cogniciones negativas como mecanismos de cambio en el tratamiento online del Trastorno de Estrés Postraumático (TEPT) relacionado a violación. CAMBIOS EN EL AFRONTAMIENTO Y LAS COGNICIONES EN EL TRATAMIENTO DE TEPT Las intervenciones basadas en la terapia cognitiva conductual (CBT en sus siglas en inglés), incluyendo aquellas administradas vía telepsicología, representan tratamientos eficaces del trastorno de estrés postraumático (TEPT). A pesar de su demostrada eficacia, limitadas investigaciones han examinado los mecanismos de cambio para la CBT. Examinamos las cogniciones relacionadas al trauma y el afrontamiento como mecanismos de tratamiento entre 46 mujeres que completaron un ensayo clínico aleatorio basado en CBT, de un programa interactivo para sobrevivientes de violación, implementado por medio de telepsicología. Los resultados indicaron que tanto el programa interactivo, d = 1.5, y la condición control activa, un sitio web psicoeducativo, d = 1.4, resultaron en grandes reducciones en los síntomas del TEPT postprueba. Los análisis de los puntajes de ganancias residuales mostraron que las reducciones en los tres tipos de las cogniciones relacionadas al trauma evaluadas fueron fuertemente relacionados a reducciones en los síntomas del TEPT en las mujeres asignadas al programa interactivo, rs = .60-.79, pero solo débilmente asociados a la reducción de síntomas entre aquellas asignadas al control activo, rs = .06-.31. Los resultados también sugirieron que un incremento en el tipo de afrontamiento relacionado al trauma se relacionó débilmente a las reducciones en los síntomas del TEPT entre los participantes en el programa interactivo, rs = -.16 y -.17, pero contrariamente, disminuciones en el tipo de afrontamiento relacionado con el trauma se asociaron débilmente con reducciones en los síntomas del TEPT entre aquellas en el grupo de control activo, rs = .07 y .28. Las reducciones en el afrontamiento evitativo se relacionaron modestamente con las reducciones en los síntomas de TEPT entre las mujeres en el programa interactivo, rs = .38 y .38, pero no estuvo relacionado a los cambios en los síntomas del TEPT entre aquellas asignadas al control activo, rs = .03 y .05. Se discuten las implicaciones para el trabajo futuro examinando los mecanismos del cambio para los tratamientos del TEPT.

Unacknowledged Rape in the Community: Rape Characteristics and Adjustment.

Unacknowledged rape, labeling a rape as a nonvictimizing event, remains largely unstudied among non-college women. This study therefore sought to examine differences in assault characteristics, adjustment, and disclosure by rape acknowledgment status among a sample of lower income rape victims (n = 104) recruited from a reproductive health clinic (mean age = 28.8 years). Although unacknowledged rape was infrequent (17.1% of victims), unacknowledged victims reported that the perpetrator used less force and were less likely to have assertively resisted, as compared to acknowledged victims. There were no significant differences in disclosure, depression, and somatic complaints between unacknowledged and acknowledged rape victims. Implications of the findings for understanding rape acknowledgment and postrape adjustment among community women are discussed.

Sexual Assault and Sexual Risk Behaviors Among Lower-Income Rural Women: The Mediating Role of Self-Worth.

Sexual victimization is associated with risky sexual behaviors. Limited research has examined mechanisms via which victimization affects risk behaviors, particularly following different types of sexual victimization. This study examined self-worth as a mediator of the relationship between sexual victimization history: contact childhood sexual abuse (CSA), completed rape in adolescence/adulthood (adolescent/adulthood sexual assault [ASA]), and combined CSA/ASA, and two sexual risk behaviors: past year partners and one-time encounters. Participants were diverse (57.9% African American), low-income women recruited from an OB-GYN waiting room (n = 646). Women with a history of sexual victimization, 29.8% (n = 186) reported lower self-worth, t(586) = 5.26, p < .001, and more partners, t(612) = 2.45, p < .01, than nonvictims. Self-worth was a significant mediator only among women with combined CSA/ASA histories in both risk behavior models.

College Campus Community Readiness to Address Intimate Partner Violence Among LGBTQ+ Young Adults: A Conceptual and Empirical Examination.

This paper provides an overview of a conceptual model that integrates theories of social ecology, minority stress, and community readiness to better understand risk for and outcomes of intimate partner violence (IPV) among LGBTQ+ college students. Additionally, online survey data was collected from a sample of 202 LGBTQ+ students enrolled in 119 colleges across the United States to provide preliminary data on some aspects of the proposed model. Results suggested that students generally thought their campuses were low in readiness to address IPV; that is, students felt that their campuses could do more to address IPV and provide IPV services specific to LGBTQ+ college students. Perceptions of greater campus readiness to address IPV among LGBTQ+ college students was significantly and positively related to a more favorable LGBTQ+ campus climate and a greater sense of campus community. Additionally, IPV victims were more likely to perceive higher levels of campus community readiness than non-IPV victims. There was no association between IPV perpetration and perceptions of campus community readiness. Greater sense of community was marginally and inversely related to IPV victimization and perpetration. Sense of community and LGBTQ+ campus climate also varied to some extent as a function of region of the country and type of institution. Implications for further development and refinement of the conceptual model, as well as future research applying this model to better understand IPV among sexual minority students are discussed.

Predicting risky sexual behavior in emerging adulthood: examination of a moderated mediation model among child sexual abuse and adult sexual assault victims.

Although having a sexual victimization history is associated with engaging in sexual risk behavior, the mechanisms whereby sexual victimization increases risk behavior are unclear. This study examined use of sex as an affect regulation strategy as a mediator of the relationship between depressive symptoms and sexual risk behavior among 1,616 sexually active college women as well as examined having a history of child sexual abuse (CSA), adolescent/adult sexual assault (ASA), or both (CSA/ASA) as moderators. Results supported the mediated model as well as moderated mediation, where depressive symptoms were more strongly associated with use of sex as an affect regulation strategy among ASA victims, and sex as an affect regulation strategy was more strongly related to sexual risk behavior for CSA/ASA victims.

Therapeutic boundaries in telepsychology: Unique issues and best practice recommendations.

Technology-assisted mental health services are becoming much more routinely utilized by clients and practitioners alike. Clinicians practicing telepsychology must prepare themselves in order to provide competent care in this ever-evolving context of service delivery. Although much has been written with regards to considerations of ethical and legal practice, practical and logistical guidelines, and the advantages and disadvantages of the delivery of services via the use of technology, little to no attention has been paid to issues related to therapeutic boundaries in the telepsychology relationship. Clinicians must consider how to maintain appropriate boundaries in telepsychology settings in order to prevent harm and optimize treatment gains. Such considerations are also necessary given that it is probable that the telepsychology clinician will encounter novel boundary issues that are unlikely to occur in the traditional face-to-face therapy setting. We discuss the clinical utility of boundaries, potential boundary issues in telepsychology settings, and suggested best practice recommendations to ensure competent, ethical, and efficacious treatment in this novel context of service delivery.

Past 6-Month Prevalence of IPV Victimization among Transgender and Gender-Diverse Undergraduate Students: A Brief Report.

Research has largely neglected the issue of intimate partner violence (IPV) among transgender and gender-diverse (TGD; e.g., nonbinary and genderqueer) individuals. However, existing research suggests that TGD individuals are disproportionately affected by IPV. The current study sought to explore if and how rates of IPV vary among subgroups of TGD undergraduate students and contextual factors of IPV among TGD individuals including the co-occurrence of multiple forms of IPV victimization, the type of relationship in which IPV occurred, and the gender identity of the IPV perpetrator. Participants were 280 TGD undergraduate students attending 20 medium- and large-sized residential public universities across the contiguous United States. Of the entire sample of TGD undergraduate students (N = 280), a total of 27.5% endorsed past 6-month IPV victimization (20.0% psychological, 6.1% physical, 8.9% sexual, 11.4% coercive control, and 5.7% LGBTQIA+-specific). Among only the participants who endorsed past 6-month IPV victimization (N = 77), 45.4% reported one form of IPV victimization, 26.0% two forms, 22.1% three forms, and 6.5% four forms. Further, 41.3% of TGD IPV victims were in a casual relationship, 56.0% were in a serious relationship, and 2.7% were in multiple relationship types. Finally, 55.8% of victims reported their perpetrator was a man, 22.1% a woman, and 22.1% a TGD individual. No significant differences in rates of IPV were found between TGD respondents. These data highlight the urgent need for programming efforts on college campuses that are specifically designed to prevent and address IPV among and against TGD students. Future research should evaluate universal- and population-specific risk and protective factors for IPV among TGD individuals to inform prevention and response efforts for this highly vulnerable population.

Quantifying Criminal Sexual Acts: The Illegal Sexual Exploitation Module of the Revised Sexual Experiences Survey-Victimization (SES-V) Measure.

Since the initial development of the Sexual Experiences Survey (SES) four decades ago, the SES has been designed to measure a range of forms of sexual exploitation, including acts that are coercive but not legally sanctioned as well as acts that legally qualify as crimes. That feature was retained in the revised Sexual Experiences Survey-Victimization (SES-V) measure. This article reviews the theoretical and empirical literature that guided the development of the Illegal Sexual Exploitation module of the SES-V, which measures experiences of nonconsensual exploitation resulting in sexual contact and which is designed to correspond to legal definitions across multiple jurisdictions. This article addresses research and applied contexts in which the distinction between legal and illegal sexual exploitation is important and the challenges and limitations involved in writing survey items that correspond to legal definitions. It also discusses revisions made to the items that make up the Illegal Sexual Exploitation module of the SES-V as compared to the illegal items in prior versions of the SES, including a new operationalization of non-consent and an expansion of the sexual acts and exploitative tactics that are included. Finally, the article discusses directions for future research on the Illegal Sexual Exploitation module of the SES-V.

Random intercept cross-lagged relations among trauma coping self-Efficacy, trauma coping, and PTSD symptoms among rural hurricane survivors.

BACKGROUND AND OBJECTIVES: The trajectories of recovery and non-recovery following a disaster are well-documented, but the mechanisms of post-disaster adaptation remain poorly understood. Rooted in social cognitive theory and the transactional model of stress and coping, this study longitudinally investigated the reciprocal relations among coping self-efficacy (CSE), coping behaviors (approach and avoidant), and posttraumatic stress symptoms (PTSS) among highly exposed hurricane survivors. DESIGN: 261 Hurricane Florence survivors completed measures of hurricane-related CSE, coping behaviors, and hurricane-related PTSS across three timepoints, beginning 5-8.5 months after Hurricane Florence. METHOD: Random-intercept cross-lagged panel models investigated the relations among study variables. RESULTS: Reciprocal, cross-lagged relations were identified between higher CSE and approach coping from T2 to T3. The lagged relations between approach coping at T1 and T2 were significant, as well as between avoidant coping at T2 and T3. Significant cross-sectional relations were also present for CSE, coping behaviors, and PTSS at T3. CONCLUSIONS: Results provide partial support for the positive feedback loop involving CSE and approach coping, but not for the negative feedback loop involving avoidant coping. CSE may be an important mechanism in longer-term disaster recovery, in part by increasing use of approach coping.

The Role of Minority Stress in Psychological Distress and Hazardous Drinking Among Sexual Minority College Student Victims of Intimate Partner Violence.

Sexual minority, individuals who are not heterosexual, college students experience high rates of intimate partner violence (IPV), which is linked to a myriad of deleterious outcomes. However, little work has evaluated whether there are differences in IPV outcomes among sexual minority college students as compared to heterosexual college students. Further, the extent to which minority stress at the institutional and individual level relates to IPV outcomes among sexual minority students is understudied. As such, the purpose of the current study was to evaluate IPV outcomes in a large sample of undergraduate students attending 18 medium- to large-sized universities across the contiguous U.S. Results supported that sexual minority victims of IPV had more anxious and depressive symptoms than heterosexual victims of IPV but were not more likely to engage in hazardous drinking. Further, analyses supported that several campus-level (but not individual-level) indicators of minority stress moderated the relation between IPV victimization and negative outcomes among sexual minority students, such that the association between IPV and negative outcomes was stronger among students embedded in campuses with higher levels of minority stressors. Results support the critical importance of interventions addressing campus-level minority stressors to reduce deleterious IPV outcomes among sexual minority college student victims.

Self-compassion reduces posttraumatic stress symptom severity in hurricane survivors via perceived social support.

OBJECTIVE: Following disasters such as hurricanes, self-compassion (e.g., being understanding and showing care toward oneself) can be a valuable personal resource that facilitates social support and reduces posttraumatic symptoms. As a result of their increased connection to other people and interpersonal competence, self-compassionate people may perceive more social support following a traumatic event, which in turn reduces posttraumatic stress symptoms (PTSS). The present study is the first to utilize a longitudinal design and latent variable modeling to test this mediation hypothesis. METHOD: A three-wave longitudinal design was utilized to assess hurricane exposure, self-compassion, perceived social support, and PTSS in hurricane survivors at baseline (T1), 3-month (T2), and 6-month (T3) follow-up. Participants at T1 included 261 hurricane survivors (88.5% women) who were racially diverse and particularly vulnerable to loss of resources (53.2% with an income of less than $30,000). Participants were recruited using online, print, and face-to-face methods, and all survey responses were completed online. RESULTS: Participants reported high hurricane stressor exposure (M = 9.14 serious stressors out of a possible 24). Controlling for hurricane exposure, self-compassion at T1 predicted PTSS at T3, and this was mediated by perceived social support at T2. CONCLUSIONS: Following hurricane exposure, self-compassionate people experience less PTSS over time because they perceive their social support resources to be more robust. Implementation of self-compassion education and training following a disaster could improve perceived social support networks that provide an additional protective factor against PTSS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Words Can Hurt: A Taxonomy of Verbally Pressured Sexual Exploitation in the SES-V.

This article describes the development of the Verbally Pressured Sexual Exploitation module of the Sexual Experiences Survey (SES)-Victimization (introduced by Koss et al., 2024). This module assesses the use of verbal or nonphysical, paraverbal pressure to obtain sexual acts without freely given permission. An interdisciplinary team of seven sexual exploitation researchers collaborated to create this module, with consultation from the full 15 member SES-V revision collaboration team. In this paper, we describe our process for developing this module. We briefly review empirical literature and theoretical frameworks (e.g., rape scripts, normative sexual scripts, intersectionality, and sex-positivity) that informed this work. Summary tables compare the SES-V items to verbal pressure items in prior versions of the SES and to other existing measures of violence. The comprehensive taxonomy developed herein includes six domains of Verbally Pressured sexual exploitation across 11 item stems. The components of the taxonomy include: positive verbal pressure, neutral verbal pressure, negative verbal pressure, substance-related pressure, postural violence, and threats to critical resources. The paper concludes with suggestions for future research, with priority on intersectional research that can illuminate the phenomenology and contexts of sexual exploitation against marginalized groups.

Examination of the Multilevel Sexual Stigma Model of Intimate Partner Violence Risk Among LGBQ+ College Students: A Prospective Analysis Across Eighteen Institutions of Higher Education.

Sexual stigma operates at multiple levels (institutional, group, individual), which serves to disadvantage sexual minority (LGBQ+) individuals and increases risk for deleterious outcomes. The current study evaluated a novel multilevel sexual stigma model of intimate partner violence (MLSSM-IPV) that incorporates multiple levels of sexual stigma as related to IPV risk via several pathways (e.g. hazardous drinking, affective symptoms). We evaluated this model in a longitudinal study of LGBQ+ undergraduate college students (n = 2,415) attending 18 universities who completed surveys in the Fall and Spring semesters. Group-level sexual stigma on each campus was assessed via surveys with heterosexual students (n = 8,517) and faculty, staff, and administrators (n = 2,865), and institutional-level stigma was evaluated via a campus climate assessment. At the campus level, institutional stigma was related to LGBQ+ students' self-stigma and identity concealment. Moreover, self-stigma prospectively predicted IPV victimization, and hazardous drinking mediated the relations between self-stigma and IPV perpetration and victimization. Results suggest that interventions addressing stigma and hazardous drinking may be efficacious in reducing IPV among LGBQ+ students. Further, comprehensive efforts to improve campus climate for LGBQ+ students are likely to produce a plethora of benefits for these students.