Do Concerns About Police Reporting Vary by Assault Characteristics? Understanding the Nonreporting Decisions of Sexual Assault Victims Who Utilize Alternative Reporting Options.

INTRODUCTION: Forensic nurses routinely provide services to sexual assault victims who are uncertain about reporting their assault to police. The purpose of this study was to determine whether assault characteristics are related to the concerns about police reporting expressed by sexual assault victims who have forensic evidence collected but do not report their assault to police at that time. METHODS: We analyzed medical records of patients who received services at a hospital-based forensic nursing program between 2010 and 2021. Records were included if a sexual assault evidence kit was collected, the patient declined to report the assault to police, and the patient completed a nonreport sexual assault evidence kit supplement form that included a question asking why they chose not to report the assault (N = 296). We qualitatively analyzed patients' reasons for not reporting the assault and then used two-variable case-ordered matrices and chi-square analyses to explore relationships between reasons for not reporting and assault characteristics. RESULTS: Identified reasons for not reporting included lacking information about the assault, fear of harm/retaliation, and self-blame/minimization. Physical force, drug/alcohol consumption, and victim-offender relationship were related to patients referencing lacking information and fearing harm/retaliation as reasons for not reporting, but not related to the frequency of patients referencing self-blame/minimization. IMPLICATIONS: Results indicate that assault characteristics are related to reasons for not reporting at the time of the medical forensic examination. Being aware of these relationships may help forensic nurses provide patient-centered services and anticipatory guidance.

"It Made Me Feel Like Someone Wasn't Doing Their Job:" Sexual Assault Kit (SAK) Victim Notifications and Institutional Betrayal by the Criminal Legal System.

In the United States, sexual assault survivors are advised to have a medical forensic exam and the collection of a sexual assault kit (SAK) to preserve biological evidence (e.g. semen, blood, saliva, hair) if they are considering reporting the assault to the police. Law enforcement personnel are supposed to submit the SAK (also known as a "rape kit") to a crime laboratory for forensic DNA testing, which can help identify or confirm the identity of the offender. However, police do not routinely submit SAKs for testing, and large stockpiles of untested kits have been found in police storage throughout the United States. Public outrage has prompted many cities to submit these older rape kits for DNA analysis, and this testing has identified thousands of suspected perpetrators. Police and prosecutors are re-opening these older sexual assault cases, which requires reestablishing contact with survivors who made the initial report years ago - a process referred to as "victim notification." In this study, we conducted qualitative interviews with survivors who received a SAK victim notification and participated in the re-investigation and prosecution of their cases. We explored how survivors reacted to this de facto admission of an institutional betrayal and the emotions they felt during and after the notification. Participants experienced considerable emotional distress (e.g. PTSD, anxiety, fear), anger and betrayal, and hope after they were recontacted by the police. Implications for making victim notifications more trauma informed are discussed.

Reasons for Not Reporting Among Sexual Assault Survivors Who Seek Medical Forensic Exams: A Qualitative Analysis.

After a sexual assault, survivors have the option of seeking a medical forensic exam, which includes medical evaluation and treatment, as well as forensic evidence collection. Forensic evidence is collected in a sexual assault evidence kit (SAEK) and typically released to police to aid in the investigation and potential prosecution of the assault. However, 20% to 25% of survivors who have a SAEK collected do not report their assault to police at that time and choose instead to have their SAEK stored for possible future use. This study sought to understand the reasons for not reporting among this group of survivors. We examined medical records of 296 individuals aged 18 and older who had documented their reasons for not reporting to police in their medical record and used a non-theory-driven coding framework to conduct a reflexive thematic analysis based on that data. We identified four themes: Reporting Won't Help, Reporting Will Harm, Not Now, and Not What I'm Here For. These data illustrate that survivors are making an active choice which, for many, was based on concerns that reporting would not meaningfully help their situation or may even make their situations worse. For some survivors, the decision to have forensic evidence collected without a police report was based on their needs at that moment, whereas for other survivors it was based on their desire to move on from the assault more permanently. Practice and policy recommendations are discussed, including the importance of providing survivors information about what police reporting would look like in specific circumstances as well as ensuring that financial concerns are not a barrier to survivors receiving post-assault medical care without forensic evidence collection.

Victim Notification Protocols for Untested Sexual Assault Kits: Survivors' and Advocates' Perspectives on Law Enforcement-Led Outreach Methods.

Current estimates suggest there are 300,000-400,000 untested sexual assault kits (SAKs) in police department storage facilities throughout the United States. As these kits are being discovered and then submitted for forensic DNA testing, legal system personnel may recontact victims. These "victim notifications" involve informing survivors their kits were previously untested, sharing the results of new DNA testing, and asking for their engagement in reinvestigating and prosecuting the case. Typically, victim notifications are conducted by police, and survivors are connected with victim advocates soon thereafter. In this study, we interviewed survivors about their experiences of being notified by the police. We also interviewed about their work supporting survivors. Both survivors and advocates expressed strong concerns about police conducting notifications without an advocate present.

Domestic violence survivors' housing stability, safety, and well-being over time: Examining the role of domestic violence housing first, social support, and material hardship.

Intimate partner violence remains a significant public health issue and survivors often need various forms of support to achieve safety. The increased likelihood of experiencing housing instability and homelessness among survivors has led to an uptake in domestic violence agencies implementing housing-based interventions, such as Domestic Violence Housing First (DVHF), to address survivors' needs. The present study expands on prior research supporting the effectiveness of DVHF to examine situational factors that moderate the outcomes associated with this model among 406 survivors seeking services from domestic violence agencies located in the Pacific Northwestern region of the United States. Using latent profile analysis, participants were grouped into three latent classes: (a) "high abuse/instability," (b) "still affected," and (c) "doing better." Latent transition analysis was used to estimate the probability that participants would transition into a different latent class over time with social support (SS), material hardship, and receipt of DVHF services included as model predictors. Receipt of DVHF predicted improvements in survivors' safety, housing stability, mental health, and well-being, such that receiving DVHF was associated with higher odds of survivors transitioning into the "doing better" class. Social support and material hardship also emerged as significant factors predicting class membership, such that higher levels of social support and financial stability predicted membership in the "doing better" class. Additionally, social support and financial stability appeared to augment receipt of DVHF services, with DVHF being more strongly associated with positive outcomes among participants who also had high levels of social support and lower levels of material hardship. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Organizational Readiness and Response During COVID-19: Reflections From a Sexual Assault Agency Serving a Predominately African American Community.

The coronavirus disease 2019 (COVID-19) pandemic forced victim service organizations to establish new service provision protocols to include remote/telehealth services. We conducted N = 12 qualitative interviews with sexual assault advocates working in an urban agency in a predominately African American U.S. city to understand how they adapted services to meet the needs of their community. A thematic analysis revealed this organization was under-prepared for prolonged interruption of in-person services. Even though this agency was able to create telehealth options, many clients did not have the financial and technological resources to utilize these services. Advocates reported that survivors expressed a strong preference for in-person services, which afford more privacy and confidentiality. The pervasive digital divide within this urban community limited survivors' access to comprehensive services and jeopardized their safety.

Post-Assault Health Care for Sexual Assault Survivors During COVID-19: A Mixed Methods Analysis of Service Rates in a Predominately African American Community.

This study examined how the COVID-19 pandemic affected sexual assault healthcare services in a predominately African American U.S. city. In mixed methods research design, we used quantitative interrupted time series modeling to evaluate changes in service rates for three core post-assault healthcare services-medical forensic exams (MFEs), medical advocacy MFE accompaniment, and counseling-from January 2019 through June 2021. We also conducted qualitative interviews with 12 sexual assault advocates to understand how their clients were impacted by COVID and how their agency adapted services to respond to the needs of their community. Both the quantitative and qualitative data revealed marked disruptions in service provision. The number of MFEs, medical advocacy accompaniments, and counseling sessions significantly decreased during the pandemic's initial surge, and survivors feared seeking hospital-based health care due to concerns that they might contract COVID-19 in hospital emergency departments. The number of MFEs performed by program staff did not return to pre-pandemic levels during this study's observation period, but the number of medical advocacy accompaniments and counseling sessions did significantly rebound. Counseling services eventually exceeded pre-pandemic levels as agency staff supported clients with both assault- and COVID-related trauma and loss. These results underscore the need for community-based sexual assault healthcare services, so that if public health emergencies limit the availability, accessibility, and safety of hospital emergency department care, sexual assault survivors have other settings for obtaining post-assault health care.

Open science and data sharing in trauma research: Developing a trauma-informed protocol for archiving sensitive qualitative data.

OBJECTIVE: The open science movement seeks to make research more transparent, and to that end, researchers are increasingly expected or required to archive their data in national repositories. In qualitative trauma research, data sharing could compromise participants' safety, privacy, and confidentiality because narrative data can be more difficult to de-identify fully. There is little guidance in the traumatology literature regarding how to discuss data-sharing requirements with participants during the informed consent process. Within a larger research project in which we interviewed assault survivors, we developed and evaluated a protocol for informed consent for qualitative data sharing and engaging participants in data de-identification. METHOD: We conducted qualitative interviews with N = 32 adult sexual assault survivors regarding (a) how to conduct informed consent for data sharing, (b) whether participants should have input on sharing their data, and (c) whether they wanted to redact information from their transcripts prior to archiving. RESULTS: No potential participants declined participation after learning about the archiving mandate. Survivors indicated that they wanted input on archiving because the interview is their story of trauma and abuse and it would be disempowering not to have control over how this information was shared and disseminated. Survivors also wanted input on this process to help guard their privacy, confidentiality, and safety. None of the participants elected to redact substantive data prior to archiving. CONCLUSIONS: Engaging participants in the archiving process is a feasible practice that is important and empowering for trauma survivors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal patterns of posttraumatic stress disorder symptoms among sexual assault survivors: A latent transition analysis.

OBJECTIVE: The aim of this study was to identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a community sample of sexual assault survivors whose assaults occurred varying lengths of time in the past and to explore patterns of transition between those latent classes over time. METHOD: Latent class analysis was used to identify naturally occurring subgroups of PTSD symptoms in a sample of sexual assault survivors who completed two mailed surveys 1 year apart (N = 1,271). Latent transition analysis was then used to examine individuals' probabilities of transitioning into each latent class at Time 2 based on their latent class membership at Time 1. RESULTS: A four-class model emerged as the best fitting model at both Time 1 and Time 2. Classes demonstrated overall severity and symptom cluster severity differences. Transition into a lower severity class was more common than transition into a higher severity class, though escalation was demonstrated by 6-20% of participants in each latent class. CONCLUSIONS: The substantial heterogeneity in sexual assault survivors' PTSD symptoms highlights the variety of ways that posttraumatic stress may be experienced years after a sexual assault. Future research should explore factors that affect long-term symptoms, including cumulative lifetime trauma and social support. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sexual assault survivors' engagement with advocacy services during the COVID-19 pandemic.

Sexual assault advocates provide support to survivors as they navigate medical, legal, housing, and other complex systems. However, social distancing measures enacted in response to coronavirus disease 2019 (COVID-19) forced changes to traditional advocacy services. The current study aimed to understand how the COVID-19 pandemic transformed survivors' engagement with sexual assault advocacy services. Semi-structured interviews were conducted with 12 sexual assault advocates from a community-based advocacy organization in Detroit. Thematic analysis was employed to uncover emergent themes reflecting COVID-19's impact on survivors' engagement with advocacy services. Three themes were identified: (1) Disruption to advocacy services; (2) difficulty obtaining tangible resources; and (3) desire for COVID-related support, information, and resources. This study highlights the needs of sexual assault survivors during the COVID-19 pandemic and explores how public health emergencies have the potential to exacerbate the needs of this vulnerable population. Implications and future directions for service provision and research are considered.

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.

Posttraumatic stress disorder and measurement invariance in a sample of sexual assault survivors: Are symptom clusters stable over time?

OBJECTIVE: Many sexual assault victims develop posttraumatic stress disorder (PTSD) after their assault, the symptoms of which can last for months or years. Although severity of PTSD symptoms generally decreases over time, it is unclear whether symptom clusters decrease at a consistent pace or whether certain symptom clusters resolve more quickly than do others. Put in terms of measurement invariance, do all symptom clusters maintain stable contributions to the underlying construct of PTSD over time? This article responds to that question by analyzing longitudinal data collected from a diverse sample of sexual assault survivors. METHOD: We conducted a longitudinal confirmatory factor analysis to assess measurement invariance of the Posttraumatic Stress Diagnostic Scale. We also tested the impact of time since the assault and revictimization between measurement occasions on posttraumatic stress symptoms. RESULTS: Results indicated that although 3 out of 4 symptom clusters remained stable, the contribution of the dysphoria symptom cluster to the latent factor of PTSD varied over time. Findings also suggested that whereas time since the assault was not a significant predictor of posttraumatic stress symptoms, revictimization between Wave 1 and Wave 2 surveys did predict posttraumatic stress at the 2nd measurement occasion. CONCLUSIONS: Trauma researchers and practitioners are advised to monitor item-level movement on dysphoria scales rather than focus on the average cluster score, because items in this symptom cluster may change in a less predictable way than do items in other symptom clusters. Lack of attention to this issue may lead to inaccurate or incomplete conclusions about how PTSD symptom clusters evolve over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Trauma-Informed Approach to Sexual Violence Research Ethics and Open Science.

The practice of ethics in social science research is a reflexive process of self-review to define a profession's collective responsibility in the face of changing norms and expectations. In recent years, we have seen transformative changes in how society thinks about supporting sexual assault survivors, and how the scientific community thinks about our obligations to society. Decades of research on trauma and its impact has raised awareness about the needs of victimized individuals, giving rise to the trauma-informed practice movement, which emphasizes that service providers must center survivors' well-being in all interactions, decisions, and program practices. The field of sexual assault research helped give rise to this movement and provides empirical support for its guiding tenets, and in this article, we explore how to bring these ideas full circle to begin articulating trauma-informed principles for research. A trauma-informed perspective on research challenges scientists to go beyond the requirements of the Belmont Report (1979) and institutional review boards' (IRB) regulations to develop research procedures that fully support survivors' choice, control, and empowerment. Such reflection on participants' rights is particularly important given the open science movement sweeping academia, which calls on scientists to share their data publicly to promote transparency, replication, and new discoveries. Disseminating data could pose significant safety, privacy, and confidentiality risks for victims of sexual assault, so we need to evaluate what open science means within a trauma-informed framework. In this article, we examine three key stages of the research process-participant recruitment, data collection, and dissemination-and consider how trauma-informed principles could help, but also could complicate, research practices. We explore these tensions and offer potential solutions so that research on sexual trauma embodies trauma-informed practice.

How to Right a Wrong: Empirically Evaluating Whether Victim, Offender, and Assault Characteristics can Inform Rape Kit Testing Policies.

Hundreds of thousands of previously untested sexual assault kits (SAKs) have been uncovered in police property storage facilities across the United States, representing a national failure in institutional response to sexual assault. Faced with this discovery, jurisdictions must now decide if and how they should test these kits. Some stakeholders have suggested prioritizing kits for testing by victim, offender, or assault characteristics, based on the belief that these characteristics can predict the likely utility of DNA testing. However, little research has examined the empirical merits of such prioritization. To address this gap in the literature and inform SAK testing policies, we randomly sampled 900 previously untested SAKs from Detroit, MI. The sampled SAKs were submitted for DNA testing, and eligible DNA profiles were entered into Combined DNA Index System (CODIS), the federal DNA database. Police records associated with each SAK were coded for victim, offender, and assault characteristics, and logistic regression analyses were conducted to test whether these characteristics predict which SAKs yield DNA profiles that match ("hit") to other criminal offenses in CODIS. Testing this sample of previously-untested SAKs produced a substantial number of CODIS hits, but few of the tested variables were significant predictors of CODIS hit rate. These findings suggest that testing all previously-unsubmitted kits may generate information that is useful to the criminal justice system, while also potentially addressing the institutional betrayal victims experienced when their kits were ignored.

Sexual misconduct in prison: What factors affect whether incarcerated women will report abuses committed by prison staff?

More than 80,000 prisoners each year are sexually victimized during incarceration, but only about 8% report victimization to correctional authorities. Complicating reporting is the fact that half of the perpetrators are staff members. Given the restrictive and highly regulated prison environment, studies that examine reporting behaviors are difficult to conduct and to date information available relied on those who have reported or hypothetical victimization studies. This study uses an ecological framework and archival data from a class action lawsuit of sexual misconduct to determine predictors of reporting. Relying on a subsample of 179 women, chosen because they have all experienced at least 1 penetration offense, we use bivariate and multivariable mixed effects logistic regression analyses to examine individual, assault, and context-level predictors of reporting on 397 incidents of staff sexual misconduct. The final model revealed that that 6 predictors (age at time of assault, physical injury, multiple incidents, perpetrator with multiple victims, the year the abuse began, and the number of years women have left on their sentence) account for 58% of the variance in reporting. Disclosure to inmate peers and/or family and friends was significant in the bivariate results. These findings indicate the need for stronger and more systematic implementation of Prison Rape Elimination Act guidelines and remedies that create and enforce sanctions, including termination, for staff violating policy and state law. (PsycINFO Database Record