Interpersonal trauma, shame, and substance use: A systematic review.

BACKGROUND: Interpersonal trauma is a risk factor for a wide array of adverse mental health outcomes, including substance use. Research has begun investigating the role of shame in the intersection between substance use and interpersonal trauma. The current systematic review summarizes the existing literature documenting the relation among shame, substance use, and interpersonal trauma. METHOD: Articles were collected using a Boolean search strategy of terms related to interpersonal trauma, substance use, and shame across six databases. Independent search and screening by three researchers led to a final review of 27 articles, 15 of which were qualitative studies. RESULTS: Findings highlight robust associations among shame, interpersonal violence, and substance use across varied samples. Findings emphasize that increased shame is associated with greater substance use among survivors of interpersonal violence and elevated shame and greater interpersonal violence are present among individuals who use substances given the high prevalence rates. Burgeoning research suggests that shame mediates the relationship between interpersonal violence and substance use. CONCLUSION: Results from our review suggest that shame may be an important treatment target for individuals presenting with substance use and a history of interpersonal violence. Future studies, with longitudinal designs, are needed to parse out the temporal relation among shame, substance use, and interpersonal violence.

Correlates of Sexual Victimization Among Community College Women.

The current study documents the correlates associated with the severity of sexual victimization among women enrolled in a 2-year community college. Comparisons between women with a history of severe sexual victimization (i.e., rape and attempted rape), moderate sexual victimization (i.e., unwanted contact and sexual coercion), and no history of sexual victimization revealed that women with a history of severe sexual victimization endorsed more drinks per week, increased problem drinking behavior, and more use of drug before sex and higher levels of self-protective dating behaviors compared with women with no history of sexual victimization. These findings suggest that programs should target the intersection of alcohol and drug use as correlates of sexual victimization among community college women.

Associations Among Online Social Reactions to Disclosure of Sexual Victimization, Coping and Social Isolation.

Social reactions to the disclosure of sexual victimization are critical to post-assault recovery. The popular social media hashtag "#MeToo" resulted in numerous survivors of sexual victimization disclosing their experience online. Whereas previous research has examined the association between social reactions to in-person disclosure of sexual victimization and factors commonly associated with adjustment among survivors - such as coping and social support - research is needed to examine correlates of social reactions to online disclosure of sexual victimization. Accordingly, the current study investigated the relationship between online social reactions to the disclosure of sexual victimization via #MeToo and engagement in various coping strategies (problem-focused coping, emotion-focused coping) and social isolation among a sample of 195 adults with a history of sexual victimization. Results indicated that the provision of online resources was associated with lower use of problem-focused and emotion-focused coping strategies. Receipt of online emotional and informational support was associated with increased use of emotion-focused coping strategies. Further, receipt of online social reactions that turned against the survivor and receipt of online social reactions that "made fun of you, insulted you, or said something to hurt you" were associated with higher levels of social isolation. Lastly, online unsupportive acknowledgment and "sharing your tweet with other people" were associated with lower levels of social isolation. Results highlight how online social reactions to disclosure of sexual victimization via #MeToo intersect with coping and social support among survivors of sexual victimization and help to give context to the experience of online disclosure of sexual victimization.

Cross-sectional examination of correlates of sexual victimization disclosure via #MeToo.

Background: Sexual victimization is a serious public health problem, with a range of negative impacts on mental and physical health. Responses that individuals get to disclosure of sexual victimization play an important role in recovery. With the increased use of social media, more survivors are talking about their experiences of sexual victimization online. Research is needed to document the correlates of online disclosure of sexual victimization.Objective: The current study examined the role of demographic characteristics, assault severity, coping strategies, and social isolation as putative correlates of disclosing sexual victimization online via the hashtag #MeToo.Methods: A sample of 637 adults recruited via social media who reported a history of sexual victimization since the age of 14 completed self-report surveys using online survey software to assess disclosure of sexual victimization, assault severity, coping strategies, and social isolation.Results: Multivariate analyses suggest that levels of emotion-focused coping were positively associated with the disclosure of sexual victimization online via #MeToo. Further, individuals who had experienced completed rape by verbal coercion were less likely to disclose via #MeToo, compared to individuals who experienced other forms of assault.Conclusion: Coping strategies and assault severity play an important role in determining whether survivors disclose sexual victimization online via #MeToo. Findings suggest that individuals may disclose via #MeToo to seek support or express their emotions. Further, individuals whose sexual victimization experiences do not conform to 'typical' sexual victimization experiences are less likely to disclose via #MeToo.

HIGHLIGHTSGreater reported use of emotion-focused coping is associated with an increased likelihood of disclosing via #MeToo.Individuals who experienced completed rape by verbal coercion were less likely to disclose via #MeToo, compared to individuals who experienced other forms of assault.Findings highlight the need to further investigate correlates of disclosure via #MeToo.

The impact of exposure to physical and sexual violence on opioid consequences among trauma-exposed individuals recruited from the community who use opioids.

Interpersonal violence and opioid use disorder are significant and intersecting public health concerns in the USA. The current study evaluated the consequences associated with opioid use (e.g., physical, social, interpersonal, intrapersonal, and impulse control) as a function of a history of exposure to interpersonal trauma, specifically physical and sexual violence. Participants were 84 trauma-exposed individuals recruited from the community who use opioids (M age = 43.5 50% men; 55% white). Whereas no significant differences emerged in the consequences of opioid use based on a history of physical violence, individuals with a history of sexual violence demonstrated higher levels of impulsive consequences of opioid use compared to individuals without a history of sexual violence. These data highlight the importance of considering the role of exposure to sexual violence in the context of opioid use disorder treatment.

Timing of Sexual Assault Disclosure: A Study of College Women.

The present study examined correlates of immediate (within 48 h) and delayed (after 48 h) sexual assault disclosure among a sample of 83 college women who experienced sexual victimization since age 14. The use of physical resistance and experiencing a "freeze response" was positively associated with delayed disclosure. Identifying the perpetrator as a friend/acquaintance, compared to a was a romantic partner, increased the likelihood of immediate disclosure. Other individual characteristics (i.e., assault characteristics, a history of childhood sexual abuse, attitudes towards seeking help, and sexual assertiveness) and microsystem-level characteristics (i.e., perceived social support) did not impact the timing of disclosure.

Gender equitable attitudes as a significant mediator of bystander intentions among sexual minority adolescents.

INTRODUCTION: Bystander intervention is a promising approach for prevention of sexual violence. Assessing factors that may promote or hinder bystander intervention among sexual minority adolescents (i.e., lesbian, gay, bisexual, queer) is essential, given high rates of violence among sexual minority youth. Prior research examining barriers and facilitators of bystander intervention intentions does not consider how factors may vary by sexual identity. As such, the current study aimed to (1) examine how barriers and facilitators of bystander intentions, bystander intentions, and bystander behavior vary between heterosexual and sexual minority high school adolescents and (2) explore mediators of the association between sexual identity and bystander intervention intentions. We proposed that students' level of school connectedness, gender equitable attitudes, and anticipated positive consequences of bystander intervention (e.g., having a moral desire to help) would promote bystander intervention intentions, whereas binge drinking, and students anticipated negative consequences of bystander intervention (e.g., fear for one's own safety) would tend to weaken bystander intervention intentions. METHODS: Participants included 2,645 10th grade students (Mage = 15.37, SD = 0.61) recruited from high schools in the Northeast United States. RESULTS: Sexual minority youth reported higher bystander intentions, bystander behavior, anticipated positive consequences of bystander intervention, gender equitable attitudes, and binge drinking relative to heterosexual youth. Sexual minority youth had lower school connectedness than heterosexual youth. Anticipated negative consequences of bystander intervention did not vary by group. Parallel linear regression analyses found that only anticipated positive consequences of bystander intervention and gender equitable attitudes fully mediated the relationships between sexual identity and bystander intentions. CONCLUSIONS: Bystander intervention programs may benefit from attending to specific facilitators of bystander intervention among sexual minority youth, such as gender equitable attitudes.

Online Social Reactions to Disclosure of Sexual Victimization via #MeToo and Symptoms of Post-Traumatic Stress Disorder.

Sexual victimization is a major public health concern with significant consequences for survivors, their families, and society at large. Studies examining in-person disclosure of sexual victimization suggest that the way others respond to disclosure has a significant impact on survivors' well-being. With the advent of social media, more survivors are choosing to disclose their experience online. Research is needed to understand how social reactions to online disclosure of sexual victimization impact survivors. Accordingly, the current study examined the association between online social reactions to the disclosure of sexual victimization and symptoms of post-traumatic stress disorder (PTSD) symptoms in a sample of 195 individuals who disclosed their experience online via the hashtag #MeToo. Symptoms of PTSD were positively associated with the level of assault severity reported by the survivor, as well as receipt of online social reactions to disclosure via #MeToo that made fun, insulted, or said something to hurt the survivor. Online social reactions to disclosure via #MeToo that involved turning away from the survivor or providing unsupportive acknowledgment of the experience were unrelated with PTSD symptoms. PTSD symptoms were also not associated with the receipt of positive online social reactions to disclosure via #MeToo. Like research addressing in-person social reactions to disclosure of sexual victimization, some forms of online negative social reactions to disclosure of sexual victimization via #MeToo appear to be associated with worse psychological outcomes among survivors. Thus, online disclosure of sexual victimization and its impact needs to be attended to in clinical and research settings.

Trauma-Related Shame Mediates the Associations Between Self-Blame, Bisexual Minority Stress, and Rape-Related PTSD Symptoms.

Bisexual women experience higher rates of rape and post-traumatic stress disorder (PTSD) prevalence compared to heterosexual and lesbian women. In addition, bisexual women experience unique antibisexual stigma and minority stress, which are associated with post-trauma outcomes. The aim of the current study was to test trauma-related shame as a mechanism in the relations of self-blame and bisexual minority stress (i.e., antibisexual stigma and internalized binegativity) with rape-related PTSD symptom. The sample consisted of 192 cisgender bisexual women (ages 18-35 years) who reported an experience of rape since the age of 18. Results from path analysis conducted in Mplus indicated that trauma-related shame mediated the link between self-blame and rape-related PTSD severity, as well as the links from antibisexual stigma and internalized binegativity to rape-related PTSD severity. There was also an indirect serial effect from antibisexual stigma to internalized binegativity to shame to PTSD severity. Thus, findings highlight the mechanistic role of trauma-related shame in rape-related PTSD symptoms. We identified two risk pathways: (a) general/universal risk from self-blame about rape and shame to PTSD severity and (b) group-specific risk from bisexual minority stress and shame to PTSD severity. Results indicate that reducing trauma-related shame may be an important target to improve post-rape outcomes. Finally, stigma associated with rape and sexual violence as well as antibisexual stigma must be eradicated to improve post-trauma outcomes among bisexual survivors.

Risk factors for perpetrating sexual aggression among adolescents: Differences by gender and sexual orientation.

Although anyone-regardless of gender or sexual orientation-can perpetrate sexual aggression, most studies examining risk factors for engaging in sexual aggression include samples of boys and men, and do not consider the sexual orientation of the respondent. The current study addresses this gap in the literature by examining how risk factors for sexual aggression vary as a function of gender and sexual orientation in a sample of 1782 high school youth. Participants completed surveys evaluating engagement in consent behaviors, rape myth acceptance, perception of peer rape myth acceptance, perceived peer engagement in violence, and perceived peer support for violence. A one-way MANOVA found that constructs varied as a function of gender and sexual orientation. Specifically, heterosexual boys reported lower engagement in consent behaviors, higher rape myth acceptance, and higher perceived peer support for violence compared to heterosexual girls and sexual minority girls. The results highlight the importance of considering gender and sexual orientation when designing sexual aggression prevention programs.

The Impact of Physical and Sexual Violence on Opioid Consequences among Trauma- exposed Individuals Recruited from the Community who Use Opioids.

Interpersonal violence and opioid use disorder are significant and intersecting public health concerns in the United States. The current study evaluated the consequences associated with opioid use as a function of history of interpersonal trauma, specifically physical and sexual violence. Participants were 84 trauma-exposed individuals recruited from the community who use opioids (M age = 43.5 50% men; 55% white). Whereas no significant differences emerged in the consequences of opioid use based on a history of physical violence, individuals with a history of sexual violence demonstrated higher levels of impulsive consequences of opioid use compared to individuals without a history of sexual violence. These data highlight the importance of considering the role of sexual violence in the context of opioid use disorder treatment.

Enhancing distress tolerance to uplift motivation in recovery: Results from an open development trial.

Objective: This open pilot study examines the feasibility, acceptability, and qualitative outcomes of an interactive web- and text message-delivered personalized feedback intervention aimed at cultivating motivation and tolerance of distress for adults initiating outpatient buprenorphine treatment. Methods: Patients (n = 10) initiating buprenorphine within the past 8 weeks first completed a web-based intervention focused on enhancing motivation and providing psychoeducation on distress tolerance skills. Participants then received 8 weeks of daily personalized text messages that provided reminders of salient motivational factors and recommended distress tolerance-oriented coping skills. Participants completed self-report measures to assess intervention satisfaction, perceived usability, and preliminary efficacy. Additional perspectives were captured via qualitative exit interviews. Results: In total, 100% of retained participants (n = 9) engaged with the text messages throughout the entire 8-week period. Mean scores of 27 (SD = 5.05) on the Client Satisfaction Questionnaire at the end of 8-week period indicated a high degree of satisfaction with the text-based intervention. The average rating on the System Usability Scale was 65.3 at the end of the 8-week program, suggesting that the intervention was relatively easy to use. Participants also endorsed positive experiences with the intervention during qualitative interviews. Clinical improvements were observed across the intervention period. Conclusions: Preliminary findings from this pilot suggest that the content and delivery method of this combined web- and text message-based personalized feedback intervention is perceived by patients as feasible and acceptable. Leveraging digital health platforms to augment buprenorphine has potential for high scalability and impact to reduce opioid use, increase adherence/retention to treatment, and prevent future incidence of overdose. Future work will evaluate the efficacy of the intervention in a randomized clinical trial design.

Predictors of college women's disclosure of sexual assault prior to and during college.

Talking to others about experiences of sexual assault can facilitate recovery. The present study explored associations between assault characteristics, attitudes, coping strategies, social support, and the college women's disclosure of adolescent sexual victimization (N = 134), as well as sexual victimization over a 7-month interim during college (N = 67). A sample of first-year college women completed pencil and paper assessments of sexual victimization, assault characteristics, tendency to disclose, self-concealment, attributions of blame, likelihood to report sexual victimization, social support., and coping strategies. A series of bivariate and multivariate analyses examined predictors of sexual assault disclosure. Whereas acknowledgment of the sexual assault as victimization predicted disclosure of adolescent sexual assault, less acquaintance with the perpetrator and strong social attachments predicted disclosure of sexual assault occurring during women's first year of college. Data suggest that the factors that influence disclosure of sexual assault may vary across periods of adolescent and young adult development.

Characterizing Intimate Partner Violence in the United States During the COVID-19 Pandemic: A Systematic Review.

Intimate partner violence (IPV) is a significant global health concern. Numerous research studies document increases in IPV since the onset of the COVID-19 pandemic in March 2020. Despite this widespread recognition, research around the nature of this violence is still growing. This systematic review summarizes the existing literature documenting the prevalence and characteristics of IPV during the COVID-19 pandemic. Inclusion criteria are as follows: reported original data empirical study, assessed for IPV among adult population in the United States, and was published in English between December 2019 and March 2022. A total of 53 articles were then independently reviewed and sorted into four thematic subcategories: victimization, perpetration, articles addressing victimization and perpetration, and provider perspectives. Studies document consistent increases in the prevalence of IPV victimization and perpetration. Providers within agencies providing support to individuals impacted by IPV also documented increased strain on the agencies.

Role of blame and rape-related shame in distress among rape victims.

OBJECTIVE: Posttraumatic stress disorder (PTSD) and depression are highly prevalent among rape victims. Both blame (self-blame and victim-blaming responses to rape disclosure) and shame are frequently elevated among rape victims and contribute to PTSD and depression. However, it is unclear which type of shame is relevant. The aim of the current study was to examine the indirect effect of self-blame and victim blame on PTSD and depression via rape-related shame and general shame, in the presence of shame proneness and rape characteristics. METHOD: Online questionnaires were completed by 229 women who experienced adult rape and had disclosed to at least one person. RESULTS: Findings revealed distinct patterns for PTSD and depression. For PTSD, there was a significant indirect effect of victim blame (and self-blame) via rape-related shame but not via general shame. In contrast, for depression, there was a significant indirect effect of victim blame (and self-blame) via both rape-related shame and general shame. CONCLUSION: Results emphasized the importance of considering the type of shame (i.e., rape-related shame and general shame) when explaining PTSD and depression among women who experienced rape. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mindful self-compassion for veteran women with a history of military sexual trauma: feasibility, acceptability, potential benefits, and considerations.

Background: Military sexual trauma (MST) is reported by up to 74% of women veterans in the United States and is a driver of poor behavioural and physical health. Self-compassion is a transdiagnostic, protective factor linked with improved posttraumatic stress disorder (PTSD), depression, and health behaviours. Thus, Mindful Self-Compassion training (MSC) may help ameliorate MST-related impacts. However, MSC can also temporarily increase distress (i.e. backdraft). Delivering it with elective trauma-informed yoga (TIY), which regulates acute distress, may help address this issue.Objective: This VA quality improvement project examined feasibility, acceptability, and reported benefits and challenges of a manualized 8-week MSC including within non-randomized subgroups: MSC (n = 4) and MSC+ elective TIY classes (MSC+; n = 4).Methods: Nine women veterans with a history of MST at a Vet Center in the Northeastern U.S.A. enrolled; eight completed, excluding one MSC+ participant. Measures included attrition (n = 9), attendance (n = 8), weekly (n = 8) and posttreatment acceptability (n = 6), validated symptom severity assessments (n = 7), and an exit interview (n = 8).Results: Among completers, MSC attendance was excellent (89%) and higher among in MSC+ vs. MSC (94% vs. 84% sessions completed). On average across the two groups, depressive and PTSD symptom severity decreased by 21% and 30%, respectively. In exit interviews, participants across groups described improved coping with distress and psychiatric symptoms, reduced stress, and improved self-care and health behaviours. Although women in both groups reported backdraft during the programme, MSC+ also reported healthier coping and improved emotional processing.Conclusion: The results of this programme evaluation infer MSC may be feasible, acceptable, and beneficial for women survivors of MST in one Vet Center in the Northeastern USA. Further, temporary elevations in MSC-related distress may be ameliorated with adjunctive TIY. Given requests of women veterans in the USA. for additional complementary and integrative health treatment options, formal research on these approaches is warranted.

This programme evaluation with women veterans with a history of military sexual trauma (MST) explored the preliminary feasibility, acceptability, and reported benefits and challenges of a Mindful Self-Compassion (MSC) programme, with or without trauma-informed yoga.Women across groups reported improved psychiatric symptoms, self-care, and health behaviours, although those in MSC+ yoga reported healthier coping and improved emotional processing.Results suggest MSC training may be feasible, acceptable, and potentially beneficial for women veterans with MST in one clinical setting in the Northeastern USA, with potential synergistic effects of adjunctive yoga.

Self-compassion and Shame Among Rape Survivors.

Women are at increased risk for post-traumatic stress disorder (PTSD) and depression associated with rape, and shame plays a vital role in the development and maintenance of PTSD and depression. Thus, there is a need to identify factors that may decrease shame among female survivors of adult rape. Self-compassion may be one such factor. The present study used path analysis in MPlus version 7.3 to examine the indirect effect of self-compassion on PTSD and depression via rape-related shame. We hypothesized that higher levels of self-compassion would be associated with lower levels of rape-related shame, which in turn would be associated with lower levels of PTSD and depression. College women (N = 305) who reported experiencing rape completed anonymous online surveys assessing rape, self-compassion, rape-related shame, PTSD, and depression. Consistent with our hypothesis, results indicated that self-compassion was negatively associated with assault-related shame, which in turn was positively associated with PTSD and depression. There was also a significant indirect effect of self-compassion on PTSD and depression via rape-related shame. Further, rape-related shame fully explained the relation between self-compassion and PTSD. Findings suggest that self-compassion may be an appropriate target to reduce rape-related shame and may subsequently facilitate reductions in PTSD and depression symptoms.

Rape Disclosure and Depression Among Community Women: The Mediating Roles of Shame and Experiential Avoidance.

Many women who disclose a rape encounter victim-blaming responses, which are associated with negative outcomes. The present study examined rape-related shame and experiential avoidance as mediators of the relation between victim-blaming responses to rape disclosure and depression among 103 rape survivors drawn from a community sample. Results revealed that victim-blaming responses were positively associated with depressive symptoms through rape-related shame and experiential avoidance, and shame was indirectly related to depression via avoidance. Findings suggest clinical interventions should focus on rape-related shame and experiential avoidance in targeting depression among rape survivors, and future research should continue to examine how victim-blaming responses to rape disclosure may be related to these factors.