Prevalence, pattern and predictors of intimate partner violence amongst female undergraduates in Abia State, Nigeria; public health implications.

BACKGROUND: Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. It is a major public health problem globally. This study determined the prevalence, patterns and predictors of IPV amongst female undergraduates in Abia State. METHODS: A cross-sectional study was conducted from January - February 2022 amongst 306 female undergraduates in Abia State. A mixed method of an online structured questionnaire created on Google forms & onsite self-administered questionnaire were deployed for data collection. Descriptive, bivariate and multivariate analyses were done using IBM SPSS Version 26.0. The level of significance was set at 5%. RESULTS: A total of 306 respondents participated in the survey. The overall prevalence of IPV amongst female undergraduates was 51.2% (95% CI: 44.8-57.6%). Emotional abuse was the most common form of abuse 78.9%, followed by Physical abuse 42.0% and Sexual abuse 30.8%. Predictors of IPV reported include female earning/receiving more than their partner monthly (aOR = 2.30; 95% CI: 1.20-4.41); male (partner) alcohol consumption (aOR = 5.17; 95% CI: 2.46-10.88), being a smoker of cigarette/marijuana (aOR = 11.01; 95% CI: 1.26-96.25) and having witnessed domestic violence as a child (aOR = 3.55; 95% CI: I.56-8.07). Adverse effects such as unwanted pregnancies (12%), miscarriages (10%), eating/sleeping disorders (21%) and bruises (23%) amongst others were noted in some of the victims. CONCLUSION: Over half of all female undergraduates in Abia State have experienced IPV with emotional abuse being the commonest. Some Individual and relationship factors were identified as predictors of IPV. We recommend intensifying primary prevention campaigns against risk factors identified like smoking and alcohol consumption.

Reproductive coercion and abuse in intimate relationships: Women's perceptions of perpetrator motivations.

Reproductive coercion and abuse is a hidden and poorly recognised form of violence against women. It refers broadly to behaviours that interfere with or undermine a person's reproductive autonomy, specifically to promote or prevent pregnancy. Reproductive coercion and abuse can involve physical, sexual, financial or psychological abuse in order to achieve these aims, and is overwhelmingly perpetrated by men against women. As an emerging field of scholarship, conceptual understanding of reproductive coercion and abuse is still in its infancy; however, it is often described as being linked to coercive control. In this article, we seek to highlight the complexity of this relationship through qualitative analysis of in-depth interviews with 30 victim/survivors in Australia recruited from the community, focusing on their perceptions of the perpetrator's motivations. We developed four themes from our analysis: 1) His needs came first; 2) The illusion of a perfect father; 3) Creating a weapon of control; and 4) My body was his. Perceived perpetrator motivations ranged from entitlement and self-interest to a deep desire for domination and entrapment. Pregnancy preventing behaviour was more likely to be linked with entitlement and self-interest, whereas pregnancy promoting behaviour tended to be described by participants in relationships where there was a broader pattern of ongoing control and entrapment. Thus, we suggest that coercive control is a motivating factor for some, but not all men who perpetrate reproductive coercion and abuse. A greater understanding perpetrator motivations may be important for practitioners, particularly those working in sexual and reproductive health services, since it could be relevant to women's level of risk for coercive controlling behaviour or more extreme forms of physical or sexual violence.

Care-seeking patterns and timely access to care among survivors of sexual violence in North Kivu, the Democratic Republic of the Congo: a retrospective file-based study.

BACKGROUND: Sexual violence is widespread in war-torn North Kivu province in the Democratic Republic of the Congo (DRC). Timely access to care is crucial for the healing and wellbeing of survivors of sexual violence, but is problematic due to a variety of barriers. Through a better understanding of care-seeking behaviours and factors influencing timely access to care, programmes can be adapted to overcome some of the barriers faced by survivors of sexual violence. OBJECTIVE: The aim of this study was to describe demographics, care-seeking patterns and factors influencing timely care-seeking by survivors of sexual violence. METHODS: Retrospective file-based data analysis of sexual violence survivors accessing care within two Médecins Sans Frontières (MSF) programmes supporting the Ministry of Health, in North Kivu, DRC, 2014-2018. RESULTS: Most survivors (66%) sought care at specialised sexual violence clinics and a majority of the survivors were self-referred (51%). Most survivors seeking care (70%) did so within 3 days. Male survivors accessing care were significantly more likely to seek care within 3 days compared to females. All age groups under 50 years old were more likely to seek care within 3 days compared to those aged 50 years and older. Being referred by the community, a family member, mobile clinic or authorities was significantly associated with less probability of seeking care within 3 days compared to being self-referred. CONCLUSION: Access to timely health care for survivors of sexual violence in North Kivu, DRC, is challenging and varies between different groups of survivors. Providers responding to survivors of sexual violence need to adapt models of care and awareness raising strategies to ensure that programmes are developed to enable timely access to care for all survivors. More research is needed to further understand the barriers and enablers to access timely care for different groups of survivors.

Main findings: Timely access to care for survivors of sexual violence is crucial yet challenging in many places, including in North Kivu, the Democratic Republic of the Congo. This study shows that a majority of survivors access care through specialised clinics, that access is limited for male and child survivors, and highlights factors influencing timely access to care for survivors of sexual violence.Added knowledge: This study shows that age, sex, and different referral pathways impact timely care seeking among survivors of sexual violence accessing care.Global health impact for policy and action: A better understanding of care-seeking patterns and which factors influence timely care seeking is useful when designing and implementing programmes responding to survivors of sexual violence.

PTSD Symptoms Among College Students: Linkages with Familial Risk, Borderline Personality, and Sexual Assault.

College students have high rates of post-traumatic stress disorder (PTSD) symptoms as well as high rates of sexual assault. What is less clear, however, is whether different sexual assault types (e.g. coercive, physically forced, and incapacitation) are associated with greater PTSD symptoms. Moreover, understanding early familial and mental health histories of college students is important for explaining PTSD symptoms. As such, we use a social stress framework to examine the relationships between early familial risk (i.e. child abuse, perceived maternal rejection), borderline personality (BP) symptoms, and three sexual assault types with PTSD symptoms among college students. A total of 783 undergraduate students (65.4% female) completed paper and pencil surveys in fall 2019 and spring 2020 at a large public university. Results revealed that females were more likely to experience child sexual abuse and all three forms of sexual assault, while males experienced higher rates of child physical abuse. OLS regression results showed positive associations between child sexual abuse, perceived maternal rejection, BP symptoms and all three types of sexual assault with PTSD symptoms. Females also experienced more PTSD symptoms compared to males. Findings have implications for targeted interventions to improve mental health outcomes.

Estimating and monetizing the causal effect of severe interpersonal violence against children in sports on subjective well-being.

BACKGROUND: Interpersonal Violence (IV) against children in sports is a prevalent problem and has a major impact on their well-being. However, the causal relationship and the costs for society remain unclear. OBJECTIVE: The aim of this study is to estimate the causal effect of severe IV in sports on Subjective Well-Being (SWB) and to monetize the collective loss for society. PARTICIPANTS AND SETTING: The study used survey data from 4003 respondents in the Netherlands and Flanders (Belgium). The questionnaire included current SWB as well as 41 items to assess experiences with psychological, physical and sexual IV in sports before the age of 18. Severity was quantified by experts and reported frequency. METHODS: By using the number of sports that someone participated in during their youth as an instrumental variable to control for confounding, the study estimates the causal effect of severe IV on SWB. The Three-Stage Well-Being Valuation Approach was used to monetize the loss in SWB in terms of income compensation. RESULTS: The results show that experiencing severe IV in sports results in significant lower SWB levels (b = -0.45, p < .01). The lower SWB is comparable to an annual loss of income of 9672 euro per person. CONCLUSIONS: We have found evidence for a causal effect of severe IV in childhood on the SWB later in life. The results highlight the long-term, extensive impact of experiencing severe IV in sports that exceeds direct physical and psychological health outcomes.

Prevalence, correlates, and trends of intimate partner violence against women in Pakistan: Results from Pakistan Demographic and Health surveys 2012-13 and 2017-18.

BACKGROUND: Intimate partner violence (IPV) is a global public health problem. The objectives of this study were to analyze the prevalence and correlates of IPV perpetrated by men against women from the recent nationally representative Pakistan Demographic and Health Survey (PDHS) 2017-18, and to analyze levels and trends of IPV perpetrated by current/former husbands from PDHS conducted in 2012-13, in the four provinces and the capital city. METHODS: Association of having ever experienced IPV, defined as either emotional, physical and/or sexual violence, by ever married women aged 15-49, with 12 explanatory socio-demographic, attitudinal, and experiences were analyzed using simple and multiple logistic regression models. RESULTS: The prevalence of having ever experienced IPV was 33.48% (95% CI: 30.76-36.32). In the final multivariable model, number of living children, having knowledge of parental physical IPV, husband's use of alcohol, and marital control were statistically significantly associated with IPV. Proportions and trend analysis of emotional and physical IPV between the PDHS 2017-18 and PDHS 2012-13, showed that in general, rural areas of provinces reported higher prevalence of emotional and physical IPV, compared with urban areas, and in general, emotional, and physical IPV prevalence declined from PDHS2012-13 to PDHS2017-18. CONCLUSIONS: The prevalence of having experienced physical and/or sexual intimate partner violence in Pakistan was lower than the prevalence for the WHO Eastern Mediterranean region. However, IPV burden at the provincial urban-rural residency status underscore the need for location specific strategies to effectively address IPV in Pakistan.

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.

"Counteract the gaslighting" - a thematic analysis of open-ended responses about what women survivors of intimate partner sexual violence need from service providers.

BACKGROUND: Intimate partner sexual violence (IPSV) is a prevalent but misunderstood form of gender-based violence with significant impacts women's health and well-being. Research suggests that IPSV has a specific context and unique impacts, but little is known about how to tailor service responses. To address this gap, we explored help-seeking experiences and needs among IPSV survivors after disclosure. METHODS: This study draws on qualitative data from a subsample of women who participated in a cross-sectional survey about the service needs of intimate partner violence survivors. Women who reported IPSV and provided information about IPSV-specific help-seeking needs after disclosure were included in the analysis. Open-ended text responses of 37 IPSV survivors were analysed using thematic analysis. RESULTS: IPSV was invisible and silenced in service responses. Three themes suggest potential ways forward. In the first theme, 'Don't dismiss it', women needed providers to take their disclosures seriously and listen to the significant impacts of IPSV on their well-being and safety. In the second theme, 'See the bigger picture', women needed service providers to understand that IPSV fits into broader patterns of abuse, and that psychological abuse and coercive control impacts women's ability to consent. In the third theme, 'counteract the gaslighting', women needed providers to educate them about the continuum of IPSV and help them label IPSV as a form of violence. CONCLUSIONS: Our exploratory findings extend the limited evidence base on IPSV and highlight a need for further in-depth research to explore a tailored approach to supporting IPSV survivors. To avoid contributing to the silencing of IPSV survivors, service responses should recognise the harmful and sexualised nature of IPSV, challenge cultural stereotypes that minimise IPSV, and understand that co-occurring psychological abuse may exacerbate shame and prevent women from articulating the source of their distress.

Attachment Theory and Sexual Offending: Making the Connection.

PURPOSE OF REVIEW: The purpose of this review is to discuss how attachment theory can be applied to explain sexual violence. Specifically, it discusses how the development of certain risk factors contributes to these behaviors and how attachment-based models can be used to address this issue through prevention and therapeutic interventions. RECENT FINDINGS: Recent research demonstrates that individuals who commit sexual offenses have higher rates of insecure attachment styles and that these styles are associated with a number of criminogenic risk factors associated with sexual offending. Such risk factors include cognitive processing difficulties, affect dysregulation, and challenges in interpersonal relationships, among others. Fortunately, treatment interventions have been shown to foster more secure attachment styles and reduce these risk factors. Attachment theory is a viable theory to both understand and intervene with those who have committed sexual violence to reduce the risk factors associated with sexual violence.

The day-to-day relationship between posttraumatic stress symptoms and social support after sexual assault.

Background: Experiencing sexual assault is associated with a significant increase in risk for developing posttraumatic stress disorder and related concerns (e.g. alcohol misuse). Cross-sectional and longitudinal evidence suggests that social support may be both broadly protective against and eroded by posttraumatic stress symptoms. However, little is known about how different aspects of social support and posttraumatic stress symptoms influence each other in the weeks and months immediately following sexual assault, when posttraumatic stress (PTS) symptoms first emerge.Objective: The present study assessed the day-to-day relationship between social support and PTS in a sample of distressed, alcohol-using, recently-assaulted female survivors participating in a clinical trial of an app-based intervention (N = 41).Method: Participants completed 3 weeks of daily diaries starting within 10 weeks of sexual assault. Mixed-effects models were used to examine prior-day and same-day relationships between PTS and four social support constructs (social contact, emotional support, pleasantness of social interactions, and talking about sexual assault).Results: Results indicate that higher quantity and pleasantness of social interactions over the full sampling period was associated with lower PTS symptoms on any given day. Experiencing better-than-typical social interactions on one day was associated with lower than typical PTS symptoms on that day and the next day. On days when participants discussed their sexual assault with others, they tended to be having higher than usual PTS symptoms.Conclusions: Findings suggest that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.Trial registration: ClinicalTrials.gov identifier: NCT03703258.

In N = 41 distressed and alcohol-using female survivors of recent sexual assault, having a higher quantity of social interactions and more pleasant social interactions within 10 weeks of assault was associated with lower posttraumatic stress symptoms.When survivors' social interactions were more pleasant than average on one day, their posttraumatic stress symptoms tended to be lower than average the next day, and recent survivors were more likely to talk about sexual assault on days when their posttraumatic stress symptoms were higher than usual.Interventionists should take note that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.

Trauma and its implications for women's cardiovascular health during the menopause transition: Lessons from MsHeart/MsBrain and SWAN studies.

Trauma exposure, whether experienced during childhood or adulthood, is prevalent among women. While experiences of trauma are well known to impact mental health, emerging research also links them to women's physical health. The Study of Women's Health Across the Nation (SWAN) and the MsHeart/MsBrain studies, two separate studies devoted to studying midlife women's health, have contributed importantly to the understanding of the implications of trauma to women's health at midlife and beyond. Specifically, findings from these studies have revealed that both childhood and adult trauma exposure are associated with poorer cardiovascular and cerebrovascular health in women, including greater subclinical cardiovascular disease, indicators of cerebral small vessel disease, and increased risk for clinical cardiovascular disease events. When considering trauma types, findings have pointed to the particular importance of sexual and interpersonal violence, such as childhood sexual abuse, intimate-partner violence, sexual harassment, and sexual assault to women's vasculatures. Further, using a range of measures of menopausal vasomotor symptoms, the SWAN and the MsHeart/MsBrain studies have also shown that women with greater trauma exposure have more objectively assessed and self-reported vasomotor symptoms. Finally, although links between trauma exposure and health are not typically explained by post-traumatic stress disorder, work also points to the additional importance of post-traumatic stress disorder to women's cardiovascular and brain health. Collectively, these studies have underscored the importance of trauma to the occurrence of menopausal symptoms, to cardiovascular health, and to women's brain health at midlife and beyond. Future directions and implications for prevention and intervention are discussed.

A Descriptive Model of Voyeuristic Behavior.

Over the last 50 years, there has been a plethora of research exploring sexual offending with a recent focus on online offending. However, little research has focused on voyeurism despite convictions and media awareness growing rapidly. Currently, there is sparse theoretical or empirical literature to guide research and practice for individuals engaging in voyeuristic behaviors. As such, 17 incarcerated men with a conviction of voyeurism in the UK were interviewed on the cognitive, affective, behavioral, and contextual factors leading up to and surrounding their offense(s). Grounded theory analyses were used to develop a temporal model from background factors to post-offense factors; the Descriptive Model of Voyeuristic Behavior (DMV). The model highlights vulnerability factors for men engaging in voyeuristic behaviors in this sample. Following this, the same 17 men were plotted through the model and three key pathways were identified: Sexual Gratification, Maladaptive Connection Seeking, and Access to Inappropriate Person(s). The characteristics of each pathway are discussed, and treatment implications considered.

Learning From Consumers of Mandated Sex-Offending Programs: "It's Not Treatment, I Wish It Was."

The purpose of this qualitative study was to explore clients' perceptions of sex-offending treatment. The sample included 291 people required to register as sex offenders in the U.S. who answered an open-ended question in an online survey asking them to describe their positive and negative experiences in mandated treatment. Using qualitative analysis, three overarching themes (with several subthemes) were identified: (1) positive and (2) negative treatment experiences and (3) the affiliation between the criminal justice system and clinical services. Experiences in sex offending treatment were viewed as positive when clients had opportunities to learn about themselves, experience group cohesion, build a positive alliance with a caring therapist, learn tools and skills for emotional health, explore the roots of offense behavior, and create healthy life plans to reduce risk for re-offending. Negative themes emerged when treatments were viewed as coercive, confrontational, or demeaning; when therapists seemed inexperienced or unqualified; and when seemingly outdated or unscientific methods were emphasized without explanation or dialogue. The entanglement between court-mandated treatment providers and the criminal justice system led to concerns about confidentiality, conflicts of interest, and role ambiguity. Drawing upon literature related to therapeutic alliance, trauma-informed care, and Risk-Need-Responsivity models, we offer suggestions for integrating client feedback to improve treatment responsivity and prevent re-offending.

Emotion Regulation Difficulties Moderate the Association Between Typical Drinking and Sexual Assault Victimization Among Sexual and Gender Minority University Students.

Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties.

Disclosure of traumatic details and obsessive-compulsive contamination symptoms in sexual assault survivors.

OBJECTIVE: Contamination concerns are common following sexual victimization and are associated with increased attentional bias and difficulty disengaging from contamination cues. While most survivors of sexual trauma disclose their experience to others, it is unclear whether disclosure increases feelings of contamination or whether, consistent with the fever model of disclosure, existing contamination-related distress increases the amount of content shared during disclosure, indicative of attentional bias toward contamination-inducing aspects of the trauma memory. METHOD: Accordingly, the current study examined the directionality and relationships between contamination symptoms and content shared during sexual assault disclosure in 106 sexual assault survivors (76.4% women). Forced decision regression with subsequent independence test (RESIT) was used to identify directionality of relationships, and multivariate and linear regressions examined these proposed effects in the presence of assault and demographic characteristics. RESULTS: More severe contamination symptoms predicted greater sharing of details during sexual assault disclosure yet had no impact on sharing of emotions, cognitions, and beliefs during disclosures. Although RESIT suggested that contrary to other content domains, disclosure of social experiences may directionally predict contamination symptoms, this relationship did not retain statistical significance in a linear regression model. CONCLUSIONS: Findings support the fever model of disclosure and attentional bias theories regarding contamination-related stimuli, and suggest that survivors experiencing postassault contamination symptoms may be more likely fixate on the contamination-invoking details of the trauma memory when disclosing. Such fixation has the potential to interfere with typical treatment-related processes (e.g., habituation) and should be thoughtfully addressed to maximize treatment gains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Literature Review of Mental Health Symptom Outcomes in U.S. Veterans and Servicemembers Following Combat Exposure and Military Sexual Trauma.

Combat exposure (CE) and military sexual trauma (MST) are among the most common types of traumatic experiences faced by veterans and active duty servicemembers and, as such, have both garnered increased research focus over the past decades. However, there has not yet been a critical review of the literature to examine the distinct clinical presentations associated with different trauma types. This is particularly important, as understanding distinct clinical profiles could help researchers and clinicians refine treatment approaches based on trauma type. To address this question, we conducted a search of the available literature in PsycINFO and PubMed prior to October 2022. We identified 43 articles evaluating the distinct and overlapping clinical symptoms of CE and MST. Study findings were conceptually organized by psychiatric condition. In general, there was substantial variability in study methodology including sample size, composition, and operationalizations of CE and MST. Despite this variability, notable patterns emerged across studies. Specifically, MST and CE uniquely predicted posttraumatic stress disorder symptoms, MST was more related to depressive symptoms and suicidality than CE, and CE appeared to be more related to alcohol use and other externalizing behaviors. Gender also played a significant role in the relationship between CE, MST, and clinical variables across studies. This review suggests that individuals with a history of MST and CE likely have distinct clinical presentations and more research into these presentations could better inform assessment and treatment. Important methodological gaps in the literature are also discussed.

Systematic review and data synthesis on the treatment of sexual violence victimization by an intimate partner.

This study aims to conduct a systematic review and synthesis on the treatment of sexual violence victimization by an intimate partner evaluating specifically the impact of treatment on mental health outcomes of female sexual intimate partner violence (IPV) survivors. We followed the Cochrane Handbook for Systemic Reviews of Interventions guidelines for the process of conducting systematic reviews. We were unable to conduct meta-analyses due to the substantial heterogeneity of the interventions for IPV. A qualitative summary of 6 controlled studies identified no benefit to the treatment of sexual coercion, posttraumatic stress disorder, depression, or anxiety for female sexual IPV survivors. However, we are limited by a paucity of data for each outcome on this subject. In conclusion, sexual coercion is a complex issue that has adverse effects on mental health and the well-being of the survivors. More research is needed that investigates what kind of interventions are effective for this specific population.

Impact of violence against women on quality of life and menopause-related disorders.

Violence against women is a pressing global issue that poses a number of significant health risks. The influence of violence on women's health during the menopause has been underestimated, especially its impact on the early onset of menopause and on the exacerbation of symptoms that determine quality of life. The objectives of our study were to analyse whether experiencing any type of violence increases the risk of early menopause, worsens menopausal symptoms, and results in a lower quality of life. This cross-sectional observational study recruited 29 postmenopausal women who had experienced violence from a partner in their lifetimes. Additionally, 89 postmenopausal who had not suffered from violence were included as a control group. All the women who had experienced violence from a partner reported psychological and economic violence, 75 % reported physical violence, 57.1 % reported sexual violence, and 39.3 % reported all types of violence. Violence was found to be associated with menopausal symptoms and poorer quality of life. These associations persisted after adjustment for multiple factors, and women who had experienced any form of violence reported a worse quality of life during menopause. Moreover, violence-exposed women reached menopause approximately 20 months earlier (p < 0.05), and 20.7 % of these women developed premature ovarian insufficiency (p < 0.001).

The Impact of Resilience on Employment Among Post-9/11 Veterans With and Without Military Sexual Trauma Exposure.

INTRODUCTION: Successful employment is a functional outcome of high importance for veterans after military discharge. There is a significant rising concern regarding exposure to military sexual trauma (MST) and related mental health outcomes that can impair functional outcomes, such as employment. Although resilience training is a key component of preparing for military service, to date the impact of resilience on employment outcomes for veterans with exposure to MST has yet to be examined. We sought to examine the relationship between resilience and employment in a national sample of post-9/11 veterans with and without MST exposure. MATERIALS AND METHODS: A national survey was conducted between October 2021 and January 2022 to respond to the 2021 National Defense Authorization Act mandate to identify factors affecting post-9/11 women veteran's unemployment. Of veterans, 1,185 completed the survey. Of these, 565 (47.6%) were post-9/11 veterans. The survey collected data on demographics and employment; MST, adult sexual trauma (AST, outside of military), and childhood sexual trauma (CST) exposure; resilience (Response to Stressful Experiences Scale); Post Traumatic Stress Disorder (PTSD) Checklist (PCL-5); and depression (Patient Health Questionnaire-2). Multivariable logistic regression models identified gender-specific associations of resilience with employment among those exposed and not exposed to MST, adjusting for AST, CST, PTSD, and depression. Significance was set at P < .05. RESULTS: Of 322 women and 243 men post-9/11 veterans, 86.5% were employed. MST exposure (MST[+]) was reported by 31.4% (n = 101) of women and 16.9% (n = 41) of men. MST(+) women veterans were more likely to report CST (35.6% vs. 14.5%; P < .001), AST (68.3% vs. 17.2%; P < .001), and both CST and AST (19.8% vs. 7.2%; P < .001) than MST(-) women. MST(+) men were more likely to report AST (65.9% vs. 7.9%; P < .001), and both CST and AST (14.6% vs. 1.0%; P < .001) than MST(-) men. Levels of self-reported resilience were similar for MST(+) women and men and their MST(-) counterparts (women: 11.1 vs. 11.0; men: 11.5 vs. 12.0). For MST(+) women, each unit increase in resilience was associated with a 36% increase in odds of employment (OR: 1.36, 95% CI, 1.08-1.71); resilience was not associated with increased odds of employment among MST(-) women. Among MST(+) men veterans, each unit increase in resilience was associated with an 83% increase in odds of employment (aOR: 1.83, 95% CI, 1.13-2.98), and like women veterans, resilience was not associated with employment among MST(-) men. CONCLUSIONS: Among MST(+) women and men post-9/11 veterans, higher resilience was associated with increased odds of employment, whereas resilience was not associated with employment in MST(-) veterans. These findings suggest that resiliency during and after military service is a key component for potentially improving long-term outcomes. Improving resilience using evidence-based approaches among post-9/11 veterans exposed to MST may be an important avenue for increasing successful functional outcomes such as employment. Moreover, MST(+) women and men veterans may benefit from trauma-informed care as a substantial proportion of these individuals also report exposure to CST, AST, PTSD, and depression.

Empowerment Self-Defense Intervention Outcomes: A Descriptive Review of Measures.

Global research about empowerment self-defense (ESD)-a sexual assault resistance intervention recommended as a component of a comprehensive sexual assault prevention strategy-continues to emerge, with studies reporting positive effects, including reduced risk of sexual assault victimization. Researchers have suggested ESD may produce additional positive public health outcomes beyond the prevention of sexual violence, but more research is needed to understand the benefits associated with ESD training. However, to conduct high-quality research, scholars have suggested a need for improved measurement tools. To better understand these measurement gaps, the purpose of this study was to identify and review measures used in ESD outcome studies; and in doing so, to determine the range of outcomes previously measured in quantitative studies. Within the 23 articles meeting study inclusion criteria, there were 57 unique scales that measured a range of variables. These 57 measures were grouped into nine construct categories: assault characteristics (n = 1); attitudes and beliefs (n = 6); behavior and behavioral intentions (n = 12); fear (n = 4); knowledge (n = 3); mental health (n = 8); any past unwanted sexual experiences (n = 7); perception of risk and vulnerability (n = 5); and self-efficacy (n = 11). Except for mental health, most scales were developed in the Global North using college student populations, so measures for diverse populations (e.g., diverse in age, culture, ethnicity, geographical origin) are critically needed. Future research should focus on identifying and/or developing standardized tools that measure the full constellation of targeted outcomes. Evaluation of the methodological quality of studies assessing psychometric performance of the tools should also be prioritized.