Social Reactions to Sexual Assault Disclosure: The Role of Posttraumatic Cognitions.

Sexual assault can have a detrimental impact on women's mental, physical, sexual, and interpersonal health and well-being. After experiencing sexual assault, 74% to 88% of individuals disclose the assault to someone they trust. After such disclosures, individuals experience both perceived positive and negative reactions. While positive reactions may be protective and aid in recovery, negative reactions can contribute to feelings of self-blame and maladaptive beliefs about the cause of the assault. Previous studies have shown independent associations between social reactions, negative cognitions, and posttraumatic stress symptoms (PTSS) following sexual assault. However, prior research has not explored the joint role of social reactions and posttraumatic cognitions in relationship to PTSS and sexual assertiveness. Moreover, the mechanism regarding these associations is not well established. The present study tested a path model of the effects of social reactions (positive and negative) to disclosure of sexual assault on posttraumatic cognitions, PTSS, and sexual assertiveness in college women. It was hypothesized that posttraumatic cognitions would mediate the relationship between social reactions and both sexual assertiveness and PTSS. A total of 102 college women participated in the study and completed measures of Sexual Experiences, Social Reactions, Posttraumatic Cognitions, PTSS, and Sexual Assertiveness. Results indicated that negative social reactions were indirectly associated with sexual assertiveness through posttraumatic cognitions. Social reactions were indirectly associated with PTSS partially through posttraumatic cognitions. Furthermore, there was a direct relationship between negative social reactions and PTSS. Positive social reactions were not significantly associated with outcome variables. Results highlight the influential nature of negative social reactions and posttraumatic cognitions. The importance of educating bystanders on the influence of social reactions is further discussed.

Barriers to successful dietary control among pregnant women with phenylketonuria.

PURPOSE: The teratogenic effects of maternal PKU are preventable, yet affected babies continue to be born. This study's purpose was to identify barriers to successful dietary control among pregnant women with PKU. METHODS: An interview-based study was conducted of women with PKU who were known to metabolic disease clinics in three states and pregnant during 1998 to 2000. Medical records were used to document timing of metabolic control. RESULTS: Of 24 women in the study, only 8 (33%) initiated the diet before pregnancy. Of 22 medical records received, only 12 (55%) indicated control of blood phenylalanine levels before 10 weeks' gestation. Risk factors for late dietary control included young age and belief that treatment costs complicated the diet. Although all of the women expressed confidence in the metabolic clinic staff, few perceived their obstetricians were knowledgeable about the maternal PKU diet. Of 13 women enrolled in state-based assistance programs, 9 (69%) reported proof of pregnancy was required for eligibility. Many women using private insurance reported their insurers were unwilling to pay for medical foods. When the data were stratified according to state of residence, differences were observed in the rate of live-born infants, prepregnancy medical food use, average travel time to the metabolic clinic, and gestational week when metabolic control was achieved. CONCLUSION: Our study's findings may be used to target educational messages to women with PKU and to direct future research directions. For example, obstetric knowledge of maternal PKU needs further evaluation. Discrepancies should be resolved between maternal PKU medical recommendations and the policies of third party-payers. The disparities in financial assistance and services available to pregnant women with PKU residing in different states should be examined further.