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1.
Psychiatr Danub ; 31(4): 440-447, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31698400

RESUMO

BACKGROUND: This study examined testimonies of women who were sexually assaulted multiple times by multiple unknown offenders. In these testimonial narratives, it is possible to detect specific modalities of traumatic event expression. This expression lacks any spatial, temporal, auditory or emotional determinants of the event. SUBJECTS AND METHODS: These fourteen women (out of 17) were imprisoned and forcefully isolated in detention camps or private houses in the occupied territories of Croatia and Bosnia and Herzegovina, during the war. At the same time, some of these women were raped by the offenders that were previously known to them. The average length of detention was 141 days among the seventeen victims (range of 7 to 395 days), while the average time from the first day of imprisonment to the first day of testimony was 311 days (range of 30 to 889 days). RESULTS: Based on the narrative descriptions of the events acquired from these testimonies, our analysis showed that these expressions differed when the offender was known to the victim, contrasted to the situation when the offender was completely unknown. This finding has a significant implication in victim's testimony at judicial hearings. Specifically, women that were raped by unknown perpetrator(s) were often unable to provide persuasive testimony and their recollection of the events was deemed insufficient for the further prosecution. Testimonies in these cases substantially lacked in vividness and were devoid of visuospatial determinants of the rape event. Consequently, this often resulted in the case's dismissal. CONCLUSION: The unusual and problematic expression of these traumatic memories might indicate that these events were not properly stored in the conceptual form of memory. Ultimately, victims could not make any coherent recollection or reconstruct the cascade of events by using perceptual information. We argue that this could be due to an aberrant mechanism of memory storage and difficulties that emerge on the level of sensory input. This problem needs to be further examined and correspondingly accounted for since it can exert significant influence on judicial outcomes in the domain of sexual assault cases worldwide.


Assuntos
Vítimas de Crime/psicologia , Rememoração Mental , Estupro/psicologia , Estupro/estatística & dados numéricos , Crimes de Guerra/psicologia , Bósnia e Herzegóvina , Croácia , Feminino , Humanos , Memória Episódica
4.
BMC Womens Health ; 19(1): 76, 2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200696

RESUMO

BACKGROUND: Rape, unintended pregnancy, and abortion are among the most controversial and stigmatized topics facing sexual and reproductive health researchers, advocates, and the public today. Over the past three decades, public health practicioners and human rights advocates have made great strides to advance our understanding of sexual and reproductive rights and how they should be protected. The overall aim of the study was to understand young women's personal experiences of unintended pregnancy in the context of Nicaragua's repressive legal and sociocultural landscape. Ten in-depth interviews (IDIs) were conducted with women ages 16-23 in a city in North Central Nicaragua, from June to July 2014. CASE PRESENTATION: This case study focuses on the story of a 19-year-old Nicaraguan woman who was raped, became pregnant, and almost died from complications resulting from an unsafe abortion. Her case, detailed under the pseudonym Ana Maria, presents unique challenges related to the fulfillment of sexual and reproductive rights due to the restrictive social norms related to sexual health, ubiquitous violence against women (VAW) and the total ban on abortion in Nicaragua. The case also provides a useful lens through which to examine individual sexual and reproductive health (SRH) experiences, particularly those of rape, unintended pregnancy, and unsafe abortion; this in-depth analysis identifies the contextual risk factors that contributed to Ana Maria's experience. CONCLUSIONS: Far too many women experience their sexuality in the context of individual and structural violence. Ana Maria's case provides several important lessons for the realization of sexual and reproductive health and rights in countries with restrictive legal policies and conservative cultural norms around sexuality. Ana Maria's experience demonstrates that an individual's health decisions are not made in isolation, free from the influence of social norms and national laws. We present an overview of the key risk and contextual factors that contributed to Ana Maria's experience of violence, unintended pregnancy, and unsafe abortion.


Assuntos
Aborto Induzido/psicologia , Estupro/psicologia , Direitos Sexuais e Reprodutivos/psicologia , Direitos da Mulher , Feminino , Humanos , Nicarágua , Gravidez , Gravidez não Planejada/psicologia , Saúde Reprodutiva , Fatores de Risco , Saúde Sexual , Adulto Jovem
6.
Eur. j. psychol. appl. legal context (Internet) ; 11(1): 1-7, ene.-jun. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183537

RESUMO

Research findings suggest that sex offenders show worse performance than the general population in neuropsychological tests. Nevertheless, moderators such as age of the victim, use of antisocial control groups, and characteristics of administered measures have been highlighted. Here, 100 participants completed a battery of cognitive measures tapping fluid reasoning, verbal ability, and three basic executive processes (inhibition, switching, and updating). They were matched by educational level and classified in four groups: controls, non-sex offenders, rapists, and child abusers. The analyses revealed that rapists showed lower fluid reasoning scores than controls and child abusers. Furthermore, rapists and child abusers showed lower executive updating performance than controls and non-sex offenders. Importantly, child abusers did show fluid reasoning scores on a par with controls (controlling for updating differences), but their executive updating performance was equivalent to the one revealed by rapists (controlling for fluid intelligence differences). Implications of these findings for the design of efficient intervention programs are discussed


Los datos de investigación empírica sugieren que los delincuentes sexuales presentan un peor desempeño que la población general en las pruebas neuropsicológicas. Aun así, se ha resaltado la influencia de variables moderadoras como la edad de la víctima, el uso de grupos control que incluyan individuos antisociales y las características de las medidas utilizadas. En este estudio cien participantes completaron una batería de pruebas cognitivas que evalúan razonamiento fluido, capacidad verbal y tres funciones ejecutivas básicas (inhibición, cambio y actualización). Los participantes estaban igualados en su nivel educativo y divididos en cuatro grupos: controles, delincuentes no sexuales, agresores sexuales con víctimas adultas y abusadores de menores. Los análisis revelaron que los agresores sexuales con víctimas adultas presentaban puntuaciones menores que los controles y los abusadores de menores en razonamiento fluido. Más aún, los agresores con víctimas adultas y los abusadores tenían peor desempeño que los controles y los delincuentes no sexuales en actualización ejecutiva. Es destacable que los abusadores de menores mostraran puntuaciones en razonamiento fluido equiparables a las de los controles (controlando estadísticamente las diferencias en actualización), pero su desempeño en actualización ejecutiva fue equivalente al mostrado por los agresores con víctimas adultas (controlando estadísticamente las diferencias en inteligencia fluida). Finalmente se discuten las implicaciones de estos resultados para el diseño de programas de intervención efectivos


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Estupro/psicologia , Delitos Sexuais/psicologia , Abuso Sexual na Infância/psicologia , Função Executiva , Psicologia Criminal/métodos , Criminosos/psicologia , Comportamento Criminoso , Testes Neuropsicológicos/estatística & dados numéricos , Estudos de Casos e Controles
7.
Perspect Biol Med ; 62(1): 153-158, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31031302

RESUMO

In this essay, a medical student reflects on her experience as part of a service trip to rural Honduras. Although she feels proud of the work the group does and the impact that they are able to make, she is also forced to grapple with the vast amount of unremitted suffering that she will inevitably leave behind.


Assuntos
Neoplasias do Colo do Útero/diagnóstico , Feminino , Honduras , Humanos , Programas de Rastreamento , Estupro/psicologia , População Rural , Maus-Tratos Conjugais
9.
Epidemiol Psychiatr Sci ; 28(6): 598-602, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30977461

RESUMO

To experience sexual violence and abuse is to experience silence. This commentary explores some of the ways in which psychiatry reinforces the silencing of sexual violence survivors. We argue that current psychiatric responses to sexual violence typically constitute iatrogenic harm including through: a failure to provide services that meet survivors' needs, a failure to believe or validate disclosures; experiences of medicalisation and diagnoses which can delegitimise people's own knowledge and meaning; 'power over' relational approaches which can prevent compassionate responses and result in staff having to develop their own coping strategies; and poorly addressed and reported experiences of sexual violence within psychiatric settings. We argue that these multiple forms of silencing have arisen in part because of biomedical dominance, a lack of support and training in sexual violence for staff, inconsistent access to structured, reflective supervision, and the difficulties of facing the horror of sexual violence and abuse. We then describe community-based and grassroots responses, and consider the potential of trauma-informed approaches. Whilst this paper has a UK focus, some aspects will resonate globally, particularly given that Western psychiatry is increasingly being exported around the globe.


Assuntos
Serviços de Saúde Mental , Estupro/psicologia , Delitos Sexuais/psicologia , Pesquisa sobre Serviços de Saúde , Humanos
10.
J Sex Marital Ther ; 45(5): 424-439, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30946623

RESUMO

Using data from a U.S. probability survey of individuals aged 14 to 60, we aimed (1) to assess the proportion of respondents who ever reported scary sexual situations and (2) to examine descriptions of sexual experiences reported as scary. Data were cross-sectional and collected via the GfK KnowledgePanel®. Scary sexual situations were reported by 23.9% of adult women, 10.3% of adult men, 12.5% of adolescent women, and 3.8% of adolescent men who had ever engaged in oral, vaginal, or anal sex. Themes included sexual assault/rape, incest, being held down, anal sex, choking, threats, multiple people, novelty/learning, among others.


Assuntos
Coito/psicologia , Vítimas de Crime/psicologia , Medo/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estupro/psicologia , Medição de Risco , Amostragem , Comportamento Sexual/psicologia , Estados Unidos , Adulto Jovem
11.
Transcult Psychiatry ; 56(3): 510-528, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30843762

RESUMO

Despite the well-documented prevalence of rape as a strategy of war, little is known about the specific psychological consequences to children born of conflict-related sexual violence. The results of data analysis of 7 focus groups and 60 in-depth interviews with children born of genocidal rape in Rwanda indicated that they are carrying the trauma of their own stigmatization and marginalization, are burdened with their mothers' trauma, and, we conclude, symbolize unresolved collective trauma for the society. Analysis also reveals that healing for these young adults requires interpersonal and intrapersonal compassion and acceptance, a meaningful connection with a peer group, societal recognition, and empowerment to help contribute to and transform their lives and societies. Each of these pathways to healing-intrapersonal, interpersonal, and social-is contingent upon the other, and none can be considered in isolation. To support this largely invisible population striving to fulfill their potential, opportunities need to be created for self-acceptance and acceptance by mothers, families, and communities; sharing and building emotional and social bonds with their cohort group; formal recognition; official social rituals to validate their experiences and those of the mother-child dyad in the context of culture and community; and for socioeconomic opportunities to enable them to fully participate in building the future of Rwanda.


Assuntos
Genocídio/psicologia , Estupro/psicologia , Sobreviventes/psicologia , Feminino , Grupos Focais , Humanos , Relação entre Gerações , Entrevistas como Assunto , Masculino , Saúde Mental , Pesquisa Qualitativa , Ruanda , Estigma Social , Adulto Jovem
13.
Health Care Women Int ; 40(3): 278-294, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30608211

RESUMO

We conducted a qualitative study to examine the critical pathways of 23 women survivors of sexual assault who navigated health care-based services in six states in Guatemala. We also captured the components of quality health care that were important to them, including the experience of the waiting room, being able to make active decisions, providing informed consent, and receiving emotional support. Our results from the in-depth, semi-structured interviews indicate the importance of creating and strengthening mechanisms for social support and trauma-informed, competent, and sensitive health services to accompany women as they move toward rebuilding their lives post-sexual violence.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Serviços de Saúde/estatística & dados numéricos , Estupro/psicologia , Sobreviventes/psicologia , Adolescente , Adulto , Feminino , Guatemala , Pesquisas sobre Serviços de Saúde , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Apoio Social , Adulto Jovem
14.
Int J Law Psychiatry ; 62: 135-147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30616848

RESUMO

The governance of sleep sex (or sexsomnia) in the criminal law is a nightmare. Press reports of sleeping, often drunk, men acquitted as automatons of raping adults and children suggest cases are rising. The use of automatism, rather than insanity, in these cases is strong evidence of the immemorial struggle faced by legal psychiatry in appropriately construing unconscious defendants. This paper responds by drawing on well-established psychoanalytic conceptions of unconsciousness to present sexsomnia as dispositional to the defendant. Taking the Freudian concepts of eros and death instinct, it asserts that sexsomniacs are acting on repressed sadistic desires. Accordingly, those on notice of their sexsomnia, who fail to mitigate the risk of further attacks, should be guilty of rape. Reliance on (a reformed) insanity defence - being a denial of responsibility at the time of the offence - undermines the scope of the criminal law to self-responsibilise sexsomniacs against perpetrating unwanted sex.


Assuntos
Parassonias/psicologia , Psicanálise , Estupro/psicologia , Sono , Feminino , Humanos , Masculino , Parassonias/terapia , Psicanálise/métodos , Teoria Psicanalítica , Estupro/legislação & jurisprudência
15.
Braz J Psychiatry ; 41(1): 82-89, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30328955

RESUMO

OBJECTIVE: Much research has been published on the role of sexual revictimization in the emergence of mental disorders in adulthood, but findings have sometimes been contradictory. The present systematic review sought to assess the state of the evidence on revictimization as a potential factor for the emergence of posttraumatic stress disorder (PTSD). METHODS: Electronic searches were conducted in five databases (MEDLINE/PubMed, Cochrane Library, Campbell Library, PsycINFO, and LILACS), using the terms PTSD, posttraumatic stress disorder, child abuse, and rape. RESULTS: We identified nine articles that established a connection among childhood sexual abuse (CSA), sexual revictimization in adulthood, and development of PTSD. Eight of the nine papers included were classified as having strong methodological quality (grade VI). One was classified as IV, with an average quality-of-evidence rating. The mean methodological quality score of the articles was 5.5, and the quality of evidence was deemed strong. CONCLUSION: In the included studies, PTSD symptoms were most prevalent in the CSA + adult sexual assault groups, providing further evidence for the revictimization hypothesis.


Assuntos
Abuso Sexual na Infância/psicologia , Vítimas de Crime/psicologia , Estupro/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Criança , Feminino , Humanos
17.
Trauma Violence Abuse ; 20(1): 67-80, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29333937

RESUMO

The literature consistently demonstrates evidence that child sexual abuse survivors are at greater risk of victimization later in life than the general population. This phenomenon is called sexual revictimization. Although this finding is robust, there is a large amount of variability in the prevalence rates of revictimization demonstrated in the literature. The purpose of the present meta-analysis was to calculate an average prevalence rate of revictimization across the literature and to examine moderators that may potentially account for the observed variability. Based on a review of PsycINFO and PILOTS, 1,412 articles were identified and reviewed for inclusion. This process resulted in the inclusion of 80 studies, which contained 12,252 survivors of child sexual abuse. The mean prevalence of sexual revictimization across studies was 47.9% (95% confidence intervals [43.6%, 52.3%]), suggesting that almost half of child sexual abuse survivors are sexually victimized in the future. The present study failed to find support for any of the examined moderators. Potential explanations of and implications for the results are offered, including suggestions for therapists.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Abuso Sexual na Infância/estatística & dados numéricos , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Criança , Abuso Sexual na Infância/psicologia , Feminino , Humanos , Masculino , Estupro/psicologia , Medição de Risco , Adulto Jovem
18.
Sex Abuse ; 31(5): 543-559, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28969492

RESUMO

Athletes are cited as common perpetrators of sexual victimization and are at greater risk of becoming offenders compared with nonathletes. Demographic, lifestyle, and social characteristics of 624 nonathletes and 101 athletes from 21 U.S. Division I postsecondary educational institutions were assessed, with the updated Illinois Rape Myth Acceptance scale gauging endorsement of rape myths. Results indicate that athletes and nonathletes were similar in the degree of rape myth acceptance, with athletes reporting stronger agreement with rape myths than nonathletes did. Predictors of rape myth acceptance among nonathletes are multidimensional. In contrast, nondemographic characteristics like Greek membership, the number of alcoholic beverages consumed, and knowing a sexual assault victim predict rape myth acceptance for athletes, with gender not predicting rape myth acceptance nor different between genders of athletes. Policy implications and future research are discussed.


Assuntos
Atletas/psicologia , Atitude , Cultura , Estupro/psicologia , Percepção Social , Consumo de Bebidas Alcoólicas/psicologia , Feminino , Humanos , Masculino , Fatores de Risco , Estereotipagem , Estudantes , Adulto Jovem
19.
Violence Against Women ; 25(2): 208-222, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29504472

RESUMO

Research has shown that judgments of a rape victim could be influenced by exposure to negative social reactions: students indicated less willingness to provide sympathy and support to a hypothetical rape victim when they learned she had been blamed and stigmatized. The current study, which utilized a sample of 100 college students, replicated and extended these results and showed that men were affected by others' negative social reactions in their hypothetical judgments and in their behavioral responses to a rape victim (sitting farther away). This study demonstrates the potentially far-reaching detrimental influence of negative social reactions.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Estupro/psicologia , Fatores Sexuais , Comportamento Social , Estudantes/psicologia , Vítimas de Crime/psicologia , Feminino , Humanos , Julgamento , Masculino , Estigma Social , Estudantes/estatística & dados numéricos , Adulto Jovem
20.
Psychol Trauma ; 11(2): 207-215, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29963892

RESUMO

OBJECTIVE: Although there are several evidence-based treatments that are effective in mitigating the symptoms of posttraumatic stress disorder (PTSD), rates of nonresponse to treatment as well as treatment dropout remain high. In order to determine which symptoms remain most problematic at the end of treatment for PTSD, the present study examined residual symptoms in a treatment study that evaluated the effects of cognitive processing therapy (CPT) and prolonged exposure (PE). METHOD: The sample consisted of 108 female rape survivors who initially met criteria for PTSD and who were then randomized into and completed either CPT or PE. The sample was 71% White and 25% African American, with an average age of 32 years (SD = 9.98 years). RESULTS: Symptoms of PTSD, depression, guilt, and social adjustment were evaluated in the sample of treatment completers, and findings suggest that overall symptoms improved over the course of treatment. Results further suggested that distress related to trauma reminders, detachment, and insomnia were the most common residual PTSD symptoms at posttreatment, while self-blame, concerns about body image, and fatigue were the most common residual symptoms of depression. The most common residual symptom of guilt was lack of justification for actions that had to be taken during the index event. CONCLUSIONS: This pattern of findings is in line with past research suggesting that evidence-based practices are effective in the treatment of PTSD, but underscores the need to continue to evaluate residual symptoms to best assist clients in achieving full recovery. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Terapia Cognitivo-Comportamental , Terapia Implosiva , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Imagem Corporal/psicologia , Depressão/etiologia , Depressão/terapia , Prática Clínica Baseada em Evidências , Fadiga/etiologia , Fadiga/terapia , Feminino , Seguimentos , Culpa , Humanos , Escalas de Graduação Psiquiátrica , Estupro/psicologia , Estupro/reabilitação , Ajustamento Social , Transtornos de Estresse Pós-Traumáticos/etiologia , Sobreviventes/psicologia , Resultado do Tratamento
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