Sexual Victimization Among Sexual and Gender Minoritized Groups: Recent Research and Future Directions.

PURPOSE OF THE REVIEW: Sexual victimization is a significant public health concern. Compared to heterosexual and cisgender peers, sexual and gender minoritized (SGM) individuals are at elevated risk for sexual victimization. Prominent theories suggest that this risk is due in part to the stigma SGM individuals face when navigating heteronormative cultures. The goal of this article is to review the prevalence, risk factors, and consequences of sexual victimization in SGM individuals. RECENT FINDINGS: Studies continue to show that SGM individuals-bisexual and/or gender minoritized in particular-are at higher risk for sexual victimization. Little work has focused on risk factors, though recent research continues to highlight post-victimization disparities among SGM individuals. Emerging studies also point to theoretically informed factors that may influence victimization risk and recovery, including sexual and gender-related stigma. To inform prevention and intervention efforts, future research would benefit from streamlining assessment, methodology, and dissemination practices.

A preliminary examination of sexual and physical victimization 6 months after recent rape.

One in four US women will experience a completed or attempted rape in their lifetime, and more than 50% of survivors will experience two or more rapes. Rape and physical violence also co-occur. Multiple experiences of sexual and physical violence are associated with elevated mental and physical health problems. This secondary analysis examined the prevalence and correlates of experiencing sexual or physical violence within 6 months of a sexual assault medical forensic exam (SAMFE). Between May 2009 and December 2013, 233 female rape survivors aged 15 and older were enrolled in a randomized controlled trial during a SAMFE in the emergency department (ED). Demographics, rape characteristics, distress at the ED, and pre-rape history of sexual or physical victimization were assessed. New sexual and physical victimization was assessed 6 months after the SAMFE via telephone interview. Six months after the exam, 21.7% reported a new sexual or physical victimization. Predictors of revictimization during follow-up included sexual or physical victimization prior to the index rape, making less than $10,000 annually, remembering the rape well, life threat during the rape, and higher distress at the ED. In adjusted models, only pre-rape victimization and making less than $10,000 annually were associated with revictimization. Factors assessed at the ED can inform subsequent victimization risk. More research is needed to prevent revictimization among recent rape victims. Policies to provide financial support to recent rape victims and/or targeted prevention for those with pre-rape victimization at the SAMFE could reduce revictimization risk. TRIAL REGISTRATION: NCT01430624.

Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members.

Evidence-based treatments for posttraumatic stress disorder (PTSD) are underutilized by active duty service members in the United States. Social support may help service members overcome avoidance and facilitate treatment utilization. In turn, treatment utilization may improve social support. To evaluate these possibilities, the aim of the current study was to examine potential reciprocal associations between social support and treatment utilization among service members. Secondary analyses were conducted on a randomized controlled trial of 161 U.S. military service members with PTSD. Participants completed assessments of perceived social support and attendance at individual therapy sessions at baseline and 3- and 6-month follow-ups. To determine reciprocal relations between social support and treatment utilization, a Bayesian approach was used to estimate a random-intercept cross-lagged panel model with a two-part variable for treatment utilization (i.e., any therapy, and if so, dose). There were no between-person associations between average social support and treatment utilization. One prospective cross-lagged within-person association emerged as significant: social support at 3 months was negatively associated with any therapy use at 6 months; the model explained 26.1% of the variance in this observed variable. The findings revealed that low social support promoted subsequent treatment utilization, but such treatment did not lead to changes in social support. This suggests service members with PTSD may have been motivated to attend individual therapy in pursuit of social connection and support. Future research is needed to determine if reciprocal associations between various forms of social support and therapy utilization differ by treatment modality.

Prepartying and incapacitated rape: Is drinking a risk factor or an outcome?

BACKGROUND: Incapacitated rape (IR) is common in college and has been linked to heavier post-assault drinking and consequences, including blackouts. Following IR, college students may adjust their drinking in ways meant to increase perceived safety, such as enhancing situational control over one's drinks through prepartying, which is drinking before going out to a main social event. Although it is possible that prepartying could influence risk related to IR, it is unclear whether or how prepartying and IR are associated. METHODS: To address these gaps, we examined prepartying as both a risk factor and a consequence of IR, including the reasons for prepartying. Across two studies (Study 1 N = 1074; Study 2 N = 1753) of college women and men, we examined associations between IR and prepartying motives, alcohol consumption, and alcohol-related blackouts. RESULTS: Within the cross-sectional Study 1, negative binomial regressions revealed that having a history of IR was associated with more alcohol consumption and blackouts when prepartying. In a multivariate model, past-year IR was associated with preparty motives related to interpersonal enhancement, intimate pursuit, and barriers to consumption, but not situational control. Within the prospective Study 2, a path model revealed that preparty drinking was a prospective predictor of IR in the following year, but past-year IR did not predict subsequent prepartying. CONCLUSIONS: Findings revealed a robust link between recent history of IR and prepartying regardless of gender. Prepartying was a prospective risk factor for subsequent IR. Although more research in this area is needed, addressing prepartying in alcohol interventions may contribute to the prevention of negative outcomes, including sexual assault.

College students' virtual and in-person drinking contexts during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has resulted in pronounced changes for college students, including shifts in living situations and engagement in virtual environments. Although college drinking decreased at the onset of the pandemic, a nuanced understanding of pandemic-related changes in drinking contexts and the risks conferred by each context on alcohol use and related consequences have yet to be assessed. METHODS: Secondary data analyses were conducted on screening data from a large parent clinical trial assessing a college student drinking intervention (N = 1669). Participants across six cohorts (from Spring 2020 to Summer 2021) reported on the frequency of drinking in each context (i.e., outside the home, home alone, home with others in-person, and home with others virtually), typical amount of drinking, and seven alcohol-related consequence subscales. RESULTS: Descriptive statistics and negative binomial regressions indicated that the proportion and frequency of drinking at home virtually with others decreased, while drinking outside the home increased from Spring 2020 to Summer 2021. Limited differences were observed in the proportion or frequency of individuals drinking at home alone or at home with others in-person. Negative binomial and logistic regressions indicated that the frequency of drinking outside the home was most consistently associated with more alcohol-related consequences (i.e., six of the seven subscales). However, drinking at home was not without risks; drinking home alone was associated with abuse/dependence, personal, social, hangover, and social media consequences; drinking home with others virtually was associated with abuse/dependence and social consequences; drinking home with others in-person was associated with drunk texting/dialing. CONCLUSION: The proportion and frequency of drinking in certain contexts changed during the COVID-19 pandemic, although drinking outside the home represented the highest risk drinking context across the pandemic. Future prevention and intervention efforts may benefit from considering approaches specific to different drinking contexts.

Does Gratitude Promote Resilience During a Pandemic? An Examination of Mental Health and Positivity at the Onset of COVID-19.

Researchers have emphasized the detrimental effects of COVID-19 on mental health, but less attention has been given to personal strengths promoting resilience during the pandemic. One strength might be gratitude, which supports wellbeing amidst adversity. A two-wave examination of 201 college students revealed anxiety symptom severity increased to a lesser extent from pre-COVID (January-March 2020) to onset-COVID (April 2020) among those who reported greater pre-COVID gratitude. A similar trend appeared for depression symptom severity. Gratitude was also correlated with less negative changes in outlook, greater positive changes in outlook, and endorsement of positive experiences resulting from COVID-19. Thematic analysis showed "strengthened interpersonal connections" and "more time" were the most commonly reported positive experiences. Overall findings suggest gratitude lessened mental health difficulties and fostered positivity at the onset of the pandemic, but more research is needed to determine whether gratitude and other strengths promote resilience as COVID-19 continues.

Is the COVID-19 Pandemic a High-Risk Period for College Student Alcohol Use? A Comparison of Three Spring Semesters.

BACKGROUND: There has been widespread concern that the COVID-19 pandemic may be a high-risk time for alcohol use among heavy drinking populations such as college students. Initial efforts to evaluate changes in college drinking have not yet accounted for typical drinking patterns within a semester. METHODS: To fill this gap, we evaluated how college student drinking patterns changed with the onset of restrictions related to the COVID-19 pandemic during spring 2020 relative to spring 2018 and 2019. Participants were 1,365 college students aged 19 and older, including 895 students who reported past-month alcohol use. Daily drinking data were extracted from an online Timeline Followback survey. RESULTS: Negative binomial hurdle models revealed that, with the onset of the COVID-19 pandemic in spring 2020, college student drinkers did not increase their drinking frequency as was typical in late spring semester, and the number of drinks per occasion declined substantially (28% reduction), greater than the change observed from early to late spring 2018 (3% reduction) or spring 2019 (8% increase). This reduction in drinking quantity in spring 2020 was larger for college student drinkers who moved residences because of the pandemic (49% reduction) than students who did not move (21% reduction). Perceptions in pandemic-related changes in drinking also revealed that 83.5% of college student drinkers self-reported that their drinking stayed the same or decreased. CONCLUSIONS: Findings suggest that, on average, college students drank less-not more-during the onset of the COVID-19 pandemic and highlight the importance of living situation in college student drinking behavior. More research is needed to assess alcohol use in other universities, as this information could be utilized in norms-based interventions to further reduce drinking in students who remain at risk.

A Prospective Study of Predictors and Consequences of Hooking Up for Sexual Minority Women.

Hooking up, which refers to a sexual encounter (ranging from kissing to penetrative sex) between individuals who are not in a committed relationship, is an increasingly normative form of sexual exploration among emerging adults. Past research has focused on hookups within a heteronormative context, and some of this work has examined hookups as a way to cope with distress. Building on this work, we examined the role of hookups as a means for lesbian and bisexual women to cope with minority stress through increasing connection and engagement with the LGBTQ (lesbian/gay/bisexual/transgender/queer or questioning) community. A nationally recruited sample of 520 lesbian and bisexual women ages 18 to 25 years completed questionnaires regarding their hookup behaviors as part of a longitudinal study. Childhood sexual abuse, posttraumatic stress symptoms, alcohol use, minority stress, and involvement and connectedness with the LGBTQ community were also assessed. First, regression analyses were used to examine baseline predictors of hookup behaviors reported at a 12-month follow-up. Findings revealed that alcohol use was associated with a greater likelihood of any subsequent hookups, and individuals reporting more minority stress subsequently hooked up with more partners. Second, hookup behaviors at 12 months were examined as predictors of outcomes at a 24-month follow-up, after controlling for baseline variables. Findings revealed that hookup behaviors were associated with reduced minority stress as well as increased involvement with and connectedness to the LGBTQ community, suggesting hookups may serve a protective function. Overall, findings support the notion that, for sexual minority women, hookups may operate as a means of coping and connection.

Cognitive Processing Therapy for Substance-Involved Sexual Assault: Does an Account Help or Hinder Recovery?

Sexual assault (SA) often occurs in the context of substances, which can impair the trauma memory and contribute to negative cognitions like self-blame. Although these factors may affect posttraumatic stress disorder (PTSD) treatment, outcomes for substance-involved SA have not been evaluated or compared with other types of SA. As such, we conducted a secondary analysis of a dismantling trial for cognitive processing therapy (CPT), focusing on 58 women with an index trauma of SA that occurred since age 14. Women who experienced a substance-involved SA (n = 21) were compared with those who experienced a non-substance-involved SA (n = 37). Participants were randomized to CPT, CPT with written account (CPT+A), or written account only (WA). Regressions controlling for pretreatment symptom levels revealed no differences by SA type in PTSD severity at posttreatment. At 6-month follow-up, substance-involved SA was associated with more severe residual PTSD severity than non-substance-involved SA, with no significant differences by treatment condition. Among participants in the substance-involved SA group, the largest effect for reduced PTSD symptom severity from pretreatment to follow-up emerged in the CPT condition, d = -2.02, with reductions also observed in the CPT+A, d = -0.92, and WA groups, d = -1.23. Although more research in larger samples is needed, these preliminary findings suggest that following substance-involved SA, a cognitive treatment approach without a trauma account may facilitate lasting change in PTSD symptoms. We encourage replications to better understand the relative value of cognitive and exposure-based treatment for PTSD following substance-involved SAs.

Managing post-sexual assault suicide risk.

Suicidal ideation and suicidal behavior are common after experiencing a sexual assault. Therefore, it is imperative to assess for and manage suicidal ideation using evidence-based techniques after a sexual assault medical forensic examination (SAMFE). We assessed factors associated with higher suicidal ideation identified in a post-SAMFE mental health screening conducted over the phone and strategies to manage suicide risk. We also discuss three case examples and unique considerations when assessing post-SAMFE suicide risk. It was found that among individuals who completed a post-SAMFE screen, individuals who have been previously hospitalized for a mental health problem, who had higher acute stress symptoms, and who were homeless reported more suicidal ideation than those without those histories or symptom presentations. No matter the risk factors for suicidal ideation post-SAMFE, it is essential to screen all individuals post-SAMFE due to their high risk for suicidal ideation and death by suicide.

Program Evaluation of an Integrated Behavioral Health Clinic in an Outpatient Women's Health Clinic: Challenges and Considerations.

Many women receive their regular check-ups and preventive care through a women's health clinic, including their behavioral health needs. Most of these clinics have not yet developed the capacity to adequately manage behavioral health concerns. We describe our clinical experience integrating behavioral health services into a women's health clinic. In one year, 108 women (54% White, Mage= 35) were referred for behavioral health treatment 47% were identified using a screening questionnaire, 51% were referred by their women's health provider and 2% were self-referred. The most common presenting concerns were anxiety (52%) and depressive symptoms (48%). Sixty-one (56%) patients completed an intake assessment, of whom 33 (54%) engaged in follow-up treatment (M = 3.7 treatment sessions, SD = 3.0). Behavioral health screening and treatment appears to be feasible and effective within a women's health setting. Further research is needed to overcome barriers to referrals and treatment engagement in this population.

Observing Alcohol Myopia in the Context of a Trauma Film Paradigm: Differential Recall of Central and Peripheral Details.

BACKGROUND: A major tenet of the alcohol myopia model is that intoxication results in a narrowing of attention to the most central environmental cues, at the cost of more peripheral information. Though long hypothesized, no known study of alcohol myopia has demonstrated differential immediate recall of central and peripheral cues using a standardized task. To address this gap, we conducted an alcohol administration study with a clear, standardized focus-a trauma film. METHODS: Ninety-eight female social drinkers completed self-report measures, and then were randomized to consume a placebo beverage, a low dose of alcohol (mean breath alcohol concentration [BrAC] = 0.04%), or a high dose of alcohol (mean BrAC = 0.11%). Participants then moved to a staged room where they viewed a film clip depicting a sexual assault. After leaving the room, participants completed a written free recall task of the film and the room. RESULTS: The distinction between recall of central and peripheral details was supported by confirmatory factor analysis. Consistent with the alcohol myopia model, relative to placebo, a high dose of alcohol led to impaired recall of peripheral (but not central) details. Although the interaction between BrAC and information type (central vs. peripheral) was not statistically significant, simple effects revealed a strong association between BrAC and peripheral information, and no association between BrAC and central information. Bolstering myopia as an explanation for our findings, neither central nor peripheral information correlated with self-reported tendencies to dissociate or distract oneself, or typical alcohol consumption or expectancies. CONCLUSIONS: Alcohol myopia can be observed through an immediate free recall task following a stressful film. Additional research is needed to continue evaluating dose-dependent differential recall in larger samples. This task may be useful for clarifying the role of alcohol myopia in clinical phenomena, such as aggressive behavior and processing traumatic events.

Risk for Revictimization Following Interpersonal and Noninterpersonal Trauma: Clarifying the Role of Posttraumatic Stress Symptoms and Trauma-Related Cognitions.

One victimization experience can increase the risk for subsequent victimization, which is known as revictimization. The aims of this study were to build on sexual revictimization research by (a) broadening the understanding of revictimization to interpersonal (and potentially noninterpersonal) trauma generally and (b) gaining specificity in the mechanisms that underlie revictimization. Using a prospective multisite design, an ethnically and racially diverse sample of 453 young women from the community (age range: 18-25 years, 60.7% European American) completed an initial survey and at least one follow-up survey within the subsequent year. Participants completed self-report measures of trauma history, posttraumatic stress symptoms, and maladaptive posttraumatic cognitions. Structural equation models revealed that interpersonal revictimization was observed when controlling for past noninterpersonal trauma, odds ratio (OR) = 2.27, 95% CI [1.23, 4.18], and supported the role of posttraumatic stress symptoms as a mechanism underlying such revictimization, 95% CI of indirect effect (IE) [0.08, 0.51]. Additionally, a history of noninterpersonal trauma (controlling for past interpersonal trauma) increased risk of subsequent interpersonal victimization via posttraumatic stress symptoms, 95% CI of IE [0.01, 0.38]. Notably, however, when maladaptive cognitions were included as mediators in addition to posttraumatic stress symptoms, the only unique indirect effect was for the association between interpersonal trauma and risk of revictimization specifically through perceived threat of harm, 95% CI of IE [0.05, 0.20]. These findings suggest that efforts to reduce interpersonal revictimization should target maladaptive posttraumatic cognitions, particularly perceptions of threat in the environment.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Riesgo de revictimización luego de trauma interpersonal y no interpersonal: Aclarando el rol de los Síntomas de Estrés postraumático y las Cogniciones relacionadas con el Trauma REVICTIMIZACIÓN, TEPT Y COGNICIONES Una experiencia de victimización puede aumentar el riesgo de una subsiguiente victimización, conocida como revictimización. Los objetivos de este estudio fueron desarrollar una investigación sobre la revictimización sexual mediante (a) una comprensión más amplia de la revictimización al trauma interpersonal (y potencialmente no interpersonal) en general, y (b) la obtención de especificidad en los mecanismos que subyacen a la revictimización. Utilizando un diseño multisitio prospectivo, una muestra étnica y racialmente diversa de 453 mujeres jóvenes de la comunidad (rango de edad: 18-25 años, 60.7% europeo-estadounidense) completaron una encuesta inicial y al menos una encuesta de seguimiento dentro del año siguiente. Las participantes completaron medidas de auto reporte del historial de traumas, síntomas de estrés postraumático y cogniciones postraumáticas no adaptativas. Los modelos de ecuaciones estructurales revelaron que se observó una revictimización interpersonal al controlar traumas no interpersonales pasados, odds ratio (OR) = 2.27, IC 95% [1.23, 4.18], y apoyaron el rol de los síntomas de estrés postraumático como un mecanismo subyacente a dicha revictimización, IC del 95% de efecto indirecto (IE) [0.08, 0.51]. Además, un historial de trauma no interpersonal (controlando el trauma interpersonal pasado) incrementó el riesgo de subsecuente victimización interpersonal mediante síntomas de estrés postraumático, IC del 95% de IE [0.01, 0.38]. Sin embargo, notablemente, cuando se incluyeron las cogniciones no adaptativas como mediadores además de los síntomas de estrés postraumático, el único efecto indirecto fue la asociación entre el trauma interpersonal y el riesgo de revictimización, específicamente a través de la percepción de la amenaza de daño, IC del 95% de IE [0.05, 0.20]. Estos hallazgos sugieren que los esfuerzos para reducir la revictimización interpersonal deben dirigirse a las cogniciones postraumáticas no adaptativas, en particular las percepciones de amenaza en el medio ambiente.

Victim Alcohol Intoxication During a Sexual Assault: Relations With Subsequent PTSD Symptoms.

This study examines associations between women's alcohol intoxication at the time of sexual assault and posttraumatic stress disorder (PTSD) symptoms. Drawing on the dual representation theory (Brewin, Gregory, Lipton, & Burgess, 2010), we hypothesized that intoxication at the time of assault would be positively associated with both overall symptoms of PTSD and PTSD reexperiencing symptoms in particular. A total of 143 community women (ages 18-26 years; 71.3% European American) reporting sexual victimization completed questionnaires assessing severity of coercion involved in the assault, perceived level of intoxication at the time of assault, and current PTSD symptoms. Overall, results suggested that greater alcohol intoxication (but not alcohol use alone) was associated with more severe PTSD symptoms when controlling for severity of coercion. Furthermore, higher levels of victim intoxication at the time of the assault were most predictive of reexperiencing symptoms relative to the other symptom clusters.

Alcohol Expectancies, Posttraumatic Stress Disorder, and Alcohol Use in College Students With a History of Childhood Trauma.

OBJECTIVE: Prior research has emphasized that the key mediator in the posttraumatic stress disorder (PTSD) symptom-alcohol use relationship is the expectancy of alcohol's tension-reducing properties. This study extends the literature by examining various alcohol outcome expectancies. METHODS: Cross-sectional data were obtained from 198 college students who reported experiencing at least one traumatic event in childhood. Participants answered surveys measuring PTSD symptoms, alcohol outcome expectancies, and three measures of alcohol consumption and related problems. RESULTS: Participants included 131 males (mean age = 19.65 years, SD = 1.06, range = 18 to 24) and 67 females (mean age = 19.43 years, SD = 0.82, range = 18 to 23), who were predominantly European-American (82%). For males and females, results of the multivariate analyses suggested that self-perception expectancies mediated the effects of PTSD symptoms on alcohol use severity, whereas sociability expectancies mediated the effects of PTSD symptoms on monthly alcohol use. For women, risk and aggression and sexuality expectancies mediated the relationship between PTSD symptoms and alcohol use severity, while risk and aggression expectancies mediated the relationship between PTSD symptoms and alcohol use consequences. For men, sociability expectancies mediated the effects of PTSD symptoms on alcohol use severity. Across genders, tension-reduction expectancies did not mediate the relationship between PTSD symptom and the three alcohol measures. CONCLUSIONS: This study was unable to find support for the self-medication hypothesis via the tension-reduction outcome expectancy pathway. However, other significant findings can be interpreted in light of the self-medication hypothesis. For example, alcohol may aid in coping with social impairments related to PTSD symptoms, particularly in a college sample. This study also highlighted gender differences in the association between PTSD symptoms and alcohol consumption and related problems.

Adverse childhood experiences, posttraumatic stress disorder symptoms, and emotional intelligence in partner aggression.

Intimate partner violence (IPV) has been linked to childhood abuse, posttraumatic stress disorder (PTSD), and low emotional intelligence (EI). Relationships among adverse childhood experiences (ACE), PTSD symptoms, and partner aggression (i.e., generalized tendency to aggress toward one's partner) were assessed in 108 male IPV offenders. It was hypothesized that ACE is positively correlated with partner aggression, PTSD mediates the ACE-aggression relationship, and the ACE-PTSD-aggression mediation varies by selected EI facets. Results indicate that ACE has an indirect effect on partner aggression via PTSD and PTSD mediates the ACE-aggression link when emotional self-regulation is low and when intuition (vs. reason) is high. Trauma-exposed IPV offenders may benefit from comprehensive treatments focusing on PTSD symptoms, emotional control, and reasoning skills to reduce aggression.

PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies.

OBJECTIVE: Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault. METHOD: Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity. RESULTS: Meta-analysis of 22 unique samples (N = 2,106) indicated that 74.58% (95% confidence interval [CI]: [67.21, 81.29]) and 41.49% (95% CI: [32.36, 50.92]) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: [41.27, 54.61]) and 29.91% (95% CI: [23.10, 36.73]) of scales' maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed. CONCLUSIONS: Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.

Personalized normative feedback for hazardous drinking among college women: Differential outcomes by history of incapacitated rape.

OBJECTIVE: Personalized normative feedback (PNF) interventions are effective at reducing hazardous drinking in college. However, little is known about who is most receptive to PNF. College women with a history of alcohol-related incapacitated rape (IR) are at elevated risk for hazardous drinking, but it is unclear what impact intervention messaging may have on this group and how their outcomes compare to those without past IR. To address this gap, this study involved secondary data analysis of a large web-based clinical trial. METHOD: Heavy drinking college women (N = 1,188) were randomized into PNF (n = 895) or control conditions (n = 293). Postintervention, women reported their reactions to intervention messaging. Hazardous drinking outcomes (typical drinking, heavy episodic drinking [HED], peak estimated blood alcohol content [eBAC], blackout frequency) were assessed at baseline and 12 months. RESULTS: Past IR was reported by 16.3% (n = 194) of women. Women with a history of IR reported more baseline hazardous drinking and greater readiness to change than women without IR. For those who received PNF, history of IR related to greater perceived impact of the intervention, but no difference in satisfaction with the message. After controlling for baseline drinking, regressions revealed the effect of PNF was moderated by IR for frequency of HED at 12 months. Simple main effects revealed PNF was associated with lower levels of hazardous drinking at follow-up among women with past IR. CONCLUSIONS: This initial investigation suggests PNF is a low resource and easily disseminated intervention that can have a positive impact on college women with past IR. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Is the Risk for Sexual Revictimization Cumulative? A Prospective Examination.

INTRODUCTION: Sexual abuse during childhood is associated with risk for sexual assault as an adult, known as revictimization. Although multiple experiences of sexual assault in adulthood are also common, it is unclear how risk trajectories might continue to evolve in emerging adulthood, defined as ages 18-25. Clarifying risk trajectories is important to inform the development of targeted risk reduction interventions. To fill this gap, we examined cumulative risk for sexual assault in emerging adult women following multiple experiences of childhood sexual abuse (CSA) and adulthood sexual assault (ASA). METHODS: Women (n = 447; aged 18-25 years at enrollment) completed behaviorally specific assessments of unwanted sexual experiences at up to 9 time points across 3 years. Logistic regression was used to predict any sexual assault during the 3-year period as a function of victimization history at baseline. A multilevel logistic regression analysis among ASA survivors was then used to determine whether each successive ASA increased risk for further victimization. RESULTS: Extending prior research, findings revealed that the risk for sexual assault during the 3-year study was greater for women reporting more prior experiences of CSA and ASA. Unexpectedly, each ASA increased the risk for a subsequent ASA to a lesser extent among women with more experiences of CSA. CONCLUSIONS: Findings suggest that the risk for sexual revictimization can be cumulative, but that risk does not increase indefinitely. Future research should investigate the points at which survivors of multiple assaults may begin to experience a decreased risk for later assaults, as well as the factors associated with change in risk status (e.g., removal from violent environments or relationships, changes in institutional policies). Such research could inform intervention targets.

Alcohol Use Before Sexual Violence and Cognitive Appraisals: Differential Associations With Barriers to Help-Seeking.

The current study examined two cognitive appraisals-labeling (identifying an unwanted sexual experience as sexual violence) and self-blame-as potential mechanisms between survivor alcohol use before sexual violence and three help-seeking barriers (minimization, negative treatment, and social-emotional barriers) among non-service-seeking sexual violence survivors. Participants were 141 undergraduate women who completed self-report measures. Three parallel mediation models were tested. Survivors who were drinking were more likely to label their victimization as sexual violence and, in turn, perceived fewer minimization and greater social-emotional barriers. Further, survivors who were drinking blamed themselves more and, in turn, perceived greater negative treatment and social-emotional barriers.