[Addressing sexual violence in health services]. / La violencia sexual y su abordaje en el sistema de salud.

Sexual violence is a very underdetected public health problem, with important short and long-term consequences on physical, mental, social, sexual and reproductive health, which must be taken into account by health services. Health systems are part of the set of resources necessary for a comprehensive approach from the ecological model: prevention and promotion of healthy sexuality with equality, adequate and coordinated care in the event of sexual assault and subsequent support to prevent sequelae. All sexual violence has health consequences, even those that may seem less serious such as sexual harassment or sexual cyberviolence. We must know the needs of the victim and their possible emotional reactions. A risk assessment will be carried out, the victim will be referred to a hospital if necessary and comprehensive and integrated care will be provided. Care and follow-up must focus on the survivor and with professionals trained in trauma to understand the consequences of sexual violence, offer a safe and trusting environment and know how to reinforce their qualities and support.

Expert Recommendations from the AEDV on Legal Aspects Surrounding the Management of Sexually Transmitted Diseases. / Recomendaciones de expertos de la AEDV sobre los aspectos legales en el manejo de las infecciones de transmisión sexual.

The incidence of sexually transmitted diseases has been on the rise in our setting for decades. These infections represent not only an individual problem, but also a problem of public health. Therefore, the management of STDs involves reducing community incidence, which means that common issues in the clinical practice such as failure to attend may become a more complex problem, which adds to the difficult and delicate task of locating sexual contacts that would benefit from screening and the appropriate treatment. On the other hand, STDs have direct legal implications in cases of underage patients, or suspected sexual assault. Therefore, the correct handling of these scenarios requires knowledge of the legal framework that regulates them. Dermatologists are clinically trained and prepared to deal with these conditions. Nonetheless, the legal issues involved are often difficult to solve. This document stands as a simple reference guide to help solve the main legal issues we may encounter in a consultation when dealing with STDs.

Parent-to-child aggression, intimate partner aggression, conflict resolution, and children's social-emotional competence in early childhood.

Early childhood is critical to the development of children's social-emotional competence, which predicts peer relations and school adjustment in later periods of childhood. The effects of experiencing or witnessing aggression on children's social-emotional development are well known, yet the role of conflict resolution within the family has not been sufficiently studied. Social information processing models suggests that children who experience positive forms of conflict resolution within the family are likely to generalize these experiences and related skills outside the family, and thus develop greater social-emotional competence. In this longitudinal study, 128 parents (representing 79 families) participated in four quarterly telephone interviews in which they described aggressive conflicts that occurred in their family for which their children were present, including the degree to which each conflict was resolved. They also reported on the frequency of intimate partner aggression (IPA) and parent-to-child aggression (PCA) that occurred while the child was in toddlerhood and preschool as well as children's social-emotional competence at the end of the study. Multi-level models reveal that parents' reports of positive conflict resolution mitigated the concurrent and longitudinal negative effects of children's exposure to both IPA and PCA on their social-emotional competence. These findings reinforce prevention scientists' emphasis on conflict resolution skills as an essential component of parent education programs.

La primera infancia es fundamental para el desarrollo de la competencia socioemocional de los niños, la cual predice las relaciones entre pares y la adaptación escolar en periodos posteriores de la niñez. Se conocen muy bien los efectos que producen el sufrir o ser testigos de agresión en el desarrollo socioemocional de los niños, sin embargo, aún no se ha estudiado de manera suficiente el papel que desempeña la resolución de conflictos dentro de la familia. Los modelos de procesamiento de la información social sugieren que los niños que viven formas positivas de resolución de conflictos dentro de la familia son propensos a generalizar estas experiencias y las habilidades afines fuera de la familia y, por lo tanto, a desarrollar una mayor competencia socioemocional. En este estudio longitudinal, 128 padres (que representaban 79 familias) participaron en cuatro entrevistas telefónicas cada tres meses en las cuales describieron conflictos agresivos que hubo en su familia en los cuales sus hijos estuvieron presentes, incluido el grado en el cual se resolvió cada conflicto. También informaron la frecuencia de agresión en la pareja y de agresión de padres a hijos que tuvo lugar durante sus primeros años de vida y en la etapa del preescolar, así como la competencia socioemocional de los niños al final del estudio. Los modelos multinivel indican que los informes de los padres sobre la resolución positiva de los conflictos mitigaron los efectos negativos longitudinales y simultáneos de la exposición de los niños a la agresión en la pareja y a la agresión de padres a hijos en su competencia socioemocional. Estos resultados refuerzan el énfasis en las habilidades de resolución de conflictos de los científicos de la prevención como componente esencial de los programas de educación para padres.

Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model.

Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.

La depresión posterior al parto y la autoeficacia de los padres (PSE) son factores de riesgo para la débil conducta del niño. Poco se sabe, sin embargo, acerca del curso de las trayectorias duales de síntomas depresivos que ocurren simultáneamente y PSE o su impacto en el desarrollo socioemocional de los niños. Este estudio se propuso identificar las trayectorias del PSE posterior al parto y los síntomas depresivos en nuevas, primerizas mamás usando un modelo de mezcla de crecimiento. Los resultados mostraron una clase de mujeres con 'bajo riesgo' (88.8%) que manifestaron bajos niveles de depresión y altos niveles de PSE durante el período posterior al parto; un segundo grupo de mujeres, llamado 'de temprano riesgo' (6.3%) con altos niveles de depresión que disminuyeron a lo largo del tiempo, pero más bajos niveles de PSE que se mantuvieron equitativamente estables; y un final grupo de trayectoria denominado la clase del 'riesgo tardío' (4.9%) con iniciales bajos niveles de depresión y altos niveles de PSE que significativamente aumentaron y disminuyeron, respectivamente, a lo largo del período. El trauma en la temprana niñez, el estés de crianza, así como las débiles prácticas de crianza fueron afiliaciones asociadas dentro de una clase de alto riesgo. Las mamás en los grupos de alto riesgo reportaron niños con conductas más agresivas y desafiantes a la edad de tres años. Concluimos con una discusión de las implicaciones de nuestros resultados para desarrollar intervenciones eficaces y sensibles.

La dépression postpartum et l'auto-efficacité parentale (abrégé en français ici AEP) sont des facteurs de risque pour les problèmes de comportement de l'enfant. On sait peu de choses, cependant, à propos du cours des trajectoires duels des symptômes dépressifs concomitants et l'AEP ou son impact sur le développement socio-émotionnel des enfants. Cette étude a cherché à identifier les trajectoires d'AEP postpartum et de symptômes dépressifs chez des mères étant mères pour la première fois, en utilisant un modèle de croissance mixte. Les résultats ont fait état d'une classe de femmes avec un "risque moindre" (88,8%) qui faisaient preuve de niveaux peu élevés de dépression et de niveaux élevés d'AEP durant la période postpartum; un deuxième groupe de femmes, appelé "risque précoce" (6,3%) avec des niveaux élevés de dépression qui ont décru au fil du temps et avec des niveaux plus bas d'AEP qui restaient relativement stables; et un groupe de trajectoire finale estimé comme étant la classe de 'risque tardif' (4,9%) avec initialement des niveaux moindres de dépression et des niveaux élevés d'AEP qui ont respectivement augmenté et baissé de manière importante, au fil de cette période. Le trauma de la petite enfance, le stress de parentage et de mauvaises pratiques parentales étaient liés à l'appartenance à la classe à haut risque. Les mères des groupes à risque élevé ont fait état d'enfants avec un comportement plus agressif et défiant à l'âge de trois ans. Nous concluons en discutant les implications pour le développement d'interventions efficaces et sensibles.

[Experiences and perception of health professionals of out-of-hospital emergencies in the face of attacks]. / Vivencias y percepción de los profesionales sanitarios de las urgencias extrahospitalarias ante las agresiones.

OBJECTIVE: To know the opinions of the health professionals who work at the Ourense Continuous Care Point (PAC) regarding work aggressions. DESIGN: Qualitative study with phenomenological approach carried out between January and May 2019. SETTING: PAC. PARTICIPANTS: Twenty professionals of different categories. METHOD: Structural sampling. Open interviews recorded in audio were used, with the prior consent of the participants. RESULTS: The interviewed professionals state that they have been victims of aggressions, especially verbal ones. These aggressions according to the participants are so common that they have normalized them within their working day. None has ever denounced this type of behavior, largely because they consider that the bureaucracy and administrative procedures are tedious, and others due to ignorance of the procedure. These types of situations, at work level, cause them feelings of sadness, anger and helplessness and are the cause according to them, of the increase in defensive medicine. Professionals believe that the cause of the increase in aggressions among the group is due to poor education and inadequate management of patient empowerment. CONCLUSIONS: Health professionals continually suffer aggressions, especially verbal, being common in their day to day. These attacks are not reported, but they cause multiple negative and disruptive feelings, changing their way of working.

Neuroticism and Marital Satisfaction During the Early Years of Chinese Marriage: The Mediating Roles of Marital Attribution and Aggression.

On the basis of three annual waves of data obtained from 268 Chinese couples, we tested an actor-partner interdependence mediation model in which spouses' neuroticism was linked to their own and partners' marital satisfaction through both intrapersonal processes (i.e., marital attribution) and interpersonal processes (i.e., marital aggression). Considering intra- and interpersonal processes simultaneously, four indirect, mediating pathways were identified: Time 1 Wives' Neuroticism → Time 2 Wives' Attribution or Aggression, while controlling for Time 1 Wives' Attribution or Aggression → Time 3 Wives' or Husbands' Marital Satisfaction, while controlling for Time 1 Wives' or Husbands' Marital Satisfaction. This study not only adds to a limited body of research examining why neuroticism is associated with conjugal well-being, but also extends prior research by focusing on Chinese couples and utilizing a longitudinal, dyadic mediation model. Such findings have important practical implications. Couples involving neurotic partners may benefit from interventions based on cognitive-behavioral approaches. When working with couples challenged by neuroticism, practitioners need to help them address dysfunctional interactive patterns as well as distorted cognitive styles.

Sobre la base de tres series de datos anuales obtenidos de 268 parejas chinas, evaluamos un modelo de mediación e interdependencia actor-pareja en el cual el neuroticismo de los cónyuges se conectó con su propia satisfacción conyugal y la de sus parejas mediante procesos intrapersonales (p. ej.: atribución conyugal) y procesos interpersonales (p. ej.: agresión conyugal). Teniendo en cuenta los procesos intrapersonales e interpersonales simultáneamente, se identificaron cuatro vías mediadoras indirectas: Serie 1: Neuroticismo de las esposas → Serie 2: Agresión o atribución de las esposas, mientras se controla la agresión o la atribución de las esposas de la serie 1 → Serie 3: Satisfacción conyugal de las esposas o los esposos, mientras se controla la satisfacción conyugal de las esposas o los esposos de la serie 1. Este estudio no solo aporta a las escasas investigaciones que analizan por qué el neuroticismo está asociado con el bienestar conyugal, sino que también amplía investigaciones previas centrándose en las parejas chinas y utilizando un modelo de mediación diádico y longitudinal. Dichos resultados tienen implicancias prácticas importantes. Las parejas que tienen compañeros neuróticos pueden beneficiarse con intervenciones basadas en enfoques cognitivo-conductuales. Cuando se trabaja con parejas afectadas por el neuroticismo, los médicos necesitan ayudarlas a abordar los patrones interactivos disfuncionales así como los estilos cognitivos distorsionados.

The therapeutic effects of Portulaca oleracea L. in hepatogastric disorders.

AIM: This research was conducted to obtain accurate information on the protective effects of Portulaca oleracea L. against hepatogastric diseases. RESULTS: P. oleracea L. (Purslane) has traditionally been used for the treatment of hepatogastric diseases. However, the low number of research studies has shown that P. oleracea L. possesses protective effects against hepatotoxic agents. The safety of P. oleracea L. has been demonstrated in several clinical trials. CONCLUSION: Modern pharmacological studies have indicated the gastroprotective and hepatoprotective effects of P. oleracea L. by using in vivo and in vitro models. However, due to lack of information of its effects in humans, more studies should be conducted to confirm the efficacy of P. oleracea L. in humans.

Sex differences in the development of physical aggression: An intergenerational perspective and implications for preventive interventions.

This article reviews the state of knowledge on the development of chronic physical aggression (CPA), with the aim of identifying the most effective prevention strategies. We specifically focus on the early development of physical aggression, on sex differences in the use of physical aggression, and on the transmission of behavior problems from one generation to the other. The body of research on the development of CPA from the past three decades that we review shows increasing evidence that its prevention requires a long-term biopsychosocial developmental approach which also must include an intergenerational perspective. Recent genetic and epigenetic research has indicated that there are both important genetic and environmental effects on gene expression which start at conception. We conclude that one of the most effective strategies to break the intergenerational transmission of CPA involves giving long-term support to pregnant women with a history of behavior problems, their spouse, and their offspring.

The affective basis of violence.

Violence is a complex matter, and understandingly perhaps, it is the objective, behavioral aspects that are commonly focused on. Here, however, it is the subjective psychological and especially affective substrates of violence that are brought to the fore. Psychoanalytic perspectives provide a way of thinking about these that also sets them in a human-developmental context. In this essay, psychoanalytic ideas about aggression and violence are considered, and what they have to say about the relationship between states of mind and behavior is critically reviewed. There also is an exploration of the ways that some recent findings in developmental science and neuroscience can refine and augment an understanding of these relationships, facilitating the construction of a psychobiological model, which may be placed in a social context. From this biopsychosocial perspective, aggression is seen as a heuristic concept that encapsulates numerous interacting elements that in ordinary development integrate and serve to promote optimal organism survival: By contrast, from this perspective, in humans violence may be understood as a pathological variant of aggression.

DEVELOPMENT AND SOCIALIZATION OF PHYSICAL AGGRESSION IN VERY YOUNG BOYS.

The expression of physical aggression is normative in early child development; it peaks in the second year of life, with steep declines for most children by the third and fourth years as children learn alternatives to aggression. Some children, however, fail to demonstrate declines in aggressive acts, and many of these are boys. The current review uses a dynamic systems (DS) approach to identify early individual and contextual factors that may dynamically influence trajectories of aggression as a characteristic way of engaging within communities and relationships. Within the DS framework, we focus on the parent-infant relationship as central to the development of adaptive emotion-regulation capacities of the infant and young child. Biological sex differences that may influence this early relationship are highlighted, as is the influence of contextual processes such as family violence. Clinical implications suggested by both the empirical and theoretical literatures are then described.

Can perpetrators discern survivors from voice?

Background: Research has shown that potential perpetrators and individuals high in psychopathic traits tend to body language cues to target a potential new victim. However, whether targeting occurs also by tending to vocal cues has not been examined. Thus, the role of voice in interpersonal violence merits investigation.Objective: In two studies, we examined whether perpetrators could differentiate female speakers with and without sexual and physical assault histories (presented as rating the degree of 'vulnerability' to victimization).Methods: Two samples of male listeners (sample one N = 105, sample two, N = 109) participated. Each sample rated 18 voices (9 survivors and 9 controls). Listener sample one heard spontaneous speech, and listener sample two heard the second sentence of a standardized passage. Listeners' self-reported psychopathic traits and history of previous perpetration were measured.Results: Across both samples, history of perpetration (but not psychopathy) predicted accuracy in distinguishing survivors of assault.Conclusions: These findings highlight the potential role of voice in prevention and intervention. Gaining a further understanding of what voice cues are associated with accuracy in discerning survivors can also help us understand whether or not specialized voice training could have a role in self-defense practices.

We examined whether listeners with history of perpetration could differentiate female speakers with and without assault histories (presented as rating the degree of 'vulnerability' to victimization).Listeners' higher history of perpetration was associated with higher accuracy in differentiating survivors of assault from non-survivors.These findings highlight that voice could have a crucial role in prevention and intervention.

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

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

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

Male sex and hazardous alcohol use following military sexual assault increase suicide risk among US service members and veterans.

Background: Higher alcohol use and military sexual assault (MSA) are associated with increased risk of death by suicide. Risk for death by suicide is rapidly increasing among females, who report higher rates of MSA, yet actual death by suicide and alcohol use are higher among males. It is not well understood whether higher alcohol use confers greater suicide risk in male or female service members and veterans who have experienced MSA.Objective: To determine whether the association between alcohol misuse and suicide risk was moderated by biological sex in a sample of male and female service members (N = 400, 50% female) who reported MSA.Method: Participants completed surveys of alcohol use and suicide risk as well as a demographic inventory. Linear regression with an interaction term was used to determine if suicide risk differed by sex and alcohol use severity after accounting for discharge status, sexual orientation, and age.Results: Average scores on the suicide risk measure were consistent with an inpatient psychiatric sample and scores on the AUDIT-C were indicative of a probable positive screen for alcohol misuse. Suicide risk was most pronounced among males who reported higher levels of hazardous alcohol use. A sensitivity analysis examining suicide risk by sex and screening results for alcohol misuse (positive/negative) showed that men with a probable positive screen had higher suicide risk.Discussion: The current study provides novel findings on suicide risk among survivors of military sexual violence by including both male and female survivors. Interventions to decrease suicide risk following MSA may consider alcohol reduction strategies, and optimizing these interventions in males. Engaging military culture at both the US Departments of Defense and Veterans Affairs to encourage more healthy alcohol consumption may mitigate this public health concern. Future research may consider how country of origin relates to these associations.

Average scores for the suicide risk measure and alcohol use were high among a sample of male and female survivors of military sexual assault.Suicide risk was most pronounced among males who reported higher levels of hazardous alcohol use.A sensitivity analysis examining suicide risk by sex and screening results for alcohol misuse (positive/negative) showed that men with a probable positive screen had higher suicide risk.

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.

A comparison of two strategies to assess sexual violence: general vs. specialised trauma screening strategies in two high-risk substance use health disparity samples.

Background/Objective: Using two different high-risk samples, the present study compared and contrasted two different strategies/questionnaire types for assessing a history of sexual violence: a general trauma screening vs. specialised behaviourally-specific questionnaires.Methods: Sample 1 included 91 men and women seeking detoxification treatment services in a publicly funded, urban clinic who completed a trauma and substance use questionnaire battery during treatment. Sample 2 included 310 women at a rural college who completed a trauma and religious coping questionnaire battery for course credit. All participants completed both types of questionnaires: One general trauma screening questionnaire (i.e. the Life Events Checklist [LEC]) and two behaviourally-specific specialised questionnaires (i.e. the 2007 Sexual Experiences Survey [SES] and the Childhood Trauma Questionnaire [CTQ]).Results: There were large differences in the cases identified by the behaviourally-specific questionnaires (SES and CTQ) compared to the general trauma screening questionnaire (the LEC) in both samples but few differences in the prevalence rates of sexual violence detected by each questionnaire type. In the detoxification sample, the differences were especially notable for men. Follow-up analyses indicated that degree of traumatisation impacted results likely by increasing participant's willingness to endorse face-valid items on the LEC.Conclusions: For men, the behaviourally-specific questionnaires (SES/CTQ) were necessary to identify cases. For those with more severe trauma histories, the LEC was equivalent to the SES/CTQ in identifying a similar number of sexual violence cases. Thus, clinicians and researchers should consider the population when selecting assessments to identify sexual violence history.

For men and rural college women, general trauma questionnaires are not as accurate as specialised sexual violence measures in detecting cases.While prevalence rates were often similar, which cases were detected by general trauma and specialised questionnaires were different.Individuals with greater trauma exposure were more likely to endorse face-valid sexual violence items on the general trauma questionnaires.

Preventing sexual violence in sexual orientation and gender diverse communities: A call to action.

Background: Members of the lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender diverse (SOGD) communities are at disproportionately higher risk for sexual violence compared to cisgender heterosexual people. Despite this elevated risk, relatively few sexual violence prevention efforts effectively reduce these victimization disparities based on sexual orientation or gender identity.Objective: This narrative review provides an overview of the prevalence of sexual violence in the SOGD communities, delineates risk factors for sexual victimization among SOGD community members, and reviews and evaluates existing prevention efforts for the SOGD communities. We outline specific recommendations for ensuring that prevention efforts meet the needs of the SOGD communities.Method: Drawing on ecological systems theory and public health approaches to sexual violence prevention, we outline current approaches and opportunities for preventionists and scholars to push the field forward.Results: There have been promising prevention programmes designed to be implemented within SOGD communities specifically; however, it is important that general primary prevention programmes endeavour to specifically address sexual violence perpetrated against SOGD people. While many packaged programmes that endeavour to prevent sexual violence across all gender identities and sexual orientations are inclusive of SOGD participants, more programming is needed that integrates anti-oppression training to target social norms that perpetuate SOGD-specific rape myths and normalize sexual violence against SOGD community members.Conclusion: Ecological prevention strategies in line with a public health approach for primary prevention may be particularly valuable for reducing victimization disparities based on SOGD status and identity. Comprehensive sexual education and anti-discrimination policies should be considered front-line prevention programming. To assess if these strategies are effective, the implementation of large-scale surveillance surveys that use comprehensive assessments of sexual orientation, gender identity, and sexual violence are needed. Using theoretically grounded implementation strategies for prevention programmes can ensure effective programme delivery.

Despite their increased vulnerability, relatively few prevention strategies that specifically aim to reduce sexual violence among sexual and gender diverse (SOGD) communities and existing packaged programmes are less effective for preventing victimization among SOGD than for cisgender, heterosexual groups.Packaged prevention programmes should continue adapting with the specific aims to reduce these SOGD-based disparities.Broader changes at the outer layer of the social-ecological model (e.g. anti-discrimination, anti-bullying, inclusive sex-education) are critical primary prevention approaches to reduce SOGD-based sexual violence disparities.

Associations of past-year overall trauma, sexual assault and PTSD with social support for young adult sexual minority women.

Background: Young adult sexual minority women (SMW) are at elevated risk for sexual assault (SA), posttraumatic stress disorder (PTSD), and inadequate social support. While SA and PTSD can lead to reductions in social support from close significant others, the impact of SA and PTSD on SMWs' social support has not previously been assessed.Objective: This study examined the associations of past year SA and PTSD with SMW's social support from intimate partners, family, and friends. It was hypothesized that SA and PTSD would be negatively associated with support from partners, family and friends, and that PTSD would moderate the effect of SA on support in early adulthood.Method: Young adult SMW in the United States (N = 235) who were M = 23.93 (SD = 2.15) years old, primarily lesbian or bisexual (n = 186, 79.1%) and White (n = 176, 74.9%) completed measures on past year exposure to SA and non-SA trauma, PTSD, and social support from intimate partners, family and friends.Results: PTSD was associated with less social support from partners, (b = -0.06, SE = 0.02, p = .010, R2change = .02), family, (b = -0.06, SE = 0.03, p = .025, R2change = .02), and friends, (b = -0.07, SE = 0.02, p = .008, R2change = .02). There was a significant interaction between PTSD and SA on social support from partners (b = -0.01, SE = 0.01, p = .047, R2change = .01). Neither non-SA nor SA trauma was associated with support from family or friends.Conclusions: Results underscore the potential impact of recent SA on intimate partnerships for young adult SMW with more severe PTSD. Future work should explore how addressing PTSD and improving social support quality may help SMW recover from traumatic experiences and ameliorate the effects of SA on intimate partnerships.

We examined the associations of past-year sexual and non-sexual assault trauma and PTSD with sexual minority women's social support from close significant others.Higher PTSD was associated with lower social support from partners, family and friends.In intimate partnerships, sexual assault was only associated with less social support when PTSD symptoms were more severe.

Mental health of sexual assault victims and predictors of their use of support from in-house psychologists at Belgian sexual assault care centres.

BACKGROUND: Sexual assault (SA) can induce a negative impact on victims' mental health. Specialised SA services generally offer medical care and a forensic examination to SA victims. However, there is a large variation in how these services provide mental health support. OBJECTIVE: This study aims to assess mental health problems of SA victims attending the Belgian Sexual Assault Care Centres (SACCs) and identify predictors for victims' use of support from in-house psychologists. METHOD: Health records of victims ≥ 16 years who presented within one week post-SA to one of the three Belgian SACCs between 25 October 2017 and 31 October 2019 were reviewed. An AIC-based stepwise backward binary logistic regression was used to analyse the association between victim, assault, service use and mental health characteristics and follow-up by a SACC-psychologist. RESULTS: Of the 555 victims, more than half had a history of mental health problems. Of those assessed, over 70% showed symptoms of posttraumatic stress disorder (PTSD), depression and/or anxiety disorder. One in two victims consulted a SACC-psychologist. Victims with a mental health history (OR 1.46, p = .04), victims accompanied by a support person during acute care (OR 1.51, p = .04), and victims who were assaulted by an acquaintance in comparison to those assaulted by a stranger (OR 1.60, p = .039) were more likely to attend their appointment with the SACC-psychologist. CONCLUSION: The study reaffirms the high mental health burden among victims attending specialised SA services, stressing the need to provide effective mental health interventions at these services and improve their longer-term use by victims. Prescheduling of appointments with an in-house psychologist in combination with phone reminders may improve the uptake of such services. Health care providers must be vigilant about potential barriers faced by victims without a mental health history or social support in attending appointments with mental health professionals.

The mental health burden is high among victims attending Belgian Sexual Assault Care Centres.Half of the victims use the support of an in-house psychologist. Victims with a history of mental health problems, those accompanied by a support person during acute care, and those assaulted by an acquaintance in comparison to those assaulted by a stranger, are more likely to use this support.Effective mental health support should be recognised as an integral and essential part of care for SA victims. Uptake and longer-term engagement with this mental health support should be improved for those victims diagnosed with PTSD.

Workplace violence in hospital emergency departments and consequences for health care professionals and support staff: a cluster analysis. / Violencia laboral de usuarios y sus consecuencias sobre profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios: análisis de clúster.

OBJECTIVES: Workplace violence of any type is influenced by multiple factors and leads to physiological, psychological, social, and organizational change. Emergency and other urgent care settings have assault rates up to 5-fold higher than other health care settings. This study aimed to analyze the consequences of physical and nonphysical violence on health care and support personnel in hospital emergency departments. MATERIAL AND METHODS: Cross-sectional descriptive analysis of responses to a 121-item survey of 584 health care and support workers in 12 Spanish hospital emergency departments. We analyzed the magnitude of the problem with a two-step self-clustering method and then assessed the associations between variables and workplace violence. RESULTS: Two groups were identified. The first consisted of 298 cases with high mean (SD) scores for nonphysical assaults (51.5 [7.9]) and low scores for physical violence (4.8 [2.9]). The second group consisted of 285 cases with intermediate scores for nonphysical assaults (27.1 [8.4]) and low scores for physical violence (3.4 [1.3]). CONCLUSION: Emergency departments have incidents of nonphysical workplace violence more often than physical violence. Emergency personnel with high exposure to workplace violence, particularly nonphysical assaults, experience physiological, psychosocial, and organizational changes.

OBJETIVO: La violencia laboral en cualquiera de sus modalidades se halla influenciada por múltiples factores, dando lugar a cambios fisiológicos, psicológicos, sociales y organizacionales, y los entornos de urgencias y emergencias presentan una incidencia de hasta cinco veces más con respecto al resto de servicios sanitarios. El objetivo de este estudio es analizar las características que desarrollan los profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios (SUH) que sufren violencia laboral física y no física. METODO: Es un diseño trasversal, descriptivo-analítico mediante la aplicación de un formulario de 121 ítems a una muestra de 584 profesionales sanitarios y no sanitarios de 12 hospitales españoles con SUHS, se aplicó análisis estadístico para magnitud del evento y análisis de clúster mediante método stepwise con solución de autoclustering y posterior relación de variables del estudio con violencia laboral. RESULTADOS: Tras la aplicación inicial del método descrito, se conformaron 2 grupos, el primero de ellos incluye a 298 casos y se caracteriza por puntuaciones altas en violencia no física (media: 51,5, desviación estándar: 7,9) y bajas en física (4,8, 2,9). Por otro lado, el segundo grupo está compuesto por 285 casos y se caracteriza por puntuaciones intermedias en violencia no física (27,1, 8,4) y bajas en física (3,4, 1,3). CONCLUSIONES: En los SUH existen manifestaciones de violencia laboral no física que presentan una mayor incidencia que las manifestaciones de violencia física. Aquellos profesionales con elevada exposición a violencia laboral, y en concreto a violencia no física, presentan alteraciones biopsicosociales y organizacionales.

Teen Well Check: an e-health prevention program for substance use, sexual assault, and sexual risk behaviors for adolescents in primary care.

Objective: Adolescents are at risk for substance use, sexual assault, and sexual risk behaviours; however, to date no integrated prevention programmes address all three risk behaviours. The goal of this study was to evaluate the usability and acceptability of Teen Well Check, an e-health prevention programme targeting substance use, sexual assault, and sexual risk among adolescents in primary care settings.Methods: The current study included content analysis of interviews with adolescents in primary care (aged 14-18; n = 25) in the intervention development process, followed by usability and acceptability testing with qualitative interviews among adolescents in primary care (aged 14-18; n = 10) and pediatric primary care providers (n = 11) in the intervention refinement process. All data were collected in the Southeastern U.S.Results: Feedback on Teen Well Check addressed content, engagement and interaction, language and tone, aesthetics, logistics, inclusivity, parent/guardian-related topics, and the application of personal stories. Overall, providers reported they would be likely to use this intervention (5.1 out of 7.0) and recommend it to adolescents (5.4 out of 7.0).Conclusions: These findings suggest preliminary usability and acceptability of Teen Well Check. A randomized clinical trial is needed to assess efficacy.

Adolescents are at risk for substance use, sexual assault, and sexual risk behaviours.The goal of this study was to evaluate the usability and acceptability of Teen Well Check, an e-health prevention programme targeting substance use, sexual assault, and sexual risk among adolescents in primary care settings.Providers and adolescents rated Teen Well Check as usable and acceptable, and providers indicated that they would recommend it to their adolescent patients.