An audit study of barriers to mental health treatment for wrongly incarcerated people.

OBJECTIVE: People who have been wrongly incarcerated report exceptionally poor mental health, and despite having been exonerated, they face discrimination similar to other formerly incarcerated people when seeking housing and employment opportunities. The current audit study was designed to test whether exonerees likewise face discrimination when seeking mental health treatment. HYPOTHESES: Therapists will reply less often to treatment inquiries from exonerees and parolees compared to another prospective client with the same symptoms and trauma history-and when therapists do reply, they will less often be willing to meet with exonerated or paroled help seekers. METHOD: We emailed 752 therapists across the United States while posing as a man seeking therapy for the mental health symptoms most commonly reported by exonerees. By random assignment, this help seeker had been either incarcerated and paroled, wrongly incarcerated and exonerated, or working as a first responder (control). For each email, we noted whether the therapist replied and, if so, the speed and length of the reply. We also content analyzed all replies for predetermined themes, including willingness to meet. RESULTS: Overall, therapists replied less often to exonerees (50.6%) than to first responders (62.9%) or parolees (61.1%), who did not differ (V = .11). Therapists' replies also differed in their willingness to meet (V = .13), such that inquiries from first responders would more often result in a meeting with a therapist (31.7%) compared with inquiries from exonerees (19.6%) or parolees (21.0%). CONCLUSIONS: Exonerees' staggering rates of mental illness may be compounded by lesser treatment access. Therapists' reluctance to assist exonerees may reflect stigma and/or perceived incompetence. Our data highlight the need to destigmatize wrongful conviction, empower clinicians to treat exonerated clients, and advance legislation and other means to expand exonerees' access to mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Unwanted Pursuit Behavior Victimization as a Predictor of Engagement in Nonsuicidal Self-Injury.

While prior research has studied associations between child abuse and nonsuicidal self-injury (NSSI), there is limited research assessing unwanted pursuit behavior (UPB) victimization and NSSI. In addition, few studies have assessed the self-reported functions of NSSI among survivors of violence. Among a sample of 18-25-year-old young adults (N = 333), both UPB victimization and child abuse were significantly associated with NSSI frequency. In regression models, UPB victimization was associated with increased use of affect regulation, antidissociation/feeling-generation, self-punishment, and antisuicide functions, while child abuse was associated only with antidissociation/feeling-generation and self-punishment. Affect regulation mediated the association between UPB victimization and NSSI frequency, but not the association between child victimization and NSSI frequency. Implications for research and clinical practice will be discussed.

Effects of Intimate Partner Violence During COVID-19 and Pandemic-Related Stress on the Mental and Physical Health of Women Veterans.

BACKGROUND: Little is known about women veterans' intimate partner violence (IPV) experiences during the COVID-19 pandemic or the impacts of pandemic-related stress on their mental and physical health. OBJECTIVES: To identify IPV experiences among women veterans prior to and during the pandemic, pandemic-related stressors, and examine their respective contributions to mental and physical health. DESIGN: National sample of women veterans drawn from a larger web-based longitudinal study. Relationships between recent IPV and pandemic-related stressors were tested with linear regressions, controlling for pre-pandemic IPV and mental and physical health symptoms, demographic, and military-related covariates. PARTICIPANTS: One hundred forty-two women veterans (Mage=58.8 years). MAIN MEASURES: We assessed IPV (CTS-2), PTSD (PCL-5), depression (CESD), anxiety (DASS-A), physical health (PHQ-15), and physical health-related quality of life (SF-12) prior to the pandemic (June 2016-December 2016/January 2017) and during the pandemic study period (March 2020-December 2020/January 2021). We assessed pandemic-related stressors (EPII) during the pandemic study period. KEY RESULTS: Over a third (38.7%) of participants experienced IPV during the pandemic study period (psychological: 35.9%, physical: 9.9%, sexual: 4.2%). Overall rates, frequency, and severity of IPV experience did not significantly differ between the pre-pandemic and pandemic study periods. Few participants tested positive for COVID-19 (4.2%); however, most participants reported experiencing pandemic-related stressors across life domains (e.g., social activities: 88%, physical health: 80.3%, emotional health: 68.3%). IPV during the pandemic and pandemic-related stressors were both associated with greater PTSD and depressive symptoms. Pandemic-related stressors were associated with worse anxiety and physical health symptoms. Neither IPV during the pandemic nor pandemic-related stressors were associated with physical health-related quality of life. CONCLUSIONS: IPV experiences during the pandemic were common among women veterans, as were pandemic-related stressors. Although IPV did not increase in the context of COVID-19, IPV experiences during the pandemic and pandemic-related stressors were linked with poorer mental and physical health.

The role of general self-efficacy in intimate partner violence and symptoms of posttraumatic stress disorder among women veterans.

Whereas some prior studies have assessed associations between general self-efficacy, intimate partner violence (IPV) experiences, and posttraumatic stress disorder (PTSD) symptoms cross-sectionally, there is limited research investigating the potential directions of these effects or the longitudinal effects over multiple assessment points. We investigated the role of general self-efficacy in experiences of IPV and PTSD symptoms across time among 411 women veterans of the U.S. Armed Forces. Online survey data were collected at baseline (Time 1; T1), 18 months after baseline (Time 2; T2), and 2 years after baseline (Time 3; T3). Structural equation models were used to test hypotheses that T2 general self-efficacy would mediate reciprocal associations between IPV experiences and PTSD symptoms while controlling for T2 IPV experiences, T1 PTSD symptoms, and demographic and military covariates (i.e., age, military sexual trauma, and combat exposure). Specifically, we hypothesized that T2 general self-efficacy would mediate the association between (a) T1 IPV experiences and T3 IPV experiences, (b) T1 IPV experiences and T3 PTSD symptoms, (c) T1 PTSD symptoms and T3 IPV experiences, and (d) T1 PTSD symptoms and T3 PTSD symptoms. Findings revealed that T1 PTSD symptoms predicted lower T2 general self-efficacy, and, in turn, lower T2 general self-efficacy was associated with higher T3 IPV experiences, 95% CI [0.06, 0.41]; no other hypotheses were supported. The findings speak to the importance of clinical interventions which promote general self-efficacy as well as assess and treat PTSD symptoms among women who experience IPV.

Exploring the association between anticipated and actual responses to disclosures of intimate partner violence and sexual assault.

Victims of intimate partner violence (IPV) and sexual assault (SA) commonly disclose their experiences to friends or family members, or within other personal relationships. Disclosure recipients' responses to these disclosures are associated with victims' mental health. Previous research has separately measured both actual responses to IPV/SA and anticipated responses to IPV/SA (e.g., response to a hypothetical scenario) from the perspective of disclosure recipients. Yet, little research has described the association between disclosure recipients' anticipated and actual responses. The aim of the current paper was to use a prospective design to examine the association between disclosure recipients' anticipated and actual responses to IPV/SA, including positive and negative social reactions, perceptions of victim responsibility, empathy, and confusion and ineffectiveness about how to respond. Participants (N = 126 college students aged 18-23; 70.6% women) answered questions about their anticipated responses to a hypothetical IPV/SA disclosure scenario, and then six months later answered the same questions about their actual responses to an actual disclosure of IPV/SA. Although most anticipated and actual responses were significantly associated, associations were moderate in size. Some associations were stronger for participants with a closer relationship to the victim, for participants who had their own victimization history, for women, and for men. Individuals can predict their responses to some degree, but are not totally accurate in doing so.

Associations between traumatic brain injury from intimate partner violence and future psychosocial health risks in women.

OBJECTIVE: The effects of traumatic brain injury (TBI) incurred during military service are widely studied; however, less is known about TBI resulting from intimate partner violence ("IPV-related TBI"). Women Veterans are at high risk for IPV, yet no research has examined future psychosocial health risks associated with IPV-related TBI history in this population. METHODS: We examined psychiatric and physical health outcomes, as well as IPV, in a sample of women Veterans who, at Time 1, reported IPV-related TBI with (n = 13) or without (n = 20) persistent symptoms; that is, symptoms such as memory problems, balance problems or dizziness, sensitivity to bright light, irritability, headaches, and sleep problems that began or got worse immediately following the IPV-related TBI and occurred within the past week. These women completed web-based surveys 18 months later (Time 2), which included validated measures of psychiatric and physical health symptoms as well as past-year IPV. We conducted linear regressions to model whether T1 IPV-related TBI with persistent symptoms predicted worse health outcomes at T2, in comparison to T1 IPV-related without persistent symptoms. RESULTS: Controlling for significant covariates (i.e., military sexual trauma; MST), IPV-related TBI with persistent symptoms at Time 1 was associated with significantly worse outcomes at Time 2 across all health outcome domains (sr2 range: 0.12-0.37). After controlling for MST and probable posttraumatic stress disorder (PTSD) at Time 1, IPV-related TBI with persistent symptoms at Time 1 remained significantly associated with worse Time 2 symptoms of insomnia, depression, and physical health (sr2 range: 0.12-0.25). CONCLUSION: Women who experience IPV-related TBI with persistent symptoms are at higher risk for worse psychosocial health outcomes 18 months later. Findings necessitate screening IPV survivors for TBI with persistent symptoms and tailoring TBI and psychosocial interventions to reduce risk for ongoing health sequelae.

Traumatic brain injury and PTSD symptoms as a consequence of intimate partner violence.

OBJECTIVE: To effectively diagnose and treat women who have experienced intimate partner violence (IPV), it is important to identify the full range of physical and mental health consequences, including hidden wounds such as traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). We aimed to identify the occurrence of IPV-related TBI and associated PTSD symptoms among women veterans who experienced IPV. METHODS: A web-based survey was administered in 2014 to a national sample of U.S. women veterans. Among 411 respondents (75% participation rate), 55% reported IPV during their lives. These participants (N=224) completed screening measures of IPV-related TBI, PTSD, and past-year IPV and comprised the current sample. RESULTS: A total of 28.1% (n=63) met criteria for IPV-related TBI history, and 12.5% (n=28) met criteria for IPV-related TBI with current symptoms. When adjusting for race, income, and past-year IPV, women with IPV-related TBI with current symptoms were 5.9 times more likely to have probable IPV-related PTSD than those with no IPV-related TBI history. Despite symptom overlap between TBI and PTSD, women with IPV-related TBI with current symptoms were significantly more likely to meet criteria for all four DSM-5 PTSD symptom clusters compared to women with an IPV-related TBI history without current symptoms (Cramér's V's=.34-.42). CONCLUSION: Findings suggest there may be clinical utility in screening women who experience lifetime IPV for both TBI and PTSD symptoms in order to help clinicians better target their examinations, treatment, and referrals.

Intimate partner violence among women veterans by sexual orientation.

National estimates suggest intimate partner violence (IPV) rates are equal or higher among lesbian, bisexual, or questioning (LBQ)-identified women than heterosexual-identified women. Women veterans are a population at high risk for IPV, yet the occurrence of lifetime and past-year IPV experiences by sexual orientation have not been examined in this population. Lifetime and past-year IPV experiences and current IPV-related posttraumatic stress disorder (PTSD) symptoms were assessed with validated screening measures as part of a 2014 web-based national survey of women veterans. Among 403 respondents, 9.7% (n = 39) identified as LBQ, and 90.3% (n = 364) identified as heterosexual. When controlling for age, LBQ-identified women veterans were significantly more likely to report lifetime sexual and physical IPV and lifetime intimate partner stalking. In the past year, LBQ-identified veterans were twice as likely to endorse emotional mistreatment and physical IPV, and three times more likely to endorse sexual IPV, than were heterosexual-identified women veterans. However, sexual orientation was unrelated to IPV-related PTSD symptoms, when controlling for age, race, and number IPV forms experienced. IPV is prevalent among LBQ-identified women veterans, suggesting the need to understand the potentially unique contextual factors and health-care needs of this group.

Cognitive emotion regulation strategies as a mediator between cyber dating violence and post-traumatic stress disorder symptoms among college students.

Objective: Cyber dating violence (CDV) is prevalent among emerging adults and could lead to post-traumatic stress disorder (PTSD) symptoms. However, limited research has been conducted on potential mitigating (or exacerbating) factors, such as the use of cognitive emotion regulation strategies (CER). The present study examined whether CER strategies mediate the relationship between CDV and PTSD. Participants: Among a sample of 598 college students, the present study focuses on those who reported past-year CDV (56%; N = 335). Methods: An online survey was completed by college students to assess CDV, CER, and PTSD using validated self-report measures. Results: CDV was bivariately correlated with PTSD symptoms as well as adaptive and maladaptive CER. Within a mediation model, maladaptive (but not adaptive) CER mediated the relationship between CDV and PTSD. Conclusions: CDV is common among college students. Targeting maladaptive CER, such as self-blame and rumination, could lead to reductions in PTSD symptoms.

Are Benefits of Participation Higher Than Risks? An Exploration of Reactions to Participation in Research on Intimate Partner Stalking Among College Young Adults.

Ethical guidelines dictate that research studies should present more benefit than harm to participants, thus, it is important to study participants' reactions to participation, particularly in the context of potentially traumatic topics. While several studies have indicated that positive evaluations of research typically outweigh perceived harms among survivors of physical, sexual, or psychological intimate partner violence, few studies have assessed survivors of intimate partner stalking (IPS) or unwanted pursuit behaviors (UPBs). Among 602 undergraduates (78% women), the present study examined reactions to research participation in a study on IPS/UPBs. Results indicated that, among victims and non-victims of IPS, positive global evaluations and perceived benefits outweighed negative emotional reactions and perceived drawbacks to participation. While some participants (7.5%) reported emotional reactions to participation, most, on average, evaluated the study positively (94.4%), many reported benefits (45.5%), and just one (0.2%) reported drawbacks. Emotional reactions were positively correlated with both drawbacks and benefits of participation. Frequency of UPBs/IPS and IPV were positively correlated with emotional reactions to participation; however, when included in a model with psychological distress (i.e., post-traumatic stress disorder and depressive symptoms), symptom frequencies were more strongly related to reactions to research than victimization variables. In all, research on IPS/UPBs appears to be evaluated generally positively and can likely be undertaken safely when using safeguards to inform participants and debrief them following participation.

Social Reactions to Disclosures of Intimate Partner Stalking and Unwanted Pursuit Behaviors: Associations With PTSD, Academic Outcomes, and Empowerment.

Among college survivors of unwanted pursuit behaviors (UPBs; 40.1%, n = 189) or intimate partner stalking (IPS, i.e., UPBs causing emotional distress; 32.1%, n = 151), the present study examined effects of social reactions to disclosures on post-traumatic stress disorder (PTSD) symptomatology, academic outcomes, and personal empowerment. Compared to UPB survivors, IPS survivors were more likely to disclose and reported higher positive and negative reactions to disclosure as well as greater frequency of UPBs/IPS, IPV, and PTSD symptoms. Among both groups, only negative social reactions were positively associated with PTSD symptoms. However, among IPS (but not UPB) survivors, only positive social reactions were related to academic outcomes and empowerment when controlling for PTSD and IPS frequency. Implications for research and practice are discussed.

College students' perceptions of alcohol's role in disclosures of sexual assault and intimate partner violence.

Objective: Much is known about how alcohol increases the risk of sexual assault or intimate partner violence victimization during college. This research qualitatively explores perceptions about how alcohol influences disclosures about these events to informal supports. Participants: Participants included college students who received a disclosure wherein they or the survivor were drinking during the disclosure (n = 81). Methods: Responses were coded with regard to who was drinking and whether the effect of drinking during the disclosure was perceived as positive, negative, mixed, or neutral/none. Results: Participants perceived alcohol to have both positive (e.g., increasing the likelihood of discussing difficult topics) and negative (e.g., cognitive impairment increased negative emotions) effects on disclosures. Conclusion: Prevention and intervention efforts should identify targeted strategies (e.g., remembering one or two easy and helpful phrases; revisiting the topic again while sober) to help survivors and disclosure recipients have constructive conversations in the presence of alcohol.

Do Women's Coping Responses to Unwanted Pursuit Behaviors Reduce Future Victimization? A Prospective Exploration.

While some studies have assessed perceptions of the effectiveness of coping responses to unwanted pursuit behavior (UPB) victimization, there is limited research assessing the prospective effectiveness of various coping responses in reducing victimization. The current study assessed the effectiveness of a range of coping responses in reducing UPB victimization over an 8-week timeframe. Undergraduate women who had reported experiencing two or more incidents of UPB following the break-up with a man within the past 3 years (N =181) completed measures on coping responses. Whereas Moving Against and Moving Toward responses were bivariately correlated with increases in UPB victimization across the 8-week interim, in a multivariate model, none of the coping responses were associated with Time 2 UPB victimization; rather, higher frequencies of both Time 1 UPB victimization and concurrent Time 2 intimate partner violence predicted Time 2 UPB victimization. More research and replication studies are needed since the results here suggest that current UPB response recommendations (e.g., changing social media accounts, maintaining a log of contact from the perpetrator) do not result in reductions in victimization; further research is needed to identify responses that do result in a reduction of unwanted pursuit.

Nonconsensual Distribution of Sexually Explicit Images Within a Context of Coercive Control: Frequency, Characteristics, and Associations with Other Forms of Victimization.

The present study examined the frequency and characteristics of nonconsensual distribution of sexually explicit images (NCD) among undergraduates (n = 496) and its co-occurrence with other forms of interpersonal violence (e.g., physical, sexual, and psychological abuse). Overall, 17.34% of participants reported NCD victimization; most were women (90.70%). Women who reported NCD from current/former partners (71.79%), compared to non-romantic acquaintances, reported more additional interpersonal violence from the same perpetrator and marginally higher threats of NCD, but were no more likely to receive NCD demands. NCD appears to occur within a pattern of elevated violence; prevention and intervention efforts are needed.

Predictors of uptake and retention in an intervention to improve social reactions to disclosures of sexual assault and partner abuse.

Objective Examine uptake (e.g., initial session participation) and retention (e.g., booster session participation) in an intervention about responding to sexual assault and partner abuse disclosures. Participants: Participants were 836 students (primarily White; upper-middle class) at a medium-sized university. Method: Participants completed baseline surveys, were invited to a two-session intervention, and responded to a follow-up survey. Results: Initial session attendance was 36.2% (n = 303); of those, 83.1% (n = 252) attended the booster. Female, sexual minority students, and students with fewer prior negative reactions, and higher initial session satisfaction were more likely to attend than other students. Participants' reported reasons for not attending included scheduling problems and topic discomfort. Participants reported that remote attendance and higher cash incentives would have made attendance more likely. Conclusion: Findings indicate the draw of cash incentives, a need to reach high-risk students and integrate into existing organizations, and the potential for individualized prevention.

Prospective mental health effects of intimate partner stalking among women veterans.

OBJECTIVE: Women veterans are disproportionately affected by intimate partner violence (IPV). Within the civilian literature, intimate partner stalking (IPS) is a common, uniquely deleterious form of IPV; the present study seeks to prospectively examine the psychological effects of IPS among women veterans. METHOD: Women veterans (n = 266) were recruited using the KnowledgePanel, a probability-based survey panel; participants completed surveys at time 1 (T1) and at time 2 (T2) follow-up 18 months later. Women responded to questionnaires assessing IPV and IPS experiences, and symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety. RESULTS: At T1, 54.5% of women reported lifetime IPV, of whom 64.1% reported IPS; at T2, 49.2% reported past-year IPV, of whom 7.6% experienced past-year IPS. Bivariately, women in the T1 IPS group reported higher T2 PTSD, depression, and anxiety symptoms than the T1 IPV only and no IPV groups. In a multivariate model, there remained indirect effects of T1 IPS on T2 PTSD symptoms, when other forms of violence (i.e., T1 and T2 IPV, MST, IPS) were controlled. CONCLUSIONS: When added to models including other forms of IPV, women who experienced IPS reported increased risk for PTSD symptoms, which predicted heightened PTSD symptoms over time. Providers treating women veterans should assess for experiences of IPS as an additional form of IPV and address PTSD to prevent the development of subsequent comorbid psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Predictors of Disclosure Recipients' Social Reactions to Victims' Disclosures of Dating and Sexual Violence: A Longitudinal Study of College Students.

Dating violence (DV) and sexual violence (SV) are pernicious issues among college students that lead to deleterious outcomes, which are more likely when victims receive more negative social reactions (e.g., blaming the victim) and fewer positive social reactions to disclosure (e.g., providing emotional support). Most research studies have examined victims' reports of social reactions to their assault disclosures, with only a few cross-sectional studies of predictors of disclosure recipients' provision of positive and negative social reactions to victims. The purpose of the current study was to address these gaps in the literature. Participants were 481 college students (76.4% women, 89.2% White/Non-Hispanic) who reported being a disclosure recipient during the past six months (measured at Time 2 to cross-sectionally and longitudinally predict their social reactions to victims' disclosures). Results suggested that both victim and disclosure recipient characteristics (e.g., gender, race), disclosure recipient perceptions of victims (e.g., empathy for victim, blame of victim, victims' coping) and both disclosure recipient and victim behavior at the time of disclosure (e.g., drinking, distress) were related to disclosure recipient social reactions. These findings underscore the need for programs for potential informal disclosure recipients that target psychological variables (e.g., post-traumatic stress disorder) and behavior at the time of disclosure, as well as their perceptions of victims more generally, in addition to improving their knowledge and ability to respond with positive social reactions and avoid negative social reactions.

The Feasibility of a Novel Recruitment Protocol for Collecting Survivor Data via Disclosure Recipient Referrals.

The current arricle describes a novel recruitment protocol for collecting data from sexual assault and intimate partner violence survivors referred to research studies by individuals to whom they had previously disclosed. Challenges in both recruiting participants and interpreting data are described. Only 35.8% of cases had usable data for both survivors and disclosure recipients, suggesting that this referral method had limited success in recruiting matched pairs. Suggestions for modifications to improve the protocol for future research are offered. Potential advantages and drawbacks of various methods for recruiting dyads are described in order to facilitate future research on survivors' disclosure processes, social reactions, and the influence of social reactions on survivor recovery.

A Mixed-Method Process Evaluation of an Intervention to Improve Social Reactions to Disclosures of Sexual Assault and Partner Abuse.

Because of the high rates and deleterious consequences of sexual assault (SA) and partner abuse (PA) on college campuses, there is a proliferation of programming to both prevent and respond to these issues. Most research to date, however, presents outcome evaluation data on these programs and neglects to present process evaluation data which are critical for program refinement and dissemination. The purpose of this study was to present process evaluation data (i.e., acceptability and feasibility) specific to a program that endeavored to increase positive and decrease negative social reactions from disclosure recipients to individuals disclosing SA and PA. Participants were 303 students who completed the program and participated in postintervention surveys and a subset of students (n = 18) who completed exit interviews. Results documented that the program was both feasible and acceptable, as evidenced by high satisfaction ratings. Important suggestions were also provided for how to improve the program, such as reducing repetition and making scenarios more realistic. Finally, participants who reported higher program engagement and more program usage generally reported more intentions to provide positive social reactions, less intentions to provide negative social reactions, and less actual negative social reactions. This information is useful not only for adapting the current program discussed herein but also for program developers and preventionists wishing to create similar programming to effectively prevent and improve response to SA and PA.

A Pilot Evaluation of an Intervention to Improve Social Reactions to Sexual and Partner Violence Disclosures.

The purpose of this study was to evaluate an intervention (Supporting Survivors and Self [SSS]) created to increase positive social reactions and decrease negative social reactions to sexual assault and partner violence disclosures among informal support disclosure recipients. Participants were 1,268 college students from a medium-sized New England university who completed an online baseline survey and were assigned to either the treatment or control condition. The SSS intervention trained potential informal supports on what to say and not to say to disclosure recipients. Six months after the SSS intervention, participants in both conditions completed the follow-up survey online. Although intentions to provide positive social reactions significantly increased among participants in the treatment group compared with the control group and there were marginally significant effects in the anticipated directions for alcohol-specific intended social reactions, no overall difference was observed across conditions in actual social reactions provided. Moderation analyses suggested that, in general, the SSS intervention was more effective on various outcomes for students who were younger, male, non-White, sexual minorities, and/or non-victims. Moderation analyses also suggested that the intervention varied in efficacy depending on the circumstances of the disclosure. Despite the mixed outcomes of the SSS intervention, these data suggest that the SSS intervention was effective in improving social reactions for some students and under some circumstances. Future research is needed to further refine the SSS intervention to bolster its effectiveness in reducing negative social reactions and increasing positive social reactions for all students.