Formal Reporting of Identity-Based Harassment at an Academic Medical Center: Incidence, Barriers, and Institutional Responses.

PURPOSE: To examine the incidence of, barriers to, and institutional responses to formal reporting of experiences of identity-based harassment at an academic medical center. METHOD: The authors invited 4,545 faculty and medical trainees at the University of Michigan Medical School to participate in a 2018 survey about civility and respect. This analysis focused on respondents who indicated experiencing at least 1 form of identity-based harassment (sexual harassment, gender policing harassment, heterosexist harassment, racialized sexual harassment) within the past year, perpetrated by staff, students, and faculty or by patients and patients' families. The authors assessed the incidence of formally reporting harassment to someone in authority, barriers to reporting, and institutional responses following reporting. RESULTS: Among the 1,288 (28.3%) respondents with usable data, 83.9% (n = 1,080) indicated experiencing harassment. Of the harassed individuals, 10.7% (114/1,067), including 13.1% (79/603) of cisgender women and 7.5% (35/464) of cisgender men, indicated they formally reported their harassment experiences. Among these reporters, 84.6% (66/78) of cisgender women and 71.9% (23/32) of cisgender men indicated experiencing positive institutional remedies. Many reporters indicated experiencing institutional minimization (42.9% [33/77] of cisgender women; 53.1% [17/32] of cisgender men) or retaliation (21.8% [17/78] of cisgender women; 43.8% [14/32] of cisgender men). Cisgender men were significantly more likely to indicate experiencing specific negative institutional responses, such as being considered a troublemaker (OR 3.56, 95% CI: 1.33-9.55). Among respondents who did not formally report harassment experiences, cisgender women were significantly more likely to cite concerns about institutional retaliation, such as being given an unfair performance evaluation or grade (OR 1.90, 95% CI: 1.33-2.70). CONCLUSIONS: Most respondents who experienced harassment did not formally report it to anyone in authority. Many reporters faced institutional minimization and retaliation. These findings suggest a need to reshape institutional harassment prevention and response systems in academic medicine.

The Embodiment of Insult: A Theory of Biobehavioral Response to Workplace Incivility.

This article builds a broad theory to explain how people respond, both biologically and behaviorally, when targeted with incivility in organizations. Central to our theorizing is a multifaceted framework that yields four quadrants of target response: reciprocation, retreat, relationship repair, and recruitment of support. We advance the novel argument that these behaviors not only stem from biological change within the body but also stimulate such change. Behavioral responses that revolve around affiliation and produce positive social connections are most likely to bring biological benefits. However, social and cultural features of an organization can stand in the way of affiliation, especially for employees holding marginalized identities. When incivility persists over time and employees lack access to the resources needed to recover, we theorize, downstream consequences can include harms to their physical health. Like other aspects of organizational life, this biobehavioral theory of incivility response is anything but simple. But it may help explain how seemingly "small" insults can sometimes have large effects, ultimately undermining workforce well-being. It may also suggest novel sites for incivility intervention, focusing on the relational and inclusive side of work. The overarching goal of this article is to motivate new science on workplace incivility, new knowledge, and ultimately, new solutions.

See no evil, hear no evil, speak no evil: Theorizing network silence around sexual harassment.

#MeToo has inspired the voices of millions of people (mostly women) to speak up about sexual harassment at work. The high-profile cases that reignited this movement have revealed that sexual harassment is and has been shrouded in silence, sometimes for decades. In the face of sexual harassment, managers, witnesses and targets often remain silent, wittingly or unwittingly protecting perpetrators and allowing harassment to persist. In this integrated conceptual review, we introduce the concept of network silence around sexual harassment, and theorize that social network compositions and belief systems can promote network silence. Specifically, network composition (harasser and male centrality) and belief systems (harassment myths and valorizing masculinity) combine to instill network silence around sexual harassment. Moreover, such belief systems elevate harassers and men to central positions within networks, who in turn may promote problematic belief systems, creating a mutually reinforcing dynamic. We theorize that network silence contributes to the persistence of sexual harassment due to the lack of consequences for perpetrators and support for victims, which further reinforces silence. Collectively, this process generates a culture of sexual harassment. We identify ways that organizations can employ an understanding of social networks to intervene in the social forces that give rise to silence surrounding sexual harassment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Incidence and Group Comparisons of Harassment Based on Gender, LGBTQ+ Identity, and Race at an Academic Medical Center.

Background: A key recommendation from the landmark National Academies report called for research examining experiences of underrepresented and/or vulnerable groups, including people of color and sexual- and gender-minority people. We examine the prevalence of gender policing harassment (GPH), heterosexist harassment (HH), and racialized sexual harassment (RSH), by gender, LGBTQ+, race, and department grouping, which has not been previously examined in academic medicine. Materials and Methods: All faculty (n = 2723), fellows, residents, and first through third year medical students (n = 1822) at the University of Michigan Medical School (UMMS) who had been working at the organization for at least 1 year were invited to complete a 20-minute online survey. We assessed harassment within the past year, perpetrated by insiders (i.e., staff, students, and faculty) and from patients and patients' families. Results: A total of 705 faculty (25.9% of the targeted sample) and 583 trainees (32.0% of the targeted sample) were in the analytic sample. Women were significantly more likely to experience GPH from both sources than men, and LGBTQ+ individuals were more likely to face HH from both sources than cisgender heterosexual participants. Underrepresented minorities, Asian/Asian American, and female participants had higher rates of RSH perpetrated by insiders. There were significant department-group differences across harassment types. Conclusions: Less-studied forms of harassment are common within academic medicine and are perpetrated from various sources. Identity-based harassment should be investigated further to gain a comprehensive understanding of its impact within academic medicine. Clinical Trial Registration Number not applicable.

Disrespect at Work, Distress at Home: A Longitudinal Investigation of Incivility Spillover and Crossover Among Older Workers.

The prevalence of workplace mistreatment toward older adults is well-documented, yet its effects are understudied. We applied the strength and vulnerability integration model (SAVI) to hypothesize that, despite its low intensity, workplace incivility has numerous deleterious outcomes for older employees over time. Specifically, we investigated whether and how incivility relates to well-being outside of work, among both targeted employees and their partners. We drew on affective events theory to examine how incivility "spills over" to older targets' personal lives. We also tested whether incivility is potent enough to "crossover" to the well-being of older targets' partners at home. Based on longitudinal data from a national study of older workers (N = 598; 299 couples), results demonstrate that workplace incivility related to decrements in targets' affective well-being, which in turn, was associated with life dissatisfaction, interference with work, and lower overall health. Workplace incivility also predicted declines in partner well-being, although these crossover effects varied by gender: Men's postincivility affective well-being predicted their female partners' life satisfaction but not vice versa. However, women's uncivil experiences directly related to the affective well-being of their male partners. These results suggest that for both older workers and their partners, the harms of incivility eventually extend beyond the organizations where they originate.

#MedToo: A Large-Scale Examination of the Incidence and Impact of Sexual Harassment of Physicians and Other Faculty at an Academic Medical Center.

Background: A landmark National Academies report highlighted the need for rigorous evaluation of sexual harassment in medicine. We examined the prevalence and impact of sexual harassment using the Sexual Experiences Questionnaire, the standard for measurement of sexual harassment, but which has not been previously applied within academic medicine. Materials and Methods: A 20-minute online survey was administered to all faculty who had been working at University of Michigan Medical School for at least 1 year (n = 2723). We assessed sexual harassment within the past year from insiders (i.e., from staff, students, and faculty) and from patients and patients' families. We also evaluated mental health, job satisfaction, sense of safety at work, and turnover intentions. Results: In the final sample (n = 705; which included 25.9% of the originally targeted population), most respondents, 82.5% of women and 65.1% of men, reported at least one incident of sexual harassment from insiders in the past year; 64.4% of women and 44.1% of men reported harassment from patients and patients' families. The most frequently experienced dimension of sexual harassment for women and men was sexist gender harassment. Increased experiences of harassment were independently associated with lower mental health, job satisfaction, and sense of safety at work, as well as increased turnover intentions, with no significant interactions by gender. Conclusions: Sexual harassment against medical faculty is alarmingly common at an institution that is not expected to be atypical. Interventions must address sexual harassment, which affects mental health and career outcomes of male and female physicians.

Advocating alternatives to mandatory reporting of college sexual assault: Reply to Newins (2018).

Our recent article "Compelled Disclosure of College Sexual Assault" examines college and university policies requiring most, if not all, employees to report student disclosures of sexual assault to university authorities, with or without student consent. We provided evidence that these mandatory reporting policies have become ubiquitous in American higher education, despite limited evidence of their safety or efficacy. Commenting on our article, Newins offers helpful advice for psychologists navigating the role of "responsible employee," such as seeking out information about their campus policy for reporting sexual assault disclosures and informing students of reporting mandates. The comment concludes with a call for researchers to investigate the many questions that remain unanswered about these policies. We agree with Newins's recommendations and, in this reply, encourage psychologists to push the envelope further. In addition to better understanding and managing reporting responsibilities, psychologists should advocate for policies that respect survivor autonomy, dignity, and right to self-determination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Compelled disclosure of college sexual assault.

Sexual assault is a widespread problem on college campuses. In response, many institutions are developing policies mandating that certain employees report any student disclosure of sexual assault to university officials (and, in some cases, to police), with or without the survivor's consent. These policies, conceptualized here as compelled disclosure, have been prompted and shaped by federal law and guidance, including Title IX and The Clery Act. Proponents of compelled disclosure assert that it will increase reports-enabling universities to investigate and remedy more cases of sexual assault-and will benefit sexual assault survivors, university employees, and the institution. However, many questions remain unanswered. How broad (or narrowly tailored) are contemporary compelled disclosure mandates in higher education? Do any empirical data support assumptions about the benefits of these policies? Are there alternative approaches that should be considered, to provide rapid and appropriate responses to sexual violence while minimizing harm to students? The current article begins with an overview of federal law and guidance around compelled disclosure. Next, a content analysis of a stratified random sample of 150 university policies provides evidence that the great majority require most, if not all, employees to report student sexual assault disclosures. A review of the literature then suggests that these policies have been implemented despite limited evidence to support assumptions regarding their benefits and effectiveness. In fact, some findings suggest negative consequences for survivors, employees, and institutions. The article concludes with a call for survivor-centered reforms in institutional policies and practices surrounding sexual assault. (PsycINFO Database Record

The evolving landscape of Title IX: Predicting mandatory reporters' responses to sexual assault disclosures.

Approximately 1 in 4 women is sexually assaulted in college, a problem that federal law has attempted to address with recent changes. Under the evolving landscape of Title IX, and related law, universities nationwide have overhauled their sexual assault policies, procedures, and resources. Many of the new policies designate undergraduate resident assistants (RAs) as Responsible Employees-requiring them to provide assistance and report to the university if a fellow student discloses sexual assault. We investigated factors that predict the likelihood of RAs enacting their policy mandate, that is, reporting sexual assault disclosures to university authorities and referring survivors to sexual assault resources. Based on data from 305 Responsible Employee RAs, we found that likelihood to report and refer varied, depending on RAs' knowledge of reporting procedures and resources, trust in these supports, and perceptions of mandatory reporting policy. Understanding mandatory reporter behavior is crucial, because help-providers' responses can have serious implications for the recovery of sexual assault survivors. Our findings elucidate some effects of changes in the interpretation and implementation of Title IX, with potential to inform the development of more theoretically and empirically informed policies. (PsycINFO Database Record

"It Happens to Girls All the Time": Examining Sexual Assault Survivors' Reasons for Not Using Campus Supports.

Sexual assault is a prevalent problem in higher education, and despite the increasing availability of formal supports on college campuses, few sexual assault survivors use them. Experiencing sexual assault can have devastating consequences on survivors' psychological and educational wellbeing, which may intensify if survivors do not receive adequate care. Drawing from existing theoretical frameworks and empirical research, this study used a mixed methodological approach to examine why survivors did not use three key campus supports-the Title IX Office, the sexual assault center, and housing staff-and if these reasons differed across the three supports. Using data from 284 women who experienced sexual assault in college, our qualitative findings identified four overarching themes, including logistical issues (e.g., lacking time and knowledge), feelings, beliefs, and responses that made it seem unacceptable to use campus supports, judgments about the appropriateness of the support, and alternative methods of coping. Quantitative findings revealed that survivors' reasons for not seeking help differed across supports. Collectively, our findings suggest that community norms and institutional policies can make it challenging for survivors to use campus supports. We propose several suggestions for institutional change (e.g., taking a stronger stance against "less serious" forms of sexual assault, reducing a quasi-criminal justice approach to investigation and adjudication, limiting mandated reporting).

(Missing) Knowledge About Sexual Assault Resources: Undermining Military Mental Health.

In 2005, the Department of Defense reformed military sexual assault (MSA) prevention and response efforts. However, research suggests that some Service members may not be informed of MSA resources. We examined how lacking such knowledge may undermine psychological well-being (i.e., symptoms of depression and posttraumatic stress) among MSA survivors as well as Service members who feel unsafe from MSA. The data were collected by the DoD in 2010 and sampled active duty Service women and men. Experiencing MSA, feeling unsafe from MSA, and lacking knowledge of MSA resources predicted greater psychiatric symptoms. Service members who felt unsafe from MSA reported greater psychiatric symptoms as a function of lacking knowledge of MSA resources. Findings suggest that education about sexual assault resources may be critical for the protection of mental health-among survivors and nonvictims alike.

Observed Workplace Incivility toward Women, Perceptions of Interpersonal Injustice, and Observer Occupational Well-Being: Differential Effects for Gender of the Observer.

The present study examined perceptions of interpersonal injustice as a mediator of the relationship between observed incivility toward women at work and employees' occupational well-being. We also examined gender of the observer as a moderator of these mediational relationships. Using online survey data from 1702 (51% women; 92% White) employees, results showed that perceptions of injustice partially mediated the relationship between observed incivility toward women and job satisfaction, turnover intentions, and organizational trust. Men reported greater perceptions of injustice than did women the more they observed the uncivil treatment of women at work, and the indirect effects of observed incivility toward women on well-being were stronger for men compared to women. Observed incivility toward women also had direct relationships with the occupational well-being outcomes over and above the impact mediated through injustice, particularly for women. Specifically, observing incivility toward female coworkers directly related to lowered job satisfaction and perceptions of safety for female bystanders. In addition, although both male and female bystanders reported heightened turnover intentions and lowered trust in the organization with higher levels of observed incivility toward women, these relationships were stronger for female than male observers. Our findings both replicate and extend past research on vicarious workplace incivility toward women.

Sexual assault training in the military: evaluating efforts to end the "invisible war".

Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members' training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD's 2010 annual report on military sexual assault concluded that "most Active Duty members receive effective training on sexual assault" (p. 104). Our results cast doubt on that assertion.

Two sides of the same coin: gender harassment and heterosexist harassment in LGBQ work lives.

This project investigated the incidence, interplay, and impact of gender- and sexuality-based harassment, as experienced by lesbian, gay, bisexual, and queer (LGBQ) employees in higher education. Unlike much queer empirical research, participants in this study were residents of noncoastal regions of the U.S. that are predominantly White, rural, and conservative (i.e., "red states"). They completed surveys about their harassment experiences (gender harassment-sexist, gender harassment-policing, and heterosexist harassment), perceived support systems (from supervisors and organizations), and job attitudes (job burnout, job stress, and job satisfaction). Results showed that gender harassment-both sexist and policing subtypes-rarely occurred absent heterosexist harassment, and vice versa. Harassment severity (experiencing moderate to high levels of all three harassment types) was significantly associated with greater levels of job burnout (both disengagement and exhaustion) and job dissatisfaction. Even infrequent experiences of harassment related to large increases in the "threat" variety of job stress (i.e., sense of feeling hassled and overwhelmed on the job). Additionally, employees who perceived the lowest organizational support reported the most harassment. We interpret results in light of research on organizational behavior and LGBQ psychology. Moreover, we discuss our findings in the context of Title VII, currently interpreted to protect against harassment based on gender, sex, and sex stereotyping, but not sexual orientation. Our results can inform several possible avenues of expanding gay civil rights in employment: broadening judicial interpretations of Title VII, passing new legislation (e.g., the Employment Non-Discrimination Act, or ENDA), and strengthening organizational supports and policies that protect against sexuality-based abuses.

Sex-based harassment in employment: new insights into gender and context.

Legal definitions of sex-based harassment have evolved over the decades; it is important that social science perspectives on this phenomenon evolve as well. This study seeks to refine our understanding of conditions in which sex-based harassment thrives, with empirical evidence from three organizations. Previous research has suggested that underrepresentation of one's gender in the employment context increases risk for sex-based harassment. This work has focused mainly on sexual-advance forms of harassment, mainly in the lives of women. Less is known about the gender harassment of women, or about any kind of harassment of men. Extending this scholarship, we analyzed survey data from women and men working in three diverse domains: academia (N = 847), the court system (N = 1,158), and the military (N = 19,960). Across all samples, the underrepresentation of women in a workgroup related to increased odds of women experiencing gender harassment, but not sexual-advance harassment. For men, the opposite pattern emerged: underrepresentation did not increase men's risk for either type of harassment, instead relating to decreased odds of harassment in some contexts. We interpret these results in light of theories of tokenism, gender stereotyping, and sex role spillover in organizations. Our findings support the recommendation that, to reduce harassment (whether it be illegal or legal, gender- or sexuality-based, targeted at women or men), organizations should strive for gender balance in every job at every level. For male-dominated contexts, this implies a need to recruit, retain, and integrate more women throughout the organizational hierarchy.

Latino/a depression and smoking: an analysis through the lenses of culture, gender, and ethnicity.

Rates of major depressive disorder (MDD) and cigarette smoking increase with Latino/a acculturation, but this varies by gender and ethnic subgroup. We investigated how lived experiences (i.e., discrimination, family conflict, family cohesion, familismo) clustered together in the everyday lives of Latina/os. We further examined associations of cluster profile and Latino/a subgroup with MDD and smoking, and tested whether gender moderated these associations. Data came from the National Latino Asian American Study, which included 2,554 Latino/as (48 % female; mean age = 38.02 years). K-means cluster analysis revealed six profiles of experience, which varied by gender and socio-cultural characteristics. Proportionately more women than men were in groups with problematic family lives. Acculturated Latino/as were disproportionately represented in profiles reporting frequent discrimination, family conflict, and a lack of shared family values and cohesion. Profiles characterized by high discrimination and family problems also predicted elevated risk for MDD and smoking. Findings suggest that Latino/a acculturation comes jointly with increased discrimination, increased family conflict, and reduced family cohesion and shared family values, exacerbating risk for MDD and smoking. This research on pathways to depression and smoking can inform the development of targeted assessment, prevention, and intervention strategies, tailored to the needs of Latino/as.