Development and Validation of a BMI-Based Figure Rating Scale for Chinese Adolescents.

Figure rating scales (FRS) have been widely used to measure body dissatisfaction. In the current study, an FRS based on body mass index (BMI) and body shape of Chinese adolescents (C-BMI-FRS) was developed and validated. The perceived actual figure chosen from C-BMI-FRS by 2,237 Chinese adolescents aged 15-18 years old correlated strongly with BMI (r = .83 in girls and r = .80 in boys). Additionally, there was a strong relation between actual and ideal figure discrepancy (AID) scores and measures of body satisfaction (r = -.54 in girls, r = -.28 in boys) and eating disorder symptoms (r = .54 in girls, and r = .52 in boys). There also were moderate associations of AID scores with self-esteem (r = -.16) and negative affect (r = .18) in girls. Test-retest reliability over an 8- to 10 -week interval exceeded .57 for actual figure, ideal figure, and AID scores. Overall, findings support the utility of C-BMI-FRS as a measure of body dissatisfaction among Chinese adolescents.

Validation of the Chinese Version of the Body Image Concern Inventory.

The Body Image Concern Inventory (BICI) was developed to assess dysmorphic appearance concern and has been found to be a reliable and valid instrument in Western societies. To examine the psychometric properties of a new Chinese BICI, the BICI was administered to 1,231 Chinese young adults (Study 1) and 47 female patients with eating disorders and 56 matched controls (ED; Study 2). In study 1, Cronbach's alpha of .92 and test-retest reliability of .73 over a 6-month interval was observed for the total scale. Confirmatory factor analysis supported a 3-factor model for the BICI: avoidant behaviors (AB), safety behaviors against perceived flaws (SB), and negative appearance evaluation (NE). In study 2, ED patients scored significantly higher on the BICI total and three subscale scores than controls. In addition, AB best differentiated ED patients and matched controls (Cohen's d = 1.52); SB best differentiated between the non-clinical female and male groups (Cohen's d = 0.75); NE was most closely associated with level of negative affect and subjective well-being (inverse relationship) in both clinical and non-clinical groups. In conclusion, the Chinese BICI is a reliable and valid tool for evaluating dysmorphic appearance concern among Chinese speakers.

College Campus Community Readiness to Address Intimate Partner Violence Among LGBTQ+ Young Adults: A Conceptual and Empirical Examination.

This paper provides an overview of a conceptual model that integrates theories of social ecology, minority stress, and community readiness to better understand risk for and outcomes of intimate partner violence (IPV) among LGBTQ+ college students. Additionally, online survey data was collected from a sample of 202 LGBTQ+ students enrolled in 119 colleges across the United States to provide preliminary data on some aspects of the proposed model. Results suggested that students generally thought their campuses were low in readiness to address IPV; that is, students felt that their campuses could do more to address IPV and provide IPV services specific to LGBTQ+ college students. Perceptions of greater campus readiness to address IPV among LGBTQ+ college students was significantly and positively related to a more favorable LGBTQ+ campus climate and a greater sense of campus community. Additionally, IPV victims were more likely to perceive higher levels of campus community readiness than non-IPV victims. There was no association between IPV perpetration and perceptions of campus community readiness. Greater sense of community was marginally and inversely related to IPV victimization and perpetration. Sense of community and LGBTQ+ campus climate also varied to some extent as a function of region of the country and type of institution. Implications for further development and refinement of the conceptual model, as well as future research applying this model to better understand IPV among sexual minority students are discussed.

Violent Attacks and Damaged Victims: An Exploration of the Rape Scripts of European American and African American U.S. College Women.

Scripts are influential in shaping sexual behaviors. Prior studies have examined the influence of individuals' rape scripts. However, these scripts have not been evaluated among diverse groups. The current study examined the rape scripts of African American ( n = 72) and European American ( n = 99) college women. Results supported three rape scripts: the "real rape," the "party rape," and the mismatched intentions rape, that were equally common. However, there were some differences, with African Americans' narratives more often including active victim resistance and less often containing victim vulnerability themes. Societal and cultural influences on rape scripts are discussed.

Therapeutic boundaries in telepsychology: Unique issues and best practice recommendations.

Technology-assisted mental health services are becoming much more routinely utilized by clients and practitioners alike. Clinicians practicing telepsychology must prepare themselves in order to provide competent care in this ever-evolving context of service delivery. Although much has been written with regards to considerations of ethical and legal practice, practical and logistical guidelines, and the advantages and disadvantages of the delivery of services via the use of technology, little to no attention has been paid to issues related to therapeutic boundaries in the telepsychology relationship. Clinicians must consider how to maintain appropriate boundaries in telepsychology settings in order to prevent harm and optimize treatment gains. Such considerations are also necessary given that it is probable that the telepsychology clinician will encounter novel boundary issues that are unlikely to occur in the traditional face-to-face therapy setting. We discuss the clinical utility of boundaries, potential boundary issues in telepsychology settings, and suggested best practice recommendations to ensure competent, ethical, and efficacious treatment in this novel context of service delivery.

Stereotyped beliefs about male and female OB-GYNS: relationship to provider choice and patient satisfaction.

BACKGROUND: Up to 60% of women prefer a female obstetrician-gynecologist (OB-GYN), perhaps in part due to holding negative stereotypes of male providers. However, provider gender stereotypes have not been directly examined. The purpose of the current studies was to evaluate women's stereotypes of male and female OB-GYN providers and the impact of these stereotypes on provider evaluations. METHODS: First, stereotypes of male and female OB-GYNs were elicited from 96 undergraduate women who described the attributes and behaviors of a typical male or female OB-GYN. Next, 126 undergraduate women were randomized to review recordings depicting male or female OB-GYNs engaging in male or female-stereotype congruent behaviors during a well-woman visit. RESULTS: Participants overall had positive stereotypes of female OB-GYNs (e.g. knowledgeable, easy to talk to) but some negative stereotypes of males (e.g. unable to fully understand women's health issues). However, male and female OB-GYNs who engaged in female stereotype-congruent behaviors were similarly preferred over providers who engaged in male-stereotype congruent behavior. CONCLUSION: Women generally regard female OB-GYNs as highly competent, whereas some believe that being male is a disadvantage in providing OB-GYN care. However, providers who engage in behaviors associated with high quality care are evaluated positively, regardless of the provider's gender.

Predicting risky sexual behavior in emerging adulthood: examination of a moderated mediation model among child sexual abuse and adult sexual assault victims.

Although having a sexual victimization history is associated with engaging in sexual risk behavior, the mechanisms whereby sexual victimization increases risk behavior are unclear. This study examined use of sex as an affect regulation strategy as a mediator of the relationship between depressive symptoms and sexual risk behavior among 1,616 sexually active college women as well as examined having a history of child sexual abuse (CSA), adolescent/adult sexual assault (ASA), or both (CSA/ASA) as moderators. Results supported the mediated model as well as moderated mediation, where depressive symptoms were more strongly associated with use of sex as an affect regulation strategy among ASA victims, and sex as an affect regulation strategy was more strongly related to sexual risk behavior for CSA/ASA victims.

Perceptions of similarity and responsibility attributions to an acquaintance sexual assault victim.

Individuals view similar rape victims as less responsible for the rape than victims perceived as dissimilar. However, it is unclear if individuals hold victims they perceive as similar less responsible for the assault, or if individuals view themselves as more similar to victims they do not view as responsible for the assault. The current study, therefore, examined the temporal relationship between these constructs. A total of 167 college women listened to a date narrative that ended in sexual assault, consensual sex, or no sexual activity (these last two served as controls). Results supported that participants viewed themselves as less similar to the woman in the narrative when the date ended in sexual assault. Only similarity ratings made following learning that the woman was sexually assaulted predicted responsibility attributions suggesting that viewing a victim as responsible for the assault results in decreased perceptions of similarity toward her. Implications and suggestions for future research are discussed.

Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women.

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds.

The association between sexual assault and suicidal activity in a national sample.

Sexual violence is a potential key risk factor for adolescent suicidal behavior but has not been studied extensively. Thus, the current study examined the extent to which sexual assault predicted suicide attempts among adolescent students in the national Youth Risk Behavior Surveillance System survey (2007 data). Gender differences in suicidal behavior overall and among sexual assault victims were examined. The results supported that students with sexual assault histories were significantly more likely (odds ratio [OR]=6.4) to have reported at least one suicide attempt in the past year than students who did not report sexual assault histories. Male students with a sexual assault history reported suicide attempts requiring medical attention more frequently than male attempters without sexual assault histories, as well as both groups of female suicide attempters. Implications of the findings for suicide prevention and intervention programs are discussed.

Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas.

A sizable body of research supports trauma's cumulative nature. However, few studies have evaluated potential mechanisms through which the experience of multiple traumas leads to elevated distress. The current study sought to evaluate differences between sexual trauma victims and women who had not experienced sexual trauma in their adjustment following a mass trauma (college women exposed to the 2007 Virginia Tech campus shooting). In addition, the study examined whether maladaptive schema change (lower self-worth and less belief in benevolence) and social support mediated the relationship between experiencing multiple traumas (sexual trauma and the campus shooting) and distress. The sample consisted of 215 college women who were assessed preshooting as well as two months and one year following the campus shooting. Women who had experienced sexual trauma (either contact sexual abuse or sexual assault) were compared to those who had not on their one-year postshooting PTSD and depressive symptoms. Results supported that sexual trauma victims reported significantly more depressive symptoms and shooting-related PTSD as well as less belief in benevolence and lower family support. Family support and benevolence beliefs at the two month postshooting assessment were significant medi-ators of the association between sexual trauma history and depression and PTSD. Implications of the findings for future research evaluating the cumulative impact of multiple traumatic experiences are discussed.

Social support, world assumptions, and exposure as predictors of anxiety and quality of life following a mass trauma.

This study examined the influence of a mass trauma (the Virginia Tech campus shootings) on anxiety symptoms and quality of life, as well as the potential vulnerability/protective roles of world assumptions and social support. Pre-trauma adjustment data, collected in the six months prior to the shooting, was examined along with two-month post-shooting data in a sample of 298 female students enrolled at the university at the time of the shootings. Linear regression analyses revealed consistent predictive roles for world assumptions pertaining to control and self-worth as well as family support. In addition, for those more severely exposed to the shooting, greater belief in a lack of control over outcomes appeared to increase vulnerability for post-trauma physiological and emotional anxiety symptoms. Implications of the results for research and intervention following mass trauma are discussed.

Evaluation of an information processing model following sexual assault.

There is growing recognition that individuals vary in their response to traumatic experiences. Resick and Schnicke (1992) developed an information processing model of trauma response patterns, theorizing that individuals vary in how they integrate the experience into their schematic beliefs. Specifically, individuals can respond to trauma by assimilation, altering the trauma to fit with extant schemas; accommodation, altering extant schemas; or over-accommodation, engaging in maladaptive schema change. Littleton (2007) supported that these response patterns are reflected in distinct coping patterns among rape victims. The current study utilized latent profile analysis (LPA) to replicate Littleton's (2007) findings in a sample of 340 college rape victims, as well as evaluated the extent to which these response patterns were related to distress, trauma-related schemas, re-victimization risk behaviors, and re-victimization. Results of the LPA supported the existence of the three response patterns. In addition, victims classified into the three response patterns differed in their distress, adherence to trauma-related schemas, and re-victimization risk behaviors. While no significant differences in re-victimization rates were found, re-victimization was common. Implications of the findings for future research and intervention are discussed.

Psychosocial stress during pregnancy and perinatal outcomes: a meta-analytic review.

The objective of this study was to evaluate the relationship between psychosocial stress in pregnancy and negative perinatal outcomes and to identify key moderators of this relationship. To evaluate this relationship, a meta-analytic review was conducted of studies that prospectively assessed the relationship between psychosocial stress in pregnancy and perinatal outcomes. A total of 35 studies, written or published between 1991 and 2009, involving 31,323 women were located. The overall association between psychosocial stress and negative perinatal outcomes was significant, but negligibly small in size (r (35) = -0.04, CI = -0.08, -0.01). Examining specific perinatal outcomes, only the associations with neonatal weight (r (14) = -0.07, CI = -0.03, -0.01) and risk for low birth weight (r (5) = 0.07, CI = 0.03, 0.10) were statistically significant, but again, very small. Results support that psychosocial stress explains a negligible to very small amount of the variability in perinatal outcomes. Future research should focus on identifying other psychosocial and lifestyle variables that alone or in interaction with other factors explain larger amounts of the variability in perinatal outcomes. Future research should also examine whether psychosocial stress increases risk for negative outcomes in combination with other biomedical and psychosocial risk factors.

The impact of social support and negative disclosure reactions on sexual assault victims: a cross-sectional and longitudinal investigation.

Social support is an important factor in posttrauma adjustment. However, little research has simultaneously evaluated helpful and harmful aspects of support on victims' post-assault adjustment, as well as the relationships among these variables over time. The current study evaluated perceived support and negative disclosure reactions as predictors of post-assault factors in a sample of 262 college rape victims. Of these women, 74 completed a 6-month follow-up. Analyses suggested that perceived support and negative disclosure reactions may play unique roles in victims' adjustment. Implications for future research examining the role of different aspects of support in posttrauma recovery are discussed.

An evaluation of health care providers' sexual violence screening practices.

OBJECTIVE: To evaluate whether health care providers (HCPs) screen women and provide them with information about sexual violence and how women receive this information. STUDY DESIGN: A multiethnic sample of 945 low-income women recruited from family planning clinics responded to an anonymous survey regarding their discussions with HCPs about sexual violence. RESULTS: Forty-eight percent of women reported that they had been screened or given information about sexual violence by a HCP. Only 6% of women expressed discomfort with being screened, and more than 95% found the information given to them by HCPs to be helpful. Latina, less educated, and monolingual Spanish-speaking women were less likely to have been screened or provided information. CONCLUSION: Women find discussions of sexual violence by their HCPs to be helpful and nonintrusive. Educational, linguistic, and cultural factors appear to affect the likelihood that HCPs discuss sexual violence with their patients.

Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis.

OBJECTIVE: The purpose of this study was to identify correlates of anxiety symptoms during pregnancy and determine the strength of the relationship between anxiety symptoms and adverse perinatal outcomes. STUDY DESIGN: A meta-analytic review was conducted of studies that evaluated the relationship between self-reported anxiety symptoms during pregnancy and potential correlates or perinatal outcomes. RESULTS: Fifty studies of 48 samples of women met inclusion criteria. Anxiety symptoms during pregnancy were associated with a number of psychosocial variables including depressive symptoms (r = 0.66), stress (r = 0.40), and self-esteem/self-worth (r = -0.47). There were no significant associations of anxiety symptoms with perinatal outcomes (all rs < 0.19). CONCLUSION: Anxiety symptoms during pregnancy appear to be associated with similar psychosocial variables as anxiety at other times. There is no evidence of an association of anxiety symptoms with adverse perinatal outcomes among those studied thus far. However, significant gaps still exist in the literature in this area.

Rape acknowledgment and postassault experiences: how acknowledgment status relates to disclosure, coping, worldview, and reactions received from others.

Many rape victims are unacknowledged. These victims do not label their experience as rape; instead they give the experience a more benign label, such as a miscommunication. The current study examined the relationship between victims' acknowledgment status and post-assault behaviors, moving beyond prior research. Analyses of covariance were conducted comparing the post-assault experiences of unacknowledged and acknowledged college rape victims (n = 256), controlling for differences in victims' assault characteristics, multiple victimization, and post-traumatic stress symptoms. Results supported that unacknowledged and acknowledged victims differed in their coping, disclosure, belief in justice, and receipt of egocentric reactions following disclosure. Implications for future work examining the dynamic interplay among assault characteristics, sexual scripts, acknowledgment status, and post-assault factors are discussed.

Development of the body image concern inventory.

Development of the Body Image Concern Inventory (BICI), a measure designed to assess dysmorphic concern, is described. A panel of expert raters supported the construct validity of the measure, and four college student samples (Ns=184, 200, 56, 40) supported the internal consistency of the BICI. In addition, in studies 1 and 3, concurrent validity was established through comparison of the BICI to extant self-report and interview measures of dysmorphic symptomatology. Convergent validity patterns were assessed through comparison with measures of obsessive-compulsive and eating disorder symptomatology in studies 2 and 4. Finally, the results of study 4 supported that the BICI discriminated individuals with a diagnosis of Body Dysmorphic Disorder or bulimia (disorders that frequently involve high levels of dysmorphic concern) from those with subclinical symptoms. Results suggest that the BICI is a reliable, valid, and user-friendly tool for assessing dysmorphic concern, with utility in both research and clinical settings.

Negative body image and disordered eating behavior in children and adolescents: what places youth at risk and how can these problems be prevented?

In this review, we examine the prevalence of negative body image and disordered eating behaviors (i.e., excessive dieting, binge eating, inappropriate weight loss techniques) in children and adolescents. We also explore correlates and predictors of the development of these problems, including individual, familial, and social factors, as well as discuss factors that may serve a protective function. In addition, we critically evaluate the psychoeducational programs that have been developed to prevent the onset of these problems and reduce the severity of symptoms in children and adolescents. Moreover, we suggest several possible strategies for how such prevention programs can be modified to enhance their efficacy. Finally, likely moderator and mediator variables of the effectiveness of such programs are proposed.