Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity.

BACKGROUND: Post-traumatic stress disorder (PTSD) is associated with elevated risk for metabolic syndrome (MetS). However, the direction of this association is not yet established, as most prior studies employed cross-sectional designs. The primary goal of this study was to evaluate bidirectional associations between PTSD and MetS using a longitudinal design. METHOD: A total of 1355 male and female veterans of the conflicts in Iraq and Afghanistan underwent PTSD diagnostic assessments and their biometric profiles pertaining to MetS were extracted from the electronic medical record at two time points (spanning ~2.5 years, n = 971 at time 2). RESULTS: The prevalence of MetS among veterans with PTSD was just under 40% at both time points and was significantly greater than that for veterans without PTSD; the prevalence of MetS among those with PTSD was also elevated relative to age-matched population estimates. Cross-lagged panel models revealed that PTSD severity predicted subsequent increases in MetS severity (ß = 0.08, p = 0.002), after controlling for initial MetS severity, but MetS did not predict later PTSD symptoms. Logistic regression results suggested that for every 10 PTSD symptoms endorsed at time 1, the odds of a subsequent MetS diagnosis increased by 56%. CONCLUSIONS: Results highlight the substantial cardiometabolic concerns of young veterans with PTSD and raise the possibility that PTSD may predispose individuals to accelerated aging, in part, manifested clinically as MetS. This demonstrates the need to identify those with PTSD at greatest risk for MetS and to develop interventions that improve both conditions.

Sexual revictimization prevention: an outcome evaluation.

This investigation tested a program to reduce women's risk for sexual revictimization. Participants were 66 women with histories of sexual victimization as adolescents or adults who were randomly assigned to a preventive intervention group or a no-treatment control group. They completed initial measures assessing history of sexual assault, self-efficacy, and psychological functioning, returning approximately 2 months later for follow-up assessment using the same measures. Results suggest that the prevention program may be effective in reducing the incidence of sexual assault revictimization in this population. In addition, participants in the intervention group displayed significant improvement in psychological adjustment and self-reported self-efficacy.

The impact of alcohol and alcohol expectancies on male perception of female sexual arousal in a date rape analog.

The impact of alcohol and alcohol expectancies on men's perception of female sexual arousal and men's ability to discriminate accurately female sexual intentions in a dating situation was examined. In a 2 (alcohol) x 2 (expectancy) balanced placebo design, men were exposed to an audiotape of a date rape and asked to signal when the man should stop making sexual advances. On 4 occasions during the vignette, participants rated how sexually aroused the woman on the tape was at that moment. Relative to controls, participants who consumed alcohol or expected to consume alcohol took significantly longer to identify the inappropriateness of the man's sexual behavior toward his date. Similarly, alcohol participants also rated the woman's arousal level significantly higher at the first 2 refusals. Implications of the results are discussed.

Cognitive-behavioral treatment for rapists: can we do better?

A review of treatment studies with rapists suggests that the currently used cognitive-behavioral treatment strategies remain limited in their success. The current article proposes that some reasons for the limited success may be that current treatment approaches do not adequately address the heterogeneity of the population, emphasize changing patterns of physiological arousal and cognitive distortions rather than psychological acceptance, and neglect to address differences in the function of sexually aggressive behavior among individuals. With the hope of decreasing rates of victimization and preventing recidivism by rapists, this article offers several treatment suggestions that should be tested empirically to determine if treatment efficacy can be increased with this population.

The effect of alcohol on the responses of sexually coercive and noncoercive men to an experimental rape analogue.

This study examined the impact of the psychological and pharmacological effects of alcohol on the ability of sexually coercive and noncoercive men to discriminate when a female wants a partner to stop sexual advances. In a 2 (alcohol vs. no alcohol) x 2 (expectancy vs. no expectancy) x 2 (sexually coercive vs. noncoercive status) randomized factorial design, male college students were exposed to an audiotape of a date rape. Participants who consumed, or expected to consume, alcohol took significantly longer to determine that the man should refrain from attempting further sexual contact. In addition, nonsexually coercive participants assigned to conditions in which they expected to consume alcohol responded similarly to their sexually coercive counterparts in their responses. The implications of these findings are discussed.

Females' perception of date rape: an examination of two contextual variables.

PIP: This study examined the role of perceived token resistance and previous sexual contact on women's ability to discriminate when a female wants her partner to stop his sexual advances. Participants included 101 White female undergraduate students and were randomly assigned to one of the four conditions: 1) perceived resistance with genital contact; 2) no resistance with genital contact; 3) perceived resistance with no genital contact; and 4) no resistance without genital contact. Subjects listened to an audiotaped date rape after being informed of the couple's sexual history based on the condition assigned to them. They were also informed that the couple had been on five previous dates, in which the man had manipulated the woman's breasts or genitals. In addition, the woman did not object to this contact, or the woman initially objected to the contact but subsequently stopped resisting contact. Participants in the perceived token resistance conditions took significantly longer to determine when the man should refrain from attempting further sexual contact. The findings of this study could be used to increase information on date rape, to educate individuals about the responses associated with date rape, and to reinforce rules concerning appropriate sexual behavior.^ieng

Cross-cultural comparison of US and Nigerian adolescents' HIV-related knowledge, attitudes, and risk behaviour: implications for risk reduction interventions.

Attitudes towards AIDS prevention, AIDS-related knowledge, and sexual behaviour of Nigerian adolescents and their African-American counterparts in two geographic regions of the United States were compared to assess cross-cultural similarities and differences between the adolescents. This study was conducted as the first in a programmatic sequence of activities leading toward the adaptation of a risk reduction intervention that was developed in the US for implementation with Nigerian youths. Subjects (n = 511) completed self-report measures of AIDS-related knowledge, attitudes towards condoms, attitudes towards AIDS prevention, sexual behaviour over the past two months, self- and response efficacy, and perceived vulnerability. Between-group comparisons revealed that US adolescents were more knowledgeable, held more favourable attitudes towards prevention and toward condoms, reported more sex partners, engaged in higher frequencies of unprotected vaginal intercourse, and became sexually active at later age than Nigerian adolescents. The findings are discussed with respect to their implications for translating risk reduction interventions developed in the US for African-American adolescents for later cross-cultural implementation with adolescents in developing countries where such risk reduction efforts are urgently needed.