Alcohol Use, Rape Myth Acceptance, Rape Empathy, and Sexual Assault History Influence the Believability of a Hypothetical Victim's Report of Sexual Assault.

College sexual assault is a common problem, and survivors often do not report their experience to college campus officials or law enforcement for fear of not being believed. This study examined how contextual factors such as alcohol use and whether the perpetrator was described as a student-athlete or student, and rater characteristics, such as the history of sexual assault and attitudes toward rape, influenced college students' perceptions of the believability of a hypothetical victim's sexual assault account. In all, 449 (N = 449) undergraduates read a vignette describing a hypothetical sexual assault and were assigned randomly to one of four conditions with varying contextual features: college athlete-no alcohol, college athlete-alcohol, college student-no alcohol, or college student-alcohol. They then rated how much they believed the victim in the vignette had been raped (0 [not at all] to 100 [completely]). The presence of alcohol use in the vignette was associated with lower ratings of believability, and participants who were higher in rape myth acceptance and lower in rape empathy rated the hypothetical victim's rape account as less believable. In addition, women who had been raped previously rated the victim in the vignette as more believable than women with no history of sexual assault. Implications for how college campuses might respond more effectively to reported sexual assaults are discussed.

The Role of Social Work in Confronting the Farmer Suicide Crisis: Best Practice Recommendations and a Call to Action.

Although estimates of prevalence vary, suicide rates among farmers are high and pose an important challenge for mental health policy and practice. The lack of mental health resources in many rural communities is a significant barrier to improving farmer mental health outcomes. The current paper will review (1) current findings related to the psychosocial functioning of agriculturalists including rates of suicide and common mental health concerns within this population; (2) describe stressors and risk factors associated with mental health symptoms in rural and agricultural communities; and (3) discuss barriers associated with accessing mental health treatment. This article also includes recommendations for increasing the cultural competence of social work practitioners working with rural communities. Finally, existing research on using technology and workforce development approaches for increasing access to mental health in rural communities is presented and recommendations for future research are explored.

Dose Matters in Evaluation of a School-Based Adolescent Sexual Health Education Program.

BACKGROUND: Research on the effects of intervention dose on outcomes within adolescent sexual health education programming is lacking. Existing research on dose typically utilizes the number of sessions as a variable. In a school setting, there are scheduling limitations, student absences, and other logistical barriers that have the potential to affect the number of sessions for an intervention and, in turn, impact the efficacy of programming. METHODS: This article evaluates the effectiveness of a school-based, peer-led adolescent comprehensive sexual health education program, with a focus on dose. A repeated measures MANOVA was used to evaluate the effects of individual difference variables and intervention variables on changes in participants' knowledge and attitudes across 2 time points. Additionally, paired t-tests were used to evaluate changes in specific behaviors. RESULTS: Results indicated that knowledge improved following the intervention, and specifically larger doses, measured in minutes, of the intervention were associated with larger improvements in knowledge. There were no significant effects related to attitudes or behavioral outcomes. CONCLUSIONS: This study adds to the knowledge base by including analysis of how the dose of intervention may impact youth outcomes. Implications for school health practices and research are discussed.

Virtual Reality Exposure Simulation for Student Veteran Social Anxiety and PTSD: A Case Study.

Exposure based exercises are a common element of many gold standard treatments for anxiety disorders and post-traumatic stress disorder and virtual reality simulations have been evaluated as a platform for providing clients with opportunities for repeated exposure during treatment. Although research on virtual reality exposure therapy (VRET) indicates effectiveness and high levels of user satisfaction, VRETs require a participant to complete exposure exercises in-offices with specialized equipment. The current exploratory case method study evaluates the experience and outcomes of one student veteran with social anxiety disorder and PTSD completing twelve sessions of VRET exposure using a mobile phone simulation of a virtual grocery store. The participant reported decreases in psychological symptoms, improvements in neurological connectivity, and better sleep quality upon completing the trial. Results suggest that VRET using a mobile application is feasible and warrants further research to evaluate effectiveness more fully. Implications include the use of a mobile based virtual reality simulation for intervening in social anxiety for student veterans.

Sexual Attitudes, Perceptions of Attractiveness, and Level of Coercion Affect Undergraduate Men's Judgments of Women's Responses to Sexual and Nonsexual Social Situations.

The aims of this study were to (a) evaluate undergraduate men's (N = 108) judgments of the effectiveness of women's responses to increasingly coercive sexual victimization risk and nonsexual social situations and (b) examine whether individual difference factors (e.g., perceptions of attractiveness, rape empathy) influenced these judgments. As part of a larger study, undergraduate women were video recorded responding to a series of vignettes depicting increasingly coercive sexual and nonsexual social situations. Undergraduate men then rated the effectiveness of these responses in either decreasing risk for sexual victimization (for the sexual victimization risk situations) or increasing the likelihood of achieving a social goal (for the nonsexual social situations), as well as each woman's physical attractiveness. Multilevel modeling results revealed that both situational-level (i.e., level of coercion) and individual-level factors (i.e., rape empathy, perceived attractiveness of the women, and rape myth acceptance) were associated with men's judgments of the effectiveness of women's responses in sexually risky situations. Specifically, responses were rated as less effective in decreasing victimization risk as the level of coercion increased, and men who reported lower rape empathy, lower perceived attractiveness of the woman, and higher rape myth acceptance judged women's responses as less effective than men who reported higher rape empathy, higher perceived attractiveness, and lower rape myth acceptance. Attractiveness was the only significant predictor of men's judgments of women's responses to nonsexual situations, with more attractive women being perceived as more effective. The findings of the current study highlight the importance of understanding the interaction between individual difference variables and situational features in understanding men's judgments of women's responses.

Predictors of Treatment Outcome in Group or Individual Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Active Duty Military.

Background: The purpose of this study was to examine demographic, psychological, military, and deployment variables that might predict posttraumatic stress disorder (PTSD) symptom improvement in a sample of active duty service members who received either group or individual cognitive processing therapy (CPT). Methods: Data were analyzed from 165 active duty service members with pre- and posttreatment data participating in a randomized controlled trial comparing group with individual CPT. Pretreatment variables were examined as predictors of change in PTSD severity from baseline to posttreatment, assessed using the PTSD Symptom Scale-Interview Version (PSS-I). Predictors of PSS-I change were first evaluated using Pearson correlations, followed by partial and multiple correlations to clarify which associations remained when effects of other predictors were controlled. Multiple regression analyses were used to test for interactions between pretreatment variables and treatment format. Results: Only age was a significant predictor of PTSD symptom change after controlling for other variables and statisitically correcting for testing multiple variables. There was also an interaction between age and treatment format. Conclusions: Younger participants had greater symptom improvement, particularly if they received individual treatment. Other pretreatment variables did not predict outcome. CPT appears to be robust across most pretreatment variables, such that comorbid disorders, baseline symptom severity, and suicidal ideation do not interfere with application of CPT. However, individual CPT may be a better option particularly for younger service members.

Type of Judge Influences Judgments of College Women's Responses to Increasingly Coercive Sexual and Nonsexual Social Situations.

Research examining women's ability to respond to sexually risky situations has relied on trait-based measures or experts' judgments to determine the effectiveness of women's responses. To date, no work has examined whether there are differences among relevant judges with respect to these evaluations. As part of a larger study, 100 undergraduate women listened to descriptions of sexual and nonsexual social situations, viewed clips of a male actor making increasingly coercive verbal requests to each situation, provided a videotaped response to each request, and evaluated the effectiveness of their own responses in decreasing risk for sexual victimization. Women's responses were provided to experts in sexual violence research (n = 8) and undergraduate men (n = 107) who also rated their effectiveness. All raters were asked to attend to both verbal and nonverbal behaviors when providing their ratings. As verbal coercion increased across both types of situations, responses were rated by undergraduate women and undergraduate men as more effective, suggesting that responses become more effective as risk increases for a negative outcome. Experts rated women's responses to moderate coercion as being more effective than responses to low coercion but rated responses to high coercion as less effective than responses to moderate coercion. Additionally, experts and undergraduate women rated women's responses to the sexual victimization risk vignettes as more effective than responses to the nonsexual social situation vignettes. In most cases, experts and undergraduate women's ratings were not statistically different from one another; however, undergraduate men rated undergraduate women's responses to both the sexual victimization risk and the nonsexual social situation vignettes as less effective than experts or undergraduate women. This article discusses applications of these findings for future prevention efforts focused on maximizing the effectiveness of women's responses in sexually risky situations.

Conceptualizing comorbid PTSD and depression among treatment-seeking, active duty military service members.

BACKGROUND: Among active duty service members and veterans with PTSD, depression is the most commonly diagnosed comorbid psychiatric condition. More research is warranted to investigate the relationship between PTSD and depression to improve treatment approaches. Byllesby et al. (2017) used confirmatory factor analyses in a sample of trauma-exposed combat veterans with PTSD and found that only the general distress factor, and not any specific symptom cluster of PTSD, predicted depression. This study seeks to replicate Byllesby et al. (2017) in a sample of treatment-seeking active duty soldiers. METHODS: Confirmatory factor analyses, bifactor modeling, and structural equation modeling (SEM) were used with data gathered at pretreatment and posttreatment as part of a large randomized clinical trial. RESULTS: Confirmatory factor analyses and bifactor modeling demonstrated that PTSD symptom clusters, Negative Alterations in Cognition and Mood (NACM) and Alterations in Arousal and Reactivity (AAR), as well as the general distress factor significantly predicted depression at pretreatment and posttreatment. LIMITATIONS: The current study was predominantly male, limiting the generalizability to female service members with PTSD. Also, self-report measures were used, which may introduce response-bias. CONCLUSIONS: The current study did not replicate Byllesby et al. (2017). Results demonstrated that the relationship between PTSD and depression among active duty service members can be explained by both transdiagnostic factors and disorder-specific symptoms.

Do Some Students Need Special Protection From Research on Sex and Trauma? New Evidence for Young Adult Resilience in "Sensitive Topics" Research.

Institutional review boards (IRBs) have expressed concerns that certain individuals or groups, such as participants who are younger, ethnic minorities, or who have certain psychological or personality traits, may be particularly distressed when participating in "sensitive topics" research. This study examined the effects of several demographic and individual difference factors (i.e., age, sex, ethnicity, religiosity, Big Five personality traits, and baseline psychological distress levels) on reactions to participation in sensitive topics research. Participants were 504 undergraduates who completed an extensive battery of either trauma/sex questionnaires or cognitive tests and rated their positive and negative emotional reactions and the perceived benefits and mental costs of participating. They also compared research participation to normal life stressors. Our findings indicated that individual difference and demographic risk factors do not increase participant distress after participating in sex/trauma research over and above that experienced after participating in traditionally minimal-risk cognitive tasks. Participants generally found research participation less distressing than normal life stressors and even enjoyable.

Group-delivered cognitive/exposure therapy for PTSD in women veterans: A randomized controlled trial.

OBJECTIVE: Group delivery of posttraumatic stress disorder (PTSD) treatment has several advantages, however group research is not comparable to individual trials. This study extends the group literature by improving methodology in examining the efficacy of a 3-module (cognitive, exposure, skills) group treatment for PTSD, establishes a format for the delivery of group exposure therapy, and compares 3 treatment modules within the group. METHOD: Eighty-six Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) women veterans were randomized to a 16-week, 3-member group treatment (Tx) or a waitlist (WL) condition. The primary (Clinician Administered PTSD Scale [CAPS]) and secondary (Medical Outcomes Study Short Form-36 [SF-36], Quality of Life Inventory [QOLI], and PTSD Checklist [PCL]) outcome measures were administered at baseline, post Tx/WL, and at 3- and 6-months post Tx (PCL additionally at pre/post for each treatment module). RESULTS: PTSD symptoms significantly improved in Tx arm participants (p < .001, ES = 1.72; unit of analysis group: n = 14), as did mental and physical life functioning (SF-36; p < .001), and quality of life (QOLI; p < .001). The WL significantly improved on the SF-36 (mental; p = .04) and QOLI (p = .02). Clinical improvement (CAPS) in the Tx arm reflected a treatment response (≥10-point decrease) in 77% and loss of PTSD diagnosis (<45) in 52% of participants, comparable to individual prolonged exposure (PE) treatment. Finally, PCL scores significantly lowered in exposure and cognitive modules. CONCLUSIONS: This study supports the use of group format for PTSD with 3 modules using improved methodology, with a novel, 3-member group which allows repeated in-session weekly imaginal exposures. The results suggest future examination of group delivered PE. (PsycINFO Database Record

Trauma and sex surveys meet minimal risk standards: implications for institutional review boards.

Institutional review boards assume that questionnaires asking about "sensitive" topics (e.g., trauma and sex) pose more risk to respondents than seemingly innocuous measures (e.g., cognitive tests). We tested this assumption by asking 504 undergraduates to answer either surveys on trauma and sex or measures of cognitive ability, such as tests of vocabulary and abstract reasoning. Participants rated their positive and negative emotional reactions and the perceived benefits and mental costs of participating; they also compared their study-related distress with the distress arising from normal life stressors. Participants who completed trauma and sex surveys, relative to participants who completed cognitive measures, rated the study as resulting in higher positive affect and as having greater perceived benefits and fewer mental costs. Although participants who completed trauma and sex surveys reported slightly higher levels of negative emotion than did participants who completed cognitive measures, averages were very low for both groups, and outliers were rare. All participants rated each normal life stressor as more distressing than participating in the study. These results suggest that trauma and sex surveys pose minimal risk.

Sexual attitudes mediate the relationship between sexual victimization history and women's response effectiveness.

This study evaluated the effects of a sexual victimization history, sexual attitudes, and psychopathology on the effectiveness of women's responses to high- and low-risk dating and social situations. Two hundred fifteen undergraduate women listened to a description of each situation, viewed a clip of an actor making a verbal request, and provided a videotaped, verbal response to each situation. Participants then completed measures assessing their victimization history, sexual attitudes, and symptoms of psychopathology. Finally, participants viewed their responses and rated how effective each response was at decreasing their risk for having an unwanted sexual experience, defined as one in which they would be verbally or physically coerced into having sexual contact of any kind with a man. Experts in the sexual violence research area also rated the effectiveness of participants' responses using the same instructions. Results revealed that sexual attitudes mediated the relationship between victimization history and the effectiveness of participants' responses to high- and low-risk situations. Specifically, more severe victimization experiences were linked to more liberal sexual attitudes, which, in turn, were related to responses that were rated by experts as less effective in decreasing risk of sexual victimization.