Survival sex among a diverse sample of women with histories of intimate partner violence: Results from a domestic violence shelter.

OBJECTIVE: The current study sought to investigate the prevalence and correlates of survival sex among a diverse sample of women residing in a domestic violence (DV) shelter. METHOD: Two hundred seven women (44% Black, 37.7% White, 10.6% Multiracial, 4.3% Latina, 1% Arab, 1% Asian/Pacific Islander, and 1.4% Indigenous or Aboriginal) residing in a Summit County, Ohio, DV shelter completed a survey assessing their involvement in survival sex, the associated contextual factors (e.g., age at first incidence of survival sex, the reason for engaging in survival sex), and self-report measures assessing substance use, post-traumatic stress disorder (PTSD) symptoms, intimate partner violence (IPV) victimization, adverse childhood experiences (ACEs), and empowerment. RESULTS: More than two-thirds of participants reported engaging in survival sex, and participants who did were more likely to have elevated rates of substance use, PTSD symptoms, ACEs, and IPV victimization, along with lower empowerment. Most commonly, women reported engaging in survival sex for fear that the other person would take away valuable support or things they needed. Participants also reported engaging in survival sex for securing shelter, for money, for food, and to obtain drugs or alcohol. Notably, a sizable minority of women first engaged in survival sex as minors, suggesting overlap with the phenomenon of domestic minor sex trafficking. CONCLUSIONS: Engaging in survival sex may be commonly experienced by women residing in DV shelters and is associated with trauma history and post-traumatic stress symptoms. Despite the small, non-representative sample, results indicate education for providers is necessary to interact effectively with this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Role of Race, Social Support, Empowerment, and Posttraumatic Cognitions in Survivors of Intimate Partner Violence Symptoms of Posttraumatic Stress Disorder.

Black women experience more frequent and severe intimate partner violence (IPV), but there are mixed findings on their posttraumatic stress disorder (PTSD) symptom severity. This may be explained by cultural-salient factors which are associated with fewer posttraumatic cognitions. We hypothesized an indirect effect of race on PTSD symptoms via social support, empowerment, and posttraumatic cognitions, serially. Path analysis revealed Black women reported increased social support, which was associated with higher levels of empowerment, which was associated with lower levels of posttraumatic cognitions. Decreased posttraumatic cognitions were associated with less severe PTSD symptoms. Results increase understanding of culturally-salient factors that may impact PTSD symptoms in Black women.

Associations among Intimate Partner Violence, Posttraumatic Stress Disorder Symptoms, and Disordered Eating among Women Intimate Partner Violence Survivors Residing in Shelter.

Previous research has not assessed the association between intimate partner violence (IPV) and disordered eating (DE), nor the potential indirect effect through posttraumatic stress disorder (PTSD) symptoms, among residents of IPV shelters. Among 212 IPV survivors, this study examined these and the differential associations by PTSD symptom cluster and types of DE. In the current sample, 67.9% met criteria for probable PTSD, 20.3% met criteria for a probable eating disorder, and 18.4% had probable comorbid diagnoses. Consistent with escape theory, there was an indirect effect of IPV on DE through PTSD symptoms. Additionally, there was an indirect effect of IPV on weight/shape concerns and binge symptoms through PTSD symptoms. Although there was a significant total effect of IPV on compensatory behaviors, there was no indirect effect through PTSD symptoms. When PTSD symptom clusters were examined concurrently, the only indirect effect of IPV on weight/shape concerns was via the PTSD symptom cluster of negative alterations in cognition and mood. Although there was an indirect effect of IPV on binge symptoms via PTSD symptoms overall, no specific PTSD symptom cluster drove this association. Implications highlight the need for attention to DE within this population. Consistent with escape theory, survivors' DE might serve to distract from psychological distress.

Emotional Responses to a Sexual Assault Threat: A Qualitative Analysis Among Women With Histories of Sexual Victimization.

Sexual assaults against women are a leading threat to human rights and public health in the United States. Considering the high rates of sexual revictimization among women and the limited understanding of the mechanisms which fuel this phenomenon, the goal of the present study was to investigate the role of emotion in coping with a hypothetical threat of sexual assault for previously sexually victimized college women. A total of 114 college women with a history of sexual victimization listened to an audio-recording describing a sexual assault scenario and then described how they felt. A qualitative analysis paradigm was used to capture participants' responses in an open-ended, real-time, experiential manner. Data were analyzed using Consensual Qualitative Research-Modified methodology. Four main themes emerged (Negative Reactions, Indifferent Evaluations, Active Responses, and Cognitive Appraisal of the Situation), along with various subcategories, demonstrating the variability of women's responses to a sexual assault threat. Many women experienced uncomfortable or distressing emotional reactions to the vignette, primarily through discomfort, but also through anger, anxiety, and being upset. Few women reported experiencing fear, and a small number reported experiencing self-blame. The low endorsement of fear and anger in our high-risk sample indicates emotional dysregulation as a potential mechanism of repeated sexual victimization and a promising target for clinical intervention. Overall, results may inform sexual assault risk reduction efforts and the empowerment of women who have experienced sexual victimization.

The Prevalence of Sexual Violence Perpetration in Sexual Minority Men: A Secondary Analysis of Systematic Review Data.

Prior literature illustrates that sexual minority people (e.g., bisexual, gay, queer) are at increased vulnerability for sexual violence victimization compared to heterosexual peers, including while in college. However, the study of sexual violence perpetration in sexual minority populations, much less specifically sexual minority college men, has been neglected. This article reviews the literature and presents a secondary data analysis of a systematic review on college men's sexual perpetration rates and associated methodology. We also conducted analyses to summarize available literature regarding publishing dates, authors, and data inclusivity. METHODS: We downloaded the dataset and associated materials from Mendeley.com's data archive. RESULTS: To our surprise, we could not analyze sexual perpetration prevalence rates in sexual minority men using the systematic review data due to absence of reported data across all 77 independent samples including over 5,500 male participants. We found no significant relationship between inclusion of sexual minority men and the use of measurement strategies specialized to assess sexual minority needs. We did find a positive relationship between recency of publication and the inclusion of sexual minority men, r(76) = .24, p = .03, and that most authors/co-authors were women (72%). CONCLUSIONS: Preventing perpetration is central to ending sexual violence; therefore, future research should include sexual minority people and use appropriate methodology in the investigation of sexual perpetration characteristics and patterns.

The Frequency of Sexual Perpetration in College Men: A Systematic Review of Reported Prevalence Rates From 2000 to 2017.

BACKGROUND: The prevalence of sexual perpetration in college men is unknown. Prior reviews of sexual violence prevalence rates have produced wide-ranging estimates, likely due to wide variation in measurement strategies. OBJECTIVES: This article systematically reviewed research findings (from 2000 to 2017) regarding prevalence rates of sexual perpetration in college men and measurement strategies. Data Sources: PsycINFO and Web of Science databases. Eligibility Criteria: Empirical reports published between 2000 and 2017 that included male participants, available in English, and reported lifetime prevalence findings in Canadian or American college students. Participants: Data from 78 independent samples including 25,524 college men. RESULTS: The average prevalence rate of any sexual perpetration was 29.3% (SD = 16.8), and the average rate of rape was 6.5% (SD = 6.3). Studies that used non-Sexual Experiences Survey (SES)-based questionnaires recorded higher prevalence rates (41.5%) than SES-using studies (26.2%). At least 16 different sexual perpetration questionnaires were identified. Modifying standardized questionnaires was extremely common; this was reported in over half of the studies. Studies using modified standardized questionnaires found higher prevalence rates of sexual perpetration than studies using nonmodified standardized questionnaires. LIMITATIONS: This report focused exclusively on college men in the United States and Canada. CONCLUSIONS AND IMPLICATIONS: On average, 29% of college males report engaging in behaviors defined as sexual perpetration; however, there was a strong influence of measurement strategy on reported rates.

Yes, (Most) Men Know What Rape Is: A Mixed-Methods Investigation Into College Men's Definitions of Rape.

Sexual violence, including rape, is a pervasive problem on college campuses in the United States. Although men perpetrate the majority of sexual violence, men's attitudes, experiences, and perspectives are not typically included in research on rape and sexual violence. We addressed this empirical gap through our mixed-methods analysis of 365 college-aged men's definitions of the term "rape." Our analysis via consensual qualitative research revealed that men's definitions fit into nine primary domains: lack of consent, taken advantage of, sex, sexual activity, unwanted, gender/sex-specific, harm to victim, relationship, and emotional response, as well as a miscellaneous domain. Further, using chi-square tests of independence, we compared responses from men with and without histories of sexual violence perpetration. Findings showed that the definitions generated by men with a history of perpetration were less likely to include nonpenetrative sexual violence and were more likely to use gender/sex-specific language. We conclude that most young men have a generally accurate understanding of rape, though perpetrators' understandings may be somewhat narrower and more limited than those without a history of perpetration. We end with recommendations for refocusing sexual education curricula to better aid in the prevention of sexual violence perpetration. Specifically, given that (most) men know what rape is, educators should emphasize the cultural and situational factors that make rape more likely so all people can reduce the risk of sexual violence and take proactive precautions to prevent it.

Internalized Body Stigma as a Barrier to Accessing Preventative Healthcare for Young Women.

Internalizing stigma toward the body can have negative implications for women's sexual health. In the current study, we examined how young women's internalized stigma toward their body shape, genitals, and menstrual periods are associated with their use of preventative healthcare services for sexual health. Additionally, we tested two mechanisms that may mediate the relationship between internalized body stigma and preventative care: self-objectification (in the form of a loss of autonomy) and comfort communicating with a healthcare provider. We collected and analyzed survey data from 685 undergraduate women. We tested a serial mediation model, such that the internalization of body stigma predicted greater self-objectification, greater self-objectification predicted less comfort communicating with a provider, and discomfort communicating with a provider predicted lower receipt of preventative care. Results partially supported the proposed serial mediation model, such that internalizing stigma towards body shape, genitals, and menstrual periods was associated with discomfort communicating via greater self-objectification. Internalized stigma toward genitals and menstrual periods were significant predictors of preventative care use, even when accounting for self-objectification and communication. Findings suggest that interventions to address genital and menstrual stigma could be especially beneficial for enabling young women to seek preventative care.

Predictors of Assertive and Nonassertive Styles of Self-Defense Behavior During a Lab-Based Sexual Assault Scenario.

The current study examined how psychological factors influence hypothetical behavioral responses to threat (BRTT). College women (n = 113) with a history of sexual victimization completed a standardized lab-based self-defense scenario. Interpersonal skills, coping style, and assertive and nonassertive BRTT during a prior assault predicted assertive BRTT during the task. The use of nonassertive BRTT during past assaults no longer predicted assertive BRTT during the task when accounting for rape acknowledgment. Findings regarding rape acknowledgment demonstrate the complexity of recovery from sexual assault. Our results highlight interpersonal skills as an intervention target for innovative sexual assault risk reduction interventions.

An appraisal of the American Psychological Association's Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder.

In 2017, the American Psychological Association published the Clinical Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. Although the Guideline Development Panel aimed to produce guidelines based on the best available scientific evidence, concerns were raised that the guidelines would constrain the implementation of some effective psychotherapies and limit clinician autonomy, potentially leading to coverage for only manualized, time-limited, cognitive-behavioral treatments. The following article reviews the PTSD guidelines in light of the evidence-based practice in psychology policy adopted by the American Psychological Association in 2006. We highlight the strengths of the guidelines as currently written while recognizing areas in which the guidelines do not meet evidence-based practice in psychology recommendations. A clinical vignette of the treatment of a complex patient with PTSD and significant comorbidities is provided to illustrate the difficulty of clinical decision-making and how the guidelines may complicate the delivery of effective treatments. We conclude with recommendations on how to consider a broad range of research evidence, appropriately integrate clinician expertise, and better appreciate the role of patient values and preferences in PTSD treatment decision-making. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Intergenerational transmission of child abuse: Predictors of child abuse potential among racially diverse women residing in domestic violence shelters.

Parental risk for perpetrating child abuse is frequently associated with intergenerational patterns of abuse: being abused increases the risk for future abuse. Yet, the mechanisms of intergenerational abuse are unclear, and the risk factors for perpetrating child abuse are interrelated. Research suggests that history of childhood abuse, psychiatric distress, and exposure to intimate partner violence (IPV) are all related risk factors for perpetrating child abuse. We investigated these three risk factors using the developmental psychopathology framework in a racially diverse sample of high-risk women: women residing in domestic violence shelters. 211 mothers residing in domestic violence shelters completed measures of their own childhood abuse (defined narrowly in a 10-item self-report survey), exposure to and severity of IPV victimization, and structured interviews to diagnose psychiatric disorders. We utilized a hierarchical regression model to predict child abuse potential, accounting for risk factors in blocks roughly representing theorized temporal relationships: childhood abuse followed by psychiatric diagnoses, and then recency of exposure to IPV. Consistent with hypotheses, the strongest predictor of current child abuse potential was the psychiatric diagnosis of PTSD. Mediation tests further explicated that the relationship between maternal history of childhood sexual abuse and current potential for perpetrating child abuse is mediated by IPV-related PTSD symptoms. Results suggest that IPV-related PTSD symptoms, rather than exposure to abuse (i.e., childhood abuse or IPV), is most strongly associated with child abuse potential in recent IPV survivors. Interventions which can ameliorate maternal psychopathology and provide resources are recommended for these vulnerable families.

Trauma and Health Symptoms in a Community Sample: Examining the Influences of Gender and Daily Stress.

Although there is a rich body of literature on trauma and health, limited research has investigated the variables of gender, trauma symptoms, physical health, mental health, and daily stress together in a community sample. Considering the deleterious effects of trauma on health, our overarching inquiry was whether trauma symptoms can predict overall mental and physical health with attention to gender and daily stress as potential moderators. Participants (n = 103; 50.5% women) completed self-report measures of trauma symptoms, mental health, physical health, and daily stress, along with demographic information. Trauma symptoms predicted 25.2% of the variance in general health symptoms. Gender significantly added to the variance accounted for, but daily stress was not significant in the model. Trauma symptoms predicted 37.1% of the variance in mental health symptoms. Daily stress significantly added to the model, but gender did not. Results are interpreted through the integration of family stress theory and feminist frameworks, adding to the literature by further illuminating the relationships between gender, daily stress, health symptoms, and trauma in a community sample.

Secure Base Narrative Representations and Intimate Partner Violence: A Dyadic Perspective.

This study aimed to understand the relationship between secure base phenomena and dating violence among couples. Within a relationship, a secure base can be defined as a balancing act of proximity-seeking and exploration at various times and contexts with the assurance of a caregiver's availability and responsiveness in emotionally distressing situations. Participants were 87 heterosexual couples. The Actor-Partner Interdependence Model was used to examine the relationship between each partner's scores on secure base representational knowledge and intimate partner violence. Findings demonstrated that women's secure base representational knowledge had a significant direct negative effect on the victimization of both men and women, while men's secure base representational knowledge did not have any significant partner or actor effects. Therefore, findings suggest that women with insecure attachments may be more vulnerable to being both the victims and the perpetrators of.

Therapy for Childhood Sexual Abuse Survivors using Attachment and Family Systems Theory Orientations.

The aim of this paper is to understand the effects of childhood sexual abuse on a survivor's later life. For understanding and treating the emotional distress and interpersonal problems resulting from childhood sexual abuse, attachment theory provides a valuable framework. When this framework is combined with family systems theory, it can help therapists understand the family context where sexual abuse occurs and how this affects health and functioning throughout the lifespan. Case examples of female adult sexual abuse survivors are also explored, with insight from the intersection of systems and attachment theories.

Emotional abuse in intimate relationships: the role of gender and age.

This study aimed to investigate the moderating roles of gender and age on emotional abuse within intimate relationships. This study included 250 participants with an average age of 27 years. Participants completed the Emotional Abuse Questionnaire (EAQ; Jacobson & Gottman, 1998), which 4 subscales are isolation, degradation, sexual abuse, and property damage. Multigroup analysis with 2 groups, female (n = 141) and male (n = 109), was used to test the moderation effect. Younger men reported experiencing higher levels of emotional abuse, which declined with age. Older females reported experiencing less emotional abuse than older males. Overall, emotional abuse was more common in younger participants. Younger women experienced higher rates of isolation, and women's overall experience of property damage was higher than that of men and increased with age. Results are interpreted through the social exchange and conflict frameworks.