Women's Behavioral Coping Responses During Sexual Assault: Association With Posttraumatic Stress Disorder Symptoms and the Moderating Role of Alexithymia.

We examined the associations between women's behavioral coping responses during sexual assault and posttraumatic stress disorder (PTSD) symptoms, and the moderating role of alexithymia in college women (N = 152). Immobilized responses (b = 0.52, p < .001), childhood SA (b = 0.18, p = .01), and alexithymia (b = 0.34, p < .001) significantly predicted PTSD. The interaction between immobilized responses and alexithymia was significant (b = 0.39, p = .002), indicating a stronger association for those higher in alexithymia. Immobilized responses are associated with PTSD, particularly for those with difficulty identifying and labeling emotions.

Evaluation of a Brief Suicide Prevention Training Program for College Campuses.

Suicide is the second leading cause of death in college students. While research indicates a positive impact of gatekeeper training programs on knowledge and attitudes, few have examined change in suicide prevention behaviors. The purpose of this study was to evaluate the effects of a brief suicide prevention training for college campuses on knowledge, self-efficacy to intervene, and gatekeeper behaviors. A longitudinal design was employed to examine changes from pretest to post-test and 3-month follow-up. Participants included 517 students, staff, and faculty who attended a 90-minute training and completed self-report surveys. The training included both didactic and experiential components. Repeated measures ANOVAs indicated that knowledge, self-efficacy to discuss suicide and to refer to resources, and gatekeeper behavior increased from pretest to post-test and follow-up. Students exhibited a greater increase in gatekeeper behaviors, in comparison to non-students. Large changes were observed on publicizing suicide prevention information and having informal conversations about suicide with students, and 76% had engaged in gatekeeper behavior at follow-up. Findings offer support for the potential efficacy of a brief prevention program, with promising effects on several suicide prevention behaviors. Declines on knowledge and self-efficacy from post-test to follow-up highlight the importance of booster sessions and complementary programming.

Beliefs About Consent and Sexual Assault Perpetration in a Longitudinal Study of College Men.

This study examined the mediating role of beliefs about both active and passive consent in the prospective associations between sexual assault (SA) risk factors and coercive, incapacitated, and forcible attempted/completed SA among college men. Participants were 471 college men who completed self-report surveys at the end of each of their 4 years of college. SA risk factors (risky behavior, rape-supportive beliefs and peer norms, personality traits, childhood adversity) were assessed at Wave 1, beliefs about consent were assessed at Wave 2, and perpetration was assessed at Waves 3 and 4. Multivariate regression models with bias-corrected bootstrapping assessed longitudinal mediation. SA risk factors were negatively associated with endorsement of active consent (verbal approval required) and positively associated with passive consent (assume "yes" until you hear a "no"), with strongest effects observed for coercive SA. Both types of beliefs about consent served as mediators between risk factors and perpetration. Findings suggest that prevention programs should include a focus on reducing SA risk factors, clarifying definitions of consent, and improving sexual communication.

Driving Aggression and Anxiety: Intersections, Assessment, and Interventions.

OBJECTIVE: Driving aggression and anxiety are significant contributors to risky driving and motor vehicle crashes (MVCs), which are leading causes of U.S. morbidity and mortality. Even though aggression and anxiety can be conceptualized as related features of the fight-or-flight response, literature on these topics has not been integrated. Driving aggression and anxiety are also transdiagnostic constructs that span multiple psychiatric disorders. Assessment and treatment of these complex problems must be understood to reduce the public health burden of MVCs. METHOD: A comprehensive literature search was conducted using PsycInfo and Google Scholar. RESULTS: Definitions and prevalence of constructs including driving anger, aggressive driving, posttraumatic stress disorder, driving phobia, and transdiagnostic factors are delineated. Psychosocial correlates and assessment instruments are reviewed. Theoretical models that explicate personological, affective, cognitive, and behavioral components are explored. Differential and shared processes underlying driving aggression and anxiety are examined. Interventions are described, with a focus on promising cognitive-behavioral methods. CONCLUSION: Driving aggression and anxiety likely share affective and cognitive characteristics such as emotional reactivity and distorted threat appraisals. Further research is needed to support theoretical models linking driving aggression and anxiety, and to validate assessment instruments that capture both constructs. Epidemiologic studies are needed to determine norms, prevalence, and clinical cutpoints. Integration of interventions for these interrelated problems could ultimately reduce risky driving and MVCs.

Subclinical Posttraumatic Stress Disorder Symptoms: Relationships with Blood Pressure, Hostility, and Sleep.

The purpose of this study was to examine the relationships among subclinical PTSD symptoms, blood pressure, and several variables linked to both frank PTSD and the basic psychobiological adaptation to stress. The authors recruited a sample of 91 healthy, young men and women between 18 and 35 years. We examined links among subclinical posttraumatic stress disorder symptoms, blood pressure, sleep quality, and hostility. Posttraumatic stress disorder symptoms were associated with poorer sleep quality and higher hostility scores in both women and men. In men, PTSD symptoms were also associated with elevated resting diastolic blood pressure, and sex was an important moderator of that relationship. Moreover, sleep quality and hostility are substantive mediators of the relationship between diastolic blood pressure and PTSD. Behavioral interventions designed to increase sleep quality and restructure hostile attitudes could potentially serve as preventive interventions for PTSD and the underlying cardiovascular comorbidities in young adults.

Correlates and reasons for mental health treatment dropout among active duty soldiers.

Many soldiers who seek treatment for mental health problems drop out of treatment before it is complete. The present study examined factors that are associated with dropout among active duty soldiers. Soldiers who had sought treatment (N = 260) responded to measures of beliefs about mental health treatment, mental health symptoms, treatment-seeking behaviors, and treatment dropout. Fifty-seven soldiers reported dropping out before treatment was completed. Commonly endorsed reasons for dropout were that soldiers were too busy with work and a preference to handle the symptoms oneself. A series of logistic regressions revealed that depression symptoms (odds ratio [OR] = 1.07), functional impairment (OR = 1.49), career stigma (OR = 1.70), differential treatment stigma (OR = 1.62), practical barriers (OR = 1.76), negative beliefs about treatment (OR = 1.98), and self-reliance (OR = 1.78) were associated with an increased likelihood of dropout. Positive beliefs about treatment were associated with a decreased likelihood of dropout (OR = 0.60). Functional impairment, career stigma, and self-reliance remained unique predictors in a final forward conditional regression. These findings highlight the need for interventions to support service members in treatment by educating them on the benefits of treatment and reducing practical barriers. (PsycINFO Database Record

Understanding Disparities in Service Seeking Following Forcible Versus Drug- or Alcohol-Facilitated/Incapacitated Rape.

Victims of drug- or alcohol-facilitated/incapacitated rape (DAFR/IR) are substantially less likely to seek medical, rape crisis, or police services compared with victims of forcible rape (FR); however, reasons for these disparities are poorly understood. The current study examined explanatory mechanisms in the pathway from rape type (FR vs. DAFR/IR) to disparities in post-rape service seeking (medical, rape crisis, criminal justice). Participants were 445 adult women from a nationally representative household probability sample who had experienced FR, DAFR/IR, or both since age 14. Personal characteristics (age, race, income, prior rape history), rape characteristics (fear, injury, loss of consciousness), and post-rape acknowledgment, medical concerns, and service seeking were collected. An indirect effects model using bootstrapped standard errors was estimated to examine pathways from rape type to service seeking. DAFR/IR-only victims were less likely to seek services compared with FR victims despite similar post-rape medical concerns. FR victims were more likely to report fear during the rape and a prior rape history, and to acknowledge the incident as rape; each of these characteristics was positively associated with service seeking. However, only prior rape history and acknowledgment served as indirect paths to service seeking; acknowledgment was the strongest predictor of service seeking. Diminished acknowledgment of the incident as rape may be especially important to explaining why DAFR/IR victims are less likely than FR victims to seek services. Public service campaigns designed to increase awareness of rape definitions, particularly around DAFR/IR, are important to reducing disparities in rape-related service seeking.

"The role of different stigma perceptions in treatment seeking and dropout among active duty military personnel": Correction to Britt et al. (2015).

UNLABELLED: Reports an error in "The role of different stigma perceptions in treatment seeking and dropout among active duty military personnel" by Thomas W. Britt, Kristen S. Jennings, Janelle H. Cheung, Cynthia L. S. Pury and Heidi M. Zinzow (Psychiatric Rehabilitation Journal, 2015[Jun], Vol 38[2], 142-149). Six participants were included in the sample for the treatment-seeking analyses who scored 50 or above on the PTSD Checklist, but did not meet the specific criteria on the three PTSD subscales. Of these six participants, four screened positive for another problem. Removing the two participants who did not screen positive for another problem did not affect the significance of any of the predictors in the analyses. (The following abstract of the original article appeared in record 2015-12033-001.) OBJECTIVE: Many military personnel with mental health problems do not seek treatment from mental health professionals, and if they do seek treatment, they drop out of treatment before receiving the recommended number of sessions. The present study examined the role of 4 different stigma perceptions on these outcomes: perceived stigma to career, perceived stigma of differential treatment, self-stigma from seeking treatment, and stigmatizing perceptions of soldiers who seek treatment. METHOD: One thousand three hundred twenty-four active duty soldiers completed a self-report survey assessment that included measures of the 4 different stigma perceptions, indices of mental health symptoms, receipt of mental health treatment, and whether they had dropped out of treatment before it was completed. RESULTS: Participants screening positive for a mental health problem reported higher scores on all 4 stigma perceptions. All 4 stigma perceptions were each associated with a reduced likelihood of treatment seeking when considered individually, but only stigmatizing beliefs about those who seek treatment were uniquely associated with treatment seeking. Perceived stigma for one's career and differential treatment from others, along with self-stigma from treatment seeking, were associated with an increased probability of dropping out of mental health treatment. Self-stigma from treatment seeking was the only unique predictor of dropout. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Different stigma perceptions were associated with treatment seeking and dropout. Further longitudinal research is needed to examine how stigma perceptions influence these important outcomes. Practitioners need to be aware of how different stigma perceptions can influence treatment seeking and potentially target stigma perceptions during treatment to prevent dropout.

Barriers and Facilitators of Mental Health Treatment-Seeking in U.S. Active Duty Soldiers With Sexual Assault Histories.

Despite significant mental health needs among sexual assault (SA) victims in the military, little is known about treatment-seeking patterns or factors associated with service use. This study examined service use behavior, barriers, and facilitators of mental health treatment-seeking in an active duty sample of 927 U.S. Army soldiers with mental health problems. SA victims (n = 113) did not differ from non-victims on barriers or facilitators after adjusting for demographic and mental health variables, with stigma rated as the largest barrier. Most SA victims (87.6%) had sought informal support and 59.3% had sought formal treatment. One third of treatment-seekers had dropped out of treatment. Multivariate logistic regression analyses identified several correlates of treatment-seeking among SA victims: Black race (OR = 7.57), SA during the military (OR = 4.34), positive treatment beliefs (OR = 2.22), social support for treatment (OR = 2.14), self-reliance (OR = 0.47), and stigma towards treatment seekers (OR = 0.43). Mental health symptoms were not associated with treatment seeking. Findings suggested that treatment-facilitating interventions should focus on improving recognition of mental health symptoms, altering perceptions related to self-reliance, and reducing stigma. Interventions should also enlist support for treatment-seeking from unit members, leaders, and significant others.

The role of different stigma perceptions in treatment seeking and dropout among active duty military personnel.

OBJECTIVE: Many military personnel with mental health problems do not seek treatment from mental health professionals, and if they do seek treatment, they drop out of treatment before receiving the recommended number of sessions. The present study examined the role of 4 different stigma perceptions on these outcomes: perceived stigma to career, perceived stigma of differential treatment, self-stigma from seeking treatment, and stigmatizing perceptions of soldiers who seek treatment. METHOD: One thousand three hundred twenty-four active duty soldiers completed a self-report survey assessment that included measures of the 4 different stigma perceptions, indices of mental health symptoms, receipt of mental health treatment, and whether they had dropped out of treatment before it was completed. RESULTS: Participants screening positive for a mental health problem reported higher scores on all 4 stigma perceptions. All 4 stigma perceptions were each associated with a reduced likelihood of treatment seeking when considered individually, but only stigmatizing beliefs about those who seek treatment were uniquely associated with treatment seeking. Perceived stigma for one's career and differential treatment from others, along with self-stigma from treatment seeking, were associated with an increased probability of dropping out of mental health treatment. Self-stigma from treatment seeking was the only unique predictor of dropout. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Different stigma perceptions were associated with treatment seeking and dropout. Further longitudinal research is needed to examine how stigma perceptions influence these important outcomes. Practitioners need to be aware of how different stigma perceptions can influence treatment seeking and potentially target stigma perceptions during treatment to prevent dropout.

Factors associated with use of verbally coercive, incapacitated, and forcible sexual assault tactics in a longitudinal study of college men.

Although verbally coerced and incapacitated sexual assaults are common, less is known about perpetrators of these incidents in comparison to perpetrators of forcible assaults. Furthermore, few studies have investigated factors that differentiate perpetrators who employ different forms of sexual assault tactics. The current study included 526 men who completed self-report inventories at the end of each of their four years in college. Measures assessed sexual assault tactics, demographics, incident characteristics, risky behavior, rape supportive beliefs and peer norms, antisocial traits, and childhood adversity. Perpetrators were grouped based on the most severe tactics reported over the course of 7 assessed time periods, with 13% in the verbal coercion group, 16% in the incapacitation group, and 5% in the forcible group. ANOVAs determined that the forcible group scored significantly higher than incapacitation and verbal coercion groups on risky behavior, rape supportive beliefs/norms, antisocial traits, and childhood adversity. The incapacitation group scored higher than the verbal coercion group on risky behavior. In a multinomial logistic regression analysis comparing tactic groups to non-perpetrators, all tactic groups scored significantly higher on risky behavior and rape supportive beliefs/norms, and the forcible group scored higher on antisocial traits and childhood adversity. Perpetrators in the forcible group had engaged in more repeat offenses, and perpetrators of both the incapacitated and forcible assaults were more likely to use alcohol before the incident. Findings highlight the need for interventions that are tailored to offense trajectories, alter rape supportive attitudes and peer norms, and decrease campus substance use. Aggr. Behav. 41:34-43 2015. © 2014 Wiley Periodicals, Inc.

A longitudinal study of risk factors for repeated sexual coercion and assault in U.S. College men.

The purpose of the current study was to understand the prevalence, severity, and predictors of repeated sexual coercion and assault (SCA) in a non-criminal sample. Participants were 795 college men who were surveyed at the end of each of their 4 years in college. Participants completed self-report inventories once per year for 4 years. Measures assessed demographics, adverse childhood experiences, offense characteristics, antisocial personality characteristics, attitudes towards women and forced sex, perceived social norms, sexual behavior, and substance use. Results indicated that, among the 238 participants who reported at least once incident of SCA, 68 % engaged in repeated SCA, with repeat offenders engaging in aggressive acts of higher severity that began at an earlier age. A multinomial logistic regression model compared single and repeat offenders to non-perpetrators. Both single and repeat offenders endorsed more risky behaviors and sexually aggressive beliefs than non-perpetrators. Single offenders were higher on childhood adversity than non-perpetrators and repeat offenders were higher on antisocial personality traits than non-perpetrators. A second multivariate model compared single offenders to repeat offenders. Repeat offenders scored higher than single offenders on risky behaviors, sexually aggressive beliefs, and antisocial traits. Findings highlight the high prevalence of repeated SCA in young adults, the need for interventions that decrease rape supportive attitudes and risky substance use, and the importance of expanding models of sexual recidivism to include multiple risk factors.

Does Encouragement by Others Increase Rape Reporting? Findings from a National Sample of Women.

Our study explores the role of victims' consultation with others about whether or not to report their rape to police. Three groups were observed within this sample of 435 rape victims from a national telephone household probability sample of women: those who did not consult with anyone about reporting (n = 364), those who consulted with someone and were encouraged to report to police (n = 40), and those who consulted with someone and were not encouraged to report (n = 31). Descriptive analyses indicated that the encouraged group was more likely to report to police than either of the other two groups (which did not differ from each other). Because there were no differences between the two consulting groups on demographic or rape-related variables, they were combined in subsequent analyses. Consulting with others about whether to report, peri-traumatic fear of injury or death, assault perpetration by a stranger, and concerns about contracting a sexually transmitted disease were significant predictors of reporting to police after controlling for other significant predictors in a multivariate regression analysis. Implications of these findings are discussed, including the benefits and consequences of formal rape reporting for victims, and the role that disclosure recipients may have in assisting victims post-rape (e.g., encouragement of reporting, emotional support).

Driving-related anxiety in recently deployed service members: cues, mental health correlates, and help-seeking behavior.

Recent military operations have involved repeated trauma exposure while driving vehicles. Combat deployment and post-traumatic stress disorder (PTSD) have been associated with risky driving practices, increasing the likelihood of fatalities and problems adjusting to civilian life. However, no studies have specifically examined the role of driving-related anxiety, including common cues and mental health correlates. This study conducted structured interviews with 46 recently deployed service members. Interviews assessed the prevalence of driving-related anxiety or hyperarousal (anger or irritation) in relation to civilian driving scenarios, combat exposure, post-traumatic stress symptoms, depression symptoms, and help-seeking behavior. The majority of participants reported high driving anxiety or hyperarousal in response to scenarios involving close proximity to other cars. Driving-related anxiety was positively correlated with PTSD and depression. Although PTSD and driving anxiety were positively associated with help seeking, only one-third of soldiers sought help for driving anxiety and most sought help from informal sources (i.e., friend and battle buddy). The findings underscore the need to address driving-related anxiety in combat-exposed service members with mental health symptoms, with a particular focus on specific anxiety-provoking situations. Furthermore, interventions that reduce stigma and improve access to formal care could improve help seeking and treatment for these problems.

Correlates of reasons for not reporting rape to police: results from a national telephone household probability sample of women with forcible or drug-or-alcohol facilitated/incapacitated rape.

Rape tactics, rape incident characteristics, and mental health problems (lifetime depression, PTSD, and substance abuse) were investigated as correlates of eight different reasons for not reporting a rape to police among women who had experienced but did not report a rape to police (n = 441) within a national telephone household probability sample. Rape tactics (nonmutually exclusive) included drug or alcohol-facilitated or incapacitated rape (DAFR/IR; n = 119) and forcible rape (FR; n = 376). Principal Components Analysis (PCA) was conducted to extract a dominant set of patterns among the eight reasons for not reporting, and to reduce the set of dependent variables. PCA results indicated three unique factors: Not Wanting Others to Know, Nonacknowledgment of Rape, and Criminal Justice Concerns. Hierarchical regression analyses showed DAFR/IR and FR were both positively and significantly associated with Criminal Justice Concerns, whereas DAFR/IR, but not FR, was associated with Nonacknowledgment as a reason for not reporting to police. Neither DAFR/IR nor FR emerged as significant predictors of Others Knowing after controlling for fear of death or injury at the time of the incident. Correlations among variables showed that the Criminal Justice Concerns factor was positively related to lifetime depression and PTSD and the Nonacknowledgement factor was negatively related to lifetime PTSD. Findings suggest prevention programs should educate women about the definition of rape, which may include incapacitation due to alcohol or drugs, to increase acknowledgement and decrease barriers to police reporting.

Connecting active duty and returning veterans to mental health treatment: interventions and treatment adaptations that may reduce barriers to care.

Recent military operations in Afghanistan and Iraq have involved multiple deployments and significant combat exposure, resulting in high rates of mental health problems. However, rates of treatment-seeking among military personnel are relatively low, and the military environment poses several obstacles to engaging in effective clinical interventions. The current paper first reviews barriers and facilitators of treatment-seeking and engagement among military personnel, including stigma, practical barriers, perceptions of mental health problems, and attitudes towards treatment. Next, this paper reviews treatment adaptations and other interventions that are intended to reduce barriers to care among active duty and returning military personnel. These include early interventions, brief formats, integrating clinicians into the medical and military context, technology-based interventions, addressing negative treatment perceptions, screening/early identification, and enlisting unit support.

Receipt of post-rape medical care in a national sample of female victims.

BACKGROUND: It is important for rape victims to receive medical care to prevent and treat rape-related diseases and injuries, access forensic exams, and connect to needed resources. Few victims seek care, and factors associated with post-rape medical care-seeking are poorly understood. PURPOSE: The current study examined prevalence and factors associated with post-rape medical care-seeking in a national sample of women who reported a most-recent or only incident of forcible rape, and drug- or alcohol-facilitated/incapacitated rape when they were aged ≥14 years. METHODS: A national sample of U.S. adult women (N=3001) completed structured telephone interviews in 2006, and data for this study were analyzed in 2011. Logistic regression analyses examined demographic variables, health, rape characteristics, and post-rape concerns in relation to post-rape medical care-seeking among 445 female rape victims. RESULTS: A minority of rape victims (21%) sought post-rape medical attention following the incident. In the final multivariate model, correlates of medical care included black race, rape-related injury, concerns about sexually transmitted diseases, pregnancy concerns, and reporting the incident to police. CONCLUSIONS: Women who experience rapes consistent with stereotypic scenarios, acknowledge the rape, report the rape, and harbor health concerns appear to be more likely to seek post-rape medical services. Education is needed to increase rape acknowledgment, awareness of post-rape services that do not require formal reporting, and recognition of the need to treat rape-related health problems.

Prevalence and risk of psychiatric disorders as a function of variant rape histories: results from a national survey of women.

PURPOSE: Rape is an established risk factor for mental health disorders, such as posttraumatic stress disorder (PTSD), major depressive episodes (MDE), and substance use disorders. The majority of studies have not differentiated substance-involved rape or examined comorbid diagnoses among victims. Therefore, the aim of the present study was to estimate the prevalence of common trauma-related psychiatric disorders (and their comorbidity) in a national sample of women, with an emphasis on distinguishing between rape tactics. A secondary objective was to estimate the risk for psychiatric disorders among victims of variant rape tactics, in comparison to non-victims. METHODS: A nationally representative population-based sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18-86 years) participated in a structured telephone interview assessing rape history and DSM-IV criteria for PTSD, MDE, alcohol abuse (AA), and drug abuse (DA). Descriptive statistics and multivariate logistic regression analyses were employed. RESULTS: Women with rape histories involving both substance facilitation and forcible tactics reported the highest current prevalence of PTSD (36%), MDE (36%), and AA (20%). Multivariate models demonstrated that this victim group was also at highest risk for psychiatric disorders, after controlling for demographics and childhood and multiple victimization history. Women with substance-facilitated rapes reported higher prevalence of substance abuse in comparison to women with forcible rape histories. Comorbidity between PTSD and other psychiatric disorders was higher among rape victims in comparison to non-rape victims. CONCLUSIONS: Researchers and clinicians should assess substance-facilitated rape tactics and attend to comorbidity among rape victims. Empirically supported treatments are needed to address the complex presentations observed among women with variant rape histories.

Examining posttraumatic stress symptoms in a national sample of homicide survivors: prevalence and comparison to other violence victims.

The present study examined posttraumatic stress disorder (PTSD) symptoms among friends and family members of homicide victims (homicide survivors). Out of a national sample of 1,753 young adults who completed follow-up interviews after participating in the National Survey of Adolescents, 268 homicide survivors and 653 victims of other interpersonal violence were selected for the study. Participants completed structured telephone interviews that covered the loss of a family member or close friend to homicide, violence exposure, and PTSD symptomatology. Findings indicated that 39% of homicide survivors met criteria for all 3 symptom clusters and 30% of homicide survivors met criteria for 2 PTSD clusters (functional impairment was not assessed). Multivariate logistic regression analyses demonstrated that homicide survivors were more likely than victims of other violence to meet criteria for all 3 PTSD symptom clusters (OR = 1.91, p < .05) and 2 symptom clusters (OR = 1.77, p < .05) when demographic characteristics and number of violent events were included in the model. These findings highlight the high prevalence of subthreshold PTSD symptoms among homicide survivors. Results suggest that homicide survivors are at elevated risk for PTSD symptoms in comparison to victims of other interpersonal violence.

Self-rated health in relation to rape and mental health disorders in a national sample of college women.

OBJECTIVE: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. PARTICIPANTS: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. METHODS: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. RESULTS: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). CONCLUSIONS: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.