Care-seeking patterns and timely access to care among survivors of sexual violence in North Kivu, the Democratic Republic of the Congo: a retrospective file-based study

BACKGROUND

Sexual violence is widespread in war-torn North Kivu province in the Democratic Republic of the Congo (DRC). Timely access to care is crucial for the healing and wellbeing of survivors of sexual violence, but is problematic due to a variety of barriers. Through a better understanding of care-seeking behaviours and factors influencing timely access to care, programmes can be adapted to overcome some of the barriers faced by survivors of sexual violence.

OBJECTIVE

The aim of this study was to describe demographics, care-seeking patterns and factors influencing timely care-seeking by survivors of sexual violence.

METHODS

Retrospective file-based data analysis of sexual violence survivors accessing care within two Médecins Sans Frontières (MSF) programmes supporting the Ministry of Health, in North Kivu, DRC, 2014-2018.

RESULTS

Most survivors (66%) sought care at specialised sexual violence clinics and a majority of the survivors were self-referred (51%). Most survivors seeking care (70%) did so within 3 days. Male survivors accessing care were significantly more likely to seek care within 3 days compared to females. All age groups under 50 years old were more likely to seek care within 3 days compared to those aged 50 years and older. Being referred by the community, a family member, mobile clinic or authorities was significantly associated with less probability of seeking care within 3 days compared to being self-referred.

CONCLUSION

Access to timely health care for survivors of sexual violence in North Kivu, DRC, is challenging and varies between different groups of survivors. Providers responding to survivors of sexual violence need to adapt models of care and awareness raising strategies to ensure that programmes are developed to enable timely access to care for all survivors. More research is needed to further understand the barriers and enablers to access timely care for different groups of survivors.

Precollege Risk Markers for College Rape and Verbal Sexual Coercion: Same or Different?

Verbal sexual coercion (VSC) and rape are common experiences among college women. Although they have been theorized to involve different risk markers, few prospective studies have examined predictors of VSC and rape separately. The present prospective study was designed to identify precollege risk markers for VSC and rape in first-year college women, with the goal of considering the degree to which they overlap or differ. Women (N = 449) recruited from the community just prior to high school graduation completed measures of sexual victimization (SV) since age 14 but prior to college, sexual refusal assertiveness, high school heavy episodic drinking (HED), college drinking intentions, and sociosexuality. Follow-up surveys at the end of the first and second college semesters assessed VSC and rape. Using the Sexual Experiences Survey's severity scoring method, women were classified into one of three groups according to the most severe type of SV reported in the first year of college: neither VSC nor rape (71%), VSC (16%), and rape (13%). Most women who experienced rape (73%) also experienced VSC. Precollege SV and college drinking intentions predicted both rape and VSC. Sexual refusal assertiveness and high school HED did not independently predict either form of victimization. Sociosexuality predicted rape but not VSC. Findings suggest a substantial overlap in the predictors of VSC and rape and support the severity continuum underlying many conceptualizations of SV.

Making Visible the Myths About Cyber-Sexual Violence Against Women: An Analysis of Social Reactions Toward Victims on Twitter

Cyber-sexual violence is a prevalent and harmful form of aggression committed against women, yet little attention has been paid to the attitudes about cyber-sexual violence. This research therefore aimed to explore the negative attitudes or myths that serve to justify, minimize, and deny the experiences of cyber-sexual violence disclosed by women on Twitter. Using a thematic analysis, we analyzed 4,048 replies to 18 experiences reported on Twitter around the time of the International Day for the Elimination of Violence against Women. After the data were cleaned and coded, the results revealed 18 myths about cyber-sexual violence, grouped into four main themes: (1) minimization/conceptualization, (2) victim blaming, (3) factors related to the diffusion context, and (4) exonerating the perpetrator's responsibility. This study constitutes the first attempt to analyze the myths surrounding cyber-sexual violence on Twitter, including content areas not yet addressed in the literature, such as contextual factors. Strikingly, most of the analyzed reactions appeared to deny and downplay the importance of sexually aggressive behaviors perpetrated against women online, suggesting that these beliefs could influence the underreporting of cyber-sexual violence. Based on these data, it was concluded that while Twitter can serve as a useful "loudspeaker" for victims, it is also a mechanism by which myths about cyber-sexual violence can be supported and disseminated. Finally, it highlights the importance to consider the influence of online cultural frame on the social perception of cyber-sexual violence and point out the specific beliefs that educators, researches and psychologist could work though psychoeducational programs.

Differences Between Girls and Boys in the Disclosure of Sexual Violence

This article addresses the differences between girls and boys in the disclosure of sexual violence. The dataset combines data from the Finnish Child Victim Survey (FCVS) of 2008 (N = 13,459) and 2013 (N = 11,364), focusing on victims of sexual violence, ages 11 to 17 years, from the perspectives of disclosure and gender. Frequency and percentage analysis, cross tabulation, and a Chi-square test were used in the analysis. In the FCVS for both years, around 85% of the victims were girls. In almost two-thirds of the cases, the offender was a relative, friend, or some other known person, while in more than one-third of the cases, the offender was unknown to the victim. The second most common case was that the victim knew the offender, who was not, however, a friend. Sexual violence was found to be, in many ways, gendered. Most of the victims were girls, and most of the offenders were men. There was also a gender difference in the disclosure of experiences. Twenty-one percent of the girls and 45% of the boys reported that they had not told anyone about their experiences. Irrespective of the type of offender, the victims most often (63%) told a peer about their experiences, while 23% told parents, and only 10% told authorities. Moreover, victims reported shame and fear, distrust toward adults, and disbelief that disclosure would be helpful as reasons for not disclosing their experiences. To address this problem, raising awareness of the phenomenon, promoting an atmosphere that supports disclosing experiences of sexual violence, and improving readiness to address them are required.

Factors Associated with Sexual Victimization Among Transgender Emerging Adults

This cross-sectional study documented between-group differences in risk factors associated with sexual victimization histories in an ethnically and racially diverse sample of transgender emerging adults (N = 248, ageM = 22.61 years). The sample was recruited using the Internet-based CloudResearch platform to answer questionnaires assessing predictors for recent experiences of intimate partner violence (IPV). Participants were categorized into four groups based on cross-classified self-reports of child sexual abuse (CSA) and recent sexual IPV, prior to the use of multivariate analysis of variance to evaluate mean score differences for past-year substance use, minority stressor, and relationship functioning variables. Participants reporting sexual IPV reported higher scores for all substance use variables, while transfeminine participants reported significantly higher scores for alcohol use problems and negative consequences related to substance use. Participants reporting both CSA and sexual IPV also reported the highest scores for everyday discrimination. Participants who experienced sexual IPV also reported the highest scores for internalized sexual stigma. Sexual revictimization among transgender adults occurs in the context of harmful patterns of substance use and several minority stressors. Our findings have implications for healthcare or counseling services for transgender emerging adults who have experienced multiple forms of victimization, substance use problems, and minority stressors, including the importance of trauma-informed and integrated intervention services, and specialized training for service providers.

General practice trainees' understanding of post-sexual assault care: the impact of a specialist educational intervention

BACKGROUND

Sexual assault (SA) is a highly prevalent issue, with significant adverse health sequelae. Given that general practitioners (GPs) may serve as the first point of contact for many SA victims, their awareness of post-SA care and appropriate understanding of referral pathways to a sexual assault treatment unit (SATU) are critically important. This study evaluated GP trainees' knowledge of and comfort with post-SA care.

METHODS

Educational intervention study using a didactic teaching session was delivered by a specialist forensic examiner on post-SA care. A pre and post-study questionnaire was implemented to assess participants' knowledge and comfort levels with subject material. Significance was set at p-value below 0.05.

RESULTS

Seventy-five GP-trainees attended the teaching session. Fifty-three completed the pre-teaching questionnaire and 50 completed the post-teaching questionnaire. Only a minority of trainees had received prior teaching in post-SA care as a medical student (13.2% n = 7) or as a postgraduate (28.3% n = 15). After the teaching session, there was a significant improvement trainees' comfort levels in explaining a forensic examination (p < 0.0001), referral pathways to a SATU (p < 0.0001) and offering advice in relation to emergency contraception (p < 0.0001). There was also a significant improvement in understanding HIV post-exposure prophylaxis (PEP) (p < 0.001) and forensic examination (FE) time-lines (p < 0.001).

CONCLUSION

This study reveals that GP-trainees have had limited exposure to teaching on post-SA care. Additionally, significant improvements were observed following a 1-h didactic teaching session on post-SA care. Trainees demonstrated increased understanding of SATU referral pathways, understanding of immediate medical care after SA, including PEP and FE timelines.

The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence

The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence is not well understood. To address this we conducted a systematic review and meta-synthesis of qualitative studies. Our search strategy included electronic searches of 18 databases and grey literature, citation tracking and reference list screening. Studies were eligible if they presented qualitative data from racially and/or ethnically minoritised women or girls, who had experienced sexual violence at any age and described their experiences of receiving treatment from statutory mental health and/or substance use services. Studies were analysed using meta-ethnography. Fourteen papers based on 12 individual studies were included. Analysis developed three main themes: (1) understanding minoritised women holistically, (2) processing the trauma and beginning the healing and (3) the need for social connectedness and empowering relationships. For minoritised women to benefit from treatment, mental health and substance use services need to challenge the dynamics of the multiple traumas minoritised women experience. Knowledge and understanding of the racial trauma minoritised women experience is limited and many are subjected to further harm from racist practices occurring in some treatment services. Offering culturally safe, trauma-informed care which promotes anti-racist practices may help improve mental health and substance use service responses to minoritised women who have experienced sexual violence.

Waist-to-Hip Ratio Predicts Sexual Perception and Responses to Sexual Assault Disclosures

The current work investigates the effects of target of perception's waist-to-hip ratio (WHR) on perceivers' judgments of sexual unrestrictedness and sexual victimization prototypicality. Studies 1a and 1b found that women with lower WHRs were perceived as relatively more sexually unrestricted. Studies 2a and 2b found that women with lower WHRs were perceived as relatively more prototypic of sexual victimization. Study 3 built on these findings to consider implications for responses to sexual assault disclosures. Perceivers disbelieved and minimized a disclosure of assault relatively more when made by a woman with a higher WHR. In sum, this body of work implicates WHR as a body cue that can inform consequential sexual perception. Thereby, this work identifies factors that could influence judgments of credibility of sexual violence reports, which may have implications for hesitancy to report sexual violence.

Sexual exploitation of young men: Background characteristics and needs from a life-course perspective

BACKGROUND

Sexually exploited young men are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent young men to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame.

OBJECTIVE

By gaining more insight into the background characteristics of young men who experienced sexual exploitation and their needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts.

METHODS

Twenty-six young men (age 14-32) who experienced sexual exploitation or other forms of sexual violence in their youth or were at high-risk, participated in this qualitative study that was conducted in The Netherlands. By means of semi-structured interviews and case-file analyses, data was collected to identify risk and protective factors in their life-course and support needs.

RESULTS

Several vulnerabilities (e.g. previous experiences of abuse and neglect, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led young men into high-risk situations. Among these were involvement in pay dates, criminality and having to survive from day to day, which contributed to victimization. Prevailing gender norms and experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support.

CONCLUSIONS

These results will contribute to adequate prevention and trauma-informed intervention strategies that meet the unique needs of young men at risk for, or victim of sexual exploitation.

Facilitators and Barriers of Bystander Intervention Intent in Image-Based Sexual Abuse Contexts: A Focus Group Study with a University Sample

Image-based sexual abuse (IBSA) encompasses the taking, sharing, and/or threatening to share nude or sexual images of others without their consent. The prevalence of IBSA is growing rapidly due to technological advancements, such as access to smartphones, that have made engagement in such activities easier. Bystanders offer an important means of intervention, but little is known about what facilitates or inhibits bystander action in these contexts. To address this gap in the literature, seven focus groups (n = 35) were conducted to explore the factors that facilitate and inhibit bystander action in the context of three different IBSA scenarios (taking, sharing, and making threats to share nude or sexual images without consent). Using thematic analysis, eight themes were identified, suggesting that the perceived likelihood of intervention increased with greater feelings of responsibility, empathy with the victim, reduced feelings of audience inhibition, greater feelings of safety, greater anger toward the IBSA behavior, closer relationships with the victim and perpetrator, the incident involving a female victim and male perpetrator, and perception of greater benefits of police involvement. These findings are considered alongside the physical sexual violence literature in highlighting the similarities and nuances across the different contexts. Implications for the development of policies and educational materials are discussed in relation to encouraging greater bystander intervention in IBSA contexts.

Organized sexualized and ritual violence: Results from two representative German samples

BACKGROUND

Organized sexualized and ritual abuse (ORA), a contentious issue since the 1980s, remains a polarizing topic. Although there is much debate about the existence of this phenomenon, a differentiated perspective is lacking, and no representative study has yet addressed the frequency.

OBJECTIVE

This paper aims to investigate the frequency of ORA in Germany using two representative datasets.

PARTICIPANTS AND SETTING

Data were collected from representative samples of the German population (N = 2522, N = 2515). Participants aged 16 to 96 years (50 and 53 % female) were recruited. They were selected by a random route procedure and asked to fill out a paper-pencil-questionnaire.

METHODS

The four aspects of ORA (severe sexual violence, perpetrator networks, commercial exploitation, ideology) were assessed based on the definition provided by an expert group. Additionally, in the second survey, a direct yes/no question about the experience of ORA as well as details on perpetrators and offense characteristics were surveyed.

RESULTS

Frequency of ORA was low. The direct question on ORA was affirmed by 0.5 % (n = 13), while according to the criteria of the definition, only 0.2 % or less of individuals experienced organized sexualized abuse, and <0.1 % experienced ritual abuse.

CONCLUSION

Although ORA is discussed thoroughly, frequencies in the German population are low. This may be due to inconsistent terminology and operationalization of definitions with lack of precision. However, an intersection of conspiracy beliefs and the topic of ritual violence sheds another light on this issue that should receive more attention.

Development of a brief bedside tool to screen women sexual assault survivors for risk of persistent posttraumatic stress six months after sexual assault

This study aims to develop and validate a brief bedside tool to screen women survivors presenting for emergency care following sexual assault for risk of persistent elevated posttraumatic stress symptoms (PTSS) six months after assault. Participants were 547 cisgender women sexual assault survivors who presented to one of 13 sexual assault nurse examiner (SANE) programs for medical care within 72 h of a sexual assault and completed surveys one week and six months after the assault. Data on 222 potential predictors from the SANE visit and the week one survey spanning seven broadly-defined risk factor domains were candidates for inclusion in the screening tool. Elevated PTSS six months after assault were defined as PCL-5 > 38. LASSO logistic regression was applied to 20 randomly selected bootstrapped samples to evaluate variable importance. Logistic regression models comprised of the top 10, 20, and 30 candidate predictors were tested in 10 cross-validation samples drawn from 80% of the sample. The resulting instrument was validated in the remaining 20% of the sample. AUC of the finalized eight-item prediction tool was 0.77 and the Brier Score was 0.19. A raw score of 41 on the screener corresponds to a 70% risk of elevated PTSS at 6 months. Similar performance was observed for elevated PTSS at one year. This brief, eight-item risk stratification tool consists of easy-to-collect information and, if validated, may be useful for clinical trial enrichment and/or patient screening.

Sexual Assault Among College Women: The Role of Survivor Acknowledgment, Rape Myth Acceptance, Weight Bias, and Body Appreciation

Approximately one in five college women experience a sexual assault (SA), though a meaningful percentage of survivors do not acknowledge or label their experience as such. Research indicates that acknowledgment status is often influenced by how closely SA incidents align with the "real rape" script and degree of survivor rape myth acceptance (RMA). However, studies evaluating acknowledgment paired with other attitudes and health outcomes among survivors is sparse. The current study examined the relation between acknowledgment status, RMA, weight-related constructs, and psychological well-being among three groups of college women (N = 584): non-survivors, unacknowledged survivors, and acknowledged survivors. Findings indicate that, among survivors, acknowledged compared to unacknowledged SA is significantly associated with diminished body appreciation, self-esteem, and increased internalized weight bias, though no differences in psychological distress were found.

Yes, It's that Common and Yes, It's that Bad: An Estimation of the Prevalence and Psychological Correlates of Rape and Sexual Assault in College Women

Rape myths play a role in rape denialism, in which individuals deny the prevalence and severity of sexual assault. This project aimed to address two common rape myths: that rape is uncommon and its effects are exaggerated. To test these claims, we explored two archival samples consisting of undergraduate women. Study 1, a 5-year chart review of university counseling center intake forms (n = 883), demonstrated that 30.2% of clients had experienced "sexual violence," "sexual contact without consent," or both. Study 2, a re-analysis of an emerging adulthood resilience survey dataset (n = 359), demonstrated that 20.6% of subjects had a history of sexual assault, and that those women reported lower life satisfaction and more severe psychological symptoms than those who did not. These findings are in line with previous literature debunking harmful rape myths that contribute to the perpetuation of rape culture. Our data help validate these rape notions as mythical; rape is indeed common and devastating.

The shame of sexual violence towards women in rural areas

This perspective paper presents a discussion around the issues of sexual violence (SV) in rural and remote areas and the associated discourses of shame. The authors propose that shame of SV adds additional trauma to survivors, further impacting survivors' mental health which may be exacerbated in rural areas. Shame is a complex emotion that can result in increased feelings of guilt, humiliation, and embarrassment. Shame has been identified as an underlying risk factor and a mechanism for post-assault mental health problems. We propose it can be particularly pronounced for women subjected to sexual assault in rural or remote areas. This paper will explore the link between SV and shame, explain how shame attached to SV may be used as an informal social control mechanism for women, particularly in rural and remote areas, and discuss the role of health practitioners, particularly mental health nurses, who play a key role in supporting people impacted by SV. SV is an insidious social phenomenon that can have profound consequences for individuals, families, and communities. Addressing shame and stigma is a crucial component of supporting survivors of SV in rural and remote areas. There is a need for targeted community-led interventions and responsive support services to address the complex and multifaceted issues contributing to SV in rural and remote communities.

Validity and reliability of the Violence Risk Scale-Sexual Offense version in a community sexual offense outpatient setting

The present study examined the convergent, structural, and predictive properties of Violence Risk Scale-Sexual Offense version (VRS-SO) scores in a sample of 200 men on community supervision for sexual offenses, attending forensic community outpatient services and followed up an average 8.6 years. The VRS-SO and two additional dynamic sexual recidivism risk measures-STABLE 2007 and Sex Offender Treatment Intervention and Progress Scale (SOTIPS)-were coded archivally from clinic files; Static-99R ratings were extracted. Recidivism data were captured from Royal Canadian Mounted Police records. VRS-SO static, dynamic, and total scores demonstrated expected patterns of convergence with total and subscale scores of the risk measures. Moreover, a confirmatory factor analysis of the VRS-SO dynamic item scores demonstrated acceptable model fit for a correlated three-factor solution consistent with prior confirmatory factor analyses. Discrimination analyses demonstrated that VRS-SO dynamic and total scores and STABLE 2007 scores had large prediction effects for 5-year sexual recidivism (area under the curves [AUCs] = .71-.72) while SOTIPS had a medium effect for this outcome (AUC = .67); the measures yielded medium to large effects for nonsexual recidivism. Cox regression survival analyses demonstrated that VRS-SO dynamic, Sexual Deviance factor, and SOTIPS scores each incrementally predicted sexual recidivism controlling for Static-99R or VRS-SO static factor scores. VRS-SO calibration analyses demonstrated that expected or predicted 5-year sexual recidivism rates showed generally close correspondence to the rates predicted or observed in the present community sample. Results support the psychometric properties of the VRS-SO, a sexual violence risk assessment and treatment planning measure, to a community outpatient sample. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Using Military Screening Questions to Anonymously Recruit Post-9/11 Era Service Members and Veterans Using Online Survey Methods

INTRODUCTION

The ability to collect data on posttraumatic reactions following military sexual trauma is impacted by data collection methods, such that under-reporting can occur when data are believed to be identifiable. This may be especially true for topics that are sensitive, including sexual trauma. Ensuring participation from service members using non-identifiable methods is challenging when service history cannot be confirmed. The COVID-19 pandemic complicated data collection due to contact and social distancing requirements and limitations. To attempt to overcome these challenges, this study utilized an anonymous survey delivered by Qualtrics, Inc. with military validation checks that served as a screening mechanism. The purpose of the current report is to describe the development and use of military validation questions to recruit a sample of military sexual assault survivors using an anonymous survey.

MATERIALS AND METHODS

Qualtrics, Inc., a data collection software company, was contracted to collect data on military service members and veterans who reported military sexual assault. We developed and piloted four validation checks regarding military knowledge, which had to be answered correctly before participants could engage in the survey. This information was common to those who have served but uncommon to civilians, ensuring, to the best of our ability, that those responding were or had been service members. An incorrect response to any of the validation checks resulted in termination from the study. The probability of guessing correctly all four items was 0.16%.

RESULTS

The current study collected data on 200 women and 200 men, all of whom reported military sexual assault. Data collection took approximately 6 weeks to complete. The validation checks resulted in screening out 1,450 potential participants who provided fraudulent responses. The average cost per participant, which included recruitment costs and participant payment, was $20. Given the histories of military sexual assault, the cohort reported high rates of probable positive screens for posttraumatic stress disorder (PTSD), suicide risk, and moderately severe depression, as well as other interpersonal challenges that are typically reported by those exposed to sexual assault, suggesting our validation checks were effective in recruiting the desired sample. Though not an original goal of our recruitment efforts, 9.75% (n = 39) of our sample identified as a sexual orientation other than heterosexual, including gay, bisexual, questioning, or "other."

CONCLUSIONS

Use of Qualtrics, Inc. to incorporate validation checks helped us to be more reasonably confident that we were collecting data from military service members who reported military sexual assault. While the probability of a person without current or past military service passing the validation checks was low, it was not impossible. An unanticipated benefit of this platform was the short duration of time it took to complete data collection; the sample was collected within about 6 weeks. This platform may be a good option for investigators who cannot collect face-to-face data.

The impact of the #MeToo movement on language at court A text-based causal inference approach

This study assesses the effect of the #MeToo movement on the language used in judicial opinions on sexual violence related cases from 51 U.S. state and federal appellate courts. The study introduces various indicators to quantify the extent to which actors in courtrooms employ language that implicitly shifts responsibility away from the perpetrator and onto the victim. One indicator measures how frequently the victim is mentioned as the grammatical subject, as research in the field of psychology suggests that victims are assigned more blame the more often they are referred to as the grammatical subject. The other two indices designed to gauge the level of victim-blaming capture the sentiment of and the context in sentences referencing the perpetrator. Additionally, judicial opinions are transformed into bag-of-words and tf-idf vectors to facilitate the examination of the evolution of language over time. The causal effect of the #MeToo movement is estimated by means of a Difference-in-Differences approach comparing the development of the language in opinions on sexual offenses and other crimes against persons as well as a Panel Event Study approach. The results do not clearly identify a #MeToo-movement-induced change in the language in court but suggest that the movement may have accelerated the evolution of court language slightly, causing the effect to materialize with a significant time lag. Additionally, the study considers potential effect heterogeneity with respect to the judge's gender and political affiliation. The study combines causal inference with text quantification methods that are commonly used for classification as well as with indicators that rely on sentiment analysis, word embedding models and grammatical tagging.

Reports on sexual violence published in an online Chinese newspaper: A new frame research

The leading role of the media is very important in the new media era to build the reporting system and framework of sexual violence crimes, guide people's awareness and public opinion, and improve society's vigilance on sexual crimes. This study took People's Daily Online, a representative online media in China, as a research object to analyse the reporting of sexual crimes over the past 15 years. We conducted relevant searches for specific keywords set in the Python crawler and used IBM SPSS Statistics 19 software to analyse the frequency of relevant content. The results of the research show that, firstly, there have been significant changes in the number of news stories about sexual crimes. Second, the majority of sexual crime news stories are from mainland China. Third, the focus of the news stories and people is relatively concentrated on the perpetrators. Fourth, the People's Daily Online's coverage of sexual crimes focuses on blaming the perpetrators. Fifth, sexual crimes show that the framework is more episodic. This paper examines changes in the coverage of sexual crimes in China and captures how the media cover socially relevant issues, providing important insights for future social health, psychological awareness and diversion, and media policy.

"In the End You Keep Silent": Help-Seeking Behavior Upon Sexual Victimization in Older Adults

Sexual violence is considered a prominent mental health problem. Exposure to sexual victimization during lifetime has been linked to mental health problems in old age. Research in adult victims has shown that they experience many barriers for disclosure and seeking professional help upon sexual victimization. However, information on help-seeking behavior in older victims of sexual violence is non-existent. With this study we aim for a better understanding of help-seeking behavior upon sexual violence in older adults. We used a mixed methods approach with an explanatory sequential design. Data were collected through structured face-to-face interviews with a random sample of 227 sexual violence victims of 70 years and older living in Belgium. Quantitative data were triangulated with qualitative data from 15 in-depth interviews with older victims. We found that up to 60% of older sexual violence victims never disclosed their experiences and 94% never sought professional help. Help-seeking is a complex process comprising several phases, which are affected by strong feelings of shame and self-blame, ageist premises and taboos about sexuality. In the end, most victims choose to cope on their own. Occasional disclosure only happens decades after the sexual violence took place. Older victims do not spontaneously disclose to healthcare workers but expect professionals to initiate the conversation. In conclusion, few older victims disclose or seek professional help upon sexual victimization. Healthcare professionals working with older adults need capacity building through training, screening tools, and care procedures to initiate conversation on sexual violence, and to detect signs, prevent, mitigate and respond to sexual victimization in older adults.

Barriers to recruitment and retention of undergraduate men as college sexual assault prevention peer educators

Objective: Male allies play an important role in sexual assault prevention, yet many college sexual assault prevention programs struggle to recruit and retain men. This study aims to identify barriers to recruitment and retention of male sexual assault prevention peer educators. Participants: Seventeen undergraduate male student leaders participated in this study during summer 2018. Methods: Semi-structured phone interviews were conducted, recorded, and transcribed. Response data were thematically analyzed. Results: Barriers to recruitment include perceived gender norms and discomfort with the topic of sexual assault. Barriers to retention include male peer educators' perception that women are resistant to men discussing sexual assault. Suggestions for improving recruitment and retention efforts are also identified. Conclusions: Recruitment and retention of male sexual assault prevention peer educators may require recruitment approaches that are tailored to men and programmatic changes that position men as allies in sexual assault prevention.

Longitudinal patterns of posttraumatic stress disorder symptoms among sexual assault survivors: A latent transition analysis

OBJECTIVE

The aim of this study was to identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a community sample of sexual assault survivors whose assaults occurred varying lengths of time in the past and to explore patterns of transition between those latent classes over time.

METHOD

Latent class analysis was used to identify naturally occurring subgroups of PTSD symptoms in a sample of sexual assault survivors who completed two mailed surveys 1 year apart (N = 1,271). Latent transition analysis was then used to examine individuals' probabilities of transitioning into each latent class at Time 2 based on their latent class membership at Time 1.

RESULTS

A four-class model emerged as the best fitting model at both Time 1 and Time 2. Classes demonstrated overall severity and symptom cluster severity differences. Transition into a lower severity class was more common than transition into a higher severity class, though escalation was demonstrated by 6-20% of participants in each latent class.

CONCLUSIONS

The substantial heterogeneity in sexual assault survivors' PTSD symptoms highlights the variety of ways that posttraumatic stress may be experienced years after a sexual assault. Future research should explore factors that affect long-term symptoms, including cumulative lifetime trauma and social support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Attitudes, Emotions, and Emotion Regulation as Underlying and In-The-Moment Predictors of Men's Intentions to Perpetrate Sexual Assault: An Application of the I3 Model

Sexual assault is a significant problem among young men, and several underlying and in-the-moment factors are associated with this behavior. However, research has not examined how underlying factors may influence men's in-the-moment use of emotion regulation (ER) strategies, emotional experience during sexual situations, or intentions to perpetrate sexual assault. 187 young, single men from the United States who had sex with a woman in the past year completed questionnaires, projected themselves into hypothetical sexual scenarios, and indicated how they would behave when their partner withdrew consent during these scenarios. Participants were grouped into profiles of ER strategy use, which was used as part of a model predicting sexual assault perpetration. Specifically, men with greater hostility toward women were especially likely to use a "low acting with awareness, low resignation" profile, which was associated with greater anger, impulsivity, and intentions to perpetrate. This could be attributed to the increased cognitive load, increased rumination on their partner's refusal, or increased drive to obtain sex associated with this profile. Future research should replicate these results in a more diverse sample, and examine the efficacy of interventions redirecting participants away from a "low acting with awareness, low resignation" profile on sexual assault prevention.

Institutional Betrayal and Closeness Among Women Veteran Survivors of Military Sexual Trauma: Associations with Self-Directed Violence and Mental Health Symptoms

Institutional betrayal is defined as harm caused by an institution to an individual in the context of trust and dependence. High institutional betrayal is associated with poorer health outcomes, and high levels of trust, dependence, or identification with the institution (institutional closeness) may exacerbate the negative effects of institutional betrayal. While military sexual trauma is prevalent among women Veterans and associated with high rates of institutional betrayal, studies of the impact of military sexual trauma-related institutional betrayal have been limited in size and scope and have not examined the potential role of institutional closeness. We conducted a secondary analysis of national survey data collected from women Veterans who screened positive for military sexual trauma (n = 229). Hierarchical logistic and linear regression were used to examine associations between predictor variables (institutional betrayal, institutional closeness, and their interaction) and outcomes of interest and adjusted for age, education, and military sexual assault history. Institutional betrayal was associated with increased odds of suicidal ideation and suicide attempt during or following military service, as well as more severe symptoms of depression and posttraumatic stress disorder (PTSD). Institutional betrayal was not associated with non-suicidal self-injury or lifetime substance misuse. Counter to hypotheses, institutional closeness did not moderate relationships between institutional betrayal and mental health symptoms or self-directed violence. Results underscore the necessity of preventing and addressing institutional betrayal among women Veterans who experience military sexual trauma.

The Reintegration of Men into Society after a Sexual Offense: A Hermeneutic Phenomenology Study

The purpose of this study was to describe the lived experience and meaning of being a 'sex offender' for the individual who is reintegrating into society, considering issues associated with self-perception, perception of others, stigma and humanization. Fourteen male adults were invited to participate in this hermeneutic phenomenological study. Data analysis was completed using an iterative process as described by van Manen. Five major themes were identified: exposed secret leads to humiliation; being considered a sex offender is living in fear of the unknown; stigma and shame consume the identity of the individual charged with a sexual offense; reframing and "leveling" of the crime are coping strategies; and the path toward healing and forgiveness is complex. Contextualizing individuals' experiences and examining barriers and motivators post-charge are essential to minimize stigma and risk factors linked to recidivism, as well as to facilitate recovery and healing.