Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood

Sexual assault experience, depression, and heavy substance use among German adults: an exploratory mediation analysis

BACKGROUND

The experience of sexual assault may be associated with numerous adverse outcomes, including depressive disorders and heavy substance use. We aimed to examine the relationship between heavy substance use and depression in victims of sexual assault.

METHODS

We used nationally representative data from the German Health and Sexuality Survey (GeSiD) with N = 4,955 women and men aged 18-75 years. We assessed (i) the potential effect of sexual assault experience on depression mediated through hazardous alcohol, heavy tobacco, and frequent cannabis use and (ii) sexual assault experience on heavy substance use mediated through depression using logistic regression analysis to estimate proportion mediated (PM).

RESULTS

We found some evidence of mediation between sexual assault as a lifetime event and depression by heavy tobacco use (PM = 1.6%) and frequent cannabis use (PM = 14.7%) among women. We also observed mediation by hazardous alcohol use (PM = 35.5%) and heavy tobacco use (PM = 48.6%) among men who experienced childhood sexual assault. Focusing on depression as a potential mediator, we found some evidence of mediation between sexual assault as a lifetime event and heavy tobacco use among women (PM = 17.6%) and men (PM = 13.3%), and between sexual assault as a lifetime event and frequent cannabis use (PM = 26.9%) among women.

CONCLUSIONS

Our findings suggest that public health specialists, clinicians, and therapists should develop early interventions to prevent addiction and the development of depression after experiencing sexual assault.

Guardians of consent: enhancing rape prevention through social control mechanisms

Introduction

Rape is a severe violation involving non-consensual sexual acts, often accompanied by force, threats, or coercion, leading to profound physical, emotional, and social consequences for survivors.

Aim

This review aims to examine and synthesize research on effective strategies for rape prevention and intervention, with a particular focus on social control mechanisms, legal frameworks, cultural change, educational programs, public awareness campaigns, community vigilance, victim support services, and the influence of digital media.

Methodology

A comprehensive review was conducted by searching PubMed, Scopus, PsycINFO, and Google Scholar for peer-reviewed articles, policy papers, and reports from the past 20 years. Keywords like "rape prevention," "legal frameworks," and "consent education" were used with Boolean operators to refine the focus. Articles addressing prevention strategies, social control, legal reforms, or public awareness with empirical findings or theoretical insights were included, while unrelated studies were excluded. From 6500 records, 39 studies were ultimately included after screening and eligibility assessments.

Results

The global and national burden of rape is substantial, with significant prevalence differences influenced by cultural, socio-economic, and legal factors. Effective prevention of rape necessitates a multifaceted approach that includes stringent legal frameworks, comprehensive education on consent, public awareness campaigns, social control, and community vigilance.

Discussion

Social control plays a critical role in these prevention strategies, encompassing both formal mechanisms like legal sanctions and informal controls such as societal norms and cultural attitudes. Challenges to these efforts include persistent rape myths, victim-blaming, inconsistent legal definitions of consent, and the evolving complexities of digital media. However, global examples such as Sweden's consent-based legal reforms and the UK's cultural shift through public campaigns demonstrate that these challenges can be addressed effectively. National efforts, including the "It's On Us" campaign in the United States and legal reforms in India, further highlight the importance of tailored interventions to address specific contextual challenges.

Conclusion

Ultimately, overcoming these challenges requires an integrated strategy that combines legal reforms, educational initiatives, cultural change, and robust support systems for survivors. By learning from successful global and national models, societies can build more effective frameworks for preventing rape and ensuring justice for those affected.

Psychological intervention in women victims of childhood sexual abuse: a randomized controlled clinical trial comparing EMDR psychotherapy and trauma-focused cognitive behavioral therapy

Introduction

Childhood sexual abuse persists as a painful societal reality, necessitating responses from institutions and healthcare professionals to prevent and address its severe long-term consequences in victims. This study implements an intervention comprising two psychotherapeutic approaches recommended by the WHO and international clinical guidelines for addressing short-, medium-, and long-term posttraumatic symptomatology: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Both approaches are adapted from group formats for implementation in small online groups via Zoom.

Methods

The impact of both therapeutic approaches on trauma improvement was assessed in a sample of 19 women who were victims of childhood sexual abuse through a Randomized Clinical Trial comparing EMDR Psychotherapy and Trauma-Focused Cognitive Behavioral Therapy after a baseline period. Intra and inter comparison were made using statistics appropriate to the sample.

Results

Both therapeutic approaches significantly reduced symptomatology across various evaluated variables, suggesting their efficacy in improving the quality of life for these individuals. Following CBT-FT treatment, patients exhibited enhanced emotional regulation, reduced reexperiencing, and avoidance. The EMDR group, utilizing the G-TEP group protocol, significantly improved dissociation, along with other crucial clinical variables and the perception of quality of life.

Discussion

Although the limitations of this study must be taken into account due to the size of the sample and the lack of long-term follow-up, the results align with existing scientific literature, underscoring the benefits of trauma-focused psychological treatments. The online group format appears promising for enhancing the accessibility of psychological treatment for these women. Furthermore, the differential outcomes of each treatment support recent research advocating for the inclusion of both approaches for individuals with trauma-related symptomatology.

Ethics and dissemination

The study has been approved by the Ethics Committee of the Valencian International University (VIU) (Valencia, Spain) (Ref. CEID2021_07). The results will be submitted for publication in peer-reviewed journals and disseminated to the scientific community.

Clinical trial registration

https://clinicaltrials.gov/ct2/show/NCT04813224, identifier NCT04813224.