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Dworkin ER, Menon SV, Bystrynski J, Allen NE. Sexual assault victimization and psychopathology: A review and meta-analysis. Clin Psychol Rev 2017; 56:65-81. [PMID: 28689071 PMCID: PMC5576571 DOI: 10.1016/j.cpr.2017.06.002] [Citation(s) in RCA: 328] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/22/2017] [Accepted: 06/18/2017] [Indexed: 01/18/2023]
Abstract
Sexual assault (SA) is a common and deleterious form of trauma. Over 40years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970 to 2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges' g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and relatively stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. The use of broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) was not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.
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Murrey GJ, Bolen J, Miller N, Simensted K, Robbins M, Truskowski F. History of Childhood Sexual Abuse in Women with Depressive and Anxiety Disorders: A Comparative Study. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/01614576.1993.11074065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lindquist CH, Barrick K, Krebs C, Crosby CM, Lockard AJ, Sanders-Phillips K. The context and consequences of sexual assault among undergraduate women at Historically Black Colleges and Universities (HBCUs). JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:2437-61. [PMID: 23515164 DOI: 10.1177/0886260513479032] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
To examine the context of sexual assault and postassault actions and consequences among women attending historically Black colleges or universities (HBCUs), web-based surveys were administered in November 2008 to 3,951 undergraduate women attending four HBCUs. Data on the context in which assaults occurred were generated for women who had been sexually assaulted since entering college (n = 358). Multivariate models were run on the full sample to examine the association between sexual assault and symptoms of depression and posttraumatic stress disorder (PTSD). Results indicated that most survivors were assaulted by assailants well known to them and when the survivor and perpetrator were drinking alcohol. Very few survivors disclosed their experiences to formal sources of support. Survivors had significantly more symptoms of depression and were more likely to screen positive for PTSD than nonvictims. Further research on disclosure and its moderating role on the mental health consequences of sexual assault is needed.
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Leino EV, Kisch J. Correlates and Predictors of Depression in College Students: Results from the Spring 2000 National College Health Assessment. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2005.10608162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- E. Victor Leino
- a Research director at the American College Health Association , Box 28937, Baltimore , MD , 21240-8937 , USA
| | - Jeremy Kisch
- b Columbia Counseling Center , Suite 127, 5525 Twin Knolla Road, Columbia , MD , 21045 , USA
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Campbell R, Dworkin E, Cabral G. An ecological model of the impact of sexual assault on women's mental health. TRAUMA, VIOLENCE & ABUSE 2009; 10:225-46. [PMID: 19433406 DOI: 10.1177/1524838009334456] [Citation(s) in RCA: 430] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This review examines the psychological impact of adult sexual assault through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology contribute to post-assault sequelae. Using Bronfenbrenner's (1979, 1986, 1995) ecological theory of human development, we examine how individual-level factors (e.g., sociodemographics, biological/genetic factors), assault characteristics (e.g., victim-offender relationship, injury, alcohol use), microsystem factors (e.g., informal support from family and friends), meso/ exosystem factors (e.g., contact with the legal, medical, and mental health systems, and rape crisis centers), macrosystem factors (e.g., societal rape myth acceptance), and chronosystem factors (e.g., sexual revictimization and history of other victimizations) affect adult sexual assault survivors' mental health outcomes (e.g., post-traumatic stress disorder, depression, suicidality, and substance use). Self-blame is conceptualized as meta-construct that stems from all levels of this ecological model. Implications for curbing and/or preventing the negative mental health effects of sexual assault are discussed.
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Affiliation(s)
- Rebecca Campbell
- Michigan State University, Department of Psychology, East Lansing, MI 48824-1116, USA.
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Boykins AD, Mynatt S. Assault history and follow-up contact of women survivors of recent sexual assault. Issues Ment Health Nurs 2007; 28:867-81. [PMID: 17729171 DOI: 10.1080/01612840701493394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this comparative descriptive study is to describe and examine differences in assault characteristics and the issues surrounding follow-up contact of women survivors of a recent sexual assault. This study identified assault characteristics: half of the assaults were by strangers; approximately one-third of the assaults occurred in the victim's home; 29% of the victims were abducted; weapons and physical force were used in over half of the cases; 63% were vaginal assaults; and 86% involved penile penetration. Three months after the assault and the initial examination, only 23% (n = 18) of the study participants could be contacted by telephone for follow-up. The study's findings provide not only data regarding the characteristics of sexual assault, but also the difficulties in contacting adult female survivors for follow-up services. Recommendations outline the importance of thorough, individualized examinations and the need for improved, timely, follow-up services for sexual assault victims.
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Affiliation(s)
- Anita D Boykins
- Loewenberg School of Nursing, University of Memphis, Memphis, Tennessee 38152, USA.
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Butterfield MI, Becker ME. Posttraumatic stress disorder in women: assessment and treatment in primary care. Prim Care 2002; 29:151-70, viii. [PMID: 11856664 DOI: 10.1016/s0095-4543(03)00079-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The focus of this article is to provide primary care clinicians with a better understanding of women who have undergone sexual trauma and have related post-traumatic stress disorder. Victimization has adverse physical and mental health effects and affects a woman's clinical presentation, her coping skills, and the primary care intervention strategies needed to treat her. The article reviews issues of victimization and related PTSD among women, including the prevalence and sequel of victimization, and provides a theoretical framework for primary care intervention, treatment, and referral.
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Affiliation(s)
- Marian I Butterfield
- Department of Veterans Affairs, Health Services Research, Duke University Medical Center, Durham, North Carolina 27705, USA.
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Flanagan AS, Furman WC. Sexual victimization and perceptions of close relationships in adolescence. CHILD MALTREATMENT 2000; 5:350-359. [PMID: 11232262 DOI: 10.1177/1077559500005004006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An attachment perspective is proposed as a framework for conceptualizing the impact of sexual victimization on close relationships. Two studies were conducted to empirically examine the links between sexual victimization and perceptions of romantic, parental, and peer relationships. Study One included 154 undergraduate women, and Study Two included 48 high school seniors. In both studies, approximately half the women reported having experienced some form of coerced sexual experience. The majority were victimized by an acquaintance, and most victims had experienced multiple incidents. The first study found that victimized women had significantly more preoccupied romantic views than nonvictimized women. Retrospective reports indicated that women victimized in college were significantly more dismissing with their fathers in high school. In Study Two, victims reported more negative interactions with romantic partners, but no differences were found for romantic styles. Victims also reported more dismissing parental styles and more negative interactions with their fathers than nonvictims.
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Affiliation(s)
- A S Flanagan
- Psychology Department, Framingham State College, Framingham, MA 01701, USA.
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Bartoi MG, Kinder BN, Tomianovic D. Interaction effects of emotional status and sexual abuse on adult sexuality. JOURNAL OF SEX & MARITAL THERAPY 2000; 26:1-23. [PMID: 10693113 DOI: 10.1080/009262300278614] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study examined the additive, interaction effects of emotional status with sexual abuse on adult sexual functioning and sexual responsibility. The Golombok Rust Inventory of Sexual Satisfaction (GRISS; Rust & Golombok, 1986), the Personality Assessment Inventory (PAI; Morey, 1991), and a questionnaire regarding sexual experiences, number of unwanted pregnancies, number of unsafe sexual partners, and sexual abuse history, were administered to 200 psychology students. One hundred and forty-three participants were retained in the study. Two-way multivariate analyses of variance (MANOVA) were conducted for the sexual functioning variables (as measured by the GRISS), while two-way analyses of variance (ANOVA) were conducted for the sexual irresponsibility variables (as measured by the sexual experiences questionnaire). It was found that women who have high anxiety scores on the PAI and have a history of sexual abuse reported higher numbers of unwanted pregnancies, while sexual abuse history was not associated with numbers of unwanted pregnancies for women with lower levels of anxiety. Results were not significant, however, for the sexual functioning variables. In addition, depression and alcoholism did not have interacting effect on the association between sexual abuse history and any of the sexuality variables. These results may suggest that the effects of sexual abuse on adult sexuality may not be as pervasive as was once thought.
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Goodman LA, Koss MP, Felipe Russo N. Violence against women: Physical and mental health effects. Part I: Research findings. ACTA ACUST UNITED AC 1993. [DOI: 10.1016/s0962-1849(05)80114-3] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mackey T, Sereika SM, Weissfeld LA, Hacker SS, Zender JF, Heard SL. Factors associated with long-term depressive symptoms of sexual assault victims. Arch Psychiatr Nurs 1992; 6:10-25. [PMID: 1567243 DOI: 10.1016/0883-9417(92)90050-s] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Of 63 sexual assault victims who were a mean 7.9 years postevent, almost two thirds (60%, n = 38) demonstrated some degree of depression. Over half (56%, n = 35) the sample also reported a history of childhood sexual abuse. Three factors had a significant positive association with higher levels of depression: nondisclosure of the assault to significant others due to concerns about stigma; the presence of children living with the victim; and a civil lawsuit pending. One factor, currently being sexually active, had a significant negative association with depression. Results are discussed from the perspective of depression, a common pathway by which unresolved sexual trauma is expressed.
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Affiliation(s)
- T Mackey
- Department of Psychiatric-Mental Health Nursing, University of Michigan, Ann Arbor 48109-0482
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Abstract
A diagnosis of posttraumatic stress disorder (PTSD) encompasses several of the symptoms associated with the response to rape. The object of this study was to determine the incidence of PTSD among 51 rape victims and to compare the groups with and without PTSD with respect to the characteristics of the assaults. The results showed that 70% of the victims had PTSD and further suggested that PTSD was likely to be a long-term problem for these women. The results supported the view that psychological treatment approaches to rape victims should take into account the posttraumatic nature of the response. The incidence of rapes by strangers, of physical force being used, of weapons being displayed and of injuries being sustained by the victim were all higher in the group of women who had PTSD. These are all features that can be readily identified in the initial assessment of the rape victim and may help to identify the victims at risk of developing long-term psychological sequelae after rape. Appropriate therapeutic action taken early may influence the prognosis for a significant proportion of rape victims.
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Affiliation(s)
- I T Bownes
- Department of Mental Health, Queen's University of Belfast, Northern Ireland, United Kingdom
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Brown BE, Garrison CJ. Patterns of symptomatology of adult women incest survivors. West J Nurs Res 1990; 12:587-96; discussion 596-600. [PMID: 2238638 DOI: 10.1177/019394599001200502] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- B E Brown
- College of Nursing, University of Tennessee, Knoxville
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Abstract
The number of sexual attacks on children is staggering, yet it is extremely difficult to understand what effective treatments are available for the pedophile by reviewing the literature. Therefore, the authors present an update of the changing conceptualizations regarding the offenders and their victims. An overview of the currently used modalities to treat the pedophile is presented with emphasis on the promising cognitive-behavioral approach. A brief description of this approach is given with two case illustrations.
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