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Salim SR, Harper KL, Livingston NA, Feinstein BA, Messman TL. Bisexual minority stress as a risk factor for sexual violence-related posttraumatic stress disorder symptoms among bisexual+ women: A multilevel analysis. J Trauma Stress 2025; 38:63-74. [PMID: 39290082 DOI: 10.1002/jts.23102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 09/19/2024]
Abstract
Bisexual+ (e.g., bisexual, pansexual, queer) women experience higher rates of sexual violence (SV) and posttraumatic stress disorder (PTSD) than heterosexual and lesbian women, as well as unique identity-related minority stress. We examined between- and within-person associations between bisexual minority stress and PTSD symptoms related to SV in a sample of young bisexual+ women (N = 133) who reported adult SV (Mage = 22.0 years, range: 18-25 years; 85.0% White; 99.3% cisgender). We analyzed data from four waves of data collection (baseline to 3-month follow-up) using multilevel models. Controlling for SV severity, there was a significant within-person effect of antibisexual stigma from lesbian/gay people on PTSD, β = .17, p = .010, suggesting that at waves when women experienced more stigma, they also reported higher PTSD symptom levels. At the between-person level, women who reported higher levels of antibisexual stigma from heterosexual people, β = .26, p = .043, and anticipated binegativity, β = .29, p = .005, on average across study waves also reported higher average levels of PTSD. Additionally, anticipated binegativity explained the association between average antibisexual stigma and PTSD, β = .15, p = .014, 95% CI [0.45, 4.61]. Bisexual minority stress may be associated with higher PTSD symptom severity following SV among young bisexual+ women, and the anticipation of binegativity may be a target mechanism in this association. Study findings highlight the importance of examining the joint contributions of SV and minority stress to identify novel targets for future research and practice to address PTSD symptoms.
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Affiliation(s)
- Selime R Salim
- Department of Psychology, Miami University, Oxford, Ohio, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Kelly L Harper
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Nicholas A Livingston
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Terri L Messman
- Department of Psychology, Miami University, Oxford, Ohio, USA
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Jung MS, Dlamini NS. Factors Influencing Professional Help-Seeking Intentions for Sexual and Gender-Based Violence Among Female University Students in Eswatini. Public Health Nurs 2025; 42:325-333. [PMID: 39498788 DOI: 10.1111/phn.13477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 10/09/2024] [Accepted: 10/20/2024] [Indexed: 11/07/2024]
Abstract
OBJECTIVES To investigate the prevalence of sexual and gender-based violence (SGBV) among female college students, identify factors influencing intention to seek professional help among SGBV survivors, and compare help-seeking determinants among survivors based on their prior utilization of healthcare services. DESIGN A cross-sectional online survey was employed among female students aged 18-24 years from two universities in Eswatini. MEASUREMENTS AND SAMPLE A total of 271 female college students were recruited to assess SGBV experience, attitudes, social norms, perceived control, help-seeking intention, and other factors not originally included in the theory of planned behavior. Data analyses utilized descriptive statistics, comparative analyses, and multiple regression methods. RESULTS Among the participants, 73.1% reported experiencing one or more forms of SGBV, while only 43.4% sought professional help through health services. Help-seeking intentions of survivors were significantly associated with positive attitudes, subjective norms, and marital status, collectively explaining 66% of the variance. In subgroup analyses, the subjective norm and attitude emerged as the most robust predictors of help-seeking intentions. CONCLUSION The results revealed a high prevalence of SGBV and a concerning trend of low help-seeking behavior, with attitudes and subjective norms emerging as the most influential factors shaping intention. These results provide valuable insights for designing theory-driven and culturally sensitive public health nursing interventions and educational programs aimed at effectively supporting SGBV survivors.
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Affiliation(s)
- Mi Sook Jung
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Stockman D, Uzieblo K, Fomenko E, Littleton H, Keygnaert I, Lemmens G, Verhofstadt L. Psychological Distress and Relational Intimacy following Sexual Violence: A Longitudinal Study. Psychol Belg 2024; 64:185-200. [PMID: 39712937 PMCID: PMC11661156 DOI: 10.5334/pb.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/14/2024] [Indexed: 12/24/2024] Open
Abstract
Increasing evidence shows how distress following sexual violence might spill over to victims' romantic relationship functioning. However, studies investigating the reverse spillover between relationship functioning and psychological distress following sexual violence are lacking. The current study therefore aimed to investigate the bidirectional association between victims' psychological distress (posttraumatic stress, depression, anxiety and stress) and emotional and sexual intimacy using a three-wave yearly survey study of a community sample of sexual violence victims (N = 274, 89% women, 3% men and 8% trans persons, Mage = 32 years, SD = 10.7). Results show evidence for spillover effects for posttraumatic stress and stress on emotional intimacy and for anxiety on sexual intimacy. In addition, reverse spillover effects for emotional intimacy were found on all indicators of psychological distress and for sexual intimacy on depression and anxiety. These results suggest that victims' individual and relational functioning is bidirectionally associated. In addition, results suggest that targeting intimacy levels within romantic relationships might improve victims' individual functioning and vice versa. Future research that includes dyadic assessment could enhance our understanding of the bidirectional associations between individual functioning and couple functioning following sexual violence.
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Affiliation(s)
- Dagmar Stockman
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Expertise Network People and Society, Artevelde University College of Applied Sciences, Ghent, Belgium
- Faculty of Psychology and Educational Sciences Campus Kulak, Catholic University Leuven, Kortrijk, Belgium
| | - Katarzyna Uzieblo
- Department of Criminology, Vrije Universiteit Brussel, Brussels, Belgium
- Helpline 1712, Centre for General Well-being, Leuven, Belgium
| | - Elizaveta Fomenko
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Heather Littleton
- Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, United States
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department Head and Skin –Psychiatry, Ghent University, Ghent, Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Salvador Sánchez L, Rodríguez Conesa N, Sánchez Ramón S, Rey Novoa M. [Addressing sexual violence in health services]. Aten Primaria 2024; 56:102837. [PMID: 38212181 PMCID: PMC11583887 DOI: 10.1016/j.aprim.2023.102837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024] Open
Abstract
Sexual violence is a very underdetected public health problem, with important short and long-term consequences on physical, mental, social, sexual and reproductive health, which must be taken into account by health services. Health systems are part of the set of resources necessary for a comprehensive approach from the ecological model: prevention and promotion of healthy sexuality with equality, adequate and coordinated care in the event of sexual assault and subsequent support to prevent sequelae. All sexual violence has health consequences, even those that may seem less serious such as sexual harassment or sexual cyberviolence. We must know the needs of the victim and their possible emotional reactions. A risk assessment will be carried out, the victim will be referred to a hospital if necessary and comprehensive and integrated care will be provided. Care and follow-up must focus on the survivor and with professionals trained in trauma to understand the consequences of sexual violence, offer a safe and trusting environment and know how to reinforce their qualities and support.
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Affiliation(s)
- Lydia Salvador Sánchez
- Medicina Familiar y Comunitaria, Gerencia Regional de Salud, Consejería de Salud de Castilla y León, Valladolid, España.
| | - Nerea Rodríguez Conesa
- Enfermera especialista en Obstetricia y Ginecología, Hospital Universitario Río Hortega, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España
| | - Susana Sánchez Ramón
- Medicina Familiar y Comunitaria, Servicio de Urgencias, Hospital Universitario Río Hortega, Departamento de Medicina, Dermatología y Toxicología, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Modesto Rey Novoa
- Médico Especialista en Ginecología y Obstetricia, Servicio de Ginecología y Obstetricia, Complejo Asistencial Universitario de Burgos, Burgos, España
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Mahon C, Dooley B, O’Reilly A, Fitzgerald A. Socioecological Risk and Protective Factors for Sexual Victimization in Post-Secondary Students in Ireland: A Brief Report. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:4356-4386. [PMID: 38456476 PMCID: PMC11462777 DOI: 10.1177/08862605241235626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV.
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Affiliation(s)
- Ciara Mahon
- University College Dublin (UCD), Dublin, Ireland
| | | | - Aileen O’Reilly
- University College Dublin (UCD), Dublin, Ireland
- Jigsaw, The National Centre for Youth Mental Health, Dublin, Ireland
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Stockman D, Van Parys H, Uzieblo K, Littleton H, Keygnaert I, Lemmens G, Verhofstadt L. Coping with sexual violence as a post-assault formed couple: A dyadic phenomenological interview analysis. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:787-810. [PMID: 38962932 DOI: 10.1080/0092623x.2024.2374245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Increasing evidence shows that survivors of sexual violence frequently experience relationship difficulties following their victimization. Little is known regarding how couples which formed post-assault cope with the impact of the prior assault. Hence, the aim of the current study was to gain insight into post-assault formed couples' experiences in coping with the impact of sexual violence. To this end, an interview study was conducted with five female survivors and their male partners who began their romantic relationship post-assault. A dyadic phenomenological interview analysis revealed that sexual victimization is a dyadic stressor but is not always considered as such by the couple. In addition, disclosure is described as a potential bonding experience. Flexibility and creativity from both partners are required as they adapt to the post-assault impact. In addition, meaningful communication and considering the perspective of one's partner seemed to be key to dyadically cope successfully. The current study also identified challenges couples had to manage, including caregiver burden and role confusion. Results suggest that interventions supporting couples in their continuous efforts toward mutual understanding can foster trust and growth.
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Affiliation(s)
- Dagmar Stockman
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Expertise Network People and Society, Artevelde University College of Applied Sciences, Ghent, Belgium
- Faculty of Psychology and Educational Sciences Campus Kulak, Catholic University Leuven, Kortrijk, Belgium
| | - Hanna Van Parys
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Kasia Uzieblo
- Department of Criminology, Vrije Universiteit Brussel, Brussels, Belgium
- Helpline 1712, Centre for General Well-being, Leuven, Belgium
| | - Heather Littleton
- Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, USA
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Women's clinic, Ghent University Hospital, Ghent, Belgium
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department Head and Skin - Psychiatry, Ghent University, Ghent, Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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