Effects of psychotherapy with people who have been sexually assaulted: A meta-analysis

This paper presents the results of a meta-analysis of the treatment outcome studies of different types of psychotherapeutic approaches for sexual assault victims experiencing PTSD or rape trauma symptoms. There were 15 outcome studies identified for inclusion in the meta-analysis dating from 1988–2005, and these studies comprised 25 treatment conditions. Separate meta-analyses were conducted according to study design (independent samples and repeated measures), in keeping with meta-analytic conventions. The overall results for the two meta-analyses were highly consistent, and effect sizes were in the large range for independent samples (g = .91) and repeated measures treatments (g = .90). Effects were maintained at follow-up from 6–12 months after treatment. Studies represented diverse treatment approaches, and most treatments were effective in improving outcome according to symptom reduction. A number of moderating variables were examined. Better outcomes were achieved with individual therapy compared to group approaches. The use of semi-structured approaches and homework techniques were positively related to the magnitude of effect size.     

Reactions to a survey among those who were and were not sexually assaulted while serving in the military

Surveys are among the most common methods for evaluating military sexual assault experiences among members of the U.S. military; however, little research has examined how receiving surveys about such sexual assaults might affect recipients. In the present sample of 530 active duty and veteran military personnel, just 10% reported unexpected upset, 11% reported regretting participation in the survey, and 22% reported benefitting from that participation overall. A minority of respondents with a history of sexual assault while in the military reported unexpected upset, although the prevalence was three times higher than that of participants without such history (24% vs 8%). There were no statistically significant differences in perceived regret and benefit of participation in the survey between those with and without a history of sexual assault while in the military. Although limited in number, male military sexual assault survivors (n = 8) were significantly more likely than female survivors to report being more upset by the survey than they had anticipated. Implications for future research are discussed.     

Comparison of pausing behavior in children who stutter and children who have Asperger syndrome

Purpose

The objective of this research was to compare the number and types of grammatical and non-grammatical silent pauses presented by stutterers and subjects with Asperger syndrome in their narratives.

Method

Ten children who stutter and four participants with Asperger syndrome (mean ages of both groups 10 years) were assessed at the Speech and Language Disorders Department of the Universidade Federal de São Paulo/Brasil. They narrated a story based on a pre-selected sequence of pictures. They were filmed and their productions were analyzed using version 5.0.47 of Praat (http://www.fon.hum.uva.nl/praat/download_win.html). Silent intervals in the speech that ranged from 0.25 to 4 s were considered pauses. The pauses were classified as grammatical and non-grammatical, depending on the words that preceded and followed them.

Results

Both groups presented grammatical and non-grammatical pauses and the former predominated. The children with Asperger syndrome produced a greater number of pauses than the stutterers.Educational objectives: The reader will be able to: (1) characterize the use of pauses in the oral narrative; (2) distinguish a grammatical pause from a non-grammatical pause regarding the use and function; (3) recognize the pattern of pause found in the two populations.     

Psychological studies of children who have cancer

Increasingly, more optimistic prognoses for children who have cancer have led investigators to study the adjustment reactions of children who survive this traumatic experience. There is considerable evidence that the experience of having cancer, receiving prolonged and often painful treatment, and the uncertain condition of cancer survivorship have profound emotional effects on children. The characteristic features of the psychological impact of cancer are the experience of continuing uncertainty in a life-threatening crisis and the resultant search for meaning. Studies are beginning to find that even very young children actively struggle to organize and make sence of this experience.     

Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.     

Sexual abuse intervention: a support group for parents who have a sexually abused child

A pilot program for parents of sexually abused children is discussed with a focus on intervention at a systems level. The Parent Support group is based on an eclectic approach and the interventions at the therapeutic and educational levels are described. The evolution of the group is addressed based on the group objectives. Each of the thirteen sessions is described to illustrate the various intervention strategies. Suggestions for implementing a similar group are discussed based on the authors' experience utilizing the presented model.     

Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway

The purpose of this study was to investigate consumption patterns of gay‐oriented sexually explicit media (SEM) among men who have sex with men (MSM) in Norway, with a particular emphasis on a possible relationship between gay SEM consumption and HIV risk behavior. Participants included 529 MSM living in Norway recruited online to complete a SEM consumption and sexual risk survey. Of the 507 participants who responded to the all items measuring exposure to SEM, 19% reported unprotected anal intercourse with a casual partner (UAI) in last 90 days, and 14% reported having had sero‐discordant UAI. Among those with UAI experience, 23% reported receptive anal intercourse (R‐UAI) and 37% reported insertive anal intercourse (I‐UAI). SEM consumption was found to be significantly associated with sexual risk behaviors. Participants with increased consumption of bareback SEM reported higher odds of UAI and I‐UAI after adjusting for other factors using multivariable statistics. MSM who started using SEM at a later age reported lower odds of UAI and I‐UAI than MSM who started earlier. Future research should aim at understanding how MSM develop and maintain SEM preferences and the relationship between developmental and maintenance factors and HIV sexual risk behavior.     

Murder and criminal responsibility: An examination of MMPI profiles

The clinical forensic applications of the MMPI in: (1) the identification of violent behavior, including murder, and (2) the determination of sanity, is briefly reviewed. Samples of evaluatees charged with murder were obtained in Chicago and Toledo, and were examined for differences on MMPI profiles for evaluatees clinically determined to be sane versus insane. Further comparisons were made between these evaluatees and a group of treated patients previously found not guilty by reason of insanity for murder. Results suggested that the MMPI is limited in its discriminability between sane and insane evaluatees, and specifically questioned the usefulness of certain profiles in rendering sanity opinions. The MMPI did demonstrate expected differences between insane evaluatees and their treated counterparts.     

Predictors of moderated drinking in a primarily alcohol-dependent sample of men who have sex with men

Understanding for whom moderated drinking is a viable, achievable, and sustainable goal among those with a range of alcohol use disorders (AUD) remains an important public health question. Despite common acceptance as severe risk factors, there is little empirical evidence to conclude whether co-occurring mental health disorders or drug dependence contribute to an individual's inability to successfully moderate his drinking. Utilizing secondary data analysis, the purpose of this study was to identify predictors of moderation among both treatment-seeking and non-treatment-seeking, primarily alcohol-dependent, problem-drinking men who have sex with men (MSM), with an emphasis on the high risk factors psychiatric comorbidity and drug dependence. Problem drinkers (N = 187) were assessed, provided feedback about their drinking, given the option to receive brief AUD treatment or change their drinking on their own, and then followed for 15 months. Findings revealed that neither psychiatric comorbidity or drug dependence predicted ability to achieve moderation when controlling for alcohol dependence severity. Those who were younger, more highly educated, and had more mild alcohol dependence were more likely to achieve moderated drinking. Impact of treatment on predictors is explored. Limitations of this study and arenas for future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The use of indigenous interviewers in a study of latino men who have sex with men: A research note

The use of indigenous researchers has long been practiced in ethnographic research; a similar use of indigenous personnel has not been as commonly undertaken in interview studies of men who have sex with men (MSM). This research note reports on the use of indigenous interviewers in a study of Latino MSM’s perceptions about sexual relationships and behaviors. The full study explores sexual relationships among Latino MSM, and HIV risk behaviors undertaken by a population of MSM residing in a community in southern California. This research note describes both the strengths and limitations that arise from employing indigenous interviewers for improving the overall quality of sensitive data. Benefits discussed include improved access to an otherwise highly restricted group, enhanced rapport-building capabilities, and greater understanding of language unique to the study population. Limitations discussed include the use of previously untrained interview personnel and age and gender issues.     

The effects of HIV-related thought suppression on risk behavior: cognitive escape in men who have sex with men.

This study investigated the relationship between suppressing thoughts about HIV risk and several outcomes related to HIV risk, including sexual risk behavior and HIV prevention service use, in men who have sex with men (MSM). Synthesizing the ironic processing theory (D. M. Wegner, 1994) with a cognitive escape paradigm (D. J. McKiman, D. G. Ostrow, & B. Hope, 1996), it was hypothesized that thought suppression might increase risk by leading MSM to "escape" from sexual safety norms and engage in risky sex behaviors and, via a paradoxical process, increase future use of community prevention services. Results from a sample of MSM (N = 709) indicated that thought suppression was positively related to concurrent sexual risk behavior and to future use of prevention services.     

Social support,psychological vulnerability,and HIV risk among African American men who have sex with men

Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support and (iii) influences of social support on sexual behaviours. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multilevel interventions that enhance social support networks and address the social-psychological, emotional and interpersonal factors that contribute to HIV risk among African American MSM.     

Virtual and physical venues as contexts for HIV risk among rural men who have sex with men.

Rural men who have sex with men (MSM) have few identifiable venues in which to congregate and meet potential sex partners. The Internet provides a venue for rural MSM to meet, and this is potentially troubling because studies of urban MSM suggest that HIV risk is higher for men who date online. The goals of this study were to identify venues where rural MSM meet their sexual partners and to examine their association with high-risk sexual practices. Six hundred sixty-three predominantly single, gay, Caucasian MSM completed an online survey of their sexual activities. Results showed that the Internet and bars were the most popular venues for meeting sex partners. Highest rates of risk behaviors were associated with Internet dating and venues in which immediate sexual encounters typically occur, suggesting that prevention in rural areas should target multiple-risk environments.     

Alcohol use and high-risk sexual behavior among men who have sex with men: the effects of consumption level and partner type.

Alcohol use may increase HIV sexual risk behavior, although findings have varied across study populations and methods. Using event-level data from 1,712 seronegative men who have sex with men, the authors tested the hypothesis that social context would moderate the effect of alcohol consumption on unprotected anal sex (UAS). For encounters involving a primary partner, rates of UAS did not vary as a function of alcohol use. However, consumption of 4 or more drinks tripled the likelihood of UAS for episodes involving a nonprimary partner. Thus, the effects of alcohol vary according to the context in which it is used. Interventions to reduce substance-related risk should be tailored to the demands of maintaining sexual safety with nonprimary partners.     

Sexual abuse and HIV-risk behaviour among black and minority ethnic men who have sex with men in the UK

Black and minority ethnic (BME) men who have sex with men (MSM) face a major burden in relation to HIV infection. It was hypothesised that sexual abuse would predict sexual risk-taking, and that this relationship would be mediated by victimisation and maladaptive coping variables. Four hundred and thirty-two BME MSM completed the survey; 54% reported no sexual abuse and 27% reported sexual abuse. Mann–Whitney tests showed that MSM with a history of sexual abuse reported higher frequency of drug use, and of homophobia and racism than those reporting no prior sexual abuse. A structural equation model showed that the experience of sexual abuse was positively associated with sexual risk-taking and that this relationship was mediated by victimisation variables: frequency of racism and frequency of homophobia and by the maladaptive coping variable: frequency of drug use. The findings can inform the design of psycho-sexual and behavioural interventions for BME MSM.