THE EVALUATION OF A SEXUAL ASSAULT SELF-DEFENSE AND RISK-REDUCTION PROGRAM FOR COLLEGE WOMEN: A PROSPECTIVE STUDY

The present study evaluated the efficacy of a sexual assault risk-reduction program that included a physical self-defense component for college women ( N = 500). Program group women significantly increased their protective behaviors over the 6-month follow-up period compared to the waiting-list control group. However, there were no significant differences between the two groups regarding rates of sexual victimization, assertive communication, or feelings of self-efficacy over the follow-up periods. Program group women who were victimized during the 3-month follow-up period evidenced less self-blame and greater offender blame for their assaults than control group women who were victimized following the program. Given that program women evidenced a greater awareness of sexual assault at the end of the study than control group women, the difficulty in addressing the impact of programming on rates of sexual victimization is discussed.     

Self-Blame Among Sexual Assault Victims Prospectively Predicts Revictimization: A Perceived Sociolegal Context Model of Risk

This investigation focused on relationships among sexual assault, self-blame, and sexual revictimization. Among a female undergraduate sample of adolescent sexual assault victims, those endorsing greater self-blame following sexual assault were at increased risk for sexual revictimization during a 4.2-month follow-up period. Moreover, to the extent that sexual assault victims perceived nonconsensual sex is permitted by law, they were more likely to blame themselves for their own assaults. Discussion focuses on situating victim-based risk factors within sociocultural context.     

A randomized clinical trial of online-biblio relationship education for expectant couples

This study evaluated the efficacy of a self-paced, Internet-based marriage and relationship skills education program ("Power of Two Online"). The program integrated an online intervention with print supplemental resources. New and expectant parents (n = 79) were randomly assigned to the 2-month intervention or placebo-control group. Assessments were conducted at baseline, 1-month, and 2-month follow-up intervals. Latent growth curve modeling was used to examine differences between conditions for marital satisfaction and conflict management. Participants who received the intervention reported trajectories of improved marital satisfaction and improved marital conflict management over time relative to controls. Implications for widespread dissemination of marriage and relationship education as a primary prevention tool are discussed.     

Disinhibition as a Mechanism in Sexual Victimization: A Prospective Study

Disinhibition was examined as a mechanism in revictimization using a prospective research design. Of the sample of 211 young adult women, 43.1% reported prior sexual victimization (birth to the time of our initial assessment) and 32.2% reported sexual assault during the 6-month follow-up. The findings suggest that disinhibition was a partial mediator. Prior sexual victimization was associated with increased disinhibition as well as increased future sexual assault. Greater disinhibition was associated with increased future sexual assault. Once disinhibition was accounted for, the original relationship between prior and future sexual assault was reduced. Disinhibition partially explained revictimization and these behaviors might serve as possible targets of change in sexual victimization prevention work.     

Risk of sexual revictimization: A theoretical model

Survivors of child sexual abuse suffer serious short- and long-term psychological consequences. Sexual revictimization as an adult is one of the consequences that has been reported. At present, there is no theoretical model identifying the risk factors that result in child sexual abuse survivors being at greater risk of experiencing an adult sexual assault. The proposed model is designed to integrate existing research, stimulate further empirical work, and eventually aid in the development of a program to prevent revictimization. The variables hypothesized to play a mediating role in the pathway to revictimization include: severe psychological symptoms as a consequence of the child sexual abuse, poor coping styles, an insecure attachment style, hyperfemininity, delinquent behavior, drug use, and high risk sexual behavior.     

Sexual victimization in relation to perceptions of risk: mediation, generalization, and temporal stability

There is evidence that personal experience with trauma is associated with increases in both personal and comparative risk perception. This study investigates this relation in terms of sexual victimization among women, focusing on three potential mediators: perceived control over sexual assault, perceived similarity to a typical sexual assault victim, and psychological distress. Mediational analyses were investigated using structural equation modeling. Although victimization experience was not related to comparative risk perception, it was associated with greater personal risk perception. This relation was mediated by perceived similarity to a typical sexual assault victim. Prospective analyses indicated that personal risk perception does change in response to sexual victimization but also indicated that heightened risk perception may be an accurate assessment of risk that actually precedes victimization experience. Implications for the meaning of perceived similarity and perceptions of risk for sexual assault victims are discussed.     

A COMPARISON OF GROUP AND INDIVIDUAL SEXUAL ASSAULT VICTIMS

The experiences of 44 group sexual assault victims (multiple offenders, one victim) were compared with 44 individual sexual assault victims (one offender, one victim). Sexual assaults included various degrees of sexual victimization ranging from verbal coercion to rape. Participants were located from among a national sample of 3,187 college women. Group sexual assaults, compared to individual sexual assaults, were in general more violent, involved greater resistance from the victims, and were more likely to be perpetrated by strangers or relatives and to involve an experience which met the legal definition of rape. Group sexual assaults were less likely to involve multiple episodes by the same offender(s). Group sexual assault victims were more likely than individual sexual assault victims to seek police and crisis services, to have contemplated suicide, and to have sought therapy postassault. Despite these differences, the two groups were similar in the amount of drinking and drug use during the assault and their scores on standardized measures of psychological symptoms.     

ALCOHOL AND DATING RISK FACTORS FOR SEXUAL ASSAULT AMONG COLLEGE WOMEN

American societal norms frequently link alcohol, dating, and sexuality. This cross-sectional study examined the role of alcohol and dating risk factors for sexual assault among a representative sample of female students at a large urban university. Over half of the 1,160 women had experienced some form of sexual assault. Ninety-five percent of these assaults were committed by someone the woman knew and almost half of these assaults involved alcohol consumption by either the man, the woman, or both. Discriminant function analyses indicated that dating, sexual, and misperception experiences and alcohol consumption during these experiences predicted assault group status. Furthermore, alcohol consumption during consensual sex and sexual misperceptions were positively related to alcohol consumption during the sexual assault. The predictors of assault group status were similar for African American and Caucasian women. Theoretical implications are discussed and suggestions are made for combining alcohol and sexual assault prevention programming.     

A Mediation Model of Sexual Assault among Latter-Day Saints

Socialization that occurs within some conservative Christian contexts might facilitate development of attitudes and beliefs that increase women’s risk for sexual assault. Patriarchal community structure and rigid gender role adherence place women in subordinate roles and maintain gender inequality. Within conservative, dogmatic contexts, comprehensive sex education and education about assault might be minimal, and rape myths are hypothesized to be more prevalent. This study assessed sexual assault experiences (victimization and perpetration) in a sample of 208 male and female college students affiliated with the Church of Jesus Christ of Latter-Day Saints (LDS). Women reported victimization of all forms of sexual coercion at higher rates than men reported perpetration. In addition, traditional gender role adherence mediated the link between dogmatic, religiously fundamentalist beliefs and acceptance of rape mythology for both men and women. Traditional gender role adherence also mediated the link between religious fundamentalism and sexual assault behaviors for men.     

SEXUAL ASSAULT VICTIMS' ACKNOWLEDGMENT STATUS AND REVICTIMIZATION RISK

How a victim of rape characterizes her assault has potential implications for her postassault experiences and revictimization risk. Prior research has identified several potential benefits to not conceptualizing one's experience as a form of victimization. The current study sought to identify whether there are costs to not acknowledging rape as well, specifically whether unacknowledged victims are at elevated risk of revictimization. The revictimization risk behaviors of 334 acknowledged and unacknowledged female college rape victims were compared. Unacknowledged victims reported more hazardous alcohol use and were more likely to report that they continued a relationship with the assailant after the assault. A subsample of 105 victims completed a 6-month follow-up survey regarding sexual victimization during the follow-up period. Unacknowledged victims were nearly twice as likely to report having experienced an attempted rape during the 6-month follow-up period. Implications of the results for future work evaluating rape acknowledgment, rape recovery, and revictimization are discussed.     

A critical review of field studies on the link of alcohol and adult sexual assault in women

This article reviews field studies examining two central questions regarding the link between alcohol and sexual assault. First, evidence is reviewed to evaluate whether there is a distal relationship between alcohol and risk of sexual assault victimization. Specifically, studies are examined to determine whether drinking may affect the risk of being victimized and how victimization may contribute to subsequent drinking. Second, evidence for a proximal role of drinking prior to a sexual assault victimization incident (by either victim and/or offender) is examined to determine alcohol's role in rape and injury outcomes to victims. Critical theoretical and methodological issues in these two types of studies are discussed with regard to the extant literature. Paralleling the two areas of research reviewed, two theoretical models are proposed to guide future research on (1) the global associations of drinking and sexual assault risk across the life span (macrolevel model) and (2) the role of drinking in the outcomes of actual sexual assault incidents (microlevel model). Suggestions are made for future research and intervention in this area.     

Correlates of Postassault Self-Defense/Assertiveness Training Participation for Sexual Assault Survivors

Past research has shown that self-defense/assertiveness training may have positive implications for sexual assault survivors. However, little is known about the correlates of self-defense/assertiveness training participation for sexually victimized women. In this study we examined the assault characteristics and experiences that relate to women's enrollment in postassault training using data from 1,623 female college sexual assault survivors. It appears that more violent attacks may lead survivors to enroll in postassault training, especially when their resistance was less effective. Postassault training participants were marginally more likely to have told someone about their assault, experienced less supportive reactions from others, exhibited marginally less current anxiety, and reported more postassault suicidal ideation than nonparticipants. These survivors may enroll in training to exercise control over future assaults occurring and as a way of healing from sexual assault. Suggestions for future research and the development of self-defense training programs for sexual assault survivors are presented.     

Subjective Sleep Disturbances in Sexual Assault Survivors: Associations With Trauma and Posttraumatic Stress Disorder Symptom Severity

Prior work implicates sleep disturbance in the development and maintenance of posttraumatic stress disorder (PTSD). However, the majority of this literature has focused on combat veteran men, and limited work has examined links between sleep disturbance and PTSD symptoms in sexual assault survivors. This is a notable gap in the literature, as sexual trauma is disproportionately likely to result in PTSD and is more common in women. We sought to examine the relations between subjective sleep disturbance, sexual assault severity, and PTSD symptoms in a sample of sexual assault survivors with PTSD (PTSD+), without PTSD (PTSD-), and healthy controls. The sample (N = 60) completed the Insomnia Severity Index and prospectively monitored their sleep for 1 week using the Consensus Sleep Diary. The sexual assault survivors also completed the Sexual Experiences Survey and PTSD Checklist-5. Results of group comparisons found that the PTSD+ group reported significantly higher insomnia symptoms, longer sleep onset latency, more nocturnal awakenings, and lower sleep quality compared to the healthy control group and higher insomnia symptoms compared to the PTSD- group. Results of regression analyses in the sexual assault survivors found that insomnia symptoms and number of nocturnal awakenings were significantly associated with higher PTSD symptoms, and sexual assault severity was significantly associated with higher insomnia symptoms, longer sleep onset latency, and lower sleep quality. These findings highlight specific features of sleep disturbance that are linked to trauma and PTSD symptom severity among sexual assault survivors.     

Sexual Assault Training in the Military: Evaluating Efforts to End the “Invisible War”

Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members’ training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD’s 2010 annual report on military sexual assault concluded that “most Active Duty members receive effective training on sexual assault” (p. 104). Our results cast doubt on that assertion.     

Integrated Cognitive-Behavioral Therapy for Social Anxiety and HIV/STI Prevention for Gay and Bisexual Men: A Pilot Intervention Trial

Given the alarmingly high HIV and sexually transmitted infection (STI) incidence among gay and bisexual men (GBM) worldwide, there is a critical need for HIV prevention interventions specifically for GBM. Social anxiety, or anxiety about being evaluated in interpersonal situations, is a risk factor for condomless anal sex (CAS) among GBM (e.g., Hart & Heimberg, 2005; Hart, James, Purcell, & Farber, 2008). Social anxiety may also increase substance use in sexual situations, which is another risk factor for HIV/STIs in this risk group (Semple, Strathdee, Zians, McQuaid, & Patterson, 2011). The goal of the Sexual Confidence Study was to provide initial evidence of efficacy for a 10-session integrated cognitive-behavioral therapy for social anxiety, substance use management in sexual situations, and HIV sexual risk reduction for HIV-negative GBM. Diagnostic and self-report assessments were completed at baseline, posttreatment, 3-month follow-up, and 6-month follow-up. In this open trial design, we observed a 50% reduction in engagement in HIV/STI sexual risk behavior at 6-month follow-up. We also observed large uncontrolled treatment effect sizes for reductions in social anxiety disorder and problematic alcohol use. These preliminary findings suggest that the present treatment may offer an efficient way of concurrently reducing social anxiety, problematic alcohol use, and the risk of contracting HIV and STIs via CAS with serodiscordant partners among HIV-negative GBM.     

Emotional Reactions During and After Trauma: A Comparison of Trauma Types

Peri- and posttraumatic emotional responses have been understudied, and furthermore, have rarely been compared among trauma types. The current study compared college students' retrospective self-reports of peri- and posttraumatic responses of fear, shame, guilt, anger, and sadness among four types of traumatic events: sexual assault, physical assault, transportation accident, and illness/injury. Overall emotional responding was generally high for all trauma types, and for those in the sexual assault group, emotion increased sharply from the peri- to posttraumatic time point. Generally, fear was higher during the trauma compared to after the trauma, whereas the other emotions tended to remain stable or increase posttrauma. The sexual assault group tended to report higher levels of posttrauma emotion than the other trauma type groups.     

Using Ecological Theory to Evaluate the Effectiveness of an Indigenous Community Intervention: A Study of Sexual Assault Nurse Examiner (SANE) Programs

In recent years, there has been renewed interest among community psychologists in indigenous interventions, which are programs created by local practitioners (rather than researchers) already rooted in their communities. Indigenous interventions have strong ecological validity, but their effectiveness is often unknown because so few are rigorously evaluated. The goal of this project was to use Kelly and Trickett’s ecological theory as a conceptual framework for evaluating an indigenous intervention and its mediating mechanisms of effectiveness. The focal intervention was a midwestern Sexual Assault Nurse Examiner (SANE) program, which provides post-assault medical care, crisis intervention, and medical forensic exams for sexual assault survivors. Prior studies of SANE programs have suggested that these interventions may help increase sexual assault prosecution rates. In this case example, we used a mixed methods design to determine if this program contributed to increased prosecution rates, and if so, why. Based on qualitative interviews with key stakeholders, we found substantial evidence for the Principle of Interdependence such that the SANE program strengthened the interconnections between the legal and medical systems, which contributed to increased prosecution. The intervention was effective in these outcomes because it promoted Cycling of Resources throughout the systems and fostered Adaptation of new roles for legal and medical personnel. Moving beyond this specific case example, this paper also examines cross-cutting advantages and struggles of using an ecological approach in the evaluation of indigenous community interventions.     

SEXUAL ASSAULT EXPERIENCE IN ADULTHOOD AND PRIOR VICTIMIZATION EXPERIENCES

Several retrospective investigations of sexual assault have assessed the extent to which a sexual victimization experience early in life is a risk factor for a subsequent victimization experience. The present investigation was an attempt to extend previous work by conducting a prospective analysis of sexual assault in a sample of 857 college women to assess the pathways through which victimization experiences become linked. The design was such that both victims'and nonvictims'history of child and adolescent sexual victimization experiences were assessed prior to their most recent assault experience. Psychological functioning was also assessed utilizing standardized measures of depression and anxiety. After the assault experience, psychological functioning of victims was reassessed, and nonvictims were reassessed after a comparable period of time. Results of the path analysis indicated that a sexual victimization early in life is a risk factor for an adult victimization experience. Furthermore, the results revealed a link between psychological functioning and victimization experiences. The discussion emphasizes clinical implications of these findings and suggested avenues for future research.     

LABELING OF ABUSE EXPERIENCES AND RATES OF VICTIMIZATION

Research has consistently found that a history of previous sexual victimization increases risk for future sexual assault, which might be due to women with a history of sexual victimization having difficulty identifying risky cues and not perceiving their own vulnerability for future assaults. This study investigated how acknowledgment of previous experiences with interpersonal violence is related to risk perception and rates of victimization. Participants were 198 college women who completed assessments of victimization, personal risk appraisal, and acknowledgment. Analyses indicated differences in rates of victimization based on labeling of experiences and differences in efforts to change behaviors to reduce risk for future assaults based on level of acknowledgment. Also, there were a number of situational factors significantly related to likelihood of acknowledgment. The findings differed for physical and sexual violence. This study suggests that acknowledgment is an important factor to consider in studies of sexual and physical revictimization.