Vulnerability to mental contamination

Mental contamination refers to feelings of contamination that arise without physical contact with a contaminant. Mental contamination has been documented among sexual assault victims, some of whom report feeling dirty and wanting to wash in response to memories of the assault. This study examined variables associated with increased vulnerability to mental contamination. Female undergraduates (n=100) filled out a series of questionnaires and listened to an audiotape that instructed them to imagine experiencing a forced kiss by an undesirable male. Controls (n=20) imagined a consensual kiss by a desirable male. Women in the non-consensual condition reported stronger feelings of dirtiness and urge to wash than those in the consensual condition. Twenty-seven women in the non-consensual condition spontaneously rinsed in order to alleviate physical sensations evoked by the tape. Regression analyses revealed that significant predictors of dirtiness included contact contamination fear and disgust sensitivity, and there was a trend for anxiety sensitivity to predict dirtiness. Contact contamination fear was also a significant predictor of urge to wash. Prior experience with unwanted sexual contact was a significant predictor of rinsing, and there was a trend for fear of negative evaluation to predict rinsing. Discussion focuses on the implications of these findings for our understanding of mental contamination.     

Stability of emotions for traumatic memories in acute and chronic PTSD

While memory for central factual information regarding an emotional event is considered to be relatively accurate, memory for emotions seem to be quite inaccurate (Christianson & Safer, 1995). We extended this line of research to examine memory for the emotional intensity surrounding a traumatic event (e.g., memory for the fear and horror of the event). We conducted a series of two studies. In Study 1, we examined memory for the emotional intensity of the traumatic event in recent sexual or non-sexual assault victims with acute PTSD at 2 and 12 weeks following the assault. In Study 2, we compared memory for emotional intensity in sexual and non-sexual assault victims with either acute or chronic PTSD at initial assessment and 12 weeks later. For both studies, participants were asked to recall general emotional intensity, fear intensity, and dissociative intensity of the traumatic event. Results suggested that memory for the fear of the traumatic event did not fluctuate over time. However, memory for the general emotional and dissociative intensity did fluctuate over time, decreasing for individuals with acute PTSD and increasing for individuals with chronic PTSD.     

PSYCHOMETRIC CHARACTERISTICS OF THE SOCIAL REACTIONS QUESTIONNAIRE

Negative social reactions are common responses to disclosures of sexual assault. A study was undertaken to evaluate the psychometric characteristics of a new measure of social reactions to sexual assault victims, the Social Reactions Questionnaire (SRQ). Good reliability and validity were demonstrated for the measure in three samples of sexual assault victims: community volunteers, college students, and victims contacting mental health agencies. The SRQ provides a much needed measure of both the positive forms of social support and several negative social reactions received by sexual assault victims disclosing their assaults to a range of informal social network members and formal support providers.     

Challenges to Doing Sexual Violence Work

Sexual assault victims experience a number of effects as a result of their victimization. Sexual assault crisis workers are assigned the responsibility of trying to minimize the negative consequences of sexual assault. In their efforts to serve sexual assault victims, it is likely that certain problems make it difficult to adequately help victims. This study considers how 43 sexual assault crisis workers (27 directors of sexual assault crisis centers and 16 workers) define the challenges of serving sexual assault victims. Major challenges reported included a lack of awareness about sexual assault, victim blaming, and a lack of resources. Implications are provided.     

Male sexual assault victims: a selective review of the literature and implications for support services

In recent years much has been done to publicize the plight of female rape victims. However, the sexual assault of adult males has received little attention in the research literature or by the public. This paper provides a selective review of the research into the prevalence and effects of male sexual assault victims. Research shows that the effects of sexual assault on adult males are often severe. This paper also outlines findings from experimental studies that have shown that reactions towards male sexual assault victims depend on both the victim's sexual orientation and the perpetrator's gender. Finally, implications for support services are outlined. Victims of both male and female perpetrators are considered, and both gay and heterosexual victims are discussed in relation to the specific needs of these victims. The needs of transgendered victims are also briefly considered, as are the needs of the sexual partners of male sexual assault victims. This paper concludes by offering some suggestions for future research.     

Mechanisms of change in ERP treatment of compulsive hand washing: does primary threat make a difference?

The present study sought to examine patterns of habituation in exposure and response prevention (ERP) treatment of compulsive hand washing. Sub-clinical compulsive washers (n=27) with illness or non-illness primary threats were compared in order to detect potential differences in response to a single session of ERP. Changes in anxiety, disgust, and urge to wash were analyzed, and significant reductions in both anxiety and disgust were noted. Urge to wash significantly declined among washers primarily concerned with illness; among those concerned with non-illness threats, urge to wash did not significantly decline. Moreover, anxiety was found to decline when controlling for disgust and vice versa. Lastly, when both anxiety and disgust were entered into a model predicting changes in urge to wash, anxiety but not disgust predicted urge to wash for those with illness-related threats; for washers with non-illness threats, the findings were the reverse. Several clinical and theoretical implications are discussed.     

Alcohol Consumption, Outcome Expectancies, and Victimization Status Among Female College Students

The present study examined differences in the extent of alcohol consumption and endorsement of alcohol-related outcome expectancies between victims of alcohol- or drug-related sexual assault, victims of non-alcohol- or non-drug-related sexual assault, and nonvictim controls. The alcohol consumption patterns alcohol outcome expectancies and victimization status of 176 female college students were assessed. Results indicated that relative to nonvictims and victims of non-alcohol- or non-drug-related sexual assault, victims of alcohol- or drug-related sexual assault reported more frequent and greater alcohol consumption and a greater extent of endorsement of alcohol outcome expectancies. Furthermore. extent of alcohol consumption was associated with different alcohol expectancy outcomes for each group. Implications for the prevention of sexual assault and directions for future research 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.     

The effects of mental context reinstatement on children's accounts of sexual abuse*

Forensic interviewers guided 46.4‐ to 13‐year‐old alleged victims of sexual abuse to recall the context in which the reported incidents had taken place. A comparable group of 50 alleged victims were interviewed using an interview protocol that was identical except that the mental context reinstatement (MCR) techniques were not included. MCR did not increase the total number of event‐related details reported, but it did lead children to reported proportionally more details (55% versus 46%) in response to invitations rather than focused prompts. Such information is more likely to be accurate. MCR had an especially powerful effect on the youngest children (4‐ to 6‐year‐olds) studied. The results suggest that non‐suggestive contextual cues may indeed be useful in forensic interviews. Published in 2001 by John Wiley & Sons, Ltd.     

Analyses of mental contamination: Part II,individual differences

Recent research on mental contamination (internal, psychological feelings of dirtiness) has focused primarily on examining the experimental variables necessary to provoke contamination-related thoughts, feelings and behaviour; yet, relatively little is known regarding the individual differences among participants' mental contamination responses to these situational and experimental characteristics. The purpose of this study was to determine whether variables associated with symptoms, beliefs and appraisals could predict the experience of mental contamination after an established provocation. Female undergraduate students (n = 70 from Part I of this study; Elliott & Radomsky, 2009), completed a series of questionnaires then listened to an audio recording and imagined that they were receiving a forced, non-consensual kiss from a man described as moral or immoral. Participants indicated the presence and degree of mental contamination and appraisals of the man and act, then completed a behavioural task for which spontaneous washing was recorded. Results indicated that, although symptoms of physical contamination were able to predict feelings of mental contamination, appraisal variables emerged as unique predictors of feelings of mental contamination. Results are discussed in terms of cognitive-behavioural conceptualizations of and treatments for contamination fears.     

The Treatment of Mental Contamination: A Case Series

The recommended treatment for obsessive-compulsive disorder (OCD) is cognitive behavior therapy (CBT) incorporating exposure and response prevention (ERP), which is effective for approximately 50% of patients. However, there has been little advance in treatment outcomes since the introduction of ERP in 1979. It has been suggested that some progress can be made in treating contamination obsessions and washing compulsions by addressing feelings of dirtiness and contamination that arise without physical contact with a tangible contaminant. To date, the treatment of these “mental contamination” fears in OCD has not been systematically explored. This paper reports on a case series of 12 participants with OCD who received 10 to 20 sessions of a CBT-based treatment for mental contamination. At the end of treatment, 7 participants no longer met the diagnostic criteria for OCD and mental contamination and these gains were maintained at 6-month follow-up. The clinical implications of these findings are discussed.     

Social support and recovery from sexual assault: A review

This article reviews empirical studies of social support and sexual assault in order to evaluate the empirical evidence for the role of support in recovery from mental health and physical health consequences of this crime. Evidence is mixed with regard to the effect of social support, with some studies showing no significant effect and others showing positive effects of support on postassault recovery. Negative aspects of social relations (e.g., negative social reactions), while less studied, show consistent and strong negative effects on sexual assault victims. Factors that may modify the relationship of support and sexual assault outcomes are reviewed, including: assault characteristics, specific support provider factors, victim coping and functioning, preassault support network, and other postassault experiences, such as criminal justice system involvement. Limitations of existing research are noted. Suggestions for future research on the relationship of social support and sequelae of sexual assault are provided, with a focus on development of support network interventions for victims.     

Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault.

Cognitive factors hypothesised to influence the development and maintenance of PTSD were investigated. 92 assault victims completed questionnaires assessing a range of cognitive variables. Factors relating to onset of PTSD were investigated by comparing victims who did and who did not suffer PTSD. Factors relating to maintenance of PTSD were investigated by comparing victims who had recovered from PTSD with victims who had persistent PTSD. Cognitive factors associated with both onset and maintenance of PTSD were: appraisal of aspects of the assault itself (mental defeat, mental confusion, appraisal of emotions); appraisal of the sequelae of the assault (appraisal of symptoms, perceived negative responses of others, permanent change); dysfunctional strategies (avoidance/safety seeking) and global beliefs impacted by assault. Cognitive factors that were associated only with the onset of PTSD were: detachment during assault; failure to perceive positive responses from others and mental undoing. Relationships between the cognitive variables and PTSD remained significant when variations in perceived and objective assault severity were statistically controlled. The cognitive factors identified in the study may contribute to PTSD directly, by generating a sense of ongoing threat, or indirectly, by motivating cognitive and behavioural strategies that prevent recovery, or by affecting the nature of the traumatic memory.     

Understanding and Responding to Victims of Interpersonal Sexual Violence and Sexual Assault within Committed Relationships

Abstract

The purpose of this article is to increase therapeutic discussion surrounding intimate partner sexual violence (IPSV) by increasing understanding in how victims of IPSV perceive and respond to the assault. Although IPSV has received little research attention, sexual violence within relationships occurs at an alarmingly high rate. Theories of sexual assault, such as sex-role socialization, are discussed to aid clinicians in better identifying assaultive behaviors and common physical and emotional responses of victims. Additionally, the authors provide a framework for the assessment of IPSV and suggestions on “best practices” for creating conversations that promote hope and healing.     

Sexual Assault History and Health-Related Outcomes in a National Sample of Women

This study examined correlates of past-year chronic medical conditions and lifetime contact with health care professionals for mental health and substance abuse problems in women with differing histories of sexual victimization  ( N  = 627)  identified from the National Comorbidity Survey (e.g., assault in childhood, adulthood, or both life phases). Posttraumatic stress disorder (PTSD) and stressful life events were associated with greater odds of chronic medical conditions among women sexually assaulted in childhood only. Additional traumatic events were associated with greater odds of chronic medical conditions among victims of adult sexual assault. Older age and being married were associated with greater odds of lifetime health care professional contact for mental health/substance abuse issues among certain victim subgroups. Stressful life events were related to greater help-seeking for child victims, and traumatic events were related to greater help-seeking in adult victims. Alcohol dependence symptoms and PTSD were each associated with greater odds of lifetime health care professional contact among women victimized in both life phases, whereas depression was related to greater odds of help-seeking for women victimized in one life phase only. Psychosocial factors may play unique roles in health outcomes for women with different sexual assault histories.     

Understanding Intimate Partner Sexual Assaults: Findings from Sexual Assault Kits

ABSTRACT

In 2013, Cuyahoga County, Ohio, began DNA testing and investigating nearly 5000 previously unsubmitted sexual assault kits (SAKs) from 1993 through 2009. We examined case files from a sample of SAKs that were tested but not previously adjudicated (n = 429). More than 10% (n = 45) involved victims who reported to police that a former or current intimate partner sexually assaulted them. This article integrates the available data on the offenders, the victims, the initial investigation, and the specifics of the assaults to provide a more complete understanding of intimate partner sexual assault (IPSA). More than one-third of the IPSA offenders were serial sex offenders; that is, the offenders sexually assaulted an intimate partner and another person(s). Comparing IPSAs to all other sexual assaults, IPSAs more frequently involved bodily force, less frequently involved a weapon, and IPSA investigations were more frequently closed because (1) the victims stated they lied or the police doubted the victims and (2) the victims declined to prosecute. The most common sequencing of events was a demand for sex by the offender followed by a verbal refusal by the victim and the use of bodily force in the sexual assault. The findings, however, indicate a great deal of variation in the sequencing of events surrounding the sexual assault, with over 25% involving no physical confrontation before or after the sexual assault and no demands for sex. Unsubmitted SAK data provide a unique window into understanding the understudied and underreported issue of IPSA.     

An evolutionary analysis of psychological pain following human (Homo sapiens) rape: IV. The effect of the nature of the sexual assault

Mental pain is hypothesized to manifest an adaptation for analyzing and coping with social problems that would have reduced inclusive fitness in human (Homo sapiens) evolutionary history. We examined this hypothesis in the psychological pain of 790 rape victims. Reproductive-aged and postreproductive-aged victims were more likely than prereproductive-aged victims to have experienced vaginal intercourse and to have had sperm present in the reproductive tract. As predicted, vaginal intercourse constituted the most psychologically devastating form of sexual assault for reproductive-aged women. Nonreproductive-aged victims were not more traumatized by vaginal rapes. When rapes included ejaculation in the victim's reproductive tract, reproductive-aged victims may have been more traumatized. These results suggest that the psychology that regulates mental pain processes information about the nature of the sexual act in the event of a woman's rape.     

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 prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault

The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design. Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault. Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change); negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors.