Evaluating a novel intervention to reduce trauma symptoms and sexual risk taking: qualitative exit interviews with sexual minority men with childhood sexual abuse

Childhood sexual abuse (CSA) continues to affect sexual minority men (SMM) at disproportionate levels and contributes to multiple negative health outcomes, including sexual-risk taking and HIV acquisition. This paper presents qualitative evaluative feedback from SMM (N = 9) who participated in a 10-session Cognitive Behavioral Therapy-Trauma and Sexual Health (CBT-TSH) intervention to reduce CSA-related posttraumatic stress reaction and distress. The treatment was designed to increase accurate sexual risk appraisals and to improve self-care health behaviors related to HIV/STI acquisition. The researchers identified four emerging themes: (1) motivation to participate, (2) response to cognitive therapy, (3) process of change, and (4) considerations for intervention improvement. These qualitative findings provide useful feedback on the acceptability of an innovative program that integrates CBT for trauma related to CSA with sexual risk-reduction counseling.     

New Opportunities

Sexual assault is a pervasive problem in the U.S. military, especially against women. Bystander intervention is increasingly promoted as important for reducing sexual violence, and it may be particularly helpful in contexts with high rates of sexual violence. Bystander training encourages and enables people to intervene safely and stop sexual violence. In this study, we drew from an ecological model to investigate intrapersonal, microsystem, and exosystem factors that predicted Service members' assumption of personal responsibility to intervene in an alcohol‐involved sexual assault. Moreover, we examined how these predictors played a role in decisions about how to intervene: confronting the perpetrator, assisting the victim, or finding someone to help. We analyzed data from 24,610 active duty personnel collected by the Department of Defense. Several factors significantly related to Service members' bystander intentions: gender, rank, morale, attitudes about sexual assault, training, and trust in the military sexual assault system predicted the likelihood and method of bystander intervention. These findings help identify how and why people intervene (or fail to intervene) when they witness situations that could develop into sexual violence.     

The View from Inside the System: How Police Explain Their Response to Sexual Assault

Prior research has documented the problematic community response to sexual assault: the majority of sexual assaults reported to police are never prosecuted. Social dominance theory suggests that this response is a form of institutional discrimination, intended to maintain existing social structures, and that police personnel likely draw upon shared ideologies to justify their decision‐making in sexual assault case investigations. This study drew upon social dominance theory to examine how police justified their investigatory decisions to identify potential leverage points for change. The study revealed that the likelihood of a case referral to the prosecutor increased with each additional investigative step completed; of the different types of justifications provided by police for a less‐than‐thorough investigative response and stalled case, blaming the victim for the poor police investigation proved to be the most damaging to case progression; and the type of explanation provided by police was impacted by specific case variables. As suggested by social dominance theory, the study demonstrates that police rely on several different mechanisms to justify their response to sexual assault; implementing criminal justice system policies that target and interrupt these mechanisms has the potential to improve this response, regardless of specific case factors.     

Young Women’s Social and Occupational Development and Mental Health in the Aftermath of Child Sexual Abuse

We examined social role functioning and depressive symptoms of young adults who were abused as children in data from a longitudinal community sample. Sexually abused women and men were more depressed during their senior year of high school, and this difference was more pronounced 2 years later. We then examined a mediational model to determine whether social functioning explained the course of depressive symptoms over this transitional period. Focusing only on young women, for whom the prevalence of abuse was much higher, results indicated that two-thirds of the effect of abuse on depressive symptoms was explained by experiences and choices in the domains of work, education and intimate relationships. Having less supportive intimate relationships and lower rates of attendance at 4-year colleges were particularly important. Findings reveal the key role played by early adult interpersonal and occupational development in perpetuating the mental health impact of childhood trauma.     

Language Impairment and Sexual Assault of Girls and Women: Findings from a Community Sample

Both children and adults with disabilities face increased prevalence of abuse and assault, including sexual assault. Women and girls are disproportionately the victims of sexual assault in both disabled and nondisabled populations. Communication difficulties have been identified as a factor that may increase the vulnerability of individuals with disabilities to sexual assault. However, few studies have examined whether language impairment increases risk for sexual assault. This study reports on a community sample of children with speech or language impairment, followed to age 25. Sexual assault history was assessed based on two questions from the Composite International Diagnostic Interview Posttraumatic Stress Disorder module. Women with language impairment (n = 33) were more likely than women with unimpaired language (n = 59) to report sexual abuse/assault, controlled for socioeconomic status. Sexual assault was associated with higher rates of psychiatric disorders and poorer functioning. Women with neither language impairment nor a history of sexual assault had fewer psychiatric disorders and higher functioning than women with language impairment and/or a history of sexual assault.     

The interpersonal meaning of sexual promiscuity

In order to investigate the interpersonal meaning of sexual promiscuity, the relations between various sexual activities and the Interpersonal Circumplex (IPC) were examined. Two hundred and ten participants (105 women and 105 men; mean age = 24.88 years) indicated the number of people they had engaged in various sexual activates with (e.g., oral manipulation of genitals, sexual intercourse, etc.). These participants’ interpersonal styles were also assessed using the primary dimensions of the IPC: dominance and warmth. As predicted, a positive linear relation was found, for men and women, between interpersonal dominance and the number of partners a person had for each type of sexual activity. Additionally, for both men and women, a curvilinear relation was found between interpersonal warmth and the number of partners a person had for each type of sexual activity. Specifically, participants who were either extremely warm or extremely cold tended to have more sexual partners than individuals who were moderately warm. These findings extend past research linking the Five Factor Model traits of extraversion and agreeableness to sexual promiscuity and also help illustrate the dual interpersonal meaning of sexual experience.     

Variable preferences for sexual dimorphism in stature (SDS): Further evidence for an adjustment in relation to own height

In contemporary Western populations, some physical characteristics are sexually dimorphic, and it is known that these traits also affect human mate preferences. Height is one such characteristic, and evidence suggests that females prefer taller over shorter males, indeed, taller males have been found to have greater reproductive success. However, relative height is also important with ‘Sexual Dimorphism in Stature’ (SDS) calculated as male height/female height. Pawlowski (2003) showed that people adjust their preferences for SDS in relation to their own height in order to increase their potential pool of partners. The aim of the present study was to replicate Pawlowski’s study on a larger sample of participants, and to investigate the universality of the reported preference adjustment within European societies. We present data of 1102 men and women from three countries (Germany, Austria, and the UK) that confirm Pawlowski’s original data on a Polish sample. Moreover, the mechanism of an adjustment of SDS preferences in relation to own height was found in all three countries, suggesting that height dependent partner preference is a genuine feature in Western societies.     

The Continuation of Perpetrator Behaviors that Influence Perceptions of Sexual Harassment

This study was designed to investigate sexual harassment perceptions based on continuation of unwanted sexual attention following victim resistance. Participants were 504 undergraduates who responded to statements regarding a sexual harassment scenario, in which the perpetrator continued or discontinued attention, which varied in severity according to nonphysical, physical, or restraint contact. Results showed that continued attention and any type of physical contact strengthened harassment perceptions, although men’s perceptions were weaker unless restraint was present. No sex differences were observed in the restraint condition. Women had stronger perceptions than men did in the physical condition, but showed a non-significant trend toward stronger perceptions in the nonphysical condition. Findings suggest that continuation following resistance may clarify for observers that harassment is occurring. Conceptualizations of harassment severity are suggested.     

Gay male sexual assault survivors: the relations among internalized homophobia, experiential avoidance, and psychological symptom severity

This study explored the relations among internalized homophobia (IH), experiential avoidance, and psychological symptom severity in a community sample of 74 gay male sexual assault survivors. Results indicated that IH is associated with both depressive and posttraumatic stress disorder (PTSD) symptom severity. IH accounted for more variance than assault severity in predicting both PTSD and depression symptom severity. IH and experiential avoidance similarly predicted PTSD symptom severity. In comparison with IH, however, experiential avoidance is a stronger predictor of depression symptom severity. Results also showed that experiential avoidance partially mediated the relation between IH and both depressive and PTSD symptom severity. The implications of these findings are discussed and suggestions for future research are provided.