The Community Response to Rape: Victims' Experiences with the Legal, Medical, and Mental Health Systems

This research examined how the legal, medical, and mental health systems respond to the needs of rape victims. A national random sample of rape victim advocates (N = 168) participated in a phone interview that assessed the resources available to victims in their communities. as well as the specific experiences of the most recent rape victim with which they had completed work. Results from hierarchical and iterative cluster analysis revealed three patterns in victims' experiences with the legal, medical, and mental health systems. One group of victims had relatively positive experiences with all three systems, a second group had beneficial outcomes with only the medical systems, and the final group had difficult encounters with all three systems. Multinominal logistic regression was then used to evaluate an ecological model predicting cluster membership. Community-level factors as well as features of the assault and characteristics of the victims predicted unique variance in victims' outcomes with the legal, medical, and mental health systems. These findings provide empirical support for a basic tenet of ecological theory: environmental structures and practices influence individual outcomes. Implications for ecological theory and interventions to improve the community response to rape victims' needs are discussed.     

Sex Under Pressure: Jerks,Boorish Behavior,and Gender Hierarchy

Pressuring someone into having sex would seem to differ in significant ways from pressuring someone into investing in one’s business or buying an expensive bauble. In affirming this claim, I take issue with a recent essay by Sarah Conly (‘Seduction, Rape, and Coercion’, Ethics, October 2004), who thinks that pressuring into sex can be helpfully evaluated by analogy to these other instances of using pressure. Drawing upon work by Alan Wertheimer, the leading theorist of coercion, she argues that so long as pressuring does not amount to coercing someone into having sex, her consent to sex answers the important ethical questions about it. In this essay, I argue that to understand the real significance of pressuring into sex, we need to appeal to background considerations, especially the male-dominant gender hierarchy, which renders sexual pressuring different from its non-sexual analogues. Treating pressure to have sex like any other sort of interpersonal pressure obscures the role such sexual pressure might play in supporting gender hierarchy, and fails to explain why pressure by men against women is more problematic than pressure by women against men. I suggest that men pressuring women to have sex differs from the reverse case because of at least two factors: (1) gendered social institutions which add to the pressures against women, and (2) the greater likelihood that men, not women, will use violence if denied, and the lesser ability of women compared to men to resist such violence without harm. I would like to thank Marcia Baron, Sylvia Berryman, Elizabeth Brake, Dominic McIver Lopes, Jennifer Warriner, Janet Wesselius, two anonymous reviewers for Res Publica and the audiences at the University of British Columbia Feminism and Philosophy Workshop and the Western Canadian Philosophical Association meetings in Winnipeg for helpful discussion and comments.     

Manipulation and force as sexual coercion tactics: conceptual and empirical differences

This study examines the relationship between perpetrator characteristics, situational characteristics, and type of sexual coercion tactics used to obtain sexual contact (including sexual intercourse) with an unwilling partner. Men who used manipulation or force were compared to each other and to men who engaged in only consensual sex. Participants were college men drawn from the first wave of a 5-year longitudinal study. Stepwise discriminant function analyses, univariate analyses of variance (ANOVA), and chi(2) analyses tested group differences. As predicted, men who used force reported more childhood sexual abuse, witnessed more domestic violence, were more accepting of male violence, and were less likely to endorse love as a motive for sex than men in both the manipulation and consent groups. Men in the force group were also more likely to have had a casual relationship with the woman, and to be drinking and also intoxicated during the coercive incident than men in the manipulation group. Hypothesized differences between men who used force and manipulation regarding parental physical punishment, traditional gender role attitudes, delinquency, hedonistic and dominance motives for sex, prior sexual contact, and the length of the relationship were not supported. The results suggest that types of tactic used in sexual assaults can be distinguished on the basis of person and situational variables and that knowledge of these differences can facilitate future research, as well as rape deterrent and intervention programs.     

Victim Gender,Number of Perpetrators,and Interpersonal Interaction in Stranger Rape: An Analysis of Direct and Moderator Effects

This study examined the direct and moderator effects of number of perpetrators and gender of victim on interpersonal behaviour in stranger rape. Crime scene behaviours representative of hostility, involvement, control, and offender penetration in rape were examined for 496 UK, police‐recorded cases of stranger rape. Cases were grouped according to victim gender (male or female) and number of perpetrators (lone or multiple). This resulted in four groups (lone female, lone male, multiple female, and multiple male) with 124 cases in each. Binary logistic regression and one‐way analysis of variance were used to investigate the relationships between the two predictor variables and 11 criterion variables. Significant direct effects of number of perpetrators were found whereby multiple perpetrator offences were more likely to involve violence and less likely to involve involvement interactions than lone perpetrator offences. Significant direct effects of victim gender were also found whereby male victims were more likely than female victims to experience hostile interactions and be threatened with a weapon and were less likely to experience offender penetration and involvement interactions. Significant crossover interactions were also found for four hostility variables. The utility of the findings are discussed in relation to crime prevention, victim support, and offender intervention. Copyright © 2013 John Wiley & Sons, Ltd.     

Delivered as Described: A Successful Case of Cognitive Processing Therapy With an Older Woman Veteran With PTSD

Cognitive processing therapy (CPT) is a first-line, evidence-based treatment for posttraumatic stress disorder (PTSD). Little is known, however, about the use of CPT for older adults. As the United States population continues to grow and age, an understanding of the utility of CPT for older adults is vital. We present a case study describing the assessment and cognitive treatment of a 74-year-old woman veteran with PTSD secondary to military sexual trauma. CPT was associated with decreased PTSD symptoms as measured before and after treatment. Factors contributing to the veteran’s response, as well as contextual and environmental factors, are discussed. The case demonstrates that CPT may be effective for older adults without major modification.     

Rape Myth Acceptance: A Comparison of Military Service Academy and Civilian Fraternity and Sorority Students

Although both the military and fraternities have been theorized to be characterized by norms and attitudes that serve to legitimize violence against women, no previous work has examined the potential similarity and differences in rape-supportive beliefs of these 2 environments or the people drawn to them. Further, the belief systems of women within these organizations have received little attention. As such, the current study sought to serve as an initial exploration of the rape-supportive belief systems of people drawn to these groups. Participants were recruited from students entering 2 military service academies (U.S. Military Academy, n = 1,169, 1,003 men, 166 women; U.S. Naval Academy, n = 1,916, 1,551 men, 365 women) and fraternities and sororities at a Midwestern university (n = 393, 188 men, 205 women). All participants completed the Illinois Rape Myth Acceptance Scale–Short Form. Consistent with previous findings related to gender, men were more accepting of rape myths than women. Further, there was more variability in the levels of rape myth acceptance among military service academy and fraternity men than among military service academy and sorority women. Although across all groups the women expressed significantly lower levels of rape myth acceptance than the men, women and men from the United States Military Academy were more closely aligned in their beliefs than women and men from the other samples. Implications for sexual assault prevention education are discussed.     

Sex Differences in Women's Mental Health Problems and Their Causes

No abstract available for this article.     

Treatment of Depression in Disadvantaged Women

Low-income minority women are underrepresented in mental health service settings, yet they are clearly at risk for psychiatric disorders. We staff a clinic specialized in the treatment of depression in economically disadvantaged medical patients. We will share our experience treating disadvantaged and ethnic minority women and will discuss the ingredients necessary to provide quality therapy for these women. We will begin by discussing how poor and minority women access treatment, and the strategies we have used to keep these women in treatment. Then we will consider how services can be made sensitive to the special needs of disadvantaged women, including particular techniques we have found useful in their treatment. Finally, we will discuss common therapeutic issues for these women, as well as successful strategies for helping with the common issues.     

Survivors’ Advice to Service Providers: How to Best Serve Survivors of Sexual Assault

Recognizing the relatively low rate at which sexual assault survivors seek services, researchers in the last decade have turned their attention to better understanding survivors’ experiences with victim services. Surprisingly, limited research has directly asked sexual assault survivors for recommendations on how to improve victim services, including both criminal justice and community-based services. The current study builds on the existing literature to gather input from women survivors that can translate into ways to improve victim services. As part of a larger longitudinal study, the current investigation asked 224 ethnically diverse adult (aged 18–62) women survivors of recent sexual assault to provide recommendations for how victim services can best serve survivors of sexual assault at multiple time points. Nearly all women in the study (91%) offered specific recommendations on how to improve victim services. Recommendations included ensuring availability of a female provider, improving communication with survivors as well as within and between service providers, helping survivors obtain resources, believing and not blaming survivors, demonstrating greater understanding of trauma-related responses and approaching survivors with greater compassion, and implementing better training on effectively working with survivors. Implications for victim service provision are discussed.     

Levels of change in parent–infant psychotherapy

This paper offers a way of thinking about the process of parent–infant psychotherapy. I start by outlining some ideas as to what can go awry in troubled parent–infant relationships, and then a way of working with parents with pre-verbal babies. I suggest a model for understanding three interlaced levels at which change might occur if a psychodynamic, systemically sensitive, therapeutic intervention is offered. I describe a particularly challenging clinical case in which a mother and I also worked with video material of her and her son.