Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims.

The efficacy of a brief prevention program (BP) aimed at arresting the development of chronic posttraumatic stress disorder (PTSD) was examined with 10 recent female victims of sexual and nonsexual assault who received 4 sessions of a cognitive-behavioral program shortly after the assault. Their PTSD and depression severity was compared with that of 10 matched recent female assault victims who received repeated assessments of their trauma-related psychopathology (assessment control; AC). The BP program consisted of education about common reactions to assault and cognitive-behavioral procedures. Two months postassault, victims who received the BP program had significantly less severe PTSD symptoms than victims in the control condition; 10% of the former group met criteria for PTSD versus 70% of the latter group. Five and a half months postassault, victims in the BP group were significantly less depressed than victims in the AC group and had significantly less severe reexperiencing symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.

Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N=171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N=131). Coping strategies again mediated the relations among the measures of past and present control and distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do Assault-Related Variables Predict Response to Cognitive Behavioral Treatment for PTSD?

This study examined the hypothesis that variables such as history of prior trauma, assault severity, and type of assault, previously found to be associated with natural recovery, would also predict treatment outcome. Trauma-related variables were examined as predictors of posttreatment posttraumatic stress disorder (PTSD) severity in a sample of 73 female assault victims with chronic PTSD who completed treatment in a comparative outcome study (E. B. Foa et al., 1999). Results indicated that after controlling for initial severity of PTSD symptoms, the experience of trauma in childhood and sustaining physical injury during the adult assault were predictive of greater PTSD severity following treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting relapse: A meta-analysis of sexual offender recidivism studies.

Evidence from 61 follow-up studies was examined to identify the factors most strongly related to recidivism among sexual offenders. On average, the sexual offense recidivism rate was low (13.4%; n?=?23,393). There were, however, subgroups of offenders who recidivated at high rates. Sexual offense recidivism was best predicted by measures of sexual deviancy (e.g., deviant sexual preferences, prior sexual offenses) and, to a lesser extent, by general criminological factors (e.g., age, total prior offenses). Those offenders who failed to complete treatment were at higher risk for reoffending than those who completed treatment. The predictors of nonsexual violent recidivism and general (any) recidivism were similar to those predictors found among nonsexual criminals (e.g., prior violent offenses, age, juvenile delinquency). Our results suggest that applied risk assessments of sexual offenders should consider separately the offender's risk for sexual and nonsexual recidivism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder following assault: The role of cognitive processing, trauma memory, and appraisals.

Two studies of assault victims examined the roles of (a) disorganized trauma memories in the development of posttraumatic stress disorder (PTSD), (b) peritraumatic cognitive processing in the development of problematic memories and PTSD, and (c) ongoing dissociation and negative appraisals of memories in maintaining symptomatology. In the cross-sectional study (n=81), comparisons of current, past, and no-PTSD groups suggested that peritraumatic cognitive processing is related to the development of disorganized memories and PTSD. Ongoing dissociation and negative appraisals served to maintain PTSD symptoms. The prospective study (n=73) replicated these findings longitudinally. Cognitive and memory assessments completed within 12-weeks postassault predicted 6-month symptoms. Assault severity measures explained 22% of symptom variance; measures of cognitive processing, memory disorganization, and appraisals increased prediction accuracy to 71%. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychological impact of rape victims.

This review article examines rape victims' experiences seeking postassault assistance from the legal, medical, and mental health systems and how those interactions impact their psychological well-being. This literature suggests that although some rape victims have positive, helpful experiences with social system personnel, for many victims, postassault help seeking becomes a "second rape," a secondary victimization to the initial trauma. Most reported rapes are not prosecuted, victims treated in hospital emergency departments do not receive comprehensive medical care, and many victims do not have access to quality mental health services. In response to growing concerns about the community response to rape, new interventions and programs have emerged that seek to improve services and prevent secondary victimization. The contributions of rape crisis centers, restorative justice programs, and sexual assault nurse examiner programs are examined. Strategies for creating more visible and impactful roles for psychologists and allied professionals are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping strategies and posttraumatic stress disorder in female victims of sexual and nonsexual assault.

The coping behaviors and (posttraumatic stress disorder [PTSD]) symptoms of 215 female assault victims (103 rape victims and 112 nonsexual assault victims) were assessed within 2 weeks following the assault (Time I), and 133 of them (62%) were followed up 3 mo later (Time 2). Posttrauma symptom severity significantly decreased during the 3-mo study period, but PTSD severity levels at Times I and 2 were highly correlated. Three coping scales were constructed on the basis of exploratory factor analyses: Mobilizing Support, Positive Distancing, and Wishful Thinking. Three mo postassault, rape victims showed higher levels of wishful thinking and PTSD than nonsexual assault victims. Wishful thinking showed a positive association and positive distancing a negative association with PTSD severity, controlling for assault type, initial levels of PTSD severity, and other coping strategies. The clinical relevance of these findings is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research.

Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to experience sexual assault and child sexual abuse, but less likely to experience accidents, nonsexual assaults, witnessing death or injury, disaster or fire, and combat or war. Among victims of specific PTEs (excluding sexual assault or abuse), female participants exhibited greater PTSD. Thus, sex differences in risk of exposure to particular types of PTE can only partially account for the differential PTSD risk in male and female participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is there still a place for halothane in paediatric anaesthesia?

The purpose of this study was to determine if the colposcope improves detection of genital trauma in adult women who are victims of sexual assault compared with gross visual examination alone. A prospective, 1-month pilot study was conducted of 17 women patients who presented consecutively to Charity Hospital New Orleans during April 1994 requesting sexual assault examinations. Use of the colposcope allowed documentation of trauma in 9 of the 17 sexual assault victims (53%), compared with 1 of 17 (6%) by gross visualization alone (statistically significant: chi2 = 0.64, P = .0114). The colposcope improved detection of genital trauma in adult female sexual assault victims as compared with gross visual examination alone at a statistically significant level.     

Student acceptance and expectation of sexual assault.

46 male and 108 female students' (aged 18–33 yrs) attitudes regarding the acceptance and expectation of sexual assault were examined. Participants also completed M. Burt's (1980) Rape Myth Acceptance (RMA) Scale. It is noted that acceptance of sexual aggression can lead to the exoneration of the perpetrator, whereas expectations of sexual aggression can lead to victim blaming. A feminist perspective of rape, with a focus on sexual socialization, indicates that rape myth beliefs deny or justify male sexual aggression against women. Therefore, it was predicted and found that high RMA participants expected and accepted more sexual assault than low RMA participants. Sexual assault was also expected more often than it was accepted, suggesting that these judgments are made separately. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Links between sexual abuse in childhood and behavioural disorders in adolescent girls: A multivariate approach.

Assessed the links between adolescent behavioral problems and childhood sexual abuse in 3 groups of girls (aged 13–19 yrs). A set of questionnaires was administered to a control group (N?=?181) and 2 clinical groups, one (N?=?62) presenting with sexual behavioral problems and the other (N?=?107) with behavioral problems of a nonsexual nature. Girls in the clinical groups who disclosed sexual abuse had experienced frequent abuse, with penetration, at an older age. Abuse revealed in the control group was less frequent, involved fondling only, and occurred at an earlier age. Considering the clinical groups alone, sexually related behavioral disorders were associated with high frequency, severity, an adolescent abuser, and a reaction of fear. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Longitudinal Examination of Male College Students' Perpetration of Sexual Assault.

Self-administered surveys were completed by 197 men in college at 2 time points, 1 year apart. Men who committed sexual assault at multiple time points (repeat assaulters) had the most extreme scores on measures of hostility toward women, past sexual experiences, drinking in sexual situations, and adolescent delinquency. Nonassaulters had the least extreme scores and men who committed sexual assault at only 1 time point had scores that tended to fall in between. Repeat assaulters also expressed significantly less remorse when they described their sexual assault at Time 1 than did past assaulters who committed sexual assault only at the initial time point. These findings demonstrate the importance of initiating prevention and treatment programs in early adolescence, before longstanding attitudes and behaviors tolerant of sexual assault are established. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Somatic symptoms, social support, and treatment seeking among sexual assault victims.

In an effort to clarify the relationship between the experience of sexual assault and physical health, rape victims and a matched comparison group were repeatedly assessed for somatic symptoms, psychological distress, health care use, and self-rated health perceptions during the year immediately after the assault. Women who experienced sexual assault reported more somatic complaints, poorer perceptions of physical health, greater psychological distress, and increased use of medical services. However, victims did not show a significantly higher use of mental health services and continued to seek medical attention at the end of the year after the assault, when health perceptions and somatic symptoms were no longer significantly elevated. The use of mental health services and social support as moderating variables are examined, and implications for the medical and psychological treatment of sexual assault victims are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of Levels and Patterns of Positive Life Changes Following Sexual Assault.

This study builds on previous work suggesting that many survivors report positive life changes soon after a sexual assault and that those who retain those changes over time report the least distress 1 year post-assault (P. Frazier, A. Conlon, & T. Glaser, 2001). The purposes of this study were to assess correlates of early reports of positive life changes and individual trajectories of self-reported positive changes over time among female sexual assault survivors (n = 171) using hierarchical linear modeling. The factors most related to reporting positive life change soon after the assault were social support, approach and religious coping, and perceived control over the recovery process. Increases in these factors also were associated with increases in self-reported positive life changes over time. The relations between social support and positive change also were mediated by coping strategies and control appraisals, particularly perceived control over the recovery process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived control and distress following sexual assault: A longitudinal test of a new model.

Longitudinal data were collected from female sexual assault survivors (N=171) at 4 points postassault. Consistent with the predictions of the temporal model (P. Frazier, M. Berman, & J. Steward, 2002), past, present, and future control were differentially related to posttrauma distress. Both personal past (behavioral self-blame) and vicarious past (rapist blame) control were associated with higher distress levels. In addition, the belief that future assaults are less likely was more strongly associated with lower distress levels than was future control. Present control (i.e., control over the recovery process) was most adaptive. Hierarchical linear modeling analyses revealed that changes in perceived control were associated with changes in distress after linear change in distress over time was accounted for. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of a modified version of the Peritraumatic Dissociative Experiences Questionnaire.

This article reports results from 3 studies conducted to develop and validate a modified version of the self-administered form of the Peritraumatic Dissociative Experiences Questionnaire (PDEQ; C. R. Marmar, D. S. Weiss, & T. J. Metzler, 1997). The objective was to develop an instrument suitable for use with persons from diverse ethnic and socioeconomic backgrounds. In Study 1, the original PDEQ was administered to a small sample (N=15) recruited from among men admitted to the hospital for physical injuries stemming from exposure to community violence. Results led to modifications aimed at improving the utility of the instrument. In Study 2, the modified PDEQ was subjected to structural equation modeling and item response theory analyses to assess its psychometric properties in a larger, primarily male, sample of community violence survivors (N=294). In Study 3, the reliability and validity of the modified instrument were further assessed in a sample of female survivors of sexual assault (N=90). Results attest to the psychometric properties as well as the reliability and validity of the modified 8-item PDEQ. (PsycINFO Database Record (c) 2010 APA, all rights reserved)