Health,wellness, and workplace experiences of lesbian,gay, and bisexual social workers

Abstract

Using data from an online survey of 6,112 licensed social workers in 13?U.S. states, rates of reported behavioral health problems and service utilization, physical health problems, adverse childhood experiences, workplace stress, and compassion satisfaction were compared between heterosexual male, heterosexual female, gay/bisexual male, and lesbian/bisexual female respondents. Sexual minority workers reported far higher rates of mental health problems and service utilization, higher rates of physical problems, more frequent reporting of adverse childhood experiences, with no differences found between groups regarding workplace stress and compassion satisfaction. Minority stress theory and historical trauma are used as frameworks to conceptualize the findings.     

Comparing gang and individual rapes in a community sample of urban women

Little research has compared victims of gang and individual rapes, with only a few studies of college and police samples. This study compared gang (e.g., multiple offender) and individual (e.g., single offender) rapes in a large, diverse sample of female victims from the community. Comparisons of trauma histories (e.g., child sexual abuse), assault characteristics (e.g., offender violence) and outcomes (sexual acts, physical injuries), and current functioning (e.g., posttraumatic stress disorder, lifetime suicide attempts) showed that gang rape victims were worse off overall compared with victims of single offenders. In terms of help seeking, there were few differences in informal support seeking, but gang rape victims perceived their social networks more negatively. Gang rape victims reported to police, medical, and mental health sources more often than single-offender victims and received more negative social reactions from those they told about their assaults. Suggestions for future research and intervention with gang rape victims are provided.     

The Nature of Women's Rape Fantasies: An Analysis of Prevalence,Frequency, and Contents

This study evaluated the rape fantasies of female undergraduates (N = 355) using a fantasy checklist that reflected the legal definition of rape and a sexual fantasy log that included systematic prompts and self-ratings. Results indicated that 62% of women have had a rape fantasy, which is somewhat higher than previous estimates. For women who have had rape fantasies, the median frequency of these fantasies was about 4 times per year, with 14% of participants reporting that they had rape fantasies at least once a week. In contrast to previous research, which suggested that rape fantasies were either entirely aversive or entirely erotic, rape fantasies were found to exist on an erotic–aversive continuum, with 9% completely aversive, 45% completely erotic, and 46% both erotic and aversive.     

The Cultural Context of Nondisclosure of Alcohol-Involved Acquaintance Rape Among Asian American College Women: A Qualitative Study

With high college enrollment and increasing alcohol use, Asian American (AA) college women may be at particular risk for experiencing alcohol-involved acquaintance rape. Although AA women have expressed the weakest intentions to report rape when compared to other ethnic groups, cultural factors influencing these intentions remain unexamined. Guided by grounded theory, 17 self-identified AA college women were interviewed about how the average AA college woman would respond to an alcohol-involved acquaintance rape. Despite awareness of benefits of disclosing rape, participants emphasized that nondisclosure would be the normative response. Three themes emerged from participants: institutional, sociocultural, and psychological contexts of nondisclosure. At an institutional level, nondisclosure referenced mental health and police services, which included Asian stereotypes and mistrust of police. Within a sociocultural context, rape nondisclosure focused on negative consequences on relationships with parents and, to a lesser extent, on friendships. Emotional avoidance and not labeling an acquaintance rape as rape were psychological strategies for rape nondisclosure. Participant's conceptualizations of mental and physical health concerns, specifically post-rape concerns, were framed within sociocultural/macrostructural contexts and may not match that of the more individualistic U.S. mainstream conceptualizations of health. Culturally sensitive rape education may be more effective in increasing rape prevention and support.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

Midlife and Older Gay Men Living with HIV/AIDS: The Influence of Resiliency and Psychosocial Stress Factors on Health Needs

HIV/AIDS research has mostly focused on younger gay men. This cross-sectional study originated from a larger study of 316 respondents to include a subsample of 38 midlife and older gay men living with HIV/AIDS. The study explores physical and mental health utilization rates, including physical and mental health status. Resiliency, internal health locus of control beliefs, and psychosocial stressors of age and sexual orientation discrimination, stigma, and internalized homophobia were also examined. A total of 65.8% of the HIV/AIDS participants received no mental health services the past year, despite reporting higher mental health distress. Of those reporting an HIV status, 10.5% indicated having no health visits in the preceding year and more delays in seeking care when needed and unmet health needs for which services were not sought. Participants reporting higher resiliency indicated less mental health distress and better health access indicators. Stigma and internalized homophobia negatively affected resiliency. Implications for practitioners working with midlife and older gay men are provided.     

Reporting Rape in a National Sample of College Women

Abstract

Background: Studies indicate that a small percentage of rapes are reported to law enforcement officials. Research also suggests that rapes perpetrated by a stranger are more likely to be reported and that rapes involving drugs and/or alcohol are less likely to be reported. College women represent a unique and understudied population with regard to reporting rape. Methods: In the current study, the authors interviewed a national sample of 2,000 college women about rape experiences in 2006. Results: Only 11.5% of college women in the sample reported their most recent/only rape experience to authorities, with only 2.7% of rapes involving drugs and/or alcohol reported. Minority status (ie, nonwhite race) was associated with lower likelihood of reporting, whereas sustaining injuries during the rape was associated with increased likelihood of reporting. Discussion: Reporting, particularly for rapes involving drugs and alcohol, is low among college women. Implications for policy are discussed.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

Association between child sexual abuse and sexual revictimization in adulthood among women sex partners of injection drug users

Community-recruited women (n = 1490) were interviewed about their early and adult sexual victimization histories to determine whether there was an association between child sexual abuse and adult revictimization by sex partners and strangers/nonsex partners. Adolescent sexual abuse, lifetime sex-trading, drug treatment, and mental health treatment were examined as mediating variables. One-fourth of the women had been revictimized (i.e., experienced child sexual abuse and at least one instance of adult sexual victimization). Child sexual abuse was associated with both rape and other sexual victimization by a sex partner in adulthood, as well as adult rape by a stranger/nonsex partner. Drug and mental health treatments reduced abused women's chances of being raped by a sex partner; drug treatment also decreased the likelihood of other sexual victimization by a sex partner. Sex-trading increased abused women's likelihood of rape by a stranger or nonsex partner. Intervention--including drug treatment--can help women with child sexual abuse histories overcome some of the abuse-related sequelae that make them vulnerable to adult revictimization.     

Homelessness,housing instability,intimate partner violence,mental health,and functioning: A multi-year cohort study of IPV survivors and their children

Abstract

Homelessness and housing instability frequently accompany intimate partner violence and can negatively impact health and functioning. When children are exposed to homelessness or housing instability their ability to develop and function is compromised. The purpose of this study is to examine the differential impact of homelessness and unstable housing on health and functioning of women and their children over a 2-year period. Two hundred and seventy-seven mothers reporting intimate partner violence (stalking, physical, or sexual violence by an intimate partner) were asked about housing stability, abuse, risk for murder, mental health, employment/wages, and their child's functioning over a 2-year period. Outcomes of mothers reporting homelessness and unstable housing were compared to mothers reporting stable housing. Over one-third (36%) of the mothers reported at least one episode of unstable housing over the 2-year period and 11% reported homelessness. Measures of maternal mental health and child functioning were worse for both unstably housed and homeless women, compared to stably housed women, with a higher risk for sexual abuse and risk for murder for homeless women. New models of rapid rehousing are needed that address not only the housing problems of women who have experienced intimate partner violence but also the mental health and safety issues that the women and their children face.     

Barriers to reporting sexual assault for women and men: perspectives of college students

The authors asked college students to rate the importance of a list of barriers to reporting rape and sexual assault among male and female victims. The authors' findings indicate that barriers prevalent 30 years ago, prior to efforts by the rape reform movement, continue to be considered important among college men and women. The barriers rated as the most important were (1) shame, guilt, embarrassment, not wanting friends and family to know; (2) concerns about confidentiality; and (3) fear of not being believed. Both genders perceived a fear of being judged as gay as an important barrier for male victims of sexual assault or rape and fear of retaliation by the perpetrator to be an important barrier for female victims.     

The relationship between adult sexual assault and prostitution: an exploratory analysis

Previous research has established a link between childhood sexual abuse and engaging in prostitution as an adult. The purpose of this study was to extend this literature by exploring whether being raped as an adult is associated with exchanging sex for money. Interviews with 102 rape survivors in a major metropolitan area revealed that 23.5% had engaged in prostitution post-rape. Those who had exchanged sex for money were more likely to be women of color, to have a high school education or less, to be unemployed, and to have children to support, than those who had not engaged in prostitution post-assault. The prostitution subsample also had significantly higher levels of psychological distress, physical health symptomatology, and substance use. Survivors were asked whether and how the rape was associated with engaging in prostitution: most (75%) stated that they felt it was related to the assault. The most commonly cited reason for engaging in prostitution by these survivors was that they were trying to regain some control over their lives and their bodies; exchanging sex for money was seen as one way to control men's access to them. Implications for future research on victimization and prostitution are discussed.     

Racially Charged Legislation and Latino Health Disparities: The Case of Arizona's S.B. 1070

Researchers have established that minority groups tend to suffer worse health outcomes compared to their white counterparts, though the specific mechanisms at play are still under investigation. The passing of Arizona's 2010 “Support Our Law Enforcement and Safe Neighborhoods Act,” commonly referred to as “S.B. 1070,” provides a unique opportunity to examine the effects of an increasingly racially charged milieu on Latino health. Using the Arizona sample of the 2009–2011 Behavioral Risk Factor Surveillance System, we find that the changing social setting around S.B. 1070 is related to poorer Latino self-reported health, but only for those whose primary language is Spanish. Furthermore, serving as control groups, we find no such relationship in other U.S.-Mexico border states that had no analogous legislation (Texas, New Mexico, and California). We expand on stress process theory and group position theory to explain this increase in Arizona's negative health reporting, despite traditional social and economic protective factors.     

Criminal sittings – rape in the colony, New Zealand, 1862

In 1862 His Honor, Justice Johnston, issued his instructions to the jury of the New Zealand Supreme Court for two simultaneous rape trials – the alleged rape of a European woman by two Māori men, and an alleged “assault with intent to commit a rape” of a Māori woman by a European man. This article argues that those instructions should be read within an historiographical critique of British colonial expansion, print capitalism and violence. Drawing on feminist postcolonial theorizing the question posed here, is, “What is the historical, ideological context for a newspaper reporting of the possible rape of a Māori woman in 1862?     

Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability

Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.     

Secondary victims of rape

Rape is often a very traumatic experience, which affects not only the primary victim (PV) but also his/her significant others. Studies on secondary victims of rape are few and have almost exclusively studied male partners of female rape victims. This study examined the impact of rape on 107 secondary victims, including family members, partners, and friends of male and female rape victims. We found that many respondents found it difficult to support the PV and that their relationship with the PV was often affected by the assault. Furthermore, the sample showed significant levels of traumatization, and it was estimated that approximately one quarter of the respondents suffered from posttraumatic stress syndrome (PTSD). Degree of traumatization was associated with a more recent assault, higher efforts to support the PV, recurrent thoughts about having been able to prevent the assault, a lack of social support for the respondent, and feeling let down by others. The respondents were generally interested in friend-, family-, and partner-focused interventions, particularly in receiving education about how best to support a rape victim.     

Differences in psychological health and family dysfunction by sexual victimization type in a clinical sample of African American

We examined levels of sexual victimization among a sample of 249 14‐ to 19‐year‐old African American adolescent women. Victimization was common: 32.1% reported having been raped, 33.7% had experienced sexual coercion, and 10.8% reported an attempted rape. Only 23.4% had never been victimized. We investigated whether levels of psychological health and family dysfunction varied as a function of the type of sexual victimization. Girls who had been raped had lower levels of self‐esteem and mastery and higher levels of depression compared to girls who reported no sexual victimization. Significantly higher levels of family cohesion and significantly lower levels of family support were reported by girls who had been raped versus girls who reported no sexual victimization. These findings are a starting point for future studies by providing evidence that levels of mental health and family dysfunction vary by the type of sexual victimization experienced.     

Longitudinal Associations Between Husbands' and Wives' Depressive Symptoms

Although concordance between husbands' and wives' mental health problems is often reported, questions remain about the nature of these relations. Extending research in this area, this study examined dynamic-longitudinal pathways among husbands' and wives' depressive symptoms and marital satisfaction as a moderator of associations. Participants were 296 heterosexual couples. Husbands and wives reported on their depressive symptoms and marital satisfaction. Results from dynamic bivariate latent difference score analyses indicated unidirectional longitudinal coupling such that higher levels of husbands' depressive symptoms predicted subsequent elevations in wives' depressive symptoms over time. This relation was stronger among couples reporting marital distress as compared to couples reporting higher marital satisfaction. The findings underscore the importance of considering one's spouses' depressive symptoms in treatment efforts.     

SEX-ROLE ATTITUDE CHANGE AND REPORTING OF RAPE VICTIMIZATION, 1973–1985

This article examines the relationship between sex-role attitude change and female victims' reports of rape incidents to police in an analysis of time-series data from national attitude surveys of college freshmen and adults, and from annual victimization surveys. Declining support for traditional sex-role attitudes among both college women and men is strongly related to an increase in the proportion of rapes by nonstranger assailants that were reported to police from 1973 to 1985. However, victims' reports of rapes by strangers are more closely related to offenders' use of weapons during sexual assaults. These findings and other evidence against alternative explanations suggest that the cultural bases for "rape myths" have eroded during the 1970s and 1980s, and that broader definitions of rape have contributed to increased reporting of certain forms of sexual assault to police.     

Distressing Sexual Difficulties in Heterosexual and Non-Heterosexual Croatian Men: Assessing the Role of Minority Stress

Although research has shown a connection between minority stressors and internalizing mental health problems, the role of minority stress has mainly been neglected in the assessment of sexual problems among non-heterosexual men. Using online samples of heterosexual (n = 933) and non-heterosexual participants (n = 561) aged 18 to 50 years, this study aimed to comparatively assess sexual difficulties and problems and explore the role of minority stress in non-heterosexual men's sexual problems. Although the age-adjusted odds of reporting rapid ejaculation, delayed ejaculation, and sex-related anxiousness significantly differed between the two groups, the overall prevalence of sexual difficulties and the associated levels of distress did not significantly differ between the samples. In multivariate assessment, anxiety and depression significantly increased the odds of reporting distressing sexual difficulties among both heterosexual and non-heterosexual participants. In the non-heterosexual sample, positive body image significantly decreased the odds of experiencing sexual problems. Pointing to a role of minority stress, highest levels of victimization related to sexual orientation increased the risk of sexual problems. This association was partially mediated by negative emotions. Our findings offer some support for a recent call to include sexual orientation among the social determinants of health recognized by the World Health Organization.