What really happened? A validation study of rape survivors' help-seeking experiences with the legal and medical systems

Much of what is known about rape survivors' experiences with the legal and medical systems has come from victims' accounts; rarely have researchers collected "the other side of the story" to find out what system personnel say did or did not happen in these interactions. In the current study, rape survivors who sought emergency medical care were interviewed before their hospital discharge about what services they received and how they were treated by social system personnel. Corresponding accounts were then collected from doctors, nurses, and police officers. There was significant interrater reliability between the survivors and legal and medical system personnel regarding what services were or were not provided ("service delivery") and if system personnel engaged in "secondary victimization" behaviors (i.e., statements/actions that could be distressing to victims). However, police officers and doctors significantly underestimated the impact they were having on survivors. Victims reported significantly more post-system-contact distress than service providers thought they were experiencing.     

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.     

Assessing the efficacy of the protective action-completion nexus for sexual victimizations

Research has shown that protective actions are often used by rape victims, and some actions, namely, forceful physical resistance, are more effective in preventing a completed rape than other types of actions, such as nonforceful verbal resistance. The research is less clear, however, on the extent to which women who are victims of nonrape sexual victimization use protective measures and on the effectiveness of these actions. There is also uncertainty on the nature of the relationship between different types of protective actions, contextual characteristics, and the likelihood of completion of nonrape sexual victimization incidents. To investigate these issues, we used data from a national-level study of 4,446 female college students. Our results indicate that the use of protective action varied across type of sexual victimization and that the effectiveness of these actions on reducing the risk of a completed act is differentially related to type of sexual victimization. The findings suggest the need for sexual victimization prevention and education programs to include information regarding the efficacy of protective actions in both rape and nonrape incidents.     

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.     

Intimate sexual victimization among women with protective orders: types and associations of physical and mental health problems

Intimate sexual violence was examined among a sample of women who had recently obtained protective orders against male partners using three groups: no sexual victimization (n = 368), sexual insistence (n = 114), and threatened and/or forced sex (n = 117). Differences in childhood sexual abuse as well as types of partner psychological abuse, stalking, and severe physical violence experiences were found across the groups. Multivariate analysis showed that women with no sexual victimization had significantly fewer mental health problems than women who had experienced sexual insistence and women who had been threatened or forced to have sex. Findings from this study underscore the importance of health, mental health, and criminal justice professionals assessing for a range of sexually abusive acts when working with victims of partner violence.     

The epidemiology of physical attack and rape among crack-using women

This prospective study examines the epidemiology of physical attack and rape among a sample of 171 not-in-treatment, crack-cocaine using women. Since initiating crack use, 62% of the women reported suffering a physical attack. The annual rate of victimization by physical attack was 45%. Overall, more than half of the victims sought medical care subsequent to an attack. The prevalence of rape since crack use was initiated was 32%, and the annual rate was 11%. Among those women having been raped since they initiated crack use, 83% reported they were high on crack when the crime occurred as were an estimated 57% of the perpetrators. Logistic regression analyses showed that duration of crack use, arrest for prostitution, and some college education were predictors of having experienced a physical attack. Duration of crack use and a history of prostitution were predictors of suffering a rape. Drug abuse treatment programs must be sensitive to high levels of violence victimization experienced by crack-cocaine using women. Screening women for victimization, and treating the problems that emanate from it, may help make drug abuse treatment more effective.     

Adult happiness and prior traumatic victimization in and out of the household

A large share of the American population suffers from traumatic experiences early in life. Many adults are also victims of trauma. Using data drawn from the National Comorbidity Survey–Replication, we examine the link between self-reported happiness, a broad gauge of subjective well-being, and four types of traumatic victimization that may occur at various points in the life cycle. In particular, we consider the association between home violence, sexual assault, community violence, and stalking and subsequent victims’ adult happiness. For females and males, we find that each of these traumas significantly reduces self-reported happiness later in the life course, and for both women and men, the estimated impact of home violence is greatest. Furthermore, we find that the adverse effects of trauma on happiness are comparable to the impact of critical socioeconomic developments on happiness. Moreover, we find that experiencing more than one type of these four traumas has a greater negative impact on subsequent happiness than experiencing only one type. Our findings are robust to the inclusion of a wide range of controls, and the influence of trauma on subsequent happiness is independent of personal and family characteristics. Since happiness and mental health are closely related, our work suggests that traumatic victimization undermines overall health and well-being in the U.S.     

“It All Depends on the Guy and the Girl”: A Qualitative Study of Youth Experiences with Statutory Victimization Relationships

The purpose of this exploratory study was to examine youths’ perceptions of statutory victimization relationships and youths’ experience interacting with professionals. In-person qualitative interviews were conducted with 22 youths identified as statutory rape victims by two child advocacy centers. Using grounded theory, interviews were coded thematically using constant comparison analysis. The discussion of the relationship dynamics suggested a great deal of variation. Some youths described the relationships in exploitive terms. However, more typically, the interviewed youth described the relationship as reciprocal, even some time after it had ended. The professional intervention often resulted in feelings of helplessness for the youth. The results suggest creative and flexible protocols are needed for handling these cases that recognize adolescents’ developing autonomy.     

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.     

Mental health of lesbian, gay, and bisexual youth: A developmental resiliency perspective

Research suggests that lesbian, gay, and bisexual (LGB) youth are at increased risk for both victimization and internalizing mental health problems, but limited research has studied their association or factors that increase resilience. The sample included 425 LGBs between the ages of 16 and 24 year. The majority had disclosed their sexual orientation to family or friends (98%) and 97% had someone in their lives who was accepting. Racial/ethnic minority and female participants in general reported lower levels of disclosure and acceptance. Most participants reported some form of sexual orientation-related victimization (94%). Victimization was associated with psychological distress, but a compensatory model indicated that in the context of this victimization both peer and family support had significant promotive effects. A test of a protective model found social support did not ameliorate negative effects of victimization. The positive effects of family support decreased with age. Peer and family support were particularly important, but they did not significantly dampen the negative effects of victimization. Our findings suggest that mental health professionals working with LGB youth should address social support and that public health approaches are needed to reduce levels of victimization.     

Youth Sexual Exploitation on the Internet: DSM-IV Diagnoses and Gender Differences in Co-occurring Mental Health Issues

This paper explores conventional (non-Internet-related) mental health issues and DSM-IV diagnoses seen among a sample of 512 youth receiving mental health services for an Internet-related problem, with particular attention to victims of online sexual exploitation. Youth victims of online sexual exploitation were more likely to have a post-traumatic stress disorder than youth with other Internet-related problems. Specific attention was given to differences among subgroups of female and male youth victims of online sexual exploitation as compared with same-gender youth with other Internet-related problems. Findings suggest the importance of including Internet use and victimization as part of a standard clinical assessment.     

Trauma Related Critical Incident Debriefing for Adolescents

Events like the tragedy at Columbine High School and the terrorists attacks on New York City in 2001 have highlighted the need for mental health practitioners to become familiar with interventions that are designed to assist young people who have survived extremely stressful events. Mental health professionals often see people who have experienced car accidents, severe abuse, rape, or other victimization, as well as survivors of natural and man-made disasters during the first critical stages of the recovery period. This article describes the process of critical incident de-briefing and provides a step-by-step primer for its application. The process is short-term (four sessions or less) and provides an intervention designed to reduce the frequency and severity of post-traumatic stress symptoms. Adolescents are particularly at risk because of issues surrounding identity formation, self- esteem, and developmental differences in coping mechanisms. Therefore, those who work with an adolescent cohort should be familiar with debriefing methods and how to apply them to the teenager.     

Mental Health Conditions Among North Korean Female Refugee Victims of Sexual Violence

The study aims to examine the negative effects of sexual violence on North Korean (NK) female refugees in South Korea. Although the prevalence of sexual violence victimization is extremely high and mental health problems are serious among these refugees, little to no research has been done on the relationship between sexual violence and mental health among these women. The mental health conditions of two groups of women (sexual violence victims and those who have not experienced sexual violence) were compared using ANCOVA analyses. The results show that suicidal ideation and alcohol use are significantly more prevalent in the sexual violence group than in the non‐sexual violence group. The women who had experienced sexual violence in particular should be provided with more professional and sustained treatment and management services. The government must improve the effectiveness of existing policies related to suicide and the drinking culture in South Korea.     

Physical and mental health effects of being stalked for men and women

Stalking is relatively common yet little is known of the longer-term health effects of stalking. Using the National Violence Against Women survey, we estimated lifetime stalking victimization among women and men, ages 18 to 65, identified correlates of being stalked, and explored the association between being stalked and mental and physical health status. With a criterion of being stalked on more than one occasion and being at least "somewhat afraid," 14.2% of women and 4.3% of men were victims. Among those stalked, 41% of women and 28% of men were stalked by an intimate partner. Women were more than 13 times as likely to be "very afraid" of their stalker than men. Negative health consequences of being stalked were similar for men and women; those stalked were significantly more likely to report poor current health, depression, injury, and substance use. Implications for victims, service providers, and the criminal justice system were reviewed.     

Understanding the needs of LGBTQ clients and their risk for commercial sexual exploitation: Training community mental health workers

Training on commercial sexual exploitation (CSE) and victimization of lesbian, gay, bisexual, transgender, and queer (LGBTQ) youths can increase awareness among professionals who provide services to this community. This study evaluated the effectiveness of a community-based training program geared toward mental health workers in a diverse metropolitan city. The training provided information about the continuum of sexuality and gender identity, sensitivity when working with LGBTQ clients, LGBTQ clients’ risks for CSE, and ways to improve service delivery to this population. Participants’ (N?=?64) knowledge level of these areas was examined prior to the training, immediately thereafter, and in a six-month follow-up. Participants showed an increase in knowledge from pretest to posttest. Follow-up testing on a limited sample revealed scores that were lower than posttest scores, but higher than pretest scores. Overall, through this community-based training, participants gained knowledge about the continuum of sexual and gender identity, appropriate service delivery when working with LGBTQ individuals, and the risk factors for CSE for LGBTQ youths. Participants also reported feeling satisfied with the training approach and format. Implications for future training to enhance mental health workers’ competence with LGBTQ victims of sexual exploitation are explored.     

Social reactions to child sexual abuse disclosures: a critical review

Recent studies have examined disclosure of child sexual abuse to determine the correlates and consequences of telling others about this form of victimization. The present article reviews the current empirical literature on disclosure and reactions to adult survivors to assess what is known about the process of disclosure and whether telling others is therapeutic and leads to positive outcomes. Most studies assessing social reactions in detail have concerned adult survivors retrospectively reporting on their disclosures of child sexual abuse. Few empirical studies have been conducted in this area but research suggests that few victims tell anyone about child sexual abuse as children, and that the type of reactions to disclosure vary according to when disclosure occurs (childhood or adulthood), the extent and nature of the disclosure, and the person to whom one discloses. Clear evidence shows that negative social reactions are harmful to survivors' well-being, but better assessment of specific reactions and their effects are needed in theoretically-based studies to evaluate how these responses affect survivors' recovery in the context of other variables. Suggestions for future research on social reactions of others to adult survivors disclosing child sexual abuse are presented.     

Police interviews of sexual assault reporters: do attitudes matter?

Sexual assault is underreported in the United States. Survivors are often reluctant to make police reports for various reasons; one is fear of revictimization by criminal justice professionals. Conversely, police officers often lack skills for interviewing crime victims. Posttraumatic stress reactions among victims can exacerbate the problem. Although some victims prefer female interviewers, it is not known whether they are more skilled. A sample of 429 police officers completed a written survey testing their rape myth acceptance and knowledge of how to interview rape reporters. A significant relationship between rape myth acceptance and interviewing skill was discovered. Although officer gender was related to interviewing skill, the effect was mediated by rape myth acceptance. Specific officer behaviors related to high rape myth acceptance were identified. Implications for selection of police to conduct victim interviews were discussed.