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.     

Forcible,Drug-Facilitated,and Incapacitated Rape and Sexual Assault Among Undergraduate Women

Abstract

Objective: To examine the prevalence of drug-related sexual assaults, identify the frequency of assaults that occur following voluntary versus involuntary drug or alcohol consumption, and identify contextual correlates of drug-related assaults. Participants: College-student females (n = 314). Methods: Volunteers reported experiences with forcible and drug-related sexual assaults in the spring semester of 2004. Follow-up queries regarding the most severe drug-related assaults determined whether the assaults followed voluntary or involuntary alcohol or drug consumption. Results: 29.6% (n = 93) of the respondents reported a drug-related sexual assault or rape; 5.4% (n = 17) reported a forcible sexual assault or rape. Voluntary incapacitation preceded 84.6% of drug-related assaults and involuntary incapacitation preceded 15.4% of drug-related assaults. The majority of drug-related assaults (96.1%) involved alcohol consumption prior to assault. Conclusions: Drug-related sexual assaults on college campuses are more frequent than are forcible assaults and are most frequently preceded by voluntary alcohol consumption.     

Perceptions of,and Assistance Provided to,a Hypothetical Rape Victim: Differences Between Rape Disclosure Recipients and Nonrecipients

Abstract

Objective: Undergraduate rape disclosure recipients’ and nonrecipients’ sociodemographic and life experience variables, attitudes towards rape, and responses to a hypothetical rape disclosure were compared to determine differences between them. Participants: One hundred ninety-two undergraduates at 3 universities participated in this online survey between November 2011 and April 2012. Methods: Participants reported on their rape myth acceptance (RMA) and personal direct and indirect (ie, disclosure receipt) experiences with sexual assault. Participants also responded to a hypothetical rape disclosure. Results: Disclosure recipients were more likely to report a victimization history, and less confusion and perceived ineffectiveness in helping the hypothetical victim. RMA and nonrecipient status predicted perceived victim responsibility; these variables and childhood victimization predicted confusion about helping. RMA also predicted perceived ineffectiveness of one's helping behaviors. Victimization history and female gender predicted victim empathy. Conclusions: These findings can inform sexual assault–related programming for undergraduates through the provision of targeted assistance and corrective information.     

The Reporting of Domestic Violence and Sexual Assault by Nonstrangers to the Police

We examine the effects of the gender of the victim and offender and their relationship to each other on whether sexual and physical assaults are reported to the police. We also examine the reasons victims give for not reporting assaults and whether reporting patterns have changed over time. The analyses are based on a sample of 6,291 physical assaults and 1,787 sexual assaults from the National Violence Against Women Survey. The results suggest that victims are just as likely to report domestic assaults as they are to report assaults by other people they know. Male victims are particularly reluctant to report assaults by their intimate partners, whereas third parties are particularly unlikely to report assaults by partners of either gender. Sexual assaults, particularly those that involve acquaintances, are less likely to be reported. These patterns have not changed since the 1960s.     

Health Behavior Change and the College Personal Health Class: A Multifaceted Approach

Abstract

Both the literature review and the results of a behavioral change project conducted at the University of Oregon indicate that health courses can bring about positive lifestyle changes when behavior is made a focus of the class. A multi-faceted behavioral intervention strategy was developed and used with 433 students enrolled in personal health classes during the fall term, 1983. At the end of the term, 23% of the students reported they were 100% successful in obtaining their desired behavioral changes. Another 40% reported they had just missed their goal. Overall, it appears the intervention was highly successful. More research is needed to validate the approach.     

Evaluation of the RAINN National Sexual Assault Online Hotline

ABSTRACT

This article describes the evaluation of rainn National Sexual Assault Online Hotline, a new model for delivery of rape and sexual assault crisis services through a secure, confidential chat-based online hotline. Outcome data from 623 visitors and 54 volunteers for the first 11 months of the program are presented. The results indicate that the model is viable and useful for approximately 80 percent of visitors, and volunteers are satisfied with the program. Recommendations for program development and further research are presented.     

Sexual Violence on the College Campus: A Template for Compliance With Federal Policy

Objective: The author introduces a template, the Model Policy for the Prevention and Response to Sexual Assault, to assist institutions of higher education to benchmark campus policy compliance with federal laws directed at sexual assault. The author presents a detailed review of policy criteria recommended by the National Institute of Justice. The author proposes 2 unique criteria not found in the National Institute of Justice report for consideration for a comprehensive campus sexual assault policy. Conclusion: The template provides an inclusive system to benchmark campus sexual assault policies. Conforming to the template provides compliance with federal laws and demonstrates that the campus fosters a climate that does not tolerate sexual violence.     

Associations Between Physical Activity and Health-Related Factors in a National Sample of College Students

Abstract

Objective: To examine associations between meeting the current moderate to vigorous physical activity (MVPA) recommendation and health-related factors in a national sample of college students. Participants: Participants (N = 67,861) completed the National College Health Assessment II during the Fall 2008/Spring 2009 academic year. Methods: Hierarchical binary logistic regression was used to examine the contribution of 19 variables in explaining whether or not participants met the MVPA recommendation. Results: Meeting the MVPA recommendation was associated with several protective factors among college students, including adequate daily fruit and vegetable consumption, positive perception of general health, healthy body mass index, consistent seatbelt use, not smoking cigarettes, less perceived depression, and adequate sleep. In addition, meeting the MVPA recommendation was also significantly associated with a few risky behaviors including binge drinking, physical fighting, and multiple sexual partners. Conclusions: College student PA interventions should consider also addressing fruit/vegetable consumption and binge drinking.     

College Women's Experiences with Physically Forced,Alcohol- or Other Drug-Enabled,and Drug-Facilitated Sexual Assault Before and Since Entering College

Objective: Research has shown associations between college women's alcohol and/or drug consumption and the risk of sexual assault, but few studies have measured the various means by which sexual assault is achieved.

Participants: The authors' Campus Sexual Assault Study obtained self-report data from a random sample of undergraduate women (N = 5,446).

Methods: The authors collected data on sexual assault victimization by using a cross-sectional, Web-based survey, and they conducted analyses assessing the role of substance use. The authors also compared victimizations before and during college, and across years of study.

Results: Findings indicate that almost 20% of undergraduate women experienced some type of completed sexual assault since entering college. Most sexual assaults occurred after women voluntarily consumed alcohol, whereas few occurred after women had been given a drug without their knowledge or consent.

Conclusions: The authors discuss implications for campus sexual assault prevention programs, including the need for integrated substance use and sexual victimization prevention programming.     

Patient Problems Encountered at a Student Health Service

Abstract

Objective: To assess how Ohio colleges conform to recommendations that address barriers to reporting sexual assault. Participants: A study sample of Ohio 4-year colleges (N = 105). Methods: College Web sites were examined between March and November 2011 for their availability of sexual assault policies using 8 measures. Results: Of the colleges in the sample, 66% had an online sexual assault policy. Less than 1% of colleges included definitions for applicable sexual offenses in the Ohio Revised Code. All colleges with a policy included on-campus personnel to whom a victim could report. Approximately 25% and 31% of colleges included confidential or 24/7 reporting options, respectively. Conclusions: Many colleges are failing to offer basic reporting options to victims of sexual assault. Having a clearly labeled sexual assault policy on a campus Web site that includes 24/7 reporting options and defines acts of sexual assault can aid victims in the reporting process.     

Implications for Sexual Assault Prevention: College Students as Prosocial Bystanders

Abstract

Prosocial bystander interventions are promising approaches to sexual assault prevention on college campuses. Objective: To assess bystander attitudes among undergraduate students at a northeastern university. Participants: A convenience sample of 188 students from 4 undergraduate classes was surveyed during regularly scheduled class sessions. Methods: Participants completed a short survey on bystander efficacy, readiness to change, and barriers to intervention prior to the start of class. Results: The majority of students were not involved in activities or programs focused on sexual assault prevention. Although students agreed that violence could be prevented, they perceived many barriers to their own participation in intervention. Conclusions: There is a need for gender-targeted prevention programming that introduces the idea of prosocial bystander intervention, with a focus on increasing self-efficacy and lowering barriers.     

Frequency and Types of Partner Violence Among Mexican American College Women

Objective and Participants: The authors studied the prevalence of partner violence, by type, among Mexican American college women aged 18 to 35 years (N = 149; response rate = 85%). Results: Twelve percent of women who reported a dating partner in the past year were physically or sexually assaulted, 12.1% were stalked, and 9.1% scored as psychologically abused. Among those experiencing partner violence, almost half experienced stalking and 89% reported psychological abuse. Few women (25%) who experienced physical violence believed violence was a problem in their relationship. Conclusions: Partner violence was prevalent in this population, and participants experienced many forms of violence. Because few women experiencing physical violence report that violence is a problem in their relationship, interventions must address perceptions of violence and its impact on women's mental and physical health in college populations.     

The State of the Union: Sexual Health Disparities in a National Sample of US College Students

Abstract

Objective: To examine sexual health disparities between blacks and whites in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18–24; M = 20.1) responding to the Spring 2007 American College Health Association–National College Health Assessment; 64% were female and 94.7% were white. Results: Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. Conclusions: This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.     

Does Drinking Alcohol Prior to Sexual Activity Influence College Students’ Consent?

Objectives: This study assessed the extent to which consuming alcohol prior to sexual activity influenced college students' verbal/behavior cues utilized to communicate consent (external consent) as well as their feelings associated with consent (internal consent). Methods: Data was collected via paper-and-pencil surveys administered to heterosexual college students (N = 794) in the United States. Results: After controlling for gender, relationship status, rape myth acceptance, and alcohol expectancies, findings indicated that alcohol consumption prior to sexual activity was associated with both internal and external consent. Conclusions: Current findings can help inform sexual assault prevention education programming given the high rates of sexual assault occurring on college campuses that involve alcohol consumption.     

What survivors want: Understanding the needs of sexual assault survivors

Objective: Sexual assault is a pervasive crime on our college campuses and many survivors do not seek post-assault resources. This study will explore components of alternative interventions to consider in the development of campus-based interventions for sexual assault survivors. Participants: Three stakeholder groups including survivors (n = 8), healthcare providers (n = 6), and advocates (n = 19) were recruited from May 2014 to December 2014 from two university campus communities using flyers and purposive sampling. Methods: A qualitative study design utilized semi-structured interviews and semi-structured focus groups with survivors, healthcare providers, and advocates. Results: Five themes emerged to consider for future campus-based sexual assault interventions: (a) culture of caring, (b) one-stop shop, (c) validation, (d) survivor control and agency, and (e) confidentiality. Conclusions: Although accessible and effective options for post-assault care do currently exist, participants described alternative future interventions that were either (a) print materials or (b) technology-based.     

An examination of the disparity between self-identified versus legally identified rape victimization: A pilot study

ABSTRACT

Objective: Researchers compared rape victimization based on self-identification to the current federal legal definition in a pilot study of college students. Methods: The sample was comprised of 1,648 (69.8% female; 30.2% male) college students who completed the Sexual Experiences Survey—Short Form Victimization (SES-SFV) online. Results: Based on the current legal definition of rape, 9.4% (11.1% female; 5.2% male) of students had been raped since being enrolled, but only 2.9% of students self-identified as being raped. Moreover, 15.1% of students reported ever being raped, with females acknowledging higher rates (19.7%) than males (4.3%). Conclusions: Rape continues to be a major issue for colleges and universities. A serious concern is the disparity between the number of those who met the behavioral criteria for rape victimization based on the current legal definition, but who did not self-identify as a victim. Universities must address this disparity by using multiple measures to assess the prevalence of sexual violence on campus.     

Prevalence and Correlates of Sex Exchange Among a Nationally Representative Sample of Adolescents and Young Adults

The present study examines prevalence and correlates of exchanging sex for drugs, money, food shelter, or other favors (sex exchange) among a nationally representative sample of youth and young adults. Adolescents and young adults (n = 11,620, 53% female, 47% male) from the National Longitudinal Study of Adolescent Health were used for the current sample. Participants completed in-home interviews at both waves. Results revealed that sex exchange was reported by 4.9% (n = 569) of the population in wave 2 or wave 3, and 4.6% (n = 26) of those who exchanged sex did so at both waves. More males reported exchanging sex than females (n = 332 versus n = 237). Respondents who reported child sexual abuse were more likely to exchange sex (95% CI 2.51–4.28, p < .05) than respondents who reported any other form of child abuse. Both males and females who engaged in sex exchange were at greater risk for sexually transmitted infections; however, the odds of ever exchanging sex were highest among males who ever had gonorrhea (OR = 6.2; 95% CI 3.75–10.3). Although sex exchange has been studied extensively among homeless and runaway youth, the current study reveals sex exchange also occurs in the general population.     

Latinas and Sexual Assault

SUMMARY

This paper will discuss the problem of sexual assault among Latinas, an under-researched population whose social and cultural characteristics contextualize the trauma of sexual assault in ways that need to be considered by service providers striving to provide culturally syntonic interventions. The authors will present the sparse empirical data on sexual assault among Latinas, Including prevalence, assault characteristics, and post-assault sequelae. Given the bicultural reality of most Latinas in the U.S., a working model of sexual assault in Latinas is presented that frames the problem as occurring within both traditional Latino and modern American gender role systems. The result is a dual dilemma for Latina victims of sexual assault with both negative and positive implications that need to be better understood by victims and service providers.     

Body Size and Sexual Behavior in a Community-Based Sample of Women

ABSTRACT. Women's body size is closely related to their social and sexual experiences. Clinical research has found that women's lifetime sexual behaviors may vary based on body mass index (BMI). Objectives: This study examined the relationship between BMI and recent solo and partnered sexual repertoire in a community-based, non-clinical sample of women. Methods: Two hundred thirty-eight sexually active women completed an online survey measuring age, sexual relationship status, BMI, gender of sexual partners, and engagement in sexual behaviors in the previous 4 weeks. Logistic regression analyses were conducted to determine whether BMI predicted engagement in behaviors after controlling for age and sexual relationship variables. Results: Participant age ranged from 18 to 56 years (M = 30.4, SD = 7.8). Participants were predominantly in exclusive sexual relationships (62.9%, n = 146) with men (82.8%, n = 197). Mean BMI for the sample was 29.33 (SD = 9.28). Participation in self-masturbation, masturbating a partner, performing oral sex on a partner, receiving oral sex from a partner, and penile–vaginal intercourse were not predicted by BMI after controlling for age and partner variables. Conclusions: BMI did not impact sexual repertoire during the previous 4 weeks, with the exception of an increased odds ratio for penile–anal intercourse (OR = 1.06; 95% CI [1.02, 1.10]). Researchers and practitioners working with women should not assume limitations on women's sexual repertoires because of larger body size.