Intimate partner violence (IPV) places a considerable burden on health systems globally due to its profound effects on women's health, and women who experience violence often seek care from healthcare providers (HCPs). However, HCPs often lack the preparedness and confidence to respond effectively, resulting in missed opportunities for support and care. This study, conducted in Nepal, evaluated the impact of structured training intervention on HCPs' perceived preparedness, knowledge, and attitudes toward managing IPV and its mental health consequences, including self-harm and suicidal tendencies. The study was nested within a larger cluster randomized trial. A convergent mixed-methods design with a comparison group was conducted among 46 female HCPs in all public hospitals (except one) and 17 primary healthcare centers in Madhesh Province, Nepal. The intervention group (n = 24) received a 10-day intensive IPV and mental health training, while the control group (n = 22) completed 3-day training. Quantitative data were collected using a validated self-administered Physician's Readiness to Manage IPV questionnaire and IPV consequences scale. Paired and independent t-tests were applied to assess changes. Insights from key informant interviews were thematically analyzed to explore participant experiences and perceived impacts. At baseline, over 80% of participants had not received IPV management training. Post-intervention, significant improvements were observed in HCPs perceived preparedness (median change 2.1; 95% confidence interval (CI): 1.1- 2.9), knowledge (median change 2.7; 95% CI: 2.0-3.1), and awareness of IPV consequences (mean difference 1.2; 95% CI: 0.5-2.0), with greater gains in the intervention group. Qualitative findings revealed enhanced confidence in identifying IPV, addressing psychological impacts, and supporting survivors through safety planning and referral. The training significantly improved HCPs' knowledge, preparedness, and confidence to manage IPV and related mental health issues, underscoring the need to scale similar programs to frontline providers, particularly in rural and underserved settings, to strengthen health system's response to IPV.

Suicide is a serious and growing concern in South Korean adolescents. Poly-victimization (i.e., having experienced multiple types of victimization) is a risk factor for increased levels of suicidal ideation (SI) among adolescents. The current study examined the interactive effects of sexual victimization and intersectional discrimination on SI using a national sample of Korean adolescents. Moderation analysis showed that intersectional discrimination moderated the relationship between sexual violence and SI. Specifically, the relationship between sexual victimization and SI was significant and positive in low (-1 SD), medium (mean), and high (+1 SD) levels of intersectional discrimination. In addition, the results indicated that adolescents who experienced sexual victimization in the past year and experienced high levels of intersectional discrimination had the highest chance of experiencing frequent SI. However, the significant negative interaction results suggest that the difference in SI in those who experienced sexual victimization in the past year and those who did not appeared smaller at higher levels of intersectional discrimination. These findings highlight the complexity of poly-victimization and the importance of the need for more nuanced approaches in mental health interventions for individuals affected by multiple forms of victimization.

Mental toughness is commonly associated with enhanced performance and psychological resilience across various domains, including sport. However, its potential drawbacks remain underexplored. This study investigates the relationship between mental toughness and perceptions of sexual harassment in sport, focusing on how it may shape attitudes toward misconduct within coach-athlete dynamics. A sample of 1,532 participants (n = 822 athletes) completed an online survey assessing mental toughness, sexual harassment myth acceptance, and responses to two scenarios depicting inappropriate coach behavior: a quid-pro-quo vignette and suggestive text exchanges. Results indicated that individuals with sport participation reported significantly higher mental toughness compared to non-participants. Mental toughness was positively associated with greater acceptance of sexual harassment myths and more tolerant responses to the depicted harassment, including reduced perpetrator blame, more favorable emotional reactions, and lower perceived inappropriateness. A generalized structural equation model revealed that mental toughness partially mediated the relationship between sport participation and tolerance toward questionable coach behavior. While effect sizes were small, the consistency across multiple scenarios underscores a potential unintended consequence of emphasizing mental toughness in sport contexts - namely, diminished sensitivity to harmful conduct. These findings highlight the need for sport organizations and educators to critically reassess how mental toughness is promoted. Integrating boundary-awareness and misconduct recognition into resilience training may help mitigate tolerance of inappropriate behavior, supporting athlete safety and ethical standards in sport environments.

Childhood abuse is increasingly recognized as a critical early-life stressor with enduring consequences for adult health. Although prior research has linked childhood maltreatment to adverse sexual health outcomes, the mechanisms underlying these associations remain underexplored, particularly among general populations. This study aims to examine the long-term association between childhood emotional and physical abuse and the risk of sexually transmitted infections in adulthood, with a focus on two behavioral pathways: risky sexual behavior and early sexual onset. Data were drawn from the National Longitudinal Study of Adolescent to Adult Health, comprising a nationally representative sample of 4,859 respondents. A double machine learning approach was employed to estimate causal effects, leveraging machine learning to flexibly control for high-dimensional confounders and enhance the validity of mediation analysis. Findings revealed that individuals exposed to childhood abuse had significantly higher odds of sexually transmitted infection diagnosis in adulthood. Both risky sexual behavior and early sexual onset partially accounted for this association. This study advances conceptual and methodological understanding of the long-term consequences of childhood abuse on sexual health. Findings highlight the importance of trauma-informed and developmentally sensitive prevention strategies that address early adversity and behavioral risk pathways.

The Conflict Tactics Scales-2 (CTS-2) is the most widely used scale for evaluating the severity of intimate partner violence (IPV) across different populations and cultures. The aim was to explore whether the CTS-2 allows for unbiased comparisons of IPV victimization across samples of IPV victims in Spain and Norway. Using multigroup confirmatory factor analysis (MG-CFA), measurement invariance was examined in a Spanish sample of 333 female IPV victims and a Norwegian sample of 154 female IPV victims. Configural, metric, and scalar invariance were assessed, and item-level analyses were conducted to identify sources of bias. Results demonstrated configural invariance, indicating that both samples adhered to the same factorial structure. However, metric invariance was not achieved due to two biased items. Item 22, from the Psychological Aggression subscale, showed cultural differences in wording and interpretation, while item 53, from the Injury subscale, exhibited statistical skewness. Adjusting these items resulted in partial metric invariance, allowing cautious mean comparisons. This study underscores the challenges of achieving full measurement invariance in cross-cultural contexts and challenges the hypothesized Nordic paradox. While the CTS-2 remains a valid tool, certain subscales, particularly Psychological Aggression, require careful adaptation to account for cultural differences. Furthermore, Spanish participants reported higher levels of most IPV subtypes. Future research should adopt multilevel approaches to address systemic and individual factors affecting IPV. Practitioners should also incorporate cultural nuances into the design of interventions to ensure culturally sensitive IPV assessment and treatment.

Stigmatizing norms toward bisexual individuals can lead to negative physical and mental health consequences. Widespread negative attitudes are perpetuated through social norms, which are both actual (i.e., norms held by an individual) and perceived (i.e., norms that an individual perceives others endorsing) norms. This study sought to explore binegative social norms, including differences between actual and perceived norms, and to identify how discrepancies may differ by gender and sexual identities. We conducted a nationwide online survey of young adults in the United States through Prime Panels (N = 586). We found significant discrepancies between actual norms and perceived norms on most items. Analyses revealed that bisexual and other sexual minority individuals (gay, lesbian, and queer, among others) had larger discrepancies compared to heterosexual individuals. Additionally, discrepancies between actual norms and perceived norms were generally larger for women compared to men. This suggests those in a more stigmatized group personally hold less binegative attitudes. Our findings provide evidence for the enduring power of gender inequality, heterosexism, and binegativity in that men and heterosexual people consistently hold more stigmatizing attitudes about bisexual women and were also more likely to see their attitudes as the norm. These findings suggest that a social norms campaign might be an effective strategy to reduce binegative attitudes, particularly among heterosexual individuals and men, who emerged as key groups in need of targeted intervention.

Bystander intervention has become a popular violence prevention strategy for various types of violence, from bullying to gun violence, but may also carry with it bystander burden. The purpose of this manuscript is to understand the impact of being a bystander (we use the term gun violence intervener) who takes action in situations of gun violence and risky gun use, both in terms of a bystander's own reported emotional reaction and their perceptions of the impact of their actions. The current cross-sectional study used a sub-sample (n = 2,653) of adolescents and young adults, ages 10 to 34, recruited through the AmeriSpeak panel, who reported being exposed to a gun violence incident where they tried to help. The current sample reporting these bystander experiences comprised three-quarters of the full nationally representative sample. Important contextual factors, including their relationship with the person with access to the firearm, how they found out about it, how long ago it happened, and whether anyone got hurt were explored. Nearly half of interveners felt positively about helping, and emotional benefits were associated with specific helping actions. Findings suggest tailored supports may bolster intervener resilience in gun-related situations. Better understanding the impact of trying to take helpful action will help show ways to better support gun violence interveners and ensure that intervention efforts are both encouraged, suitable and safe.

As large language models (LLMs) increasingly mediate access to information and support, their influence on sex offense survivors' help-seeking experiences warrants critical attention. This study examines whether LLMs reproduce rape myths and victim-blaming attitudes when responding to scenarios involving the non-consensual dissemination of intimate images (NCDII). Four leading LLMs were presented with 10 text-based vignettes systematically manipulating 3 contextual variables known to affect victim blaming: survivor's portrayed role in the dissemination, relationship duration, and degree of physical exposure. Each model completed a seven-item victim-blaming questionnaire per vignette. Four hundred unique outputs were produced and analyzed using mixed-design repeated-measures ANOVA. While all models attributed maximal blame to perpetrators in direct assessments, substantial differences emerged in implicit victim blaming. Grok 3 consistently exhibited higher levels, particularly in scenarios aligned with common rape myths. GPT-4o and Claude 4 Sonnet showed moderate levels, while Gemini 2.5 Pro displayed minimal blaming. Claude 4 Sonnet declined to respond to high-exposure scenarios due to its content restriction policy. The models displayed consistent response patterns across vignettes, but only Grok 3 demonstrated sensitivity to escalating myth salience. The findings highlight the risk that some LLMs may inadvertently reinforce victim-blaming responses and judgments consistent with rape myths when responding to NCDII. Given their growing role, these findings hold practical implications for developers, users, and policymakers regarding the deployment of AI tools in emotionally vulnerable situations.

Whilst there is evidence suggesting that women have worse mental health outcomes after experiencing domestic violence (DV), there is a lack of investigation into the long-term effects of DV on psychological distress and risk factors that may exacerbate poor outcomes. To address this evidence gap, the current study analysed national data from the Australian Longitudinal Study on Women's Health in relation to DV, psychological distress and potential risk factors for Australian women. Participants (n = 4,156) completed a pre and post DV Kessler Psychological Distress Scale (K10), DV measure, and measures of low self-esteem, financial stress, area of residence and perceived social support. Linear regression and linear regression with interaction effects were utilised for the analyses. The study found that experiencing DV was associated with greater psychological distress after experiencing DV when compared to participants who did not experience DV (B = 2.45, 95% CI [2.04, 2.86]). Risk factors of low self-esteem (B = 1.04, 95% CI [0.28, 1.80]) and financial stress (B = 1.52, 95% CI [0.26, 2.79]) were also associated with increased psychological distress after DV. However, contrary to expectations, there was no evidence that low social support (B = 1.66, 95% CI [-0.66, 3.98]) or remote area of residence (B = -0.52, 95% CI [-1.97, 0.94]) increased psychological distress. These findings highlight a temporal order of events, with experiencing DV being related to higher psychological distress over several years, which may be exacerbated by low self-esteem and financial stress. Recommendations for policy development include adopting a holistic approach that considers supporting financial wellbeing and enhancing self-esteem for women after experiencing DV. Future research should investigate the role of social support and area of residence as factors associated with differing psychological distress outcomes for women who experience DV.

The present study examined how young women's history of sexual victimization (SV) and revictimization affects the process of "maturing out" of heavy episodic drinking (HED) and drinking to cope (DTC) motivation from college to adulthood. Data were from a longitudinal burst study of college students at a northeastern university. Female students were surveyed in Wave 1 (college; N = 583, Mage = 19.1), Wave 2 (post-college; n = 507, Mage = 24.5), and Wave 3 (adulthood; n = 429, Mage = 30.8). SV history, HED, and DTC were assessed at each wave, with drinking outcomes measured daily during a 30-day diary protocol and aggregated at the person-level. We hypothesized that women with SV history, especially revictimized women, would show greater HED and DTC motivation, and that normative "maturing-out" of HED and DTC trajectories during the post-college period would decrease less among women with SV and revictimization history. ANOVA and longitudinal GEE models controlled for race/ethnicity, depression, and post-traumatic stress disorder (PTSD)symptoms. Women who had been revictimized reported higher DTC motivation than women with no SV history, child/adolescent SV, or adult SV. There were significant wave × SV interactions for HED, indicating that revictimized women decreased HED less over time compared to women with child/adolescent or adult-only SV. Exploratory analysis suggests that the effects of SV might be related to depressive and PTSD symptoms. Sexual revictimization may interfere with some aspects of the normative process of "maturing out" of problematic drinking that most young people exhibit after college. Given the increasing rates of alcohol use disorders among women, the current study highlights the importance of examining risk factors such as sexual revictimization, which remains a persistent public health crisis among this population.