Assault Survivors Research Articles

Harmed or Harmful: The Discourse of Trigger Warnings, Trauma, and Shelter

Harmed or HarmfulThe Discourse of Trigger Warnings, Trauma, and Shelter Mary Maxfield (bio) In May 2014 University of California–Santa Barbara sophomore Bailey Loverin published a New York Times opinion piece lauding the call to expand the use of “trigger warnings” on college campuses. Loverin had personally advocated for the use of trigger warnings on the university’s syllabi, arguing that “these warnings are less about protection and more about preparation” because they “allow survivors the chance to prepare to face the material” and contribute to the conversation.1 Although hardly the first entry in the trigger warning debate, Loverin’s piece, and her activism at her university, quickly inspired a slew of additional commentary from educators, journalists, and activists.2 “Comedic” trigger warnings—such as columnist Jill Filipovic’s tongue-in-cheek “Trigger Warning: this piece discusses trigger warnings”3 and New York Times national correspondent Jennifer Medina’s “Warning: The Literary Canon Could Make Students Squirm”4—illustrate the tendency among many commentators to view requests like Loverin’s as absurd outgrowths of an overprotected generation. Indeed, political blogger Kevin Drum, writing for Mother Jones, asked if “supporters of trigger warnings [are] just hoping to gives kids a few more years of refuge from the outside world,”5 equating college students with children who have yet to face the dangers of “real” (adult) life. McSweeney’s further solidified this link in January 2016, when it published a comedic “millennial think-piece bingo” card, which included “trigger warning culture” as a square.6 In general these responses read Loverin as the hypersensitive offspring of overprotection and entitlement. She became a metonym for the failures of the “millennial” generation and of white feminists, a symbol of hyper-frailty, childish complaint, and political correctness. Capitulating to such a standard, opponents argued, would simply reinforce her generation’s right to victimhood at the expense of free speech and critical thought. In defense of public discourse, trigger warnings could not stand. [End Page 63] Opponents of trigger warnings represent the practice as an outgrowth and cause of hypersensitivity and victim culture.7 They regularly note that trigger warnings first developed in contexts specific to trauma victims—such as forums for rape and assault survivors—and have now proliferated past the point of usefulness.8 Schools and Web forums, they argue, are not meant to be therapeutic spaces centered on healing, and the shift to re-create them as such can only harm education and public debate. Moreover, the use of trigger warnings promotes avoidance, at the expense of healing. Essentially, campaigns like Loverin’s demand that schools be a therapeutic setting (which they are not), and that they provide a service not recommended for therapeutic purposes. Acquiescing to these demands can only affirm a generation of victims. The discursive connection of trigger warnings to victimization—and to trauma more broadly—constitutes one of the only areas of overlap between supporters and opponents of the practice. Commentators link trigger warnings to trauma historically—noting that the warnings originate in feminist Web forums and anti-violence activism—and contemporarily, through references to current theoretical and medical models for trauma and trauma treatment. The references to past feminisms and current psychotherapeutic recommendations are rarely considered at length; rather, they are invoked superficially in support of existing points. Thus, I seek in this article to reconsider claims across the safe space debate, by exploring common arguments about trigger warnings in the context of historical and contemporary theorizations of trauma. Through an examination of the shelter movement, critical trauma theories, and psychotherapeutic recommendations, this essay examines claims that trigger warnings are currently “spreading,” that they are necessary for (or antithetical to) healing, and that they create a generation of victims or—conversely—represent a remedy to victimization for a marginalized group of trauma subjects. methodology In current usage, “safe space” rarely references a specific, bounded area—such as a shelter or sanctuary. Rather, existing spaces are marked as “safe” based on the actions of those within them. The “space” in question is largely figurative, with the spatial metaphor obscuring a primary focus on behavior. Investigating the contemporary discussion of “safe space” in dialogue with a literal safe...

Profile of Survivors of Sexual Assault in a Tertiary Hospital of North Karnataka

Profile of Survivors of Sexual Assault in a Tertiary Hospital of North Karnataka

Exploring the relation between posttraumatic stress disorder and interpersonal outcomes: The role of social acknowledgment and trauma type

Research demonstrates consistent relations between posttrauma symptoms and interpersonal dysfunction. The current study examined the extent to which perceptions of community rejection account for the relation between posttraumatic stress disorder (PTSD) and interpersonal outcomes in students exposed to assaultive and nonassaultive trauma. Participants (N = 137; 66.4% female; M = 20 years) completed a trauma history interview, questionnaires assessing symptom severity, social disapproval, and interpersonal outcomes. Assault survivors (n = 83) reported greater symptoms (d = 0.57), disapproval (d = 0.80), and social impairment (d = 0.51) relative to the nonassault group (n = 54). However, regression analyses indicated stronger associations between PTSD and community disapproval in survivors of nonassaultive (β = 0.69; p < 0.001) versus assaultive (β = 0.34; p < 0.001) events. Indirect effects of PTSD on perceived support and interpersonal functioning through social disapproval were also larger for nonassaultive versus assaultive groups (p < 0.05). Despite greater dysfunction among assault survivors, perceptions of disapproval may be a more salient factor for interpersonal dynamics following nonassaultive trauma.

Sexual Assault

Sexual assault affects as many as one-third of women around the world. Sexual assault includes individual traumatic events as well as chronic sexually abusive relationships, and can involve a partner, acquaintance, or stranger. Many women who have experienced sexual assault develop long-term mental and physical effects of their sexual trauma, including post-traumatic stress disorder, alcohol abuse, and dyspareunia. OBGYNs are able to have long-lasting impacts on the many survivors of sexual assault by screening effectively and providing compassionate, trauma-informed care. This review contains 10 figures and 33 references. Keywords: human trafficking, intimate partner violence, primary care, rape, sexual assault, sexual violence, trauma-informed care, women

Survivors’ Advice to Service Providers: How to Best Serve Survivors of Sexual Assault

ABSTRACTRecognizing the relatively low rate at which sexual assault survivors seek services, researchers in the last decade have turned their attention to better understanding survivors’ experiences with victim services. Surprisingly, limited research has directly asked sexual assault survivors for recommendations on how to improve victim services, including both criminal justice and community-based services. The current study builds on the existing literature to gather input from women survivors that can translate into ways to improve victim services. As part of a larger longitudinal study, the current investigation asked 224 ethnically diverse adult (aged 18–62) women survivors of recent sexual assault to provide recommendations for how victim services can best serve survivors of sexual assault at multiple time points. Nearly all women in the study (91%) offered specific recommendations on how to improve victim services. Recommendations included ensuring availability of a female provider, improving communication with survivors as well as within and between service providers, helping survivors obtain resources, believing and not blaming survivors, demonstrating greater understanding of trauma-related responses and approaching survivors with greater compassion, and implementing better training on effectively working with survivors. Implications for victim service provision are discussed.

Sexual Assault: What Every Emergency Provider Needs to Know.

Approximately one in three women and one in thirty men will be sexually assaulted at some point in their lives. While fewer than half of the survivors of sexual assault seek medical care, the majority of those who do are evaluated in emergency departments. Providing comprehensive care of sexually assaulted patients requires knowledge of the complex medical, psychological, and legal needs of this unique and vulnerable population. Unfortunately, formal education regarding best practices in providing care for victims of sexual assault is lacking in emergency medicine (EM) training. In this 30-minute video, we will review the epidemiology of sexual assault; present the current state of sexual assault education in EM; highlight interventions essential to the care of sexually assaulted patients; and provide concrete strategies to systemically improve care for these patients. Additionally, learners will become familiar with the practical steps of performing a sexual assault evidence collection kit; understand the indications for post-exposure testing and prophylaxis; and review appropriate referral for follow-up for sexually assaulted patients. LINK TO VIDEO: https://vimeo.com/162540864 PASSWORD: perls This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved. Language: en

Treatment for Sexual Assault Survivors at University Counseling Centers

ABSTRACTUniversity Counseling Centers (UCCs) provide important services for sexual assault survivors, yet little research has been conducted on interventions used by clinicians in this unique setting. As a preliminary investigation, UCC professionals were asked about services provided to survivors of sexual assault and staff perceptions of the effectiveness of these interventions. Supportive counseling was perceived to be the most effective relative to other interventions, and many participants indicated that they did not use or were not sure if other evidence-based interventions were effective with student victims. Several recommendations for future research on sexual assault services in UCCs are suggested.

Revealing a hidden curriculum of Black women’s erasure in sexual violence prevention policy

ABSTRACTThis article aims to challenge the framework by which rape and sexual assault prevention in higher education are being constituted by centring Black women’s experiences of sexual violence within a prevention and response policy framework. Numerous research studies exist in the literature regarding the specific experience of sexual violence for Black women within a national context that remains deeply committed to White supremacy [Buchanan, N. T., and A. J. Ormerod. 2002. “Racialized Sexual Harassment in the Lives of African American Women.” Women & Therapy 25 (3/4): 107–124; Crenshaw, K. 1989. “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics.” University of Chicago Legal Forum 140: 139–167; Donovan, R., and M. Williams. 2002. “Living at the Intersection: The Effects of Racism and Sexism on Black Rape Survivors.” Women & Therapy 25 (3/4): 95–105; McNair, L. D., and H. A. Neville. 1996. “African American Women Survivors of Sexual Assault: The Intersection of Race and Class.” Women & Therapy 18 (3/4): 107–118; Omolade, B. 1989. “Black Women, Black men, and Tawana Brawley – The Shared Condition.” Harvard Women’s Law Journal 12: 11–23; West, C. 2002. “Battered, Black, and Blue: An Overview of Violence in the Lives of Black Women.” Women & Therapy 25 (3/4): 5–27]. Using the critical pedagogy principle of ‘hidden curriculum’ or how what is directly communicated through educational processes also conveys unstated values, judgments, and regulatory norms, the author analyses the first report of the White House Task Force to Protect Students from Sexual Assault [2014. Not Alone: The First Report of the White House Task Force to Protect Students from Sexual Assault] for race-neutral language that contributes to the silencing of the sexual violence that Black college women experience. The necessity of race-conscious sexual assault policy is discussed.

Title IX's Reproductive Remedies

Abstract Despite the rich public debate surrounding sexual assault at colleges and universities, the problem of pregnancy among survivors has received little attention. At the same time, institutions of higher education continue to resist compliance with federal law mandating insurance coverage of reproductive health care for their students and employees. For students learning and growing in college environments where rape is far too common, access to contraception and emergency contraception is critical. This Note argues that Title TX, the civil rights law prohibiting sex discrimination in federally funded educational programs, requires colleges and universities to make contraception and emergency contraception available on campus to student survivors of sexual assault. When pregnancy resulting from rape is conceptualized as an injury, Title TX obliges schools to remedy that injury and prevent its recurrence by ensuring contraceptive access on campus. In this light, Title TX emerges as a vehicle to address both sexual assault and unwanted pregnancy--dual barriers to the equal educational opportunity envisioned by Title TX. Finally, this reading of Title TX presents an opportunity not only to make common sense health care and education policy reforms, but also to revisit broader doctrinal implications for reproductive justice as an issue of sex equality. INTRODUCTION Many voices--administrators, legal scholars, student survivors, and the accused--are participating in the ongoing national conversation about campus sexual assault. Yet little attention has been paid to the occurrence of pregnancy among survivors and their choices with respect to their pregnancies. Colleges and universities are under federal obligation to confront the prevalence of sexual violence on their campuses, to remedy its effects, and to accommodate survivors in various ways. While many schools are taking increasing steps to comply with this mandate, others remain under federal oversight for what reformers have identified as an enabling culture of sexual assault. At the same time, many educational institutions in both camps resist compliance with existing federal laws requiring the provision of contraceptive coverage to their students. Rape can have a number of lasting consequences--among them, an unwanted pregnancy. Despite the interrelatedness of rape and pregnancy, even many campus sexual assault reformers have not emphasized the importance of student survivors' reproductive autonomy. Likewise, the prevalence of campus rape has not been significantly considered in policymaking debates about the role colleges and universities should perform in meeting their students' reproductive health needs. Without access to reproductive options--namely, contraception and emergency contraception (1)--student survivors can experience a twofold deprivation of control over their own bodies, all while entrusted to the care of their educational institutions. Title IX, (2) the federal civil rights statute that prohibits sex discrimination in education, is the legal mechanism for ensuring that schools respond to incidents of sexual assault on campus. Department of Education guidance interprets the statute to require federally funded schools to make accommodations for survivors, remedy the harmful effects of sexual assault, and prevent their recurrence. (3) But the guidance does not expressly require schools to ensure survivors' access to contraception and emergency contraception, crucial tools in remedying rape's potential effects. If pregnancy that results from rape is considered an injury--in the same category as bodily harm, emotional trauma, missed semesters, and other injuries for which Title IX can create institutional liability--then Title IX requires schools to help student survivors prevent and remedy that harm. This Note argues that by requiring federally funded schools to take action to redress and prevent harm that results from a hostile environment of sex discrimination, Title IX guarantees student survivors a right to reproductive health care access on campus--namely, no-cost access to contraception and emergency contraception. …

The Impact of Class and Sexuality-Based Stereotyping on Rape Blame

In order to investigate whether stereotypes about sexuality can impact perceptions of sexual assault, participants read a scenario that described a situation in which a woman reported being raped. The woman’s socioeconomic status (SES) was varied, so that she appeared to be of low or high-SES. Following the vignette, participants completed explicit measures that assessed victim blame, attitudes toward rape victims, and perceived promiscuity. Participants also answered an open-ended question that was coded for minimizing and maximizing language. Last, participants completed an “attitude survey” that measured classist attitudes. It was hypothesized that participants who read about the low-SES woman would show more rape blame, display more negative attitudes about rape victims, respond to the open-ended question with more minimizing language, and perceive her as being more promiscuous. It was also predicted that these explicit measures would be positively correlated and that the language measure would be moderated by participants’ classism. Results supported these hypotheses. Participants who read about the low-SES survivor showed more negative attitudes, believed her to be more culpable, and more promiscuous. The explicit measures were positively correlated. Additionally, participants differed in linguistic minimization and maximization, such that participants who were low in classism were more likely to maximize the low-SES target’s experience, whereas participants who were high in classism were more likely to minimize the low-SES target’s experience. Taken together, these results suggest that low-SES women are stereotyped as being promiscuous and that this stereotype affects how they may be blamed after cases of sexual assault. Public Health Significance Statement: The results of this study suggest that low-socioeconomic status (SES) survivors of assault are more likely to be blamed and found culpable for the assault than high-SES women. These attitudes correlate with stereotypes about low-SES women’s sexuality.

Psychometric evaluation of the Posttraumatic Cognitions Inventory (PTCI) in female survivors of sexual assault

ABSTRACTThe authors of this study evaluated the factor structure, internal consistency, and concurrent and discriminant validity of the Posttraumatic Cognitions Inventory (PTCI; Foa et al. 1999) in a sample of 107 female survivors of sexual assault with a mean age of 29.1 years (SD = 7.7). All participants were recruited between July 2010 and December 2014 from a care center for sexual assault victims in Madrid, Spain. Results supported the three-factor structure of the PTCI: (1) negative cognition about self, (2) negative cognition about the world, and (3) self-blame. The negative cognitions about self and the world subscales showed adequate internal consistency (Cronbach’s alpha = 0.92 and 0.82, respectively), as well as good concurrent and discriminant validity. Nevertheless, the subscale measuring self-blame showed poor internal consistency (Cronbach’s alpha = 0.75) and discriminant validity. The PTCI presents sound psychometric characteristics and has the potential to contribute to women’s sexual posttrauma assessment.

Body-Centered Self Defense for Survivors of Sexual Assault

In this study we measured emotional change following a body-centered self-defense intervention with a group of women who had been survivors of sexual assault. Changes in emotions were identified using pre and posttest measures of the Emogram. The results of the quantitative investigation indicated changes between pretest and posttest change scores in both experimental and control groups. The experimental group showed the greatest change scores in the e-quality scores. The results of this study indicate that body-centered self-defense sessions used as a movement intervention may be considered for future research and as a clinical intervention with survivors of sexual assault.

Gendered violence and victim blame: subject perceptions of blame and the appropriateness of services for survivors of domestic sex trafficking, sexual assault, and intimate partner violence

The last decade has seen advances in both scholarship and advocacy efforts regarding the domestic sex trafficking (DST) of women and children, culminating in federal and state legislation addressing this human rights issue. Despite these advances, prostituted women and girls continue to face stigma and blame for victimization, similar to female survivors of other forms of gendered violence, specifically intimate partner violence (IPV) and sexual assault. Studies have yet to fully explore perceptions of DST as it intersects with these forms of gendered violence, particularly with regard to victim and perpetrator culpability. The current study uses a student sample of survey questionnaires to examine subject perceptions of gendered violence, with a focus on victim and perpetrator blame and appropriate social service responses for victims of DST, sexual assault, and IPV. Future research directions and policy implications are discussed.

Why Feminist Theory Matters for Feminist Practice: The Case of Rape Response

Rape crisis centers, which provide supportive services to survivors of sexual assault, are commonly lauded as one of the most successful and lasting transformations achieved by second-wave feminism (Bevacqua 2000; Martin 2005; Schmitt and Martin 2007). But the advocates who work in these centers overwhelmingly reject the use of the word “feminist” to describe themselves or the work of their agencies (Campbell, Baker, and Mazurak 1998; Corrigan 2013; Maier 2008). Here, I describe this puzzling disconnect between feminist consciousness and feminist practice and offer a theory of why the incorporation of feminist analysis could enrich the provision of services on the ground.

Identifying and treating adult survivors of sexual assault.

About 18% of women and 3% of men report being a victim of sexual assault, but fewer than one-third of victims seek immediate medical attention or psychological counseling. Over time, victims may experience physical and emotional reactions and turn to primary care providers, who should be prepared to identify survivors of sexual assault and provide thoughtful referrals for long-term follow-up.

Perceptions of Interpersonal Social Cues Predictive of Violence Among Police Officers Who Have Been Assaulted

Psychology has recently begun to examine human interpersonal social predictors of violence. One area yet unexamined is the perception of aggressive interpersonal social cues held by persons who have personally experienced violence. Using a sample of 129 police officers who were assault survivors, this study sought to identify the interpersonal social behaviors they perceived to be associated with the communication of imminent violence. Assuming a boxer’s stance, invading personal space, placing hands in pockets, clenched hands, and threatening remarks were most associated with perceived impending violence. Crying, rapid eye blinking, placing hands on hips, and avoiding eye contact, were perceived to be least associated with violence. Recent versus distant experiences with violence produced little difference in the findings.

Building Theory and Making Change: The Challenges of Studying Feminist Activism

For the last twenty years, my research has focused on the ways that legal, medical, and community organizations respond to sexual violence in the United States. This research has been informed and, I believe, enriched by my work in local organizations that provide supportive services to survivors of sexual assault and domestic violence and to those seeking access to abortion. When I arrived at Rutgers for graduate school, I was surprised and frustrated at how few of the stories I heard as a service provider had made their way into the academic discussions about feminism, feminist movements, and feminist organizations that I encountered in the political science literature.

Prevalence of HIV infection among survivors of sexual assault at presentation in hospital

Victims of sexual assaults are routinely tested for HIV in order to discover if they require prophylaxis. This study aimed to determine the prevalence of HIV infection among survivors of sexual assault attending a large peri-urban health facility in KwaZulu-Natal, a province of South Africa. Data from the medical records of the available 534 sexual assault cases that attended the facility between 2005 and 2009 were extracted and reviewed: 19.7% tested HIV positive and HIV prevalence among the survivors over the 5 years increased from 15% in 2005 to 19% in 2009. Screening sexual assault survivors for HIV provides a good opportunity to identify those who will benefit from HIV prophylaxis and HIV-infected persons who need HIV care and treatment.

From soldiers to children: developmental sciences transform the construct of posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) was first included in the American Psychiatric Association's Diagnostic and statistical manual of mental disorders in 1980. Long used to describe the reactions of soldiers affected by stress in combat situations, PTSD is now recognised as a disorder affecting abused and neglected infants and children, survivors of assault and domestic violence, and disaster victims of all ages. How did a construct so distinctly associated with the experiences of adult combat veterans come to describe behaviours seen in children, and even infants? This transformation can be understood by examining the way clinical researchers have applied the developmental sciences (child and adolescent development, neuroscience, and cognitive science) to the study of trauma. Each of the developmental sciences has contributed to our understanding of children's reactions to traumatic situations, and each plays an integral part in the effort to understand PTSD as a disorder of children as well as adults.

Negative Social Reactions to Assault Disclosure as a Mediator between Self-Blame and Posttraumatic Stress Symptoms Among Survivors of Interpersonal Assault

The type of causal attributions offered for traumatic life events has been documented as a potential vulnerability factor for posttraumatic stress disorder (PTSD). However, few investigations have sought to identify the mechanisms by which such explanations are associated with greater posttraumatic distress. One possible factor that may account for the relationship between maladaptive attributional tendencies and PTSD symptoms is the quality of social reactions received from one's social network upon disclosure. The aim of the present study was to examine the relationship between self-blaming attributions provided for traumatic events, negative social reactions, and PTSD symptom severity. Undergraduate psychology students (N = 68), who reported previously experiencing interpersonal assault, completed measures assessing their attributions for their assault and the quality of reactions received from members of their social network upon disclosure. Results from a statistical mediational analysis suggest that a self-blame may be associated with poorer psychological adjustment by virtue of negative social reactions. Results of this study further our understanding of risk and resilience among assault survivors and may have significant implications for treatment interventions for individuals with PTSD.