History Of Sexual Abuse Research Articles

RISKY SEXUAL BEHAVIOR AND ASSOCIATED FACTORS AMONG STUDENTS OF HAWASSA UNIVERSITY COLLEGE OF MEDICINE AND HEALTH SCIENCE, ETHIOPIA 2022

BACKGROUND: Any sexual activity that increases the risk of sexually transmitted infections (STI) and unwanted pregnancies is considered risky sexual behavior (RSB). Although it is assumed that university students are fully aware of HIV risks and preventive measures, evidence suggests that they are more likely to engage in RSB. OBJECTIVE: To assess the prevalence of risky sexual behavior and associated factors among students of Hawassa University, college of medicine and health science, Ethiopia METHOD: An institutional-based cross-sectional study was conducted from July 18 to August 30, 2022. A total of 334 students were selected first by stratified based on their academic year and then selected using a simple random sampling method. A structured self-administered questionnaire was used to collect the data. Epi-Data version 3.1 was used for data entry and the Statistical Package for the Social Sciences (SPSS) version 20 was used for data analysis. Bivariate and multivariate logistic regression analyses were used to identify factors associated with RSB. RESULT: The prevalence of RSB among students at Hawassa University College of medicine and health science was 109(34.4%). Drinking alcohol [AOR: 8.15; 95% CI (2.68, 11.61)], watching pornography videos [AOR: 3.32; 95% CI (1.53, 6.96)], history of childhood sexual abuse [AOR: 2.34; 95% CI (1.78, 6.37)] were found to be the independent predictors of RSB. While religious engagement [AOR: 0.62; 95% CI (0.29, 0.83)] was a protective factor for RSB. CONCLUSION AND RECOMMENDATIONS: More than one-third of students were engaged in RSB. Alcohol consumption, watching pornography videos, history of childhood sexual abuse, and religious engagement were predicting factors for RSB. Comprehensive behavioral intervention programs are needed on the identified factors; to reduce alcohol consumption, and to improve the habit of media consumption among university students. In addition, sex education programs should rethink their approach to preventing RSB, because so far the pornography influence is rarely considered.

Barriers to Condom Use among Female Sex Workers: A Systematic Review and Meta-Analysis

Background: Sex without a condom poses the highest risk of sexually transmitted infections among (STIs) female sex workers (FSWs). Objectives: This systematic review and meta-analysis was conducted to summarize the evidence related to barriers to condom use among FSWs. Methods: We searched Web of Science, PubMed, and Scopus using keywords, such as “condom use” and “sex worker” and the related synonyms. The pooled effect size was expressed as odds ratios (ORs) with 95% CIs using a random-effects model. Results: Of the 5,854 studies obtained in the initial search, 35 with a sample size of 14,218 met the eligibility criteria and were included in the final analysis. Three factors identified in studies, i.e., marital status (OR = 1.15; 95%CI [0.74, 1.50]), alcohol consumption (OR = 1.22; 95%CI [0.84, 1.59]), and STIs knowledge (OR = 1.07; 95%CI [0.54, 1.59]), were not significantly associated with not using condom among FSWs. Also, 7 factors identified in studies, i.e., history of violence (OR = 1.84; 95%CI [1.36, 2.31]), history of sexual abuse (OR = 1.87; 95%CI [1.36, 2.38]), history of STIs (OR = 1.54; 95%CI [1.10, 1.97]), HIV risk perception (OR = 1.81; 95% CI [1.58, 2.05]), knowledge of condom use (OR = 1.53; 95%CI [1.15, 1.91]), drug use (OR = 1.62; 95%CI [1.10, 2.14]), and condom use self-efficacy (OR = 1.75; 95%CI [1.52, 1.98]), were significantly associated with not using condom among FSWs. Conclusion: Many factors affect condom use among FSWs. However, in this study, the history of sexual abuse, history of violence, and HIV risk perception were identified as the main barriers to condom use among FSWs.

Timing of Sexual Assault Disclosure: A Study of College Women.

The present study examined correlates of immediate (within 48 h) and delayed (after 48 h) sexual assault disclosure among a sample of 83 college women who experienced sexual victimization since age 14. The use of physical resistance and experiencing a "freeze response" was positively associated with delayed disclosure. Identifying the perpetrator as a friend/acquaintance, compared to a was a romantic partner, increased the likelihood of immediate disclosure. Other individual characteristics (i.e., assault characteristics, a history of childhood sexual abuse, attitudes towards seeking help, and sexual assertiveness) and microsystem-level characteristics (i.e., perceived social support) did not impact the timing of disclosure.

Sexual Violence-Related Stigma, Mental Health, and Treatment-Seeking: A Multimodal Assessment in a Population-Based Study of Young Adults.

Sexual violence (SV) is a stigmatized form of trauma, yet the stigma experiences of those reporting SV are often assumed rather than explicitly measured. We adapted a measure that quantified three key features of SV stigma across three levels: negative self-image (individual), disclosure concerns (interpersonal), and concerns about public attitudes (structural). We administered this measure to a population-based sample of Swedish young adults (N = 453) who reported a history of either sexual assault (SA) or intimate partner sexual violence (IPSV). Among both groups, 89% endorsed at least one item on the stigma scale. Experiences of SV-related stigma were associated with significantly higher symptoms of generalized anxiety, depression, and posttraumatic stress disorder, with greater perceived need for mental health treatment, and with more shame (measured implicitly via a reaction-time task). Experiences of stigma were negatively associated with symptoms of alcohol misuse. Results suggest that exposure to SV stigma may be a critical, but often overlooked, correlate of post-assault recovery.

Psychometric Properties of the Brief Resilience Scale Among Alternative Sexuality Community Members.

Assessing resilience among alternative sexuality (alt-sex; e.g., kink, polyamory) community members is imperative as alt-sex individuals often face discrimination and possess intersecting marginalized identities. The Brief Resilience Scale (BRS) has extensive psychometric support; however, prior research indicates both a one- and two-factor (i.e., succumbing and resilience) structure. Further, the psychometric properties of the BRS have not been examined among alt-sex community members. As such, the current study examined the BRS factor structure among alt-sex individuals and measurement invariance across demographic groups (i.e., sexual orientation, gender identity, and sexual assault history). Confirmatory factor analyses and multi-groups invariance analyses were conducted. The two-factor BRS model demonstrated better fit to the data. Model fit did not differ by sexual orientation or gender identity. Measurement invariance was observed by lifetime sexual assault history, with higher factor loadings on succumbing items among alt-sex community members with a lifetime history of sexual assault. Our findings support use of the BRS to measure resilience among alt-sex individuals. Succumbing, or weakened resilience, is a salient factor for alt-sex community members who are sexual assault survivors, warranting further attention.

Prevalence of menopausal symptoms and severity related factors among mid-aged Paraguayan women as measured with the 10-item Cervantes Scale

Objective: To determine the prevalence of menopausal symptoms and factors related to severity in mid-aged women.Methods: Cross-sectional study in which 216 urban-living women from Asunción-Paraguay (40–60 years) were surveyed with the 10 item Cervantes Scale (CS-10) and a general questionnaire (personal and partner data).Results: Median (interquartile range [IQR]) age of the sample was 48 [9] years, 48.1% were postmenopausal, 8.8% used menopausal hormone therapy, 39.4% psychotropic drugs, 43.5% had hypertension, 6.5% diabetes, 51.9% abdominal obesity, and 89.3% had a partner (n = 193). A history of sexual abuse was present in 2.8%. Median total CS-10 score was 8.5 [9.75]. Overall, 93.3% (180/193) of women having a partner were sexually active, with a median coital frequency of 8 times per month. According to the CS-10, the three most prevalent menopausal symptoms were: aching in muscles and/or joints (70.8%), anxiety and nervousness (70.8%) and hot flashes/night sweats (54.2%). Factors associated with higher CS-10 scores were: female age and educational level, marital status, menopausal status, and marital sexual aspects. Partner educational level was inversely correlated (rho Spearman coefficient) with CS-10 total scores. However, multiple linear regression analysis found that higher total CS-10 scores (more severe menopausal symptoms) negatively correlated to coital frequency and positively correlated with peri- and postmenopausal status, parity, sedentary lifestyle and a history of sexual abuse.Conclusion: Menopausal symptoms in this mid-aged urban female Paraguayan sample were related to hormonal, sexual and other female aspects.

Sexual Assault History May Moderate Posttraumatic Cognition and Posttraumatic Stress Among Trauma-Exposed Sexual Minority Women

Sexual minority women (SMW) are highly vulnerable to trauma exposure and posttraumatic stress disorder (PTSD) symptoms following trauma exposure. Negative posttraumatic cognitions (i.e., negative cognitions about self, world, and self-blame following trauma exposure) are hypothesized to exacerbate and maintain the relationship between trauma exposure and PTSD symptoms. Posttraumatic cognitions are particularly important to examine in relation to PTSD symptoms among trauma-exposed SMW given their elevated risk for trauma exposure and PTSD. It is also important to understand whether the strength of this relationship differs as a function of trauma type to elucidate potentially differential pathways for risk by trauma type in this population. The current study explored whether trauma type (sexual assault vs. nonsexual trauma) moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity among a sample of trauma-exposed SMW. Participants were SMW (n = 516) users of an online survey platform, Prolific. Data were collected via 20-minute online survey. Results indicated that trauma type moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity, such that the relationship was stronger among those who had experienced at least one sexual assault in their lifetime. Results suggest that negative posttraumatic cognitions may be more strongly related to PTSD symptom severity among SMW who have experienced at least one sexual assault. Notably, this difference was in magnitude only, as the posttraumatic cognition–PTSD symptom relationship remained significant among nonsexual trauma survivors. Negative posttraumatic cognitions may be an especially relevant treatment target among SMW survivors of sexual assault.

Factors associated with lifetime history of eating disorder in non-psychotic patients with suicidal ideation.

Data on the sociodemographic, biographical, and clinical factors associated with a lifetime diagnosis of eating disorders (ED) in patients with non-psychotic mental disorders (NPMD) and suicidal ideation (SI) are scarce. A cohort study was conducted at the Moscow Research and Clinical Center for Neuropsychiatry. The sample consisted of consecutive patients with non-psychotic mental disorders and SI, aged 1845 years. Participants with a lifetime diagnosis of anorexia and/or bulimia (then in remission or recovery) were compared with those without ED in terms of their sociodemographic profile, clinical characteristics, lifetime traumatic events, and some behavioral patterns. All participants underwent the Russian version of the Self-Injurious Thoughts and Behaviors Interview and completed the Brief Reasons for Living Inventory, the State and Trait Anxiety Inventory, and the Beck Depression Inventory. A total of 892 patients with non-psychotic mental disorders and SI were included in the study. The mean age was 25.7 years, and 84% were assigned female at birth. Same-sex experience was more common in the ED group. Patients with an ED were more likely to have a history of physical and sexual abuse and to have witnessed domestic violence. The proportion of participants with piercings, tattoos, or severe body modifications was significantly higher in the ED group. Patients with a lifetime ED were more likely to engage in nonsuicidal self-injurious behaviors and to have a history of suicide attempts. Lifetime ED in NPMD patients with SI is associated with younger age, being assigned female at birth, having an alternative gender identity, having same-sex experience, having more than one psychiatric diagnosis, having been diagnosed with bipolar disorder, experiencing severe depression and anxiety, being exposed to multiple traumatic experiences, having various body modifications, practicing NSSI, and having a lifetime story of suicide attempts.

The importance of gynecological examination in adolescent girls and adult women with Prader-Willi syndrome.

Current published guidelines for routine care of women with Prader-Willi syndrome (PWS) do not include recommendations for gynecologic examinations. We describe our experience with gynecological examinations in women with PWS and offer recommendations for routine health care for these patients. Data were collected on all 41 PWS females ages ≥12 year, followed in our national Israeli multidisciplinary clinic between the years 2011 and 2022. Menstrual data and findings on external gynecological examination, including evaluation of the vulva and hymen were recorded at yearly visits. During the gynecological evaluation the topic of sexual education was discussed. Pelvic ultrasound, specifically for antral follicular count, was performed for those visiting the clinic during 2020-2022. Blood samples for luteinizing hormone (LH), follicular stimulating hormone (FSH), and estradiol were obtained routinely and DEXA scans for bone density were done when indicated. Of the 41 women, (median age at start of follow-up 17 years, range [12.3-39], BMI 30.4 kg/m2 [IQR 23.5-37.1]), 39 women agreed to external gynecological examination. Eleven women (27%) had spontaneous menses, with menarche at the age of 14 to as late as 31 years. The hymen was intact in all except one. Poor hygiene was observed in eight women, three women with vulvovaginitis, and five with irritated vulva related to poor hygiene. Gynecological ultrasound was performed in 27 women. In 22, endometrial thickness was less than 5 mm. The median antral follicular count (AFC) was 6 (<10th percentile for age). No correlation between AFC and menstruation or BMI was found. Mean FSH level was 5.7 ± 3.6 IU, LH was 2.29 ± 2.23, and estradiol was 128 ± 76 pmol/L. Data on DEXA measurements were available in 25 women aged 16-39. Median spine T score was -1.3 (range between 0.5 and -3.7), and hip T score was -1.2 (range between 0.8 and -3.3). A negative correlation was found between endometrial thickness and the presence of osteopenia or osteoporosis (r = -0.5, p = 0.013). Despite our recommendations, only eight of 14 women agreed to hormonal treatment or contraception. One woman who received treatment had a thromboembolic event. Routine health care for women with PWS should include gynecological examinations. The gynecological evaluation should include external genital examination, assessment of hygiene, obtaining a blood sample for hormone levels, and documenting a history of sexual experience or sexual abuse. Hormonal treatment or contraception should be offered when appropriate.

The Behavioral Health Sector Response to Child Sexual Abuse, Exploitation, and Trafficking: A Call to Action

Child sexual violence is a major public health problem in India and is associated with myriad short- and long-term behavioral health effects. Affected children are at an increased risk of post-traumatic stress disorder, major depression, anxiety disorders, behavioral problems, and substance misuse. Behavioral health professionals are highly likely to encounter patients at risk of or with a recent/remote history of child sexual abuse, sexual exploitation, or sex trafficking. Caregivers of patients may report a history of child sexual violence. Clinicians must possess the knowledge and skills to recognize and appropriately respond to suspected child sexual violence using a culturally responsive, trauma-informed, and rights-based approach. Many behavioral health professionals lack the knowledge of child sexual violence and the confidence of working with affected patients. Child sexual violence is not routinely addressed in medical school curricula, nor is it systematically addressed in postgraduate training programs. Practicing clinicians may feel ill-equipped to recognize and manage patients exposed to child sexual violence and may miss opportunities to offer critical support and assistance to vulnerable children and their families. The behavioral health sector needs an organized, systematic, and trauma-informed response to child sexual violence, and this requires specific training of professionals and development of organizational response protocols tailored to fit the needs of the organization and its patient population. Multiple resources are available in India to assist behavioral health professionals, and organization administrators accomplish these goals.

Study of Victims of Alleged Sexual Assault

BACKGROUND: Sexual assault has been a major concern to our society. It is one of the most underreported offences to the law enforcement agencies. Such offences are multi-faceted and certain details of the offence may be hard to be unearthed even after a thorough investigation.&#x0D; AIMS: To study factors associated with reporting of sexual assault cases and to correlate findings with the alleged history.&#x0D; MATERIALS AND METHODS: The study was conducted in the Department of Forensic Medicine, M.S. Ramaiah Medical College Bangalore from January 2018 and December 2020. All victims of alleged sexual assault brought for medical examination to the Department of Forensic Medicine were interviewed through a detailed questionnaire after taking consent. Relevant information was sought from the victim and the consent from victims. Descriptive statistics for qualitative type of data were summarized using frequency and percentage.&#x0D; RESULTS: 82 victims those who had come to or brought by the parents or guardian or police with alleged history of sexual assault were subjected for medical examination. All of them were females except two juveniles. Majority of the victims (n=71, 86.5%) were less than 18 years of age and were considered as juvenile / minors under Indian law. Either the victims or their parents reported to the police in most of the cases (n=76, 92.7%). In 53.65% of the cases the alleged assaults were reported to the police after three days of alleged recent sexual assault. The purpose of reporting to the police was because of honour or pride of the parents / guardian in 59.75% of the cases. It was observed that only in four cases there were positive findings of recent penetrative sexual assault in the form of fresh hymeneal tears or presence of spermatozoa in the swabs taken during genital examination.&#x0D; CONCLUSION: Majority of the victims of alleged sexual assault were minors. Only 12% of them reported to the law enforcement directly without anybody persuading. More than 50% of victims presented to the hospital after 3 days of the alleged sexual assault. In most of minor victims the sexual intercourse was consented, but it was invalid since the girl below 18 years cannot consent for sexual intercourse. Majority of adult victims had consented for sexual intercourse on promise of marriage. In view of these, no physical injuries were seen on victims and positive evidence of sexual assault was detected only in 5% of cases.

Actual and Desired Masturbation Frequency, Sexual Distress, and Their Correlates.

We investigated the prevalence of problematic masturbation using different criteria. We also investigated if masturbation-related distress was associated with sexual abuse history, family attitudes towards sexuality during childhood, and depression and anxiety symptoms. Here, 12,271 Finnish men and women completed a survey reporting masturbation frequency, desired masturbation frequency, sexual distress, childhood sexual abuse, sex-positive family background, as well as depression and anxiety symptoms. Among both sexes, those whose masturbation frequency did not match with desired frequency experienced more sexual distress. Different conceptualizations of problematic masturbation resulted in different proportions of individuals categorized as having it (i.e., 8.3% of men and 2.7% of women experienced self-perceived problematic masturbation, that is masturbating more than they desired and experiencing sexual distress; 2% of men and 0.6% of women masturbated more frequently than average and meanwhile experienced self-perceived problematic masturbation; 6.3% of men and 2.1% of women masturbated less frequently than average but still experienced self-perceived problematic masturbation). Moreover, among both sexes, self-perceived problematic masturbation was positively associated with childhood sexual abuse, depression, and anxiety, while negatively associated with a sex-positive family background. Our results point to the complexity of defining problematic masturbation. Causes of sexual distress related to masturbation need to be carefully examined case by case to choose an appropriate clinical approach.

Veterans who focus on sexual assault trauma show slower between-session habituation and symptom reduction during prolonged exposure treatment for posttraumatic stress disorder.

Prolonged exposure (PE) is an effective treatment for posttraumatic stress disorder (PTSD), but veterans with sexual assault (SA) trauma often discontinue it prematurely. Elevated dropout rates may be due to SA triggering more intense and complex emotions that are more difficult to habituate during imaginal exposures; SA during PE has yet to be examined as a moderator of distress habituation or symptom reduction. Participants were N = 65 veterans (n = 12 SA treatment focus; n = 10 SA history but not treatment focus; n = 43 no SA history) enrolled in a clinical trial of a preparatory sleep intervention followed by PE. The sample was representative of the veteran population. Growth curve modeling was used to examine differences in peak subjective units of distress scale (SUDS) ratings across imaginal exposures and changes in biweekly PTSD symptom assessments between veterans who did versus did not focus on SA during PE and between veterans who did versus did not endorse a history of SA. Peak SUDS ratings and PTSD symptoms declined slower among veterans who focused on an SA trauma relative to those who did not. In contrast, participants who endorsed SA history showed similar declines in distress and PTSD symptoms relative to veterans with no SA history. Veterans who focus on SA during PE may take longer to habituate to trauma content and experience resolution of PTSD symptoms. Awareness of this pattern could allow clinicians to deliver PE more effectively to veterans focusing on an SA trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Screening problematic use of substances among young subjects attending an emergency department, and subsequent treatment seeking

IntroductionYoung individuals constitute a key population for the screening of problematic use of substances (PUS), but they are not likely to seek support and are hard to reach. Targeted screening programs should thus be developed in the places of care they may attend for other reasons, including emergency departments (EDs). We aimed to explore the factors associated with PUS in young people attending an ED; we measured the subsequent access to addiction care after ED screening. MethodsThis was a prospective interventional single-arm study which included any individual aged between 16 and 25 years who attended the main ED of Lyon, France. Baseline data were sociodemographic characteristics, PUS status using self-report questionnaires and biological measures, level of psychological health, and history of physical/sexual abuse. Quick medical feedback was provided to the individuals presenting a PUS; they were advised to consult an addiction unit, and contacted by phone at three months to ask whether they had sought treatment. Baseline data were used to compare PUS and non-PUS groups using multivariable logistic regressions, to provide adjusted odds ratios (aORs) and 95% confidence intervals (95% CI), with age, sex, employment status, and family environment as the adjustment variables. The characteristics of PUS subjects who subsequently sought treatment were also assessed using bivariable analyses. ResultsIn total, 460 participants were included; 320 of whom (69.6%) were presenting current substance use, and 221 (48.0%) with PUS. Compared to non-PUS individuals, PUS ones were more likely to be males (aOR=2.06; 95% CI [1.39–3.07], P<0.001), to be older (per one-year increase: aOR=1.09; 95% CI [1.01–1.17], P<0.05), to have an impaired mental health status (aOR=0.87; 95% CI [0.81–0.94], P<0.001), and to have a history of sexual abuse (aOR=3.33; 95% CI [2.03–5.47], P<0.0001). Only 132 (59.7%) subjects with PUS could be reached by phone at 3 months, among whom only 15 (11.4%) reported having sought treatment. Factors associated with treatment seeking were social isolation (46.7% vs. 19.7%; P=0.019), previous consultation for psychological disorders (93.3% vs. 68.4%; P=0.044), lower mental health score (2.8±1.6 vs. 5.1±2.6; P<0.001), and post-ED hospitalization in a psychiatric unit (73.3% vs. 19.7%; P<0.0001). Discussion/ConclusionEDs are relevant places to screen PUS in youth, but the level of seeking further treatment needs to be substantially improved. Offering systematic screening during an emergency room visit could allow for more appropriate identification and management of youth with PUS.

Severe pelvic pain is associated with sexual abuse experienced during childhood and/or adolescence irrespective of the presence of endometriosis.

Is endometriosis associated with childhood and/or adolescent sexual abuse? Endometriosis is not associated with a history of sexual abuse, unlike the presence of severe pelvic pain. Several studies have highlighted a link between pelvic pain and sexual abuse during childhood/adolescence. Moreover, an inflammatory state has been described in patients with a history of childhood maltreatment. Given that inflammation and pelvic pain are two entities often encountered with endometriosis, several teams have investigated whether endometriosis is associated with abuse during childhood/adolescence. However, the results are conflicting, and the link between sexual abuse and the presence of endometriosis and/or pain is hard to disentangle. A survey nested in a cohort study of women surgically explored for benign gynecological indications at our institution between January 2013 and January 2017. For each patient, a standardized questionnaire was completed during a face-to-face interview with the surgeon in the month preceding the surgery. Pelvic pain symptoms (dysmenorrhea, deep dyspareunia, non-cyclic chronic pelvic pain, and gastrointestinal or lower urinary tract symptoms) and their intensities were assessed with a 10 cm visual analog scale (VAS). Pain was considered to be severe when the VAS score was ≥7. A 52-question survey was sent in September of 2017 to evaluate abuses, especially sexual abuse during childhood and/or adolescence, and the psychological state during childhood and adolescence. The survey was structured to cover the following sections: (i) abuses and other life events during childhood and adolescence; (ii) puberty and body changes; (iii) onset of sexuality; and (iv) family relationships during childhood and adolescence. The patients were divided into groups according to whether or not they exhibited histologically proven endometriosis. Statistical analyses were conducted using univariate and multivariate logistic regression models. Two hundred and seventy-one patients answered all the questions of the survey: 168 with (endometriosis group) and 103 without endometriosis (control group). The mean ± SD overall population age was 32.2 ± 5.1 years. There were 136 (80.9%) and 48 (46.6%) women who experienced at least one severe pelvic pain symptom in the endometriosis and the control groups, respectively (P < 0.001). No differences were found between the two study groups regarding the following characteristics: (i) a history of sexual, physical, or emotional abuse; (ii) a history of abandonment or bereavement; (iii) the psychological state regarding puberty; and (iv) the family relationships. After multivariable analysis, we found no significant association between endometriosis and a history of sexual abuse during childhood and/or adolescence (P = 0.550). However, the presence of at least one severe pelvic pain symptom was independently associated with a history of sexual abuse (odds ratio = 3.6, 95% CI (1.2-10.4)). Evaluation of the psychological state during childhood and/or adolescence can be subject to recall bias. In addition, selection bias is also a possibility given that some of the patients surveyed did not return the questionnaire. Severe gynecological painful symptoms in women with or without histologically proven endometriosis may be linked to sexual abuse experienced during childhood and/or adolescence. Patient questioning about painful symptoms and abuses is important to provide comprehensive care to the patients, from a psychological to a somatic point of view. No funding or competing interests. N/A.

Experiences of Dyspareunia in Dominican Women with a History of Sexual Abuse: A Phenomenological Study.

Dyspareunia refers to painful sexual intercourse that negatively affects a person's psychological well-being and quality of life and can also have an impact on their partner, family, and social circle. The objective of this study was to understand the experiences of women with dyspareunia and a history of sexual abuse in the Dominican Republic. This was a qualitative study based on Merleau-Ponty's hermeneutic phenomenology. Fifteen women with a diagnosis of dyspareunia and a history of sexual abuse participated. The study was carried out in Santo Domingo, Dominican Republic. In-depth interviews were conducted for data collection. Through inductive analysis using ATLAS.ti, 3 main themes were developed that represent women's experiences of dyspareunia and sexual abuse: (1) a history of sexual abuse as a background to dyspareunia, (2) living in fear in a society that revictimizes the survivor, and (3) the sexual consequences of dyspareunia. In some Dominican women, dyspareunia stems from their history of sexual abuse, which was unknown to their families and partners. The participants experienced dyspareunia in silence and found it difficult to seek help from health care professionals. In addition, their sexual health was marked by fear and physical pain. There are individual, cultural, and social factors that influence the occurrence of dyspareunia; a better understanding of these factors is vital for planning innovative preventive strategies that reduce the progression of sexual dysfunction and its impact on the quality of life of people with dyspareunia.

Mediators between sexual abuse and eating disorder severity: A comparative case-control study in treatment-naïve patients.

Sexual abuse is associated with eating disorders (EDs) severity. However, the psychological mediators of this association have received scant attention in the literature. The present study aimed to evaluate the mediating role of psychological maladjustment, alexithymia, and self-esteem in the relationship between sexual abuse and EDs severity in a sample of 134 treatment-naïve patients with an EDs and 129 paired healthy controls. In the EDs group, EDs severity among participants who had been sexually abused was mediated by greater psychological maladjustment and alexithymia (indirect effects: β=12.55, 95% CI [6.11-19.87] p<0.001; β=3.22, 95% CI [0.235-7.97] p<0.05, respectively). By contrast, these variables had no significant mediating effect on EDs severity in the control group. These findings support the hypothesis of a disorder-related relationship between sexual abuse and alexithymia and psychological maladjustment, which, in turn, influences EDs severity. Alexithymia and psychological maladjustment appear to be promising therapeutic targets for patients with EDs who have a history of sexual abuse.

Prevalence and predictors of suicidality among adults initiating office-based buprenorphine

BackgroundIndividuals who have substance use disorders may have an elevated risk of suicidality. This study sought to examine the prevalence of, and identify factors associated with, suicidality in adults with opioid use disorder (OUD) initiating office-based buprenorphine treatment.MethodsIndividuals were eligible to participate if they had OUD and had initiated treatment in the past month. Participants (n = 244) completed a semi-structured interview using the Addiction Severity Index—Lite.ResultsAt baseline, 37.70% of participants reported significant thoughts of suicide over their lifetime and 27.46% reported suicidal attempts over their lifetime. Logistic regression analyses were used to identify predictors of lifetime suicidal thoughts and attempts. A history of physical abuse (OR = 4.31, p < .001), having chronic pain-related conditions (OR = 3.28, p < .001), a history of depression (OR = 3.30, p = .001) or anxiety (OR = 7.47, p = .001), and Latino/a/x ethnicity (OR = 2.66, p = .01) were associated with an increased risk of lifetime suicidal thoughts. A history of sexual abuse (OR = 2.89, p = .01), Latino/a/x ethnicity (OR = 4.01, p < .001), a history of depression (OR = 4.03, p = .001) or anxiety (OR = 15.65, p = .007) and having a chronic pain-related condition (OR = 2.43, p = .01), were associated with an increased risk of lifetime suicide attempts.ConclusionsResults demonstrate the high prevalence of suicidal thoughts and attempts among patients initiating buprenorphine. Findings may help to better identify at-risk patients and to inform screening, prevention, and mental health treatment efforts.Trial registration: ClinicalTrials.gov, NCT04650386 (registered 12 December 2020, https://clinicaltrials.gov/ct2/show/NCT04650386) and NCT04257214 (registered 5 February 2020, https://clinicaltrials.gov/ct2/show/NCT04257214).

Sexual Assaults, Bad Hookups, and Bad Dates: Comparisons of the Contextual Features Among College Women's Hypothetical and Real-Life Sexual and Dating Experiences.

Two hundred forty-seven (N = 247) undergraduate women at a medium-sized, Southwestern university provided written descriptions of a hypothetical sexual assault (SA). Women with a prior history of SA also described their actual SA experiences; women without a SA history provided a written description of a prior bad date or hookup. The contextual features of SA scripts were compared to those of actual SA experiences. Several characteristics of a stereotypical or "blitz rape" (e.g., physical force by a stranger) were more likely to be included in SA scripts relative to women's actual SA experiences. Victimized women were also more likely to include verbal coercion, a hangout/hookup context, and previous consensual kissing in their SA experiences, in comparison to their SA scripts. The contextual features of SA experiences were also compared to the contextual features of bad dates or bad hookups. SA experiences, relative to bad dates, were more likely to include alcohol use, physical and verbal coercion by the perpetrator, and passive resistance. SA experiences, relative to bad hookups, were more likely to include physical and verbal coercion by the perpetrator, and knowing the man for less than 1 week. Victimized participants SA experiences were also found to be less likely to include previous consensual kissing and consensual intercourse in comparison to bad hookup experiences of nonvictimized women. Overall, there was considerable overlap between the contextual features present across all experiences. The lack of differentiation among these events may explain why women experience difficulty acknowledging whether they have experienced SA.

An Analysis of Risk and Protective Factors Associated with Cyber-Dating Violence Victimization of Adolescent Girls: An Ecological Perspective.

Cyber-dating violence (cyber-DV) is a prevalent issue among adolescent girls that can have negative consequences including post-traumatic stress symptoms and suicidal ideations and attempts. In the aim to reduce its prevalence and impacts, researchers are increasingly relying on the identification of risk and protective factors associated with cyber-DV across multiple ecological contexts. The current study aimed to examine the influence of individual (e.g., dissociation), interpersonal (e.g., offline forms of dating violence) and community level (e.g., community support) factors associated with the cyber-DV victimization of adolescent girls. A sample of 456 adolescent girls (M = 16.17years old, SD = 1.28) was recruited online to complete a survey. At the individual level, emotion dysregulation, dissociative symptoms, post-traumatic stress symptoms and resilience were measured. Offline forms of DV and a history of child sexual abuse were assessed at the interpersonal level. Finally, at the community level, community support, community resilience, neighborhood material and social disadvantage were evaluated. Results from a hierarchical logistic regression indicated that exposure to offline DV namely verbal-emotional DV, sexual DV, threats, as well as living in neighborhoods with lower levels of social disadvantage were significantly associated with an increased risk of cyber-DV victimization. Cyber-DV preventative intervention efforts should focus on incorporating cyber-DV specific modules and activities into offline DV prevention and intervention programs as to reduce the likelihood of adolescents suffering both forms of DV and their associated repercussions.