Parental Factors Associated with Child Post-traumatic Stress Following Injury: A Consideration of Intervention Targets

Post-traumatic stress disorder (PTSD) symptoms are relatively common following pediatric traumatic injury and are related to poor long-term child outcomes. However, due to concerns regarding the efficacy of early child preventive interventions, and difficulty intervening with injured and medicated children soon after the event, it is not feasible to provide early psychological interventions to children exposed to traumatic injury. Parental PTSD symptoms and reactions to the child’s traumatic injury impact child outcomes and provide potential targets for early intervention to reduce child symptom development without involving the child. The authors conducted a review of the literature using Psycinfo and Pubmed research databases (publication years = 1990–2017) and identified 65 published studies relevant to the topic of the review. The present review considers parent factors [parenting styles, parental post-traumatic pathology (PTS), adaptive and maladaptive coping strategies, and communication regarding the traumatic injury] and their impact on child PTS. We focus specifically on factors amenable to intervention. We further review moderators of these relationships (e.g., child age and gender, parent gender) and conclude that it is unlikely that a one-size-fits-all approach to treatment will be successful. Rather, it is necessary to consider the age and gender of parent child dyads in designing and providing targeted interventions to families following the traumatic injury of a child

Test-Retest Reliabilities of Four Tactic-first Sexual Violence History Questionnaires

Objective: The present study documented, compared, and contrasted the test-retest reliabilities of the victimization and perpetration forms of a Tactic-first Sexual Experiences Survey (T-SESs) and the PostRefusal Sexual Persistence Scale (PRSPSs). Methods: 243 Mechanical Turk workers (116 women, 124 men) completed four questionnaires in a randomized order via an anonymous web survey at Time 1 and approximately one week later at Time 2. Results: There were consistent gender differences in test-retest estimates. When assessing a history of victimization in women, both the T-SES and the PRSPS demonstrated evidence of minimal to good reliability (κ \u3e .61, ICC = .86-92) while for men the PRSPS (κ = .64) was more consistent than the T-SES (κ = .59). When assessing a history of perpetration, there were fewer gender differences although post-hoc analyses suggest potential gender differences in assessing substance use facilitated perpetration (κ .48- .83) but were limited by few cases. Continuous scoring approaches were the most reliable, dichotomous scores were mostly reliable, and categorical scores generally did not meet minimal acceptable standards. For the rape victimization acknowledgment items, we found strong evidence of reliability for women (κ = .89, n = 31) and suggestive evidence of reliability for men (n = 7). There were few differences in reliability between standard and extended versions of the questionnaires. Conclusions: All four questionnaires exhibited good evidence of one-week test-retest reliability when scored continuously. Evidence of reliability was strongest with the populations and constructs most well studied – victimization history among women and perpetration history among men

The Psychometric Properties of the Sexual Experiences Survey – Short Form Victimization (SES-SFV) and Characteristics of Sexual Victimization Experiences in College Men

Estimates of the rate of sexual victimization in college men vary wildly - likely due to the lack of validated measures. This study provides psychometric data on the Sexual Experiences Survey - Short Form Victimization (SES-SFV) and basic descriptive characteristics of sexual victimization of college men via the SES-SFV. Participants (n = 405) completed a web survey containing the study measures; a subset of 69 participants completed the SES-SFV again 1-3 weeks later. Convergent validity correlations were consistent but modest in size. Two-week test retest reliability estimates varied widely by the type of sexual victimization assessed and scoring format used; dichotomous scores were the most reliable and category scores the worst. Over one in four participants (28%) reported experiencing sexual victimization at Time 1; most reported victimization frequencies greater than one (22.8% of sample). Using behaviorally specific items, one in seven reported experiencing rape (14.1%). The most common type of sexual victimization experienced was unwanted sexual contact. Rape acknowledgement among men who experienced rape (12.2%) was much lower than has been observed in women. Our results indicate mixed evidence for the reliability and validity of the SES-SFV in college men, highlight important characteristics of sexual victimization in college men, and demonstrate the need for further research on the best strategies for the assessment of sexual victimization in college men

Differences in the type and sequence order of self-defense behaviors during a high-risk victimization scenario: Impact of prior sexual victimization

Objective: During a potential sexual assault experience, an active, assertive behavioral response to threat (BRTT) can be protective while a non-assertive BRTT may increase risk. However, little is known about how the sequence of behaviors that a woman engages in during a threatening situation may be related to sexual victimization. The present study investigated the style and sequence of behaviors in college women’s behavioral response to threat using a lab-based date rape self-defense scenario. Method: 135 college women (113 with a history of sexual victimization) completed a lab-based self-defense scenario in which the threat stimuli and situational context were standardized. Participants also completed a comprehensive assessment of multiple BRTT styles and the sequence of behaviors utilized. Results: Most participants endorsed likely using multiple BRTT styles during the hypothetical scenario. Participants with a history of sexual victimization were more likely to endorse diplomatic and immobile style behaviors and using immobile behaviors earlier in the sequence than participants without a victimization history. Conclusions: Prior research has typically assessed whether respondents are likely to engage in one type of BRTT. The present results indicate that women often anticipate using multiple BRTT strategies and that these strategies are likely situation-dependent. Further, women with a history of sexual victimization may utilize different BRTT styles likely as a result of their prior traumatization

Initial Evidence for the Reliability and Validity of the Sexual Experiences Survey-Short Form Perpetration (SES-SFP) in College Men

This study provides psychometric data on the Sexual Experiences Survey—Short Form Perpetration (SES-SFP), a revision of one of the most widely used measures of sexual perpetration, in a sample of college men. Participants (n = 402) completed a web survey containing the study measures; a subset of 66 participants completed the SES-SFP again 2 weeks later. Our results provide initial evidence of internal consistency and convergent evidence of validity for the SES-SFP in college men but question the measure’s test-retest reliability. The severity of tactics used to coerce sexually aggressive behaviors was more strongly associated with rape empathy than sexual outcome severity scores, indicating utility of assessing coercive tactics. Additional research is needed regarding the psychometric properties of the SES-SFP and other measures of sexual perpetration in order to accurately assess rates of these behaviors and inform preventive interventions

Study Title-Based Framing Effects on Reports of Sexual Violence Factors in College Students

Objective: There are many methodological issues in studying sexual violence, including potential framing effects. Framing effects refer to how researchers communicate the purpose of a study to participants, such as, how the study is advertised or explained. The aim of the current study was to investigate if framing effects were associated with differences in participants’ self-reported experiences of sexual violence and related correlates. Methods: College students (N = 782) were recruited to participate in one of four identical studies that differed in the title: “Questionnaires about Alcohol,” “Questionnaires about Crime,” “Questionnaires about Health,” or “Questionnaires about Sexual Assault.” Participants chose one of the four studies and completed measures of sexual violence as well as attitudinal and behavioral measures in randomized order. Results: We found significantly more reports of childhood sexual abuse (33.6% vs. 18.5%), rape (33.9% vs. 21.1%), higher frequency of victimization (M = 11.35 vs. 5.44), and greater acknowledged rape for bisexual people (46.2% vs. 0.0%) in the Sexual Assault condition compared to other conditions. There were no differences in sexual violence perpetration or attitudinal or behavioral measures. Conclusion: These results revealed that framing effects, based on the study title, affect outcomes in sexual victimization research. Rape was reported 1.6x more in the “Sexual Assault” condition than in the “Health” condition. It is unclear whether these framing effects reflect self-selection bias or framing related increased reports in the Sexual Assault condition, suppression of reports in other conditions, or a combination thereof

Sexual minority status and interpersonal victimization in college men

Sexual minority men are at increased risk for sexual victimization at all ages compared to heterosexual men; yet, most research on victimization focuses on the experiences of heterosexual women. This study compares the rates of multiple forms of interpersonal violence (violence perpetrated by another person) in a sample of sexual minority status college men and heterosexual men on campus. Participants (n = 53 sexual minority men; n = 364 heterosexual) completed an anonymous Web survey containing measures of childhood abuse, adolescent/adult sexual victimization, adolescent/adult sexual aggression, intimate partner victimization and aggression, rape empathy, posttraumatic stress disorder symptoms, and social desirability. Analyses of covariance, covarying for demographic characteristics and social desirability, revealed that sexual minority men were more likely to experience the most severe forms of adolescent/adult sexual victimization as well as childhood emotional abuse. There were no differences in rates of sexual aggression or intimate partner violence. Sexual minority men who experienced sexual assault were more likely to report being assaulted by other men than were heterosexual men. Regarding self-reported sexual aggression, we found no differences in rates of sexual aggression. Sexual minority men had higher levels of rape empathy and rape acknowledgment than heterosexual men. Our results indicate sexual minority men are at higher risk than heterosexual men for the most severe forms of sexual victimization and experience different psychological consequences of sexual victimization indicating there may be a need for specialized intervention services

The Frequency of Sexual Perpetration in College Men: A Systematic Review of Reported Prevalence Rates from 2000-2017

Background: The prevalence of sexual perpetration in college men is unknown. Prior reviews of sexual violence prevalence rates have produced wide-ranging estimates, likely due to wide variation in measurement strategies. Objectives: This paper systematically reviewed research findings (from 2000-2017) regarding prevalence rates of sexual perpetration in college men and measurement strategies. Data Sources: PsycINFO and Web of Science databases. Eligibility Criteria: Empirical reports published between 2000-2017 that included male participants, available in English, and reported lifetime prevalence findings in Canadian or American college students. Participants: Data from 78 independent samples including 25,524 college men. Results: The average prevalence rate of any sexual perpetration was 29.3% (SD = 16.8), and the average rate of rape was 6.5% (SD = 6.3). Studies that used non-Sexual Experiences Survey (SES) based questionnaires recorded higher prevalence rates (41.5%) than SES-using studies (26.2%). At least sixteen different sexual perpetration questionnaires were identified. Modifying standardized questionnaires was extremely common; this was reported in over half the studies. Studies using modified standardized questionnaires found higher prevalence rates of sexual perpetration than studies using non-modified standardized questionnaires. Limitations: This report focused exclusively on college men in the United States and Canada. Conclusions and Implications: On average, 29% of college males report engaging in behaviors defined as sexual perpetration; however, there was a strong influence of measurement strategy on reported rates

An Initial Application of a Biopsychosocial Framework to Predict Posttraumatic Stress Following Pediatric Injury

Objectives—Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association. Method—Participants were 96 children hospitalized for injury and assessed at 3 time points: T1 (within 2 weeks of injury), T2 (6-week follow-up), and T3 (12-week follow-up). Participants completed measures of trauma history and appraisals at T1, coping at T2, and PTSS at T1, T2, and T3. Heart rate was abstracted from medical records. Structural equation modeling was employed to evaluate study hypotheses. Results—Heart rate was not associated with PTSS or appraisals. Models including trauma history, appraisals, coping, and PTSS were constructed to test other study hypotheses and fit the data well. T1 global and trauma-specific threat appraisals were associated with T1 PTSS; T2 avoidant coping was a significant mediator of the relation between T1 and T3 PTSS. Conclusions—Findings confirm a role for appraisals and coping in the development of PTSS over the weeks following pediatric injury. Early appraisals and avoidant coping may be appropriate targets for prevention and early intervention. Future researchers should further explicate the utility of a biopsychosocial framework in predicting PTSS

Mental Health After Injury: How Neighborhoods Impact Recovery

Each year in the United States, there are over 90 million injury-related emergency department visits, resulting in $4.2 trillion in costs related to medical care, loss of work, and reduced quality of life. Nearly a quarter of injury survivors are diagnosed with a new mental health disorder within the first year of injury. This brief examines several aspects of neighborhood context and their relationship to PTSD symptom severity following an injury. Results show that survivors living in neighborhoods with higher racial segregation and lower socioeconomic status report higher PTSD symptom severity