COVID‑Specific Coercive Control among Emerging Adults Attending College: A Brief Note

The COVID-19 pandemic represents a “perfect storm” with regards to risk for intimate partner violence (IPV). Abusive partners may engage in novel forms of coercive control, such as pressuring their partner to engage in activities associated with COVID-19 infection risk (e.g., attend a large gathering). However, no empirical research has focused on COVIDspecific coercive control. The current study sought to evaluate the prevalence of COVID-specific coercive control in a large sample of U.S. college students, as well as its association with other forms of IPV and depression and anxiety. A total of 2,289 undergraduate students attending eight U.S. universities who were currently in a sexual/dating/romantic relationship completed an online survey in Fall 2020 about COVID-specific coercive control, other forms of IPV (psychological, physical, sexual, coercive control) and depression and anxiety symptoms. Overall, 15.5% (n = 355) of students reported experiencing COVID-specific coercive control. Individuals who experienced COVID-specific coercive control were more likely to have experienced all other forms of IPV than those who did not experience COVID-specific coercive control. Further, individuals who experienced COVID-specific coercive control had significantly greater anxiety than individuals who did not experience any form of IPV. Individuals who experienced both COVID-specific coercive control and other forms of IPV had the highest levels of depression and anxiety. COVID-specific coercive control may serve to increase depression and anxiety, particularly if it co-occurs with other forms of IPV. Future work should evaluate the prevalence and long-term impact of coercive control during the COVID-19 pandemic

An ecological approach to understanding the impact of sexual violence: a systematic meta-review

AimA systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)—influencing the impact of sexual violence.MethodsSearches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted.ResultsExperiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however.ConclusionReviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes

Sexual assault, sexual abuse, and harassment: Understanding the mental health impact and providing care for survivors: An International Society for Traumatic Stress Studies Briefing Paper

Recent events including revelations of the systematic cover-up of widespread childhood sexual abuse in the Catholic Church, sexual assault and harassment accusations involving many prominent individuals in the entertainment and other industries in the U.S., Canada, Europe, Australia, and Japan, global coverage of cases of violent rape and rape-murder of girls and young women in India, and the #metoo movement, have served to increase public consciousness internationally regarding the pervasiveness of various forms of sexual victimization worldwide. In response, the International Society for Traumatic Stress Studies (ISTSS) commissioned this briefing paper to inform its membership, policymakers, and global stakeholders about the prevalence, impact, and barriers faced by survivors of various forms of sexual victimization including attempted and completed rape, sexual abuse in childhood, and sexual harassment in workplace and educational settings. This paper outlines the research evidence regarding (1) the prevalence of different forms of sexual victimization worldwide including childhood sexual abuse, various forms of sexual assault in adulthood, and sexual harassment in workplace and educational settings, (2) the prevalence of various forms of sexual victimization among several marginalized groups, (3) the psychological, behavioral, and physical health impacts of sexual victimization in childhood and adulthood, (4) evidence-based interventions for survivors of sexual victimization, and (5) barriers to treatment seeking commonly faced by survivors of different forms of sexual victimization. Recommendations are also made in the areas of policy, practice, research, and for professional organizations. Research conducted throughout the world continues to document the alarmingly high prevalence of various forms of sexual victimization throughout the lifespan, including the sexual abuse of children, sexual assault of adults, and sexual harassment within individuals’ place of employment and in educational settings. Although all individuals are vulnerable to experiences of sexual victimization, sexual assault, abuse, and harassment are gendered crimes, such that women and girls are more likely to be victims of these forms of sexual violence. In addition, members of a number of marginalized groups face substantially increased vulnerability to sexual victimization. These include individuals with disabilities, sexual and gender minorities, homeless individuals, individuals engaging in various kinds of sex work, and members of indigenous populations. Further, the impact of sexual victimization is both broad and targeted, with various forms of sexual victimization, including experiences of childhood sexual abuse and sexual assault in adulthood, associated with a host of negative outcomes including the development of posttraumatic stress disorder, depression, anxiety, substance use disorders, eating disordered pathology, suicidality, dissociation, and high risk sexual behaviors. Further, sexual victimization is associated with risk for a number of negative physical health outcomes including obesity, gastrointestinal disorders, chronic pelvic pain, and reproductive health issues. There exists a robust evidence base supporting the efficacy of psychological treatment for PTSD symptomology among adult survivors of childhood sexual abuse and sexual assault. Of extant treatments, cognitive-behavioral based treatments have the strongest evidence for their efficacy. Similarly, cognitive-behavioral treatments, such as trauma-focused CBT, have demonstrated efficacy in treating PTSD and depressive symptomology among children and adolescents who have experienced sexual abuse. There is also some evidence supporting the efficacy of psychopharmacological treatment in reducing PTSD symptomology among adult survivors of sexual abuse or assault. Conversely, there is far more limited research examining the efficacy of psychological treatments for PTSD in other cultural contexts, with the vast majority of research involving United States samples. There is also much less evidence regarding the impact of trauma-focused treatments on other outcomes besides PTSD symptomology and depression, or examining how to treat additional behavioral and mental health issues among survivors of sexual victimization. Finally, almost no research has evaluated the efficacy of psychological treatments for individuals who have experienced sexual harassment in their workplace. Further, research documents that survivors of various forms of sexual victimization often face substantial barriers to disclosing their experience or seeking formal help. These barriers include issues related to defining the experience as a victimization, concerns about not being believed or taken seriously, and feelings of stigma, shame, or embarrassment. Other barriers include concerns about whether the experience will be reported to authorities, mistrust of formal support systems, and prior negative experiences following disclosure of a sexual victimization experience. Many survivors also may be unaware of services that are available to them, may believe that available services are not appropriate for them, and may also face substantial barriers to accessing the care that is available, and available care may be inadequate for addressing their needs in many parts of the world. Finally, it is important to note that many individuals who experience sexual victimization face ongoing issues related to poverty, socioeconomic disadvantage, ongoing personal and community violence, and belong to marginalized groups. Given the prevalence, impact, and substantial barriers to care faced by individuals who experience sexual victimization, including childhood sexual abuse, sexual assault, and sexual harassment, it is clear that concerted, international, and collaborative efforts involving policymakers, researchers, clinicians, professional organizations, and other global stakeholders is imperative

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

REACH Study (Recovery and Adjustment in the Community after Hurricane Florence)

The major goal of this project was to test hypotheses derived from self-regulation shift theory and social support deterioration deterrence theory among Sandhills residents directly affected by Hurricane Florence. Specifically, the first aim was to evaluate coping behaviors and coping self-efficacy as predictors of adjustment among survivors. The second aim was to evaluate social/community factors as predictors of adjustment. The final aim was to evaluate both of these factors as predictors of negative non-linear adjustment shifts

Heather Littleton's Quick Files

The Quick Files feature was discontinued and it’s files were migrated into this Project on March 11, 2022. The file URL’s will still resolve properly, and the Quick Files logs are available in the Project’s Recent Activity