Assessing Sexual Assault and Reacting to Client Disclosures During Assessment

2021 ◽  
pp. 35-42
Author(s):  
Amie R. Newins ◽  
Laura C. Wilson
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Clinical Practice ◽  
Sexual Assault ◽  
Self Report ◽  
Wide Range ◽  
Mental Health Settings ◽  
History Of ◽  
Assessment Measures

In mental health settings, not all survivors of sexual assault will present due to concerns related to their sexual assault, and even among those who do, some may not disclose this history without prompting. Given the prevalence of sexual abuse and sexual assault, all clients should be screened for a history of exposure to these experiences. A wide range of self-report and interview measures are available for this purpose; a brief overview of measures available for both child and adult populations is provided. In this chapter, considerations for choosing assessment measures are discussed to help providers select appropriate measures to use in their clinical practice. In particular, this chapter provides information about how language in assessment measures may affect disclosure from clients. Finally, this chapter provides recommendations for reacting to client disclosures during an assessment.

scholarly journals Sexual Violence and Its Associated Psychosocial Effects in Ireland

2020 ◽  
pp. 088626052097819
Author(s):  
Frédérique Vallières ◽  
Brynne Gilmore ◽  
Ann Nolan ◽  
Peggy Maguire ◽  
Kristina Bondjers ◽  
...  
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Sexual Assault ◽  
Sexual Violence ◽  
Mental Health Problems ◽  
Psychosocial Outcomes ◽  
Current Data ◽  
Self Report ◽  
Psychosocial Effects ◽  
History Of

Current data on the prevalence and psychosocial correlates of sexual violence in the Republic of Ireland is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of Irish adults have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. To achieve these objectives, we carried out a nationally representative sample of Irish adults ( N = 1,020) completed self-report measures of history of sexual violence and mental health. Results suggest that approximately one-in-three (34.4%) Irish adults experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Women were significantly more likely than men to have experienced all forms of sexual violence ( ps < .001), with the exception of sexual assault by a parent or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a parent/guardian associated with several other psychosocial outcomes in life, including education achievement, history of being taken into state care, salary, and employment status. Sexual violence is a common experience in the general population and women are disproportionately affected (1-in-2 women versus 1-in-5 men). Additional resources to increase mental health care among survivors of sexual violence is urgently needed. How our findings compare to Ireland’s previous sexual abuse and violence survey and the implications of our findings for policy are discussed.

scholarly journals Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health

2021 ◽  
pp. 088626052110139
Author(s):  
Rachel Langevin ◽  
Martine Hébert ◽  
Audrey Kern
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Psychological Distress ◽  
Sexually Abused ◽  
Maternal Mental Health ◽  
Ptsd Symptoms ◽  
Abused Children ◽  
Maternal History ◽  
History Of ◽  
Sexually Abused Children

The effects of child sexual abuse (CSA) have been found to surpass generations as maternal history of CSA is associated with increased difficulties in sexually abused children. However, little is known about the mechanisms underlying this association. The present study aimed to test maternal mental health symptoms including psychological distress, post-traumatic stress disorder (PTSD) symptoms, and dissociation as mediators of the relationship between maternal CSA and children’s internalizing, externalizing, and dissociation symptoms in a large sample of sexually abused children. A total of 997 sexually abused children aged 3-14 years old and their mothers were recruited at five specialized intervention centers offering services to sexually abused children and their families. The children were divided into two groups depending on their mothers’ self-reported history of CSA. Mothers completed a series of questionnaires assessing their mental health and children’s functioning. Maternal history of CSA was associated with increased maternal psychological distress, PTSD symptoms, and dissociation following children’s disclosure of CSA. In turn, maternal psychological distress and maternal dissociation were associated with increased child internalizing, externalizing, and dissociation symptoms. Maternal PTSD symptoms were associated with child internalizing symptoms. Maternal mental health difficulties mediated the association between maternal CSA and sexually abused children’s maladaptive outcomes. Clinicians should assess for possible history of CSA in mothers of sexually abused children and determine how best to support them to cope with the aftermaths of their child’s disclosure and with their own traumatic past.

scholarly journals Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Gunnur Karakurt ◽  
Kathleen Whiting ◽  
Stephen E. Jones ◽  
Mark J. Lowe ◽  
Stephen M. Rao
Keyword(s):  
Mental Health ◽  
Intimate Partner Violence ◽  
White Matter ◽  
Partner Violence ◽  
Exploratory Study ◽  
Case Series ◽  
Intimate Partner ◽  
Self Report ◽  
Case Series Study ◽  
History Of

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.

‘It’s Not Really a Part of Standard Practice’: Institutional Silencing of Sexuality Within Australian Mental Health Settings

2021 ◽  
pp. 104973232110613
Author(s):  
Kristi Urry ◽  
Anna Chur-Hansen ◽  
Carole Khaw
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Thematic Analysis ◽  
Professional Education ◽  
Institutional Context ◽  
Social Constructionist ◽  
Mental Health Clinicians ◽  
Making Sense ◽  
Mental Health Settings ◽  
Workplace Cultures

Research seeking to understand and improve sexuality-related practice in mental health settings has paid little attention to the institutional context in which clinicians’ practice is embedded. Through a social constructionist lens, we used thematic analysis to examine how 22 Australian mental health clinicians implicated the wider institutional context when discussing and making sense of sexuality-related silence within their work. Interviews were part of a study exploring participants’ perceptions of sexuality and sexual health in their work more generally. Broader silences that shaped and reinforced participants’ perceptions and practice choices were situated in professional education; workplace cultures; and the tools, procedures and policies that directed clinical practice. We argue that sexuality-related silence in mental health settings is located in the institutional context in which clinicians learn and work, and discuss how orienting to this broader context will benefit research and interventions to improve sexuality-related practice across health settings.

Women’s Health: Treating Survivors of Sexual Assault

2019 ◽  
Author(s):  
Elizabeth Schindler ◽  
Allison Cowan
Keyword(s):  
Mental Health ◽  
Posttraumatic Stress Disorder ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
The United States ◽  
Treatment Recommendations ◽  
Rape Recovery ◽  
History Of ◽  
Rape Survivor

Almost half of all women and almost a quarter of all men in the United States have experienced sexual violence in their lifetime. Treating individuals who have survived sexual assault can pose challenges for psychiatric and medical treatment. The rates of posttraumatic stress disorder (PTSD) are higher with sexual assault, and people with sexual trauma often feel stigmatized and have difficulty presenting for care. This chapter reviews epidemiology and neurobiology of sexual assault as well as the physical and psychological sequelae of sexual assault. Here, the authors review and propose practical treatment recommendations to assist in the treatment of individuals with a history of sexual assault. This review 5 figures, 5 tables, and 53 references. Key Words: posttraumatic stress disorder, rape recovery, sexual assault, treatment recommendations, women’s mental health, rape survivor treatment, rape

scholarly journals Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders

2018 ◽  
Vol 64 (3) ◽  
pp. 180-189
Author(s):  
Laura M. Heath ◽  
Jill Torrie ◽  
Kathryn J. Gill
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Psychological Distress ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Emotional Abuse ◽  
Substance Dependence ◽  
Physical And Mental Health ◽  
Parental History ◽  
History Of

Objective: This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. Methods: Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. Results: Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. Conclusions: This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.

Dissociation, Abuse and the Eating Disorders: Evidence from an Australian Population

1999 ◽  
Vol 33 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Lisa Brown ◽  
Janice Russell ◽  
Christopher Thornton ◽  
Stewart Dunn
Keyword(s):  
Eating Disorders ◽  
Sexual Abuse ◽  
Current Knowledge ◽  
Self Report ◽  
Australian Population ◽  
Eating Disordered ◽  
Self Mutilation ◽  
History Of ◽  
Australian Experience ◽  
Report Measure

Objective: Anumber of European and Northern American studies have investigated a possible association between dissociative phenomena, eating disorders, child sexual abuse and self-mutilation. However, there has been little confirmation from other countries and cultures, and the Australian experience of these interrelationships has not previously been studied. Method: Dissociative symptomatology and self-reported history of abusive experiences, physical and sexual, were retrospectively studied in a sample of Australian eating disordered patients using a self-report measure, the Dissociation Questionnaire (DIS-Q). Results: As hypothesised, dissociative symptoms were particularly frequent in those who reported child and adult sexual abuse and in those who self-mutilated. A correlation between multiple forms of abuse and higher dissociation scores was only partially upheld. Conclusions: Interrelationships between victimisation and dissociation are discussed within the context of current knowledge in the field, and brief suggestions for therapeutic strategies are offered.

An Experimental Investigation of the Perceived Credibility of Complainants of Sexual Revictimization: Disbelief and Victim-Blame

2019 ◽  
Vol 34 (6) ◽  
pp. 992-1010
Author(s):  
Nadia M. Wager
Keyword(s):  
Mental Health ◽  
Sexual Assault ◽  
Undergraduate Students ◽  
Interactive Effects ◽  
Victim Blame ◽  
Mental Health Issue ◽  
Sexual Revictimization ◽  
History Of Childhood ◽  
History Of ◽  
Adult Sexual Assault

This study investigated whether attitudes toward a complainant of sexual assault are affected by the knowledge that the complainant had previously made a similar allegation. This was a 3 (previous allegation; none, child sexual assault or adult sexual assault) × 2 (whether the previous allegation was substantiated) × 2 (the implied mental health status of the complainant; mental health issue vs. none) multifactorial, experimental study, employing independent-measures and hypothetical vignettes depicting stranger rape scenarios. The dependent variables were victim-blame and believability. The participants were 243 female undergraduate students. A multivariate analyses of variance (MANOVA) revealed several main and interactive effects. Allegations of sexual revictimization were associated with different levels of victim-blame and believability depending on when the previous assault occurred. A history of childhood sexual assault reduced the believability of the complainant and when combined with other factors increased the tendency to attribute victim-blame.

scholarly journals Making a difference. Invited commentary on … Effects of domestic violence and sexual abuse on mental health

2008 ◽  
Vol 32 (12) ◽  
pp. 450-451 ◽  
Author(s):  
Fiona L. Mason
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Sexual Abuse ◽  
Sexual Assault ◽  
Psychological Services ◽  
Women Doctors ◽  
Men I ◽  
Specialist Services ◽  
Making A Difference ◽  
Medical Examiners

When I qualified in 1987, I was appalled to learn that the vast majority of the on-call forensic medical examiners who examined women subjected to serious sexual assault and rape in the Metropolitan Police area were men. I was subsequently involved in the establishment of an on-call rota of women doctors who were prepared to examine victims of sexual violence. Nowadays, services deliver holistic non-judgemental intervention, particularly in sexual assault centres. These centres are specialist services providing 24-h forensic examinations, other medical and psychological services and aftercare in a secure and sensitive setting (Lovett et al, 2004; Kelly et al, 2008). This model is now being extended.

scholarly journals Converging evidence for enduring perceptions of low social status in individuals in remission from depression.

2021 ◽  
Author(s):  
Julia Gillard ◽  
Siobhan Gormley ◽  
Kirsty Griffiths ◽  
Caitlin Hitchcock ◽  
Jason Stretton ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Social Status ◽  
Community Sample ◽  
Self Report ◽  
Control Group ◽  
Social Risk ◽  
History Of ◽  
Mental Health Difficulties ◽  
Depressive Episodes

BackgroundThe risk of depressive relapse and recurrence is amplified by social risk factors including the perception of low social status. MethodsWe aimed to identify enduring difficulties with the perception of social status in a community sample with a self-reported history of mental health difficulties (Study 1) and, more specifically, in individuals in clinical remission from depression, relative to a never-depressed control group, and relative to a group experiencing a current depressive episode (Study 2). ResultsIn Study 1, elevated depressive symptoms were associated with perceptions of low social status which significantly differed between individuals with and without a self-reported history of mental health difficulties. Study 2 found enduring deficits in perceptions of social status in remitted depressed individuals, in the absence of current symptoms. LimitationsWe were unable to discern between historical or current clinical diagnosis in the community sample of Study 1, as we were reliant on self-report. We were unable to explore the effects of medication or causal relationships between depressive symptoms and social status as the studies were cross-sectional in nature. ConclusionsThese findings suggest that disrupted socio-cognitive profiles across a range of affiliative processes may confer increased vulnerability to future depressive episodes in those in remission.

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