Women who have experienced sexual trauma may have an increased risk of psychological symptoms such as anxiety, depression, and increased alcohol use (e.g., Resnick, Acierno, & Kilpatrick, 1997). Religiosity has been shown to be a possible mechanism of coping with traumatic life events (Ano & Vasconcelles, 2005; Chang et al., 2001). The current study hypothesized that sexual trauma would predict higher levels of anxiety, depression, and alcohol use, and religiosity would mediate this relationship. An international sample of 736 women were recruited via social media. The overall model was significant R2= .01, (F(1, 734) = 4.06, p < .044); regression analyses in SPSS using PROCESS revealed that sexual trauma was a significant predictor of both anxiety (b = 2.62, SE =.46, p < .001), and religiosity (b = -.71, SE =.35 , p < .044), and religiosity also predicted lower levels of anxiety (b = -.10, SE = .05, p < .037). Religiosity was found to significantly mediate the relationship between sexual trauma and anxiety, b = .071, SE = .05, 95% CI [-.002, .182], but not between depression or alcohol use. Findings confirm the relationship between sexual trauma and anxiety and further identify religiosity as an important mediator of this relationship. Future interventions should consider implementing religiosity as a way to buffer the relationship between trauma and anxiety.

Locus of control has been associated with health outcomes (Donham et al., 1983; Holder & Levi, 1988) as well as interactions with the health care field (Christensen et al., 1996) and has independently predicted health outcomes among victims of sexual trauma (Simoni & Ng, 2002). As such, it may help to explain adverse health outcomes associated with sexual trauma. The current study sought to examine the potential mediating factor that an individual’s locus of control may have on the relationship between history of sexual trauma and health outcomes/health care interactions. Locus of control was measured via the Levenson Locus of Control Scales (Levenson, 1981) which divides locus of control into three subscales: internal locus of control, powerful others, and chance. Among a sample of women aged 18-50 years old (N = 753), an internal locus of control significantly mediated the relationship between sexual trauma and health outcomes (somatic symptoms, self-rated health, depression, and anxiety) as well as the relationship between sexual trauma and health care interactions (an individual’s level of medical mistrust and medical nonadherence). While each external locus of control scale did significantly predict outcomes, they were not significant mediators. Findings indicate the importance of internal locus of control in understanding sexual trauma’s effect on health outcomes.

Stigma is one factor posited to play a role in the negative physical and mental health sequelae of sexual victimization (e.g., Finkelhor & Browne, 1985). Stigma has been shown to be associated with negative health outcomes across various marginalized populations, including LGBT individuals (e.g., Hatzenbuehler et al., 2014), and difficulties with emotion regulation (DERS) have been shown to be one mechanism through which stigma leads to psychological outcomes (Hatzenbuehler et al., 2009). This study sought to examine if DERS (Gratz & Roemer, 2004) mediated the relation between sexual victimization stigma (Gibson & Leitenberg, 2001) and physical health outcomes of general self-rated health and somatic symptoms (SSS-8; Gierk et al., 2014) in a sample of college students (N=194, 79% female, 81% white) in rural Appalachia with an experience of sexual victimization. Emotion regulation difficulties significantly mediated the relation between stigma and both health outcomes [self-rated health: R2 = .07, F(2,179) = 7.20, p < .01, indirect effect t(179) = -2.64, p < .01, CI = -.011, - .001; somatic symptoms: R2 = .23, F(2,180) = 27.50, p < .000, indirect effect t(180) = 5.41, p < .000, CI = .05, .02]. Results highlight the importance of considering the role of stigma for survivors of sexual violence, as well as suggest a treatment target in increasing emotion regulation skills.

Introduction: Sexual misconduct is a pervasive and deleterious issue within military contexts. Commonly cited psychological sequelae of sexual assault include anxiety, depression, suicidality, posttraumatic stress disorder (PTSD), as well as interpersonal relationship functioning issues. The experience of military sexual trauma (MST) is unique in that the environment in which the harm occurs, the culture, plays a significant role in the impact of the harm on survivors. MST is often also related to feelings of institutional betrayal and moral injury. While clinical treatment of interpersonal trauma history is common, there is a lack of research regarding the development and efficacy of clinical interventions used with couples affected by MST. The objective of the thesis is to examine how dimensions and impacts of MST affect intimate partner relationships. Methods: A multi-method qualitative approach was taken in the thesis, including a scoping review and two narrative reviews, contextualized using primary qualitative data in the conclusion chapter. Results: MST affects dimensions of intimate partner relationships including communication, trust and attachment, intimacy, conflict, aggression, as well as sexual function and satisfaction. The present work highlights the unique considerations for those affected by MST, suggesting that the relationship between adverse psychological outcomes, such as PTSD, and relationship distress appears to be greater for military than among civilian populations. While clinical work aims to amplify positive outcomes within couple relationships, and reduce individual symptomatology, there exists a lack of interventions tailored to meet the needs of couples affected by MST specifically. Discussion: The present thesis contributes to the growing understanding of how MST affects intimate partner relationships, as researchers and clinicians continue to seek to improve supports available for military members. The work is an appropriate start to inspire and inform future research, identifying existing gaps in the literature spurring on forthcoming work that aims to improve the wellbeing of military-connected intimate partner relationships. / Thesis / Master of Science (MSc) / The present thesis explores how military sexual trauma may affect intimate partner relationships. The work highlights how the literature discusses and describes the link between sexual assault that occurs in the military, posttraumatic stress disorder, and intimate partner relationships. In addition, the work explores concepts related to the experience of sexual assault in the military, such as betrayal, guilt, shame, as well as military culture. The thesis also identifies and summarizes information about therapeutic interventions being used with couples who are affected by military sexual trauma. The present body of work contributes to the growing understanding of how military sexual trauma affects intimate relationships and survivors, while also informing research, clinical services, and policymakers who are making meaningful change in the health and wellbeing of military members and their partners.

The goal of the study is to develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse. South Africa has one of the highest prevalence rates for child sexual abuse, and professionals working with children are consequently faced with the phenomenon on an increasing scale. Many professionals find themselves ill-equipped to address the effect of sexual abuse on the child, and the lack of an integrated understanding of the phenomenon seems to exacerbate this need. In order to effectively address the effect of sexual abuse on the child, professionals need a holistic understanding of this phenomenon and its effects, as well as a clear outline of the necessary interventions. The thesis consists of five sections, which can be outlined as follows: Section A consists of the problem statement, the research questions, the research objective, the general theoretical assumption and the theoretical approach. It includes the research methodology, the limitations of the research, definitions of the key terms and the selection and structure of the dissertation. The research focused on the following specific objectives stemming from the problem statement: -To conduct a thorough literature study on various aspects pertaining to childhood sexual abuse in order to form a holistic, well-researched perspective on the phenomenon of childhood sexual abuse and the available evidence-based interventions in the sexual abuse of children; -To develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse; -To subject the prototype of the proposed intervention model to peer review in order to determine its strengths and weaknesses and make the necessary adaptations to the model prior to its final dissemination. Section B consists of four articles, in which the goals of the research, the outcomes of the literature study and the empirical study are reported. Each article is dealt with as a self-contained unit focusing on a specific aspect of the research and contributing to the collection of data necessary for the design and evaluation of the proposed intervention model. Article 1 Knowledge of the legislation pertaining to sexual abuse is imperative for health care professionals working with a child who has been sexually abused. This article provides a critical analysis of those aspects of the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007, relevant to the health care professional. The shortcomings of the Act and the practical implications of these for healthcare professionals is pointed out. Focus also falls on the relevant sections of the Childcare Act, 38 of 2005 and how these sections complement the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007). Article 2 In order to effectively help traumatised children to achieve positive outcomes, professionals must have a clearly-defined methodology, underpinned by theory and based on an integrated approach. The first step towards this is clearly to redefine the phenomenon of child sexual abuse. As sexual abuse is both a legal and a psychosocial phenomenon, the authors are of the opinion that a more integrative definition is necessary in the South African context. The information in this article therefore aims to provide health care professionals with an integrative definition that takes into account both the South African legal definition of sexual abuse and the underlying psychosocial factors associated with it.Article 3 Sexual abuse is a phenomenon with far-reaching effects. This article provides a holistic look at the effects of sexual abuse from an ecological systems perspective. The effect of sexual abuse on the child as the focus of the microsystems is emphasized, as well as the effects on the parents or the child’s caregiver as the mesosystem. The article further considers the interactive dynamics between the different systems and explains how each system can contribute to either mitigating or exacerbating the effects of abuse on the child. Article 4 The research goal of this article is to develop and evaluate a structured play therapy intervention model to mitigate the effects of child sexual abuse. The intervention model was developed from the results of the previous articles as well as an in-depth literature study on existing therapeutic interventions. To fulfil the aim of this article, the following objectives are set: -To give an outline of the research methodology underlying the study; -To discuss the problem analysis and project plan; -To outline the intervention model for mitigating the effects of child sexual abuse; -To discuss the research findings on the proposed model. Section C gives a summary of the most important findings and conclusions regarding the research in general. It also contains recommendations and points to the contribution made to the specific field of study. Section D consists of the addenda to the research report, for example, the different instruments of measurement and the questionnaires. Section E concludes the thesis with summarized references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2015

The goal of the study is to develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse. South Africa has one of the highest prevalence rates for child sexual abuse, and professionals working with children are consequently faced with the phenomenon on an increasing scale. Many professionals find themselves ill-equipped to address the effect of sexual abuse on the child, and the lack of an integrated understanding of the phenomenon seems to exacerbate this need. In order to effectively address the effect of sexual abuse on the child, professionals need a holistic understanding of this phenomenon and its effects, as well as a clear outline of the necessary interventions. The thesis consists of five sections, which can be outlined as follows: Section A consists of the problem statement, the research questions, the research objective, the general theoretical assumption and the theoretical approach. It includes the research methodology, the limitations of the research, definitions of the key terms and the selection and structure of the dissertation. The research focused on the following specific objectives stemming from the problem statement: -To conduct a thorough literature study on various aspects pertaining to childhood sexual abuse in order to form a holistic, well-researched perspective on the phenomenon of childhood sexual abuse and the available evidence-based interventions in the sexual abuse of children; -To develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse; -To subject the prototype of the proposed intervention model to peer review in order to determine its strengths and weaknesses and make the necessary adaptations to the model prior to its final dissemination. Section B consists of four articles, in which the goals of the research, the outcomes of the literature study and the empirical study are reported. Each article is dealt with as a self-contained unit focusing on a specific aspect of the research and contributing to the collection of data necessary for the design and evaluation of the proposed intervention model. Article 1 Knowledge of the legislation pertaining to sexual abuse is imperative for health care professionals working with a child who has been sexually abused. This article provides a critical analysis of those aspects of the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007, relevant to the health care professional. The shortcomings of the Act and the practical implications of these for healthcare professionals is pointed out. Focus also falls on the relevant sections of the Childcare Act, 38 of 2005 and how these sections complement the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007). Article 2 In order to effectively help traumatised children to achieve positive outcomes, professionals must have a clearly-defined methodology, underpinned by theory and based on an integrated approach. The first step towards this is clearly to redefine the phenomenon of child sexual abuse. As sexual abuse is both a legal and a psychosocial phenomenon, the authors are of the opinion that a more integrative definition is necessary in the South African context. The information in this article therefore aims to provide health care professionals with an integrative definition that takes into account both the South African legal definition of sexual abuse and the underlying psychosocial factors associated with it.Article 3 Sexual abuse is a phenomenon with far-reaching effects. This article provides a holistic look at the effects of sexual abuse from an ecological systems perspective. The effect of sexual abuse on the child as the focus of the microsystems is emphasized, as well as the effects on the parents or the child’s caregiver as the mesosystem. The article further considers the interactive dynamics between the different systems and explains how each system can contribute to either mitigating or exacerbating the effects of abuse on the child. Article 4 The research goal of this article is to develop and evaluate a structured play therapy intervention model to mitigate the effects of child sexual abuse. The intervention model was developed from the results of the previous articles as well as an in-depth literature study on existing therapeutic interventions. To fulfil the aim of this article, the following objectives are set: -To give an outline of the research methodology underlying the study; -To discuss the problem analysis and project plan; -To outline the intervention model for mitigating the effects of child sexual abuse; -To discuss the research findings on the proposed model. Section C gives a summary of the most important findings and conclusions regarding the research in general. It also contains recommendations and points to the contribution made to the specific field of study. Section D consists of the addenda to the research report, for example, the different instruments of measurement and the questionnaires. Section E concludes the thesis with summarized references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2015

Military sexual trauma (MST) has been associated with poor emotional and psychological well-being, less overall life satisfaction, and poorer health in general as well as higher rates of posttraumatic stress disorder (PTSD). The Department of Veterans Affairs provides treatment for veterans who experienced MST and recommends cognitive processing therapy (CPT) as a preferred treatment modality. Quantitative studies have shown that CPT can decrease symptoms of PTSD; however, a neglected area of study concerns the experiences of veterans who receive CPT for MST-related PTSD. In this generic qualitative study, the perceptions and experiences of female veterans who were survivors of MST and received CPT from a VA provider through a feminist lens were explored. Twenty-one female veterans who were survivors of MST and who sought treatment at the VA and received CPT were asked to complete a written questionnaire. The research questions explored the participants' experiences with CPT, changes in their symptoms, social lives and relationships, and general functioning and well-being after receiving CPT. Thematic analysis was used to identify 3 themes. Findings revealed that although participants described their experience of deciding whether to participate in CPT and receiving CPT as difficult, they reported increased quality of life and improved well-being after CPT. The results from this study will increase understanding of the experiences of veterans with CPT. Finally, scholar practitioners may be able to use findings from this study to enhance awareness of perceptions of clients, improve practice, and better serve clients who have experienced MST.

Sexual trauma, in addition to being a human rights violation, harms people in numerous ways, including negative psychological and physical outcomes. Body-based interventions reduce sexual trauma symptoms, but limited information exists about how these interventions work. Researchers propose changes in internal body sensation awareness (i.e., interoceptive awareness; IA) as a potential mechanistic explanation. We are not aware of any studies testing that claim. Further, there is scant extant information on IA – sexual trauma relationships. Before evaluating mechanistic therapeutic hypotheses, studies need to test sexual trauma – IA associations. We focus on this understudied area here. Through a multi-method study (behavioral, self-report and qualitative data), we tested the associations between IA and sexual trauma among females. Aim 1: Characterize IA among sexual trauma survivors. We hypothesized that survivors would have significantly lower self-reported IA than existing literature. Aim 2: Quantify the amount of variance IA explains in posttraumatic stress disorder (PTSD) symptoms. We hypothesized that IA would predict significant variance in PTSD, such that increases in IA would predict increases in PTSD. We expected that an IA – dissociation symptom interaction would qualify that main effect via weakening it for survivors with higher dissociation. Aim 3: Through a moderated mediation model, test if IA mediates the sexual trauma – PTSD association. We hypothesized that IA would mediate that association. Further, we predicted that the IA – PTSD relationship would be moderated by dissociation: higher dissociation would attenuate the IA – PTSD association. In this manuscript, we report results from two samples: 1) University (n = 153), and 2) community (n = 21) participants. Given ongoing community participant recruitment, the following are university participant results. Aim 1: Self-reported IA is significantly lower among survivors than comparator samples. Aim 2: Behavioral IA explained significant variance in PTSD, though opposite to the direction we predicted: we observed that as IA increased, PTSD decreased. We observed a significant interaction between self-reported IA and dissociation in predicting declines in PTSD. PTSD symptoms were lowest among survivors with high dissociation and high IA. Aim 3: IA did not mediate the sexual trauma – PTSD association. We discuss clinical implications, limitations and future directions.

No description available.

No description available.