Professionals who work with victims of sexual trauma frequently experience emotional and psychological stressors that affect their everyday life. Vicarious traumatization is an occupational risk among helping professionals, but it is not known how this phenomenon can be identified and minimized among professionals who work with victims of sexual trauma. The purpose of this qualitative narrative study was to explore the personal experiences of licensed and nonlicensed professionals who work with female victims of sexual trauma. Constructivist self-development theory and the traumagenic dynamics model provided the framework for the study. The research questions focused on the evidence of vicarious trauma among participants, the skills and techniques used to minimize the risk of vicarious trauma, and the influence of vicarious traumatization on helping professionals. Data were collected through semistructured interviews with 8 helping professionals in the Southern United States. Findings from data coding and theme analysis indicated that (a) professionals experience psychological and emotional risks in trauma work, (b) establishing boundaries and implementing self-care techniques can minimize vicarious trauma, and (c) consistent training and ongoing discussions about vicarious trauma are essential to professionals who commit their lives to helping sexual trauma victims. Findings may be used to increase awareness and education about vicarious trauma among professionals who work with victims of sexual trauma, and to develop techniques to minimize the risk of vicarious trauma.

Sexual trauma is linked to adverse health outcomes (e.g., D’Andre et al., 2011). Given the negative sequelae of sexual trauma, exploration of factors that influence the relation between sexual trauma and health outcomes is crucial. Current literature suggests that psychological flexibility and inflexibility may be factors in promotion of individuals’ health or pathology (e.g., Gloster et al., 2017). The current study sought to explore the variability in psychological flexibility and inflexibility among participants and the potential moderating effects of psychological flexibility and inflexibility on the relation between sexual trauma and both mental and physical health outcomes. Moderation analyses failed to support significant moderation effect of psychological flexibility on either physical or mental health outcomes. However, psychological inflexibility did significantly moderate the relationship between sexual trauma and emotional wellbeing b = 5.50 t(247) = 2.69 p < 0.01 such that sexual trauma significantly predicts worse emotional wellbeing at high levels of psychological inflexibility. Similarly, in the model examining the potential moderating effect of psychological inflexibility on the relationship between sexual trauma and physical functioning, the interaction was significant, b = 7.51 t(248) = 2.13, p < 0.05, suggesting possible moderation. However, after further probing, psychological inflexibility did not significantly moderate the relationship between sexual trauma and physical functioning at any level. Additionally, t-test results suggest that regardless of a sexual trauma history, participants do not significantly differ in their levels of psychological flexibility or inflexibility. However, within moderation models both psychological flexibility and psychological inflexibility predicted physical and mental health outcomes, further supporting the association between resiliency and psychological flexibility and the link between inflexibility and worsened health outcomes. Findings suggest that interventions that promote psychological flexibility and target inflexibility may be important health promotion factors among both survivors of sexual trauma and non-traumatized populations.

Abstract available in the Annals of Behavioral Medicine.

The purpose of the following study was to evaluate sexual trauma and the effects on women veteran's quality of life ratings and current and past coping strategies. Participants were screened for sexual trauma history and divided into five mutually exclusive categories: 1)childhood sexual trauma, 2)civilian adult sexual trauma, 3)military sexual trauma, 4)multiple sexual trauma, and 5)no sexual trauma. Results of the study were mixed, retaining some hypotheses and rejecting others. Results regarding differences in QOL for the sexual trauma groups were rejected, as none of the QOL analyses were significant. Issues of small effect size for the QOL measure and low power to detect differences are discussed as limitations in the current study. Several significant findings were detected in the coping analyses. As predicted, the no trauma group was found to use significantly more approach coping strategies than the sexual trauma group for the past problem. Additionally, the sexual trauma group used significantly more avoidant coping techniques for past problem than the no trauma group. No between group differences were detected for sexual trauma type, however, several significant differences emerged in the comparisons of the multiple sexual trauma and military sexual trauma group's past coping compared to the no sexual trauma group's coping strategies. For past coping, the no trauma group used more approach strategies than the military or multiple trauma group. Past and current significant CRI subscale differences were also detected. Results regarding the relationship between QOL and CRI were rejected, as the two scales were not found to correlate significantly. Trauma history and avoidant coping were also nonsignificant predictors for General Life Satisfaction on the QOL measure. Additional exploratory analyses are presented as well as implications for research, theory and clinical practice.

Beginning May of 2013 and ending in September, I worked with Grace After Fire (Grace), a virtual nonprofit organization that focuses on issues related to female veterans. Grace’s mission is to provide female veterans with the means to gain knowledge, insight and self-renewal. Grace’s mission is accomplished through peer support and resource referral. The aim of my thesis project was to conduct an analysis of Grace’s peer support system, Table Talk: Color Me Camo (Table Talk). Because Table Talk is a fairly new program for Grace, just over a year old, the outreach coordinators were eager to learn: 1) if they were indeed meeting their mission of empowering female veterans, and 2) the point-of-view of the peer facilitators who conduct Table Talk. To help Grace gain perspective, I interviewed women who had previously attended Table Talk, as well as peer facilitators responsible for coordinating the peer support system-all of whom are female veterans. The following is their story.

This dissertation describes a qualitative study that explored the perceived barriers to reporting military sexual assaults that servicewomen experienced following a sexual assault while on active duty. The study aimed to answer the following research questions: (1) What barriers to reporting did servicewomen who survived sexual assault in a military setting perceive?; (2) What role did betrayal (the act of going against a promise) play in their decision? Semi-structured interviews with three servicewomen who were sexually assaulted while on active duty and did not report the assaults were analyzed using Interpretative Phenomenological Analysis. Four superordinate themes emerged from the data including (1) external factors, (2) internal processes, (3) interpersonal aspects, and (4) need for a cultural shift. A review of existing literature, research methodology implemented, a review of results including supporting quotes from participant narratives, and a discussion of the results will be presented in this dissertation. A minority stress model adapted for servicewomen will be explored, as well as implications for clinicians and suggestions for future research.

This work explores: liberatory possibilities and limitations of narrative in healing from rape; the work and meanings of forgiveness, specifically seeking a complex definition of forgiveness drawing on spiritual, feminist, complexity, and phenomenological philosophies; and the relationships between narrative processes and forgiveness. I use an autoethnographic approach, offering my story of rape and healing in the aftermath. I attend to the physicality of the narrative, and to the way in which memory resides in the body, thus creating an embodied text. I examine current models of rape recovery, and the terms used by organizations, practitioners, and authors of rape narratives to frame the recovery process, contending that current models and the language of recovery fails to recognize the dynamic and non-linear trajectory of healing. I return to my own process of forgiveness, which is illustrative of the unpredictable event of forgiveness, which grows from the dissolution of self and other.

Adaptation of personal experiences to a screen is no new concept, in fact it is the driving force to media content creation. All storylines and narratives are related to personal experience whether literally or metaphorically. These experiences are externalized in media by many forms, ranging from the visible and audible. Mainstream media is tied to an entertainment purpose, regardless of themes and topics presented. Therefore, it is important to understand that some of the depictions presented in media are linked to stigma or misrepresentation. This is particularly true for portrayals of mental illness and experiences of trauma. I plan on exploring how media, specifically animation, can communicate subjective experiences of mental illness and trauma. In my exploration I will also speak about the role of abstract and experimental animation in this endeavor. While live action contains an element of reality in contextualizing events or experiences, animation allows one to take full control of the visual representation of a subject and agency over constructing a narrative. Animation is a means of inquiry that exemplifies an art form and a journey of self-discovery. I created a short experimental film reconstructing my subjective experience with childhood sexual trauma. I will embrace visually stimulating abstract animation and stop motion to create an evocative visualization of my personal experience. This means of visual production takes the process of subjective experience a step further and literally becomes a process of laborious and tedious composition, culminating with a personal narrative piece.

A case study approach was followed to determine the changes in the nature and use of affect of a sexually abused girl (age 9) while in psychotherapy. One outpatient was tested twice, one year apart, using the Rorschach Inkblot Method during the twenty-month period of psychotherapy. The two protocol results were compared for changes in the Affect cluster of Rorschach tested variables, according to Exner’s Comprehensive System. The results took into account the age of patient at the time of abuse, being at a preverbal age, and the psychotherapeutic process and content. Some of the results indicated similar dynamics to previous studies at the initial testing. The results further indicated a greater ability of the subject to use affective material; greater coping capacity; a greater awareness of negative internal affective material; and a less avoidant capacity to tolerate emotional content. Some regressive tendencies in the use of affect were explored in this case study. Potential reasons for the regressive tendency were discussed in light of the individual characteristics of the subject, the available research and theory, and the therapeutic content. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2008. / Psychology / unrestricted

Existing research demonstrates that sexual trauma victims experience increased risk of adverse health outcomes including cardiovascular disorders, increased risk of chronic pain, and somatic health complaints. Similarly, sexual trauma is correlated with increased risk of adverse psychological effects including PTSD, depression, and anxiety. Perceived stigmatization as a result of sexual trauma has been hypothesized to be a mechanism through which sexual trauma affects health. Sexual trauma stigma (STS) has been found to mediate the relationship between sexual trauma and psychological distress. The experience of stigmatization has also been linked to somatization and is associated with increased anxiety. Similarly, among a sample of participants with a trauma history, adversity and resultant discrimination predicted somatic health complaints with post-traumatic stress symptoms (PTSS) partially mediating this relationship. However, the experience of STS specifically and its effect on somatic health complaints and anxiety has not yet been examined. As anxiety is associated with somatic symptoms, and is often comorbid with PTSS, it may be a mechanism through which STS effects somatic health complaints. Therefore, the current study seeks to examine the relationship between STS and somatic health complaints as well as the potential mediating effect of anxiety. It was hypothesized that STS would predict somatic health complaints, and that anxiety would mediate this relationship. An international sample of 528 women with a sexual trauma history was recruited via social media (Reddit) and mediation results were found using the “psych” package for RMarkdown (Version 5.2.2) with bootstrapping (5000 samples). Overall, the model was significant R2 = .19, (F(2,1230) = 148.53, p < .01). Regression analyses revealed that sexual trauma stigma was a significant predictor of both anxiety (b = .21, SE = .01, p < .01) and somatic health symptoms (b = .13, SE =.01, p < .01), and that anxiety also predicted somatic symptoms (b = .39, SE = .03, p < .01). Anxiety was found to significantly mediate the relationship between sexual trauma and somatic health symptoms, b = .08, SE = .01, 95% CI [0.06, 0 .11]. Current findings confirm the relationship between sexual trauma stigma and somatic health complaints and identify anxiety as an important mediator of this relationship. Providers should be aware that experiences of sexual victimization are related to feelings of stigmatization and may increase anxiety, impacting somatic health complaints. These findings indicate future clinical implications for trauma informed care within medical settings to better serve women who may experience stigma related to sexual trauma and highlights anxiety as a key target for interventions to reduce somatic symptoms.