Sexual violence is one of the few public health problems that can also be classified as a crime. Thus, it follows that approaches to prevention should be based in both public health principles as well as effective methods of crime reduction. Public health prevention typically focuses on interventions at levels of the Social-Ecological Model (SEM). The SEM is comprised of concentric circles that represent the individual, relational, community, and policy/environmental levels. Public health prevention goals include developing, implementing, and testing interventions at all levels of this model. For example, public health interventions for sexual violence prevention include approaches such as women’s self-defense training (individual-level) and bystander intervention training (relational). Although some interventions show statistically significant effects in changing knowledge and attitudes about sexual violence, very few show changes in preventing perpetration behavior. Criminologists have developed a crime prevention model, Situational Crime Prevention (SCP), which consists of five broad strategies that are further divided into twenty-five specific tactics. The goals of situational prevention are to deter crime by increasing the effort to perpetrate, increasing risks, reducing rewards, reducing provocations, and removing excuses. SCP has been utilized successfully, but the focus has primarily been prevention of property crimes. Very little attention has been paid to the potential utility of SCP for interpersonal violence, particularly for sexual violence. This dissertation proposes a new conceptual model for comprehensive sexual violence perpetration prevention that synthesizes the situational crime prevention matrix and the social-ecological model.

There is a problem with attitudes that blame the victim of sexual assault: these attitudes are widespread and show popular adhesion to assumptions about rape that have been criticized and combatted by feminists. These assumptions are known as “rape myths.” It is important to look at the role newspapers play in contemporary discourse around rape and the extent to which they reproduce rape myths or, alternatively, incorporate a feminist critique. This research examines how sexual assault is constructed in three English-language newspapers, The Toronto Star, The Globe and Mail, and The National Post in the year 2012. Using qualitative content analysis, themes of rape myths and the presence of feminist discourse are categorized. The power of language when describing rape in the media is recognized and a description of rape-supportive culture, within a feminist theoretical framework, is provided. The ultimate aim of this research is to identify and challenge myths and stereotypes surrounding rape as well as identify possible feminist discourse on rape in print news media in Canada.

Guided by feminist social constructionism, intersectionality and the social construction of disability, this thesis investigates the ways that sexual assault support workers and disability support workers in a medium-sized Ontario city construct women survivors of sexual assault who have a developmental disability, and how their service delivery reflects these constructions. The data were collected through semi-structured interviews with sexual assault support workers and disability support workers. Results suggest that these workers construct their service users in multiple, sometimes conflicting, ways, resisting and reproducing several ableist and sexist social constructions. Furthermore, sexual assault support workers and disability support workers often construct their service users in opposing ways. This reveals a divide between the two types of organizations. Bridging this gap may have the potential to improve services for women survivors of sexual assault who have developmental disabilities.

Sexual assault (SA) is an ongoing concern in the United States (US). With a rate above the national average, SA is especially a concern in the Western state in which this study was conducted. Identifying victim vulnerabilities related to SA is an area of research that is currently limited. In this retrospective study, data on victim vulnerabilities were collected from 4,038 standardized SA forensic medical examination forms. Descriptive statistical analyses were conducted to identify vulnerabilities and Pearson's chi-square tests of association were conducted to explore the relationships between extralegal variables. The extralegal variables represent data not contained within the scope of the law, rather data which pertain to the victim or relationship between victim and suspect. Study findings indicate young women are at highest risk for SA. White women are the largest racial group in the state and, accordingly, had the highest rate of SA. However, some racial minorities, including Native American and African American, were found to potentially be at higher risk per capita. A substantial number of SA victims reported having medical problems, and the number of SA victims who reported having a mental illness was double the per capita rate. Victims are most commonly assaulted by an acquaintance. Consumption of drugs or alcohol by the victim or suspect was found in a significant number of cases. A potential trend was noted with victims reporting being asleep and awakened to assault. These results identify various aspects of vulnerability to SA and support the argument that sexual predators attack vulnerable individuals. More research is needed to further evaluate the various associations found in this study. Increasing our understanding of SA and associated vulnerabilities will improve the effectiveness of outreach to vulnerable populations by means of education, screening, and preventative programs.

Abstract: Sexual assault is a serious matter, the World Health Organization calls the violence against women, a global health problem of epidemic proportions. The nurse has a personal and moral responsibility to address this public health problem in order to try to influence a positive change towards improved health. Aim: This literature review aims to describe nurses´experiences in the care of patients exposed to sexual assault. Results: The results shows that many aspects affect the nurses´ experiences. Many countries struggled, trying to keep up with an adequate care, especially with regard to forensic care, which is very important aiming to also satisfy the justice aspect for the victims. Political, institutional and organizational structures create the conditions that constitute the nurse´s experience. Most nurses did not have sufficient training nor education to perform forensic care even though most did. Many nurses described difficult emotional demands of working with these victims and asked for better support. Interdisciplinary teamwork proved to be important taking into account the holistic perspective. Conclusion: Sustainable improvement work is required to start the work of being able to handle adequate care for patients affected by sexual abuse. Sustainable improvement work that starts from the top with political, institutional and organizational changes which in turn can providea positive healthcare development with the help of the staff's commitment and job satisfaction. / Tvingande sexuella handlingar orsakar fysiskt och psykiskt lidande som kan leda till tidskrävande och svår rehabilitering. I den Nationella trygghetsundersökningen uppger totalt 5,6 procent av de tillfrågade att de utsattes för sexualbrott under 2019 i Sverige. Sexuella övergrepp är ett allvarligt problem och Världshälsoorganisationen kallar det fysiska och sexuella våldet mot kvinnor för ett globalt hälsoproblem av episka mått. Sjuksköterskan har ett personligt och moraliskt ansvar att uppmärksamma folkhälsoproblem och att försöka påverka till positiva förändringar mot en förbättrad hälsa. Litteraturöversikten syftar till att beskriva sjuksköterskors erfarenheter vid omhändertagandet av patienter utsatta för sexuella övergrepp. Resultatet visade att många aspekter påverkade sjuksköterskans erfarenheter. Många olika länder strävade med förbättringar för ett adekvat omhändertagande och särskilt fokus låg på den forensiska vården, vilket är viktigt för att tillgodose rättviseperspektivet för patienterna. Kunskapshöjande utbildning för sjuksköterskor sågs som en viktig del i vården och omvårdnaden av personer utsatta för sexuella övergrepp. Sjuksköterskor ville bland annat lära sig mer om forensisk vård och omvårdnad vilket de tyckte var viktigt, samt hur de bättre kunde hantera omhändertagandet utifrån ett holistiskt perspektiv. Politiska, institutionella och organisatoriska strukturer skapar förutsättningar för sjuksköterskors erfarenheter. De flesta sjuksköterskor hade dock varken någon praktisk övning eller utbildning för att utföra forensisk vård eller omvårdnad, trots att de flesta ändå gjorde det. Många sjuksköterskor beskrev svåra känslomässiga påfrestningar i sitt arbete och önskade bättre stödåtgärder för att motverka stress och utbrändhet. Sjuksköterskor beskrev också en stor oro när det gällde patienternas fysiska och psykiska konsekvenser efter att de lämnat sjukhusen och önskade en förbättrad och mer långsiktig uppföljning för patienterna. Interdisciplinärt samarbete visade sig vara avgörande för att, utifrån ett holistisktperspektiv, kunna ge en god, säker och personcentrerad vård. För att starta upp arbetet med att kunna hantera ett adekvat omhändertagande för patienter drabbade av sexuella övergrepp krävs ett hållbart förbättringsarbete. Ett hållbart förbättringsarbete som startar uppifrån med politiska, institutionella och organisatoriska förändringar som i sin tur kan ge en positiv verksamhetsutveckling med hjälp av sjukvårdspersonalens engagemang och arbetstillfredsställelse.

Posttraumatic Stress Disorder (PTSD) has been primarily conceptualized as a fear-based disorder, but accumulating research indicates that shame can also strongly contribute to the development and maintenance of PTSD. Existing evidence-based treatments for PTSD typically focus on dysregulated fear responding and do not directly target the affective experience of shame. Interventions that promote self-compassion have shown promise for reducing shame related to various clinical problems, but this approach has not been systematically evaluated in traumatized individuals. The aim of this study was to develop and evaluate a brief compassion-based therapy, with the hypothesis that it would reduce trauma-related shame and PTSD symptoms. The intervention consisted of six weekly individual therapy sessions focused on promoting self-compassion in response to a traumatic event and its sequelae. Using a multiple baseline design, the intervention was evaluated in a community sample of trauma-exposed adults (N = 10) with elevated shame and PTSD symptoms. Participants completed assessments on a weekly basis during a 2-, 4-, or 6-week baseline phase and 6-week treatment phase, and at 2- and 4-weeks after the intervention. By the end of treatment, 90% of participants demonstrated reliable decreases in PTSD symptom severity (p < .05), while 80% of participants showed reliable reductions in shame (p < .05), relative to their respective scores at baseline. These improvements were maintained at 2- and 4-week follow-up, with large effect sizes for PTSD symptom severity (d = 2.26) and shame (d = 2.12), compared to scores at baseline. The intervention was also associated with improvements in self-blame (d = 2.61), self-compassion (d = 2.28), mindfulness (d = 2.21), positive affect (d = 1.07), and negative affect (d = 2.14). Greater increases in self-compassion from baseline to follow-up were correlated with greater reductions in PTSD symptom severity (r = -.76, p < .05) and in shame (r = -.79, p < .01). Participants reported high levels of satisfaction with the intervention. The results from the present study support the hypothesis that compassion-based therapy is associated with reductions in trauma-related shame and PTSD symptoms. The marked improvements observed during the relatively brief intervention suggest that the intervention may be useful as either a stand-alone treatment or as a supplement to other treatments.

This study examined the potentially differing emotional consequences of sexual versus non-sexual traumas in both a student and a community residing treatment seeking sample of women. The extent to which a trauma survivor considers the traumatic event central to her identity (CES) was examined as a potential mediator between traumatic events and PTSD. Additionally, the extent to which a women views herself and her body as a sexual object, to be valued based on her appearance and sexual usefulness to others (sexual self-objectification: OBCS), was examined as a potential mediator between traumatic event and event centrality. Study results showed survivors of sexual assault reported greater CES and PTSD symptoms (PCL-S) than non-sexual trauma survivors in the student population. Mediation results showed sexual self-objectification (OBCS-Shame) significantly mediated the relationship between trauma type and CES, and CES significantly mediated the relationship between type of trauma and PTSD symptoms in the student population only. Data from the community sample did not support these conclusions as women from this sample reported higher PCL-S, CES, and OBCS-Shame scores across categories of trauma.

The abuse of a woman’s body had been a normative practice since the recordings of Old Testament narratives. This study is designed to confront the inherent gender bias that contributed to the devaluation and abuse of a female body, especially for women in minority communities. How did such a transgression become acceptable behavior for men, while women are penalized and even harshly judged for being the victim? Once the pattern of abused has been identified, the research will show sexual traumatization detrimentally impacts the overall behavior of the victim, occasionally leading to criminal activities which further exacerbate mental health issues never properly addressed. Women who are violated suffer mentally and emotionally, yet minimal attention is given to a woman to acknowledge and address the impact of the violation. The research consists of a historical autopsy of sexually traumatized women in the biblical narratives, throughout certain periods of slavery and its aftermath and in society in the 21st century. The goal was to determine if common trends are present for women who endured sexual assault. How did they survive, and did they manage to lead a productive life after trauma? It will also examine the failure of society to support victims, by providing a pathway toward healing and wholeness. The research will show that when the biblical narratives are theologically reexamined, the sacred text provides a strategic plan to help any woman recover from any sexual trauma they endured. It will conclude with a vision life workbook to help women begin the difficult work of moving forward after sexual traumatization.

This thesis explores the way we learn to advocate for sexual assault survivors. This multi-methodological, qualitative study examines both popular cultural representations of sexual assault and official training materials provided by rape crisis centers and domestic violence organizations as sites of pedagogical messaging. I argue that it is imperative to incorporate intersectional feminist frameworks into understanding how advocacy is animated in these different sites of learning. This project offers an intersectional feminist analysis of two television shows: Netflix's Unbelievable and HBO's I May Destroy You, in addition to the Texas Association Against Sexual Assault (TAASA) training manual and supplemental training materials from six different rape crisis centers within a 75-mile radius of the Dallas Ft. Worth metroplex. Together, both sets of texts work pedagogically to teach us who is a worthy victim, what counts as "real" rape (and to challenge this very framework), and who deserves organizational resources. This thesis concludes by offering an Intersectional Rape Advocacy Toolkit, aimed at offering a set of values, lessons, and practices necessary for activists to grow in mutual advocacy for survivors and mutual support for fellow activists working to put an end to rape culture.

Forensic analysis of DNA from sexual assault kits is a laborious process. These samples may be a mixture of sperm and male or female epithelial cells (E-cells). Generally, it is the sperm cells that are of greatest forensic value. Since its introduction in 1985 by Gill, Jefferys and Warrett, differential extraction has remained an essential pre-PCR extraction procedure adopted by most forensic laboratories for the preferential lysis of E-cells and isolation of sperm cells/male fraction prior to DNA profiling. The differential extraction procedure operates based on the packaging of DNA in these two types of cells. The E cells are first lysed by sodium dodecyl sulfate (SDS) and Proteinase K which leaves the sperm cells intact. The mixture is centrifuged leaving E-cell DNA in the supernatant and sperm cells in the pellet. After several wash steps to remove residual E cell DNA, the sperm fraction is then subjected to lysis using SDS, proteinase K, and dithiothreitol (DTT). DTT reduces the disulfide bonds present in the sperm nucleus, thereby releasing sperm cell DNA. The traditional Gill method of differential extraction, while proven to be highly effective in providing two separate fractions for a simplified interpretation of profiles, is a labor intensive and time-consuming process, requiring approximately six hours of an analyst’s concentration. In a casework scenario where an evidence sample is of a higher E cell concentration compared to sperm cells, it is inevitable to obtain mixture profiles that becomes more difficult to interpret. To mitigate carryover from the female fraction, the sperm cell fraction is usually subjected to multiple wash steps. Furthermore, the resulting fractions must be subjected to additional pre-PCR DNA purification procedures to remove PCR inhibitors such as SDS and Proteinase K which result in varying degrees on DNA loss. Progress has been made over the years to introduce methods that allow for PCR-ready lysates without additional purification steps, often referred to as direct lysis methods. However, none have been proven to be viable options for use in sexual assault samples. Our laboratory has developed a novel differential extraction procedure that is not only time-efficient and less laborious but also utilizes a direct-lysis procedure requiring no further pre-PCR purification for most samples. The novel procedure uses ZyGEM, which contains the thermophilic EA1 protease proven to effectively digest biological samples and produce PCR-ready lysates suitable for downstream nucleic acid amplification, thereby minimizing DNA loss. The procedure uses a multi-enzymatic approach and utilizes the different optimal activity temperatures of the enzymes to perform most of the process in a DNA extraction lab thermocycler, requiring only a single centrifugation for the usual separation of the E-cell fraction and no subsequent washing steps for the sperm cell fraction. It has the potential to be a rapid, robust procedure that can be easily implemented in any forensic laboratory. This thesis will describe the procedure and report progress in the procedure optimization. / 2019-10-24T00:00:00Z