Latent Profiles Among Sexual Assault Survivors
Transcription
Latent Profiles Among Sexual Assault Survivors
Latent Profiles Among Sexual Assault Survivors: Understanding Survivors and Their Assault Experiences Rebecca Macy, Paula Nurius, Jeanette Norris Prepared by Adrienne Rooks UNC School of Social Work 2008 Copyright 2007 Macy, Nurius, & Norris Introduction This presentation is based on a study using a sample of 415 college women to determine multivariate profiles of contextual factors among sexually assaulted women Recommendations for tailored interventions are provided Copyright 2007 Macy, Nurius, & Norris Research on Interventions to Prevent Sexual Aggression Research suggests gender-specific interventions (Rozee & Koss, 2001; Ullman, 2002) Women: resistance preparation Men: primary prevention Research shows women may benefit from targeted risk management interventions (Abbey, Zawacki, Buck, Clinton, & McAuslan, 2001) Copyright 2007 Macy, Nurius, & Norris Research on Interventions to Prevent Sexual Aggression Cont. However, little research exists on how to tailor programs Effective tailoring requires Knowledge of which assault incidence correlates should be targeted E.g., alcohol use and victimization history Cumulative effects of factors foster differing degrees of vulnerability Copyright 2007 Macy, Nurius, & Norris Previous Research on Important Contextualizing Factors Factors with proven links to acquaintance sexual assault (Macy, Nurius, and Norris, 2006) 1. 2. 3. 4. Victimization history Alcohol consumption Relationship expectations of perpetrating male Sexual assertiveness Copyright 2007 Macy, Nurius, & Norris Study Purpose “To test for distinct multivariate profiles of contextual factors among sexually assaulted women to discern how relevant contextual factors may combine differentially for groups of women” Copyright 2007 Macy, Nurius, & Norris Current Study Contextual Factors Victimization history (Gidycz, Hanson, & Layman, 1995) Alcohol use (Testa & Parks, 1996) Positive relationship expectancies about assailant prior to assault (Amick & Calhoun, 1987; Nurius & Norris, 1996) Precautionary habits (Hickman & Muehlenhard, 1997) Copyright 2007 Macy, Nurius, & Norris Victimization History Victims of sexual assault are at increased risk for repeat assaults (Breitenbecher, 2001; Gidycz et al., 1995) Possible contributing factors Inadequate response to risk cues Lack of assertion skills Low perceived self-efficacy to resist High level of substance use (Marx, Calhoun, Wilson, & Meyerson, 2001; Yeater & O’Donohue, 1999) Copyright 2007 Macy, Nurius, & Norris Alcohol Consumption Limits women’s perceptual awareness Limits women’s ability to assertively respond (Abbey et al., 2001) May be used by assailant to weaken women’s defenses Copyright 2007 Macy, Nurius, & Norris Positive Relationship Expectancies About Assailant Requires cognitive shift from social attitude to safety May result in self-doubt and internal conflict – limiting women’s resistance (Nurius, 2000; Ullman & Siegel, 1993) Copyright 2007 Macy, Nurius, & Norris Precautionary Habits Definition: Habits used to gain or exercise control in a potential sexually aggressive situation Can serve as protective factors Women who believe they can influence a threatening situation may respond more assertively Copyright 2007 Macy, Nurius, & Norris Latent Profile Analysis (LPA) Identifies specific risk and protective factors based on the contextual factors that likely influence the type of assault and how the woman will respond (Bogat et al., 2005; Mitchell & Plunkett, 2000) Established 4 significantly distinct subgroups 1. 2. 3. 4. Victimization-Relationship Relationship-Precautionary Alcohol-Low Else Alcohol-Victimization Copyright 2007 Macy, Nurius, & Norris Analyses Other related variables assessed: Childhood abuse (Wyatt, Guthrie, & Notgrass, 1992) Assailant intoxication (Abbey et al., 2001) Intimacy orientation characterizing victims’ social goals at that time (Sanderson & Cantor, 1995) Participation in assault trainings (Thompson, 1991) Assailant behaviors Coercive tactics (verbal, substance use, force) Types of sexually aggressive behaviors used against women Copyright 2007 Macy, Nurius, & Norris Participants 415 women who had experienced sexual assault Inclusion criteria >18 yrs old >16 yrs when sexually assaulted < 5 year lapse between assault and study participation Copyright 2007 Macy, Nurius, & Norris Participants Characteristics Characteristic Participants (N =417) Mean Age 21.7 (SD=3.82) Ethnicity White Asian/or Pacific Islander African American Latina Native American Other 79% 8% 5% 2% 1% 5% Grade Level Undergraduate* Postbaccalaureate 86% 14% *sample evenly distributed over the 4 undergraduate class levels Copyright 2007 Macy, Nurius, & Norris Study Definition Sexual assault: Included “rape, attempted rape, and physically coercive acts directed toward obtaining nonconsensual sexual intercourse by a nonrelative male acquaintance who was neither her husband nor a partner with whom she was living” Copyright 2007 Macy, Nurius, & Norris Recruitment Recruited from 2 colleges in the same urban northwest area Invitation letters sent to random sample of registered female students Notices placed in dorms, sororities, campus bulletin boards, and campus newspapers Copyright 2007 Macy, Nurius, & Norris Methods Participants were given a self-report questionnaire and asked to recall the most severe incident within study criteria Included priming questions and a written narrative to activate the memory Copyright 2007 Macy, Nurius, & Norris Measures: Contextualizing Factors Prior victimization Used modified version of Sexual Experiences Survey to measured sexual assault experiences prior to the most sever assault (Koss & Gidycz, 1985) Violent victimization measurement included number of incidents Alcohol consumption Measured by asking “Approximately how many drinks did you drink before the incident occurred” Copyright 2007 Macy, Nurius, & Norris Measures: Contextualizing Factors Cont. Positive relationship expectations Mean-based scale to measure the degree the participant perceived relationship with assailant as positive prior to assault E.g. to what extent did she like, trust assailant prior to assault Precautionary habits Scale measured degree to which participant engaged in behaviors, prior to assault, to protect herself from assault E.g., “tried to leave if a guy came on too strong” “avoided guys who invaded my personal space” Copyright 2007 Macy, Nurius, & Norris Group Difference Variables Childhood Abuse History Measured using yes/no response item for childhood experiences of 1. 2. Sexual abuse Physical punishment or caregiver force that caused injury Yes response to either item classified as child abuse Copyright 2007 Macy, Nurius, & Norris Group Difference Variables Cont. Assailant intoxication Asked whether assailant intoxicated at time of assault (yes/no) Degree of intoxication measured on 0-4 Likerttype scale. Intimacy orientation Three items from Social Goals Scale (Sanderson & Cantor, 1995) Measured current life-task orientation toward forming intimate relationships E.g., “I tried to date men with whom I might fall in love” Copyright 2007 Macy, Nurius, & Norris Group Difference Variables Cont. Assault training Number of assault awareness activities and trainings they participated in prior to assault Assailant assault acts 11 measures summed to create two indices Fondling-groping assault acts Penetrative assault acts Copyright 2007 Macy, Nurius, & Norris Group Difference Variables Cont. Assault coercion 10 measures summed to create 3 indices: Verbal coercion (e.g., “threats to end relationship”) Substance coercion (e.g., “use of alcohol or use of drugs to make me more vulnerable”) Forceful coercion (e.g., “use of violence or use of physical force”) Copyright 2007 Macy, Nurius, & Norris Analysis Mplus 3.0 used to perform LPA (Muthen & Muthen, 2004) Optimal number of groups identified using the substantive meaningfulness of the models and three-model fit statistics Bayesian Information Criterion (BIC) Lo-Mendell-Rubin (L-M-R) test statistic Probability statistics (Everitt et al., 2001; Muthen, 2002) Copyright 2007 Macy, Nurius, & Norris Fit Statistics for Latent Profile Models One class model Four class model BIC: 5666.82 BIC:5388.44 L-M-R: 96.86* Two class model BIC: 5551.49 L-M-R: 140.92*** Three class model Five class model BIC: 5389.55 L-M-R: 57.78 BIC: 5526.54 L-M-R: 53.33** ***p<.001, ** p<.01, * p<.05 Copyright 2007 Macy, Nurius, & Norris Latent Profile Indicator Contextual Factor Means and Standard Deviations by Groups VictimizationRelationship (n=37) Relationship-Protective (n=217) Mean SD Mean SD Alcohol use 1.12 1.56 .39 .76 Victimization 49.12 10.59 13.05 9.17 Precautionary habits 2.68 .55 3.04 .72 Relationship expectancies 2.96 1.01 3.02 .94 Contextual Factors Copyright 2007 Macy, Nurius, & Norris Latent Profile Indicator Contextual Factor Means and Standard Deviations by Groups Cont. Alcohol-Low Else (n=122) Alcohol Victimization (n=39) Mean SD Mean SD Alcohol use 5.10 1.27 9.55 1.60 Victimization 12.88 9.57 21.07 13.61 Precautionary habits 2.76 .64 2.68 .51 Relationship expectancies 2.65 0.94 2.29 1.06 Contextual Factors Copyright 2007 Macy, Nurius, & Norris Profile Group Difference Analyses Differences among groups measured using one-way ANOVA and chisquare tests Differences across profile groups on variables related to contextual factors Differences on perpetrators’ forms of coercion and assault behavior Copyright 2007 Macy, Nurius, & Norris Percentages Among Profile Groups for Group Difference Variables Sample (n=415) Victimization Relationship (n=37) RelationshipPrecautionary (n=217) Child abuse sexual and/or physical 40.0% 67.6% 37.8% Assailants consuming alcohol 60.0% 51.4% 39.6% Measures Copyright 2007 Macy, Nurius, & Norris Percentages Among Profile Groups for Group Difference Variables Alcohol-Low AlcoholElse Victimization (n=122) (n=39) Statistical Analysis X2(3) Child abuse sexual and/or physical 36.1% 38.5% 12.83** Assailants consuming alcohol 96.7% 100.0% 132.14*** Measures **p<.01, ***p<.001 Copyright 2007 Macy, Nurius, & Norris Means and Differences Tests Among Profile Groups for Group Difference Variables Measures Sample (n=415) Victimization Relationship (n=37) Mean SD Mean SD Assailant intoxication 1.63 1.67 1.24 1.61 Intimacy goal orientation 2.26 .98 2.50 .97 1.05 .89 1.08 Assault 1.20 training participation Copyright 2007 Macy, Nurius, & Norris Means and Differences Tests Among Profile Groups for Group Difference Variables Cont. Measures RelationshipPrecautionary (n=217) Alcohol-Low Else (n=122) Mean SD Mean SD Assailant intoxication .89 1.41 2.67 1.39 Intimacy goal orientation 2.36 .94 2.04 1.00 1.02 1.30 1.03 Assault 1.18 training participation Copyright 2007 Macy, Nurius, & Norris Means and Differences Tests Among Profile Groups for Group Difference Variables Cont. Measures Alcohol Victimization (n=39) Statistical Analysis Mean SD F Test (3.415) Assailant intoxication 2.00 1.47 51.63** Intimacy goal orientation 2.20 1.01 3.64* Assault training participation 1.31 1.15 1.60 *p<.05, **p<.001 Copyright 2007 Macy, Nurius, & Norris Coercion and Assault Means, Standard Deviations, and ANOVA Results Among Profile Groups Victimization Relationship (n=37) Coercion and assault Mean RelationshipPrecautionary (n=217) SD Mean SD Verbal Coercion 1.41 .76 1.18 .84 Forceful coercion 1.32 .78 1.14 .36 Substance coercion .27 .61 .13 .98 Fondlegrope assault 3.22 1.47 2.67 1.49 .89 1.06 .94 Penetrative 1.38 assault Copyright 2007 Macy, Nurius, & Norris Coercion and Assault Means, Standard Deviations, and ANOVA Results Among Profile Groups Alcohol-Low Else Alcohol Victimization (n=122) (n=39) Coercion and assault Mean SD Mean SD F Test (3.415) Verbal Coercion 1.18 .72 1.03 .74 1.50 Forceful coercion 1.01 .87 .74 .91 3.09* Substance coercion .64 .61 .64 .54 33.93*** Fondlegrope assault 2.54 1.64 2.90 1.62 2.05 .87 1.23 .87 1.58 Penetrative 1.09 assault *p<.05, **p<.01, ***p<.001 Copyright 2007 Macy, Nurius, & Norris Discussion Current study found distinct multivariate vulnerability profiles among women with history of sexual assault LPA found 4 significantly distinct subgroups of women Findings show how contextual factors can combine to effect women’s vulnerability to assault and capacity to resist Copyright 2007 Macy, Nurius, & Norris Discussion: VictimizationRelationship Characterized by Higher adolescent sexual victimization Lower alcohol consumption and precautionary habits Relatively positive relationship expectancies Contrasts the frequently made association between victimization histories and higher levels of substance use (Logan, Walker, Cole, & Leukefeld, 2002) Copyright 2007 Macy, Nurius, & Norris Discussion: VictimizationRelationship Cont. These women are at risk for being targeted by sexually aggressive men who abuse emotional needs and intimate relationships History of repeated sexual trauma findings: Higher probability of relationships with coercive men and effect of repeated trauma decreases mental health, self-efficacy, and ability to recognize and respond to danger (Gold, Sinclair, Balge, 1999; Logan et al., 2002) Training and support needs of these women differ from women with less relationship investment, but higher alcohol intake Copyright 2007 Macy, Nurius, & Norris Discussion: Alcohol-Victimization Most assailants consumed alcohol prior to assault Reported high levels of substance coercion on part of assailants Higher drinking patterns Higher numbers of drinks Lower priority on developing intimate relationships High level of alcohol consumption mixed with proximal victimization exposure Copyright 2007 Macy, Nurius, & Norris Discussion: Alcohol-Victimization Cont. Lowest levels of verbal and forceful coercion mixed with more severe levels of assault act Alcohol impairment likely causes less resistance to their assailant Consistent with prior research – alcohol and prior victimization increase women’s vulnerability to sexual assault (Miller, Downs, & Testa, 1993) At greater risk for self-blame and psychological distress Copyright 2007 Macy, Nurius, & Norris Discussion: Alcohol-Low Else Reported high alcohol use prior to assault Level of impairment and severity of assault slightly lower than alcoholvictimization group Many women do not view alcohol as a risk applying to them (Cue, George, & Norris, 1996) Copyright 2007 Macy, Nurius, & Norris Recommendations for AlcoholVictimization and Alcohol-Low Else Groups Target women consuming high quantities of alcohol with tailored interventions (Combs-Lane & Smith, 2002) Include situational alcohol consumption with other contextualizing factors (e.g., prior victimization) Harm reduction strategies paired with sexual assault avoidance and resistance training (Marlatt & Witkiewitz, 2002) Copyright 2007 Macy, Nurius, & Norris Discussion: RelationshipPrecautionary Higher precautionary behaviors imply greater awareness of sexual aggression and avoidance strategies Findings suggests strategies could be improved through training Emphasis on relational factors suggest interventions should acknowledge their importance (Amaro, 1995) Copyright 2007 Macy, Nurius, & Norris Discussion: RelationshipPrecautionary Assault avoidance involves conflicts between safety and relational priorities (Nurius, 2000) Particularly relevant for adolescents because of the developmental importance of intimate relationships (Sanderson & Cantor, 1995) Copyright 2007 Macy, Nurius, & Norris Interventions Recommendations Prevention interventions should focus on developing self-regulatory skills E.g., skills to assess, acknowledge, and act in self-protection within intimate relationships (Rozee & Koss, 2001) These skills could be useful for all women Targeted trainings for women with increased risk or protection to address resistance challenges and reinforce resistance skills Copyright 2007 Macy, Nurius, & Norris Study Limitations Self-reported experiences during assault Sample self-selected by women who contacted researchers Sample may not be representative of college women Unknown whether results are generalizable across ethnic, racial, economic, cultural, and community groups Additional research with diverse sample is needed Copyright 2007 Macy, Nurius, & Norris Suggestions for Future Research Additional research needed Life course revictimization vulnerability Effects of the combinations of childhood and adolescent victimizations Comprehensive measure of childhood violence Person-centered research to examine risk and protection factors Copyright 2007 Macy, Nurius, & Norris Resources Abbey, A., Zawacki, T., Buck, P. 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