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
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Copyright 2007 Macy, Nurius, & Norris
Resources Cont.
Cue, K. L., George, W. H., & Norris, J. (1996). Women’s appraisals of sexual
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Macy, R. J., Nurius, P. S., & Norris, J. (2006). Responding in their best
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