Sexual Assault Recovery Among Sexual Minority Women: A Longitudinal, Multi-Level Study

性少数女性的性侵犯康复：一项纵向、多层次的研究

基本信息

批准号：
10658333
负责人：
Emily Raphael Dworkin
金额：
$ 82.82万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-09 至 2027-11-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10658333
关键词：
Address Adolescent Adult Advocacy Affect Age Anxiety Attention Bisexual Black race Censuses Characteristics Climate Clinical Communities Data Data Set Disclosure Discrimination Disease Disparity Environment Etiology Exhibits Exposure to Forcible intercourse Frequencies Gender Identity Geography Heterosexuals High Risk Woman Impairment Individual Inequity Intervention Latinx Laws Lesbian Lesbian Gay Bisexual Transgender Queer Location Mediating Mental Depression Mental Health Minority Groups Modeling Municipalities Participant Patient Self-Report Penetration Perception Policies Politics Population Population Density Post-Traumatic Stress Disorders Prevalence Process Public Health Public Policy Race Reaction Recording of previous events Recovery Research Risk Role Sampling Services Sex Orientation Social Identification Stigmatization Surveys Survivors Symptoms Testing Theoretical model Time Trauma Vulnerable Populations Woman Work aged assault cisgender critical period demographics ethnic identity experience gender diversity health disparity help-seeking behavior high risk homonegativity improved innovation lens marginalized population mental development minority health disparity minority stress multilevel analysis novel prevent prospective prospective test racial identity racial minority racism recruit sexual assault sexual minority sexual minority women social determinants social stigma substance use

项目摘要

Project Summary/Abstract Sexual minority women (SMW) experience disproportionately high risk of sexual assault (SA) and resulting mental health sequelae (e.g., depression, PTSD), and these sequelae appear to be especially pronounced among Black SMW. The main theoretical model of sexual minority mental health disparities (i.e., the minority stress model) attributes this elevated risk to climate-level factors (e.g., laws, policies, and other conditions that afford risk or protection to minoritized groups) that vary across municipalities and states. Indeed, evidence suggests that climate-level factors are associated with risk for PTSD and other disorders in sexual minorities. However, nearly all studies to date have relied exclusively on assessments of individual-level perceptions of climate-level factors, and no studies have directly tested these climate-level factors in relation to SMW’s mental health following SA. This proposal therefore aims to test the minority stress model in relation to SMW’s SA recovery, including the first-ever direct test of the role of climate-level factors, to inform novel interventions and policy change efforts. We will recruit a geographically-stratified sample of 2400 SMW aged 18-35 (oversampling Black SMW) to complete self-report surveys every 6 months for 2.5 years, and use publicly- available population-level data on SMW and Black-relevant policies/laws and community presence to characterize the climates of participants’ municipalities and states. Aim 1 will involve testing cross-sectional baseline differences in mental health as a function of history of adolescent/adult SA and climate-level variables. Because the mental health effects of SA are most evident in the first 6 months following SA, Aims 2 & 3 will focus on the subsample of SMW (approximately 33%) who experience a prospective SA during the study. Aim 2 will test mediated relationships between climate-level variables, individual-level SMW minority stress, and rates of mental health symptom change in prospectively-assaulted SMW. Aim 3 will apply a critically-needed intersectional lens to these questions by testing the relationship of anti-Black climates to rates of recovery in prospectively-assaulted Black SMW. Combining these self-report and population-level datasets over multiple years provides an unprecedented opportunity to evaluate how sociopolitical environments influence health disparities while the disparities are emerging. Given persistent health disparities among SMW, identifying contributing factors across varying levels of causation is important for public health, both for SMW, and also for other minoritized groups. We will draw upon our team’s extensive expertise in SMW research and practice and utilize SMW advisory to carry out this study. Results of this study will immediately inform clinical interventions to improve recovery from SA among this highly vulnerable group and help to prioritize and justify public policy changes to reduce this mental health disparity.

项目概要/摘要性少数女性 (SMW) 遭受性侵犯 (SA) 的风险极高，并由此导致心理健康后遗症（例如抑郁症、创伤后应激障碍），这些后遗症似乎特别明显黑人 SMW 中性少数群体心理健康差异的主要理论模型（即少数群体）压力模型）将这种升高的风险归因于气候层面的因素（例如法律、政策和其他条件）为少数群体提供风险或保护），这在各个城市和州之间确实有所不同。表明气候因素与性少数群体患创伤后应激障碍和其他疾病的风险有关。然而，迄今为止几乎所有的研究都完全依赖于对个人层面的认知评估。气候层面的因素，并且没有研究直接测试这些气候层面的因素与 SMW 心理的关系。因此，本提案旨在测试与 SMW 的 SA 相关的少数群体压力模型。恢复，包括首次直接测试气候因素的作用，为新的干预措施和我们将招募 2400 名年龄在 18 岁至 35 岁之间的 SMW 样本。（对 Black SMW 进行过采样）每 6 个月完成一次自我报告调查，持续 2.5 年，并公开使用有关法定最低工资和黑人相关政策/法律以及社区存在的可用人口数据，目标 1 将涉及测试横截面心理健康基线差异作为青少年/成人 SA 历史和气候水平的函数由于 SA 对心理健康的影响在 SA 后的前 6 个月内最为明显，因此目标 2。 & 3 将重点关注在 SMW 期间经历过潜在 SA 的 SMW 子样本（约 33%）研究目标 2 将测试气候层面变量、个人层面 SMW 少数群体之间的中介关系。目标 3 将适用于预期受到攻击的 SMW 的压力和心理健康症状变化率。通过测试反黑人气候与比率的关系来解决这些问题急需的交叉镜头结合这些自我报告和人口级别的数据集，了解遭受前瞻性攻击的黑人 SMW 的恢复情况。多年来的研究提供了前所未有的机会来评估社会政治环境如何鉴于 SMW 之间持续存在的健康差异，确定不同程度因果关系的影响因素对于公共健康非常重要，对于 SMW、我们还将利用我们团队在 SMW 研究和方面的丰富专业知识。实践并利用 SMW 咨询来开展这项研究。这项研究的结果将立即告知临床。采取干预措施，改善这一高度弱势群体的 SA 恢复情况，并帮助确定优先顺序和合理性改变公共政策以减少这种心理健康差异。