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Although specialized sexual assault services have been established throughout the world to better meet survivors' needs, many survivors remain underserved. Survivors who are simultaneously experiencing additional adversities (e.g. survivors with mental illness and/or substance abuse) appear particularly underserved by formal support systems. The present study therefore set out to explore the formal help-seeking experiences and needs of survivors facing various adversities apart from the sexual assault. Interviews were conducted with five survivors seeking formal support for sexual assault in Denmark. Interviews were analyzed using Interpretive Phenomenological Analysis. Five themes are presented: 1) "Sexual Assault as Lived Experience," 2) "Survivors' Needs," 3) "Accessing Sexual Assault Services," 4) "SAC-Therapy," and 5) "The Criminal Justice System." Theme 1 made evident that the experience of sexual assault and its aftermath is deeply personal and contextual. Themes 2–5 demonstrate how such personal and contextual aspects impact service utilization and needs. Implications and recommendations are provided. Above all, meeting survivors' needs will require a more person-centered approach that acknowledges the unique context of survivors' sexual assault experiences. [ABSTRACT FROM AUTHOR]

Although research indicates that specialized sexual assault (SA) services are effective in terms of promoting postassault recovery and improving legal outcomes, little is known about how to best support survivors facing co-occurring difficulties and inequalities (e.g., preexisting mental health issues, substance abuse, poverty). This deficiency in knowledge was also expressed by service providers at Danish SA centers (SACs), who described this using the term "vulnerable survivors." Therefore, the present study aims to address this knowledge gap by exploring (a) how service providers understand vulnerability in the context of SA and (b) how service provision is currently approached for these survivors. Interviews were conducted with 18 service providers representing five professional groups (psychologists, social workers, forensic doctors, nurses, police) and analyzed using Interpretative Phenomenological Analysis. A total of eight themes emerged from the analysis, including service providers' descriptions of what characterizes vulnerability in survivors and broader perspectives on service provision for these survivors. Survivors considered least likely to attain desired supports were also those perceived to be most vulnerable with regards to risk and experiences surrounding sexual victimization (e.g., individuals with preexisting mental health issues). Service providers also believed that a large proportion of those served experience ongoing vulnerabilities that are difficult to manage within existing support models. The results thus suggest that survivors' needs cannot be met if vulnerabilities are overlooked or ignored. At the same time, the concept of vulnerability warrants caution since vulnerabilities are often placed within individual survivors, but the formal support system also appears vulnerable in its ability to meet the diverse needs and priorities of those served. The implications for SA services across the globe are discussed, including a need for more individually tailored and trauma-informed responses to SA that simultaneously address co-occurring difficulties and inequalities in survivors. [ABSTRACT FROM AUTHOR]

According to police records, many rape cases are closed because victims withdraw from the police investigation. However, little is known about the causes of victim withdrawal, and findings need to be replicated in other cultural contexts, as existing literature primarily stems from the US and UK. Based on a sample of rapes reported in a Danish police district, the present study was aimed at enhancing our understanding of the characteristics and causes of recorded victim withdrawal from the police investigation following rape using a mixed-methods approach. The objective of the study was twofold. The first objective was to investigate the impact of selected case characteristics on the likelihood of recorded victim withdrawal using a logistic regression analysis. Results showed that stranger assaults and cases with no verbal or physical victim resistance or no forensic examination were significantly associated with an increased likelihood of recorded victim withdrawal. The second objective was to qualitatively explore police documented reasons for victim withdrawal in files using content analysis. Results indicated that victims may withdraw from the investigation for several reasons, for instance due to psychological distress associated with participating in an investigation. The findings underline potential barriers for the cooperation between victims and police in the investigation of rapes and should be used for establishing initiatives toward reducing the risk of victim withdrawal in rape investigations. [ABSTRACT FROM AUTHOR]

Background: Despite knowledge about the extensive and often long-lasting consequences of sexual assault, many survivors remain underserved by formal support systems (e.g. medical, mental health and criminal justice systems). Reasons for underutilizing services are as diverse as the survivors themselves, and little is known about which survivors are most underserved and why they are underserved. Objective: To help organize existing findings on this topic, a systematic scoping review was conducted to identify adult survivors of sexual assault, who may be particularly underserved when attempting to obtain services in Western countries. Method: Five databases (PsycINFO, Embase, MEDLINE, Scopus and CINAHL) were systematically searched for studies published in English from 2000 onwards using terms such as 'sexual assault', 'help seeking', 'formal support', 'barriers' and variations thereof. Results: A total of 41 studies were included in the present scoping review, resulting in seven main categories of underserved survivors: Ethnic and cultural minorities, Disabilities, Financial vulnerability, Sexual and gender minorities, Mental health conditions, Problematic substance use, and Older age. Barriers encountered by survivors with these characteristics included limited access to formal supports and insufficient training and awareness among service providers about how to best support survivors. Conclusions: Recommendations include the need for more survivor-centred, culturally appropriate and trauma-informed services and more attention to survivors belonging to underserved groups in policy, practice and research. • We found: Survivors of sexual assault from historically marginalized groups face numerous barriers to service utilization. • This means: A more survivor-centered, culturally appropriate and trauma-informed approach to sexual assault service delivery is needed. [ABSTRACT FROM AUTHOR]

This study examined level of acute psychological distress and perceived social support in 64 victims of rape and the association with police case decisions and victims’ willingness to participate in the investigation. The results of independent-sample t tests revealed that victims’ unwillingness to participate in the investigation was significantly associated with a higher level of psychological distress in the acute phase following the assault. The results suggest that victims of rape who disengage with the police investigation may do so because of a high level of acute psychological distress. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

In a sample of female victims of sexual assault (n = 122) this study examined the possibility of a positive or negative change in outlook on life 3 and 12 months following the assault and associations to posttraumatic stress disorder (PTSD). The majority of women reported a negative change or no change in outlook on life following the sexual assault. The group of women who reported a negative outlook on life 3 months following the sexual assault had a significant higher level of PTSD severity 12 months following the assault. More research is needed to enhance our understanding of the causal relationship between life changes and psychological distress following sexual assaults. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is a major public health concern. eHealth interventions may reduce exposure to violence and health-related consequences as the technology provides a safe and flexible space for the target population. However, the evidence is unclear.Objective: The goal of the review is to examine the effect of eHealth interventions compared with standard care on reducing IPV, depression, and posttraumatic stress disorder (PTSD) among women exposed to IPV.Methods: We searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, PsycInfo, Scopus, Global Health Library, ClinicalTrials.gov, and International Clinical Trials Registry Platform for published and unpublished trials from inception until April 2019. Trials with an eHealth intervention targeting women exposed to violence were included. We assessed risk of bias using the Cochrane Risk of Bias Tool. Trials that reported effect estimates on overall IPV; physical, sexual, and psychological violence; depression; or posttraumatic stress disorder were included in meta-analyses.Results: A total of 14 trials were included in the review; 8 published trials, 3 unpublished trials and 3 ongoing trials. Of the 8 published trials, 2 were judged as overall low risk of bias trials. The trials reported 23 types of outcomes, and 7 of the trials had outcomes that were eligible for meta-analyses. Our pooled analyses found no effect of eHealth interventions on any of our prespecified outcomes: overall IPV (SMD -0.01; 95% CI -0.11 to 0.08; I2=0%; 5 trials, 1668 women); physical violence (SMD 0.01; 95% CI -0.22 to 0.24; I2=58%; 4 trials, 1128 women); psychological violence (SMD 0.07; 95% CI -0.12 to 0.25; I2=40%; 4 trials, 1129 women); sexual violence (MD 0.36; 95% CI -0.18 to 0.91; I2=0%; 2 trials, 1029 women); depression (SMD -0.13; 95% CI -0.37 to 0.11; I2=78%; 5 trials, 1600 women); and PTSD (MD -0.11; 95% CI -1.04 to 0.82; I2=0%; 5 trials, 1267 women).Conclusions: There is no evidence from randomized trials of a beneficial effect of eHealth interventions on IPV. More high-quality trials are needed, and we recommend harmonizing outcome reporting in IPV trials by establishing core outcome sets.Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019130124; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130124. [ABSTRACT FROM AUTHOR]