【正文】 Merrill et al., 1998。Assessing sexual violence Melissa M. Sisco University of Arizona Overview ? Assessment in general health settings ? Definitions of sexual violence ? Methods of assessment ? Key areas ? Important considerations ? Wrap up ? Question/answer period Assessment in general health settings Pool of sex offenders Offenders seen in medical setting Contact with medical providers Pool of sex offenders Court contact Contact with the court Pool of sex offenders Victims seen in medical setting Contact with medical providers C urt contact Lifetime prevalence rates FEMALE MALE IN GENERAL 15% to 54% (sexual abuse) 3 to 16% (sexual abuse) MILITARY 46 55% (sexual abuse) 42 45% (rape) ??? Bachman, 2020。 Sorenson et al., 1987) The danger from within ? The majority of victims (79%) know their offender well (Harned, 2020) ? The majority of women who are physically abused by an intimate partner are also sexually abused (Tjaden amp。 Finkelhor et al., 1990。 Beebe et al., 1994, Bernhard, 2020。 Thoennes, 2020) – % only spousal sexual abuse – % solely physical assault – % both during the lifetime “Who else would know?” ? 95% of crimes e to the attention of the police through direct citizen report as opposed to police contact (Fisher , Daigle, Cullen, amp。 Fisher et al., 2020。 Cameron et al., 1996。 Turner, 2020) ? 2 out of 3 sexual assaults go unreported to authorities (BJS, 1998) ? 70% of victims report sexual assaults to trusted friends or loved ones (as opposed to 6% who report to police) (Harned, 2020) Studies documenting the benefit of general assessment. ? Though no parative studies were found regarding sexual violence… ? In a pediatric setting, when a physician began actively asking all parents to fill out a questionnaire regarding child abuse, reports increased 1500% in just 1 year (Sisk, 2020) Defining sexual violence “What is sexual violence?” ? Reprehensible Joking, harassing, lying to or pressuring a person into engaging in sexual forum or behaviors after the person expressed objection ? Prosecutable Any sexually motivated act that involve a person who is unwilling or unable to consent due to intoxication, covert drugging, state of awareness, age/maturity or physical force Levels of sexual violence ? There are many dimensions to consider: – Level of contact – Relation to the victim – Prior history of criminal activity – Legal offense description – Strategy of offense – Motives – Comorbidity with other disorders ? Think about how these would infer different treatment implications Sexual violence and mental health ? Possible connections between sexual violence and mental illness: (1) a disorder may decrease the person’s ability to decipher social cues (. autism) (2) sexual violence may be a marker for a disorder (. antisocial personality disorder) (3) a disorder can drive the offensive behavior (. delusional states) (Chesire, 2020) Methods of assessment Assessment purposes ? Ensuring current victim, providers, and offender safety ? Detecting acts of sexual violence ? Judging the likelihood of reoffense ? Exploring treatment effectiveness 4 assessment tools ? Selfreport questionnaires ? Guided clinical interviews ? Unstructured clinical interviews ? Physiological response tests *Note: The assessments that will be discussed focus on evaluation of offenders. Selfreport questionnaires ? Description: Paper or puter based questions that ask for selfreport on personal behavior or attitudes. ? Sample item: Please indicate your stance on a scale of 1 (disagree strongly) to 5 (agree strongly)… “A woman in a short skirt is asking for it” (Burt, 1980) ? Benefits: The same for all, costeffective, quick, can be scientifically validated and ‘normed’. ? Drawbacks: Educational/reading level required, ‘lying’, only selfreport (no family/friends feelings about the