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

项目总结/摘要 性少数群体女性（SMW）遭受性侵犯（SA）的风险过高， 精神健康后遗症（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性少数群体心理健康差异的主要理论模型（即，少数 压力模型）将这种升高的风险归因于气候水平因素（例如，法律、政策和其他条件， 为少数群体提供风险或保护），各城市和各州的情况各不相同。事实上， 表明气候水平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水平的感知的评估。 气候层面的因素，并没有研究直接测试这些气候层面的因素与法定最低工资的心理 健康后，SA。因此，这项建议旨在测试少数人压强模式与法定最低工资的服务水平的关系 恢复，包括首次直接测试气候层面因素的作用，为新的干预措施提供信息， 政策变革的努力。我们会按地区分层抽取2400名年龄介乎18至35岁的法定最低工资 （对黑人法定最低工资进行过抽样）每6个月完成一次自我报告调查，为期2.5年，并公开使用- 关于法定最低工资和黑人相关政策/法律和社区存在的现有人口水平数据， 描述参与者所在市和州的气候特征。目标1将涉及测试横截面 心理健康的基线差异作为青少年/成人SA史和气候水平的函数 变量由于SA对心理健康的影响在SA后的前6个月最为明显， 及3将集中于在法定最低工资的次样本（约33%），他们在 study.目标2将测试气候层面变量、个人层面法定最低工资少数群体 压力，以及精神健康症状变化率。目标3将应用 一个急需的交叉透镜，这些问题通过测试的关系，反黑气候率 可能被侵犯的黑人法定最低工资。结合这些自我报告和人口水平的数据集 提供了一个前所未有的机会来评估社会政治环境如何 影响健康差距，而差距正在出现。鉴于法定最低工资之间的健康差距持续存在， 在不同程度的因果关系中识别影响因素对公共卫生非常重要，无论是对法定最低工资， 以及其他少数群体。我们将利用我们团队在SMW研究方面的广泛专业知识， 实践和利用SMW咨询来开展本研究。本研究的结果将立即通知临床 采取干预措施，改善这一高度脆弱群体从SA中的恢复，并帮助确定优先事项和理由， 改变公共政策以缩小这种心理健康差距。

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.