Sexual Assault Awareness Month is...an annual campaign ...coordinated by the NSVRC with assistance from ...state, territory, tribal and community-based organizations, rape crisis centers, government agencies, businesses, campuses and individuals ... throughout the United States... to educate communities and individuals [by] events and activities highlighting sexual violence as a public health, human rights and social justice issue, and the need for prevention efforts.Research reportage and discussion within the community of healthcare professionals lends the public a working perspective for increased medical and public health literacy that news media and patient education materials often can't supply. The following citations sample free-access professional materials relating to origins, effects and prevention of sexual assault, gender-based violence, and bullying. A separate diary is planned to sample articles on child abuse. Some articles applying to both topics may be in both diaries. Most of the articles are linked via Medscape, a free fairly-plain-English email-alert and website medical journal reporting service. For an introduction to free-use registration, see the blockquote at this brief item.
Blockquotes with article links are exerpts to give an idea of the viewpoint and approach of research and reportage. Articles listed roughly in the order they were found; they're numbered for the convenience of readers, without any other significance. Where reader comments at Medscape articles are recorded, they can be surprisingly informative about attitudes and knowledgeability of commenters.
1. ▼ Gender-Based Violence: Globally Widespread, Vastly Underreported, Reuters Health Information, Jan 2014 • Tip of the Iceberg: Reporting and Gender-Based Violence in Developing Countries, American Journal of Epidemiology, Sept 2013. Tia Palermo, Jennifer Bleck and Amber Peterman, Program in Public Health/Department of Preventive Medicine, Stony Brook University • Violence Against Women 'Epidemic,' Says WHO Global Report, Medscape Medical News, June 2013 •
Nearly a third of women throughout the world...age 15 and older... are victims of [intimate partner violence (IPV)]... [and when] violence perpetrated by nonpartners is [factored in it comes to]...about 35%... The results of the meta-analysis, [a joint venture of the World Health Organization, the London School of Hygiene and Tropical Medicine, and the South African Medical Research Council] that synthesized data from ...141 studies carried out in 81 countries... [are] included in a new World Health Organization report (AAAS Science Global Policy Forum abstract) coupled with guidelines for prevention of both partner and nonpartner violence. The report calls violence against women "a global health problem of epidemic proportions" and emphasizes that all healthcare workers, regardless of setting, need to be trained to recognize and appropriately respond to women at risk...2. ▼ Proactive Aggression in Callous-Unemotional Youth May Reflect Lack of Empathy, Reuters Health Information, Apr 2014.
[Palermo, Bleck and Peterman]...call for policy initiatives to bring perpetrators to justice; to ensure that [gender-based-violence (GBV)], including within marriage, is a prosecutable crime; to reduce the stigma of GBV; and to subsidize GBV-related health costs.
Dr. Bontha V. Babu, [Health Services Research Division, Indian Council of Medical Research, New Delhi, India], told Reuters Health by email that studies have confirmed a high prevalence of GBV across all societies. "Public health can have a role in preventing GBV and its health consequences, and primary healthcare...should institutionalize the routine screening and treatment for violence related injuries and trauma."
In an editorial, Hind A. Beydoun of Eastern Virginia Medical School in Norfolk and May A. Beydoun of the National Institute on Aging in Baltimore, Maryland, wrote, "Disclosure of GBV is a necessary first step toward reducing health risks associated with this phenomenon. Primary and secondary prevention efforts should continue to target GBV, and creative ways of addressing GBV nondisclosure should take into account regional variations and personal characteristics of affected women."
Dr. Lignet Chepuka, instructor at Kamuzu College of Nursing of the University of Malawi in Zomba, said in an email, "...informal sources were in many cases the first point of contact... Yet many people who revealed IPV to informal sources were discouraged from seeking further help. We need more work in prevention and we need to focus on how informal sources can best work effectively with formal sources so that survivors are better served. It requires deliberate effort, time, trust and privacy for one to open up to a stranger on family issues," she said. "There are many more survivors walking through the hospital corridors than imagined by health providers.
Proactive [indicated to mean "goal-directed" in this article: violence to achieve an objective] aggression in youth with callous-unemotional traits is accompanied by amygdala hypofunction in response to...facial expressions [of fear and emotional distress], according to a case-control study [reported in] JAMA Psychiatry online (abstract).3. ▼ Psychopaths Programmed to Be Reward Seekers (by endogenous dopamine dysfunction).
Dr. Abigail A. Marsh, Georgetown University, Washington, DC. ...and colleagues used functional MRI to scan 16 healthy control participants and 30 juveniles [male and female... aged 10 to 17 years] with conduct problems [and] callous-unemotional traits, hypothesizing that differences in amygdala function could underlie these differences... The presence..of callous-unemotional traits ...(now referred to as 'limited prosocial emotions' in DSM 5)... is associated with more severe, persistent, and treatment-refractory externalizing behaviors [fighting, bullying, cursing, and other forms of violence].
"...sometimes kids with conduct problems are approached clinically as though their symptoms always reflect heightened anxiety or stress that may...result from previous trauma or maltreatment," Dr. Marsh said. "Our findings, and those of others, suggest that ...[youths] with high levels of callous-unemotional (traits) actually are not emotional enough... [they are] deficient [in] empathic responses to distress...
Psychopaths doggedly pursue rewards without particular concern about potential consequences, and this tendency seems to be due to a malfunctioning brain reward system, new data suggest. Published online March 14  in Nature Neuroscience, the findings were reported by investigators from Vanderbilt University, Nashville, Tennessee.▼ Possibly related: Toward a 'Where' and 'How' Understanding of Dopamine Dysfunction in Disorders of Attention:Amphetamine-Induced Dopamine Release and Neurocognitive Function in Treatment-Naive [i.e., never treated with drugs for at least this diagnosis]Adults With ADHD [use caution to not assume judgementalness about ADD/ADHD in this research, especially in this context of this list; that's not what is significant or valuable about this research.
"The heightened dopamine release we found in the brains of individuals with psychopathic traits suggests that psychopathy may reflect dysfunction in dopamine reward circuitry," lead author Joshua W. Buckholtz, BS, who is studying for his doctoral degree in neuroscience, told Medscape Psychiatry. "This study identifies a new brain system as being involved in psychopathy and may lead the way for future studies that target this system as a way of reducing aggression and antisocial behavior," he said.
"It also sheds light on the fact that, despite the availability of good evidence for underreactivity to some kinds of emotional stimuli, psychopaths don't have a general lack of emotional reactivity. In fact, the observed overreactivity of dopamine might cause them to pay more attention to obtaining rewards (like money, sex, or status) at the cost of attending to other things, like the potential consequences of their actions to their victims or even themselves,"
Attentional Disorders4. ▼ MEDLINE Abstracts: Violence Against Women -- Factors in Perpetration
Disorders of attention can be conceptualized as disorders of ineffective frontal lobe processing of incoming stimuli. Parts of the frontal-subcortical circuits involved in executive function, reward, and motivation have been targeted in functional MRI studies of attentional disorders, yielding consistent patterns of abnormal frontal-striatal activation.
The dopaminergic system in particular has been consistently linked to attentional and cognitive processing abnormalities. In many cases, impulsivity is strongly associated with impaired attention and attention-deficit/hyperactivity disorder (ADHD) traits. In psychiatry, strict use of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), in making a diagnosis leads more often than not to the inclusion of different diagnoses under axis IV that may share common symptoms. If the DSM symptom criteria are strictly followed, the triad of inattention, impulsivity, and cognitive impairment can certainly be observed in disorders as phenomenologically separate as major depression, schizophrenia, bipolar disorder, and substance dependence [&etc.].
Brief Study Description
This commentary is based on a double-blind randomized study of 2 matched groups: 15 male patients with ADHD and 18 healthy male controls. Standard DSM-IV criteria were used to diagnose ADHD. The 2 main design points of the study involved use of 2 PET scans and administration of neuropsychological tests to both groups. PET was done with [11C]raclopride, a radiolabeled synthetic compound that antagonizes the dopamine receptor, in the study groups before and after lactate infusion and amphetamine administration. The main goal of this study was to further elucidate the neurochemical and structural abnormalities within the basal ganglia (the corpus striatum in particular) of the dopamine system indirectly, via measurement of binding to dopamine 2 and 3 (D2/D3) receptors.
by male intimate partners...: • Lancet 2002 ...Violence is used as a strategy...about finances, jealousy, and women's gender role transgressions...frequently...to resolve a crisis of male identity, at times caused by poverty or an inability to control women. Risk...is greatest in societies where the use of violence in many situations is a socially-accepted norm... Heavy alcohol consumption also increases risk of violence • AIDS Educ Prev. 2003...Many women at high risk for HIV infection face resistance and, in some cases, violence as a response to their requests for condom use. • J Consult Clin Psychol 2003...the odds of any male-to-female physical aggression were more than 8 times (11 times) higher on days when men drank than on days of no alcohol consumption. The odds of severe male-to-female physical aggression were more than 11 times (11 times) higher on days of men's drinking than on days of no drinking. •5. ▼ Bullying Doubles, Rape More Than Triples Risk for Teen Suicide
About 25% of high school students report being bullied, 13% have considered suicide, and 8% have attempted it, according to data from 2007. Building on this foundation, Shane Fernando, MS, from the University of North Texas Health Science Center, in Fort Worth, explored the link between bullying and suicide...at the American Public Health Association 138th Annual Meeting [in 2010].6. ▼ Forced Female Genital Cutting Female Genital Cutting. J Obstet Gynaecol Canada 2013 Nov;35(11):1028-45. Abstract. Reported at length in Guideline format, with evidence quality rating descriptions, in Agency for Healthcare Quality & Research, National Guidelines Clearinghouse, NIH, U.S. Dept. of Health & Human Services
He used data from the Massachusetts Youth Risk Behavior Survey, a standard US Centers for Disease Control and Prevention survey for youth between the ages of 12 and 18 years, to [elucide] mental state (such as feelings of sadness), being "physically hurt by a date or having sexual contact against your will," being the victim of bullying during the previous year, and risk behaviors during the previous 30 days [using] data from 3095 students.
...Female genital cutting (FGC) is internationally recognized as a harmful practice and a violation of girls' and women's rights to life, physical integrity, and health. The immediate and long-term health risks and complications of FGC can be serious and life threatening. ...Global migration patterns have brought FGC to Europe, Australia, New Zealand, and North America, including Canada...There is concern that FGC continues to be perpetuated in receiving countries, mainly through the act of re-infibulation... Performing or assisting in FGC is a criminal offense in Canada. Reporting to appropriate child welfare protection services is mandatory when a child [is found to have] been subjected to FGC or is at risk of being subjected to the procedure... There is a perception that the care of women with FGC is not optimal in receiving countries...7. ▼ Male Disclosure of Sexual Abuse and Rape, Topics in Advanced Practice Nursing e-Journal. 2006 (7 pages in Medscape)
...According to the Rape, Abuse, and Incest National Network, about 1 in every 10 rape victims is male in the United States, and about 2.78 million men have experienced an attempted or completed rape in their lifetime. About 44% of rape victims are under 18 years of age, and 15% are younger than 12 years. The gender of a rape or abuse victim can be a very important contextual factor in examining the varying needs of victims, as it can affect whether or not a victim receives support after being sexually abused [and] it can drastically affect the victim's likelihood to disclose rape and seek support from others...8. ▼ Harassment/Suicide Rates Doubled for Gay/Lesbian Students As of 2010,
...3.9% of heterosexuals said they were harassed because they were perceived to be LGBQ, and 26.8% of LGBQ-identified students said they were harassed. ...When it comes to electronic bullying (on social network sites such as Facebook, by text message, or on Twitter), "29.8% of the LGBQ students reported electronic bullying within the previous 12 months, whereas only 12.9% of heterosexuals reported that." ...The negative pressures seen in the school setting continue into adulthood...9. ▼ The State of Transgender Health Care Policy, Law, and Medical Frameworks Daphna Stroumsa, MD, MPH. Am J Public Health. 2014;
...Transgender people have a unique set of mental and physical health needs. These needs are compounded by prejudices against transgender people within both the medical system and society at large. These prejudices create barriers to accessing timely, culturally competent, medically appropriate, and respectful care.[9,11,12] These societal and medical barriers are associated with increased risk of violence, suicide, and sexually transmitted infections...10. ▼ The Date Safe Project
...Over the past decade, more attention is being given to dangerous sexual behavior among our youth and to the crime of sexual assault - mainly due to cases and news stories concerning celebrities, middle schools, high schools, college campuses, and the military. Unfortunately, the public debates arising from such prominent cases often lead to even greater misunderstandings of what consent means; how to teach safer understandings of intimacy to teenagers and young adults; how sexual assault is defined; and how to honor survivors of sexual assault / rape. ...The DATE SAFE Project, Inc. provides positive how-to skills and helpful insights for addressing verbal consent (asking first), respecting of boundaries, sexual decision-making, bystander intervention, and supporting survivors (opening the door for family and friends).11. ■ Association Between Perceived Insufficient Sleep, Frequent Mental Distress, Obesity and Chronic Diseases Among US Adults, 2009 Behavioral Risk Factor Surveillance System
Trafficking in persons is a human rights violation that occurs around the world. Human trafficking involves the recruitment and movement of individuals—generally by force, coercion, or deception—for the purposes of criminal exploitation or abuse... the International Labor Organization has estimated that approximately 12.3 million people are in situations of forced or bonded labor, half of whom are believed to be women and girls... Although men, women, and children are trafficked and exploited in such economic sectors as construction, farming, fishing, textiles, and mining, the trafficking of women and girls for forced prostitution is among the most well-recognized forms of trafficking. Because of the often extreme sexual, physical, and psychological abuses associated with this form of gender-based violence, women and girls who are trafficked and sexually exploited through forced sex work or in other circumstances such as domestic servitude, are a population of particular concern for mental health specialists. Researchers and advocates continue to call for urgently needed psychological support services for trafficked persons—and for sexually abused women and girls in particular... Some trafficked girls and women do not suffer extraordinary levels of abuse; nevertheless, assault, coercion, threats of harm to themselves and their families, and severely restricted freedom are common... many of the menacing tactics used to control trafficked girls and women are readily comparable with the characteristics of abuse described in the literature on torture
• BMJ 2005...2494 women consented to [structured interview]...factors indicating gender disadvantage (notably sexual violence by the husband...and poor mental health...were strongly associated with chronic fatigue...[although] women with a high body mass index had a reduced risk, suggesting an influence of poor nutrition... • J Abnorm Psychol. 2005...among  current and former female partners of men participating in a group treatment program for partner abuse...Psychological abuse exposure was more strongly and uniquely associated with PTSD symptoms than was physical abuse exposure. Among psychological abuse ratings, denigration, restrictive engulfment, and dominance/intimidation behaviors evidenced the strongest associations with PTSD symptoms. Findings from this study suggest the association between psychological abuse and PTSD is complex and multidetermined. • Biol Psychiatry. 2005...Research on thyroid activity among male combat veterans with posttraumatic stress disorder (PTSD) has consistently shown [altered] thyroid [activity]... This study is the first large scale investigation of thyroid function in women with PTSD...Thyroid function was measured in 63 women with PTSD due to childhood sexual abuse (PTSD-CSA) in comparison with a community sample of 42 women without current PTSD-CSA...Altered thyroid activity...was found in women with PTSD associated with childhood sexual abuse. • Am J Epidemiol. 2005...Adult-onset vulvodynia [vulvar pain]was strongly associated with abuse as a child more than a few times physically ...or sexually... When abused women were compared with those with no history of abuse, the association was largely confined to those harmed by a primary family member... Additional population-based studies of clinically confirmed cases of vulvodynia are needed to replicate this association. • ... ... ...
14. ▼ Persistent Pain After Sexual Assault Often Untreated (Fair warning, McLean's tentative conclusion appears to involve suppositions based on conventional incomplete evidence; that conclusion is not quoted here. --ed.)
"...sexual assault is common, experienced by 1 in 5 women over a lifetime. About two thirds of these women report that they have associated pain. Our study shows that survivors develop persistent pain and that it is not being treated," said Samuel A. McLean, MD, MPH, an emergency physician at the University of North Carolina (UNC) School of Medicine in Chapel Hill.15. ▼ Discovering Strengths and Competencies in Female Domestic Violence Survivors: An Application of Roberts' Continuum of the Duration and Severity of Woman Battering (approx.2005)
[summary of contents:] • Abstract and Introduction • Predominant Treatment for Female Domestic Violence Victims • A Solution-Focused Approach for Treating Female Domestic Violence Victims • Implications of Roberts' Continuum of Duration and Chronicity of Woman Battering for Treatment Using a Solution-Focused Approach • Implications of Roberts' Continuum of Duration and Chronicity of Woman Battering for Research From a Solution-Focused Frame • Conclusion • References •16. ■ Sexual Abuse and Military Women 2013
20. ▼ Sexual Risk Taking and Bullying Among Adolescents reported in Being a Bully Linked to Casual, Risky Sex (2013)Heterosexism(as discussed by Wikipedia)...a system of attitudes, bias, and discrimination in favor of opposite-sex sexuality and relationships [that] can include the presumption that other people are heterosexual or that opposite-sex attractions and relationships are the only norm...and therefore superior. Although heterosexism is defined in the online editions of the American Heritage Dictionary of the English Language and the Merriam-Webster Collegiate Dictionary as anti-gay discrimination and/or prejudice "by heterosexual people"...and "by heterosexuals"...respectively, people of any sexual orientation can hold such attitudes and bias. Nonetheless, heterosexism as discrimination ranks gays, lesbians, bisexuals and other sexual minorities as second-class citizens with regard to various legal and civil rights, economic opportunities, and social equality in many of the world’s jurisdictions and societies.
Teens who bully other kids, or are both bullies and bullied themselves, are more likely to engage in risky sex... "some research has found that kids and teens cope with being bullied by using drugs or alcohol, for instance. Acting out sexually may be another way young people respond to bullying", Melissa K. Holt, PhD [lead researcher,] Boston University School of Education...told Reuters Health. ...Bullies, bullying victims and kids who were both bullies and bullied were more likely to experience dating violence than other kids... Gay, lesbian, bisexual, transgender or questioning (GLBTQ) students are often minorities at school, Holt said, and may experience stigma and discrimination. "These unique stressors associated with being a sexual minority might translate into coping mechanisms that are different than those used by straight teens.".21. ■ Lost in the Shuffle: Culture of Homeless Adolescents. Pediatr Nurs. 2009
Among the [violent teen subjects] with siblings, 50.8% of the boys and 60.5% of the girls reported having physically assaulted a sibling, peer, or dating partner at least once in the past month. Only 7.9% of all violence perpetrators reported participating in dating violence only.29. ■ Depressed, Abused Mothers More Likely to Spank Their Children 2008
...14.1% [of the violent male teenage subjects] reported participating in physical dating violence, 84.4% in peer violence, and 49.6% in sibling violence. Only 2.3% reported perpetrating only physical dating violence ... 75% reported both dating violence and peer violence ... 55.6% reported both dating violence and sibling violence.
...44.2% [of the violent female teen subjects reported violence] against dating partners, 65.2%...against peers, and 59.8%...against siblings. ...12% reported only [dating violence], with 59.4% reporting both dating violence and peer violence, and 50.3% reporting both dating violence and sibling violence.
...physical dating violence was associated with alcohol, tobacco, and marijuana use; carrying a knife; delinquency; school failure and truancy; victimization by peers or family; and exposure to community violence...
[The authors] note that there are several possible reasons why the girls in this study reported [perpetrating] more physical dating violence... than [did] the boys. These include that the girls may have [included] playful hitting or self-defensive actions that boys often do not. Also, because the assessments did not ask about sexual violence, the boys may have underestimated their episodes of dating violence.
Shaking generally is attributed to the perpetrator's level of tension and frustration, often generated by an infant's crying or irritability. Risk factors for nonaccidental injuries in children and infants include... Negative childhood experiences including neglect or abuse... Additionally, parents or caretakers who have been involved with substance abuse and/or domestic violence may be at a higher risk for inflicting SBS. Societal factors, such as the general acceptance of violence on television, radio, and video games may also have a strong correlation with child maltreatment (Thomas, Leicht, Hughes, Madigan, & Dowell, 2003).31. ▼ Sexual Orientation Victimization Subject of New CDC Report (2013)
Results of a report by the Centers for Disease Control and Prevention (CDC) about victimization by sexual orientation found that lesbian women and gay men reported levels of sexual violence and intimate partner violence similar to those of heterosexuals [but] compared with lesbian and heterosexual women, bisexual women had a higher lifetime prevalence of rape, physical violence, and/or stalking by an intimate partner (43.8% and 35.0% vs 61.1%, respectively)... The National Intimate Partner and Sexual Violence Survey (NISVS) was initiated... in 2010 to collect data regarding incidence and prevalence estimates for intimate partner violence, sexual violence, dating violence, and stalking victimization [from] interviews with 16,507 men and women aged 18 years or older regarding "self-reported sexual orientation and their lifetime victimization experiences of sexual violence, stalking, and violence by an intimate partner."