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Physical activity (PA) can play an important role in improving the mental and physical health in patients with mental disorders but is not well studied in this population. The aim of this study was to assess the status of PA in outpatients with mental disorders, compare the convergence of self-rating and accelerometer measurement and examine the influence of social cognitive variables from the Motivation-Volition (MoVo) model and clinical measures on PA. Eighty-four patients were recruited from three psychiatric outpatient clinics and local psychiatrists (Distribution of ICD-10-Diagnoses: F3.x = 59.5%, F4.x = 20.2%, F2.x = 17.9%, F1.x = 2.4%). PA, Self-efficacy, Outcome-expectancies, Intention, Self-concordance, Action- and Coping-planning, Health-related Quality of Life (SF-12) and Psychiatric Symptoms (SCL-27) were assessed through questionnaires. PA was assessed objectively by accelerometers. Most of the participants did not reach PA recommendations. Subjective and objective measurement of PA showed good accordance for total PA on group level but lower accordance on individual level. Motivational and volitional determinants of health behavior change showed a similar pattern of correlations with PA as in populations without mental disorders. Outpatients with mental disorders have the ability and are willing to perform PA but a large proportion of our sample did not meet PA recommendations. To assess group levels of PA, subjective and objective measurement seem equally apt, for individual diagnostics, a combination of both should be considered. Social cognitive determinants of health behavior change seem to be as helpful for the design of PA interventions for patients with mental disorders as they are in other populations.
Prevalence and Predictors of Sexual Aggression Victimization and Perpetration in Chile and Turkey
(2017)
Background: Although sexual aggression is recognized as a serious issue worldwide, the current knowledge base is primarily built on evidence from Western countries, particularly the U.S. For the present doctoral research, Chile and Turkey were selected based on theoretical considerations to examine the prevalence as well as predictors of sexual aggression victimization and perpetration. The first aim of this research project was to systematically review the available evidence provided by past studies on this topic within each country. The second aim was to empirically study the prevalence of experiencing and engaging in sexual aggression since the age of consent among college students in Chile and Turkey. The third aim was to conduct cross-cultural analyses examining pathways to victimization and perpetration based on a two-wave longitudinal design.
Methods: This research adopted a gender-inclusive approach by considering men and women in both victim and perpetrator roles. For the systematic reviews, multiple-stage literature searches were performed, and based on a predefined set of eligibility criteria, 28 studies in Chile and 56 studies in Turkey were identified for inclusion. A two-wave longitudinal study was conducted to examine the prevalence and predictors of sexual aggression among male and female college students in Chile and Turkey. Self-reports of victimization and perpetration were assessed with a Chilean Spanish or Turkish version of the Sexual Aggression and Victimization Scale. Two path models were conceptualized in which participants’ risky sexual scripts for consensual sex, risky sexual behavior, sexual self-esteem, sexual assertiveness, and religiosity were assessed at T1 and used as predictors of sexual aggression victimization and perpetration at T2 in the following 12 months, mediated through past victimization or perpetration, respectively. The models differed in that sexual assertiveness was expected to serve different functions for victimization (refusal assertiveness negatively linked to victimization) and perpetration (initiation assertiveness positively linked to perpetration).
Results: Both systematic reviews revealed that victimization was addressed by all included studies, but data on perpetration was severely limited. A great heterogeneity not only in victimization rates but also in predictors was found, which may be attributed to a lack of conceptual and methodological consistency across studies. The empirical analysis of the prevalence of sexual aggression in Chile revealed a victimization rate of 51.9% for women and 48.0% for men, and a perpetration rate of 26.8% for men and 16.5% for women. In the Turkish original data, victimization was reported by 77.6% of women and 65.5% of men, whereas, again, lower rates were found for perpetration, with 28.9% of men and 14.2% of women reporting at least one incident. The cross-cultural analyses showed, as expected, that risky sexual scripts informed risky sexual behavior, and thereby indirectly increased the likelihood of victimization and perpetration at T2 in both samples. More risky sexual scripts were also linked to lower levels of refusal assertiveness in both samples, indirectly increasing the vulnerability to victimization at T2. High sexual self-esteem decreased the probability of victimization at T2 through higher refusal assertiveness as well as through less risky sexual behavior also in both samples, whereas it increased the odds of perpetration at T2 via higher initiation assertiveness in the Turkish sample only. Furthermore, high religiosity decreased the odds of perpetration and victimization at T2 through less risky sexual scripts and less risky sexual behavior in both samples. It reduced the vulnerability to victimization through less risky sexual scripts and higher refusal assertiveness in the Chilean sample only. In the Turkish sample only, it increased the odds of perpetration and victimization through lower sexual self-esteem.
Conclusions: The findings showed that sexual aggression is a widespread problem in both Chile and Turkey, contributing cross-cultural evidence to the international knowledge base and indicating the clear need for implementing policy measures and prevention strategies in each country. Based on the results of the prospective analyses, concrete implications for intervention efforts are discussed.
Although sexual aggression is recognized as a serious problem worldwide, evidence on the prevalence and impact of sexual aggression is based predominantly on studies from Western countries with a Christian or non-religious majority. Little evidence is available from non-Western countries, especially from Muslim societies. The purpose of the present article was to provide a first systematic review of the studies examining the prevalence of sexual aggression in Turkey, including both victimization and perpetration reports from women and men. Additionally, differences in prevalence rates depending on relationship constellations and characteristics of victims and perpetrators were reviewed. By a two-stage literature search, 56 studies were identified for inclusion. All studies examined sexual victimization of women, only four studies included sexual victimization of men. Data on sexual aggression perpetration were extremely limited, with only two studies providing prevalence rates. Prevalence rates of sexual victimization were found to vary greatly, which may be attributed to a lack of methodological and conceptual consistency across studies. Likewise, no consistent picture was revealed for victims' or perpetrators' sociodemographic or situational characteristics associated with differences in prevalence rates. We discuss reasons for the variability in prevalence rates and outline recommendations for future research.