Introduction: Sexual assaults often go unreported on college campuses, and unwillingness to report can harm victims' mental health by decreasing their access to services. One variable which may impact sexual assault reporting is perceived social norms (i.e., what individuals think others believe). While a wide body of literature supports the impact of social norms on a wide array of college student behavior, little is known about how macrosystemic factors, such as policy change, affect social norms. One such policy change which may impact social norms related to sexual violence involves changes made in 2019 to the Federal Policy, Title IX, which raised the standard of evidence that victims must provide in order to make a formal complaint. Accordingly, the authors sought to examine the relationships between students' knowledge of Federal Title IX policy, their awareness of changes made at the Federal level, their perceptions of their peers' acceptance of these policies broadly, and willingness to report incidents of sexual violence to their specific campus's Title IX office following these changes. Participants/Method:A sample of students at a university in the southeastern U.S. (N = 308) were surveyed. Results: Within our sample, slightly less than a quarter (20.4%) of students were familiar with the purpose of the Federal Title IX policy, and the majority (58.7%) believed their peers would have a neutral attitude toward these broad policy changes. Regardless of perceived social norms about the policy, individuals who believed that their university systemically responded inappropriately to Title IX incidents were less likely to report someone else's victimization to the campus Title IX office (B = 0.753, SE = 0.211, β = 0.253, p < .001). Participants who believed others supported the changes to the policy were more likely to increase their reporting to the campus's Title IX under the new Federal policy (B = 0.309, SE = 0.057, β = 0.364, p < .001). Students who believed others did not support the changes to the Federal policy were more likely to decrease their reporting to their campus Title IX office under the new Federal policy (z = 5.65, p < .001). Discussion: Implications for institutions & policy makers are discussed.

Objective: The current studies explored associations between exposure to potentially morally injurious events (PMIEs) and mental health outcomes among frontline workers affected by the coronavirus pandemic. Method: We administered online self-report surveys to emergency responders (N = 473) and hospital personnel (N = 854) in the Rocky Mountain region of the United States between April and June of 2020. Surveys assessed frequency and intensity of exposure to PMIEs alongside psychological and functional outcomes. Results: Between 20% and 30% of frontline workers reported exposure to PMIEs of at least moderate frequency and intensity. Exposure to more intense PMIEs was associated with greater psychological symptoms (i.e., stress, depression, and anxiety) and functional impairment (i.e., professional burnout), especially among emergency responders who reported frequent exposure but also hospital workers who reported few exposures. Conclusion: Efforts to facilitate and maintain the well-being of the public health workforce should specifically address critical incidents encountered by frontline workers that have embedded moral and ethical challenges. Clinical Impact Statement This study suggests that up to 30% of emergency responders and hospital personnel encounter perceived transgressions of their internalized moral beliefs in the context of providing care during disasters and crises. Those exposed to more frequent and intense ethical challenges are more likely than those not exposed to report symptoms of burnout, depression, anxiety, and stress. Efforts to maintain the well-being of essential personnel should therefore address critical incidents encountered by frontline workers that have embedded moral and ethical challenges.

Studies of moral injury among nonmilitary samples are scarce despite repeated calls to examine the prevalence and outcomes of moral injury among civilian frontline workers. The purpose of this study was to describe the prevalence of moral injury and to examine its association with psychosocial functioning among health care workers during the COVID-19 pandemic. We surveyed health care workers (N = 480), assessing exposure to potentially morally injurious events (PMIEs) and psychosocial functioning. Data were analyzed using latent class analysis (LCA) to explore patterns of PMIE exposure (i.e., classes) and corresponding psychosocial functioning. The minimal exposure class, who denied PMIE exposure, accounted for 22% of health care workers. The moral injury-other class included those who had witnessed PMIEs for which others were responsible and felt betrayed (26%). The moral injury-self class comprised those who felt they transgressed their own values in addition to witnessing others' transgressions and feeling betrayed (11%). The betrayal-only class included those who felt betrayed by government and community members but otherwise denied PMIE exposure (41%). Those assigned to the moral injury-self class were the most impaired on a psychosocial functioning composite, followed by those assigned to the moral injury-other and betrayal-only classes, and finally the minimal exposure class. Moral injury is prevalent and impairing for health care workers, which establishes a need for interventions with health care workers in organized care settings. Impact Statement Health care workers experienced stressors that transgressed their moral beliefs during the COVID-19 pandemic. Those who were troubled by their own actions or failures to act had the most severe work, relationship, and personal care problems, followed by those troubled by the actions of others or of their institutions.

Objective: This work sought to assess relationships between sexually aggressive behavior occurring through the use of technology and social media, perceived social norms of sexually aggressive behavior, and face-to-face sexual aggression and coercion. Participants: Participants were 663 undergraduate students (73.1% Female). Methods: Participants completed measures assessing perceived social norms of sexually aggressive strategies, personal sexual strategies used, alcohol use, cyberbullying, sexual victimization, personal wellbeing, and socially desirable responding. Results: Thirty percent of participants reported engaging in some form of sexually aggressive behavior offline; 15.6% endorsed engaging in sexual cyberbullying. However, 100% of participants endorsed the belief that their peers were engaging in some form of sexually aggressive behavior either online or offline. Conditional process modeling revealed a significant indirect effect of perceived social norms of sexually aggressive behavior on face-to-face sexual aggression via sexual cyberbullying (b = .0015, p < .001, 95% CI [.0030, .0110]), indicating mediation. Conclusions: The present work highlights the importance of further research in the domain of sexual cyberbullying.

The present study examined relationships among sexual victimization, gender roles, and sexual assertiveness in an LGBTQ sample. Recruited via Mechanical Turk, 455 LGBTQ adults completed measures of sexual assertiveness, gender roles, and sexual assault victimization and perpetration. Some form of sexual victimization in the past year was reported by 31% of participants, and 66% reported some type of sexual victimization since the age of 14. Perpetration of sexual violence in the past year was reported by 17% of the sample, and 27% reported sexual violence perpetration since the age of 14. Logistic regressions revealed that gender roles predicted sexual victimization and sexual perpetration status. Additionally, sexual assertiveness was negatively correlated with both sexual victimization and perpetration status. Contrary to expectations, the interaction between gender roles and sexual assertiveness was not predictive of sexual victimization or perpetration. The implications of the findings are discussed.

The mental health of healthcare workers (HCWs) is critical to their long-term well-being and future disaster preparedness. Goal 1 of this study was to identify rates of mental health problems experienced by HCWs. Goal 2 was to test a model of risk stemming from pandemic-related stressors and vulnerability factors.This cross-sectional study included HCWs (N ​= ​2,246 [1,573 clinical providers; 673 non-clinical staff]) in the Rocky Mountain West who voluntarily completed an online survey in April/May 2020. Respondents completed measures for traumatic stress symptoms, depression, anxiety, alcohol use, and sleep. Logistic regressions stratified by professional role (clinical versus non-clinical) were specified to predict clinical screening cutoff (positive/negative) as a function of five pandemic-related stressors (immunocompromised self; immunocompromised household member; care provision to infected patients; clinical management role; positive cases).Results showed that more than half of HCWs surveyed (52.5%) screened positive (above cutoff) for traumatic stress, depression, or anxiety, with ~20% reporting problematic alcohol use, and variable insufficient sleep from ~10% off shift to ~50% on shift. Clinical employees with an immunocompromised household member had increased odds of screening positive for a mental health problem. Non-clinical HCWs who were immunocompromised were at elevated risk for screening positive a mental health problem. Being female, minority status, and younger increased odds for mental health problems.Implications include alleviating a portion of the mental health burden of HCWs involved in response to the SARS-CoV-2 pandemic by considering policies to protect immunocompromised HCWs and their families (e.g., vaccine priorities, telework options).

Unwanted sexual encounters include a broad spectrum of behaviors that may include everything from regretted or coerced sex to sexual assault and rape. Sadly, experience with unwanted sex is all too common among college aged women. A number of factors have been examined in the context of sexual interactions in this population including relationship status, sexual want, sexual assertiveness, and sexual consent. However, research to date lacks analyses which consider the potentially interactive nature of the aforementioned variables in sexual decision making. To that end, the present study examined the role of relationship status, sexual want, and sexual assertiveness on self-report consent in a sexual encounter. Female undergraduate students (N = 319) self-reported on their relationship status, as well as their sexual want (desire to engage in sexual activity), sexual assertiveness, and sexual consent behaviors within the context of their most recent sexual experience. A moderated multiple regression was conducted to determine whether sexual assertiveness moderated self-reported sexual want and consent. Relationship status was included as the primary predictor in the aforementioned model. The overall model was significant, indicating an interaction model of sexual decision-making. Generally, women displayed increased sexual consent behavior as sexual want increased across levels of sexual assertiveness, regardless of relationship status. Importantly, women low in sexual assertiveness were high in sexual compliance (i.e. consenting to/engaging in sexual activity even when self-reported sexual want was low).

Alcohol abuse is common among college students. Acceptance and commitment therapy (ACT) is widely supported as a treatment of alcohol abuse. However, little research has examined how ACT may be paired with other techniques traditionally applied to treat substance abuse, such as motivational interviewing (MI). This clinical case study describes the use of ACT and MI to facilitate treatment of a 20-year-old woman who was referred for treatment for alcohol abuse. The client remained in treatment in spite of her initial self-reported belief that treatment was unnecessary. At follow-up, the client reported increased present moment awareness, particularly of her drinking habits, and demonstrated the ability to behave in ways consistent with her values. At the completion of treatment, the client reported fewer episodes of alcohol consumption and less severe drinking. Implications of these findings are discussed, with an emphasis on the potential benefits of pairing MI techniques with ACT.

Sexual cyberbullying is a relatively novel issue wherein various forms of technology including cell phone messaging, social media, and other online tools are used to harass another individual in a sexually explicit fashion, or to coerce an individual into providing private sexual information or engage in activities which are sexual in nature. The present article explores the relevant research to date on sexual cyberbullying. A methodological critique of this literature is discussed and suggestions for future research are provided. In particular, the importance of establishing a theoretical framework which can be used to better conceptualize and understand sexual cyberbullying and other forms of technologically mediated aggression is highlighted. Contextual factors which may also influence sexual cyberbullying, such as alcohol, hookup culture, and the recent discussion of revenge porn in the media, are also discussed.

Service learning is a pedagogical technique that integrates traditional coursework with activities outside the classroom that meet the needs of the community. Gerontology-focused service learning has been incorporated into many courses that cover aging content and is believed to be beneficial to the learning process. Other research has demonstrated that service learning in general has benefits, regardless of the age of the service recipient. It is unclear whether benefits associated with gerontology-focused service learning are unique to experiences with older adults or are a product of the general benefits associated with this pedagogy. This study examined student responses to gerontology-focused service learning compared to youth-focused service learning. The results revealed that students working with older adults reported more negative expectations related to the assignment, more positive experiences interacting with the service recipients, and more reports of learning benefits attributed to service learning.