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PubMed2003

A cry from the darkness: women with severe mental illness in India reveal their experiences with sexual coercion.

THIS STUDY used qualitative research methods to investigate the problem of sexual coercion among female psychiatric patients in India. Consecutive female admissions (n = 146) to the inpatient unit of a psychiatric hospital in southern India were screened regarding coercive sexual experiences. Women who reported coercion (n = 50; 34%) participated in a semi-structured interview to learn more about their experiences. Among these women, 24 (48%) reported that the perpetrator was their spouse, 13 (26%) identified a friend or acquaintance, and 10 (20%) identified a relative such as an uncle or cousin. Most experiences occurred in the women's homes. Thirty of the 50 coerced women (60%) reported that they had not disclosed their experience to anyone, and that they had not sought help. Women revealed a sense of helplessness, fear, and secrecy related to their experiences. The problem of sexual coercion is seldom addressed in mental health care in India; the prevalence and severity of such experiences warrant immediate clinical attention and continued research.

Adolescent↗
PubMed2006

[Magnitude and characterization of sexual coercion experienced by young adults in three Brazilian state capitals: Porto Alegre, Rio de Janeiro, and Salvador].

The article estimates the magnitude of sexual coercion among young adults in three large Brazilian cities. In addition to evaluating prevalence, the article analyzes the victim's and perpetrator's characteristics, identifies the main strategies used in coercion, and explores the social scenarios that favor the occurrence of sexual violence. The article draws on data from a household survey called the GRAVAD Project, conducted in Porto Alegre, Rio de Janeiro, and Salvador and completed in 2002. Interviews were applied to a stratified sample of males and females aged 18-24 years, with 4,634 respondents (47.2% males and 52.8% females). Prevalence of some lifetime experience as victims of sexual coercion was estimated at 16.5% for women and 11.1% for men. Victim's and perpetrator's age in the first episode, the type of relationship between them, and the forms of pressure varied between males and females. The magnitude of such events, differences between men and women, and the higher prevalence rates in certain population sub-groups demand immediate preventive policies and strategies.

Adolescent↗
PubMed1988

Human behaviour and the ethics of coercion.

There is an assumption that legislation against unhealthy behaviour would be unethical, or at best unenforceable and counterproductive. However, the ethics of coercion depend on the manner in which such coercion is introduced, the essential precondition being wide, favourable community consensus. Two recent Australian examples have been the Victorian seat-belt legislation and the Tasmanian hydatid campaign. Hydatid control in Tasmania began with a voluntary campaign in the farming community which led to a popular demand for government intervention. In response to community pressure, the State Department of Agriculture introduced control measures with a stepwise increase in coercion that began with a voluntary dog-testing programme, and proceeded to a compulsory test and later to the quarantine of infected dogs. Ultimately, quarantine was extended to premises with a higher-than-average residual prevalence in sheep. Today, hydatid disease has almost disappeared in livestock. As no new human case of hydatid disease has been diagnosed in a person of under 10 years of age since 1972, or in one of under 20 years of age since 1976, human infection probably ceased by 1972. Legislation today could control the composition of processed food (for example, the salt content), or establish compulsory testing for human immunodeficiency virus antibodies. The necessary consensus could be the specific objective of health education during a voluntary phase.

Animals↗
PubMed1994

Forced into treatment. The role of coercion in clinical practice. Formulated by the Committee on Government Policy. Group for the Advancement of Psychiatry. Report no. 137.

It is clear to students of child development that setting limits and using parental power are necessary in promoting the maturational process. In fact, family systems theory addresses the issues of power and power coalitions as paramount. Forcing a child into treatment initially is a legitimate role for parents or guardians and is validated by mental health professionals, who feel that this must be accepted as part of their regular clinical work--especially in the case of school-age children, who only rarely can initiate requests for help. Further, the clinical use of power and persuasion has been addressed by a number of authors at both theoretical and pragmatic levels. Child psychiatrists deal with issues of coercion systematically and successfully in clinical practice. Although children often come into treatment against their will--sometimes because of physical pressures or threats and sometimes because of economic or emotional threats--they often can make use of a therapeutic relationship that is negotiated over time and gives careful attention to the child's identified needs and wishes. This experience leads one to recognize that many seemingly overtly coercive treatment contexts may be turned into effective treatment interventions. Exploration of the use of power and coercion as they relate to children--whether in normal development or in treatment--is helpful in the study of the psychopathology of adults who require limit setting, persuasion, or coercion in their treatment, often quite possibly because their childhood developmental experience regarding issues of power was dysfunctional.

Adolescent↗
PubMed1979

Sex differences in feelings attributed to a woman in situations involving coercion and sexual advances.

This study investigated sex differences of feelings attributed to a woman in situations involving varying degrees of coercion and sexual advances. Sixteen vignettes (12 dealing with sex and coercion, 4 dealing with coercion only) were rated on 17 semantic differential scales by 59 undergraduates (44 females, 15 males) and 45 graduate students (18 females, 27 males). The 16 vignettes yielded factors of Sexual Flattery/Overtures, Sexual Aggressiveness, and Violence. Factor analyses of the 17 semantic differential scales yielded factors of Helplessness, Aversiveness, and Threat. High agreement was found between males and females in both the graduate and undergraduate samples on the relative intensity of feelings attributed to the woman across the sex/coercion vignettes for the three dimensions of Helplessness, Aversiveness, and Threat. Even more importantly, systematic differences between males and females on intensity of attributed feelings across the semantic differential factors were independently replicated using the graduate and undergraduate samples. Analyses of variance revealed that males showed significantly greater attributions on the factors Helplessness and Threat on scenes mainly dealing with sexual flattery/overtures, whereas they showed significantly less attributions on the factor Aversiveness on scenes dealing with sexual aggressiveness and rape. In short, while there was strong agreement between men and women, there were also replicated significant systematic differences with men overestimating the psychological impact of less intense incidents and underestimating the psychological impact on women of more intense incidents.

Attitude↗
PubMed1998

Sexual coercion content in 21 sexuality education curricula.

Sexual coercion, a topic of relevance to school health personnel, may be as common in high school populations as in university populations. Twenty-one sexuality education curricula were examined for information on the topics of date rape, stranger rape, pressure, incest, sexual harassment, unwanted/inappropriate touch, and exploitation/victimization. Curricula scoring highest in total coverage also were the most comprehensive with six of the seven sexual coercion topics covered. Overall, pressure and exploitation/victimization received the greatest attention, while sexual harassment was not covered in any of the curricula. Common themes occurring within the coercion topic areas included guilt, communication/assertiveness skills, blame, drug use, premeditation, fear, sources of help. Results suggest sexuality education curricula have not responded to the increased concern regarding sexual harassment in schools.

Adolescent↗
PubMed2002

The function of female resistance behavior: intromission by male coercion vs. female cooperation in sepsis flies (Diptera: Sepsidae).

Female resistance behavior that occurs prior to intromission does not by itself imply forced copulation. Such behavior may function instead as a test of the male in order to favor some males over others, or to induce the male to desist. Thus, male persistence and forcefullness may sometimes be better described as persuasion rather than coercion. Under the persuasion hypothesis, the male only gains intromission due to an active response of the female. Under the coercion hypothesis, male and female are opposed in a physical battle which the female loses if copulation occurs. In species in which males are morphologically incapable of forcing intromission without active female cooperation (I argue here that this is probably a very common situation), data on the behavioral and ecological context in which resistance occurs can distinguish between the two possibilities. Partially congruent functions of resistance, seen from the female point of view, are female resistance to screen (male persuasion), and female resistance to avoid males non-selectively (male coercion). Sepsis flies illustrate these ideas. Females often struggle energetically in apparent attempts to dislodge mounted males and to prevent intromission, and males grasp females with powerful species-specific structures on their front legs and genitalia. This suggests the possibility of coerced intromission. But behavioral and morphological evidence demonstrate that active female cooperation occurs at the moment of intromission, and that males are probably dependent on this cooperation because they are not morphologically equipped to force their genitalia into those of an uncooperative female. Despite the impression from previous publications, male insects in general may seldom be able to achieve intromission by genitalic force. The species-specific forms of the grasping genitalia of male sepsis are probably not the result of an evolutionary arms race between coercive males and unselectively resistant females.

Animals↗
PubMedDate not supplied

The role of coercion in the treatment of women with co-occurring disorders and histories of abuse.

Debate continues on issues of involuntary treatment for individuals with behavioral healthcare problems. Women with co-occurring disorders and histories of abuse are an especially vulnerable population. This study seeks to increase our knowledge about the experiences of coercion for women in the behavioral healthcare system. Patterns of coercion are explored. This study did not find the predicted relationship between high levels of interpersonal violence and frequent involuntary treatment experiences. The results do offer support for the hypothesis that women are more likely to be currently mandated to treatment if they have been recently arrested, and that being mandated to treatment does not appear to be related to clinical issues such as recidivism and acute symptoms. As expected, women currently required to be in treatment report having less choice in other aspects of their care. Implications for future research in the current climate of increasingly coercive policies are presented.

Adult↗
PubMed2006

Short-term outcome of inpatient psychiatric care--impact of coercion and treatment characteristics.

AIMS: Little is known about the outcome of brief inpatient treatment interventions in routine psychiatric practice. The aim of this article was to study if subjective and assessed outcome of brief psychiatric inpatient care are related to patient characteristics, coercion at admission and during care, and other treatment characteristics. METHOD: A total of 233 involuntarily and voluntarily admitted patients were interviewed within 5 days from admission and at discharge or after 3 weeks of care. Outcome was measured as reported by patients and by change in GAF (Global Assessment Scale) scores. RESULTS: Predictors for a positive subjective outcome were if the patients reported that they had been well treated by the staff and had contact persons at the ward. Predictors for a GAF improvement were a low GAF score at admission and a mood disorder diagnosis. CONCLUSIONS: Subjectively reported outcome and outcome measured by assessing change in level of functioning differed. Coercion was not related to outcome. The way the patient perceived they had been treated by the staff was strongly related to subjective outcome.

Adult↗
PubMed2005

From coercion to contract: reframing the debate on mandated community treatment for people with mental disorders.

Approximately half the people receiving treatment in the public sector for mental disorder have experienced some form of "leverage" in which deprivations such as jail or hospitalization have been avoided, or rewards such as money or housing have been obtained, contingent on treatment adherence. We argue in this essay that framing the legal debate on mandated community treatment primarily in terms of "coercion" has become counterproductive and that the debate should be re-framed in terms of "contract." Language derived from the law of contract often yields a more accurate account of the current state of the law governing mandated community treatment, is more likely to be translated into a useful descriptive vocabulary for empirical research, and is more likely to clarify the policy issues at stake than the currently stalemated form of argumentation based on putative rights. Our hope is that adopting the language of contract may help to identify those types and features of mandated community treatment that are genuinely problematic, rather than perpetuating the unhelpful and misleading assumption that all types of leverage amount to "coercion."

Coercion↗
PubMed2006

Social pressure, coercion, and client engagement at treatment entry: a self-determination theory perspective.

Research on coercion in addiction treatment typically investigates objective sources of social pressure among legally mandated clients. Little research has examined the impact of clients' perceptions of social pressures in generalist addiction services. Clients seeking substance abuse treatment (N=300; 221 males and 79 females; M age=36.6 years) rated the extent to which treatment was being sought because of coercive social pressures (external motivation; alpha=.89), guilt about continued substance abuse (introjected motivation; alpha=.84), or a personal choice and commitment to the goals of the program (identified motivation; alpha=.85). External treatment motivation was positively correlated with legal referral, social network pressures to enter treatment, and was inversely related to problem severity. In contrast, identified treatment motivation was positively correlated with self-referral and problem severity, and was inversely related to perceived coercion (ps<.05). Hierarchical multiple regression analyses showed that referral source (i.e., mandated treatment status), legal history, and social network pressures did not predict any of 6 measures of client engagement at the time treatment was sought. However, treatment motivation variables accounted for unique variance in these outcomes when added to each model (DeltaR(2)s=.06-.23, ps<.05). Specifically, identified treatment motivation predicted perceived benefits of reducing substance use, attempts to reduce drinking and drug use, as well as self (and therapist) ratings of interest in the upcoming treatment episode (betas=.18-.31, ps<.05). Results suggest that the presence of legal referral and/or social network pressures to quit, cut down, and/or enter treatment does not affect client engagement at treatment entry.

Age Factors↗
PubMed2001

Perceptions of sexual coercion: learning from young people in Ibadan, Nigeria.

This study explored the problem of sexual coercion from the perspectives of 77 young people aged 14-21 in Ibadan, Nigeria, the behaviours they perceive to be sexually coercive and the contexts in which these occur through four narrative workshops. Participants were drawn from two secondary schools and 15 apprentice workshops. All four groups identified similar coercive behaviours and developed narratives of the events that typically lead up to them. Behaviours included rape, unwanted touching, incest, assault, verbal abuse, threats, unwanted kissing; forced exposure to pornographic films, use of drugs for sedation and traditional charms for seduction, and insistence on abortion if unwanted pregnancy occurs. Men were typically the perpetrators and young women the victims. Perpetrators included acquaintances, boyfriends, neighbours, parents and relatives. All the narratives revealed the inability of young people to communicate effectively with each other and resolve differences. The results suggest the need for life-skills training that facilitates communication, seeks to redress gender power imbalances, teaches alternatives to coercion as a means of resolving conflict over sexual relations and respect for sexual and reproductive rights, and provides victims with information on appropriate services, support and referral.

Adolescent↗
PubMed2000

Methodologic concerns regarding estimates of physical violence in sexual coercion: overstatement or understatement?

Self-report measures of sexual violence that ask women whether they have experienced threats of physical violence have attracted criticism in recent years; detractors claim that these measures lead researchers to overestimate the prevalence of sexual violence. Our study explored this issue by collecting data on the prevalence of threats versus force in the context of sexual aggression. Female undergraduates at two universities (n1 = 69; n2 = 111) were asked about their experiences with sexual coercion using a revised version of the Sexual Experiences Scale (Koss and Gidycz, 1985). Four of the original items were modified to distinguish between sexual contact that occurred as a result of a perpetrator using physical force and sexual contact that occurred because a perpetrator threatened physical violence. Analyses of the revised items revealed that the use of physical force was at least as likely as threats and that for some types of sexual acts, physical force was actually more likely than verbal threats. Furthermore, prevalence figures for three of the four types of sexual acts considered were not significantly altered by collapsing threat of force with use of force. Implications for future research on women's experiences of sexual coercion are discussed.

Adolescent↗
PubMed2006

Development and initial validation of an instrument to measure perceived coercion to enter treatment for substance abuse.

The present study involved 3 phases that led to the development and initial validation of the Perceived Coercion Questionnaire (PCQ), a scale that researchers use to measure perceptions of coercion of drug and alcohol users to enter drug and alcohol treatment. In Phase 1, the authors used focus groups to generate 48 pilot items. In Phase 2, the items were administered to a sample of 158 drug and alcohol users who were in residential treatment within a therapeutic community setting. Item and exploratory factor analyses reduced the number of items to 32, which represented 6 homogeneous and internally reliable subscales. In Phase 3, the PCQ was administered to a second sample of 362 drug and alcohol users. Confirmatory factor analysis led to a final scale of 30 items across 6 subscales that demonstrated sound consistency and validity. Implications for research and practice are highlighted.

Adaptation, Psychological↗
PubMed2001

A plea for respect: involuntarily hospitalized psychiatric patients' narratives about being subjected to coercion.

Eighteen involuntarily hospitalized psychiatric patients narrated their experiences of being subjected to coercion and their thoughts on how to prevent the coercion. A qualitative content analysis identified recurring themes, which were incorporated in two core themes describing the participants' experience. The core theme Not being respected as a human being included most of their narrated experiences, described in the themes Not being involved in one's own care, Receiving care perceived as meaningless and not good, and Being an inferior kind of human being. The core theme Being respected as a human being included a minor part of the narrated experiences and how the participants wanted things to be, described in the themes Being involved in one's own care, Receiving good care, and Being a human being like other people. The participants' plea for respect is discussed in relation to the ongoing deinstitutionalization of psychiatric care and the need for attitude changes in care and community, leading to the treating of mentally disordered people with more respect.

Adult↗
PubMed2006

Perceptions of sexual coercion in heterosexual dating relationships: the role of aggressor gender and tactics.

A large body of research has found a concerning prevalence rate of sexual coercion in heterosexual college student dating relationships; however, little research has examined how college students perceive and interpret these behaviors. In the current study we examined the impact of initiator gender and sexually coercive strategy (verbal pressure, purposeful intoxication, physical force, or control/mutual consent) on perceptions of the aggressor, victim, behavior, and relationship quality. Results indicated that men who coerce are viewed as aggressive; women who coerce are viewed as promiscuous. Targets of sexual coercion are not perceived as experiencing high levels of victimization following the incident. These findings suggest that college students do not perceive sexually coercive behaviors to be highly problematic. The results are discussed in terms of gender roles and practical implications for college student relationships.

Aggression↗
PubMedDate not supplied

On becoming acquainted with history's coercion specialists.

This paper discusses the careers of four very different coercion specialists taken from contemporary history. Whether in power, in opposition or unaffiliated, coercionists share an inability to evaluate institutions of authority as the source of social arrangements designed for the common good and a corresponding inability to contemplate self-criticism or self-doubt. They vary along at least two dimensions: (a) a Machiavellian talent for simulating the non-authoritarian personality over long stretches of their careers, as against a blatant and reflexive thuggery; and (b) the pursuit of agreed-upon us-and-them agendas, as against fulfilling their own personal ambitions. Authoritarian political coercion need not have very much to do with psychopathy and sociopathy as they are understood in psychiatry and clinical psychology. Colluding with political coercionists cannot be averted without a vigilant, proactive stance.

Antisocial Personality Disorder↗