Mary P Koss

Interests

Teaching

Family Violence, Human Sexuality

Research

Violence Against Women measurement, impact, prevention, justice intervention, program evaluation

Courses

Scholarly Contributions

Books

• Koss, M. P., Harway, M., O'neil, J. M., Geffner, R., Ivey, D. C., Murphy, B. C., & Mio, J. S. (2013). Violence against women: A silent pandemic. New York: Taylor and Francis. doi:10.4324/9781315811178
• Koss, M. P., White, J. W., & Kazdin, A. E. (2011). Violence against women and children, Vol 2: Navigating solutions.. Washington, DC: American Psychological Association. doi:10.1037/12308-000
• White, J. W., Koss, M. P., & Kazdin, A. E. (2011). Violence against women and children, Vol 1: Mapping the terrain.. Washington, DC: American Psychological Association. doi:10.1037/12307-000

Chapters

• Koss, M. P. (2018). Sexual Assault. In International Handbook of Psychology. Oxford University Press.
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  Sexual assault, including unwanted sexual contact, coercion and rape, are both criminal and traumatic. They are approached in a variety of ways in different global contexts. Attempts to address risk and protective factors for perpetrators and victims are limited by the difficulty of collecting empirical data on experiences that can be stigmatizing, complicated, shocking, and private. This chapter takes a global intersectional focus and explores current and historic definitions of sexual assault as well as how they influence estimates of sexual assault prevalence and subsequent psychological and public health responses. Empirical research is selectively reviewed to identify best practices in sexual assault measurement, prevalence, risk factors and impact. Then interventions and prevention are addressed with emphasis on culturally acceptable and empirically validated approaches that acknowledge intersections of identity viewed from individual through societal levels. The chapter concludes with recommendations for future directions in sexual assault surveillance, prevention and response.
• Koss, M. P., & Asaolu, I. O. (2017). Sexual Assault Globally. In Encyclopedia of Violence. Cambridge University Press.
• Lopez, E. C., & Koss, M. P. (2016). Acquaintance Rape. In F.P. Bernat and K. Frailing (eds.), Encyclopedia of Women and Crime. Hoboken, NJ: Wiley.
• Lopez, E. C., & Koss, M. P. (2016). The RESTORE Program for sex crimes: Differentiating therapeutic jurisprudence from restorative justice with therapeutic components. In E. Zinsstag & M. Keenan (eds.), Sexual Violence and Restorative Justice: Legal, Social and Therapeutic Dimensions. New York, NY: Taylor & Francis.
• Lopez, E. C., Lopez, E. C., Koss, M. P., & Koss, M. P. (2020). Title IX and Restorative Justice as Informal Resolution for Sexual Misconduct. In Handbook of Interpersonal Violence Across the Lifespan.(pp xxx-xxx). New York: Springer International Publishing. doi:10.1007/978-3-319-62122-7_200-1
• Koss, M. P. (2018). Hidden rape: Sexual aggression and victimization in a national sample of students in higher education.. In Some book on sexual violence(pp xxx-xxx). New York: Routledge. doi:10.4324/9780429493201-6
• Koss, M. P., Lopez, E. C., & Jessup-Anger, J. (2018). History of Sexual Violence in Higher Education. In New Directions for Student Services(pp 9-19). 2018 Wiley Periodicals, Inc. doi:10.1002/ss.20249
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  In this chapter, we describe the history of sexual violence sa it pertains to postsecondary institutions, focusing on social movements, research, and policy, and their implications for higher education.
• Koss, M. P. (2017). The RESTORE program of restorative justice for sex crimes: A case study in restorative justice with therapeutic components. In Sexual Violence and Restorative Justice: Legal, Social and Therapeutic Dimensions(pp 212-228). Taylor & Francis.
• Koss, M. P., & Asaolu, I. O. (2017). An introduction to sexual violence. In The Wiley Handbook of Violence and Aggression. Wiley.
• Lopez, E. C., Lopez, E. C., Koss, M. P., & Koss, M. P. (2017). The RESTORE Program for sex crimes : Differentiating therapeutic jurisprudence from restorative justice with therapeutic components. In A book on restorative justice(pp xxx-xxx). New York: Routledge. doi:10.4324/9781315630595-11
• Koss, M. P., White, J. W., & Kazdin, A. E. (2011). Violence against women and children: Perspectives and next steps.. In A book or encyclopedia. Washington, DC: American Psychological Association. doi:10.1037/12308-013
• Pennell, J., & Koss, M. P. (2011). Feminist Perspectives on Family Rights: Social Work and Restorative Practices for Stopping Abuse of Women. In Some book on feminist psychology(pp xxx-xxx). Oxford, UK: Oxford University Press. doi:10.1093/ACPROF:OSO/9780195394641.003.0009
• White, J. W., Koss, M. P., & Kazdin, A. E. (2011). Conclusions and next steps.. In Violence Against Women Navigating the Solutions(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/12307-013
• Koss, M. P. (2010). Restorative Justice for Acquaintance Rape and Misdemeanor Sex Crimes. In A book on Restorative Justice. London, UK: Oxford University Press. doi:10.1093/ACPROF:OSO/9780195335484.003.0010
• Yuan, N. P., & Koss, M. P. (2009). Rape. In Encyclopedia of Gender and Society. Thousand Oaks, CA: Sage Publications, Inc.
• Yuan, N. P., & Koss, M. P. (2008). Rape. In Encyclopedia of Interpersonal Violence. Thousand Oaks, CA: Sage Publication, Inc.
• Ingram, M., Yuan, N. P., Yuan, N. P., Koss, M. P., & Koss, M. P. (2007). Male Partner Violence. In Some book on sexual violence(pp xxx-xxx). New York: Elsevier Inc. doi:10.1016/B978-012373947-6.00246-4
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  This article defines types of male partner violence and describes the physical and mental health impact on victims. The use of posttraumatic stress disorder (PTSD) as the most common psychiatric diagnosis in the United States is discussed. Recommendations for prevention and intervention at the individual and public-policy level are offered.
• Cook, S. L., & Koss, M. P. (2005). More data have accumulated supporting date and acquaintance rape as significant problems for women. In Controversial Social Issues Second Edition(pp xxx-xxx). Thousand Oaks, CA: SAGE Publications Inc. doi:10.4135/9781483328584.N6
• Herrera, V. M., Koss, M. P., Bailey, J., Yuan, N. P., & Lichter, E. L. (2005). Survivors of male violence: Research and training intiatives to facilitate recovery from depression and PTSD. In Handbook of Girls and Women's Psychological Health.
• Walker, E. A., Newman, E., & Koss, M. P. (2004). Costs and health care utilization associated with traumatic experiences.. In Some book on violence against women(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10723-003
• Cook, S. L., & Koss, M. P. (2001). Action research: Informing interventions in male violence against women.. In The Book of Psychology(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10388-006
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  Chapter
• Koss, M. P., Koss, M. P., Kilpatrick, D. G., & Kilpatrick, D. G. (2001). Rape and Sexual Assault. In Some Encyclopedia. New York: Springer US. doi:10.1007/978-1-4615-1295-0_12
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  We had to be off the streets and in our homes before it got dark… that was the law. If you weren’t and the security police caught you, something terrible could happen. One day you would be here, the next day you could be disappeared. Since the sun was just beginning to set, I thought I was in no danger. I went to the neighborhood store to buy a few vegetables for dinner. I was in there no more than 3 minutes. Since it was still light, I didn’t think I was in any danger. Shortly after I left, I heard the footsteps. I didn’t turn around because I didn’t want to give the impression that I was afraid. The faster I walked, the closer the footsteps seemed. I was almost home when two men in civilian clothes stepped in front of me and said I had to go with them. I told them that my mother and father were waiting for me, that I hadn’t done anything wrong. The next thing I remember I was at the police station. I could hear screams and loud thumps… the thumps sounded like a heavy blanket being beaten by a stick. “Would this happen to me?” I wondered. Then they took me into a small room and ordered me to remove my clothes. “Please,” I pleaded with them, “I haven’t done anything wrong.” My pleas went unheard, and I was ordered again to remove my clothes… but I didn’t. Then one of the men started to tear at my clothes—he was the first one who raped me. I don’t remember how many of them raped me; there were so many. In the morning, they told me I could go home, and they laughed. My clothes were torn and stained with blood. When I got home, my mother wept, but my father beat me. He said it was my fault; it was my fault that I was out at night.
• Koss, M. P., & Cook, S. L. (1998). Facing the Facts: Date and Acquaintance Rape Are Significant Problems for Women. In Controversial Social Issues(pp xxx-xxx). Thousand Oaks, CA: SAGE Publications, Inc. doi:10.4135/9781483328348.N9
• Koss, M. P., & Cleveland, H. H. (1997). Stepping on Toes: Social Roots of Date Rape Lead to Intractability and Politicization. In Some book on psychology of violence(pp xxx-xxx). Thousand Oaks, CA: SAGE Publications, Inc. doi:10.4135/9781483327907.N1
• Koss, M. P. (1994). The Negative Impact of Crime Victimization on Women's Health and Medical Use. In A book on health and violence(pp xxx-xxx). Thousand Oaks California: SAGE Publications, Inc. doi:10.4135/9781483327099.N18
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Common themes and a call for action.. In Violence Against Women at Home, in Relationships, and at Work.(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-012
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Intervention and treatment for rape survivors.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-011
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Intervention, prevention, and treatment issues for sexual harassment.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-008
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Intimate violence: Treatment issues and policy initiatives.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-005
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Physical and psychological outcomes of partner violence.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-004
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Responses to sexual harassment.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-007
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). The culture and context of male violence against women.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-001
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). The physical and psychological aftermath of rape.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-010
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). The prevalence of intimate violence.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-003
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Understanding the perpetrator and the victim: Who abuses and who is abused?. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-002
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1994). Uniting all women: The fear of rape.. In No Safe Haven. Washington, DC: American Psychological Association. doi:10.1037/10156-009
• Koss, M. P., Goodman, L. A., Browne, A., Fitzgerald, L., Russo, N. F., & Keita, G. P. (1994). Sexual harassment: The last great open secret.. In No Safe Haven(pp xxx-xxx). Washington, DC: American Psychological Association. doi:10.1037/10156-006
• Koss, M. P., & Woodruff, W. J. (1991). Emerging Issues in Women’s Health. In Some Book on Women's Health(pp xxx-xxx). Springer, Boston, MA. doi:10.1007/978-1-4615-3792-2_13
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  Women represent 51.3% of the total U.S. population: 123.8 million people (Bureau of the Census, 1987). They are the predominant consumers of health care in the United States, but they are a minority of health care providers (Bartuska, 1988;Davis, 1988;Weisman & Teitelbaum, 1989). This chapter explores the anatomy of women’s health and health care. By considering data on life expectancy, mortality, morbidity, and lifestyle among different groups of American women, we gain information on the nature of women’s health care needs. By examining the statistics on poverty and violence against women, we identify social conditions that engender poor health and create obstacles to effective health care. By documenting the status of women doctoral-level providers in medical schools, we raise concerns about the ability of these institutions to provide gender-sensitive health care and education.
• Koss, M. P., & Leonard, K. E. (1984). Sexually Aggressive Men: Empirical Findings and Theoretical Implications. In New York Academy of Sciences. New York: Academic Press. doi:10.1016/B978-0-12-466280-3.50018-X
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  Sexual aggression is a general term that refers to a continuum of sexual activity involving increasing degrees of coercion up to and including rape. Sexual aggression includes the legal categories of sexual contacts, sexual acts, sexual imposition, and sexual intercourse when obtained through coercion or force and without consent. The focus of this chapter is the psychological characteristics of males who have engaged in sexual aggression against females. Since sexual aggression, though not uncommon, is not a behavior exhibited by all males, one may legitimately ask whether sexually aggressive men differ from sexually non-aggressive men. To examine this possibility, the literature concerning psychological disorders, attitudes, and sexual behavior of sexually aggressive men is reviewed, and several theoretical models of sexual aggression are presented and discussed.

Journals/Publications

• Koss, M. P. (2022). Knowledge of Sexual Transmission of Zika Virus Among Women Who Are Pregnant or Intend to Become Pregnant, or Intend to Become Pregnant, Arizona, 2017.. Public Health Reports, 137(3), 488-497. doi:doi: 10.1177/00333549211006986
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  Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona.
• Koss, M. P., Swartout, K., Raina, L., Elizabeth, A., Carolyn, B., & Robert, P. (2022). The scope of rape victimization and perpetration among national samples of college students across 30 years. Journal of Interpersonal Violence, 37((1-2)), NP25-NP47.. doi:10.1177/08862605211050103
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  Research Questions: Rape prevention practice and policy have roots in data from 1985. This study uses 2015 national data to project recent prevalence, assesses whether rates now differ from those of 30 years ago, and disaggregates 2015 prevalence into rape of alcohol incapacitated victims, rapes combining both alcohol and physical tactics, and violent rape. Methods: Cross-sectional analyses were conducted comparing two national samples. The first was collected in 1984-85 (Koss, Gidycz, & Wisniewski, 1987); the second was collected 30 years later in 2014-2015. Both surveys used in-person administration and measurement by the most current version at the time of the Sexual Experiences Survey (SES). Prevalence rates were compared using Bayesian binomial tests.Results: In 2015, 33.4% (1 in 3) of women reported experiencing rape or attempted rape and 12.7% of men reported perpetration (1 in 8). Using Jeffreys’ label for effect size of the Bayes binomial (1961), both results are “decisively” greater than expected given the 1985 benchmarks of 27.9% for victimization and 7.7% for perpetration. Victimization when incapacitated characterized approximately 75% of incidents in 2015 up from 50% in 1985. Cautions apply as cross-sectional data does not establish causality and the recent data set involved the revised SES. Conclusions: Across 30 years, neither containment nor reduction of rape was demonstrated and the increasingly prominent association with alcohol was apparent. Among the men who disclosed raping, 9 of 10 incidents were alcohol-involved. Prevention focus might profitably be directed to constraining alcohol environments and policies that facilitate rape of incapacitated persons and on misconduct responses that are proportional to the harm caused to rape victims, thereby raising the perceived risks of perpetration.
• Krause, K. C., Lopez, E. C., Koss, M. P., Krause, C. M., Welter, A., Mcclelland, D. J., Lopez, E. C., Krause, K. C., Krause, C. M., Koss, M. P., Garcia, D. O., Ernst, K. C., & Anderson, E. J. (2021). Web-Based and mHealth Interventions for Intimate Partner Violence Victimization Prevention: A Systematic Review.. Trauma, violence & abuse, 22(4), 870-884. doi:10.1177/1524838019888889
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  Mobile health (mHealth) technologies are increasingly used across health programming including intimate partner violence (IPV) prevention to optimize screening, educational outreach, and linkages to care via telehealth. We systematically evaluated current web-based and mHealth interventions, which include web- or mobile-based delivery methods for primary, secondary, and tertiary IPV victimization prevention. We searched MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Open Grey, and Google Scholar for empirical studies published 1998-2019. Studies were included if they considered empirical data, participants in adult romantic relationships, IPV as a primary or secondary outcome, and an mHealth component. The Mixed Methods Appraisal Tool was used to record critical ratings of quality among studies selected for inclusion. We assessed variation in targeted populations, types of IPV addressed, and mHealth approaches used. Of 133 studies identified for full-text review, 31 were included. Computer-based screening with or without integrated education was the most common mHealth approach (n = 8, 26%), followed by safety decision aids (n = 7, 23%). Feasibility and acceptability were found to be generally high where assessed (23% of studies, n = 7). There was limited evidence around whether mHealth interventions better addressed population needs compared to conventional interventions. mHealth tools for IPV prevention are especially acceptable in health-care settings, on mobile phone platforms, or when connecting victims to health care. Despite enthusiasm in pilot projects, evidence for efficacy compared to conventional IPV prevention approaches is limited. A major strength of mHealth IPV prevention programming is the ability to tailor interventions to individual victim needs without extensive human resource expenditure by providers.
• Mccuin, D. C., Lopez, E. C., Koss, M. P., Hayden, M. H., Garcia, D. O., Ernst, K. C., Brown, K. P., Austhof, E., Anderson, E. J., Mccuin, D. C., Lopez, E. C., Koss, M. P., Hayden, M. H., Garcia, D. O., Ernst, K. C., Brown, K. P., Austhof, E., & Anderson, E. J. (2021). Knowledge of Sexual Transmission of Zika Virus Among Women Who Are Pregnant or Intend to Become Pregnant, Arizona, 2017.. Public health reports (Washington, D.C. : 1974), 333549211006986. doi:10.1177/00333549211006986
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  Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona..In 2017, we conducted an Arizona-statewide survey 15 months after the initial release of US guidelines on sexual transmission of Zika virus. We used Poisson regression, adjusting for demographic factors, to estimate the likelihood among women who were pregnant or intended to become pregnant of knowing that Zika virus is sexually transmitted relative to other women of childbearing age. We used multinomial logistic regression models to explore associations with most used health information sources, either in person (eg, medical providers) or online (eg, Facebook), categorized by extent of dependability..Women who were pregnant or intended to become pregnant had similarly poor knowledge of the sexual transmission of Zika virus as compared with other women of childbearing age (adjusted prevalence ratio = 1.14 [95% CI, 0.83-1.55]). Only about one-third of all respondents reported knowledge of sexual transmission. Reliance on high- vs low-dependability information sources, whether in person or online, did not predict the extent of Zika virus knowledge among women who were pregnant or intended to become pregnant..As late as the second year of local Zika virus transmission in the United States, in 2017, women in Arizona were not receiving sufficient information about sexual transmission, even though it was available. To prepare for possible future outbreaks, research should explore which aspects of Zika information campaigns were ineffective or inefficient.
• Seaman, C., Prentky, R. A., Malamuth, N. M., Lopez, E. C., Lamade, R. V., Koss, M. P., Lopez, E. C., Koss, M. P., Seaman, C., Prentky, R. A., Malamuth, N. M., Lopez, E. C., Lamade, R. V., & Koss, M. P. (2021). Factors predictive of sexual violence: Testing the four pillars of the Confluence Model in a large diverse sample of college men.. Aggressive behavior, 47(4), 405-420. doi:10.1002/ab.21960
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  This article focuses on the characteristics of sexually violent men who have not been convicted of a crime. The objective of this study was to test the four key interrelated pillars of the Confluence Model. The first key pillar posits the interaction of Hostile Masculinity and Impersonal Sex as core risk predictors. The second pillar entails a "mediated structure" wherein the impact of more general risk factors is mediated via those specific to aggression against women. The third pillar comprises a single latent factor underlying various types of sexual violence. The fourth pillar expands the core model by including the secondary risk factors of lower empathy, peer support, extreme pornography use, and participation in alcohol parties. An ethnically diverse sample of 1,148 male students from 13 U.S. colleges and universities completed a comprehensive survey that assessed the hypothesized risk factors and self-reported sexual violence, which included noncontact sexual offenses, contact sexual coercion, and contact sexual aggression. A series of multiple regression analyses were conducted before testing structural equation models. The results supported the integration of the four pillars within a single expanded empirical model that accounted for 49% of the variance of sexual violence. This study yielded data supporting all four key pillars. These findings provide information about non-redudant risk factors that can be used to develop screening tools, group-based and individually tailored psychoeducational and treatment interventions.
• Seaman, C., Prentky, R. A., Malamuth, N. M., Lopez, E. C., Lamade, R. V., Koss, M. P., Seaman, C., Prentky, R. A., Malamuth, N. M., Lopez, E. C., Lamade, R. V., & Koss, M. P. (2021). Corrigendum to Malamuth et al. (2021): Reference correction.. Aggressive behavior, 47(5), 513. doi:10.1002/ab.21980
• Koss, M. P., Martins, F. F., Martins, C. D., Koss, M. P., Ernst, K. C., & Anderson, E. J. (2020). Women's Health Perceptions and Beliefs Related to Zika Virus Exposure during the 2016 Outbreak in Northern Brazil.. The American journal of tropical medicine and hygiene, 102(3), 629-633. doi:10.4269/ajtmh.19-0311
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  During the 2016 Zika pandemic in Brazil, women's perceptions of infection risk, ability to adhere to Zika prevention strategies, or access to services following exposure were not emphasized in the public health response. Women in Fortaleza, Brazil, responded to a questionnaire on social factors related to perceived Zika risk and access to health care in June 2016. Data were coded using prespecified categories, and response frequency was reported. Of 37 respondents, most reported a lack of public services to support mosquito control (n = 19) or delayed access to reproductive health care (n = 14). Only 22% described specific maternal risks or fetal outcomes as a consequence of Zika infection. Respondents indicated an overall disconnect between public health efforts and women's perceptions of their reproductive control, including limited support concerning microcephaly in infants. Interventions targeting Zika may require a greater emphasis on strengthening health systems and infrastructure to realistically prevent transmission.
• Koss, M. P., Lopez, E. C., & Kennon, K. (2019). Acquaintance Rape. The Encyclopedia of Women and Crime, 1-8. doi:10.1002/9781118929803.ewac0002
• Krause, K. C., Koss, M. P., Krause, C. M., Mcclelland, J., Krause, K. C., Krause, C. M., Koss, M. P., Garcia, D. O., & Anderson, E. J. (2019). Web-based and mHealth interventions for intimate partner violence prevention: a systematic review protocol.. BMJ open, 9(8), e029880. doi:10.1136/bmjopen-2019-029880
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  Victims of intimate partner violence (IPV), or those individuals susceptible to IPV victimisation or perpetration, may benefit from participation in primary, secondary or tertiary interventions to address or mitigate exposure to violence despite mixed evidence of IPV intervention effectiveness. However, participation in such programmes is limited by poor access, sociocultural barriers and programme cost. As the world fast approaches universal access to the internet, web-based technologies and low-cost smartphones, new avenues to provide preventive health services including mobile health (mHealth) tools, platforms and services have emerged. The objective of this systematic review is to assess current web-based and mHealth interventions, which include web-based or mobile-based delivery methods for IPV prevention. Interpersonal violence is defined as perpetration or victimisation of a physical, psychological or sexual nature among adults. Interventions may be at the primary, secondary or tertiary level of the public health model..This systematic review will incorporate studies focused on any empirical prevention intervention intended for IPV victims or perpetrators of any gender where one or more components is web based or mobile based. Articles will be retrieved from the following academic databases: MEDLINE/PubMed, Embase, CINAHL, PsycInfo and Open Grey, as well Google Scholar. Results will be limited to articles reporting primary data, published since 1998, and in English, Spanish, Portuguese or French. Data extraction procedures will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. The Mixed Methods Appraisal Tool, a critical appraisal tool, will be used to record ratings of quality and risk of bias among studies selected for inclusion. Content analysis and between-study comparisons will be used to answer the objectives of this review..Results from this review will be published in an open access format for the benefit of both academic and non-academic audiences, including community organisations and individuals seeking mHealth strategies to reduce and prevent IPV..CRD42019123006.
• Donde, S. D., Koss, M. P., Ragsdale, S. K., & Zuvker, A. N. (2017). If it wasn't rape, was it sexual assault? Comparing rape and sexual assault acknowledgement in College women who have experienced rape. Psychology of women, 1-21. doi:10.1177/1077801217743339
• Donde, S. D., Ragsdale, S. K., Koss, M. P., & Zucker, A. N. (2018). If It Wasn't Rape, Was It Sexual Assault? Comparing Rape and Sexual Assault Acknowledgment in College Women Who Have Experienced Rape. Violence against women, 24(14), 1718-1738.
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  The present study investigated (a) comparisons in rates of rape and sexual assault acknowledgment and (b) a comprehensive multivariate multinomial logistic model predicting rape and sexual assault acknowledgment in a sample of 174 college women who had experienced rape. Significantly more women acknowledged having experienced sexual assault than rape. Greater perceived perpetrator force was associated with increased likelihood of rape and sexual assault acknowledgment. Increased age and greater perceived emotional impact were associated with increased odds of rape acknowledgment. Implications for policy, education, and practice within university settings are discussed.
• Koss, M. P. (2018). Developing and implementing a treatment intervention for college students found responsible for sexual misconduct. Agression, Conflict, and Peace Research, 10(2), 134-144. doi:10.1108/JACPR-06-2017-0301
• Koss, M. P. (2018). Student Views on Campus Sexual Assault. Journal of American College Health, 1-8. doi:10.1080/07448481.2018.1500476
• Lopez, E. C., Koss, M. P., Lopez, E. C., & Koss, M. P. (2018). Training in restorative justice for sex crimes from the perspective of sexual assault specialists. The International Journal of Restorative Justice, 1(2), 309-313. doi:10.5553/ijrj/258908912018001002009
• Schaaf, S., Lamade, R. V., Burgess, A. W., Koss, M., Lopez, E., & Prentky, R. (2018). Student views on campus sexual assault. Journal of American college health : J of ACH, 1-8.
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  To report on college student opinions about the scope of college sexual misconduct (CSM), suggested university sanctions, and treatment of students found responsible of CSM.
• Koss, M. P. (2017). Award for Distinguished Contributions to the International Advancement of Psychology: Mary P. Koss.. The American psychologist, 72(9), 1016-1018. doi:10.1037/amp0000224
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  The Award for Distinguished Contributions to the International Advancement of Psychology is given to individuals who have made sustained and enduring contributions to international cooperation and the advancement of knowledge in psychology. The 2017 award winner is Mary P. Koss, whose "stellar research, consultation, and advocacy on sexual violence against women and girls...has contributed to the integration of women's rights as an integral part of human rights." Her award citation, biography, and a selected bibliography are presented here. (PsycINFO Database Record
• Koss, M. P. (2017). Developing and implementing a treatment intervention for college students found responsible for sexual misconduct.. Journal of Aggression, Conflict, and Peace Research. doi:https://doi.org/10.1108/JACPR-06-2017-0301
• Koss, M. P. (2017). Victim voice in reenvisioning responses to sexual and physical violence nationally and internationally.. American Psychologist, 72, 1019-1030. doi:http://www.dx.doi.org/10.1037/amp0000233
• Asaolu, I. O., Gunn, J. K., Koss, M. P., Koss, M. P., Iwelunmor, J. I., Gunn, J. K., Ehiri, J. E., & Asaolu, I. O. (2016). Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study.. PloS one, 11(10), e0164052. doi:10.1371/journal.pone.0164052
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  In spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15-24 years in sub-Saharan Africa..This study used the Demographic and Health Survey (DHS) data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville), representing central Africa (DHS 2011-2012); Mozambique, representing southern Africa (DHS 2011); Nigeria, representing western Africa (DHS 2013); and Uganda, representing eastern Africa (DHS 2011). Analyses were restricted to 23,367 male and female respondents aged 15-24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at p< 0.01..The analysis revealed that a majority of the respondents were female (78.1%) and aged 20-24-years (60.7%). Only a limited proportion of respondents (36.5%) had ever tested for HIV and even fewer (25.7%) demonstrated comprehensive knowledge of HIV/AIDS. There was a significant association between HIV testing and respondents' gender, age, age at sexual debut, and comprehensive knowledge of HIV in the pooled sample. Older youth (adjusted OR (aOR) = 2.19; 99% CI = 1.99-2.40) and those with comprehensive knowledge of HIV (aOR = 1.98; 1.76-2.22) had significantly higher odds of ever being tested for HIV than younger respondents and those with limited HIV/AIDS knowledge respectively. Furthermore, men had lower odds of HIV testing than women (aOR = 0.32; 0.28-0.37)..Reaching youth in sub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth. The results further suggest that these initiatives would be strengthened by including strategies to increase HIV comprehensive knowledge.
• Koss, M. P. (2016). Trajectory analysis of the campus serial rapist assumption.. JAMA Pediatrics,, 169(12), 1148-1154..
• Bramsen, R. H., Lasgaard, M., Koss, M. P., Shevlin, M., Elklit, A., & Banner, J. (2015). Testing a Multiple Mediator Model of the Effect of Childhood Sexual Abuse on Adolescent Sexual Victimization. AMERICAN JOURNAL OF ORTHOPSYCHIATRY, 83(1), 47-54.
• Koss, M. P. (2014). The RESTORE Program of Restorative Justice for Sex Crimes Vision, Process, and Outcomes. Journa of Interpersonal Violence, 29(9), 1623-1660.
• Koss, M. P. (2015). Restorative justice for sex crimes outside the context of intimate partner violence. Family & Intimate Partner Violence Quarterlyy, 7(4), 307-316.
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  This article is a rationale for the use of restorative resolution for sexual crimes and campus-based sexual assault. A step-byo-step description of the RESTORE Program is provided to illustrate how to design and implement one model of restorative justice.
• Koss, M. P. (2015). What Is the Best Way to Analyze Less Frequent Forms of Violence? The Case of Sexual Aggression. Psychology of Violence, 5(3), 305-313.
• Koss, M. P., & Lopez, E. C. (2015). Restorative justice innovations in response to campus sexual misconduct. Sexual Assault Report, Civic Research Institute.
• Swartout, K. M., Koss, M. P., White, J. W., Thompson, M. P., Abbey, A., & Bellis, A. L. (2015). Errors in Derivation Data and Validation Data. JAMA pediatrics, 169(12), 1178-9.
• Swartout, K. M., Koss, M. P., White, J. W., Thompson, M. P., Abbey, A., & Bellis, A. L. (2015). Trajectory Analysis of the Campus Serial Rapist Assumption. JAMA pediatrics, 169(12), 1148-54.
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  Rape on college campuses has been addressed recently by a presidential proclamation, federal legislation, advocacy groups, and popular media. Many initiatives assume that most college men who perpetrate rape are serial rapists. The scientific foundation for this perspective is surprisingly limited.
• Bramsen, R. H., Bramsen, R. H., Lasgaard, M., Lasgaard, M., Koss, M. P., Koss, M. P., Elklit, A., Elklit, A., Banner, J., & Banner, J. (2014). Investigating the effect of child maltreatment on early adolescent peer-on-peer sexual aggression: testing a multiple mediator model in a non-incarcerated sample of Danish adolescents. European journal of psychotraumatology, 5.
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  The aim of the present study was to investigate the relationship between child maltreatment and severe early adolescent peer-on-peer sexual aggression, using a multiple mediator model.
• Koss, M. P. (2013). Restorative justice and sexual assault: Outcome approasal through textural analysis. Open Area Studies Journal, 5, 1-11.
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  Restorative Justice is a community alternative to criminal justice. Its principles and practices are grounded inharm reduction, consensually-determined reparation, and in many applications, a facilitated conference between an offenderand respective victim, and family members and/or community persons impacted by the crime. Projects based onRestorative Justice are rare for sex offenders. In this article, we review one such program funded as a demonstration project.Based on the rubric that we adapted from a template developed by Stephen Webster, we assessed the veracity ofapology letters written by adult sex offenders, who earned the right to apologize to their victim, following participation ina 12-month program based on principles and practices of Restorative Justice. Content of the apology letters demonstratedanticipated changes in classic features of sexual assault as a harm-causing, ego-centered, trauma-producing, controlseeking,relationship-imposing act. Despite individualized formulation by each responsible person, the letters from misdemeanorand felony cases were similar in acknowledgment of harm and in the articulation of gratitude, but varied in responsibilityacceptance and trauma discontinuation
• Koss, M. P. (2014). Campus sexual misconduct: Restorative justice approaches to enhance compliance with Title IX guidance. Trauma, Violence, & Abuse, 15, 242-258. doi:10.1177/1524838014521500
• Koss, M. P. (2014). Campus sexual misconduct: Restorative justice approaches to enhance compliance with Title IX guidance.. Trauma, Violence, & Abuse, 15, 242-258.
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  Campus response to sexual violence is increasingly governed by federal law and administrative guidance such as the 1972 Title IX, the 2011 Dear Colleague Letter (DCL), and the 2013 Violence Against Women Act. Educational institutions are directed to expand disciplinary responses and establish coordinated action to eliminate sexual violence and remedy its effects. Compliance fosters a quasi-criminal justice approach not suited to all sexual misconduct and inconsistent with developing practice in student conduct management. This article envisions restorative justice (RJ) enhancements to traditional student conduct processes that maintain compliance, expand options, empower victim choice, and increase responsiveness to DCL aims. The article (1) defines sexual violence and sexual harassment within the DCL scope, (2) elaborates the DCL position on permissible alternative resolutions and differentiates mediation from RJ, (3) sequences action steps from case report to finalization, including both restorative and traditional justice pathways; and (4) discusses building support for innovation beginning with existing campus response.
• Koss, M. P. (2014). Investigating the effect of child maltreatment on early adolescente peer-on-peer sexual aggression: testing a multiple mediator model in a non-incarcerated sample of Danish adolescents. European Journal of Psychotraumatology, 5, 2014.
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  Objective The aim of the present study was to investigate the relationship between child maltreatment and severe early adolescent peer-on-peer sexual aggression, using a multiple mediator model.Methods The study comprised 330 male Grade 9 students with a mean age of 14.9 years (SD=0.5).Results Estimates from the mediation model indicated significant indirect effects of child physical abuse on sexual aggression via peer influence and insecure-hostile masculinity. No significant total effect of child sexual abuse and child neglect on sexual aggression was found.ConclusionsFindings of the present study identify risk factors that are potentially changeable and therefore of value in informing the design of prevention programs aiming at early adolescent peer-on-peer sexual aggression in at-risk youth.
• Koss, M. P. (2014). The RESTORE Program of Restorative Justice for Sex Crimes Vision, Process, and Outcomes. JOURNAL OF INTERPERSONAL VIOLENCE, 29(9), 1623-1660.
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  The article reports empirical evaluation of RESTORE, a restorative justice (RJ) conferencing program adapted to prosecutor-referred adult misdemeanor and felony sexual assaults. RESTORE conferences included voluntary enrollment, preparation, and a face-to-face meeting where primary and secondary victims voice impacts, and responsible persons acknowledge their acts and together develop a re-dress plan that is supervised for 1 year. Process data included referral and consent rates, participant characteristics, observational ratings of conferences compared with program design, services delivered, and safety monitoring. Outcome evaluation used 22 cases to assess (a) pre-post reasons for choosing RESTORE, (b) preparation and conference experiences, (c) overall program and justice satisfaction, and (d) completion rates. This is the first peer-reviewed quantitative evaluation of RJ conferencing for adult sexual assault. Although the data have limitations, the results support cautious optimism regarding feasibility, safety, and satisfactory outcomes. They help envision how conferencing could expand and individualize justice options for sexual assault.
• Koss, M. P. (2014). VAWA After the Party: Implementing Proposed Guidelines on Campus Sexual Assault Resolution. CUNY Law Review, December 22 2014, no pagination.
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  The 20th anniversary of the passage of the Violence Against Women Act (“VAWA”) and its reauthorization in 2013[1] merits celebration and marks a time to contemplate the future legislative and policy agenda. This commentary considers the effect of existing and proposed VAWA guidelines on the process for sexual assault adjudication at institutions of higher education. The focus is several documents including the US Department of Education Office of Civil Rights “Dear Colleague Letter”[DCL],[2] DCL clarification,[3] and the Proposed Guidelines for the Violence Against Women Act Reauthorization as disseminated for comment in the Federal Register of June 20, 2014.[4] We aim to establish that taken together, these documents: (1) blur the distinctions between campus misconduct resolution and criminal justice process;[5] (2) lack scholarly analysis of sexual assault justice on campus;[6] and (3) clash with contemporary values and practice standards of student affairs professionals.[7] This commentary identifies enhancements derived from restorative justice principles [RJ] and situates them within misconduct resolution framework while maintaining consistency with DCL and VAWA required elements. RJ offers a range of formats that are relevant to the student body at large as well as to individuals involved in sexual misconduct of varying severity and can be implemented at multiple time points in case processing. We draw upon many sources that collectively express desire for policy guidance that supports evidence-based innovations intended to increase congruence with victims’ perceptions of what constitutes justice, raise the likelihood that offenders will be held responsible by sanctions proportional to the harm done, and augment the extent to which institutional responses deter future sexual misconduct.[8]
• Koss, M. P. (2014). VAWA after the party. Implementing proposed guidelines on campus sexual assault resolution. CUNY Law Review.
• Koss, M. P. (2014). What Is the Best Way to Analyze Less Frequent Forms of Violence? The Case of Sexual Aggression.. Psychology of Violence, 3(http://dx.doi.org/10.1037/a0038316), no pagination specified.
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  Objective: Most frequency data on violence are non-normally distributed, which can lead to faulty conclusions when not modeled appropriately. And, we can’t prevent what we can’t accurately predict. We therefore review a series of methods specifically suited to analyze frequency data, with specific reference to the psychological study of sexual aggression. In the process, we demonstrate a model comparison exercise using sample data on college men’s sexual aggression. Method: We used a subset (n = 645) of a larger longitudinal dataset to demonstrate fitting and comparison of 6 analytic methods: OLS regression, OLS regression with a square-root–transformed outcome, Poisson regression, negative binomial regression, zero-inflated Poisson regression, and zero-inflated negative binomial regression. Risk and protective factors measured at Time 1 predicted frequency of sexual aggression at Time 2 (8 months later) within each model. Models were compared on overall fit, parsimony, and interpretability based upon previous findings and substantive theory. Results: As we predicted, OLS regression assumptions were untenable. Of the count-based regression models, the negative binomial model fit the data best; it fit the data better than the Poisson and zero-inflated Poisson models, and it was more parsimonious than the zero-inflated negative binomial model without a significant degradation in model fit. Conclusion: In addition to more accurately modeling violence frequency data, count-based models have clear interpretations that can be disseminated to a broad audience. We recommend analytic steps investigators can use when analyzing count outcomes as well as further avenues researchers can explore in working with non-normal data on violence. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
• Koss, M. P., & Koss, M. P. (2014). The RESTORE program of restorative justice for sex crimes: vision, process, and outcomes. Journal of interpersonal violence, 29(9), 1623-60.
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  The article reports empirical evaluation of RESTORE, a restorative justice (RJ) conferencing program adapted to prosecutor-referred adult misdemeanor and felony sexual assaults. RESTORE conferences included voluntary enrollment, preparation, and a face-to-face meeting where primary and secondary victims voice impacts, and responsible persons acknowledge their acts and together develop a re-dress plan that is supervised for 1 year. Process data included referral and consent rates, participant characteristics, observational ratings of conferences compared with program design, services delivered, and safety monitoring. Outcome evaluation used 22 cases to assess (a) pre-post reasons for choosing RESTORE, (b) preparation and conference experiences, (c) overall program and justice satisfaction, and (d) completion rates. This is the first peer-reviewed quantitative evaluation of RJ conferencing for adult sexual assault. Although the data have limitations, the results support cautious optimism regarding feasibility, safety, and satisfactory outcomes. They help envision how conferencing could expand and individualize justice options for sexual assault.
• Koss, M. P., Koss, M. P., Wilgus, J. K., Wilgus, J. K., Williamsen, K. M., & Williamsen, K. M. (2014). Campus Sexual Misconduct: Restorative Justice Approaches to Enhance Compliance With Title IX Guidance. Trauma, violence & abuse, 15(3), 242-257.
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  Campus response to sexual violence is increasingly governed by federal law and administrative guidance such as the 1972 Title IX, the 2011 Dear Colleague Letter (DCL), and the 2013 Violence Against Women Act. Educational institutions are directed to expand disciplinary responses and establish coordinated action to eliminate sexual violence and remedy its effects. Compliance fosters a quasi-criminal justice approach not suited to all sexual misconduct and inconsistent with developing practice in student conduct management. This article envisions restorative justice (RJ) enhancements to traditional student conduct processes that maintain compliance, expand options, empower victim choice, and increase responsiveness to DCL aims. The article (1) defines sexual violence and sexual harassment within the DCL scope, (2) elaborates the DCL position on permissible alternative resolutions and differentiates mediation from RJ, (3) sequences action steps from case report to finalization, including both restorative and traditional justice pathways; and (4) discusses building support for innovation beginning with existing campus response.
• Lehrer, J. A., Lehrer, E. L., & Koss, M. P. (2014). Sexual and dating violence among adolescents and young adults in Chile: a review of findings from a survey of university students. CULTURE HEALTH & SEXUALITY, 15(1), 1-14.
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  This paper synthesises and discusses results from the 2005 Survey of Student Well-Being, a closed-ended questionnaire administered to students attending general education courses at a major public university in Santiago (n = 484 women, 466 men). The survey included questions on sexual violence (SV) and dating violence (DV), public health problems that have received little attention in Chile and other Latin-American countries. This paper highlights key findings from a series of papers based on these data, noting lessons learned in the Chilean context that may be useful for other Latin-American countries. Important gaps in the international literature on SV and DV are also discussed. A central finding is the high prevalence of SV and DV in this sample of university students, warranting further public health attention to these problems. Potentially, the findings will contribute to changes in awareness, policy and practice along similar lines to efforts that transformed the US landscape regarding SV and DV on college campuses in the 1980s.
• Lehrer, J. A., Lehrer, E. L., & Koss, M. P. (2014). Unwanted Sexual Experiences in Young Men: Evidence from a Survey of University Students in Chile. ARCHIVES OF SEXUAL BEHAVIOR, 42(2), 213-223.
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  The public health problem of unwanted sexual experiences (USE) in male youths has received little attention. In this study, we examined prevalence of USE, risk factors, contexts, and barriers to disclosure with data from a quantitative survey of students enrolled in General Education courses at a public university in Chile. This study focused on the male sample (N = 466). Approximately 20.4 % of participants reported some form of USE since age 14. Forced sex through physical coercion, forced sex through verbal coercion or while intoxicated, attempted forced sex, and less severe forms of USE were reported by 0.2, 10.1, 1.4, and 8.7 % of participants, respectively. USE before age 14 was reported by 9.4 % of participants and was a significant predictor of USE since age 14 (AOR 6.38, 95 % CI 3.22-12.65, p < .01). The perpetrator of USE since age 14 was most commonly identified as a date/partner or friend/acquaintance; other findings on contexts and barriers to disclosure were also generally consistent with previous results in the literature. In addition, we found substantial co-occurrence of USE since age 14 with two other forms of coercion: physical dating violence victimization and coerced condom non-use. The study findings indicate a need for further attention to these public health problems and have implications for the development of violence and HIV/STI prevention programs for adolescent boys and young adult men in Chile and elsewhere.
• Bletzer, K. V., & Koss, M. P. (2013). From Parallel to Intersecting Narratives in Cases of Sexual Assault. QUALITATIVE HEALTH RESEARCH, 22(3), 291-303.
• Bramsen, R. H., Bramsen, R. H., Lasgaard, M., Lasgaard, M., Koss, M. P., Koss, M. P., Shevlin, M., Shevlin, M., Elklit, A., Elklit, A., Banner, J., & Banner, J. (2013). Testing a multiple mediator model of the effect of childhood sexual abuse on adolescent sexual victimization. The American journal of orthopsychiatry, 83(1), 47-54.
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  The present study modeled the direct relationship between child sexual abuse (CSA) and adolescent peer-to-peer sexual victimization (APSV) and the mediated effect via variables representing the number of sexual partners, sexual risk behavior, and signaling sexual boundaries. A cross-sectional study on the effect of CSA on APSV was conducted, utilizing a multiple mediator model. Mediated and direct effects in the model were estimated employing Mplus using bootstrapped percentile based confidence intervals to test for significance of mediated effects. The study employed 327 Danish female adolescents with a mean age of 14.9 years (SD = 0.5). The estimates from the mediational model indicated full mediation of the effect of CSA on APSV via number of sexual partners and sexual risk behavior. The current study suggests that the link between CSA and APSV was mediated by sexual behaviors specifically pertaining to situations of social peer interaction, rather than directly on prior experiences of sexual victimization. The present study identifies a modifiable target area for intervention to reduce adolescent sexual revictimization.
• Bramsen, R. H., Lasgaard, M., Koss, M. P., Elklit, A., & Banner, J. (2013). Investigating the effect of child maltreatment on early adolescent peer-on-peer sexual aggression: testing a multiple mediator model in a non-incarcerated sample of Danish adolescents. EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY, 5.
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  Objective: The aim of the present study was to investigate the relationship between child maltreatment and severe early adolescent peer-on-peer sexual aggression, using a multiple mediator model.
• Koss, M. P. (2013). Sexual and dating violence in Chilean youth: Lessons from a 2005 Survey of University Students. American Sociological Review, 15, 1-14.
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  Restorative justice is a generally community-based alternative to criminaljustice. Its practices are grounded in harm reduction, consensuallydetermined reparation, and in many applications, facilitated conferencing between a designated offender and respective victim, and members of the family and/or the community impacted by the crime. Restorative justice projects are rare for sex offenders. In this article, we review one such program, developed from conferencing models for adult sex crimes. We use textual analysis to assess the veracity of letters of apology written by adult sex offenders who earn the right to apologize through a 12-month process of meaningful accountability that includes individual psychotherapy, and, importantly, completion of reparation recommended and approved by the survivor victim. Based on a rubric adapted from a template developed by Webster (2002), textual analysis was performed on the apology letters “prepared for” and “read to/by” survivor victims. Apology letters were similar in harm acknowledgment and gratitude articulation, but varied in responsibility acceptance and trauma discontinuation. Overall, the letters demonstrated the expected changes in the classic features of sexual assault, despite individualized textual formulation by each responsible person.
• Koss, M. P. (2013). Testing a multiple mediator model of the effect of childhood sexual abuse on adolescent sexual victimization.. American Journal of Orthopsychiatry, 83(1), 47-xx.
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  The present study modeled the direct relationship between child sexual abuse (CSA) and adolescent peer-to-peer sexual victimization (APSV) and the mediated effect via variables representing the number of sexual partners, sexual risk behavior, and signaling sexual boundaries. A cross-sectional study on the effect of CSA on APSV was conducted, utilizing a multiple mediator model. Mediated and direct effects in the model were estimated employing Mplus using bootstrapped percentile based confidence intervals to test for significance of mediated effects. The study employed 327 Danish female adolescents with a mean age of 14.9 years (SD = 0.5). The estimates from the mediational model indicated full mediation of the effect of CSA on APSV via number of sexual partners and sexual risk behavior. The current study suggests that the link between CSA and APSV was mediated by sexual behaviors specifically pertaining to situations of social peer interaction, rather than directly on prior experiences of sexual victimization. The present study identifies a modifiable target area for intervention to reduce adolescent sexual revictimization. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
• Koss, M. P. (2013). Trajectories and Predictors of Sexually aggressive behaviors during emerging adulthood. Psychology of Violence, 3(3), 247-. doi:10.1037/a0030624
• Koss, M. P. (2013). Trajectories and Predictors of Sexually aggressive behaviors during emerging adulthood.. Psychology of Violence, 3(3), 247-249.
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  Objective: To assess longitudinal trajectories of college males’ sexually aggressive behaviors and determine time-varying individual- and peer-level risk factors that differentiate men who follow these different paths. Method: Our analytic sample consisted of 795 men who participated in a longitudinal study on high-risk behaviors among college students. The sample was surveyed at the end of each of their 4 years at university on a variety of measures, including sexual aggression (SA) and its hypothesized risk factors (hostile masculinity, number of sexual partners, alcohol misuse, and peer norms). Results: Using latent growth mixture modeling, we found four distinct SA trajectories: (a) consistently high, (b) decreasing, (c) increasing, and (d) consistently low. Multinomial logistic regression revealed that hostile masculinity and peer norms positively predicted trajectory membership at times when each trajectory reflected a high level of SA. Conclusions: Our study adds to the knowledge base by elucidating the different ways sexually aggressive behaviors change during emerging adulthood and how confluence-model-derived factors predict the different trajectories. The finding that changes over time in these risk factors correspond with SA perpetration risk informs prevention programming by illuminating the importance of continual focus on these risk factors throughout the college years, perhaps through annual self-assessments. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
• Koss, M. P., Wilgus, J. K., & Williamsen, K. M. (2013). Campus Sexual Misconduct: Restorative Justice Approaches to Enhance Compliance With Title IX Guidance. TRAUMA VIOLENCE & ABUSE, 15(3), 242-257.
  More info

  Campus response to sexual violence is increasingly governed by federal law and administrative guidance such as the 1972 Title IX, the 2011 Dear Colleague Letter (DCL), and the 2013 Violence Against Women Act. Educational institutions are directed to expand disciplinary responses and establish coordinated action to eliminate sexual violence and remedy its effects. Compliance fosters a quasi-criminal justice approach not suited to all sexual misconduct and inconsistent with developing practice in student conduct management. This article envisions restorative justice (RJ) enhancements to traditional student conduct processes that maintain compliance, expand options, empower victim choice, and increase responsiveness to DCL aims. The article (1) defines sexual violence and sexual harassment within the DCL scope, (2) elaborates the DCL position on permissible alternative resolutions and differentiates mediation from RJ, (3) sequences action steps from case report to finalization, including both restorative and traditional justice pathways; and (4) discusses building support for innovation beginning with existing campus response.
• Lehrer, J. A., Lehrer, J. A., Lehrer, E. L., Lehrer, E. L., Koss, M. P., & Koss, M. P. (2013). Sexual and dating violence among adolescents and young adults in Chile: a review of findings from a survey of university students. Culture, health & sexuality, 15(1), 1-14.
  More info

  This paper synthesises and discusses results from the 2005 Survey of Student Well-Being, a closed-ended questionnaire administered to students attending general education courses at a major public university in Santiago (n = 484 women, 466 men). The survey included questions on sexual violence (SV) and dating violence (DV), public health problems that have received little attention in Chile and other Latin-American countries. This paper highlights key findings from a series of papers based on these data, noting lessons learned in the Chilean context that may be useful for other Latin-American countries. Important gaps in the international literature on SV and DV are also discussed. A central finding is the high prevalence of SV and DV in this sample of university students, warranting further public health attention to these problems. Potentially, the findings will contribute to changes in awareness, policy and practice along similar lines to efforts that transformed the US landscape regarding SV and DV on college campuses in the 1980s.
• Lehrer, J. A., Lehrer, J. A., Lehrer, E. L., Lehrer, E. L., Koss, M. P., & Koss, M. P. (2013). Unwanted sexual experiences in young men: evidence from a survey of university students in Chile. Archives of sexual behavior, 42(2), 213-23.
  More info

  The public health problem of unwanted sexual experiences (USE) in male youths has received little attention. In this study, we examined prevalence of USE, risk factors, contexts, and barriers to disclosure with data from a quantitative survey of students enrolled in General Education courses at a public university in Chile. This study focused on the male sample (N = 466). Approximately 20.4 % of participants reported some form of USE since age 14. Forced sex through physical coercion, forced sex through verbal coercion or while intoxicated, attempted forced sex, and less severe forms of USE were reported by 0.2, 10.1, 1.4, and 8.7 % of participants, respectively. USE before age 14 was reported by 9.4 % of participants and was a significant predictor of USE since age 14 (AOR 6.38, 95 % CI 3.22-12.65, p 
• Tasca, M., Rodriguez, N., Spohn, C., & Koss, M. P. (2013). Police Decision Making in Sexual Assault Cases: Predictors of Suspect Identification and Arrest. JOURNAL OF INTERPERSONAL VIOLENCE, 28(6), 1157-1177.
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  As the initial gatekeepers of the criminal justice system, police officers hold considerable discretion in the investigation of offenses and in the decision to make an arrest. This is particularly true with sexual assault given the unique nature of these cases. Yet most research in this area has focused on prosecutors' charging decisions rather than police outcomes for reports of sexual assaults. In an effort to address this gap in the literature, we rely on official records collected from all sexual assaults reported to police in a large Arizona city in 2003 (N = 220) to examine the effects of crime seriousness, evidentiary strength, victim blame, and believablity factors on suspect identification and arrest. Results revealed that both legal and extralegal factors influenced whether police identify and arrest a suspect. These findings raise questions surrounding the role that police play in securing victim cooperation and the extent to which stereotypes of "legitimate" victims shape police officers' willingness to investigate sexual assault cases.
• Tasca, M., Tasca, M., Rodriguez, N., Rodriguez, N., Spohn, C., Spohn, C., Koss, M. P., & Koss, M. P. (2013). Police decision making in sexual assault cases: predictors of suspect identification and arrest. Journal of interpersonal violence, 28(6), 1157-77.
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  As the initial gatekeepers of the criminal justice system, police officers hold considerable discretion in the investigation of offenses and in the decision to make an arrest. This is particularly true with sexual assault given the unique nature of these cases. Yet most research in this area has focused on prosecutors' charging decisions rather than police outcomes for reports of sexual assaults. In an effort to address this gap in the literature, we rely on official records collected from all sexual assaults reported to police in a large Arizona city in 2003 (N = 220) to examine the effects of crime seriousness, evidentiary strength, victim blame, and believablity factors on suspect identification and arrest. Results revealed that both legal and extralegal factors influenced whether police identify and arrest a suspect. These findings raise questions surrounding the role that police play in securing victim cooperation and the extent to which stereotypes of "legitimate" victims shape police officers' willingness to investigate sexual assault cases.
• Thompson, M. P., Swartout, K. M., & Koss, M. P. (2013). Trajectories and Predictors of Sexually Aggressive Behaviors During Emerging Adulthood. PSYCHOLOGY OF VIOLENCE, 3(3), 247-259.
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  Objective: To assess longitudinal trajectories of college males' sexually aggressive behaviors and determine time-varying individual- and peer-level risk factors that differentiate men who follow these different paths. Method: Our analytic sample consisted of 795 men who participated in a longitudinal study on high-risk behaviors among college students. The sample was surveyed at the end of each of their 4 years at university on a variety of measures, including sexual aggression (SA) and its hypothesized risk factors (hostile masculinity, number of sexual partners, alcohol misuse, and peer norms). Results: Using latent growth mixture modeling, we found four distinct SA trajectories: (a) consistently high, (b) decreasing, (c) increasing, and (d) consistently low. Multinomial logistic regression revealed that hostile masculinity and peer norms positively predicted trajectory membership at times when each trajectory reflected a high level of SA. Conclusions: Our study adds to the knowledge base by elucidating the different ways sexually aggressive behaviors change during emerging adulthood and how confluence-model-derived factors predict the different trajectories. The finding that changes over time in these risk factors correspond with SA perpetration risk informs prevention programming by illuminating the importance of continual focus on these risk factors throughout the college years, perhaps through annual self-assessments.
• Thompson, M. P., Thompson, M. P., Swartout, K. M., Swartout, K. M., Koss, M. P., & Koss, M. P. (2013). Trajectories and Predictors of Sexually Aggressive Behaviors during Emerging Adulthood. Psychology of violence, 3(3), 247-259.
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  To assess longitudinal trajectories of college males' sexually aggressive behaviors and determine time-varying individual- and peer-level risk factors that differentiate men who follow these different paths.
• Bletzer, K. V., Bletzer, K. V., Koss, M. P., & Koss, M. P. (2012). From parallel to intersecting narratives in cases of sexual assault. Qualitative health research, 22(3), 291-303.
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  Restorative justice alternatives to criminal justice are designed to balance the needs of victims, offenders, families, friends, and the community at large to achieve social justice, repair of victims, and deterrence of crime. In the model we evaluated from RESTORE (Responsibility and Equity for Sexual Transgressions Offering a Restorative Experience), each offender and victim received individual services and met in guided conferencing to mutually determine reparative actions for the offender. At the exit meeting, the offender, as the responsible person, read a written apology to the survivor/victim. In this article, we analyze the expression of empathy in the apology, in which the initial mitigation of responsibility in early documents was replaced by acknowledgment of harm to the survivor/victim and acceptance of responsibility for the assault. Those accused of felony rape and those targeting a visible person in cases of misdemeanor indecent exposure expressed greater regret and remorse than offenders of indecent exposure with an indeterminate victim.
• Bramsen, R. H., Bramsen, R. H., Lasgaard, M., Lasgaard, M., Koss, M. P., Koss, M. P., Elklit, A., Elklit, A., Banner, J., & Banner, J. (2012). Adolescent sexual victimization: a prospective study on risk factors for first time sexual assault. European child & adolescent psychiatry, 21(9), 521-6.
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  The present study set out to investigate predictors of first time adolescent peer-on-peer sexual victimization (APSV) among 238 female Grade 9 students from 30 schools in Denmark. A prospective research design was utilized to examine the relationship among five potential predictors as measured at baseline and first time APSV during a 6-month period. Data analysis was a binary logistic regression analysis. Number of sexual partners and displaying sexual risk behaviors significantly predicted subsequent first time peer-on-peer sexual victimization, whereas a history of child sexual abuse, early sexual onset and failing to signal sexual boundaries did not. The present study identifies specific risk factors for first time sexual victimization that are potentially changeable. Thus, the results may inform prevention initiatives targeting initial experiences of APSV.
• Koss, M. P., & Travis, C. (2012). Evolutionary Models of Why Men Rape: Acknowledging the Complexities. EVOLUTION, GENDER, AND RAPE, 191-205.
• Malamuth, N. M., Addison, T., & Koss, M. P. (2012). Pornography and sexual aggression: are there reliable effects and can we understand them?. Annual Review of Sex Research, 11(1), 26-91. doi:10.1080/10532528.2000.10559784
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  Abstract In response to some recent critiques, we (a) analyze the arguments and data presented in those commentaries, (b) integrate the findings of several meta-analytic summaries of experimental and naturalistic research, and (c) conduct statistical analyses on a large representative sample. All three steps support the existence of reliable associations between frequent pornography use and sexually aggressive behaviors, particularly for violent pornography and/or for men at high risk for sexual aggression. We suggest that the way relatively aggressive men interpret and react to the same pornography may differ from that of nonaggressive men, a perspective that helps integrate the current analyses with studies comparing rapists and nonrapists as well as with cross-cultural research.
• Malamuth, N. M., Hald, G. M., & Koss, M. P. (2012). Pornography, Individual Differences in Risk and Men’s Acceptance of Violence Against Women in a Representative Sample. Sex Roles, 66(7), 427-439. doi:10.1007/s11199-011-0082-6
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  Based on the Confluence Model of Sexual Aggression, we hypothesized that individual differences in risk for sexual aggression moderate the association between pornography use and attitudes supporting violence against women. This hypothesis was in keeping with the findings of a recent meta-analysis which indicated such a positive association between porn use and attitudes. However, in this meta-analysis there was also a high degree of heterogeneity among studies, suggesting the existence of crucial moderating variables. Unfortunately, the available literature included in this meta-analysis did not enable identifying the basis for such moderation. To fully test our hypothesis of individual differences moderation and related hypotheses requires a representative sample. Fortunately, a unique nationally representative sample of U.S. men in any form of post-high school education that we obtained in 1984–85 enabled testing our predictions. Participants had anonymously completed questionnaires that included items pertaining to pornography use, attitudes about violence against women, and other measures assessing risk factors highlighted by the Confluence Model. As predicted, while we found an overall positive association between pornography consumption and attitudes, further examination showed that it was moderated by individual differences. More specifically, as predicted this association was found to be largely due to men at relatively high risk for sexually aggression who were relatively frequent pornography consumers. The findings help resolve inconsistencies in the literature and are in line not only with experimental research on attitudes but also with both experimental and non-experimental studies assessing the relationship between pornography consumption and sexually aggressive behavior.
• Swartout, K. M., Thompson, M. P., Koss, M. P., & Su, N. (2012). What Is the Best Way to Analyze Less Frequent Forms of Violence? The Case of Sexual Aggression. PSYCHOLOGY OF VIOLENCE, 5(3), 305-313.
• Bletzer, K. V., Bletzer, K. V., Koss, M. P., & Koss, M. P. (2011). From Parallel to Intersecting Narratives in Cases of Sexual Assault. Qualitative health research.
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  Restorative justice alternatives to criminal justice are designed to balance the needs of victims, offenders, families, friends, and the community at large to achieve social justice, repair of victims, and deterrence of crime. In the model we evaluated from RESTORE (Responsibility and Equity for Sexual Transgressions Offering a Restorative Experience), each offender and victim received individual services and met in guided conferencing to mutually determine reparative actions for the offender. At the exit meeting, the offender, as the responsible person, read a written apology to the survivor/victim. In this article, we analyze the expression of empathy in the apology, in which the initial mitigation of responsibility in early documents was replaced by acknowledgment of harm to the survivor/victim and acceptance of responsibility for the assault. Those accused of felony rape and those targeting a visible person in cases of misdemeanor indecent exposure expressed greater regret and remorse than offenders of indecent exposure with an indeterminate victim.
• Bletzer, K. V., Bletzer, K. V., Yuan, N. P., Yuan, N. P., Koss, M. P., Koss, M. P., Polacca, M., Polacca, M., Eaves, E. R., Eaves, E. R., Goldman, D., & Goldman, D. (2011). Taking humor seriously: talking about drinking in Native American focus groups. Medical anthropology, 30(3), 295-318.
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  Focus groups provide a source of data that highlight community ideas on a topic of interest. How interview data will be utilized varies by project. With this in mind, we identify ways that focus group data from a particular population (Native American) articulate a health issue of individual tribal concern (alcohol consumption). Taking our analytic framework from linguistics, one of the four fields of inquiry in anthropology, we examine format ties and the performance of humor as stylistic features of tribal focus groups and illustrate how linguistic devices can be used in analyzing aspects of adolescent and adult drinking. Focus group data require systematic review and analysis to identify useful findings that can lead to inquiry points to initiate collaborative work with local experts before the data can be developed and configured into effective program initiatives.
• Bramsen, R. H., Bramsen, R. H., Lasgaard, M., Lasgaard, M., Elklit, A., Elklit, A., Koss, M. P., & Koss, M. P. (2011). The development and psychometric assessment of the adolescent sexual coercion risk scale. Journal of interpersonal violence, 26(8), 1524-40.
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  The objective of this study was to develop a psychometric measure of risk for sexual victimization from adolescent peers. Items were generated on the basis of the literature and on consultations with a multidisciplinary group of key informants. The items were administered to a sample of 327 female Grade-9 students and examined using exploratory factor analysis. The Adolescent Sexual Coercion Risk Scale items formed two lower-order factors composed of items regarding signaling sexual boundaries and displaying risk behaviors, respectively. Subsequent confirmatory factor analysis supported the two factors, and preliminary psychometric analyses demonstrated that the factors have satisfactory internal consistency. In addition, low scores on the ability to signal sexual boundaries and high scores on risk behaviors were associated with self-reported peer sexual victimization, supporting the validity of the factors as measures of risk. Future validation and potential usage of the measure are discussed.
• Cook, S. L., Cook, S. L., Gidycz, C. A., Gidycz, C. A., Koss, M. P., Koss, M. P., Murphy, M., & Murphy, M. (2011). Emerging issues in the measurement of rape victimization. Violence against women, 17(2), 201-18.
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  We provide an overview of emerging directions in the measurement of rape, the most extreme form of sexual victimization. The context for our overview is how operational definitions of rape have evolved, where consensus has emerged, and where it eludes the field. We discuss two approaches to the detection of rape victimization in survey methods, namely behaviorally specific questions and a new, two-stage approach, and how each can be evaluated in terms of validity. We point out promises and pitfalls of the two-stage approach and make suggestions for its implementation and evaluation. We conclude that all empirical research to date supports the use of behaviorally specific compared to broad questions, that a standard definition of rape and its components of act, tactics, and nonconsent is imperative to move the field forward, and that research to systematically validate methods of detecting rape victimization is needed. To that end, we propose an agenda.
• Cook, S. L., Gidycz, C. A., Koss, M. P., & Murphy, M. (2011). Emerging Issues in the Measurement of Rape Victimization. VIOLENCE AGAINST WOMEN, 17(2), 201-218.
• Koss, M. P. (2011). Hidden, unacknowledged, acquaintance, and date rape: Looking back, looking forward. Psychology of Women Quarterly, 35(2), 348-354. doi:10.1177/0361684311403856
• Koss, M. P., Denmark, F., Krauss, H., Halpern, E., & Sechzer, J. (2011). Restoring rape survivors - Justice, advocacy, and a call to action. VIOLENCE AND EXPLOITATION AGAINST WOMEN AND GIRLS, 1087, 206-234.
• Swartout, K. M., Koss, M. P., White, J. W., Thompson, M. P., Abbey, A., & Bellis, A. L. (2011). Trajectory Analysis of the Campus Serial Rapist Assumption. JAMA PEDIATRICS, 169(12), 1148-1154.
• Thompson, M. P., Koss, M. P., Kingree, J. B., Goree, J., & Rice, J. (2011). A Prospective Mediational Model of Sexual Aggression Among College Men. JOURNAL OF INTERPERSONAL VIOLENCE, 26(13), 2716-2734.
• Thompson, M. P., Thompson, M. P., Koss, M. P., Koss, M. P., Kingree, J. B., Kingree, J. B., Goree, J., Goree, J., Rice, J., & Rice, J. (2011). A prospective mediational model of sexual aggression among college men. Journal of interpersonal violence, 26(13), 2716-34.
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  Guided by the Theory of Planned Behavior (TPB), the authors examined prospective associations of attitudes, norms, and control with sexual aggression (SA) perpetration 1 year later among male college students. Data were collected from 652 males via confidential, self-report surveys at the end of their 1st and 2nd years in college. Results indicated that attitudes conducive to SA and perceived norms supportive of SA were associated with a higher likelihood of engaging in SA 1 year later, and mediated the associations of some established risk factors for SA. The findings identify potentially changeable risk factors for perpetrating SA and can thus contribute to the foundation on which to build theoretical and empirically based prevention programs.
• Dunkle, K. L., Jewkes, R., Nduna, M., Jama, N., Levin, J., Sikweyiya, Y., & Koss, M. P. (2010). Transactional sex with casual and main partners among young South African men in the rural Eastern Cape: Prevalence, predictors, and associations with gender-based violence. SOCIAL SCIENCE & MEDICINE, 65(6), 1235-1248.
• Poindexter, W. T., Reikowsky, R. C., Koss, M. P., & Pennell, J. (2010). Supporting Family-Led Processes Within a Social Work Agency: Lessons Learned. Protecting Children, 25(2), 19-26.
• Yuan, N. P., Yuan, N. P., Eaves, E. R., Eaves, E. R., Koss, M. P., Koss, M. P., Polacca, M., Polacca, M., Bletzer, K., Bletzer, K., Goldman, D., & Goldman, D. (2010). "Alcohol is something that been with us like a common cold": community perceptions of American Indian drinking. Substance use & misuse, 45(12), 1909-29.
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  This study examined tribal members' perspectives on alcohol, risk factors, consequences, and community responses. Focus groups were conducted with five American Indian tribes between 1997 and 2001. Participants were knowledgeable of the cultural lives of their reservation communities. Although there was agreement regarding the pervasiveness of heavy drinking, participants reported different opinions about the meaning of alcohol and appropriate intervention strategies. Three dilemmas were identified, suggesting that community ambivalence may serve as a barrier to reducing problem drinking. Implications, limitations, and future research directions are discussed. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.
• Dunkle, K. L., Jewkes, R. K., Nduna, M., Levin, J., Jama, N., Khuzwayo, N., Koss, M. P., & Duvvury, N. (2008). Perpetration of partner violence and HIV risk behaviour among young men in the rural Eastern Cape, South Africa. AIDS, 20(16), 2107-2114.
• Jewkes, R., Dunkle, K., Koss, M. P., Levin, J. B., Nduna, M., Jama, N., & Sikweyiya, Y. (2008). Rape perpetration by young, rural South African men: Prevalence, patterns and risk factors. SOCIAL SCIENCE & MEDICINE, 63(11), 2949-2961.
• Koss, M. P., Abbey, A., Campbell, R., Cook, S. L., Norris, J., Testa, M., Ullman, S. E., West, C. M., & White, J. W. (2008). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization (Psychology of Women Quarterly (2007) 31, (357-370)). Psychology of Women Quarterly, 32(4), 493-493. doi:10.1111/j.1471-6402.2008.00468.x
• Koss, M. P., Koss, M. P., White, J. W., & White, J. W. (2008). National and global agendas on violence against women: historical perspective and consensus. The American journal of orthopsychiatry, 78(4), 386-93.
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  A policy analysis of 11 national and global institutions' violence against women agendas spanning 1990 to 2006 is presented. Analysis revealed 85 distinct recommendations. The highest percentages of them referenced prevention (29%); data, design, and measurement (21%); and psychotherapy and support (19%). Consensus (percentage of recommendations for future activities included in four or more agendas) was highest for advocacy (75%), funding (50%), prevention (48%), and data, design, and measurement (44%). Changes in emphasis over time, aims that have been abandoned, and observations contrasting U.S. and global agendas are also examined. The results create a context to inform the agendas currently in development within psychology, criminal justice, medicine, nursing, public health, and other disciplines. Next steps to guide future policy work include investigation of advocates', practitioners', researchers', and policymakers' perceived progress in implementing existing recommendations, empirical cataloguing of achievements that demonstrate progress toward aims, constituent input on reprioritization of activities, and contemporizing action steps.
• Dunkle, K. L., Dunkle, K. L., Jewkes, R., Jewkes, R., Nduna, M., Nduna, M., Jama, N., Jama, N., Levin, J., Levin, J., Sikweyiya, Y., Sikweyiya, Y., Koss, M. P., & Koss, M. P. (2007). Transactional sex with casual and main partners among young South African men in the rural Eastern Cape: prevalence, predictors, and associations with gender-based violence. Social science & medicine (1982), 65(6), 1235-48.
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  We explored the prevalence and predictors of transactional sex with casual partners and main girlfriends among 1288 men aged 15-26 from 70 villages in the rural Eastern Cape province of South Africa. Data were collected through face-to-face interviews with young men enroling in the Stepping Stones HIV prevention trial. A total of 17.7% of participants reported giving material resources or money to casual sex partners and 6.6% received resources from a casual partner. Transactionally motivated relationships with main girlfriends were more balanced between giving (14.9%) and getting (14.3%). We constructed multivariable models to identify the predictors for giving and for getting material resources in casual and in main relationships. Each model resulted in remarkably similar predictors. All four types of exchange were associated with higher socio-economic status, more adverse childhood experiences, more lifetime sexual partners, and alcohol use. Men who were more resistant to peer pressure to have sex were less likely to report transactional sex with casual partners, and men who reported more equitable gender attitudes were less likely to report main partnerships underpinned by exchange. The most consistent predictors of all four types of transaction were perpetration of intimate partner violence and rape against women other than a main partner. The strong and consistent association between perpetration of gender-based violence and both giving and getting material goods from female partners suggests that transactional sex in both main and casual relationships should be viewed within a broader continuum of men's exercise of gendered power and control. HIV prevention interventions need to explicitly address transactional sex in the context of ideas about masculinity, which place a high emphasis on heterosexual success with, and control of, women.
• Koss, M. P., Abbey, A., Campbell, R., Cook, S., Norris, J., Testa, M., Ullman, S., West, C., & White, J. (2007). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization. PSYCHOLOGY OF WOMEN QUARTERLY, 31(4), 357-370.
• Bletzer, K. V., & Koss, M. P. (2006). After-rape among three populations in the Southwest: a time of mourning, a time for recovery.. Violence against women, 12(1), 5-29. doi:10.1177/1077801205277352
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  Narrative analysis of open-ended interviews with 62 female survivors of rape from three populations in the Southwest (Native American, Mexican American, Anglo) uncovered commonalities and dissimilarities in women's description of their experience of afterrape (rape survival). Although all three groups reported experiences that confirm aspects of prior analyses of reactions to rape, the narrative analysis highlights variations in reactions to rape across the three groups. These variations, and more established commonalities, provide baseline material for strengthening primary and secondary interventions for women who have experienced sexual violence.
• Bramsen, R. H., Lasgaard, M., Elklit, A., & Koss, M. P. (2006). The Development and Psychometric Assessment of the Adolescent Sexual Coercion Risk Scale. JOURNAL OF INTERPERSONAL VIOLENCE, 26(8), 1524-1540.
• Dunkle, K. L., Dunkle, K. L., Jewkes, R. K., Jewkes, R. K., Nduna, M., Nduna, M., Levin, J., Levin, J., Jama, N., Jama, N., Khuzwayo, N., Khuzwayo, N., Koss, M. P., Koss, M. P., Duvvury, N., & Duvvury, N. (2006). Perpetration of partner violence and HIV risk behaviour among young men in the rural Eastern Cape, South Africa. AIDS (London, England), 20(16), 2107-14.
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  To examine associations between the perpetration of intimate partner violence and HIV risk behaviour among young men in rural South Africa.
• Jewkes, R., Dunkle, K., Nduna, M., Levin, J., Jama, N., Khuzwayo, N., Puren, A., Duvvury, N., & Koss, M. P. (2006). Factors associated with HIV sero-positivity in young, rural South African men.. International journal of epidemiology, 35(6), 1455-60. doi:10.1093/ije/dyl217
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  To describe factors associated with HIV infection in men aged 15-26 years..Rural Eastern Cape Province, South Africa..A total of 1277 sexually experienced Xhosa male volunteers from 70 villages participating in a cluster randomized controlled trial of an HIV behavioural intervention. Xhosas circumcise during manhood initiation rituals..Cross-sectional, analysis of the study's baseline interviews..HIV sero-status, sexual practices measured with an interviewer-administered questionnaire..About 2% of the men were HIV positive. A logistic regression model showed HIV positivity to be associated with age (OR 1.55; 95%CI 1.22-1.95), having made a woman pregnant (OR 2.93; 95% CI 1.28-6.68), having been circumcised (OR 0.40; 95% CI 0.16-0.98), and having had sex with a man (OR 3.61; 95% CI 1.0-13.0)..Our findings provide further evidence to suggest that circumcision is protective. There was much heterosexual risk taking among men but only pregnancy (with its association with sexual frequency) predicted HIV sero-positivity. Although relatively rare, same-sex sexual experiences were a risk factor. Male-male sexual contact is rarely assessed in HIV research in Africa and almost never addressed in general HIV prevention programming. Our findings suggest that it should be given more attention.
• Jewkes, R., Dunkle, K., Nduna, M., Levin, J., Jama, N., Khuzwayo, N., Puren, A., Duvvury, N., & Koss, M. P. (2006). Factors associated with HIV sero-status in young rural South African women: connections between intimate partner violence and HIV.. International journal of epidemiology, 35(6), 1461-8. doi:10.1093/ije/dyl218
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  This paper aims to describe factors associated with HIV sero-status in young, rural South African women and the relationship between intimate partner violence (IPV) and HIV..A total of 1295 sexually active female volunteers, aged 15-26, from 70 villages were recruited to participate in a cluster randomized controlled trial of an HIV behavioural intervention. The main measures were HIV sero-status, and IPV and sexual practices measured using a questionnaire administered during baseline interviews..About 12.4% of women had HIV and 26.6% had experienced more than one episode of physical or sexual IPV. After adjusting for age, HIV infection was associated with having three or more past year partners [odds ratio (OR) 2.39; 95% confidence interval (95% CI) 1.48-3.85], sex in past 3 months (OR 3.33; 95% CI 1.87-5.94), a partner three or more years older (OR 1.69; 95% CI 1.16-2.48), and a more educated partner (OR 1.91; 95% CI 1.30-2.78). IPV was associated with HIV in two-way analyses (OR 1.56; 95% CI 1.08-2.23), but the effect was non-significant after adjusting for HIV risk behaviours. The experience of IPV was strongly associated with past year partner numbers, time of last sex, and partner's education; it was also marginally associated with partner age difference. Adverse experiences in childhood, including sexual abuse, increased the likelihood of having more past year partners (OR 1.43; 95% CI 1.21-1.69)..IPV was strongly associated with most of the identified HIV risk factors. Our findings provide further evidence of links between IPV and HIV among women and the importance of joint prevention.
• Jewkes, R., Jewkes, R., Dunkle, K., Dunkle, K., Koss, M. P., Koss, M. P., Levin, J. B., Levin, J. B., Nduna, M., Nduna, M., Jama, N., Jama, N., Sikweyiya, Y., & Sikweyiya, Y. (2006). Rape perpetration by young, rural South African men: Prevalence, patterns and risk factors. Social science & medicine (1982), 63(11), 2949-61.
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  Sexual violence is a well-recognised global health problem, but there has been remarkably little research on men as perpetrators. The objectives of this paper are to describe the prevalence, patterns and factors associated with rape of an intimate partner and a woman who was not a partner with men aged 15-26 years in rural South Africa. The analysis presented here is of data collected during a baseline survey of participants in a cluster randomised controlled trial of an HIV behavioural intervention. A total of 1370 male volunteers were recruited from 70 rural South African villages. They completed a questionnaire asking about background, sexual practices and perpetration of rape and intimate partner violence. Among these men 16.3% had raped a non-partner, or participated in a form of gang rape; 8.4% had been sexually violent towards an intimate partner; and 79.1% had done neither. The mean age of first rape was 17 years. There was overlap between rape of a non-partner and partner, in that 44.3% of men who raped an intimate partner had also raped a non-partner, but overall the great majority of men who raped did not disclose both types of rape. The factors associated with rape of an intimate partner and non-partner had similarities and differences. After adjusting for the other variables, both forms of rape were strongly associated with ever having been physically violent to a partner, having had transactional sex with a casual partner and more sexual partners. Non-partner rape was also associated with peer-related variables, including gang membership and peer pressure to have sex, and also drug use. Non-partner rape was more common among wealthier and relatively more socially advantaged men. Both types of rape were associated with having more adverse childhood experiences. There was considerable overlap between rape-associated factors and known HIV risk factors, suggesting a need for further research on the interface of rape and HIV, and integrated prevention programming.
• Jewkes, R., Nduna, M., Levin, J., Jama, N., Dunkle, K., Khuzwayo, N., Puren, A., Wood, K., Duvvury, N., & Koss, M. P. (2006). A cluster randomized-controlled trial to determine the effectiveness of Stepping Stones in preventing HIV infections and promoting safer sexual behaviour amongst youth in the rural Eastern Cape, South Africa: trial design, methods and baseline findings.. Tropical medicine & international health : TM & IH, 11(1), 3-16. doi:10.1111/j.1365-3156.2005.01530.x
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  To describe the study design, methods and baseline findings of a behavioural intervention trial aimed at reducing HIV incidence..A cluster randomized-controlled trial (RCT) conducted in 70 villages in rural South Africa. A behavioural intervention, Stepping Stones, was implemented in 35 communities in two workshops of 20 men and 20 women in each community who met for 17 sessions (50 h) over a period of 3-12 weeks. Individuals in the control arm communities attended a single session of about 3 h on HIV and safer sex. Impact assessment was conducted through two questionnaire and serological surveys at 12-month intervals. The primary outcome was HIV incidence and secondary measures included changes in knowledge, attitude and sexual behaviours. Qualitative research was also undertaken with 10 men and 10 women from two sites receiving the intervention (one rural and one urban) and five men and five women from one village in the control arm. They were interviewed individually three times prior to the workshops and then 9-12 months later..A total of 2776 participants (1409 intervention and 1367 control) were enrolled at baseline and had an interview, and HIV sero-status was established. HIV baseline prevalence rates in women were 9.8% in the intervention arm and 12.8% in the control arm. In men the prevalence was 1.7% in the intervention arm and 2.1% in the control arm. Demographic and behavioural characteristics were similar in the two arms. In the intervention groups 59.9% of participants attended more than 75% of the sessions. In the control group 66.3% attended the control session..This is the third RCT to be conducted in sub-Saharan Africa evaluating a behavioural intervention using HIV incidence as a primary outcome. It is of particular interest as the intervention in question is used in many developing countries. There is good baseline comparability between the study arms and the process data on the workshops suggested that the interventions were feasible and adequately implemented.
• Koss, M. P. (2006). Critique of Vernon Quinsey's paper. Annals of the New York Academy of Sciences, 989(1), 146-150. doi:10.1111/j.1749-6632.2003.tb07301.x
• Koss, M. P., & Koss, M. P. (2006). Restoring rape survivors: justice, advocacy, and a call to action. Annals of the New York Academy of Sciences, 1087, 206-34.
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  Rape results in mental and physical health, social, and legal consequences. For the latter, restorative justice-based programs might augment community response, but they generate controversy among advocates and policy makers. This article identifies survivors' needs and existing community responses to them. Survivors feel their legal needs are most poorly met due to justice system problems that can be summarized as attrition, retraumatization, and disparate treatment across gender, class, and ethnic lines. Empirical data support each problem and the conclusion that present justice options are inadequate. The article concludes by identifying common ground in advocacy and restorative justice goals and calls for a holistic approach to the needs of rape survivors that includes advocating for expanded justice alternatives. A call to action is issued to implement restorative alternatives to expand survivor choice and offender accountability. Conventional and restorative justice are often viewed as mutually exclusive whereas the author argues they are complementary.
• Malamuth, N. M., Hald, G. M., & Koss, M. (2006). Pornography, Individual Differences in Risk and Men's Acceptance of Violence Against Women in a Representative Sample. SEX ROLES, 66(7-8), 427-439.
• Yuan, N. P., Eaves, E. R., Koss, M. P., Polacca, M., Bletzer, K., & Goldman, D. (2006). "Alcohol is Something That Been With Us Like a Common Cold": Community Perceptions of American Indian Drinking. SUBSTANCE USE & MISUSE, 45(12), 1909-1929.
• Yuan, N. P., Koss, M. P., Polacca, M., & Goldman, D. (2006). Risk factors for physical assault and rape among six native American tribes. JOURNAL OF INTERPERSONAL VIOLENCE, 21(12), 1566-1590.
• Yuan, N. P., Yuan, N. P., Koss, M. P., Koss, M. P., Polacca, M., Polacca, M., Goldman, D., & Goldman, D. (2006). Risk factors for physical assault and rape among six Native American tribes. Journal of interpersonal violence, 21(12), 1566-90.
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  Prevalence and correlates of adult physical assault and rape in six Native American tribes are presented (N = 1,368). Among women, 45% reported being physically assaulted and 14% were raped since age 18 years. For men, figures were 36% and 2%, respectively. Demographic characteristics, adverse childhood experiences, adulthood alcohol dependence, and cultural and regional variables were assessed. Using logistic regression, predictors of physical assault among women were marital status, an alcoholic parent, childhood maltreatment, and lifetime alcohol dependence. Predictors of sexual assault among women were marital status, childhood maltreatment, and lifetime alcohol dependence. Among men, only childhood maltreatment and lifetime alcohol dependence predicted being physically assaulted. Tribal differences existed in rates of physical assault (both sexes) and rape (women only). The results underscore the problem of violence victimization among Native Americans and point to certain environmental features that increase risk of adulthood physical and sexual assault. Implications for tribe-specific interventions are discussed.
• Abbey, A., Abbey, A., Parkhill, M. R., Parkhill, M. R., Koss, M. P., & Koss, M. P. (2005). THE EFFECTS OF FRAME OF REFERENCE ON RESPONSES TO QUESTIONS ABOUT SEXUAL ASSAULT VICTIMIZATION AND PERPETRATION. Psychology of women quarterly, 29(4), 364-373.
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  Self-reports of sexual assault are affected by a variety of factors including the number of questions, question phrasing, and context. Participants (307 women, 166 men) were randomly assigned to one of two forms of a questionnaire. One form had the tactics used to obtain forced sex as the initial frame of reference, whereas the other form had the type of sex that was forced as the initial frame of reference. Seventy-five percent of the women who received the tactics-first version reported that they had at least one victimization experience since the age of 14, as compared to 62% of the women who received the type-of-sex-first version. Sixty-nine percent of the men who received the tactics-first version reported that they had at least one perpetration experience since the age of 14, as compared to 36% of the men who received the type-of-sex-first version. These findings have implications for how questionnaires should be designed to maximize reporting of sexual assault incidents.
• Hopkins, C. Q., & Koss, M. P. (2005). Incorporating feminist theory and insights into a restorative justice response to sex offenses.. Violence against women, 11(5), 693-723. doi:10.1177/1077801205274570
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  Sex offenses, particularly nonpenetration sex offenses and acquaintance sexual assault, are all too common. Because these crimes reinforce women's fear of crime and restrict spatial and social freedom, it is paramount for the justice system to act affirmatively; however, it does not. This article identifies several failures in the current response to these sex offenses. We describe the research demonstration project, RESTORE, operating in Pima County, Arizona, which uses a restorative justice response as a way of remedying some of those failures. Identifying central feminist insights that guided the development of that project, the article addresses concerns raised by feminists about the use of restorative justice for gendered violence. We conclude that most if not all of these concerns apply to cases of on going domestic violence--cases specifically excluded from the RESTORE program--rather than to cases of acquaintance sexual assault or nonpenetration sex offenses.
• Koss, M. P. (2005). Empirically enhanced reflections on 20 years of rape research.. Journal of interpersonal violence, 20(1), 100-7. doi:10.1177/0886260504268601
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  Using PsychInfo review of rape and sexual assault publications, the period of greatest fertility coincided with the establishment (1975) and demise (1987) of the National Center for the Prevention and Control of Rape. To document what has been learned and when, the era in which new rape concepts entered the literature is summarized and important developments highlighted. Then, new investigations that are urgently needed are elaborated. The author expresses concern that current federal investment is insufficient to sustain and expand a science workforce adequate to the tasks ahead. Since 1995, more than 1 billion US dollars have been awarded to prosecutors, law enforcement, and community agencies to assist victims of violence. In contrast, between 1996 and 2003, only 14 of 178 (7%) of investigator-initiated grants funded by the Department of Justice and the Centers for Disease Control and Prevention for violence against women had titles pairing the word sexual with assault, violence, abuse, or rape.
• Koss, M. P., Koss, M. P., & Figueredo, A. J. (2005). "Change in cognitive mediators of rape's impact on psychosocial health across 2 years of recovery": Correction to Koss and Figueredo (2004).. Journal of Consulting and Clinical Psychology, 73(3), 566-566. doi:10.1037/0022-006x.73.3.566
• Koss, M. P., Koss, M. P., & Figueredo, A. J. (2005). Erratum: Cognitive mediation of rape's mental health impact: Constructive replication of a cross sectional model in longitudinal data (Psychology of Women Quarterly (2004) (279)). Psychology of Women Quarterly, 29(2), 227-227. doi:10.1111/j.1471-6402.2005.00185.x
• Bletzer, K. V., & Koss, M. P. (2004). Narrative constructions of sexual violence as told by female rape survivors in three populations of the southwestern United States: scripts of coercion, scripts of consent.. Medical anthropology, 23(2), 113-56. doi:10.1080/01459740490448911
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  There is a growing literature on the narrative construction of rape as sexual violence. This is puzzling, since, in certain contexts, violence may stifle narrative production. Researchers of atrocities, for example, propose that the experience of recurring terror disrupts narrative cohesion in reporting lived trauma. Genocidal horror occurs in the context of communities and ethnic groups. Our rape survival data from women of three populations in the southwestern United States reflect traumas of sexual violence against women, experienced within everyday lives. From interviews with 62 female rape survivors, we (1) identify narrative conventions and linguistic devices to show how these women structure accounts of sexual assault that reflect their cultural background; (2) contrast scripts of coercion and consent; (3) examine how the way in which these women describe the coercive actions of the perpetrator(s) contradicts the assumptions of legal discourse; and (4) discuss the narrative production of several women in abusive relationships and compare it to the narrative production (or lack thereof) of persons who experience state-engineered terror.
• Germain, A., Krakow, B., Faucher, B., Zadra, A., Nielsen, T., Hollifield, M., Warner, T. D., & Koss, M. P. (2004). Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD.. Dreaming, 14(4), 195-206. doi:10.1037/1053-0797.14.4.195
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  Exposure, abreaction, and mastery have been proposed as the therapeutic processes of nightmare (NM) reduction. Imagery rehearsal therapy (IRT) effectively reduces NMs but involves minimal exposure and abreaction. The authors investigated the use of mastery in the scripting of new dreams (NDs) elaborated during IRT. NM an dN D reports were collected from 44 female sexual assault survivors with chronic NMs during their initial application of IRT. Mastery was assessed with a standardized dream coding system and a multidimensional mastery scale. NDs contained significantly fewer negative elements and more occurrences of positive elements and mas
• Koss, M. P. (2004). Friendly Fire: Rape and Sexual Harassment Within the U.S. Military.. Psyccritiques, 49(4), 437-439. doi:10.1037/004388
• Koss, M. P., & Figueredo, A. J. (2004). Change in cognitive mediators of rape's impact on psychosocial health across 2 years of recovery. Journal of Consulting and Clinical Psychology, 72(6), 1063-1072.
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  PMID: 15612852;Abstract: A previously published cross-sectional model of cognitive mediation of rape's impact on health (M. P. Koss, A. J. Figueredo, & R. J. Prince, 2002) was replicated longitudinally. Rape survivors (n = 59) were assessed 4 times at 3-24 months postrape. Growth curve analysis demonstrated significant change in all mediators and outcomes. Previously reported effects of Characterological Self-Blame, Behavioral Self-Blame, and Maladaptive Beliefs on Psychosocial Distress were partially cross-validated in intercept and slope data. The results suggest that Characterological Self-Blame sets the initial level of Psychosocial Distress and that reduction in Behavioral Self-Blame drives recovery. These effects on distress were wholly mediated through self-blame's association with alterations in beliefs about self and others.
• Koss, M. P., & Figueredo, A. J. (2004). Cognitive mediation of rape's mental health impact: Constructive replication of a cross-sectional model in longitudinal data. Psychology of Women Quarterly, 28(4), 273-286.
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  Abstract: The constructive replication of a prespecified, cognitively mediated model of rape's impact on psychosocial health is reported using longitudinal data (see Koss, Figueredo, & Prince, 2002, for a summary of model development). Rape survivors (n = 59) were assessed four times, 3 to 24 months postrape. Structural equations modeling of baseline data (intercepts) and rate of change over time (slopes) revealed that all large effects replicated, smaller effects did not. The model's central features were confirmed and showed that Psychological Problem History exacerbated Characterological Self-Blame, leading to more Maladaptive Beliefs, which determined initial Psychosocial Distress and its rate of decline. The major contributions of the study include: (a) placement in a research program designed to balance the strengths/limitations of cross-sectional and longitudinal data; (b) analysis of prerape characteristics, cognitive mediators, and multiple psychosocial distress variables in a system; and (c) a strategy for structural equations modeling in small samples.
• Koss, M. P., Bachar, K. J., Hopkins, C. Q., & Carlson, C. (2004). Expanding a community's justice response to sex crimes through advocacy, prosecutorial, and public health collaboration: introducing the RESTORE program.. Journal of interpersonal violence, 19(12), 1435-63. doi:10.1177/0886260504269703
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  Problems in criminal justice system response to date-acquaintance rape and nonpenetration sexual offenses include (a) they are markers of a sexual offending career, yet are viewed as minor; (b) perpetrators are not held accountable in ways that reduce reoffense; and (c) criminal justice response disappoints and traumatizes victims. To address these problems, a collaboration of victim services, prosecutors, legal scholars, and public health professionals are implementing and evaluating RESTORE, a victim-driven, community-based restorative justice program for selected sex crimes. RESTORE prepares survivors, responsible persons (offenders), and both parties' families and friends for face-to-face dialogue to identify the harm and develop a redress plan. The program then monitors the offender's compliance for 12 months. The article summarizes empirical data on problems in criminal justice response, defines restorative justice models, and examines outcome. Then the RESTORE program processes and goals are described. The article highlights community collaboration in building and sustaining this program.
• Krakow, B., Haynes, P. L., Warner, T. D., Melendrez, D., Johnston, L., Hollifield, M., Sisley, B. N., Shafer, L., Santana, E. M., & Koss, M. P. (2004). Nightmares, insomnia, and sleep-disordered breathing in fire evacuees seeking treatment for posttraumatic sleep disturbance.. Journal of traumatic stress, 17(3), 257-68. doi:10.1023/b:jots.0000029269.29098.67
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  Eight months after the Cerro Grande Fire, 78 evacuees seeking treatment for posttraumatic sleep disturbances were assessed for chronic nightmares, psychophysiological insomnia, and sleep-disordered breathing symptoms. Within this sample, 50% of participants were tested objectively for sleep-disordered breathing; 95% of those tested screened positive for sleep-disordered breathing. Multiple regression analyses demonstrated that these three sleep disorders accounted for 37% of the variance in posttraumatic stress symptoms, and each sleep disorder was significantly and independently associated with posttraumatic stress symptoms severity. The only systematic variable associated with posttraumatic stress symptoms of avoidance was sleep-disordered breathing. The findings suggest that three common sleep disorders relate to posttraumatic stress symptoms in a more complex manner than explained by the prevailing psychiatric paradigm, which conceptualizes sleep disturbances in PTSD merely as secondary symptoms of psychiatric distress.
• Mohler-kuo, M., Dowdall, G. W., Koss, M. P., & Wechsler, H. (2004). Correlates of rape while intoxicated in a national sample of college women.. Journal of studies on alcohol, 65(1), 37-45. doi:10.15288/jsa.2004.65.37
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  Heavy alcohol use is widespread among college students, particularly in those social situations where the risk of rape rises. Few studies have provided information on rapes of college women that occur when they are intoxicated. The purpose of the present study was to present prevalence data for rape under the condition of intoxication when the victim is unable to consent and to identify college and individual-level risk factors associated with that condition..The study utilizes data from 119 schools participating in three Harvard School of Public Health College Alcohol Study surveys. The analytic sample of randomly selected students includes 8,567 women in the 1997 survey, 8,425 in the 1999 survey, and 6,988 in the 2001 survey..Roughly one in 20 (4.7%) women reported being raped. Nearly three quarters (72%) of the victims experienced rape while intoxicated. Women who were under 21, were white, resided in sorority houses, used illicit drugs, drank heavily in high school and attended colleges with high rates of heavy episodic drinking were at higher risk of rape while intoxicated..The high proportion of rapes found to occur when women were intoxicated indicates the need for alcohol prevention programs on campuses that address sexual assault, both to educate men about what constitutes rape and to advise women of risky situations. The findings that some campus environments are associated with higher levels of both drinking and rape will help target rape prevention programs at colleges.
• Testa, M., Vanzile-tamsen, C., Livingston, J. A., & Koss, M. P. (2004). ASSESSING WOMEN'S EXPERIENCES OF SEXUAL AGGRESSION USING THE SEXUAL EXPERIENCES SURVEY: Evidence for Validity and Implications for Research. Psychology of Women Quarterly, 28(3), 256-265. doi:10.1111/j.1471-6402.2004.00143.x
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  In this study we examined the ability of a modified Sexual Experiences Survey (SES; Koss, Gidycz, & Wisniewski, 1987) to assess sexual victimization among a local community sample of women (n = 1,014). Women who reported sexual victimization were interviewed regarding the most recent incident. Those who responded negatively to all SES items were asked whether they had ever feared they would be sexually assaulted but were not, and to describe that incident. Independent coders read a subset of transcripts (n = 137) and classified each incident as reflecting: one of the SES items, a form of unwanted sex not included on the SES, or not unwanted sex. Coders viewed nearly all incidents elicited by the SES as reflecting some type of unwanted sex. Respondent-coder agreement for rape and coercion incidents was high, but low for contact and attempted rape incidents. The SES scoring continuum, reflecting objective severity of acts, was only modestly associated with subjective trauma associated with rape, attempted r...
• Hamby, S. L., & Koss, M. P. (2003). Shades of Gray: A Qualitative Study of Terms Used in the Measurement of Sexual Victimization:. Psychology of Women Quarterly, 27(3), 243-255. doi:10.1111/1471-6402.00104
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  Methodological analyses of sexual victimization research are still rare, despite the explosion of interest in this topic and widely varying rates across studies. In-depth analysis of the meaning of differences in rates is especially lacking. A series of five ethnically and geographically diverse focus groups were held to explore how wording in sexual victimization surveys affects the reporting of various types of negative sexual experiences. Participants provided rich formulations about sexual intercourse that suggest there is a wide range of coercion, from peer pressure to lose one's virginity to partner pressure to demonstrate one's commitment to stereotypical forced rape. Focus group participants asserted that many terms that are often used synonymously, such as unwanted, nonvoluntary, and forced, have distinct meanings. They also described how different social pressures on women and men, and differences in physical size lead to inevitable differences in perceptions of coerciveness. Although recent sexual victimization surveys have increased the specificity of descriptions of sexual acts, these findings suggest that it is equally important to be precise in communicating what is meant by coercion.
• Koss, M. P., & White, J. W. (2003). National and Global Agendas on Violence Against Women: Historical Perspective and Consensus. AMERICAN JOURNAL OF ORTHOPSYCHIATRY, 78(4), 386-393.
• Koss, M. P., Bachar, K. J., & Hopkins, C. Q. (2003). Restorative justice for sexual violence: repairing victims, building community, and holding offenders accountable.. Annals of the New York Academy of Sciences, 989, 384-96; discussion 441-5.
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  Problems in criminal justice system response to date and acquaintance rape, and the nonpenetration sexual offenses are identified: (1) these crimes are often markers of a career of sexual offense, yet they are widely viewed as minor; (2) perpetrators of these crimes are now held accountable in ways that reduce their future threat of sex offending; and (3) current criminal justice response to these crimes disappoints and traumatizes victims and families. In response to these identified problems, we are implementing and evaluating RESTORE, an innovative victim-driven, community-based restorative justice program. Restorative justice views crime as harm for which the person responsible must be held accountable in meaningful ways. RESTORE uses a community conference to involve the victim, offender, and both parties' family and friends in a face-to-face dialogue directed at identifying the harm, and developing a plan for repair, rehabilitation, and reintegration into the community.
• Koss, M. P., Bailey, J. A., Yuan, N. P., Herrera, V. M., & Lichter, E. L. (2003). Depression and PTSD in survivors of male violence: Research and training initiatives to facilitate recovery. Psychology of Women Quarterly, 27(2), 130-142. doi:10.1111/1471-6402.00093
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  Male violence is an enduring feature of women's lives from childhood through old age. The review covers child sexual abuse, rape, and partner violence with emphasis on the prevalence of violence, its mental health consequences, the course of recovery, and mediators and moderators of traumatic impact. The primary focus is depression and posttraumatic stress disorder, the two major diagnostic entities through which postassault emotions and behaviors have been conceptualized and measured. The effects of psychiatric conceptualizations of victimization and patterns of individual recovery are critically reviewed. The PTSD paradigm as the sole foundation for most victimization research is also debated. Following the review, mental health services for victimized women are examined. The article concludes with public policy recommendations to improve the availability and accessibility of mental health services with emphasis on reaching those survivors who are less likely to consult the formal system.
• Koss, M. P., Yuan, N. P., Dightman, D., Prince, R. J., Polacca, M., Sanderson, B., & Goldman, D. (2003). Adverse childhood exposures and alcohol dependence among seven Native American tribes.. American journal of preventive medicine, 25(3), 238-44. doi:10.1016/s0749-3797(03)00195-8
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  Alcohol abuse and alcoholism are leading causes of death among Native Americans. Little is known about the impact of negative childhood exposures, including parental alcoholism, childhood maltreatment, and out-of-home placement, on risk of lifetime DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) diagnosis of alcohol dependence in this population..Face-to-face interviews were conducted with 1660 individuals from seven Native American tribes from 1998 to 2001. Logistic regression was used to estimate the impact of specific types and number of different adverse childhood experiences on alcohol dependence. Relationships between tribe-specific cultural characteristics and alcohol dependence were also examined..There were significant tribal differences in rates of alcohol dependence and several adverse childhood exposures. Lifetime prevalence of alcohol dependence was high among all tribes (men: 21%-56%, women: 17%-30%), but one (men: 1%, women: 2%). High prevalence rates were documented for one or more types of adverse childhood experiences (men: 74%-100%; women: 83%-93%). For men, combined physical and sexual abuse significantly increased the likelihood of subsequent alcohol dependence (odds ratio [OR]=1.58; 95% confidence interval [CI], 1.10-2.27). For women, sexual abuse (OR=1.79; 95% CI, 1.21-2.66) and boarding school attendance increased the odds of alcohol dependence (OR=1.57; 95% CI, 1.03-2.40). Two separate patterns of dose-response relationships were observed for men and women. Significant inter-tribal differences in rates of alcohol dependence remained after accounting for tribe-specific cultural factors and geographic region..Effects of childhood exposures on high-risk behaviors emphasize screening for violence in medical settings and development of social and educational programs for parents and children living on and near tribal reservations.
• Koss, M. P., Figueredo, A. J., & Prince, R. J. (2002). Cognitive mediation of rape's mental, physical, and social health impact: Tests of four models in cross-sectional data. Journal of Consulting and Clinical Psychology, 70(4), 926-941.
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  PMID: 12182276;Abstract: Four nested, theoretically specified, increasingly complex models were tested representing cognitive mediation of rape's effects on mental, physical, and social health. Data were cross-sectional (N = 253 rape survivors). Outcomes were standardized assessments of social maladjustment, physical, and psychological symptoms, including posttraumatic stress disorder (PTSD). The best-fitting model was not fully cognitively mediated. Personological and rape characteristics influenced the level of self-blame experienced and the intensity of maladaptive beliefs about self and others. Self-blame and maladaptive beliefs predicted psychological distress, which strongly influenced all health outcomes. Self-ratings of rape memory characteristics contributed little to predicting postrape distress. The model accounted for 56% of the variance in general distress, including 91% of psychological symptom severity; 54% of PTSD symptoms; 65% of social maladjustment; and 17% of physical symptoms. Longitudinal replication is planned.
• Krakow, B., Melendrez, D., Johnston, L., Warner, T. D., Clark, J. O., Pacheco, M., Pedersen, B., Hollifield, M., Schrader, R., & Koss, M. P. (2002). Sleep-disordered breathing, psychiatric distress, and quality of life impairment in sexual assault survivors.. The Journal of nervous and mental disease, 190(7), 442-52. doi:10.1097/00005053-200207000-00004
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  Using American Academy of Sleep Medicine research criteria, sleep-disordered breathing (SDB) was assessed in a pilot study of 187 sexual assault survivors with posttraumatic stress symptoms. Nightmares, sleep quality, distress, and quality of life were also assessed along with historical accounts of prior treatments for sleep complaints. Presumptive SDB diagnoses were established for 168 patients. Twenty-one of 168 underwent sleep testing, and all met objective SDB diagnostic criteria. There were no clinically meaningful differences in age, body-mass index, sleep quality, distress, or quality of life measures between 21 confirmed SDB cases and 147 suspected cases not tested. Compared with 19 women without SDB, 168 women with diagnosed or suspected SDB reported significantly worse nightmares, sleep quality, anxiety, depression, posttraumatic stress, and impaired quality of life. Despite suffering from sleep problems for an average of 20 years, which had not responded to repeated use of psychotropic medications or psychotherapy, few of these women had been referred to sleep specialists. SDB appears widespread among sexual assault survivors seeking help for nightmares. Research is needed to clarify the associations among SDB, distress, and physical and mental health impairment in trauma patients.
• Krakow, B., Schrader, R., Tandberg, D., Hollifield, M., Koss, M. P., Yau, C. L., & Cheng, D. T. (2002). Nightmare frequency in sexual assault survivors with PTSD.. Journal of anxiety disorders, 16(2), 175-90. doi:10.1016/s0887-6185(02)00093-2
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  Sexual assault survivors with post-traumatic stress disorder (PTSD) were assessed for frequency of nightmares, measured retrospectively on the Nightmare Frequency Questionnaire (NFQ) and prospectively on nightmare dream logs (NLOG). Retrospective frequency was extremely high, averaging occurrences every other night and an estimated number of nightmares greater than five per week. Test-retest reliability data on the NFQ yielded weighted kappa coefficients of .85 (95% CI, .74-.95) for nights and .90 (95% CI, .83-.97) for nightmares. Correlations between retrospective and prospective nightmare frequencies ranged between .53 (P = .001) for nights and .63 (P = .001) for nightmares. Correlations between frequency and distress measures (anxiety, depression, post-traumatic stress) yielded coefficients ranging from (r = .28-.53). Compared with intrusive, cumbersome and time-consuming prospective measurements, the NFQ appears reliable, convenient, and equally useful in assessing nightmare frequency in a group of sexual assault survivors. Nightmare frequency, prevalence, distress and impairment are discussed.
• Koss, M. P. (2001). Book Reviews: More Than a MouthfulRape on the Public Agenda: Feminism and the Politics of Sexual Assault, BevacquaMaria. Boston, MA, Northeastern University Press, 2000, 280 pp., $18.95 (paper), ISBN: 1-55553-446-5.. Psychology of Women Quarterly, 25(4), 396-397. doi:10.1177/036168430102500403
• Koss, M. P., Koss, M. P., Figueredo, A. J., Coan, J. A., & Boeschen, L. E. (2001). Experiential avoidance and post-traumatic stress disorder: A cognitive mediational model of rape recovery.. Journal of Aggression, Maltreatment & Trauma, 4(2), 211-245. doi:10.1300/j146v04n02_10
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  Summary Does experiential avoidance predict PTSD severity among rape survivors? We tested a hypothesized model where causal attributions, cognitive schemas, and memory characteristics mediated the relationship between experiential avoidance and PTSD. Experiential avoidance was measured as a cognitive coping strategy; women scoring high on this measure did not try to integrate or make meaning of their rape experiences, but rather attempted to block out memories of their rapes or minimize or rationalize their rape experiences in some way. Data were cross-sectional. Participants were rape survivors (N = 139; 23% with current PTSD). Results included a measurement model of social cognitive factors and PTSD and the structural model. Two sets of pathways were delineated, both exacerbated PTSD. Overall, 60% of the variance in PTSD was explained. The results suggested that the effects of experiential avoidance on psychological outcomes were detrimental, but small. Re-experiencing was the only memory characteristic...
• Krakow, B., Germain, A., Warner, T. D., Schrader, R., Hollifield, M., Tandberg, D., Melendrez, D., Johnston, L., & Koss, M. P. (2001). The relationship of sleep quality and posttraumatic stress to potential sleep disorders in sexual assault survivors with nightmares, insomnia, and PTSD.. Journal of traumatic stress, 14(4), 647-65. doi:10.1023/a:1013029819358
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  Sleep quality and posttraumatic stress disorder (PTSD) were examined in 151 sexual assault survivors, 77% of whom had previously reported symptoms of sleep-disordered breathing (SDB) or sleep movement disorders (SMD) or both. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Posttraumatic Stress Scale (PSS). High PSQI scores reflected extremely poor sleep quality and correlated with PSS scores. PSQI scores were greater in participants with potential SDB or SMD or both. PSQI or PSS scores coupled with body-mass index and use of antidepressants or anxiolytics predicted potential sleep disorders. The relationship between sleep and posttraumatic stress appears to be more complex than can be explained by the current PTSD paradigm; and, sleep breathing and sleep movement disorders may be associated with this complexity.
• Krakow, B., Hollifield, M., Johnston, L., Warner, T. D., Tandberg, D., Lauriello, J., Mcbride, L., Cutchen, L., Cheng, D., Emmons, S., Germain, A., Melendrez, D., Sandoval, D., Prince, H., Schrader, R. M., & Koss, M. P. (2001). Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial.. JAMA, 286(5), 537-45. doi:10.1001/jama.286.5.537
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  Chronic nightmares occur frequently in patients with posttraumatic stress disorder (PTSD) but are not usually a primary target of treatment..To determine if treating chronic nightmares with imagery rehearsal therapy (IRT) reduces the frequency of disturbing dreams, improves sleep quality, and decreases PTSD symptom severity..Randomized controlled trial conducted from 1995 to 1999 among 168 women in New Mexico; 95% had moderate-to-severe PTSD, 97% had experienced rape or other sexual assault, 77% reported life-threatening sexual assault, and 58% reported repeated exposure to sexual abuse in childhood or adolescence..Participants were randomized to receive treatment (n = 88) or to the wait-list control group (n = 80). The treatment group received IRT in 3 sessions; controls received no additional intervention, but continued any ongoing treatment..Scores on the Nightmare Frequency Questionnaire (NFQ), Pittsburgh Sleep Quality Index (PSQI), PTSD Symptom Scale (PSS), and Clinician-Administered PTSD Scale (CAPS) at 3- and 6-month follow-up..A total of 114 participants completed follow-up at 3 and/or 6 months. Comparing baseline to follow-up (n = 97-114), treatment significantly reduced nights per week with nightmares (Cohen d = 1.24; P
• Krakow, B., Melendrez, D., Pedersen, B., Johnston, L., Hollifield, M., Germain, A., Warner, T. D., Schrader, R., & Koss, M. P. (2001). Complex insomnia: insomnia and sleep-disordered breathing in a consecutive series of crime victims with nightmares and PTSD.. Biological psychiatry, 49(11), 948-53. doi:10.1016/s0006-3223(00)01087-8
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  Sleep disturbance in posttraumatic stress disorder is very common. However, no previous posttraumatic stress disorder studies systematically examined sleep breathing disturbances, which might influence nightmares, insomnia, and posttraumatic stress disorder symptoms..Forty-four consecutive crime victims with nightmares and insomnia underwent standard polysomnography coupled with a nasal pressure transducer to measure airflow limitation diagnostic of obstructive sleep apnea and upper airway resistance syndrome..Forty of 44 participants tested positive on objective sleep studies based on conservative respiratory disturbance indices of more than 15 events per hour; 22 patients suffered from obstructive sleep apnea and 18 suffered from upper airway resistance syndrome..In an uncontrolled study, insomnia and sleep-disordered breathing were extremely prevalent in this small and select sample of crime victims. Research is needed to study 1) prevalence of sleep-disordered breathing in other posttraumatic stress disorder populations using appropriate controls and nasal pressure transducers and 2) effects of sleep treatment on posttraumatic stress symptoms in trauma survivors with comorbid obstructive sleep apnea or upper airway resistance syndrome. In the interim, some posttraumatic stress disorder patients may benefit from sleep medicine evaluations.
• Rozee, P. D., & Koss, M. P. (2001). Rape: A Century of Resistance. Psychology of Women Quarterly, 25(4), 295-311. doi:10.1111/1471-6402.00030
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  In this paper, we offer an overview of feminist contributions to the reframing and redefinition of rape over the last century. Topics of discussion include empirical research on rape prevalence that shows a consistent 15% prevalence rate despite continuing rape prevention and education efforts. The effects of sociocultural interventions focusing on legal reforms and psychosocial interventions focusing on rape prevention and education efforts are reviewed. The paper concludes with suggestions for refocusing intervention efforts to include rape prevention training for men, rape resistance training for women, and community-based legal interventions.
• Koss, M. P. (2000). Blame, shame, and community: justice responses to violence against women.. American Psychologist, 55(11), 1332-1343. doi:10.1037/0003-066x.55.11.1332
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  Justice processing for crimes against women is reviewed. The data reveal conviction rates for partner violence and rape by known acquaintances are miniscule; mandatory arrest, protection orders, and diversion programs inadequately deter rebattering; few losses are compensated; and the adversarial justice process is retraumatizing, exacerbating survivor's self-blame. To better address crimes against women, several nations and tribal communities use communitarian approaches, forms of restorative justice. The offense is framed to include the perpetrator, victim, and community. The process forgoes incarceration to have family, peers, and advocates design perpetrator rehabilitation, victim restoration, and social reintegration of both victim and perpetrator. Evaluations suggest communitarian justice may increase victim satisfaction, raise the social costs of offending, multiply social control and support resources, and open a new avenue to targeted prevention. Language: en
• Koss, M. P. (2000). Evolutionary Models of Why Men Rape: Acknowledging the Complexities. Trauma, Violence, & Abuse, 1(2), 182-190. doi:10.1177/1524838000001002005
• Koss, M. P., & Goldman, D. (2000). Genetic factors and alcoholism.. American journal of public health, 90(11), 1799. doi:10.2105/ajph.90.11.1799
• Krakow, B., Artar, A., Warner, T. D., Melendrez, D., Johnston, L., Hollifield, M., Germain, A., & Koss, M. P. (2000). Sleep disorder, depression, and suicidality in female sexual assault survivors.. Crisis, 21(4), 163-170. doi:10.1027//0227-5910.21.4.163
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  The role of sleep in psychiatric illness in general, and depression and suicidality in particular, is poorly understood and has not been well researched despite the pervasiveness of sleep complaints in these conditions. As an exploratory, hypothesis-generating study, female sexual assault survivors with posttraumatic stress disorder (n = 153) who had enrolled in a nightmare-treatment program were assessed for subjectively determined sleep breathing and sleep movement disorders. Diagnoses of potential disorders were based on clinical practice parameters and research algorithms from thefield of sleep disorders medicine. Potential sleep breathing and sleep movement disorders were present in 80% of the participants (n = 123) and included three subgroups: sleep-disordered breathing only (n = 23); sleep movement disorder only (n = 45); and both sleep disorders (n = 55). Based on the Hamilton Depression Rating Scale and Suicide subscale, participants with potential sleep disorders suffered greater depression (Cohen's d = .73-.96; p < .01) and greater suicidality (Cohen's d = .57-.78; p < .05) in comparison to participants without potential sleep disorders. The group with both sleep disorders suffered from the most severe depression and suicidality. A provisional hypothesis is formulated that describes how sleep disorders may exacerbate depression and suicidality through the effects of chronic sleep fragmentation.
• Krakow, B., Germain, A., Gaddy, L., Hollifield, M., Tandberg, D., Johnston, L., Melendrez, D., Lowry, C. S., & Koss, M. P. (2000). A retrospective study on improvements in nightmares and post-traumatic stress disorder following treatment for co-morbid sleep-disordered breathing.. Journal of psychosomatic research, 49(5), 291-8. doi:10.1016/s0022-3999(00)00147-1
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  To assess the impact of treatment for co-morbid sleep-disordered breathing (SDB) on patients with nightmares and post-traumatic stress..Twenty-three chronic nightmare sufferers (15 with post-traumatic stress disorder, PTSD) who also suffered co-morbid SDB (obstructive sleep apnea, OSA, n=16; upper airway resistance syndrome, UARS, n=7) completed a telephone interview, on average, 21 months after having been offered treatment for SDB at a university sleep disorders clinic..At follow-up, 14 reported maintaining treatment (Treatment Group) and 9 reported discontinuing treatment (No-Treatment Group). More patients in the Treatment Group reported improvement in sleep (93% vs. 33%) and in daytime well being (93% vs. 33%) compared with those in the No-Treatment group. The Treatment Group reported a median improvement in nightmares of 85% compared with a median 10% worsening in the No-Treatment Group. In the PTSD subset (n=15), nine in the Treatment Group reported a median 75% improvement in PTSD symptoms whereas six in the No-Treatment Group reported a median 43% worsening..In this small sample of patients, treatment of SDB was associated with improvements in nightmares and PTSD. Relationships between nightmares, PTSD and SDB are discussed.
• Krakow, B., Germain, A., Tandberg, D., Schrader, R., Hollifield, M., Cheng, D., Edmond, T., & Koss, M. P. (2000). Sleep breathing and sleep movement disorders masquerading as insomnia in sexual-assault survivors.. Comprehensive psychiatry, 41(1), 49-56. doi:10.1016/s0010-440x(00)90131-7
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  A descriptive, hypothesis-generating study was performed with 156 female sexual-assault survivors who suffered from insomnia, nightmares, and posttraumatic stress disorder (PTSD). They completed 2 self-report sleep questionnaires to assess the potential presence of intrinsic sleep disorders. Seventy-seven percent of the sample (120 of 156) endorsed additional sleep complaints, besides their insomnia symptoms, that indicate the potential presence of sleep-disordered breathing ([SDB] 81 of 156, 52%) and sleep-related movement disorders ([SMD] 94 of 156, 60%). The potential for SDB was strongly correlated with the body mass index (BMI), an increase in arousal symptoms, and greater total PTSD severity. In some sexual-assault survivors, the relationship between sleeplessness and posttraumatic stress may be caused or exacerbated by intrinsic sleep disorders, and not be solely a function of psychophysiological insomnia--the traditional diagnostic term usually offered to explain the sleep problems associated with PTSD. Prevalence studies that use objective diagnostic evaluations such as polysomnography (PSG) are needed to test these hypotheses.
• Krakow, B., Hollifield, M., Schrader, R., Tandberg, D., Lauriello, J., Mcbride, L., Warner, T. D., Cheng, D., Edmond, T., Kellner, R., & Koss, M. P. (2000). A controlled study of imagery rehearsal for chronic nightmares in sexual assault survivors with PTSD: a preliminary report.. Journal of traumatic stress, 13(4), 589-609. doi:10.1023/a:1007854015481
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  Imagery-rehearsal therapy for chronic nightmares was assessed in a randomized, controlled study of sexual assault survivors with posttraumatic stress disorder (PTSD). Nightmares, sleep quality, and PTSD were assessed at baseline for 169 women, who were randomized into two groups: treatment (n = 87) and wait-list control (n = 82). Treatment consisted of two 3-hr sessions and one 1-hr session conducted over 5 weeks. Of 169 participants, 91 women (Treatment, n = 43, Control, n = 48) completed a 3-month follow-up and 78 did not. At follow-up, nightmare frequency and PTSD severity decreased and sleep quality improved in the treatment group with small to minimal changes in the control group. Treatment effects were moderate to high (Cohen's d ranged from 0.57 to 1.26). Notwithstanding the large dropout rate, imagery-rehearsal therapy is an effective treatment for chronic nightmares in sexual assault survivors with PTSD and is associated with improvement in sleep quality and decreases in PTSD severity.
• White, J. W., Smith, P. H., Koss, M. P., & Figueredo, A. J. (2000). Intimate partner aggression - What have we learned? Comment on Archer (2000). Psychological Bulletin, 126(5), 690-696.
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  PMID: 10989618;Abstract: This commentary on J. Archer (2000) identifies limitations at the level of the primary data, the formal meta-analysis. and the interpretations of the results. Highlighted are concerns with the conceptual dichotomy that is the foundation of the analysis, how aggression was conceptualized and defined, and the methodological problems in the studies included in the database that were not neutralized by the meta-analysis. These include inadequate measurement of contextual factors and injury outcomes, scaling issues, and sampling concerns. The authors question the degree to which the field is advanced by this meta-analysis when the results are placed in the context of these limitations. Following American Association for the Advancement of Science directives (I. Lerch, 1999), the authors believe that inadequate attention was paid to the policy implications of the conclusions raising the potential to undermine societal efforts to eradicate violence against women.
• Cleveland, H. H., Koss, M. P., & Lyons, J. (1999). Rape Tactics From the Survivors' Perspective Contextual Dependence and Within-Event Independence. Journal of Interpersonal Violence, 14(5), 532-547. doi:10.1177/088626099014005005
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  This study uses sexual assault data drawn from both standard questionnaires and unstructured narratives to examine the association between the victim/perpetrator relationship and the tactics used to commit sexual assault. Participants, who were raped by strangers, acquaintances, dates, steady boyfriends, husbands, ex-husbands, and other relatives, provided narrative accounts of their rape experiences and responses to standard questionnaire items. Narratives were coded for the occurrence of different perpetrator behaviors such as use of force, threats of negative consequences, and use of alcohol or drugs to commit the rape. Based on factor analysis, these narrative-derived items were combined with questionnaire items to form two tactic scales: Power Tactics and Drug Tactics. Analysis revealed that tactic use varied according to the relationship between perpetrators and victims, and the use of Power Tactics was uncorrelated with use of Drug Tactics across all relationship types.
• Koss, M. P. (1999). A Field Trip With an Expert in Pornography.. Psyccritiques, 44(6), 493-495. doi:10.1037/002111
• Koss, M. P. (1999). Book Review: Crime Control and Women: Feminist Implications of Criminal Justice Policy. Criminal Justice Review, 24(2), 194-196. doi:10.1177/073401689902400212
• Lira, L. R., Koss, M. P., & Russo, N. F. (1999). Mexican American Women’s Definitions of Rape and Sexual Abuse. Hispanic Journal of Behavioral Sciences, 21(3), 236-265. doi:10.1177/0739986399213004
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  Focus group approach was used to explore concepts related to rape and sexual abuse among 17 Mexican immigrant women living in rural Arizona. The women discussed definitions of various forms of unwanted sexual experiences, their personal knowledge of someone who had been raped or sexually abused, and their perceptions of the roots of sexual abuse. Distinctions between rapto and violacion, child versus adult rape (including marital rape), motivations for rape, and social factors contributing to victim silencing were identified. The meaning and perceived impact of rape reflected the gender relations of the culture. Keeping silent was a consistent theme, underscoring the difficulties of accurately assessing rape prevalence in Latinas. Research, prevention, intervention, and treatment programs need to recognize the social context and impact of rape and be designed accordingly. Participants reported many rape experiences, suggesting that underreporting is a major problem in estimating rape prevalence for Latinas.
• Merrill, L. L., Newell, C. E., Thomsen, C. J., Gold, S. R., Milner, J. S., Koss, M. P., & Rosswork, S. G. (1999). Childhood abuse and sexual revictimization in a female Navy recruit sample.. Journal of traumatic stress, 12(2), 211-25. doi:10.1023/a:1024789723779
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  To examine effects of childhood abuse on adult rape, 1,887 female Navy recruits were surveyed. Overall 35% of recruits had been raped and 57% had experienced childhood physical abuse (CPA) and/or childhood sexual abuse (CSA). Controlling for CPA, rape was significantly (4.8 times) more likely among women who had experienced CSA than among women who had not. In contrast, CPA (controlling for CSA) was unrelated to likelihood of adult rape. Alcohol problems and number of sex partners were examined as mediators. Although both variables predicted rape, their effects were independent of the effects of CSA. Finally, despite ethnic group differences in the prevalence of victimization, the predictors of rape did not differ significantly across ethnic groups.
• Ullman, S. E., Karabatsos, G., & Koss, M. P. (1999). ALCOHOL AND SEXUAL AGGRESSION IN A NATIONAL SAMPLE OF COLLEGE MEN. Psychology of Women Quarterly, 23(4), 673-689. doi:10.1111/j.1471-6402.1999.tb00391.x
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  Alcohol use prior to sexual assault by both offenders and their victims may be associated with the severity of sexual aggression men commit against women. Little research has explored the pathways (e.g., social context, behavior) through which alcohol may affect outcomes of sexual attacks. The present study analyzed the role of alcohol in sexual assaults (N = 694) committed by men identified from a national sample (N = 2,972) of male college students completing a survey. Interactions of alcohol use with assault variables did not suggest any synergistic role of alcohol use in predicting sexual aggression severity. Path analysis showed, however, that offender propensity to abuse alcohol and victim preassault alcohol use were each both directly and indirectly related to sexual aggression severity, whereas offender preassault alcohol use was not directly related to sexual aggression severity. This study suggests that alcohol use plays both direct and indirect roles in the outcomes of sexual assaults. Rape and...
• Ullman, S. E., Karabatsos, G., & Koss, M. P. (1999). Alcohol and Sexual Assault in a National Sample of College Women. Journal of Interpersonal Violence, 14(6), 603-625. doi:10.1177/088626099014006003
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  Alcohol is associated with risk of sexual assault among women and with increased risk of experiencing completed rape once attacked. In particular, alcohol use prior to sexual assault by both offenders and victims may affect the severity of sexual victimization experienced by women. Little research has explored the mechanisms (e.g., social context, behavior) through which alcohol may affect outcomes of sexual attacks using multivariate analysis. This study analyzed the role of alcohol in sexual assaults experienced by a national sample of female college students. A hierarchical multivariate regression showed that victim alcohol abuse propensity and both victim and offender alcohol use prior to attack were directly associated with more severe sexual victimization to women as measured by the Sexual Experiences Survey. This study suggests that alcohol use plays both direct and indirect roles in the outcomes of sexual assaults. Rape and alcohol abuse prevention efforts can benefit from incorporating informatio...
• Walker, E. A., Katon, W. J., Koss, M. P., Russo, J., Korff, M. V., Gelfand, A. N., & Bernstein, D. P. (1999). Adult health status of women with histories of childhood abuse and neglect.. The American journal of medicine, 107(4), 332-9. doi:10.1016/s0002-9343(99)00235-1
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  Several recent studies have found associations between childhood maltreatment and adverse adult health outcomes. However, methodologic problems with accurate case determination, appropriate sample selection, and predominant focus on sexual abuse have limited the generalizability of these findings..We administered a survey to 1,225 women who were randomly selected from the membership of a large, staff model health maintenance organization in Seattle, Washington. We compared women with and without histories of childhood maltreatment experiences with respect to differences in physical health status, functional disability, numbers and types of self-reported health risk behaviors, common physical symptoms, and physician-coded ICD-9 diagnoses..A history of childhood maltreatment was significantly associated with several adverse physical health outcomes. Maltreatment status was associated with perceived poorer overall health (ES = 0.31), greater physical (ES = 0.23) and emotional (ES = 0.37) functional disability, increased numbers of distressing physical symptoms (ES = 0.52), and a greater number of health risk behaviors (ES = 0.34). Women with multiple types of maltreatment showed the greatest health decrements for both self-reported symptoms (r = 0.31) and physician coded diagnoses (r = 0.12)..Women with childhood maltreatment have a wide range of adverse physical health outcomes.
• Walker, E. A., Unutzer, J., Saunders, K., Vonkorff, M., Koss, M. P., Katon, W., Rutter, C. M., & Gelfand, A. N. (1999). Costs of health care use by women HMO members with a history of childhood abuse and neglect.. Archives of general psychiatry, 56(7), 609-13. doi:10.1001/archpsyc.56.7.609
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  Early childhood maltreatment has been associated with adverse adult health outcomes, but little is known about the magnitude of adult health care use and costs that accompany maltreatment. We examined differences in annual health care use and costs in women with and without histories of childhood sexual, emotional, or physical abuse or neglect..A random sample of 1225 women members of a health maintenance organization completed a 22-page questionnaire inquiring into childhood maltreatment experiences as measured by the Childhood Trauma Questionnaire. Health care costs and use data were obtained from the automated cost-accounting system of the health maintenance organization, including total costs, outpatient and primary care costs, and emergency department visits..Women who reported any abuse or neglect had median annual health care costs that were $97 (95% confidence interval, $0.47-$188.26) greater than women who did not report maltreatment. Women who reported sexual abuse had median annual health care costs that were $245 (95% confidence interval, $132.32-$381.93) greater than costs among women who did not report abuse. Women with sexual abuse histories had significantly higher primary care and outpatient costs and more frequent emergency department visits than women without these histories..Although the absolute cost differences per year per woman were relatively modest, the large number of women in the population with these experiences suggests that the total costs to society are substantial.
• White, J. W., Merrill, L. L., & Koss, M. P. (1999). Predictors of Premilitary Courtship Violence in a Navy Recruit Sample. Journal of Interpersonal Violence, 16(9), 910-927. doi:10.1177/088626001016009004
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  Research on intimate partner (IP) aggression was extended to premilitary experiences of IP violence among U.S. Navy recruits. Riggs and O'Leary's (1989) model of courtship aggression was examined separately for men (N = 1,307) and women (N = 1,477). A test was conducted of the model using participant gender along with the significant variables from the initial analyses and the interaction of gender with each of these variables. Situational components explained more variance that did the background components. For women and men, the amount of variance accounted for was almost tripled after the addition of the situational factors. Partner aggression contributed to a substantial increase in the amount of variance. Partner's verbal aggression was the single best predictor of aggression, and partner's physical aggression was the second-best predictor. The situational component substantially increased the predictive power of the model. The results support the validity of the Riggs and O'Leary model.
• Boeschen, L. E., Sales, B. D., & Koss, M. P. (1998). Rape trauma experts in the courtroom.. Psychology, Public Policy and Law, 4(1-2), 414-432. doi:10.1037/1076-8971.4.1-2.414
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  This article analyzes the scientific legitimacy of using expert testimony relating to psychological sequelae of rape victimization in the courtroom and attempts to determine boundaries within which such testimony should remain to respect the limitations of current knowledge. Descriptions of the rape-related diagnoses currently used in expert testimony are followed by a discussion of the problematic issues associated with using rape trauma syndrome in the courtroom and a review of the validity and reliability issues associated with diagnosing posttraumatic stress disorder in forensic settings. The authors consider the scientific appropriateness of admitting different levels of rape expert testimony on the basis of the limitations of the scientific knowledge discussed.
• Felitti, V. J., Anda, R. F., Williamson, D. F., Spitz, A. M., Koss, M. P., Marks, J. S., Nordenberg, D. F., & Edwards, V. J. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.. American journal of preventive medicine, 14(4), 245-58. doi:10.1016/s0749-3797(98)00017-8
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  The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described..A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life..More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, > or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life..We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
• Merrill, L. L., Newell, C. E., Milner, J. S., Koss, M. P., Hervig, L. K., Gold, S. R., Rosswork, S. G., & Thornton, S. R. (1998). Prevalence of premilitary adult sexual victimization and aggression in a Navy recruit sample.. Military Medicine, 163(4), 209-212. doi:10.1093/milmed/163.4.209
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  U.S. Navy recruits (n = 3,776) were surveyed for premilitary histories of adult sexual assault. They completed a survey designed to estimate rates for experiences as victims (women) and perpetrators (men) of attempted and completed rape since the age of 14. The results show that 45.5% of the women reported being the victim of attempted (9.4%) or completed rape (36.1%) before entering the Navy. Male recruits' self-reports indicated that 14.8% admitted perpetrating attempted (3.5%) or completed rape (11.3%) before entering the Navy. A high percentage of recruits in this study reported histories of sexual assault. Female victims of sexual assault are at high risk of incurring somatic and/or psychological problems that require treatment by health care professionals. Male perpetrators of sexual assault are at high risk of repeating their behavior. The results of this study suggest that it may be cost-effective to develop treatment education, and prevention programs for military recruits. Language: en
• Koss, M. P. (1997). Dealing with date rape.. contemporary Psychology, 42(8), 716-716. doi:10.1037/000156
• Koss, M. P., Pepper, S., Koss, M. P., & Ingram, M. (1997). Psychotherapists' role in the medical response to male-partner violence. Psychotherapy, 34(4), 386-396. doi:10.1037/h0087707
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  Male-partner abuse, although it is prevalent among medical patients in emergency rooms, primary care, and obstetric clinics, is infrequently screened for and therefore inadequately treated by the majority of physicians. Research studies to support these conclusions are reviewed. On the basis of information presented, it is recommended that psychotherapists (1) recognize that absence of partner-violence injury in medical records often reveals lack of proper diagnosis rather than lack of evidence; (2) coach their patients on the selection of an appropriate provider and in approaches to disclose their history in a safe manner; and (3) advocate for better medical education regarding male-partner violence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
• Walker, E. A., Newman, E., Koss, M. P., & Bernstein, D. M. (1997). Does the study of victimization revictimize the victims?. General hospital psychiatry, 19(6), 403-10. doi:10.1016/s0163-8343(97)00061-3
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  Although the number of questionnaire surveys examining the sequelae of prior sexual and physical victimization has increased over the last decade, little attention has been given to understanding the impact of such studies on participants. As part of a larger study of long-term effects of prior sexual and physical victimization, 500 randomly selected women in an HMO received a comprehensive questionnaire including multiple symptomatic distress measures and several items inquiring into previous history of sexual, physical, and emotional abuse and neglect. They also completed a short rating scale asking about their reactions to completing the questionnaire. Despite the sensitive content, the women who participated generally found the experience to be a positive one. Only a small number of women were more upset than they had anticipated, but the vast majority felt they would have completed the survey even if they had known in advance how they would feel. The subset of women who did express distress was significantly different from the group that did not, with respect to other measures of symptomatic distress and trauma exposure. These data suggest that surveys that inquire into prior episodes of childhood victimization are generally well tolerated by women who participate, and that, although a small number may be disturbed by these investigations, in general, adverse reactions may be less common than previously anticipated.
• Koss, M. P. (1996). In my expert opinion.. contemporary Psychology, 41(11), 1123-1124. doi:10.1037/003217
• Koss, M. P. (1996). The Measurement of Rape Victimization in Crime Surveys. Criminal Justice and Behavior, 23(1), 55-69. doi:10.1177/0093854896023001005
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  Although the past 20 years have seen changes in the statutory definition of rape, its investigation, and its adjudication, for the bulk of this period those responsible for the measurement of rape victimization in national and international crime surveys have clung to inadequate rape screening. Because the resultant victimization estimates failed to capture accurately the incidence of rape, independent researchers tried to fill the data vacuum, a situation that has precluded a cumulative database and promoted an antirape backlash. Flawed federal data ill-serve policy needs and fuel a negative recovery climate for victims. This article argues that it is time for U.S. victimization statistics to measure rape with the same precision accorded other crimes and to communicate more openly to the public the limitations of crime survey methodology to detect intimate violence including rape. Language: en
• Koss, M. P., & Cleveland, H. H. (1996). Athletic participation, fraternity membership, and date rape. The question remains -- self-selection or different causal processes?. Violence against women, 2(2), 180-90. doi:10.1177/1077801296002002005
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  This commentary discusses the papers in a special issue that addresses the contribution of athletic participation and fraternity membership to the prediction of date rape on campus. The commentary focuses on issues that make it difficult to weigh the available evidence, including methodological and conceptual problems, and concludes that the field is currently unable to answer definitively whether athletes and fraternity members, compared to other men, are more sexually aggressive in general, at some locations but not others, or are similar in overall rates of sexual aggression but favor different forms of coercive sexuality. It is suggested that future research address the relative contribution of individual determinants, self-selection into social groups, and features of the environment and culture created by and reciprocally influencing athletes and fraternity members. Such studies are a high priority because of the important practical significance of their findings on shaping prevention programs for d...
• Koss, M. P., Figueredo, A. J., Bell, I., Tharan, M., & Tromp, S. (1996). Traumatic memory characteristics: A cross-validated mediational model of response to rape among employed women. Journal of Abnormal Psychology, 105(3), 421-432.
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  PMID: 8772012;Abstract: In a cross-validated mediational model, the authors examined characteristics of memories formed in response to rape and other intense unpleasant and pleasant experiences. Data were responses to a mailed survey of women medical center and university employees. Measurement models of memory and symptom factors and a structural model with pathways among cognitive appraisal, emotional valence, memory characteristics, and health outcomes were developed in Sample 1 (N = 1,307) and confirmed in Sample 2(N = 2,142). Rape had substantial direct effects on 2 memory factors (Clarity and Affect) and indirect effects through the construal of victimization. Rape was associated with memories described as more emotionally intense but less clear and coherent and less often thought of or talked about. Most effects on physical symptoms were nonsignificant. Implications of findings for neurohormonal and multiple representation models of emotional memory and to cognitive avoidance are discussed.
• Koss, M. P., Tromp, S., Tharan, M., & Tramp, S. (1995). Traumatic Memories: Empirical Foundations, Forensic and Clinical Implications. Clinical Psychology-science and Practice, 2(2), 111-132. doi:10.1111/j.1468-2850.1995.tb00034.x
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  This article reviews empirical research on memories for negative personal experiences among adults. It examines basic concepts (including neural underpinnings), theoretical models of the affect-memory relationship, and data from three sources: victims or witnesses to crimes and atrocities, “flashbulb memories” for traumatic events, and laboratory simulations of shocking experiences. Evidence suggests that memories for traumatic experiences contain more central than peripheral detail, are reasonably accurate and well-retained for very long periods, but are not completely indelible. Assertions of eyewitness memory's vulnerability to change through suggestion have overstated the evidence. Forensic and clinical implications are discussed and a plea issued for more study of the memory phenomena that characterize posttraumatic stress disorder (PTSD) and are the focus of trauma survivors’ treatment.
• Koss, M. P., Tromp, S., Tharan, M., Koss, M. P., & Figueredo, A. J. (1995). Are rape memories different? A comparison of rape, other unpleasant, and pleasant memories among employed women.. Journal of traumatic stress, 8(4), 607-27. doi:10.1007/bf02102891
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  The study examined empirically-measured memory characteristics, compared pleasant and unpleasant intense memories as well as rape and other unpleasant memories, and determined whether rape memories exhibited significantly more "flashbulb" characteristics. Data consisted of responses to a mailed survey of women employees of a medical center (N = 1,037) and a university (N = 2,142). Pleasant and unpleasant memories were differentiated by feelings, consequences, and level of unexpectedness. The most powerful discriminator of rape from other unpleasant memories was the degree to which they were less clear and vivid, contained a less meaningful order, were less well-remembered, and were less thought and talked about. Few "flashbulb" characteristics discriminated among memory types. Implications for clinical work with rape survivors were discussed.
• Mccloskey, L. A., Koss, M. P., Figueredo, A. J., Koss, M. P., Mccloskey, L. A., Koss, M. P., & Figueredo, A. J. (1995). The effects of systemic family violence on children's mental health. Child Development, 66(5), 1239-1261. doi:10.1111/j.1467-8624.1995.tb00933.x
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  This study examines the link between different forms of family aggression and children's symptoms of psychopathology. The goal of the study was to understand what forms children's problems might take in violent homes and whether close ties within the family (to the mother or a sibling) buffered children. Interviews with 365 mothers and 1 of their children between the ages of 6 and 12 about abuse in the home, support and closeness within the nuclear family, and mother's and children's mental health formed the basis of this study. Families were recruited from battered women's shelters and the community. We found that different forms of abuse in the home were highly interrelated and that children of battered women were at risk for child abuse. Domestic violence predicted children's general psychopathology, but we uncovered little evidence for the presence of specific sorts of disorders as a result of family dysfunction. Although mothers experiencing conjugal violence were more likely to have mental health problems, their mental health did not mediate the children's response to family conflict. Finally, there was less sibling and parental warmth in families marked by aggression, although when it was present, family social support failed to buffer children. Although the general pattern of results was consistent across respondents (mother and child), there was low agreement on symptoms of child psychopathology.
• Walker, E. A., Gelfand, A. N., Gelfand, M. D., Koss, M. P., & Katon, W. J. (1995). Medical and psychiatric symptoms in female gastroenterology clinic patients with histories of sexual victimization.. General hospital psychiatry, 17(2), 85-92. doi:10.1016/0163-8343(94)00058-l
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  Several recent retrospective reports have associated prior sexual victimization and long-term medical sequelae such as increased medical clinic utilization and reports of physical symptoms. However, methodological constraints have limited the generalizability of these findings. Our study was designed using structured interviews with a sequential sample of 89 female gastroenterology clinic patients, who were classified by severity of sexual trauma and studied for differences in lifetime psychiatric diagnoses, physical abuse, and medically unexplained symptom patterns. Compared with the 46 women who had experienced less severe or no prior sexual trauma, the 43 patients with severe victimization had significantly higher life-time and current rates of several selected psychiatric disorders as well as significantly higher mean numbers of lifetime psychiatric disorders, medically unexplained physical and anxiety symptoms, greater harm avoidance and dissociation scores, and increased functional disability. A logistic regression showed that the main predictors of a history of severe sexual abuse were the number of medically unexplained symptoms, adult physical abuse, and lifetime dysthymic disorder. We concluded that women with prior severe sexual trauma episodes may express medically unexplained physical symptoms as part of the long-term adaptation to their victimization.
• Walker, E. A., Koss, M. P., & Katon, W. J. (1995). Ethical sequelae of sexual and physical victimization of women: A pilot study. Womens Health Issues, 5(2), 77-78. doi:10.1016/1049-3867(95)92855-y
• Chester, B., Robin, R. W., Koss, M. P., Lopez, J., & Goldman, D. (1994). Grandmother dishonored: violence against women by male partners in American Indian communities.. Violence & Victims, 9(3), 249-258. doi:10.1891/0886-6708.9.3.249
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  Extensive and scrupulously conducted research during the past decade has established the issue of violence against women by male partners as both an international human rights issue and a public health problem of national concern. This research has rarely been extended into communities of color, and, in particular, to American Indian women. This article presents conceptual and methodological factors involved in conducting research with American Indian women, a comprehensive literature review of available data, assertions regarding abuse of women by male partners in American Indian communities, and directions for future research.
• Koss, M. P., Heise, L., & Russo, N. F. (1994). The Global Health Burden Of Rape. Psychology of Women Quarterly, 18(4), 509-537. doi:10.1111/j.1471-6402.1994.tb01046.x
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  Women's rights to be free from male violence are now recognized by the United Nations as fundamental human rights. Two parallel transformations in the understanding of rape have been central to the international effort to achieve this declaration. The first is increased recognition of the extent to which rape typically involves intimates. The second is the shift from regarding rape as a criminal justice matter towards an appreciation of its implications for women's health. The focus of this paper is the health burden of rape, which is addressed from the global perspective and includes discussion of its prevalence and psychological, sociocultural, somatic, and reproductive health consequences. Quantitative efforts to capture the relative economic impact of rape compared to other threats to women's health are also discussed. The paper concludes with an agenda for future research on rape that could enrich activists' efforts on behalf of women's health and development.
• Goodman, L. A., Koss, M. P., & Russo, N. F. (1993). Violence against women: Mental health effects. Part II. Conceptualizations of posttraumatic stress. Applied & Preventive Psychology, 2(3), 123-130. doi:10.1016/s0962-1849(05)80118-0
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  Abstract A broad range of psychological aftereffects have been noted among women who have experienced male-perpetrated violence. These symptoms vary considerably among individuals, across social contexts, and across different types of violent encounters ( Coley & Beckett, 1988 ; Goodman, Koss, & Russo, 1992; Koss, 1988 ; Straus, Gelles, & Steinmetz, 1980 ). Nevertheless, a remarkably consistent picture of the psychological sequelae of violence—particularly sexual and physical assault—emerges from the empirical and clinical literature ( Koss, 1988 ). In this article, we use the posttraumatic stress disorder diagnosis—a frame that captures many of the disparate symptoms described by researchers—as a basis for exploring several conceptual models that have been developed to explain women's responses to violence.
• Goodman, L. A., Koss, M. P., & Russo, N. F. (1993). Violence against women: Physical and mental health effects. Part I: Research findings. Applied & Preventive Psychology, 2(2), 79-89. doi:10.1016/s0962-1849(05)80114-3
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  Abstract Interpersonal violence is a ubiquitous source of fear, distress, and injury in the lives of women in the United States, crossing lines of age, race, ethnicity, and economic status ( Coley & Beckett, 1988 ; Frieze & Browne, 1989 ; Koss, 1988 ; Straus, Gelles, & Steinmetz, 1980 ). In recent years, the public health community has become increasingly aware that “this violence is a serious public health problem … [and that] nonfatal interpersonal violence has far-reaching consequences in terms of morbidity and quality of life” ( Center for Disease Control, 1985 , p. 739). This article reviews the physical and mental health effects on adult women of physical abuse and sexual assault, and describes their implications for mental health research and practice.
• Goodman, L. A., Koss, M. P., Fitzgerald, L. F., Russo, N. F., & Keita, G. P. (1993). Male violence against women. Current research and future directions. American Psychologist, 48(10), 1054-1058. doi:10.1037/0003-066x.48.10.1054
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  This Psychology in the Public Forum section, authored by the American Psychological Association's Committee on Women in Psychology's Task Force on Male Violence Against Women and by Senator Joseph Biden, examines the prevalence, impact, and public policy dimensions of physical assault, sexual assault, and sexual harassment of women. This introduction reviews common themes that emerge from the articles that follow. It concludes by emphasizing that the problem of violence against women cannot be fully understood, let alone solved, by focusing exclusively on individual psychology. Only by changing the social and cultural institutions that have given rise to the problem can a lasting solution be achieved. Language: en
• Gutek, B. A., & Koss, M. P. (1993). Changed Women and Changed Organizations: Consequences of and Coping with Sexual Harassment. Journal of Vocational Behavior, 42(1), 28-48. doi:10.1006/jvbe.1993.1003
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  Abstract Sexual harassment has been conceptualized as a form of gender-based abuse which has significant effects on victims. This article reviews research on effects of harassment in three complementary areas. Work-related, psychological, and somatic effects of sexual harassment on women workers are reviewed, as are the impacts on the employing organization. The third part of the review deals with women victims′ responses to harassment and attempts to cope with harassment. The most frequently used attempts to cope may not be effective under certain circumstances. The available research has significant shortcomings and reveals important gaps. It yields a laundry list of effects and responses, but it does not allow us to specify conditions under which particular effects will occur or the factors that affect choice of response. Compared to other facets of sexual harassment, the topic of outcomes of harassment has generated relatively little interest among researchers. Reasons for the lack of research in this area are discussed.
• Gutek, B. A., & Koss, M. P. (1993). Effects of sexual harassment on women and organizations.. Occupational medicine (Philadelphia, Pa.), 8(4), 807-19.
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  This chapter focuses on the consequences of sexual harassment of women, including the effects on the victim's work and health and the organization for which she works as well as the woman's attempts to cope with harassment when confronted with it. The responses of victims are influenced by the amount of support and understanding they receive from significant others and employers. The extent of emotional, physical, and psychological damage depends on the responsiveness of other people and the organization for which the woman works.
• Koss, M. P. (1993). All You Need to Know.. Psyccritiques, 38(5), 516-518. doi:10.1037/033335
• Koss, M. P. (1993). Detecting the Scope of Rape A Review of Prevalence Research Methods. Journal of Interpersonal Violence, 8(2), 198-222. doi:10.1177/088626093008002004
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  This article focuses on rape prevalence research and examines the relationship between measurement methods and level of rape detection. After a brief overview of empirical data, the relative threat to the validity of prevalence estimates posed by fabrication versus nondisclosure is weighed. Then various methodological choices and their relationship to the magnitude of prevalence estimates are examined. Addressed are the definitions underlying the studies, the questions used to elicit reports of rape, the context in which rape questioning occurred, the confidentiality of the responses, the method of data collection, and the sample integrity. The conclusions include 10 recommendations for the design of future studies of rape prevalence.
• Koss, M. P. (1993). Rape. Scope, impact, interventions, and public policy responses.. American Psychologist, 48(10), 1062-1069. doi:10.1037/0003-066x.48.10.1062
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  There are many ways for women to be victimized by strangers and by people they know, but rape is the crime women fear most. The research on the frequency, psychological aftereffects, somatic consequences, and immediate as well as delayed interventions for rape is reviewed; a brief consensus of the literature within each of these areas is developed; and the implications of the research for public policy are considered. Among the suggested policy responses are improvements in the databases on rape frequency, increased attention to measurement, a higher priority for teaching about rape in the education of health care providers, increased funding and technical assistance to rape crisis centers, and more diversity of interventions and research on their effects.
• Koss, M. P. (1993). The Impact of Crime Victimization on Women's Medical Use. Journal of Womens Health, 2(1), 67-72. doi:10.1089/jwh.1993.2.67
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  ABSTRACT A rapidly growing literature points to the somatic, nonpsychiatric impacts of violence on women's health. In the present study, the long-term consequences of criminal victimization on medi...
• Koss, M. P., & Gaines, J. A. (1993). The Prediction of Sexual Aggression by Alcohol Use, Athletic Participation, and Fraternity Affiliation. Journal of Interpersonal Violence, 8(1), 94-108. doi:10.1177/088626093008001007
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  Alcohol, athletics, and fraternities have been targeted in the popular media as primary causes of sexual aggression on campus. Except in the case of alcohol, the empirical data supporting these associations is weak. The present study assessed the joint contribution of these three variables to the prediction of sexual aggression among a sample of 530 undergraduate men including 140 athletes representing all varsity sports. Approximately 11% of the variance in the level of sexual aggression was accounted for by four variables including self-reported intensity of alcohol use and degree of athletic participation, but not fraternity affiliation. The alcohol and athletic variables also discriminated those men who reported participating in gang rapes ( N = 17) from those not involved. Although significant prediction was achieved, the results must be viewed cautiously as the power of the effects was small. The article concludes with the implications of the findings for rape prevention education.
• Walker, E. A., Torkelson, N., Katon, W., & Koss, M. P. (1993). The prevalence rate of sexual trauma in a primary care clinic.. Journal of The American Board of Family Practice, 6(5), 465-471. doi:10.3122/jabfm.6.5.465
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  IltIcllgnnltul: Despite the high prevalence rate of sexual victimizadon in the general populadon, little is known about the characterisdcs of abuse victims in primary care. We studied the prevalence rate of childhood and adult sexual trauma in a primary care clinic, associated psychological distress, and paden.' attitudes about physician inquiry into past sexual victimizadon. Metbotls: Self-report questionnaires were given to 162 women in a primary care clinic inquiring about past episodes of chUdhood sexual abuse, adult sexual assault, and paden.' desire that their physicians be aware of their sexually traumatic experiences. The women also completed the 'a 6:465-471.)
• Koss, M. P. (1992). Defending Date Rape. Journal of Interpersonal Violence, 7(1), 122-126. doi:10.1177/088626092007001010
• Koss, M. P. (1992). More Ericksonian approaches.. contemporary Psychology, 37(8), 791-791. doi:10.1037/032463
• Koss, M. P. (1992). Rape on Campus: Facts and Measures.. Planning for higher education, 20(3), 21-28.
• Koss, M. P. (1992). The Under detection of Rape: Methodological Choices Influence Incidence Estimates. Journal of Social Issues, 48(1), 61-75. doi:10.1111/j.1540-4560.1992.tb01157.x
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  This paper discusses the extent of rape in the U.S. today, including a critical analysis of federal and independent sources of incidence data. Rape incidence estimates derived from the National Crime Survey (NCS) are flawed because of measurement methods that undermine full disclosure of victimization. Conclusions include (a) the incidence of rape is much higher than federal statistics suggest, but data are insufficient to resolve whether an epidemic is underway, (b) acquaintance rape is far more common than documented in crime surveys, and (c) improvement in rape detection is promised by the proposed revisions in the NCS.
• Koss, M. P. (1992). Violence Against Women: Nursing Research, Education, and Practice Issues.. Psyccritiques, 37(7), 715-716. doi:10.1037/032385
• Koss, M. P., & Heslet, L. (1992). Somatic consequences of violence against women.. Archives of family medicine, 1(1), 53-9. doi:10.1001/archfami.1.1.53
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  The rapidly growing literature on the somatic, nonpsychiatric effects of violence on women's health is reviewed, including rape, battery, and the adult consequences of child sexual abuse. The sequelae of these victimizations are summarized with consideration of acute effects (genital and nongenital injuries, sexually transmitted disease, and pregnancy), late consequences (chronic pelvic pain and other forms of chronic pain, gastrointestinal symptoms, premenstrual symptoms, and negative health behaviors), and long-term increases in the use of medical services. A recurrent theme across the literature is that the medical treatment of all types of victimized women can be improved by providing attention to the underlying cause of their symptoms. Achievement of this goal requires that physicians identify victimization history and provide access to appropriate support services. Because all forms of violence against women are prevalent among primary care populations, and victimization is clearly linked to health, health care providers cannot afford to miss this relevant history. The article concludes with suggestions for fostering and responding to disclosures of victimization.
• Gidycz, C. A., & Koss, M. P. (1991). Predictors of long-term sexual assault trauma among a national sample of victimized college women.. Violence & Victims, 6(3), 175-190. doi:10.1891/0886-6708.6.3.175
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  Several multivariate studies have attempted to delineate the major predictors of long-term, sexual assault-induced aftereffects. The present study was an attempt to extend previous work by supplementing known preassault, assault, and postassault predictors of trauma with cognitive measures. The data were cross-sectional and included responses from 1,213 victims of sexual assault who were recruited from a national sample of higher education students. Utilizing hierarchical multiple regression analyses and a cross-validation procedure, the results suggested that the prior mental status of the victims, the forcefulness of the assaults, as well as two cognitive variables related to a victim's beliefs about sex and relationships predicted victims' scores on standardized measures of anxiety and depression. The relationships were such that the most traumatized victims were those women who had evidenced a history of mental health problems, who had experienced the more aggressive assaults, who tended to believe that people in relationships are not trustworthy, and tended to place conservative restrictions on the sexual acts and circumstances under which sex should occur. Taken together these variables accounted for between 9%-14% of the variance in sexual assault aftereffects. The discussion emphasizes the contribution of cognitive processes to the understanding of sexual assault trauma. Language: en
• Koss, M. P. (1991). Psychotherapy from scratch.. Psyccritiques, 36(2), 129-130. doi:10.1037/029413
• Koss, M. P. (1991). Shifting chairs on the Titanic.. Psyccritiques, 36(4), 332-333. doi:10.1037/029647
• Koss, M. P. (1991). Solar Eclipses Both Hide and Reveal.. Psyccritiques, 36(8), 710-710. doi:10.1037/030067
• Koss, M. P. (1991). Survival of the shortest.. Psyccritiques, 36(10), 866-867. doi:10.1037/030257
• Koss, M. P., Woodruff, W. J., & Koss, P. G. (1991). Criminal victimization among primary care medical patients: prevalence, incidence, and physician usage.. Behavioral sciences & the law, 9(1), 85-96. doi:10.1002/bsl.2370090110
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  The study addressed the extent to which primary care physicians encounter crime victims in their practices. Crime prevalence and incidence rates were calculated from responses to a mailed survey of 2,291 women medical patients (45% response rate). The prevalence of crime victimization was 57%. The 12 month incidence of violent crime was 118 per 1,000 patients. Most notable was the finding that rape incidence was approximately 15 times higher than National Crime Survey estimates for women, even after adjustment for telescoping. Post-crime physician usage was documented by medical chart review. Although few crime victims required hospitalization for injuries, virtually all made out-patient physician visits in each of two post-crime years. The findings suggest that physicians are an important potential source of assistance for traumatized crime victims.
• Koss, M. P., Woodruff, W. J., & Koss, P. G. (1991). Deleterious effects of criminal victimization on women's health and medical utilization.. JAMA Internal Medicine, 151(2), 342-347. doi:10.1001/archinte.1991.00400020092019
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  The long-term consequences of criminal victimization on physical health were examined among 390 adult women (74 nonvictims and 316 victims of crime). Data included health status self-ratings and objective service utilization. Findings indicated that severely victimized women, compared with nonvictims, reported more distress and less well-being, made physician visits twice as frequently in the index year, and had outpatient costs that were 2.5 times greater. Criminal victimization severity was the most powerful predictor of physician visits and outpatient costs. Utilization data across 5 years preceding and following crime were obtained from 15 rape victims, 26 physical assault victims, and 27 noncontact crime victims and were compared with five continuous years of utilization among 26 nonvictims. Victims' physician visits increased 15% to 24% during the year of the crime compared with less than 2% change among nonvictims. We conclude that these long-term deleterious effects suggest that criminally victimized women's needs for medical treatment transcend the traditional focus on emergency care and forensic evaluation. (Arch Intern Med. 1991;151:342-347)
• Malamuth, N. M., Sockloskie, R. J., Koss, M. P., & Tanaka, J. S. (1991). Characteristics of aggressors against women: testing a model using a national sample of college students.. Journal of Consulting and Clinical Psychology, 59(5), 670-681. doi:10.1037/0022-006x.59.5.670
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  Structural equation modeling was used to study the characteristics of college men ( N = 2,652) who aggressed against women either sexually, nonsexually, or both. According to the model, hostile childhood experiences affect involvement in delinquency, leading to aggression through 2 paths: (1) hostile attitudes and personality, which result in coerciveness both in sexual and nonsexual interactions and (2) sexual promiscuity, which, especially in interaction with hostility, produces sexual aggression. In addition, sexual and nonsexual coercion were hypothesized to share a common underlying factor. Although its development was guided by integrating previous theory and research, the initial model was refined in half of the sample and later replicated in the 2nd half. Overall, it fitted the data very well in both halves and in a separate replication with a sample for whom data were available about sexual but not about nonsexual aggression. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
• White, J. W., & Koss, M. P. (1991). Courtship violence: incidence in a national sample of higher education students.. Violence & Victims, 6(4), 247-256. doi:10.1891/0886-6708.6.4.247
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  An approximately representative national sample of 2,602 women and 2,105 men was surveyed regarding their frequency of inflicting and sustaining verbal and physical aggression in a heterosexual relationship. Results revealed that approximately 81% of the men inflicted, as well as received, some form of verbal aggression at least once, while the comparable figure for women was 87-88%. The percentage experiencing some form of physical aggression was lower; about 37% of the men and 35% of the women inflicted some form of physical aggression and about 39% of the men and 32% of the women sustained some physical aggression. No differences were found as a function of ethnicity, family income, and institutional characteristics. Regional differences in the use of verbal and physical aggression, and in the receipt of physical aggression, were found for men.
• Gidycz, C. A., & Koss, M. P. (1990). A Comparison of Group and Individual Sexual Assault Victims. Psychology of Women Quarterly, 14(3), 325-342. doi:10.1111/j.1471-6402.1990.tb00023.x
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  The experiences of 44 group sexual assault victims (multiple offenders, one victim) were compared with 44 individual sexual assault victims (one offender, one victim). Sexual assaults included various degrees of sexual victimization ranging from verbal coercion to rape. Participants were located from among a national sample of 3,187 college women. Group sexual assaults, compared to individual sexual assaults, were in general more violent, involved greater resistance from the victims, and were more likely to be perpetrated by strangers or relatives and to involve an experience which met the legal definition of rape. Group sexual assaults were less likely to involve multiple episodes by the same offender(s). Group sexual assault victims were more likely than individual sexual assault victims to seek police and crisis services, to have contemplated suicide, and to have sought therapy postassault. Despite these differences, the two groups were similar in the amount of drinking and drug use during the assault ...
• Koss, M. P. (1990). The women's mental health research agenda. Violence against women.. American Psychologist, 45(3), 374-380. doi:10.1037/0003-066x.45.3.374
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  This article explores the scope impact community response prevention and treatment of violence against women. For the past several years 38% to 67% of adult women experienced violence before reaching the age of 18. Despite the different violent events which women experienced its impact on the mental health status of women remained similar. Victims of violence develop an immediate "postvictimization distress response" characterized by fear and avoidance constriction of affect self-concept and self-efficacy disturbances and sexual dysfunction. Moreover the traumatic experience affects their belief in personal vulnerability and perceptions on the meaning of the world. Several conclusions were drawn from the information presented and included the following: 1) there is lack of nationally representative data to determine the scope of violence; 2) mental health professionals are not addressing the mental health implications of violence; 3) programs directed towards the victims of violence were developed without basing on empirical data; and 4) efforts to prevent violence against women were isolated from the social context. Finally a research agenda which contains directions for future research were presented to address the gaps in existing literature that were previously identified.
• Koss, M. P., Woodruff, W. J., & Koss, P. G. (1990). Relation of criminal victimization to health perceptions among women medical patients.. Journal of Consulting and Clinical Psychology, 58(2), 147-152. doi:10.1037/0022-006x.58.2.147
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  The relation of criminal victimization to health perceptions (self-rated current health) was determined among women health maintenance organization patients. Data were survey responses from 2,291 women (45% response rate), 57% of whom had experienced crime. Reliability was evaluated by assessing 241 respondents both by survey and by interview. Data were analyzed by hierarchical multiple regression, which indicated that criminal victimization was an important predictor of health perceptions even after accounting for the contributions of demographics and other stressful life events with known links to illness. Validity was supported because medical care was actually sought by 92% of crime victims during the 1st year following the crime and by 100% during the 2nd year. Conclusions included the following: (a) Crime victimization history is relevant to health status assessment, and (b) primary care medical populations are an important locus from which crime victims could be identified and their treatment options considered.
• Gidycz, C. A., & Koss, M. P. (1989). The impact of adolescent sexual victimization: Standardized measures of anxiety, depression, and behavioral deviancy. Violence & Victims, 4(2), 139-149. doi:10.1891/0886-6708.4.2.139
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  Standardized measures of depression, anxiety, and behavioral deviancy were administered to a nonclinical sample of 67 high school girls (M age = 16.3; SD = 1.28). In addition, an adolescent version of the Sexual Experiences Survey was administered to assess the history of peer sexual victimization. In this sample, 55.0% of the girls had experienced at least one sexual victimization, including 7.5% of them who had experienced completed forcible rape. Data were analyzed via multivariate analysis of variance and multiple regression. Sexually victimized girls scored significantly higher than nonvictimized girls on the Trait Anxiety Index and the Beck Depression Inventory, but not on the Antisocial Index of the Jesness Inventory. The extent of victimization contributed significantly to the prediction of both the depression score and the anxiety score. The clinical significance of the reported symptoms is discussed. Although the study was not based on a probability sample, the prevalence of rape was consistent with existing literature. Because the sample was limited to girls who have remained involved in social systems, the measured symptoms probably are a conservative estimate of retrospectively measured postassault standardized test scores among sexually victimized adolescents. VioLit summary: OBJECTIVE: The purpose of this research by Gidyez and Koss was to examine the affect of adolescent sexual victimization on the victims scores on standardized measures of anxiety, depression, and behavioral deviancy. METHODOLOGY: A quasi-experimental cross-sectional design was utilized to gather data from a convenience sample of 67 adolescent girls residing in Ohio. Parental permission was obtained for all members of the final sample. The sample had a consent rate of 25%. The authors measured sexual victimization using a self-report instrument which was a modified version of the Sexual Experiences Survey. This survey has an internal consistency reliability of .74. Its test-retest stability was measured as .93. If a girl responded yes to any item in the survey she was considered sexually victimized. victimizations were completed forcible rape. Levels of sexual victimization were operationally defined as the highest question on the survey. This was done to define a continuum of sexual victimization. The authors measured anxiety, depression, and behavioral deviancy as the possible after effects of adolescent sexual assault. Anxiety was measured using the Trait Anxiety Scale. Trait anxiety was defined as relatively stable individual differences in anxiety proneness. Depression was measured using the Beck Depression Inventory. The Asocial Index of the Jesness Inventory was used to measure behavioral deviancy. The victim and non-victim results were analyzed using one-way multivariate analysis of variance to see if there were significant differences. The relationship between demographic variables and anxiety and depression scores was examined to reveal predictive factors. FINDINGS/DISCUSSION: Fifty-five percent of the girls reported at least one sexual victimization. Seven point five percent of the girls' victimization were completed forcible rape. The overall value of the MANOVA test was significant. The authors found significant differences between the victimized and non-victimized groups on the Trait Anxiety Scale and on the Beck Depression Inventory using subsequent univariate analysis of variance. On the beck Depression Inventory 6.7% of non-victims fell in the moderate range of depression and none of the non-victims scored in the severe range. Twenty-seven percent of the victims scored in the moderate range and 10.8% of the victims fell in the severe range of depression. Significantly more victims than non-victims had contemplated suicide to the point of considering a plan for their suicide. Victims experienced more symptoms of anxiety than non-victimized girls. Sexually victimized girls experience higher levels of symptoms of depression than non-victimized girls. Demographic variables found to be predictive were, age, presence of a stepfather, family income, divorced parents, therapy experience, ethnicity, and victimization level. Subjects that were nonwhite and were more severely victimized had higher Beck Depression Inventory scores than the other subjects in the sample. AUTHORS' RECOMMENDATIONS: The authors suggested that sexual victimization be considered by counselors as a possible contributing factor in the emotional disturbance of adolescents. Further research, the author noted, could examine the quality of an adolescent's family relationships, the violence of the assault, the victim's mental health status before the incident, supportive network availability, and the victim's appraisal of the victimization experience. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Ohio KW - Juvenile Female KW - Juvenile Victim KW - Female Victim KW - Sexual Assault Effects KW - Sexual Assault Victim KW - Juvenile Anxiety KW - Juvenile Depression KW - Victim Anxiety KW - Victim Depression KW - Depression Causes KW - Anxiety Causes KW - Psychological Victimization Effects KW - Juvenile Deviance KW - Deviance Causes KW - Violence Against Women Language: en
• Koss, M. P. (1989). Book reviewBrief psychotherapies: Changing frames of mind: T.H. Peake, C.M. Borduin & R.P. Archer. Beverly Hills, CA: Sage Publications, 1988. 235 pp. $26.00. Clinical Psychology Review, 9(3), 409. doi:10.1016/0272-7358(89)90064-0
• Koss, M. P. (1989). Crisis Intervention in the Community.. Psyccritiques, 34(10), 954-955. doi:10.1037/030689
• Koss, M. P., & Burkhart, B. R. (1989). A Conceptual Analysis of Rape Victimization: Long-Term Effects and Implications for Treatment:. Psychology of Women Quarterly, 13(1), 27-40. doi:10.1111/j.1471-6402.1989.tb00983.x
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  Recent prevalence studies have suggested that 15–22% of women have been raped at some point in their lives, many by close acquaintances, although few victims seek assistance services or professional psychotherapy immediately post-assault. Surveys have revealed that 31–48% of rape victims eventually sought professional psychotherapy, often years after the actual assault. These observations suggest that the primary role of clinicians in the treatment of rape victims is the identification and handling of chronic, post-traumatic responses to a nonrecent experience. However, it is concluded that most of the existing literature on rape treatment addresses only the target symptoms that represent the immediate response to rape. In this article, contemporary theoretical and empirical discussions of stress, cognitive appraisal, cognitive adaptation, and coping are used to conceptualize the long-term impact of rape and the process of resolution. Directions for future research on the clinical treatment of rape are su...
• Koss, M. P., & Dinero, T. E. (1989). Discriminant analysis of risk factors for sexual victimization among a national sample of college women.. Journal of Consulting and Clinical Psychology, 57(2), 242-250. doi:10.1037/0022-006x.57.2.242
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  Examined the accuracy with which rape and lesser sexual assaults were predicted among a representative national sample of 2,723 college women. A total of 14 risk variables operationalized three vulnerability hypotheses: (a) vulnerability-creating traumatic experiences, (b) social-psychological vulnerability, and (c) vulnerability-enhancing situations. Each hypothesis was tested individually, and a composite model was developed via discriminant analysis. Only the traumatic experiences variables clearly improved over the base rates in identifying rape victims, but risk variables from each vulnerability hypothesis met criteria for inclusion in the composite model. A risk profile emerged that characterized only 10% of the women, but among them the risk of rape was twice the rate of women without the profile. The concept of traumatic sexualization was used to explain this finding. However, the vast majority of sexually victimized women (75-91%) could not be differentiated from nonvictims.
• Koss, M. P. (1988). A Brief on Brief.. Psyccritiques, 33(8), 711-711. doi:10.1037/025909
• Koss, M. P. (1988). Incidence and prevalence of sexual aggression and victimization in a national sample of students in higher education. Aggressive Behavior, 14(2), 136-136.
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  Rape is believed to be one of the most underreported crimes with 3 to 10 rapes committed for every one that is reported. Rape represents an extreme behavior which can be placed on a continuum of sexual aggression defined by degrees of coercion and force. The prevalence of sexual aggression among college students nationally was examined in 3,187 female and 2,872 male college students enrolled in 32 colleges chosen for their national diversity. A self-reporting questionnaire was administered in classes which included questions on demographics, sexual experiences before and after age 14, family and social history, current behavior, and psychological characteristics. The results indicated that 15.4 percent of college women reported experiencing legal rape and 4.4 percent of college men reported perpetrating legal rape. An additional 12.1 percent of women reported having experienced attempted rape and 3.3 percent of men reported having attempted to rape someone. Virtually none of these crimes were reported and thus represent "hidden rape" not reflected in crime statistics. Men did not admit to the levels of sexual aggression that women reported. Few women reported the crime or sought victim assistance. Rates of sexual victimizaton/aggression were robust and did not vary with school size, type of institution, location, or population size. Future research should investigate conditions which lead to this violence. (ABL) *********************************************************************** * Reproductions supplied by EDRS are the best that can be made * * from the original document. * *********************************************************************.*
• Koss, M. P., & Dinero, T. E. (1988). Predictors of sexual aggression among a national sample of male college students.. Annals of the New York Academy of Sciences, 528(1), 133-47. doi:10.1111/j.1749-6632.1988.tb50856.x
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  An approximately representative national sample of 2,972 male students at 32 U.S. institutions of higher education was surveyed regarding their use of several degrees of verbal coercion and physical force to obtain sexual intimacy with women without consent. The most severe form of sexual aggression each man reported was used to classify him into one of five groups: sexually nonaggressive, sexual coercion, sexual contact, attempted rape, or rape. Respondents also provided data that was grouped into three blocks of variables: early experiences (family violence exposure, childhood sexual abuse, age of sexual initiation), psychological characteristics (MMPI Scale 4, Hostility Toward Women, rape supportive beliefs, gender role orientation), and current behavior (alcohol use, pornography use, male bonding, sexual values and activity, conflict tactics). Data were analysed via blockwise discriminant function analysis. Variables were entered following a suggested development sequence. Specifically, all early experience variables were entered first as a block. Then the entire set of psychological characteristics were entered stepwise followed by all the current behavior variables. Variables from all three blocks entered the model. The classification rates have been discussed and the implications of the analyses for future causal models of male sexual aggression considered.
• Koss, M. P., Dinero, T. E., Seibel, C. A., & Cox, S. L. (1988). Stranger and Acquaintance Rape: Are There Differences In the Victim's Experience?:. Psychology of Women Quarterly, 12(1), 1-24. doi:10.1111/j.1471-6402.1988.tb00924.x
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  Most published research on the victim–offender relationship has been based on small samples that consisted mainly of women who were raped by nonintimate and nonromantic acquaintances, who viewed their experience as rape, and/or who were seeking treatment. In the present study, 489 rape victims were located among a national sample of 3, 187 female college students by a self-report survey that avoided reliance on helpseekers. Two sets of comparisons were performed. First, the experiences reported by victims of stranger rape (n = 52) were compared with those of victims of acquaintance rape (n = 416). Then, the experiences of women assaulted by different types of acquaintances were compared including nonromantic acquaintances (n = 122), casual dates (n = 103), steady dates (n = 147), and spouses or other family members (n = 44). Rapes by acquaintances, compared with strangers, were more likely to involve a single offender and multiple episodes, were less likely to be seen as rape or to be revealed to anyone, ...
• Koss, M. P., Harvey, M. R., & Butcher, J. N. (1988). The rape victim: Clinical and community approaches to treatment.. Family Relations, 37(1), 116. doi:10.2307/584442
• Koss, M. P. (1987). Eclecticism: Building Psychotherapy's Esperanto.. Psyccritiques, 32(6), 543-543. doi:10.1037/027224
• Koss, M. P. (1987). The secret reference.. contemporary Psychology, 32(10), 897-898. doi:10.1037/026451
• Koss, M. P., Gidycz, C. A., & Wisniewski, N. M. (1987). The Scope of Rape: Incidence and Prevalence of Sexual Aggression and Victimization in a National Sample of Higher Education Students.. Journal of Consulting and Clinical Psychology, 55(2), 162-170. doi:10.1037/0022-006x.55.2.162
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  Because of inadequacies in the methods used to measure sexual assault, national crime statistics, criminal victimization studies, convictions, or incarceration rates fail to reflect the true scope of rape. Studies that have avoided the limitations of these methods have revealed very high rates of overt rape and lesser degrees of sexual aggression. The goal of the present study was to extend previous work to a national basis. The Sexual Experiences Survey was administered to a national sample of 6,159 women and men enrolled in 32 institutions representative of the diversity of higher education settings across the United States. Women's reports of experiencing and men's reports of perpetrating rape, attempted rape, sexual coercion, and sexual contact were obtained, including both the rates of prevalence since age 14 and of incidence during the previous year. The findings support published assertions of high rates of rape and other forms of sexual aggression among large normal populations. Although the results are limited in generalizabil ity to postsecondary students, this group represents 26% of all persons aged 18-24 in the United States. The Federal Bureau of Investigation (FBI) defines rape as "carnal knowledge of a female forcibly and against her consent" and reports that 87,340 such offenses occurred in 1985 (FBI, 1986). However, these figures greatly underestimate the true scope of rape because they are based only on instances reported to police. Government estimates suggest that for every rape reported, 3-10 rapes are committed but not reported (Law Enforcement Assistance Administration [LEAA], 1975). Likewise, it is difficult to obtain realistic estimates of the number of men who perpetrate rape because only a fraction of reported rapes eventually result in conviction (Clark & Lewis, 1977). Victimization studies, such as the annual National Crime Survey (NCS), are the major avenue through which the full extent of the crime is estimated (e.g., Bureau of Justice Statistics [BJS], 1984). In these studies, the residents of a standard sampling area are asked to indicate those crimes of which they or anyone else in their household have been victims during the previous 6 months. These rates are then compared with official crime statistics for the area and the rate of unreported crime is esti
• Risin, L. I., & Koss, M. P. (1987). The Sexual Abuse of Boys Prevalence and Descriptive Characteristics of Childhood Victimizations. Journal of Interpersonal Violence, 2(3), 309-323. doi:10.1177/088626087002003006
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  Recent clinical reports reveal that a sizable proportion of referrals involve boys. But because child sexual abuse is a problem that is often concealed, studies of reported cases represent only a fraction of the total cases that actually occur. A small number of studies have examined the prevalence of unreported sexual abuse among nonclinical samples. The goal of the present study was to extend this previous work to a national basis. Self-reports of childhood sexual experiences were obtained from 2,972 men in an approximately representative national sample of students in higher education. Although the results are limited in generalizability to other students, this group represents 26% of all persons in the United States aged 18-24. In the present sample, 7.3% of the men reported a childhood experience that met at least one of the following three criteria for sexual abuse: (1) existence of age discrepancy between the child and perpetrator, (2) use of some form of coercion to obtain participation by the vic...
• Koss, M. P. (1986). A . . . My Name is Alice: Women's Issues in Psychotherapy.. Psyccritiques, 31(7), 531-532. doi:10.1037/024906
• Koss, M. P. (1986). Rising from the Ashes: A Self-Help Guide.. Psyccritiques, 31(7), 522-522. doi:10.1037/024893
• Levine-maccombie, J., & Koss, M. P. (1986). Acquaintance rape: Effective avoidance strategies. Psychology of Women Quarterly, 10(4), 311-320. doi:10.1111/j.1471-6402.1986.tb00756.x
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  To date, research on effective rape avoidance strategies has involved media-recruited, acknowledged rape victims and avoiders, most of whom were assaulted by total strangers. In the present study, ...
• Strupp, H. H., Koss, M. P., & Butcher, J. N. (1986). Brief psychotherapy methods in clinical research.. Journal of consulting and clinical psychology, 54(1), 60-7. doi:10.1037//0022-006x.54.1.60
• Koss, M. P. (1985). THE HIDDEN RAPE VICTIM: PERSONALITY, ATTITUDINAL, AND SITUATIONAL CHARACTERISTICS. Psychology of Women Quarterly, 9(2), 193-212. doi:10.1111/j.1471-6402.1985.tb00872.x
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  A hidden rape victim is one who has never reported her experience to a rape crisis center or to police. It has been estimated that only 10–50% of the rapes that actually occur are ever reported to authorities. Since most previous rape studies have selected samples from official sources, hidden victims have been overlooked. The goals of the present study were to describe the victimization experienced by hidden victims and to determine whether any psychological variables were related to victimization status. The psychological variables examined included personality, attitudinal, and situational characteristics relevant to the three major models of rape victimization: social control, victim precipitation, and situational blame. Subjects were 82 not sexually victimized, 37 low sexually victimized, 50 moderately victimized, and 62 highly sexually victimized women. Subjects completed questionnaires and participated in a one-to-one standardized interview. Data were analyzed via multivariate analysis of variance. Personality variables and attitudes did not differentiate the groups of women, while numerous situational variables did. The theoretical implications of these findings are discussed.
• Koss, M. P. (1985). What Treatment for Whom. Psyccritiques, 30(7), 563-564. doi:10.1037/023924
• Koss, M. P., & Gidycz, C. A. (1985). Sexual experiences survey: reliability and validity.. Journal of Consulting and Clinical Psychology, 53(3), 422-423. doi:10.1037/0022-006x.53.3.422
• Koss, M. P., Leonard, K. E., Beezley, D. A., & Oros, C. J. (1985). Nonstranger sexual aggression: A discriminant analysis of the psychological characteristics of undetected offenders. Sex Roles, 12(9), 981-992. doi:10.1007/bf00288099
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  Rape is an underreported and underconvicted crime. Therefore, many highly sexually aggressive men are missed by research employing judicial identification for sample selection. The present study examined the psychological characteristics of three types of undetected sexually aggressive men who had assaulted female acquaintances. Subjects were selected on the basis of their responses to the Sexual Experiences Survey and completed questionnaires that reflected psychological variables relevant to two major theoretical models of rape, the psychopathology model and the social control/social conflict model. Data were analyzed via discriminant analysis. The groups were significantly discriminated by seven variables, including six rape-supportive attitudes. The findings support a social control/social conflict explanation of nonstranger sexual aggression.
• Koss, M. P. (1984). TUT Dethroned in Maryland Coup.. Psyccritiques, 29(1), 33-34. doi:10.1037/022540
• Koss, M. P. (1983). The scope of rape: Implications for the clinical treatment of victims.. Clinical Psychologist.
• Koss, M. P., Graham, J. R., Kirkhart, K., Post, G., Kirkhart, R. O., & Silverberg, R. S. (1983). Outcome of eclectic psychotherapy in private psychological practice.. American journal of psychotherapy, 37(3), 400-10. doi:10.1176/appi.psychotherapy.1983.37.3.400
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  The outcome of eclectic psychotherapy in a private psychological practice was examined in 69 clients. Target symptoms, life-adjustment ratings, social-adjustment ratings, and therapy expectancy were obtained before and after four months of psychotherapy from clients, therapists, and independent clinical raters. Results indicated that significant change had occurred after four months of psychotherapy for 6 of 10 categories of target complaints, in 9 of 11 areas of life adjustment and in 14 of 22 areas of social adjustment. Overall, 70 percent of clients showed improvement in their symptoms; 14 percent were unchanged and 17 percent deteriorated. The major value of the study is an exploration of psychotherapy outcome under naturalistic conditions in a growing but rarely studied treatment setting.
• Orlando, J. A., & Koss, M. P. (1983). The effect of sexual victimization on sexual satisfaction: a study of the negative-association hypothesis.. Journal of abnormal psychology, 92(1), 104-6. doi:10.1037//0021-843x.92.1.104
• Koss, M. P., & Oros, C. J. (1982). Sexual Experiences Survey: a research instrument investigating sexual aggression and victimization.. Journal of Consulting and Clinical Psychology, 50(3), 455-457. doi:10.1037/0022-006x.50.3.455
• Koss, M. P. (1980). A multivariate analysis of long-term stay in private practice psychotherapy.. Journal of clinical psychology, 36(4), 991-3. doi:10.1002/1097-4679(198010)36:4<991::aid-jclp2270360430>3.0.co;2-q
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  Investigated the characteristics predictive of long-term stay in private practice psychotherapy in a population of 64 "long-term" clients (remained longer than 25 sessions, mean = 47 sessions) and 88 "short-term" clients (terminated before 25 sessions, mean = 7 sessions). Data consisted of T-scores on the intake MMPI and two variables (possession of insurance coverage and use of psychoactive medication) on which long and short-term clients had been found to differ in other research. Stepwise multiple regression analysis was performed and revealed that MMPI scales 2 and 0 added to the prediction of length of stay in psychotherapy (p < .01). Insurance and medication were significant predictors only when MMPI data were not used.
• Koss, M. P. (1980). Descriptive characteristics and length of psychotherapy of child and adult clients seen in private psychological practice.. Psychotherapy, 17(3), 268-271. doi:10.1037/h0085921
• Koss, M. P. (1979). Length of psychotherapy for clients seen in private practice.. Journal of Consulting and Clinical Psychology, 47(1), 210-212. doi:10.1037/0022-006x.47.1.210
• Koss, M. P., Butcher, J. N., & Hoffmann, N. G. (1976). The MMPI critical items: how well do they work?. Journal of Consulting and Clinical Psychology, 44(6), 921-928. doi:10.1037/0022-006x.44.6.921
• Koss, M. P., & Butcher, J. N. (1973). A comparison of psychiatric patients' self-report with other sources of clinical information. Journal of Research in Personality, 7(3), 225-236. doi:10.1016/0092-6566(73)90038-x
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  Abstract This study compared self-report (MMPI item responses) of psychiatric patients who were experiencing different crises situations with other sources of clinical information. The results suggest that in a large number of instances item responses communicate information which is in agreement with what was known about the patients form other sources of information. The content of item responses was consistent with interpretations from several empirical measures of the S s' test performance.

Presentations

• Nigon, B., Lopez, E. C., & Koss, M. P. (2016, August). Undergraduate Students' Attitudes Toward Bystander Intervention in Alcohol-Serving Establishments. National Sexual Assault Conference. Washington, DC: National Sexual Violence Resource Center (NSVRC).
• Koss, M. P., & Lopez, E. C. (2018, July). Innovative Interventions, Methodologies, and Variables of Interest in Interpersonal Violence and Aggression Research. International Society for Research on Aggression Biennial World Meeting. Université Paris Descartes. Paris, France: Community and Environmental Level Prevention of Sexual Assault through GIS Mapping and Bar Staff Bystander Intervention Training.
• Koss, M. P., & Lopez, E. C. (2018, November). “Safer Bars” Bystander Training for Liquor Servers: A Statewide Initiative to Prevent Sexual Violence in Arizona Communities. American Public Health Association Annual Meeting. San Diego, CA.: American Public Health Association.
• Koss, M. P., Lopez, E. C., Connors, T., & Anbar, J. (2018, August). Connecting the Dots: GIS Mapping of Sexual and Physical Violence and Liquor Licenses to Inform Community Prevention Efforts. National Sexual Assault Conference. Anaheim, CA.
• Koss, M. P., Lopez, E. C., Connors, T., & Anbar, J. (2018, November). Lessons Learned from Using GIS Mapping for Community Violence Prevention Planning. American Public Health Association Annual Meeting. San Diego, CA.: American Public Health Association.
• Koss, M. P., Lopez, E. C., Lamade, R. V., & Prentky, R. (2018, July). Symposium: Evidence-Based Development and Implementation of Novel Psychotherapeutic and Psychoeducational Interventions for University Students Found Responsible of Sexual Misconduct. University Women’s Perceptions of Campus Climate, Campus Safety, and Experiences Reporting Campus Sexual Misconduct.. Université Paris Descartes. Paris, France: International Society for Research on Aggression Biennial World Meeting.
• Koss, M. P., Lopez, E. C., Lamade, R. V., & Prentky, R. A. (2018, November). STARRSA: Developing and Implementing Psychotherapy and Psychoeducation Interventions for College Students Found Responsible for Sexual Misconduct. American Public Health Association Annual Meeting. San Diego, CA.: American Public Health Association.
• Koss, M. P., Lopez, E. C., Prentky, R., & Lamade, R. V. (2018, July). Symposium: Evidence-Based Development and Implementation of Novel Psychotherapeutic and Psychoeducational Interventions for University Students Found Responsible of Sexual Misconduct. International Society for Research on Aggression Biennial World Meeting. Université Paris Descartes. Paris, France: International Society for Research on Aggression.
• Koss, M. P., Lopez, E. C., Prentky, R., Lamade, R. V., Malamuth, N., & Swartout, K. (2018, July). Informing Student Sexual Offending Treatment Program Feasibility through University Staff/Administrator Perspectives: A Mixed-Methods Study. Symposium: Evidence-Based Development and Implementation of Novel Psychotherapeutic and Psychoeducational Interventions for University Students Found Responsible of Sexual Misconduct. International Society for Research on Aggression Biennial World Meeting. Université Paris Descartes. Paris, France.: International Society for Research on Aggression.
• Koss, M. P., Lopez, E. C., Wilgus, J., Lamade, R. V., & Prentky, R. (2018, July). Psychoeducation Meets Justice: The Spectrum of Application of STARRSA Products in Student Sexual Misconduct Response. Symposium: Evidence-Based Development and Implementation of Novel Psychotherapeutic and Psychoeducational Interventions for University Students Found Responsible of Sexual Misconduct. International Society for Research on Aggression Biennial World Meeting. Université Paris Descartes. Paris, France.: International Society for Research on Aggression.
• Lopez, E. C., Koss, M. P., & Hensell, C. J. (2015, June). Safe Bars: Preliminary Data from a Bystander-Based Training Program for Liquor-Serving Staff to Identify and Respond to Signs of Sexual Predation. Panel: The Role of Alcohol in Bystander Intervention for Sexual Violence. Research Society on Alcoholism Annual Meeting. San Antonio, TX: Research Society on Alcoholism.
• Lopez, E. C., Koss, M. P., & Hensell, C. J. (2015, September). Developing Bystander Training for Bars Around College Campuses: Lessons Learned from the Arizona Safer Bars Alliance. National Sexual Assault Conference. Los Angeles, CA: National Sexual Violence Resource Center (NSVRC).
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  This standing-room-only, two-hour session included approximately 100 participants and was recorded for subsequent online broadcast. At the time of this writing (6/18/16), the presentation is listed as having been published online 4 months ago, and has received 225 online views.

Poster Presentations

• Lopez, E. C., & Koss, M. P. (2015, April). Mediational Modeling: An Innovative, Hypothesized Approach to Measuring Bar Staff Bystander Training for Sexual Violence Perpetration Prevention. Public Health Research Poster Forum. Tucson, AZ: The University of Arizona.
• Lopez, E. C., Koss, M. P., Harty, E., Nigon, B., & Hensell, C. J. (2015, November). Using the Theory of Planned Behavior to Develop and Evaluate a Bystander Skills Training for Alcohol-Serving Staff to Respond to Sexually-Aggressive Behavior. APHA Annual Meeting. Chicago, IL: American Public Health Association.

Others

• Koss, M. P., & Lopez, E. C. (2018, July). Restorative Justice for Sexual Misconduct: Not if but When. The Gender Policy Report. https://genderpolicyreport.umn.edu/restorative-justice-for-sexual-misconduct-not-if-but-when/
• Koss, M. P., & Rutherford, A. (2018, September). What We Knew About Date Rape Then, and What We Know Now. The Atlantic, Public Media Publications. https://www.theatlantic.com/ideas/archive/2018/09/what-surveys-dating-back-decades-reveal-about-date-rape/571330/
• Koss, M. P., Abbey, A., Campbell, R., Cook, S., Norris, J., Testa, M., Ullman, S., West, C., & White, J. (2015, DEC). Revising The SES: A Collaborative Process To Improve Assessment Of Sexual Aggression And Victimization (vol 31, pg 357, 2007). PSYCHOLOGY OF WOMEN QUARTERLY.
• Koss, M. P. (2007, JUN). Hidden, Unacknowledged, Acquaintance, and Date Rape: Looking Back, Looking Forward. PSYCHOLOGY OF WOMEN QUARTERLY.