0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Prevalence Rates of Male and Female Sexual Violence Perpetrators in a National Sample of Adolescents FREE

Michele L. Ybarra, MPH, PhD1; Kimberly J. Mitchell, PhD2
[+] Author Affiliations
1Center for Innovative Public Health Research, San Clemente, California
2Crimes Against Children Research Center, University of New Hampshire, Durham
JAMA Pediatr. 2013;167(12):1125-1134. doi:10.1001/jamapediatrics.2013.2629.
Text Size: A A A
Published online

Importance  Sexual violence can emerge in adolescence, yet little is known about youth perpetrators—especially those not involved with the criminal justice system.

Objective  To report national estimates of adolescent sexual violence perpetration and details of the perpetrator experience.

Design, Setting, and Participants  Data were collected online in 2010 (wave 4) and 2011 (wave 5) in the national Growing Up With Media study. Participants included 1058 youths aged 14 to 21 years who at baseline read English, lived in the household at least 50% of the time, and had used the Internet in the last 6 months. Recruitment was balanced on youths’ biological sex and age.

Main Outcomes and Measures  Forced sexual contact, coercive sex, attempted rape, and completed rape.

Results  Nearly 1 in 10 youths (9%) reported some type of sexual violence perpetration in their lifetime; 4% (10 females and 39 males) reported attempted or completed rape. Sixteen years old was the mode age of first sexual perpetration (n = 18 [40%]). Perpetrators reported greater exposure to violent X-rated content. Almost all perpetrators (98%) who reported age at first perpetration to be 15 years or younger were male, with similar but attenuated results among those who began at ages 16 or 17 years (90%). It is not until ages 18 or 19 years that males (52%) and females (48%) are relatively equally represented as perpetrators. Perhaps related to age at first perpetration, females were more likely to perpetrate against older victims, and males were more likely to perpetrate against younger victims. Youths who started perpetrating earlier were more likely than older youths to get in trouble with caregivers; youths starting older were more likely to indicate that no one found out about the perpetration.

Conclusions and Relevance  Sexual violence perpetration appears to emerge earlier for males than females, perhaps suggesting different developmental trajectories. Links between perpetration and violent sexual media are apparent, suggesting a need to monitor adolescents’ consumption of this material. Victim blaming appears to be common, whereas experiencing consequences does not. There is therefore urgent need for school programs that encourage bystander intervention as well as implementation of policies that could enhance the likelihood that perpetrators are identified.

With more than 1 million victims and associated costs of almost $127 billion each year, sexual violence is a significant public health problem.1 In addition to societal costs, the impact on the individual can be high, including increased rates of posttraumatic stress disorder,2 physical health problems,3 and suicidal behavior.4

Sexual violence can emerge in adolescence,57 making this developmental time a critical period of inquiry. Nonetheless, nationwide estimates for adolescent perpetrators of sexual violence in community samples are lacking8 and state estimates vary significantly.1 Moreover, almost all of the sexual violence perpetration literature focuses on boys as the sexual aggressors and females as victims.912 In studies that include both adolescent males and females as perpetrators, females are less likely to engage in sexually violent behavior than males.1315 Research examining specific event characteristics of male and female sexual offenders is even more limited and is conflicting as to whether differences exist.16,17 There is a clear need for a better understanding not just of prevalence rates but also how sexual violence may be different for older and younger adolescents as well as males and females. Given emerging interest in possible links between exposure to sexual material and sexual behavior and attitudes1820 as well as violent pornography and violent sexual behavior,21 further research examining the associations between media and sexual violence also is critical.

Growing Up With Media is a longitudinal survey examining the associations between exposure to violent media and violent behavior. Wave 1 data were collected between August and September 2006 with 1586 youth-caregiver pairs. Extensive questions about sexual perpetration were added at wave 4. Therefore, data discussed in this article were collected in wave 4 (fielded between October 2010 and February 2011) and wave 5 (fielded between October 2011 and March 2012). The survey protocol was reviewed and approved by the Chesapeake Institutional Review Board, which is a private, paid Office for Human Research Protections–approved institutional review board. Caregivers provided informed consent for their participation and permission for their child’s participation; youths provided informed assent.

Fifty-seven caregivers and 8 youths actively declined to consent/assent at baseline. Because both caregiver permission and youth assent were required for youth participation, the household response rate was the same as the youth response rate, which was 31%. This is well within the expected range of well-conducted online surveys.2224 Of the 1586 households who completed the baseline survey, 67% (n = 1062) completed either or both of the wave 4 (response rate = 56%, n = 887) and wave 5 (response rate = 59%, n = 939) surveys. Characteristics of nonresponders and responders were similar (Table 1).

Table Graphic Jump LocationTable 1.  Comparison of Weighted Demographic Characteristics of Survey Respondents at Wave 4 and Wave 5 vs Nonresponders

Adult respondents were recruited at baseline through an e-mail sent to randomly identified adult Harris Poll Online panel members who reported having a child living in the household. Eligible adults were equally or more knowledgeable than other adult household members about the youth’s home media use. Youth participants were aged 10 to 15 years at recruitment (mean [SD], 12.7 [1.8] years; aged 14-21 years at waves 4 and 5), read English, lived in the household at least 50% of the time, and had used the Internet in the last 6 months. Recruitment was balanced on youths’ biological sex and age.

On average, caregivers took 15 minutes and youths took 32 minutes to complete their portion of the Growing Up With Media survey. Caregivers received $20 and youths received $25 as an incentive. To increase response rates at the end of the field period, an additional $10 bonus incentive was offered to nonresponders.

Measures
Sexual Violence Perpetration

The term sexual violence broadly refers to acts ranging from sexual harassment to rape.25 Herein, we focus on coercive and forced sexual behavior. It should be noted that while related, sexual violence is different from teen dating violence, which by definition occurs within a dating relationship; sexual violence can be perpetrated by a romantic partner, someone else known by the victim, or someone completely unknown to the victim.

Sexual violence perpetration was queried using 4 items. Three items were modified from the Sexual Experiences Survey26,27 and are consistent with the Bureau of Justice Statistics definition of rape, which can include “psychological coercion as well as physical force.”28 Youths were asked about how often they had ever done the following: (1) “tried, but was not able, to make someone have sex with me when I knew they did not want to”; (2) “made someone have sex with me when I knew they did not want to”; and (3) “gotten someone to give in to sex with me when I knew they did not want to.” The language to convey lack of consent (“I knew they did not want to”) is developmentally appropriate for the age of survey participants and is similar to that used in a national survey of adults, which used the phrase “against their will.”29

Sexual assault, as defined by the Department of Justice, refers to “unwanted sexual contact between victim and offender… [which] may or may not involve force and include such things as grabbing or fondling… [as well as] verbal threats.”28 Our fourth item, which queried sexual assault (referred to as forced sexual contact in this study), has been included in the Growing Up With Media survey since wave 1. This item, created specifically for this study, read: “In the last 12 months, how often have you kissed, touched, or done anything sexual with another person when that person did not want you to?” To more closely align this measure with the time frame of the other 3 sexual violence perpetration items (ever), youths who reported forced sexual contact at any of the 5 waves were included as perpetrators.

Details About the Most Recent Perpetration

Details about the perpetration were asked of youths who reported attempted or completed rape. First, youths were asked their age at first perpetration. Then, they were asked to think about the most recent perpetration event. Details about the most recent victim (eg, age, gender) and the event (eg, specific acts perpetrated, consequences) were asked. Youths also rated how responsible they thought they and the victim were for their most recent perpetration.

Data Cleaning and Identifying the Analytical Sample

Harris Poll Online data are comparable to data that have been obtained from random telephone samples of adult populations once appropriate sample weights are applied.3033 Data were weighted statistically at wave 1 to reflect the population of adults with children aged 10 to 15 years in the United States according to adult age, sex, race/ethnicity, region, education, household income, and child age and biological sex.34 Survey sampling weights also adjusted for adult respondents’ self-selection into the Harris Poll Online and accounted for differential participation over time.3033

Missing data (ie, refused responses) were imputed using best set regression. To reduce the likelihood of imputing truly nonresponsive answers, participants were required to have valid data for at least 80% of the survey questions asked of all youths. Of the 1062 youths who responded in wave 4 or 5, 1058 met this criterion. Stata version 11 statistical software (StataCorp LP) was used to conduct all statistical analyses. As such, reported percentages are weighted, whereas sample sizes are not.

Prevalence Rates of Sexual Violence Perpetration

Nine percent of youths (n = 108) reported some type of sexual violence perpetration in their lifetime: 8% (n = 84) kissed, touched, or made someone else do something sexual when the youth knew the other person did not want to (ie, forced sexual contact); 3% (n = 33) got someone to give into sex when he or she knew the other person did not want to have sex (hereafter referred to as coercive sex); 3% (n = 43) attempted but were not able to force someone to have sex (ie, attempted rape); and 2% (n = 18) forced someone to have sex with him or her (ie, completed rape). Overlap was noted: among perpetrators, 12% reported 2 different behaviors, 11% reported 3, and 9% reported all 4 types.

Demographic and media usage characteristics of youths reporting sexual violence perpetration vs youths not reporting perpetration are shown in Table 2 and Table 3. Males were significantly more likely than females to report coercive sex or attempted rape, with similar but nonsignificant results observed for completed rape. White youths were more likely than nonwhite youths to report perpetrating coercive sex, and Hispanic youths were less likely than non-Hispanic youths to report perpetrating coercive sex. Similar, nonsignificant patterns were noted for youths reporting completed rape. Youths living in low-income households were less likely than youths living in higher-income households to report attempted rape. Similar, nonsignificant patterns were observed for youths reporting coercive sex perpetration.

Table Graphic Jump LocationTable 2.  Demographic and Media Characteristics Based on Perpetration of Any Sexual Violence, Forced Sexual Contact, and Coercive Sex in 1058 Youthsa
Table Graphic Jump LocationTable 3.  Demographic and Media Characteristics Based on Perpetration of Attempted and Completed Rape in 1058 Youthsa
Exposure to Sexual and Violent Media

Consumption of X-rated material significantly differed for perpetrators and nonperpetrators of all types of sexual violence. Differences were almost entirely explained by whether the material was violent in nature (ie, depicted one person physically hurting another person while doing something sexual). Although not always statistically significant, perpetrators also tended to report more frequent exposure to media that depicted sexual situations (ie, kissing, fondling, and sex that young people saw in television, heard in music, saw in games, and saw online) and media that depicted violent situations (ie, physical fighting, shooting, and killing in television, music, games, and online) compared with nonperpetrators.

History of Attempted or Completed Rape

Youths who reported attempted or completed forced sex were asked follow-up questions about the most recent event. Characteristics for all youths as well as comparisons between male and female perpetrators are provided in Table 4. Comparisons between perpetrators based on age at first perpetration are shown in Table 5. Sixteen years of age was by far the most common age at first perpetration (n = 18 [40%]). Youths whose first sexual violence perpetration was at age 15 years or younger were overwhelmingly (98%) male; similarly high rates (90%) were also noted among perpetrators who began at ages 16 or 17 years. By ages 18 or 19 years, the split of male to female perpetrators was nearly equivalent. More females reported older victims, and more males reported younger victims.

Table Graphic Jump LocationTable 4.  Perpetrator and Event Characteristics of 49 Perpetrators of Attempted or Completed Rapea
Table Graphic Jump LocationTable 5.  Differences in Perpetrator and Event Characteristics of 49 Perpetrators of Attempted or Completed Rape by Age at First Perpetrationa

Thinking about the most recent time they tried to force or were able to force someone to have sex, youths reported using coercive tactics, including arguing or pressuring the person (32%) or getting angry or making the person feel guilty (63%), more commonly than using threats (5%) or physical force (8%). Alcohol was used in a notable minority of situations (15%). Tactics were generally similar by perpetrators’ sex and age at first perpetration.

Three in 4 victims (73%) were a romantic partner. Sixty-six percent of perpetrators reported that no one found out about the perpetration. Contact with the justice system was uncommon: 1% of perpetrators reported police contact and 1% an arrest. Consequences were similar for males and females, although youths reporting a younger age at first perpetration were more likely than youths first perpetrating at an older age to get in trouble with their parents. Youths first perpetrating when older were more likely to report that no one found out about the perpetration.

Fifty percent of perpetrators said that the victim was completely responsible; one-third (35%) said that they, the perpetrator, were completely responsible for the incident. Again, differences by perpetrators’ sex or age at first perpetration were not noted.

Types of Rape Acts

Vaginal sex was the most common type of sexual act reported among youths who attempted or completed a rape (60%), followed by oral sex (48%). Males were significantly more likely than females to report oral sex and the use of a finger or sex toy. Youths who started perpetrating younger were significantly more likely to report forcing oral sex, whereas youths perpetrating first when older more frequently reported forcing vaginal sex.

This study reports important findings about the extent of sexual violence perpetration among adolescents. A substantial number—almost 1 in 10 adolescents in the national Growing Up With Media study—reports perpetrating sexual violence, including coercive sex, forced sexual contact, attempted rape, and completed rape. Importantly, different developmental trajectories for male and female perpetrators are suggested. Youths who begin perpetrating at younger ages are overwhelmingly male. It is not until age 18 years that female perpetrators emerge at notable rates. For some reason, young female perpetrators are very unusual. Future research should focus on better understanding these sex and age differences to inform the ways in which prevention programs can be tailored and timed.

Perhaps because females tend to start perpetrating later, they are more likely than males to report aggressing on victims older than themselves. Consistent with previous research on youths who had police contact,36 females also appear to be more likely than males to engage in perpetration as part of a team or group: 2 of the 10 female perpetrators in this study engaged in group sexual assault compared with 1 of the 39 male perpetrators. Whether these differences are related to suggested variation in male and female developmental trajectories is an important area of future research.

A notable spike in first-perpetration rates appears at age 16 years. This age also marks the beginning of the late adolescent period of development, a time of rapid and intense growth physically, mentally, and emotionally.37,38 As youths continue to assert their independence, they also face many new challenges and temptations. Additionally, this period of adolescent development is when teens begin to develop more serious romantic relationships and a clear sexual identity.39,40 It is critical that adolescent health care professionals, parents, and others interacting with youths model and educate young people about how to develop and maintain healthy sexual relationships well before this pivotal age.

Building on previous findings in the same data set suggesting links between violent X-rated material and sexual violence,21 our study shows clear associations between the consumption of violent X-rated material and the perpetration of a broad range of sexually violent behaviors. Similar, although not always statistically significant, patterns are noted for violent media of a nonsexual nature as well as media depicting sexual situations. Although the data do not denote causality, it seems appropriate to suggest that frequent consumption of sexual and violent material and especially sexually violent material should be a marker for concern for adolescent health care professionals.

Many incidents occurred within the context of romantic relationships, yet 1 in 4 victims was not a boyfriend or girlfriend. All perpetrators in this study had some form of a relationship with their victims, however. This is consistent with the greater sexual violence literature, which suggests that adolescent victims are overwhelmingly more likely to be victimized by someone they know rather than a stranger.41,42 Prevention programs need to provide youths with safety skills that can be used in both nondating and dating scenarios.

Few perpetrators experience consequences: only 2 reported being arrested. More effort needs to be made to enhance methods of detecting and investigating sexual violence cases.43 This finding also highlights the limitations of juvenile justice data. Like sexual victimization,44 the overwhelming majority of sexual violence perpetration does not come to the attention of law enforcement. Arrest and conviction data characterize youths coming into contact with the justice system for sexual violence offenses and are helpful in designing secondary prevention programs among perpetrators, but they do not provide a full picture of sexual aggression among youths. Population-based studies are needed to inform the development of population-based prevention efforts occurring before arrest.

Challenging Bias When Researching Sexual Perpetration

It is not uncommon to believe that a man cannot be raped by a woman.45,46 Gender stereotypes can make it difficult to imagine a dominant woman coercing or forcing an unwilling man to have sex.47 Accordingly, male victims of female perpetrators are judged more harshly than male victims of male perpetrators.48 Moreover, the same behaviors perceived to be sexually aggressive when committed by a male can be perceived as romantic or promiscuous when committed by a female.47,49 Nonetheless, physiological data suggest that men can be raped; an erection does not necessarily mean sexual arousal50 and can be reflexogenic.51 Adolescent health care professionals need to assess the potential for their own gender biases in this area so that they can be more effective in identifying and treating female perpetrators and male victims when they present.

Few differences by race, ethnicity, and household income were noted; when they were, disadvantaged youths were less likely to report perpetration. Adolescent health care professionals also need to assess and perhaps challenge our assumptions about sexual perpetration as an ill conscripted solely to underprivileged populations.

Some may argue that the definitions of rape and sexual assault in our investigation are too broad. Indeed, this may be why the perpetration rate among females is higher than might be posited. Rape includes acts beyond those in which the victim is physically overpowered, however.28 Restrictive definitions have potentially led to undercounting of sexual assault experiences. For example, in the National Violence Against Women Survey, respondents were asked whether anyone had ever made them engage in a sexual activity “by using force or threat of force.”52 Psychological coercion was not clearly specified even though there are multiple coercive strategies other than physical force that can be used in a rape.53,54 To ensure that comprehensive rates of sexual assault and rape are identified as well as to begin building the research base on female perpetrators, research needs to include a fuller spectrum of rape scenarios.

Limitations of the Data and Resulting Interpretations

Perpetrator characteristics are examined by age at first perpetration, whereas the assault characteristics relate to their most recent perpetration, which may or may not be their first perpetration. Thus, it is possible that the perpetration data reflect behavior that one engaged in at age 18 years even though the youth first perpetrated at age 16 years, for example. Data should be interpreted as reflective of patterns for youths who start perpetrating earlier vs later rather than patterns of younger vs older youth per se.

Additionally, details about each type of sexual violence were not available in many cases. It is possible, for example, that age at first perpetration for completed rape is older than age at first attempted rape. Also, given the sensitivity of the subject, observed rates may be underestimates of the true prevalence of sexually violent behavior. Nonetheless, rates are much higher than the lifetime rate of 0.15% yielded in a national study of adults that was conducted face to face.29 Finally, because this was a community-based sample, the number of youths reporting sexual violence perpetration was small and yielded limited statistical power.

Clinical Implications

One in 7 perpetrators said they were not at all responsible for what happened. Accordingly, more than 4 in 5 perpetrators said the victim was at least somewhat responsible for what happened. Research about victim blaming has been studied among young adult and adult victims of rape, typically by examining attributions of blame toward the perpetrator and victim in hypothetical scenarios.5557 Generally, individuals have a tendency to perceive victims in negative terms, in addition to or even instead of perpetrators.56 More efforts need to be made toward education that has a specific emphasis on taking responsibility for one’s actions as well as eliminating blame for the victims. Further research into factors related to taking responsibility, such as motivations behind the sexual violence and feelings of remorse or regret, could be crucial to effective primary prevention for youths at risk for perpetration as well as secondary and tertiary prevention for those who have already committed such acts. Adolescent health care professionals, including those providing counseling for birth control and sexually transmitted diseases, are ideally situated to educate youths about sexual violence. Efforts to equip professionals with referral information and talking points would likely increase the uptake of this recommendation in the clinical setting.

Encouraging progress has been made in the field of bystander intervention of sexual assault, which emphasizes the range of opportunities where friends can intervene.58 Such efforts shift the focus of prevention to peers and the community from efforts reducing risk among potential perpetrators and victims. Although most of the research has been focused on college campuses, similar efforts at the high school level are emerging.59,60 Given that most adolescent perpetrators meet their victim at school, this may be an especially important venue through which to provide prevention programming.

As one of the first reports of national rates of sexual violence in adolescence, findings should be interpreted cautiously. Results need to be replicated. Certainly, however, links between perpetration and violent sexual media are apparent, suggesting a need to monitor adolescents’ consumption of this material, particularly given today’s media saturation among the adolescent population. Because victim blaming appears to be common while perpetrators experiencing consequences is not, there is urgent need for high school (and middle school) programs aimed at supporting bystander intervention. Policies that enhance the likelihood that perpetrators are identified also need to be considered. Findings suggest important differences between males and females in the etiology of adolescent sexual violence; it appears to emerge earlier for males than females, perhaps suggesting different developmental trajectories. More work is needed in this area. Based on the individual24 and social1 costs associated with sexual violence, our findings highlight the importance of identifying perpetrators early in their adolescence before they become repeat offenders.

Corresponding Author: Michele L. Ybarra, MPH, PhD, Center for Innovative Public Health Research, 555 El Camino Real, Ste A347, San Clemente, CA 92672 (michele@innovativepublichealth.org).

Accepted for Publication: April 4, 2013.

Published Online: October 7, 2013. doi:10.1001/jamapediatrics.2013.2629.

Author Contributions: Dr Ybarra had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Ybarra.

Acquisition of data: Ybarra.

Analysis and interpretation of data: Ybarra, Mitchell.

Drafting of the manuscript: Ybarra.

Critical revision of the manuscript for important intellectual content: Ybarra, Mitchell.

Statistical analysis: Ybarra, Mitchell.

Obtained funding: Ybarra.

Conflict of Interest Disclosures: None reported.

Funding/Support: The survey was supported by grant R01 CE001543 from the Centers for Disease Control and Prevention.

Role of the Sponsor: The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Additional Contributions: We thank the entire Growing Up With Media Study team from Internet Solutions for Kids, Harris Interactive, Johns Hopkins Bloomberg School of Public Health, and the Centers for Disease Control and Prevention, who contributed to different parts of the planning and implementation of the study. We also thank the families for their time and willingness to participate in this study.

Correction: This article was corrected online October 16, 2013, for an error in Table 2 and on November 15, 2013, for an error in Funding/Support.

Miller TR, Cohen MA, Wiersema B. Victim costs and consequences: a new look. https://www.ncjrs.gov/pdffiles/victcost.pdf. Accessed November 28, 2012.
Cortina  LM, Kubiak  SP.  Gender and posttraumatic stress: sexual violence as an explanation for women’s increased risk. J Abnorm Psychol. 2006;115(4):753-759.
PubMed   |  Link to Article
Conoscenti  LM, McNally  RJ.  Health complaints in acknowledged and unacknowledged rape victims. J Anxiety Disord. 2006;20(3):372-379.
PubMed   |  Link to Article
McFarlane  J, Malecha  A, Gist  J,  et al.  Intimate partner sexual assault against women and associated victim substance use, suicidality, and risk factors for femicide. Issues Ment Health Nurs. 2005;26(9):953-967.
PubMed   |  Link to Article
Snyder HN. Sexual assault of young children as reported to law enforcement: victim, incident, and offender characteristics. http://www.bjs.gov/content/pub/pdf/saycrle.pdf. Accessed November 28, 2012.
Snyder HN, Sickmund M. Juvenile offenders and victims: 2006 national report. http://www.ojjdp.gov/ojstatbb/nr2006/downloads/NR2006.pdf. Accessed November 28, 2012.
Righthand S, Welch C. Juveniles who have sexually offended: a review of the professional literature. https://www.ncjrs.gov/pdffiles1/ojjdp/184739.pdf. Accessed November 28, 2012.
Abbey  A.  Lessons learned and unanswered questions about sexual assault perpetration. J Interpers Violence. 2005;20(1):39-42.
PubMed   |  Link to Article
Maxwell  CD, Robinson  AL, Post  LA.  The nature and predictors of sexual victimization and offending among adolescents. J Youth Adolesc. 2003;32(6):465-477. doi:10.1023/A:1025942503285.
Link to Article
Malamuth  NM, Linz  D, Heavey  CL, Barnes  G, Acker  M.  Using the confluence model of sexual aggression to predict men’s conflict with women: a 10-year follow-up study. J Pers Soc Psychol. 1995;69(2):353-369.
PubMed   |  Link to Article
White  JW, Smith  PH.  Covariation in the use of physical and sexual intimate partner aggression among adolescent and college-age men: a longitudinal analysis. Violence Against Women. 2009;15(1):24-43.
PubMed   |  Link to Article
Abbey  A, McAuslan  P.  A longitudinal examination of male college students’ perpetration of sexual assault. J Consult Clin Psychol. 2004;72(5):747-756.
PubMed   |  Link to Article
Hall  GC, Barongan  C.  Prevention of sexual aggression: sociocultural risk and protective factors. Am Psychol. 1997;52(1):5-14.
PubMed   |  Link to Article
Fago  DP.  Evaluation and treatment of neurodevelopmental deficits in sexually aggressive children and adolescents. Prof Psychol Res Pr. 2003;34(3):248-257.
Link to Article
de Bruijn  P, Burrie  I, van Wel  F.  A risky boundary: unwanted sexual behaviour among youth. J Sex Aggress. 2006;12(2):81-96. doi:10.1080/13552600600841631.
Link to Article
Ray  JA, English  DJ.  Comparison of female and male children with sexual behavior problems. J Youth Adolesc. 1995;24(4):439-451. doi:10.1007/BF01537190.
Link to Article
Vandiver  DM, Teske  R  Jr.  Juvenile female and male sex offenders: a comparison of offender, victim, and judicial processing characteristics. Int J Offender Ther Comp Criminol. 2006;50(2):148-165.
PubMed   |  Link to Article
Tolman  DL, Kim  JL, Schooler  D, Sorsoli  CL.  Rethinking the associations between television viewing and adolescent sexuality development: bringing gender into focus. J Adolesc Health. 2007;40(1):84.e9-84.e16.
PubMed   |  Link to Article
Brown  JD, L'Engle  KL.  X-rated: sexual attitudes and behaviors associated with US early adolescents' exposure to sexually explicit media. Communic Res. 2009;36(1):129-151. doi:10.1177/0093650208326465.
Link to Article
Chandra  A, Martino  SC, Collins  RL,  et al.  Does watching sex on television predict teen pregnancy? findings from a national longitudinal survey of youth. Pediatrics. 2008;122(5):1047-1054.
PubMed   |  Link to Article
Ybarra  ML, Mitchell  KJ, Hamburger  M, Diener-West  M, Leaf  PJ.  X-rated material and perpetration of sexually aggressive behavior among children and adolescents: is there a link? Aggress Behav. 2011;37(1):1-18.
PubMed   |  Link to Article
Kaplowitz  MD, Hadlock  TD, Levine  R.  A comparison of web and mail survey response rates. Public Opin Q. 2004;68(1):94-101. doi:10.1093/poq/nfh006.
Link to Article
Cook  C, Heath  F, Thompson  RL.  A meta-analysis of response rates in web- or Internet-based surveys. Educ Psychol Meas. 2000;60(6):821-836. doi:10.1177/00131640021970934.
Link to Article
Lenhart A, Purcell K, Smith A, Zickuhr K. Social media and young adults. http://www.pewinternet.org/Reports/2010/Social-Media-and-Young-Adults.aspx. Accessed November 28, 2012.
Basile KC, Saltzman LE. Sexual violence surveillance: uniform definitions and recommended data elements. http://www.cdc.gov/ViolencePrevention/pub/SV_surveillance.html. Accessed November 28, 2012.
Koss  MP, Gaines  JA.  The prediction of sexual aggression by alcohol use, athletic participation, and fraternity affiliation. J Interpers Violence. 1993;8(1):94-108. doi:10.1177/088626093008001007.
Link to Article
Koss  MP, Gidycz  CA, Wisniewski  N.  The scope of rape: incidence and prevalence of sexual aggression and victimization in a national sample of higher education students. J Consult Clin Psychol. 1987;55(2):162-170.
PubMed   |  Link to Article
Bureau of Justice Statistics. Rape and sexual assault. http://www.bjs.gov/index.cfm?ty=tp&tid=317. Accessed November 21, 2012.
Hoertel  N, Le Strat  Y, Schuster  J-P, Limosin  F.  Sexual assaulters in the United States: prevalence and psychiatric correlates in a national sample. Arch Sex Behav. 2012;41(6):1379-1387.
PubMed   |  Link to Article
Berrens  RP, Bohara  AK, Jenkins-Smith  H, Silva  C, Weimer  DL.  The advent of Internet surveys for political research: a comparison of telephone and Internet samples. Polit Anal. 2003;11(1):1-22. doi:10.1093/pan/11.1.1.
Link to Article
Schonlau  M, Zapert  K, Simon  LP,  et al.  A comparison between response from a propensity-weighted web survey and an identical RDD survey. Soc Sci Comput Rev. 2004;22(1):128-138. doi:10.1177/0894439303256551.
Link to Article
Taylor  H, Bremer  J, Overmeyer  C, Siegel  JW, Terhanian  G.  The record of Internet-based opinion polls in predicting the results of 72 races in the November 2000 US elections. Int J Mark Res. 2001;43(2):127-138.
Berrens  RP, Bohara  AK, Jenkins-Smith  HC, Silva  CL, Weimer  DL.  Information and effort in contingent valuation surveys: application to global climate change using national Internet samples. J Environ Econ Manage. 2004;47(2):331-363. doi:10.1016/S0095-0696(03)00094-9.
Link to Article
US Bureau of Labor Statistics. Current Population Survey. http://www.bls.gov/cps/ Accessed July 5, 2006.
Windle  M, Grunbaum  JA, Elliott  M,  et al.  Healthy passages: a multilevel, multimethod longitudinal study of adolescent health. Am J Prev Med. 2004;27(2):164-172.
PubMed   |  Link to Article
Vandiver  DM.  Assessing gender differences and co-offending patterns of a predominantly “male-oriented” crime: a comparison of a cross-national sample of juvenile boys and girls arrested for a sexual offense. Violence Vict. 2010;25(2):243-264.
PubMed   |  Link to Article
Steinberg  L, Morris  AS.  Adolescent development. Annu Rev Psychol. 2001;52(1):83-110.
PubMed   |  Link to Article
Lerner  RM, Galambos  NL.  Adolescent development: challenges and opportunities for research, programs, and policies. Annu Rev Psychol. 1998;49(1):413-446.
PubMed   |  Link to Article
Bouchey  HA, Furman  W. Dating and romantic experiences in adolescence. In: Adams  GR, Berzonsky  M, eds. Blackwell Handbook of Adolescence. Oxford, England: Blackwell; 2003:313-329.
Collins  WA.  More than myth: the developmental significance of romantic relationships during adolescence. J Res Adolesc. 2003;13(1):1-24. doi:10.1111/1532-7795.1301001.
Link to Article
Basile  KC, Chen  J, Black  MC, Saltzman  LE.  Prevalence and characteristics of sexual violence victimization among US adults, 2001-2003. Violence Vict. 2007;22(4):437-448.
PubMed   |  Link to Article
Finkelhor  D. Developmental victimology: the comprehensive study of childhood victimization. In: Davis  R, Lurigio  A, Herman  S, eds. Victims of Crime.3rd ed. Thousand Oaks, CA: Sage Publications; 2007:9-34.
Tabachnick J, Dawson E. Stop It Now! Vermont: four year program evaluation 1995-1999. http://www.stopitnow.org/files/VT%20Final%20Evaluation%20Report%202000.pdf. Accessed March 12, 2013.
Finkelhor  D. Childhood Victimization: Violence, Crime, and Abuse in the Lives of Young People. New York, NY: Oxford University Press; 2008.
Chapleau  KM, Oswald  DL, Russell  BL.  How ambivalent sexism toward women and men support rape myth acceptance. Sex Roles. 2007;57(1-2):131-136. doi:10.1007/s11199-007-9196-2.
Link to Article
Chapleau  KM, Oswald  DL, Russell  BL.  Male rape myths: the role of gender, violence, and sexism. J Interpers Violence. 2008;23(5):600-615.
PubMed   |  Link to Article
Struckman-Johnson  C, Struckman-Johnson  D.  College men’s and women’s reactions to hypothetical sexual touch varied by initiator gender and coercion level. Sex Roles. 1993;29(5-6):371-385. doi:10.1007/BF00289430.
Link to Article
Davies  M, Rogers  P.  Perceptions of male victims in depicted sexual assaults: a review of the literature. Aggress Violent Behav. 2006;11(4):367-377. doi:10.1016/j.avb.2006.01.002.
Link to Article
Russell  BL, Oswald  DL, Kraus  SW.  Evaluations of sexual assault: perceptions of guilt and legal elements for male and female aggressors using various coercive strategies. Violence Vict. 2011;26(6):799-815.
PubMed   |  Link to Article
Sachs  BD.  A contextual definition of male sexual arousal. Horm Behav. 2007;51(5):569-578.
PubMed   |  Link to Article
Sachs  BD.  Placing erection in context: the reflexogenic-psychogenic dichotomy reconsidered. Neurosci Biobehav Rev. 1995;19(2):211-224.
PubMed   |  Link to Article
Tjaden P, Thoennes N. Full report of the prevalence, incidence, and consequences of violence against women: findings from the National Violence Against Women Survey. https://www.ncjrs.gov/pdffiles1/nij/183781.pdf. Accessed November 28, 2012.
Kahn  AS, Jackson  J, Kully  C, Badger  K, Halvorsen  J.  Calling it rape: differences in experiences of women who do or do not label their sexual assault as rape. Psychol Women Q. 2003;27(3):233-242. doi:10.1111/1471-6402.00103.
Link to Article
Russell  BL, Oswald  DL.  Sexual coercion and victimization of college men: the role of love styles. J Interpers Violence. 2002;17(3):273-285. doi:10.1177/0886260502017003003.
Link to Article
Davies  M, Rogers  P, Whitelegg  L.  Effects of victim gender, victim sexual orientation, victim response and respondent gender on judgements of blame in a hypothetical adolescent rape. Leg Criminol Psychol. 2009;14(2):331-338. doi:10.1348/978185408X386030.
Link to Article
Grubb  A, Harrower  J.  Attribution of blame in cases of rape: an analysis of participant gender, type of rape and perceived similarity to the victim. Aggress Violent Behav. 2008;13(5):396-405. doi:10.1016/j.avb.2008.06.006.
Link to Article
Grubb  AR, Harrower  J.  Understanding attribution of blame in cases of rape: an analysis of participant gender, type of rape and perceived similarity to the victim. J Sex Aggress. 2009;15(1):63-81. doi:10.1080/13552600802641649.
Link to Article
McMahon  S, Banyard  VL.  When can I help? a conceptual framework for the prevention of sexual violence through bystander intervention. Trauma Violence Abuse. 2012;13(1):3-14.
PubMed   |  Link to Article
Miller  E, Tancredi  DJ, McCauley  HL,  et al.  “Coaching boys into men”: a cluster-randomized controlled trial of a dating violence prevention program. J Adolesc Health. 2012;51(5):431-438.
PubMed   |  Link to Article
Katz  J, Heisterkamp  HA, Fleming  WM.  The social justice roots of the Mentors in Violence Prevention model and its application in a high school setting. Violence Against Women. 2011;17(6):684-702.
PubMed   |  Link to Article

Figures

Tables

Table Graphic Jump LocationTable 1.  Comparison of Weighted Demographic Characteristics of Survey Respondents at Wave 4 and Wave 5 vs Nonresponders
Table Graphic Jump LocationTable 2.  Demographic and Media Characteristics Based on Perpetration of Any Sexual Violence, Forced Sexual Contact, and Coercive Sex in 1058 Youthsa
Table Graphic Jump LocationTable 3.  Demographic and Media Characteristics Based on Perpetration of Attempted and Completed Rape in 1058 Youthsa
Table Graphic Jump LocationTable 4.  Perpetrator and Event Characteristics of 49 Perpetrators of Attempted or Completed Rapea
Table Graphic Jump LocationTable 5.  Differences in Perpetrator and Event Characteristics of 49 Perpetrators of Attempted or Completed Rape by Age at First Perpetrationa

References

Miller TR, Cohen MA, Wiersema B. Victim costs and consequences: a new look. https://www.ncjrs.gov/pdffiles/victcost.pdf. Accessed November 28, 2012.
Cortina  LM, Kubiak  SP.  Gender and posttraumatic stress: sexual violence as an explanation for women’s increased risk. J Abnorm Psychol. 2006;115(4):753-759.
PubMed   |  Link to Article
Conoscenti  LM, McNally  RJ.  Health complaints in acknowledged and unacknowledged rape victims. J Anxiety Disord. 2006;20(3):372-379.
PubMed   |  Link to Article
McFarlane  J, Malecha  A, Gist  J,  et al.  Intimate partner sexual assault against women and associated victim substance use, suicidality, and risk factors for femicide. Issues Ment Health Nurs. 2005;26(9):953-967.
PubMed   |  Link to Article
Snyder HN. Sexual assault of young children as reported to law enforcement: victim, incident, and offender characteristics. http://www.bjs.gov/content/pub/pdf/saycrle.pdf. Accessed November 28, 2012.
Snyder HN, Sickmund M. Juvenile offenders and victims: 2006 national report. http://www.ojjdp.gov/ojstatbb/nr2006/downloads/NR2006.pdf. Accessed November 28, 2012.
Righthand S, Welch C. Juveniles who have sexually offended: a review of the professional literature. https://www.ncjrs.gov/pdffiles1/ojjdp/184739.pdf. Accessed November 28, 2012.
Abbey  A.  Lessons learned and unanswered questions about sexual assault perpetration. J Interpers Violence. 2005;20(1):39-42.
PubMed   |  Link to Article
Maxwell  CD, Robinson  AL, Post  LA.  The nature and predictors of sexual victimization and offending among adolescents. J Youth Adolesc. 2003;32(6):465-477. doi:10.1023/A:1025942503285.
Link to Article
Malamuth  NM, Linz  D, Heavey  CL, Barnes  G, Acker  M.  Using the confluence model of sexual aggression to predict men’s conflict with women: a 10-year follow-up study. J Pers Soc Psychol. 1995;69(2):353-369.
PubMed   |  Link to Article
White  JW, Smith  PH.  Covariation in the use of physical and sexual intimate partner aggression among adolescent and college-age men: a longitudinal analysis. Violence Against Women. 2009;15(1):24-43.
PubMed   |  Link to Article
Abbey  A, McAuslan  P.  A longitudinal examination of male college students’ perpetration of sexual assault. J Consult Clin Psychol. 2004;72(5):747-756.
PubMed   |  Link to Article
Hall  GC, Barongan  C.  Prevention of sexual aggression: sociocultural risk and protective factors. Am Psychol. 1997;52(1):5-14.
PubMed   |  Link to Article
Fago  DP.  Evaluation and treatment of neurodevelopmental deficits in sexually aggressive children and adolescents. Prof Psychol Res Pr. 2003;34(3):248-257.
Link to Article
de Bruijn  P, Burrie  I, van Wel  F.  A risky boundary: unwanted sexual behaviour among youth. J Sex Aggress. 2006;12(2):81-96. doi:10.1080/13552600600841631.
Link to Article
Ray  JA, English  DJ.  Comparison of female and male children with sexual behavior problems. J Youth Adolesc. 1995;24(4):439-451. doi:10.1007/BF01537190.
Link to Article
Vandiver  DM, Teske  R  Jr.  Juvenile female and male sex offenders: a comparison of offender, victim, and judicial processing characteristics. Int J Offender Ther Comp Criminol. 2006;50(2):148-165.
PubMed   |  Link to Article
Tolman  DL, Kim  JL, Schooler  D, Sorsoli  CL.  Rethinking the associations between television viewing and adolescent sexuality development: bringing gender into focus. J Adolesc Health. 2007;40(1):84.e9-84.e16.
PubMed   |  Link to Article
Brown  JD, L'Engle  KL.  X-rated: sexual attitudes and behaviors associated with US early adolescents' exposure to sexually explicit media. Communic Res. 2009;36(1):129-151. doi:10.1177/0093650208326465.
Link to Article
Chandra  A, Martino  SC, Collins  RL,  et al.  Does watching sex on television predict teen pregnancy? findings from a national longitudinal survey of youth. Pediatrics. 2008;122(5):1047-1054.
PubMed   |  Link to Article
Ybarra  ML, Mitchell  KJ, Hamburger  M, Diener-West  M, Leaf  PJ.  X-rated material and perpetration of sexually aggressive behavior among children and adolescents: is there a link? Aggress Behav. 2011;37(1):1-18.
PubMed   |  Link to Article
Kaplowitz  MD, Hadlock  TD, Levine  R.  A comparison of web and mail survey response rates. Public Opin Q. 2004;68(1):94-101. doi:10.1093/poq/nfh006.
Link to Article
Cook  C, Heath  F, Thompson  RL.  A meta-analysis of response rates in web- or Internet-based surveys. Educ Psychol Meas. 2000;60(6):821-836. doi:10.1177/00131640021970934.
Link to Article
Lenhart A, Purcell K, Smith A, Zickuhr K. Social media and young adults. http://www.pewinternet.org/Reports/2010/Social-Media-and-Young-Adults.aspx. Accessed November 28, 2012.
Basile KC, Saltzman LE. Sexual violence surveillance: uniform definitions and recommended data elements. http://www.cdc.gov/ViolencePrevention/pub/SV_surveillance.html. Accessed November 28, 2012.
Koss  MP, Gaines  JA.  The prediction of sexual aggression by alcohol use, athletic participation, and fraternity affiliation. J Interpers Violence. 1993;8(1):94-108. doi:10.1177/088626093008001007.
Link to Article
Koss  MP, Gidycz  CA, Wisniewski  N.  The scope of rape: incidence and prevalence of sexual aggression and victimization in a national sample of higher education students. J Consult Clin Psychol. 1987;55(2):162-170.
PubMed   |  Link to Article
Bureau of Justice Statistics. Rape and sexual assault. http://www.bjs.gov/index.cfm?ty=tp&tid=317. Accessed November 21, 2012.
Hoertel  N, Le Strat  Y, Schuster  J-P, Limosin  F.  Sexual assaulters in the United States: prevalence and psychiatric correlates in a national sample. Arch Sex Behav. 2012;41(6):1379-1387.
PubMed   |  Link to Article
Berrens  RP, Bohara  AK, Jenkins-Smith  H, Silva  C, Weimer  DL.  The advent of Internet surveys for political research: a comparison of telephone and Internet samples. Polit Anal. 2003;11(1):1-22. doi:10.1093/pan/11.1.1.
Link to Article
Schonlau  M, Zapert  K, Simon  LP,  et al.  A comparison between response from a propensity-weighted web survey and an identical RDD survey. Soc Sci Comput Rev. 2004;22(1):128-138. doi:10.1177/0894439303256551.
Link to Article
Taylor  H, Bremer  J, Overmeyer  C, Siegel  JW, Terhanian  G.  The record of Internet-based opinion polls in predicting the results of 72 races in the November 2000 US elections. Int J Mark Res. 2001;43(2):127-138.
Berrens  RP, Bohara  AK, Jenkins-Smith  HC, Silva  CL, Weimer  DL.  Information and effort in contingent valuation surveys: application to global climate change using national Internet samples. J Environ Econ Manage. 2004;47(2):331-363. doi:10.1016/S0095-0696(03)00094-9.
Link to Article
US Bureau of Labor Statistics. Current Population Survey. http://www.bls.gov/cps/ Accessed July 5, 2006.
Windle  M, Grunbaum  JA, Elliott  M,  et al.  Healthy passages: a multilevel, multimethod longitudinal study of adolescent health. Am J Prev Med. 2004;27(2):164-172.
PubMed   |  Link to Article
Vandiver  DM.  Assessing gender differences and co-offending patterns of a predominantly “male-oriented” crime: a comparison of a cross-national sample of juvenile boys and girls arrested for a sexual offense. Violence Vict. 2010;25(2):243-264.
PubMed   |  Link to Article
Steinberg  L, Morris  AS.  Adolescent development. Annu Rev Psychol. 2001;52(1):83-110.
PubMed   |  Link to Article
Lerner  RM, Galambos  NL.  Adolescent development: challenges and opportunities for research, programs, and policies. Annu Rev Psychol. 1998;49(1):413-446.
PubMed   |  Link to Article
Bouchey  HA, Furman  W. Dating and romantic experiences in adolescence. In: Adams  GR, Berzonsky  M, eds. Blackwell Handbook of Adolescence. Oxford, England: Blackwell; 2003:313-329.
Collins  WA.  More than myth: the developmental significance of romantic relationships during adolescence. J Res Adolesc. 2003;13(1):1-24. doi:10.1111/1532-7795.1301001.
Link to Article
Basile  KC, Chen  J, Black  MC, Saltzman  LE.  Prevalence and characteristics of sexual violence victimization among US adults, 2001-2003. Violence Vict. 2007;22(4):437-448.
PubMed   |  Link to Article
Finkelhor  D. Developmental victimology: the comprehensive study of childhood victimization. In: Davis  R, Lurigio  A, Herman  S, eds. Victims of Crime.3rd ed. Thousand Oaks, CA: Sage Publications; 2007:9-34.
Tabachnick J, Dawson E. Stop It Now! Vermont: four year program evaluation 1995-1999. http://www.stopitnow.org/files/VT%20Final%20Evaluation%20Report%202000.pdf. Accessed March 12, 2013.
Finkelhor  D. Childhood Victimization: Violence, Crime, and Abuse in the Lives of Young People. New York, NY: Oxford University Press; 2008.
Chapleau  KM, Oswald  DL, Russell  BL.  How ambivalent sexism toward women and men support rape myth acceptance. Sex Roles. 2007;57(1-2):131-136. doi:10.1007/s11199-007-9196-2.
Link to Article
Chapleau  KM, Oswald  DL, Russell  BL.  Male rape myths: the role of gender, violence, and sexism. J Interpers Violence. 2008;23(5):600-615.
PubMed   |  Link to Article
Struckman-Johnson  C, Struckman-Johnson  D.  College men’s and women’s reactions to hypothetical sexual touch varied by initiator gender and coercion level. Sex Roles. 1993;29(5-6):371-385. doi:10.1007/BF00289430.
Link to Article
Davies  M, Rogers  P.  Perceptions of male victims in depicted sexual assaults: a review of the literature. Aggress Violent Behav. 2006;11(4):367-377. doi:10.1016/j.avb.2006.01.002.
Link to Article
Russell  BL, Oswald  DL, Kraus  SW.  Evaluations of sexual assault: perceptions of guilt and legal elements for male and female aggressors using various coercive strategies. Violence Vict. 2011;26(6):799-815.
PubMed   |  Link to Article
Sachs  BD.  A contextual definition of male sexual arousal. Horm Behav. 2007;51(5):569-578.
PubMed   |  Link to Article
Sachs  BD.  Placing erection in context: the reflexogenic-psychogenic dichotomy reconsidered. Neurosci Biobehav Rev. 1995;19(2):211-224.
PubMed   |  Link to Article
Tjaden P, Thoennes N. Full report of the prevalence, incidence, and consequences of violence against women: findings from the National Violence Against Women Survey. https://www.ncjrs.gov/pdffiles1/nij/183781.pdf. Accessed November 28, 2012.
Kahn  AS, Jackson  J, Kully  C, Badger  K, Halvorsen  J.  Calling it rape: differences in experiences of women who do or do not label their sexual assault as rape. Psychol Women Q. 2003;27(3):233-242. doi:10.1111/1471-6402.00103.
Link to Article
Russell  BL, Oswald  DL.  Sexual coercion and victimization of college men: the role of love styles. J Interpers Violence. 2002;17(3):273-285. doi:10.1177/0886260502017003003.
Link to Article
Davies  M, Rogers  P, Whitelegg  L.  Effects of victim gender, victim sexual orientation, victim response and respondent gender on judgements of blame in a hypothetical adolescent rape. Leg Criminol Psychol. 2009;14(2):331-338. doi:10.1348/978185408X386030.
Link to Article
Grubb  A, Harrower  J.  Attribution of blame in cases of rape: an analysis of participant gender, type of rape and perceived similarity to the victim. Aggress Violent Behav. 2008;13(5):396-405. doi:10.1016/j.avb.2008.06.006.
Link to Article
Grubb  AR, Harrower  J.  Understanding attribution of blame in cases of rape: an analysis of participant gender, type of rape and perceived similarity to the victim. J Sex Aggress. 2009;15(1):63-81. doi:10.1080/13552600802641649.
Link to Article
McMahon  S, Banyard  VL.  When can I help? a conceptual framework for the prevention of sexual violence through bystander intervention. Trauma Violence Abuse. 2012;13(1):3-14.
PubMed   |  Link to Article
Miller  E, Tancredi  DJ, McCauley  HL,  et al.  “Coaching boys into men”: a cluster-randomized controlled trial of a dating violence prevention program. J Adolesc Health. 2012;51(5):431-438.
PubMed   |  Link to Article
Katz  J, Heisterkamp  HA, Fleming  WM.  The social justice roots of the Mentors in Violence Prevention model and its application in a high school setting. Violence Against Women. 2011;17(6):684-702.
PubMed   |  Link to Article

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment
BJS' Definition of rape
Posted on October 17, 2013
Tamen Egalitarian
Citizen
Conflict of Interest: None Declared
The paper state that it's definition of rape is consistent with the Bureau of Justice Statistics' (BJS) definition of rape and provides a link to the definition in the footnotes. The BJS definition however requires that the victim of rape is the one being penetrated, although when viewing the examples of questions given in the survey it appears that the paper operate with a definition of rape where the perpetrator may be the one being penetrated and the victim may be the one penetrating, e.g. a woman forcing a man to vaginal sex. Could the author's clarify this apparent discrepancy and state outright whether their definition of rape would include a woman forcing a man to penetrate her?
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 5

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles