whether a crime was committed or whether harm was intended. Injury was reported for 52% of forcible rape incidents and 30% of drug-facilitated or incapacitated rape incidents assessed. Medical care was received following 19% of forcible rape incidents and 21% of drug-facilitated or incapacitated rape incidents. Perpetrators were known to the victim in a high percentage of forcible rape, drug-facilitated, and incapacitated rape incidents. Rape among Women in U.S. Colleges Estimates are that 673,000 of nearly 6 million women (11.5%) currently attending American colleges have ever been raped. 2 This includes an estimated half-million college women who have been forcibly raped, 160,000 who have experienced drug-facilitated rape, and over 200,000 who have experienced incapacitated rape. 1 During the past year alone, 300,000 college women (5.2%) were raped: nearly 200,000 who have been forcibly raped, nearly 100,000 who have experienced drug-facilitated rape, and over 100,000 who have experienced incapacitated rape. Among college women, about 12% of rapes were reported to law enforcement. Consistent with the national sample, victims of drug-facilitated or incapacitated rape were less likely than victims of forcible rape to report to the authorities. Barriers to reporting rape incidents to law enforcement among college women included: not wanting others to know about the rape, fear of retaliation, perception of insufficient evidence, uncertainty about whether a crime was committed or harm intended, and uncertainty about whether the incident was "serious enough". Injury was reported for 47% of forcible rape incidents and 20% of drug-facilitated or incapacitated incidents. Medical care was received following 14% of forcible rape incidents and 19% of drugfacilitated or incapacitated incidents. Perpetrators were known to victims in most rape cases.

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are prevalent and frequently co-occur. Comorbid PTSD/SUD is associated with a more complex and costly clinical course when compared with either disorder alone, including increased chronic physical health problems, poorer social functioning, higher rates of suicide attempts, more legal problems, increased risk of violence, worse treatment adherence, and less improvement during treatment. In response, psychosocial treatment options have increased substantially over the past decade and integrated approaches – treatments that address symptoms of both PTSD and SUD concurrently –are fast becoming the preferred model for treatment. This paper reviews the prevalence, etiology and assessment practices as well as advances in the behavioral and pharmacologic treatment of comorbid PTSD and SUDs.

Rape affects one in seven women nationwide. Historically, most rape victims do not report rape to law enforcement. Research is needed to identify barriers to reporting and correlates of reporting to guide policy recommendations that address such barriers. We investigated the prevalence of reporting rape among a national sample of women (N = 3,001) interviewed in 2006. The study also examined predictors of reporting as well as barriers to reporting, concerns about reporting, and women's experiences with the reporting process. Results demonstrated that the overall prevalence of reporting (15.8%) has not significantly increased since the 1990s. Differences were found between rape types, with rapes involving drug or alcohol incapacitation or facilitation being less likely to be reported than forcible rapes. Several predictors of reporting emerged in multivariable analyses. Implications for public health and public policy are discussed.

Objective Prescription opioid abuse and dependence have escalated rapidly in the United States over the past 20 years, leading to high rates of overdose deaths and a dramatic increase in the number of people seeking treatment for opioid dependence. The authors review the scope of the abuse and overdose epidemic, prescription practices, and the assessment, treatment, and prevention of prescription opioid misuse and dependence. Method The authors provide an overview of the literature from 2006 to the present, with the twin goals of highlighting advances in prevention and treatment and identifying remaining gaps in the science. Results A number of policy and educational initiatives at the state and federal government level have been undertaken in the past 5 years to help providers and consumers, respectively, prescribe and use opioids more responsibly. Initial reports suggest that diversion and abuse levels have begun to plateau, likely as a result of these initiatives. While there is a large body of research suggesting that opioid substitution coupled with psychosocial interventions is the best treatment option for heroin dependence, there is limited research focusing specifically on the treatment of prescription opioid dependence. In particular, the treatment of chronic pain in individuals with prescription opioid use disorders is underexplored. Conclusions While policy and educational initiatives appear to be effective in decreasing prescription opioid abuse and misuse, research focusing on the development and evaluation of treatments specific to prescription opioid dependence and its common comorbidities (e.g., chronic pain, depression) is critically needed.

Context Despite empirical links between sexual revictimization (i.e., experiencing two or more sexual assaults) and posttraumatic stress disorder (PTSD), no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. Objective Estimate the prevalence of sexual revictimization and PTSD among three national female samples (adolescent, college, adult household probability). Design Surveys were used to collect data from The National Women’s Study – Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women’s Study-Replication (2006; household probability). Setting Households and college campuses across the U.S. Participants 1,763 adolescent girls, 2,000 college women, and 3,001 household-residing adult women. Main Outcomes Behaviorally specific questions assessed unwanted sexual acts occurring over the lifespan due to use of force, threat of force, or incapacitation via drug or alcohol use. PTSD was assessed with a module validated against the criterion standard, Structured Clinical Interview for DSM-IV. Results 52.7% of victimized adolescents, 50.0% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20.0% of revictimized adolescents, 40.0% of revictimized college women, and 27.2% of revictimized household-residing women. Compared to non-victims, odds of meeting past 6-month PTSD were 4.3–8.2 times higher for revictimized respondents and 2.4–3.5 times higher for single victims. Conclusions Population prevalence estimates suggest that 769,000 adolescent girls, 625,000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154,000 sexually revictimized adolescents, 250,000 sexually revictimized college women, and 3.6 million sexually revictimized household women met criteria for past 6-month PTSD. Findings highlight the importance of screening for sexual revictimization and PTSD in pediatric, college, and primary care settings.

Introduction Studies indicate that a small percentage of rapes are reported to law enforcement officials. Research also suggests that rapes perpetrated by a stranger are more likely to be reported and that rapes involving drugs and/or alcohol are less likely to be reported. College women represent a unique and understudied population with regard to reporting rape. Methods In the current study, we interviewed a national sample of 2,000 college women about rape experiences in 2006. Results Only 11.5% of college women in the sample reported their most recent/only rape experience to authorities, with only 2.7% of rapes involving drugs and/or alcohol reported. Minority status (i.e., non-white race) was associated with lower likelihood of reporting, whereas sustaining injuries during the rape was associated with increased likelihood of reporting. Discussion Reporting, particularly for rapes involving drugs and alcohol, is low among college women. Implications for policy are discussed.

Background Relatively few studies have examined prevalence and predictors of posttraumatic stress disorder (PTSD) or major depressive episode (MDE) in disaster-affected adolescents. Fewer still have administered diagnostic measures or studied samples exposed to tornadoes, a common type of disaster. Further, methodological problems limit the generalizability of previous findings. This study addressed prevalence estimates and risk factors for PTSD and MDE among adolescents exposed to the spring 2011 tornado outbreak in Alabama and Joplin, Missouri. Methods A large (N=2,000), population-based sample of adolescents and caregivers, recruited randomly from tornado-affected communities, participated in structured telephone interviews. PTSD and MDE prevalence were estimated for the overall sample, by gender, and by age. Hierarchical logistic regression was used to identify risk factors for PTSD and MDE. Results Overall, 6.7% of adolescents met diagnostic criteria for PTSD and 7.5% of adolescents met diagnostic criteria for MDE since the tornado. Girls were significantly more likely than boys to meet diagnostic criteria for MDE, and older adolescents were more likely than younger adolescents to report MDE since the tornado. Female gender, prior trauma exposure, and an injured family member were associated with greater risk for PTSD and MDE. Specific incident characteristics (loss of services, concern about others’ safety) were associated with greater PTSD risk; prior disaster exposure was associated with lower MDE risk. Conclusions Whereas most adolescents were resilient following tornado exposure, roughly 1 in 15 developed PTSD, 1 in 13 developed MDE, and many more endorsed subclinical mental health problems. Information regarding specific risk factors can guide early screening, prevention, and intervention efforts in disaster-affected communities.

Objective-Rape is a well-established risk factor for mental health disorders such as posttraumatic stress disorder (PTSD) and depression. However, most studies have focused on forcible rape tactics and have not distinguished these from tactics that involve drug or alcohol intoxication. Our aim was to examine correlates of PTSD and depression in a community sample of women, with particular emphasis on evaluating the unique effects of lifetime exposure to three specific rape tactics.Methods-A nationally representative sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18-86 years) participated in a structured telephone interview by use of Computer-Assisted Telephone Interviewing technology.Results-Multivariable models showed that history of drug or alcohol facilitated rape tactics (OR = 1.87, p< .05) and history of forcible rape tactics (OR = 3.46, p<.001) were associated with PTSD. History of forcible rape was associated with depression (OR = 3.65, p<.001). Forcible rape tactics were associated with a number of factors that may have contributed to their stronger association with mental health outcomes, including force, injury, lower income, revictimization history, and labeling the event as rape.Conclusions-Our results underscore the importance of using a behaviorally specific assessment of rape history, as rape tactic and multiple rape history differentially predicted psychopathology outcomes. The association between drug or alcohol facilitated rape tactics and PTSD suggests that these are important rape tactics to include in assessments and future studies.