Opinion
EDITORIAL
Campus Sexual Assault Perpetration What Else We Need to Know Jacquelyn Campbell, PhD, RN
I commend Swartout and colleagues on their study1 in this issue of JAMA Pediatrics for their secondary data analysis of the 2 largest longitudinal data sets of men in college that operationalize sexual assault with a well-validated measure. The results shed additional needed light on the nature of Related articles pages 1148 campus sexual assault. By and 1184 combining 2 data sets, albeit 15 years apart, they maximize our ability to detect the nature of sexual assault on campus. This information will inform better strategies for best identifying, adjudicating, and treating sexually assaultive men. As they point out, one of the major findings is that most men in college do not rape women. In the combined data set, 5.6% of 1645 men committed a sexual assault that met the FBI definition of rape during college. In current conversations about campus sexual assault, many college-aged men believe they are being demonized—if they are not rapists, then they are likely to rape as soon as exposed to a university atmosphere that condones rape. Clearly this is not true, and although all universities need to improve the response to those who are raped and improve accountability for those who do rape, we should avoid any rhetoric that suggests that men at universities are likely to rape and that young women in college should be frightened of the men on their campus in general. Another important finding from this analysis, which is usually overlooked in current conversations, is that of the 5% of the study population who had committed rape before college, most (59.5%) did not commit rape during college. These young men can be labeled desisters and follow a pattern known to those who study crime patterns among adolescents and young adults. More needs to be known about what prevents those men from perpetrating rape when they go on to college so that strategies based on that knowledge can be used with others who commit rape as younger adolescents. The college experience may have contributed to their desistance, and we need to know what about that experience was preventive. There were only 34 (2.1%) young men in the combined sample who committed rape before and during college; a similar proportion (2.7%) were identified as those who met the increasing trajectory pattern in the modeling. However, those who increased their rape behavior during college were unlikely to have committed rape before college. Those with an increasing trajectory had a sharp increase in rape likelihood once they entered college and an attenuation of this increase beginning during the third year of college. Those men are perhaps the closest to the notion 1088
of serial rapists and, since the usual universal rape prevention programs now being used in many universities probably are not going to be useful for them, they clearly need to have targeted interventions to help address the history of abusive home environments as well as the attitudes of hostility against women and peer norms supportive of sexual aggression that have been identified as part of the background of sexually aggressive men. 2,3 These are young men for whom the college experience encourages their rape behavior, and we must find out and end whatever interpersonal and structural enablers are part of that experience. We already know that alcohol is part of that experience, with important research beginning to illuminate some of those relationships.4 However, as outlined in an important recent review article,5 it is critical that this research expand because alcohol will continue to be part of most university students’ experience and we must develop policies and evidencebased interventions for students to minimize alcohol’s association with violence. Although the study by Swartout et al in this issue is informative, it also highlights the dearth of high-quality research in the field. Although we have an excellent national survey of sexual assault as part of the National Intimate Partner and Sexual Violence Survey that includes women of college age, there is not sufficient representation of college students in that sample to identify the complex patterns needed to inform campus policy and prevention strategies.6 The results of the last well-measured population-based multi-university study of perpetration of sexual assault were published in 1987. Another important limitation of this study is that the samples are from only 2 universities in the southeastern United States and are limited in terms of diversity. One was 25.7% black and 5.8% other; the second was only 7.3% black and 3.3% other. Thus, the findings of this important study inform current policy discussions of college sexual assault by highlighting the need for a multifaceted approach to high school and college rape response and prevention. However, the most important finding is that there is insufficient current national research in this field to support the kind of evidence-based policy and programming in campus sexual assault prevention called for by the White House Council on Women and Girls.7 Although the Campus Climate Surveys will be informative for surveillance, without validated measures, sufficient response rates, and the ability to answer complex research questions about perpetrators, trajectories, and the interplay of risk and protective factors, they will not provide the kind of findings needed.
JAMA Pediatrics December 2015 Volume 169, Number 12 (Reprinted)
jamapediatrics.com
Copyright 2015 American Medical Association. All rights reserved.
Downloaded From: http://archpedi.jamanetwork.com/pdfaccess.ashx?url=/data/journals/peds/934747/ by a Columbia University User on 06/21/2017
Editorial Opinion
ARTICLE INFORMATION Author Affiliation: Johns Hopkins University School of Nursing, Baltimore, Maryland. Corresponding Author: Jacquelyn Campbell, PhD, RN, Johns Hopkins University School of Nursing, 436 Anne M. Pinkard Bldg, 525 N Wolfe St, Room 436, Baltimore, MD 21205 ([email protected]). Published Online: July 13, 2015. doi:10.1001/jamapediatrics.2015.1313. Conflict of Interest Disclosures: None reported. REFERENCES 1. Swartout KM, Koss MP, White JW, Thompson MP, Abbey A, Bellis AL. Trajectory analysis of the campus serial rapist assumption [published online
July 13, 2014]. JAMA Pediatr. doi:10.1001 /jamapediatrics.2015.0707. 2. Malamuth NM, Sockloskie RJ, Koss MP, Tanaka JS. Characteristics of aggressors against women: testing a model using a national sample of college students. J Consult Clin Psychol. 1991;59(5): 670-681. 3. Abbey A, Wegner R, Pierce J, Jacques-Tiura AJ. Patterns of sexual aggression in a community sample of young men: risk factors associated with persistence, desistance, and initiation over a one year interval. Psychol Violence. 2012;2(1):1-15. 4. Abbey A, McAuslan P. A longitudinal examination of male college students’ perpetration of sexual assault. J Consult Clin Psychol. 2004;72 (5):747-756.
research that examines the relationship between alcohol consumption and men’s sexual aggression perpetration. Trauma Violence Abuse. 2014;15(4): 265-282. doi:10.1177/1524838014521031. 6. Black MC, Basile KC, Breiding MJ, et al. The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2011. 7. White House Council on Women and Girls. Rape and sexual assault: a renewed call to action. http: //www.whitehouse.gov/sites/default/files/docs /sexual_assault_report_1-21-14.pdf. Published January 21, 2014. Accessed January 23, 2014.
5. Abbey A, Wegner R, Woerner J, Pegram SE, Pierce J. Review of survey and experimental
Spreading the Benefits of Infection Prevention in the Neonatal Intensive Care Unit Joseph B. Cantey, MD; Andrea Ronchi, MD; Pablo J. Sánchez, MD
Although infections due to Staphylococcus aureus are infrequent in the neonatal intensive care unit (NICU), they are associated with substantial morbidity and mortality. In this issue of JAMA Pediatrics, Ericson et al1 describe a 15-year (1997-2012) retrospective study with invasive S aureus infections, defined as a posiRelated article page 1105 tive culture of blood, cerebrospinal fluid, normally sterile body fluid, or abscess for S aureus, in 348 NICUs managed by the Pediatrix Medical Group. Among 887 910 infants admitted to these NICUs, 3888 (0.4%) had at least 1 invasive S aureus infection, which occurred in 2.2% of very low-birth-weight (VLBW) infants (birth weight
EDITORIAL
Campus Sexual Assault Perpetration What Else We Need to Know Jacquelyn Campbell, PhD, RN
I commend Swartout and colleagues on their study1 in this issue of JAMA Pediatrics for their secondary data analysis of the 2 largest longitudinal data sets of men in college that operationalize sexual assault with a well-validated measure. The results shed additional needed light on the nature of Related articles pages 1148 campus sexual assault. By and 1184 combining 2 data sets, albeit 15 years apart, they maximize our ability to detect the nature of sexual assault on campus. This information will inform better strategies for best identifying, adjudicating, and treating sexually assaultive men. As they point out, one of the major findings is that most men in college do not rape women. In the combined data set, 5.6% of 1645 men committed a sexual assault that met the FBI definition of rape during college. In current conversations about campus sexual assault, many college-aged men believe they are being demonized—if they are not rapists, then they are likely to rape as soon as exposed to a university atmosphere that condones rape. Clearly this is not true, and although all universities need to improve the response to those who are raped and improve accountability for those who do rape, we should avoid any rhetoric that suggests that men at universities are likely to rape and that young women in college should be frightened of the men on their campus in general. Another important finding from this analysis, which is usually overlooked in current conversations, is that of the 5% of the study population who had committed rape before college, most (59.5%) did not commit rape during college. These young men can be labeled desisters and follow a pattern known to those who study crime patterns among adolescents and young adults. More needs to be known about what prevents those men from perpetrating rape when they go on to college so that strategies based on that knowledge can be used with others who commit rape as younger adolescents. The college experience may have contributed to their desistance, and we need to know what about that experience was preventive. There were only 34 (2.1%) young men in the combined sample who committed rape before and during college; a similar proportion (2.7%) were identified as those who met the increasing trajectory pattern in the modeling. However, those who increased their rape behavior during college were unlikely to have committed rape before college. Those with an increasing trajectory had a sharp increase in rape likelihood once they entered college and an attenuation of this increase beginning during the third year of college. Those men are perhaps the closest to the notion 1088
of serial rapists and, since the usual universal rape prevention programs now being used in many universities probably are not going to be useful for them, they clearly need to have targeted interventions to help address the history of abusive home environments as well as the attitudes of hostility against women and peer norms supportive of sexual aggression that have been identified as part of the background of sexually aggressive men. 2,3 These are young men for whom the college experience encourages their rape behavior, and we must find out and end whatever interpersonal and structural enablers are part of that experience. We already know that alcohol is part of that experience, with important research beginning to illuminate some of those relationships.4 However, as outlined in an important recent review article,5 it is critical that this research expand because alcohol will continue to be part of most university students’ experience and we must develop policies and evidencebased interventions for students to minimize alcohol’s association with violence. Although the study by Swartout et al in this issue is informative, it also highlights the dearth of high-quality research in the field. Although we have an excellent national survey of sexual assault as part of the National Intimate Partner and Sexual Violence Survey that includes women of college age, there is not sufficient representation of college students in that sample to identify the complex patterns needed to inform campus policy and prevention strategies.6 The results of the last well-measured population-based multi-university study of perpetration of sexual assault were published in 1987. Another important limitation of this study is that the samples are from only 2 universities in the southeastern United States and are limited in terms of diversity. One was 25.7% black and 5.8% other; the second was only 7.3% black and 3.3% other. Thus, the findings of this important study inform current policy discussions of college sexual assault by highlighting the need for a multifaceted approach to high school and college rape response and prevention. However, the most important finding is that there is insufficient current national research in this field to support the kind of evidence-based policy and programming in campus sexual assault prevention called for by the White House Council on Women and Girls.7 Although the Campus Climate Surveys will be informative for surveillance, without validated measures, sufficient response rates, and the ability to answer complex research questions about perpetrators, trajectories, and the interplay of risk and protective factors, they will not provide the kind of findings needed.
JAMA Pediatrics December 2015 Volume 169, Number 12 (Reprinted)
jamapediatrics.com
Copyright 2015 American Medical Association. All rights reserved.
Downloaded From: http://archpedi.jamanetwork.com/pdfaccess.ashx?url=/data/journals/peds/934747/ by a Columbia University User on 06/21/2017
Editorial Opinion
ARTICLE INFORMATION Author Affiliation: Johns Hopkins University School of Nursing, Baltimore, Maryland. Corresponding Author: Jacquelyn Campbell, PhD, RN, Johns Hopkins University School of Nursing, 436 Anne M. Pinkard Bldg, 525 N Wolfe St, Room 436, Baltimore, MD 21205 ([email protected]). Published Online: July 13, 2015. doi:10.1001/jamapediatrics.2015.1313. Conflict of Interest Disclosures: None reported. REFERENCES 1. Swartout KM, Koss MP, White JW, Thompson MP, Abbey A, Bellis AL. Trajectory analysis of the campus serial rapist assumption [published online
July 13, 2014]. JAMA Pediatr. doi:10.1001 /jamapediatrics.2015.0707. 2. Malamuth NM, Sockloskie RJ, Koss MP, Tanaka JS. Characteristics of aggressors against women: testing a model using a national sample of college students. J Consult Clin Psychol. 1991;59(5): 670-681. 3. Abbey A, Wegner R, Pierce J, Jacques-Tiura AJ. Patterns of sexual aggression in a community sample of young men: risk factors associated with persistence, desistance, and initiation over a one year interval. Psychol Violence. 2012;2(1):1-15. 4. Abbey A, McAuslan P. A longitudinal examination of male college students’ perpetration of sexual assault. J Consult Clin Psychol. 2004;72 (5):747-756.
research that examines the relationship between alcohol consumption and men’s sexual aggression perpetration. Trauma Violence Abuse. 2014;15(4): 265-282. doi:10.1177/1524838014521031. 6. Black MC, Basile KC, Breiding MJ, et al. The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2011. 7. White House Council on Women and Girls. Rape and sexual assault: a renewed call to action. http: //www.whitehouse.gov/sites/default/files/docs /sexual_assault_report_1-21-14.pdf. Published January 21, 2014. Accessed January 23, 2014.
5. Abbey A, Wegner R, Woerner J, Pegram SE, Pierce J. Review of survey and experimental
Spreading the Benefits of Infection Prevention in the Neonatal Intensive Care Unit Joseph B. Cantey, MD; Andrea Ronchi, MD; Pablo J. Sánchez, MD
Although infections due to Staphylococcus aureus are infrequent in the neonatal intensive care unit (NICU), they are associated with substantial morbidity and mortality. In this issue of JAMA Pediatrics, Ericson et al1 describe a 15-year (1997-2012) retrospective study with invasive S aureus infections, defined as a posiRelated article page 1105 tive culture of blood, cerebrospinal fluid, normally sterile body fluid, or abscess for S aureus, in 348 NICUs managed by the Pediatrix Medical Group. Among 887 910 infants admitted to these NICUs, 3888 (0.4%) had at least 1 invasive S aureus infection, which occurred in 2.2% of very low-birth-weight (VLBW) infants (birth weight
