Empowerment Self Defense Program for Adult Native Women Survivors of Sexual Violence

Depression

Participant responses to depressive symptoms in the past two weeks using items from the Patient Health Questionnaire (PHQ-9). The 9-item scale includes likert options ranging from 0 = Not at all to 3 = Nearly every day. Higher scores indicate more depressive symptoms.

PTSD

Participant responses to items from the PTSD checklist for DSM-5 to measure post traumatic stress disorder behaviors in the past month. The 20-item scale includes likert response options ranging from 0 = Not at all to 4 = Extremely with higher scores indicating more trauma related stress.

Suicidal Ideation

Participants will respond to items on the Suicidal Ideation Attributes Scale. This is a five measure with a slider scale from 0=never to 10=always. A score greater or equal to 21 is an elevated suicide risk. A score of 0 - 20: Indicates the presence of suicidal thoughts but generally reflects a lower behavioral risk. A score of 21 or higher: Indicates a higher risk of suicidal thoughts and behavior.

Alcohol Misuse

Participants will respond to items on the Alcohol Use Disorders Identification Test. This measures the participants alcohol use. This is a 10 item multiple choice option scale. For items 1-8, 0=never, 1=monthly or less, 2=2-4 times a month, 3=2-3 times a week, 4=4 or more times a week/daily/almost daily. For item 2 (special response) 0=1 or 2 drinks, 1=3 or 4 drinks, 2=5 or 6 drinks, 3=7 to 9 drinks, 4=10 or more drinks. For items 9-10, choices are 0=No, 2=Yes, but not in the last month, 4=Yes, during the last month. The AUDIT (a 10-question survey) is scored from 0 to 40 with higher scores indicating hazardous or harmful alcohol consumption and a higher probability of alcohol dependence.

Drug Use

Participants will respond to items on the Drug Use Disorders Identification Test. This measures the participants use of drugs other than alcohol. This is a 11 items measure with multiple choice options. For items 1-2 the options are 0=Never, 1=Once a month or less often, 2=2-4 times month, 3=2-3 times a week, 4=4 times a week or more often. For item 3, the choices are 0=0, 1=1-2, 2=3-4, 3=5-6, 4=7 or more. For items 4-9, the choices are 0=never, 1=Less often than once a month, 2=Every month, 3=Every week, 4=Daily or almost every day. For items 10-11, the choices are 0=no, 1=Yes, but not over the past month, 2=Yes, over the past month. A higher score on the DUDIT (Drug Use Disorders Identification Test) indicates a higher likelihood of harmful drug use, substance abuse, or drug dependence.

Suicide

Participant responses to items from the Columbia Suicide Severity Rating Scale (C-SSRS) Self Report to measure suicide and life-threatening behavior in the past month. The 6-item scale includes two response options ranging from 0 = No to 1 = Yes with higher scores indicating severity of suicidal ideation. Low risk : score of 1-2; Moderate risk: score of 3 or certain history; High risk: score of 4-6 A higher score indicates increased levels of suicide risk and future suicidal behavior.

(Intermediary Outcome) Difficulty in Emotional Regulation

The Difficulty in Emotion Regulation Scale 18 is an 18 item measure with a 5 point scale ranging from 1=Almost never to 5=Almost always. It will include subscales of Awareness: Items 1, 4, 6 (reverse scored); Clarity: Items 2, 3, 5; Goals: Items 8, 12, 15; Impulse: Items 9, 16, 18; Nonacceptance: Items 7, 13, 14; Strategies: Items 10, 11, 17. Sum items within each subscale to obtain subscale scores. Score of 8 - 35: Low difficulties. Score of 36 - 62: Moderate difficulties. Score of 63 - 90: High difficulties. A higher score indicates a greater difficulty managing emotions, meaning you likely struggle more to recognize, accept, and manage your feelings.

(Intermediary Outcome) Fear of future sexual assault

Participants will respond to items on the Fear of Sexual Assault Scale. This is a 31 measure with a Likert scale ranging from 1=always to 5=never for items 1-26 and a Likert scale ranging from 1=very safe to 5 very unsafe for items 27-31. A higher score indicates an elevated level of anxiety, apprehension, or perceived vulnerability to becoming a victim of sexual violence.

(Intermediary Outcome) Self Blame

Participants will respond to items on the Rape Attribution Questionnaire. The Questionnaire uses multiple subscales: Behavioral self-blame, characterological self-blame, perpetrator blame, and external/societal blame. This is a 20 item measure with a Likert scale ranging from 1=strongly disagree to 6=strongly agree. A higher score indicates greater endorsement of blame or cause of sexual assault to a specific factor.

(Intermediary Outcome) Empowerment

Participants will respond to items on the Personal Progress scale. Participants will respond to statements that identify feelings or experiences and how each statement applies to them. The scale consists of a 28 items with a slider scale ranging from 1=almost never, 4=sometimes true, 7=almost always. This scale measures perceptions of power and competence, self-nurturance and resource access, interpersonal assertiveness, awareness of cultural discrimination, expression of anger and confrontation, autonomy, and personal strength and social activism. A higher score indicates positive increased personal Empowerment and Coping.