Medical Mistrust Mediates the Relationship Between Sexual Victimization and Medical Non-Adherence
Sexual victimization has been associated with significant negative health outcomes as well as increased healthcare utilization (e.g., Breiding et al., 2013; Sickel et al., 2002). However, due to fear, embarrassment, or confidentiality concerns (Logan et al., 2004; Nasta et al., 2005), women may mistrust medical advice and not adhere to treatment recommendations, exacerbating development of negative health outcomes. Some research (Meade et al., 2009) has identified sexual victimization as a predictor of medical nonadherence, but to our knowledge no research has examined the role of medical mistrust in this relationship. A sample of 857 women was recruited via social media. Regression analyses in R Markdown revealed that sexual trauma was a significant predictor of both medical nonadherence (b = 0.4, SE = .08, p < .0001) and medical mistrust (b = 1.36, SE = .027 p < .0001), and further that medical mistrust predicted medical nonadherence (b = 0.06 SE = .01, p < .0001). Additionally, medical mistrust was found to significantly mediate the relationship between sexual trauma and medical nonadherence (b = .09, SD = .03, 95% CI =.04, .14). Results emphasize the importance of trauma-informed care and patient-provider rapport in bolstering resiliency and strengthening survivors’ adherence to medical recommendations. Suggestions for further application and intervention will be discussed.
Altschuler, Rebecca; and Dodd, Julia. 2019. Medical Mistrust Mediates the Relationship Between Sexual Victimization and Medical Non-Adherence. Oral Presentation. Annual Meeting for International Society for Traumatic Stress Studies, Boston, MA. https://istss.org/ISTSS_Main/media/Documents/ISTSS-Session-Abstract-Book.pdf