Date of Award

Spring 6-5-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Keyne C. Law, Ph.D.

Second Advisor/Committee Member

Jacob Bentley, Ph.D., ABPP

Third Advisor/Committee Member

Jessica Carlile, Ph.D.

Abstract

Millions of people worldwide flee violent persecution each year, with more than 6.8 million estimated to have sought asylum in 2023 alone (United Nations High Commission on Refugees, 2025). Up to 40% of refugees and asylum-seekers are reported to be survivors of torture, with sexual torture one of the most commonly-reported means of torture, particularly among women and LGBTQ+ populations (Abu Suhaiban, 2019; Hopkinson et al., 2017; United Nations High Commission on Refugees, 2017). Sexual torture has been associated with severe impacts on mental health, including posttraumatic and depressive symptoms. Despite marked differences in sexual torture risk across gender and sexual identities, little is known about the extent to which these identity factors may also influence outcomes. This study examines gender and sexual identity as potential moderators of the relationship between sexual torture and mental health outcomes using de-identified archival asylum case data from a nonprofit refugee services organization in the Pacific Northwest. Participants were asylum-seeking survivors of torture (N = 108; 35% male, 65% female, and 0% other gender) who received pro bono medical or psychological evaluations to support their United States asylum applications from a professional network partnered with the nonprofit. Using four separate moderation analyses via two-way factorial analysis of variance (ANOVA), I hypothesized that gender and sexual identity would significantly moderate the relationship between sexual torture and mental health outcomes, with cisgender female and gender minority survivors of sexual torture demonstrating higher levels of posttraumatic and depressive symptoms than cisgender male survivors, and LGBTQ+ survivors demonstrating higher levels than heterosexual survivors. Matched sampling was used to address differences in gender and sexual identity group sizes. While all four moderation models were found to be statistically nonsignificant, women were found to be at significantly greater risk of sexual torture (r = 0.54, p < .01), and sexual torture was found in all matched samples to significantly predict posttraumatic symptoms and depressive symptoms (p = < .001-.01) with large effects (η2 = 0.32-0.38). These findings are consistent with prior literature on the extensive impact of sexual torture and underline the importance of access to effective support for survivors.

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