Table 1.

Summary of study characteristics and data extraction table.

Effectiveness of video interventions at time of forensic medical exam
Study and aim	Setting	Participants	Sample size and characteristics	Design	Intervention	Outcomes measured and time points assessed	Success of follow up	Key results within and between groups
Miller et al. (2015) Assess efficacy of video to reduce distress after a forensic medical post-sexual assault exam	SANE programme at USA hospital	• Women • 18 yrs • English speaking • Attending for forensic medical (SANE) exam within 72 hrs of sexual assault • 179 eligible	• N = 164 (91.6%) • Mean Age = 28.79 yr, SD = 10.47, range 18-70 yrs. • Ethnicity: 61.5% White; 15.5% Black; 23% other • 72% previous sexual assault • Index assault: 57% completed rape • More completed rape in standard care (67.1%: 46.8%).	Controlled Clinical Trial Video (n = 94) versus Standard Care (n=85) RA, IBA	Psychoeducational Video (VI; 9 mins) • Psychoeducation on reactions to sexual assault, methods for graded exposure and targeting avoidance, strategies to improve mood Standard Care (SC) • Rape crisis advocate provided info on exam and services.	• Subjective Units of Distress (SUDS) • The PTSD-Symptom Scale Self-Report (PSS-SR) • State-Trait Anxiety Inventory (STAI) – State component only • Pre • Post • 2 weeks • 2 months • Follow up data collected by phone.	• n = 164 tx completion • n = 69 at 2 weeks • n = 74 at 2 months	• VI versus SC on STAI scores at 2 week [F(1, 68) = 6.82, p < .05, partial h2 = 0.094; mean difference = 8.60, SEdiff = 3.41] • and 2m FU [F(1, 74) = 4.58, p < .05, partial h2 = 0.06; mean diff = 6.66, SEdiff = 3.11] • N.s. for VI versus SC on PSS-SR / SUDS • At 2week: VI (no sexual assault history) had lower total severity score on PSS-SR (mean diff = -12.61, p=.011). N.s. at 2m.
Resnick et al. (2007a) *includes Acierno et al. (2003) - Examine efficacy of a two-part video in reducing post-sexual assault substance use and abuse.	A Major University Hospital South East USA	• Women • ⩾ 15 yrs old • Attending for SANE (sexual assault nurse examiner) exam within 72 hrs of sexual assault • 592 eligible	• N = 442 (74.7%) • Mean Age: NV (n=107) Mean = 26.49 years (SD=10.4); AV (n=161) mean 25.93 years (SD = 10.24). • Majority Single (81.6%) • Ethnicity: 58.2% White; 38% Black; 3.8% other. • 59.3% Lifetime sexual or physical assault • Index assault: 92.5% included penetration.	Controlled Clinical Trial Any Video (n=283) versus Standard Care/Non-Video (n=159) RA, IBA	Any Video (AV) • Full Video (17 mins) • Medical Exam Prep Video (7mins 40secs; Info about medical exam with model demonstrating coping). • Psycho-Education (10mins; see above plus brief strategies to target substance misuse) • Standard Care/Non-Video • Rape crisis counsellor attends exam.	• Alcohol and Substance Misuse (Lifetime/Pre-assault potentially problematic use) and abuse (DSM-IV) via clinical interview • ƒ of use during previous 2 weeks – self-report at follow up • Baseline • T1 – < 3m (M=48.94 days, SD=11.14) • T2 – 3-6m (M=104.83 days, SD=19.55) • T3 – 6m or more (M=196.37 days, SD = 79.27).	• 406 tx completers • AV; n= 247 (87%) • 268 (66%) completed one FU. NV; n = 107 AV; n = 161	• Reduced ƒ marijuana use in AV among pre-sexual assault marijuana users at: • T1: F (7206) = 19.39, p < .001; • T2: F (7122) = 12.28, p < .001; • T3: F (7206) = 14.48, p < .001; • No effect of AV on alcohol or hard drug use/abuse at FU after controlling for other predictor variables.
Resnick et al. (2007b) * Includes Resnick et al. (2005) and Resnick et al. (1999) -Evaluate efficacy of video prior to forensic medical exam to reduce mental health symptoms at FU.	A major South Eastern USA university hospital	• Women • ⩾ 15 yrs old • Attending for SANE exam within 72 hrs of sexual assault • 268 eligible (rape or suspected rape)	• n = 225 (84%) • Mean age = 26.1 yrs (SD = 9.8) • Majority single (90%) • Ethnicity: 48% African American, 50% White, 2% Other • n = 46 (37%) reported previous history of rape. • 100% rape or suspected rape • No baseline diffs apart from VI group had higher baseline distress (controlled in analysis).	Controlled Clinical Trial Video (n = 117) versus Standard Care (n = 108) RA, TAM, IBA	Video Intervention (17 mins) • Medical Exam prep video with info about the exam with model coping. • Psychoeducation video on psychological reactions to sexual assault, method for graded exposure and targeting avoidance, strategies to improve mood	• Subjective Units of Distress (SUDs) • The PTSD Symptom Scale – Self report (PSS-SR) • Beck Depression Inventory (BDI) • Beck Anxiety Inventory (BAI) • Family Resource Scale (FRS) • PRE • POST • T1: 6 week (mean = 58.64 days, SD = 22.7) • T2: 6m (mean = 184.75 days, SD = 50.97). • FU interview	• n = 205 TX completion (83% video) • completed one follow up n = 140 (68.3%) • T1: n = 123 (60%; 61-Vid; 62-SC) • T2: n = 128 (68.3%; 62 video, 66 non-video)	For women with prior rape history: • T1: Video versus SC had lower PSS-SR (CR = -3.45; 90% CI for B: -18.95 to – 2.75; r = -0.28; medium ES). N.s at T2. • T1: Video versus SC had lower BDI (CR = -2.88; 90% CI for B = -18.89 to -1.04; r = -0.24; small-medium ES) and T2 with smaller ES (CR = - 1.54; 90% CI for B: -14.40 to -3.61; r = -0.13) For those with no prior rape history: • At T1 Video associated with increase in PSS-SR (CR = 1.32; 90% CI for B: -3.50 – 10.87; r = 0.11; small effect size) and higher BAI (r = 0.15; CR = 1.71; 90% CI for B: -3.03 to 14.89; r=0.15; modest effect size). N.s at T2. • N.s. effect on BDI at T1/T2
Walsh et al. (2017) . Assess efficacy of video to reduce drug and alcohol use after a sexual assault.	One of two medical centres in a Mid westerncity area (USA)	• Women • ⩾15 years old • English speaking • 711 eligible (466 excluded)	• N = 245 (34.5%) • Mean age = 27.5 yrs (SD = 9.3) • Married/cohabiting 13.6%; Single 74%; Divorce/widow 12.3% • Minority ethnic status 57.1% • Student 13.6%; Employed 34.4% • Prior sexual assault 61.7% • Past year binge drinking 44.2% • Past-year marijuana use 46.8%	Randomised Controlled Trial Prevention of Post-Rape Stress Video (n= 77) versus Pleasant Imagery and Relaxation Video (n = 77) versus Treatment as usual (n = 79) RA, IBA	Prevention of Post-Rape Stress Video (PPRS; 9 mins) • Medical exam preparation. • Psychoeducation on sexual assault, methods for targeting avoidance and graded exposure, alternative non-substance coping strategies. Pleasant imagery and Relaxation Video (PIRI; 9 minutes) • Diaphragmatic breathing, muscle relaxation, pleasant imagery and sounds. Treatment as Usual Completion of SANE exam	• Alcohol and Marijuana Use: ƒ of use, past 2weeks at FUs. Self-report alcohol use (days x drinks) or marijuana use (days) • Problematic Alcohol and Drug Use: Alcohol Use Disorder Identification Test (AUDIT) and Drug Abuse Screening Test (DAST) to assess in year prior to rape at T1; since rape at T3 • Baseline • T1: 2 months (M days = 56.95, SD = 24.87) • T2: 3.5 months (M days = 107.63, SD = 25.17) T3: 6.5 months (M days = 195.20; SD = 55.38).	• N = 233 tx completers • T1: 66% (n=154) • T2: 88% of these (n = 135) T3: 79% of these (n = 121)	• N.s. main effect of VI. In past year binge drinkers: • T3: PPRS versus TAU lower log odds of alcohol use (p < .0004). N.s. trend for PPRS versus PIRI. Minority Status: • T3: PPRS versus TAU n.s. trend for lower alcohol use in minority women and lower DAST in non-minority. Marijuana Use: • For those with no past year marijuana use: T1: PPRS versus PIRI = lower use (p < .0004) and T3: PPRS v TAU = lower use (p < .0004). • T1 and T2: Those without prior sexual assault history: PPRS versus PIRI fewer days marijuana use (p < .0004). • T3: Those with prior sexual assault history: PPRS versus PIRI less marijuana use (p < .0004).
Effectiveness of Individual Cognitive-Behavioural Based Interventions
Anderson and Frank (1991) * Includes Frank et al. (1988) To compare outcomes for 4 txs: Cognitive behavioural therapy (CBT); Systematic Desensitisation (SD) Psycho-educational Intervention (PEI); Psychological Support (PS).	Referred by two rape crisis centres in Allegheny County, Pittsburgh, USA	• Women •  < 1 month post sexual assault • 532 eligible;	• Total n = 231 (51.3%) • CBT-SD: n =60; mean age 23.3yrs (SD = 7.4) • PEI-PS: n=88; mean age is 25.4yrs (SD=9.0) • Majority single (86%) • Ethnicity: CBT and SD: 81.4% Caucasian; 18.6% African American; PEI and PS: 69% to 31% African American. • 100% rape • No baseline diffs between groups.	Controlled Clinical Trial CBT (n = 50) vs SD (n = 49) versus PEI (n = 69) versus PS (n = 63) RA, TAM for CBT-SD; Session content specified	• CBT (14hrs) reduce avoidance address unhelpful thoughts • SD (14hrs) Progressive muscle relaxation; imaginal exposure. • PEI (4hrs) Info on rape reactions, how to manage them, rape myths and reactions of others, support • PS (4hrs) Control for benefit of support alone. • Therapists were clinical psychs or psychiatric s/w • Weekly Individual sessions	• Beck Depression Inventory • Modified Veronen-Kilpatrick Fear Survey • Depressed versus not depressed ( < 16 on BDI) • PRE • POST 3 , 6 , 12 months FU	Tx Completion: • CBT: n = 34 (68%) • SD: n = 26 (53.1%) • PEI: n = 48 (69.9%) • PS: n = 40 (63.5%)	• CBT and SD and PEI and PS significant decrease on depression and fear (p < 0.0001) across time points. • N.s. difference between CBT v SD or PEI v PS, or CBT-SD versus PEI-PS at any time point. • Clinically signif. depression: At 3m 10% of CBT-SD versus 28% of PEI-PS, p < 0.01.; Trend at 6 mth, p =0.09; n.s. at 12m (21.1% versus 10%).
Echeburúa et al. (1996) Compare cognitive restructuring and coping-skills training (CR/CS) progressive muscle relaxation training (PR) in tx of acute stress disorder in victims of sexual aggression (over 1 year time).	Psychological counselling centre for women, Basque country, Spain	• Female • ⩾ 15 yrs old • 4-13 weeks post-assault (mean = 5) • Psychological treatment seekers • Meet criteria for Acute PTSD (DSM-III-R) • Screened 31	• N = 20 (66.6%) • Mean age = 22 yrs (SD = 6.9); range = 15-45 yrs • 85% Single; 15% married. • Ethnicity: n/r • 100% rape or attempted rape • No baseline imbalances	Controlled Clinical Trial (two group design with repeated measures) N = 10 in each group RA	• Cognitive Restructuring and Coping Skills Training (CR/CS) Psycho-education, cognitive model, thought modification/stopping; progressive muscle relaxation, cognitive distractions and gradual exposure techniques. Progressive Muscle Relaxation training (PR) • Both individual and weekly • Clinical psychologist • 5 hrs CR/CS; 4.15hr PR	• Clinical Interview Scale of Severity of PTSD Symptoms (DSM-III-R). • Diagnosis of PTSD • Beck Depression Inventory • State-Trait Anxiety Inventory • Modified Veronen and Kilpatrick Survey of Fears • Scale of Adaptation • Assessed during therapist i/v • Pre Tx; Post Tx • 1, 3, 6, 12 month FUs	No Dropouts	• CR/CS lower PTSD symptoms than PR; trend from post (p < .1) but by 12m FU (Mean = 5 (SD = 2.49); versus Mean = 10.5 (SD – 7.16), t = 2.30, p < .05). • Most evident in re-experiencing and avoidance subscales. • All other between group outcomes n.s (fears, anxiety, depression or inadapation). • % PTSD diagnosis: n.s. at any time but at POST: 20% of CR/CS and 50% of PR. At 12m 0% of CR/CS and 20% of PR
Kilpatrick and Veronen (1984) **Paper not available from British Library. Info gained from references e.g. Foa et al, (1993), Anderson and Frank (1991) and Vickerman and Margolin (2009).	Not reported	Rape survivors 6-21 days post-assault Recruited from rape crisis centre (adults)	• N=15 • All women • Ethnicity/Age other details not reported. • Victims randomly allocated to one of three conditions.	Controlled Clinical Trial BBIP (n= 10) versus Repeat Assessment (pre, post, 1, 2 and 3m). versus Delay Assessment (pre, post and 3m)	• Brief Behavioural intervention Procedure (BBIP). Re-experiencing event, express feelings, psycho-ed on fear cycle, guilt/blame, coping skills. • 4-6 hours contact (2 sessions) • Standardised tx delivered by peer counsellors.	• Veronen and Kilpatrick Modified Survey of Fears • Sexual dysfunction • Depression • Anxiety • Pre • Post (6-21 days) • 1, 2 & 3 month FUs	• Dropouts n/reported	• No significant diffs between BBIP, RA, DA conditions • All participants reported reductions on measures of psychopathology at the 3-month assessment (within groups).
Nixon et al. (2016) Examine effect of brief cognitive processing therapy (B-CPT) compared with active treatment as usual (TAU) for survivors of recent sexual assault with Acute Stress Disorder (ASD) Assessment over 1-year period.	A community sexual assault centre in Adelaide Australia	• Consecutive clients seeking tx at sexual assault crisis centre • > 18 yr old • Rape/sexual assault in past month • Met criteria for ASD • If applicable - stable on meds for 4 weeks. • N = 57/158 eligible.	• N = 47 (82%) • B-CPT: 1 male; 23 female (Mean age = 32.46 yrs, SD = 11.43) • TAU: 22 female (Mean age = 29.95 yrs, SD = 8.48) • Mostly Caucasian • 86% had co-morbid diagnosis, 77% previous sexual trauma, 30% psych admission. • Clinically negligible diffs on baseline variables	Controlled Clinical Trial Brief-CPT (n=25) versus TAU (n = 22) Sequential RA, TAM, IBA, ITT	• Brief Cognitive Processing Therapy (B-CPT) Modified CPT protocol; cognitive restructuring, writing and processing trauma. • 6 weekly sessions (90mins) • Treatment as Usual (TAU). Eclectic community practices. Not systematic CBT/exposure • Average 3.5 sessions • TAU received 4-5 extra sessions post tx phase. • 9 female therapists RA to CPT or TAU.	• Clinician administered PTSD scale (CAPS) • PTSD Checklist Self-report (PCL-S) • Post-traumatic Cognitions inventory (PTCI) Beck Depression Inventory (BDI) • Pre • Post (1 week tx) • 3, 6 & 12 months FU	• N = 46 tx completed • B- CPT • POST n = 15 • 3m n =11 • 6m n = 10 • 12m n = 12 TAU • POST n = 17 • 3m n =13 • 6m n = 14 • 12m n = 13	• Both B-CPT and TAU groups demonstrated large and clinically significant reductions in PTSD (ES: 0.76 – 1.45) and depression (ES: 0.42- 0.92). Moderate - large ES for PTCI reduction (0.42 to 0.94) at each FU • Smaller between group effect sizes typically favoured CPT (ES: 0.13 – 0.50 posttraumatic stress and 0.13-0.41 depression) over the course of FUs • N.s. diffs in PTSD diagnosis • Independent assessment of PTSD severity: more CPT group reached good end state functioning at 12m (50%) versus TAU (31%), p=0.32 • Comparable Adverse effects
Rothbaum et al. (2012) To examine effect of modified prolonged exposure therapy on posttraumatic stress reactions at 4 and 12-weeks post-trauma.	Public Hospital Emergency department, largest in Georgia, USA	• Mixed trauma sample: rape subgroup • Age 18 – 65 yrs • within 72 hrs. • Met Criterion A of DSM-IV for type of trauma. • Acute stress higher in intervention (controlled in analysis).	• Mixed trauma N = 137 • N = 47 for rape trauma subgroup • Age/Ethnicity other demographics not reported for subgroup. • 100% rape	Randomised Controlled Trial Modified Prolonged Exposure (n = 28) versus Assessment only (n = 19) RA, TAM, IBA	Modified Prolonged Exposure • Imaginal and in vivo exposures to trauma memories or rape related cues. Psycho-education on trauma, breathing training, homework. • 3 sessions, weekly (1hr long) • Therapists trained in PE and modified protocol to MSc/Doctoral level.	• Standardised Trauma Interview • PTSD Diagnostic Scale (PDS) • Immediate Stress Reaction Checklist (ISRC) • PTSD Symptom Scale – clinician administered (PSS-I) • Beck Depression Inventory (BDI) • Pre; 4-week FU; & 12-week FU	• n = 102 (74%) at 4week FU. • n = 91 (66%) at 12week FU. • Subgroup figures n.r. • Majority in person. Some by phone/mail	For rape subgroup: • At 4 week: PE group had significantly lower PSS-I scores (M=20.10, SE = 2.38) versus assessment (M =30.45, SE = 2.73), with large ES (Cohen’s d =0.7, p < .01) • At 12 week: (M = 16.63, SE= 3.05) versus assessment (M = 25.04, SE = 3.37) with large ES (Cohen’s d = 0.52; p=.05). Results for rape subgroup and Depression not reported. Nor previous trauma PTSD (PDS)
Tarquinio et al. (2012) - To test effectiveness of early EMDR on the psychological consequences of rape.	Referrals to French research centre (n=6); from GP (n=5); or regional support agencies (n= 6).	• First sexual assault experience • Between 24 – 72hr post-assault • Age 18-60yrs	• N = 17 • All female • Mean age = 32.2 yrs (SD = 9.1) • Cohabiting 53%; Married 23.5%; Single 23.5% • 100% rape	Cohort – one group repeated measures.	URG-EMDR (1 session) • Imaginal exposure to trauma, emotional pts identified, desensitisation with rapid eye movement until SUD of 2-3 reached. • Average duration is 1h 53 mins (SD = 48.7 mins) • 1 to 2 h (13/17); 2 to 3 h (3/17); 3 h /more (1/17) • Psychologists	• The Intrusion of Events Scale (IES) • Self-Report Sexual Function • Subjective Units of Distress (SUD) • Pre • Post  • 4-week  • 6-months	No dropouts reported.	• Improvement between pre-post on IES [total Wilks’s λ score (3, 14) = .09, P < .001; Wilks’s λ score for intrusion (3, 14) = .07, P < .001 and Wilks’s λscore for avoidance (3, 14) = .18, p < .001] and SUD (Wilks’s λ (3, 14) = 069, p < .001). N.s at other FUs. • Levels of desire (Wilks’s λ (3,14) =.12) and excitation (Wilks’s λ (3,14) =.09) improve at 4weeks (p < .0001) then stabilised.

Note: n.r.; not reported; n.s.; not significant; yr; year; m; month; tx; treatment; RA; random assignment; TAM; treatment adherence monitored; IBA; independent blind assessor, s/w; social worker, POST; post-treatment; FU; follow up assessment; ITT; intention to treat analysis, ES; Effect Size. Significant values have been presented in bold.