Selime Salim

All Publications

• Written Exposure Therapy and Dialectical Behavior Therapy Skills Training as a Novel Integrated Intervention for Women With Co-Occurring PTSD and Eating Disorders: Two Case Studies. Cognitive and behavioral practice Tilstra-Ferrell, E. L., Salim, S. R., Lopez, C., Foster, A., Hahn, C. K. 2025; 32 (3): 397-414

  Abstract

  Approximately one quarter of people with posttraumatic stress disorder (PTSD) also have an eating disorder (ED). Yet, there is scant research on interventions addressing PTSD and EDs (PTSD-ED) simultaneously. Two case studies illustrate the treatment of two women with PTSD-ED using Written Exposure Therapy (WET) for PTSD combined with targeted skills from Dialectical Behavior Therapy (DBT) for Eating Disorders (i.e., dialectical abstinence, self-soothing, pro/cons, mindful urge-surfing, coping ahead). Data include pre-, posttreatment, and 6- to 8-week follow-up scores of PTSD and ED symptoms. Client One completed five sessions. At intake, she met criteria for PTSD and Other Specified Feeding and Eating Disorder based on information gathered in a clinical interview and self-report measures. She reported reductions in both PTSD and ED symptoms at posttreatment and at a 6- to 8-week follow-up. Client Two completed seven sessions. At intake, she met criteria for PTSD and Binge Eating Disorder (BED) based on information gathered in a clinical interview and self-report measures. She reported reductions in symptoms of PTSD and BED at her final session and at a 6- to 8-week follow-up. Results from the presented case studies suggest WET for PTSD combined with DBT skills for EDs shows promise for reducing co-occurring PTSD and ED. Future studies should formally assess the feasibility, acceptability, and effectiveness of integrated WET and DBT skills for the treatment of PTSD-ED.

  View details for DOI 10.1016/j.cbpra.2024.02.004

  View details for PubMedID 40787091

• Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series BEHAVIORAL SCIENCES Hahn, C. K., Salim, S. R., Tilstra-Ferrell, E. L., Brady, K. T., Marx, B. P., Rothbaum, B. O., Saladin, M. E., Guille, C., Gilmore, A. K., Back, S. E. 2025; 15 (7)

  Abstract

  Background/Objectives: The co-occurrence of posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) symptoms is common following sexual assault, particularly among emerging adult women. CUD is associated with more severe PTSD symptoms and other mental health comorbidities including depression, suicidality, and emotion dysregulation. Addressing these issues concurrently soon after sexual assault could help decrease the risk for downstream negative health outcomes. Integrated trauma-focused interventions for PTSD and co-occurring substance use disorders have been shown to decrease PTSD severity and substance use. Yet, existing protocols are lengthy and have rarely been applied following recent trauma exposure or specifically to address CUD symptoms. Methods: This case series describes the application of Written Exposure Therapy (WET) for PTSD adapted to integrate cognitive-behavioral skills training for substance use among women following recent sexual assault. The adapted integrated intervention, Skills Training and Exposure for PTSD and Substance Misuse (STEPS), was delivered to three emerging adult women (age range = 19-25) who experienced recent sexual assault (weeks since assault range = 1-12 weeks). Results: This case series describes the novel intervention and examines clinical outcomes post-treatment and at the 1-month follow-up. Past-week PTSD symptoms (based on a clinical interview) and past-month cannabis use decreased among all participations after receiving STEPS. Conclusions: Preliminary findings from the case series provide new knowledge and insights regarding the application of STEPS following recent sexual assault among individuals with co-occurring PTSD and CUD. Therapeutic strategies for addressing PTSD and CUD concurrently and implications for future clinical research are discussed.

  View details for DOI 10.3390/bs15070877

  View details for Web of Science ID 001535462400001

  View details for PubMedID 40723661

  View details for PubMedCentralID PMC12292178

• Irresponsibility Stereotypes Exacerbate Effects of Sexual Violence on Cisgender Bisexual Women's Coping Drinking Motives JOURNAL OF STUDIES ON ALCOHOL AND DRUGS Salim, S., Bhuptani, P., Tilstra-ferrell, E., Hahn, C., Messman, T. 2025; 86 (3): 455-460

  Abstract

  Bisexual women experience disparities in alcohol use outcomes compared with both lesbian and heterosexual women. Bisexual women also experience higher rates of sexual violence and alcohol use following sexual violence. We examined whether coping drinking motives explain the link between adult sexual violence severity and alcohol use and whether dimensions of binegativity (i.e., hostility, instability, irresponsibility) moderate the effects of sexual violence.The sample consisted of 355 young (ages 18-35) cisgender bisexual women drinkers (mean age = 25.8, 84.2% White) recruited via MTurk. Measures included the Sexual Experiences Survey-Short Form Victimization, Anti-Bisexual Experiences Scale, Modified Drinking Motives Questionnaire-Revised, and Alcohol Use Disorders Identification Test-Consumption subscale. The PROCESS macro for SPSS was used.There was an interaction between sexual violence severity and irresponsibility stereotypes in predicting coping motives. Sexual violence severity related to greater coping motives at mean and high, but not low, levels of irresponsibility stereotypes. Indirect effects of sexual violence severity on alcohol use via coping motives were significant at mean and high, but not low, levels of irresponsibility stereotypes. Hostility and instability dimensions of binegativity did not interact with sexual violence severity in predicting coping motives.Results identified sexual violence severity and irresponsibility stereotypes as compounding experiences that may explain greater alcohol use. Bisexual women exposed to this dimension of binegativity may be particularly vulnerable to drinking alcohol to cope with distress following sexual violence. Interventions for alcohol use may be enhanced by helping bisexual women cope with sexual violence-related distress and irresponsibility stereotypes.

  View details for DOI 10.15288/jsad.23-00407

  View details for Web of Science ID 001502644500016

  View details for PubMedID 39105575

• Mental Health Symptoms and Substance Use After Recent Sexual Assault Based on Sexual Orientation. Violence and victims Salim, S. R., Tilstra-Ferrell, E. L., Mai, K., Rheingold, A., Gilmore, A. K., Hahn, C. K. 2025

  Abstract

  The current study examined differences in acute stress and depression symptoms, alcohol use, and drug use between sexual minority and heterosexual survivors in the weeks following a sexual assault. The sample included 26 sexual minority and 66 heterosexual survivors (N = 92, 94.4% cisgender women, 51.1% White, and 31.5% Black) who completed screening during a follow-up mental health service after receiving a sexual assault medical forensic examination. Group differences on brief mental health and substance use screening measures were examined using χ2 tests and t tests. Sexual minority survivors reported higher acute stress symptoms and were more likely to report drug use in the past 2 weeks, but no differences in depression symptoms and alcohol use were found. Results highlight the need for increased research on sexual minority survivors' unique experiences and needs following recent sexual assault.

  View details for DOI 10.1891/VV-2024-0011

  View details for PubMedID 39904533

• Characterizing Engagement with Web-Based Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Traumatic Stress and Substance Misuse After Interpersonal Violence. International journal of environmental research and public health Brockdorf, A. N., Tilstra-Ferrell, E. L., Danielson, C. K., Moreland, A. D., Rheingold, A. A., Salim, S. R., Gilmore, A. K., Siciliano, R. E., Smith, D. W., Hahn, C. K. 2025; 22 (2)

  Abstract

  Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal violence are prevalent and associated with greater substance misuse; however, more research is needed to refine the delivery of PTSD-substance use content within the SBIRT model. This study examined clinical data collected as part of a web-based SBIRT developed for co-occurring substance misuse and PTSD symptoms after interpersonal violence to characterize the clinical symptoms and responses of adults presenting to agencies serving intimate partner and sexual violence survivors. The respondents (N = 52) completed self-report measures during the SBIRT tool to personalize the recommendations, as well as motivational enhancement exercises. Descriptive statistics were conducted. The results underscored high rates of probable PTSD, substance use, and trauma-related motives for substance use. The respondents were ready to change their substance use on average after receiving personalized feedback. Many expressed values related to trauma recovery and self-empowerment, perceived these values as useful for substance use reduction, and set goals to seek mental health services or reduce their drinking quantity. The findings point to several clinical targets for integrated PTSD-substance misuse interventions for interpersonal violence survivors.

  View details for DOI 10.3390/ijerph22020190

  View details for PubMedID 40003416

  View details for PubMedCentralID PMC11855337

• Bisexual minority stress as a risk factor for sexual violence-related posttraumatic stress disorder symptoms among bisexual+ women: A multilevel analysis. Journal of traumatic stress Salim, S. R., Harper, K. L., Livingston, N. A., Feinstein, B. A., Messman, T. L. 2024

  Abstract

  Bisexual+ (e.g., bisexual, pansexual, queer) women experience higher rates of sexual violence (SV) and posttraumatic stress disorder (PTSD) than heterosexual and lesbian women, as well as unique identity-related minority stress. We examined between- and within-person associations between bisexual minority stress and PTSD symptoms related to SV in a sample of young bisexual+ women (N = 133) who reported adult SV (Mage = 22.0 years, range: 18-25 years; 85.0% White; 99.3% cisgender). We analyzed data from four waves of data collection (baseline to 3-month follow-up) using multilevel models. Controlling for SV severity, there was a significant within-person effect of antibisexual stigma from lesbian/gay people on PTSD, beta =.17, p =.010, suggesting that at waves when women experienced more stigma, they also reported higher PTSD symptom levels. At the between-person level, women who reported higher levels of antibisexual stigma from heterosexual people, beta =.26, p =.043, and anticipated binegativity, beta =.29, p =.005, on average across study waves also reported higher average levels of PTSD. Additionally, anticipated binegativity explained the association between average antibisexual stigma and PTSD, beta =.15, p =.014, 95% CI [0.45, 4.61]. Bisexual minority stress may be associated with higher PTSD symptom severity following SV among young bisexual+ women, and the anticipation of binegativity may be a target mechanism in this association. Study findings highlight the importance of examining the joint contributions of SV and minority stress to identify novel targets for future research and practice to address PTSD symptoms.

  View details for DOI 10.1002/jts.23102

  View details for PubMedID 39290082

• Suicidal Thoughts Among Young Bisexual Women: Sexual Violence, Minority Stress, and Interpersonal Factors JOURNAL OF COUNSELING PSYCHOLOGY Salim, S. R., Messman, T. L. 2024

  Abstract

  The present study tested a model of suicidal thoughts among bisexual women focusing on sexual violence, bisexual minority stress, and risk factors for suicide identified within the interpersonal theory of suicide (i.e., perceived burdensomeness and thwarted belongingness). The model was tested using cross-sectional, baseline data and longitudinally using 3- and 6-month follow-up assessments in a sample of bisexual women (N = 393, 98.3% cisgender, ages 18-35). Using structural equation modeling, we tested a serial mediation model predicting recent suicidal thoughts related to sexual violence and antibisexual stigma via internalized binegativity and expectations of rejection and subsequent perceived burdensomeness and thwarted belongingness. Findings suggest that bisexual minority stress and child/adolescent sexual abuse relate to suicidal thoughts among bisexual women. In the cross-sectional model, the hypothesized serial links between antibisexual stigma and concurrent suicidal thoughts via expectations of rejection and internalized binegativity and subsequent perceived burdensomeness were significant. These paths were not significant in prospective analyses. Child/adolescent sexual abuse (but not adult sexual assault) related to suicidal thoughts via perceived burdensomeness; these paths were not significant in prospective analyses. It appears important to address both universal (i.e., perceived burdensomeness) and group-specific (i.e., expectations of rejection and internalized binegativity) mechanisms of risk in suicide prevention efforts with young bisexual women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

  View details for DOI 10.1037/cou0000752

  View details for Web of Science ID 001300823100001

  View details for PubMedID 38990661

• Latent Profiles of Social Reactions to Sexual Assault Disclosure Among Bisexual Women PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY Salim, S. R., Katz, B. W., Eshelman, L. R., Bhuptani, P. H., Hahn, C., Messman, T. L. 2024

  Abstract

  Bisexual women experience higher rates of sexual assault (SA) and posttrauma distress compared to monosexual women. We examined the patterns of reactions to SA disclosure (positive and two types of negative) and bisexual minority stress (antibisexual stigma from heterosexual and lesbian/gay people, internalized binegativity) experienced by young bisexual women who experienced adult SA. We also examined differences in assault-related experiences, posttraumatic stress disorder and depression symptoms, and hazardous drinking based on the identified patterns.The current sample was drawn from two parent samples of women and included survivors who had disclosed an adult SA: (a) n = 149 bisexual women (98% cisgender, ages 18-35, 87.9% White) recruited via Amazon's Mechanical Turk and (b) n = 81 cisgender bisexual women (ages 18-25, 84% White) recruited via online ads. Latent profile analyses and analyses of variance were conducted.Analyses identified four latent profiles characterized by: (a) low stigmatizing responses, (b) high negative SA disclosure reactions, (c) high antibisexual stigma, and (d) highest stigmatizing responses. The fourth profile had higher posttraumatic stress disorder and depression symptoms and hazardous drinking compared to the other profiles.Results suggest women in the profile characterized by highest negative reactions to SA disclosure and highest bisexual minority stress (antibisexual stigma and internalized binegativity) may experience greatest distress postassault. Results highlight the importance for researchers, policymakers, and clinicians to consider and address both SA-related and identity-related stigma among bisexual survivors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

  View details for DOI 10.1037/tra0001722

  View details for Web of Science ID 001300834500001

  View details for PubMedID 38976387