Adult Sexual Assault Research Articles

Correlates of Posttraumatic Growth in Adult Sexual Assault Victims.

This exploratory study examined how demographics, child sexual abuse (CSA), assault-related factors, and post-assault responses predict posttraumatic growth in a diverse sample (N = 1863) of female adult sexual assault victims. Multiple regression analysis showed that demographics (older age, ethnic minority race, less education) were all significantly related to greater posttraumatic growth, while CSA was unrelated to posttraumatic growth. Assault characteristics were weaker predictors of posttraumatic growth; whereas women's perception of life threat during the assault was related to greater posttraumatic growth. Post-assault factors including: greater levels of maladaptive coping, characterological self-blame, negative social reactions from others, and posttraumatic stress disorder (PTSD) symptoms were all related to less posttraumatic growth. Conversely, positive social reactions from others, perceived control over recovery, adaptive individual coping, and disrupted core beliefs were all related to greater posttraumatic growth. Clinicians should facilitate these modifiable social psychological factors when treating survivors.

The relationship between adulthood traumatic experiences and psychotic symptoms in female patients with schizophrenia

Previously, research aiming to investigate the effects of interpersonal traumatic experiences on psychotic symptoms mainly focused on adverse experiences in childhood. As mentioned above, patients with schizophrenia, particularly women, are at high risk for physical and sexual abuse in adulthood. In this study we aimed to investigate the effects of adulthood trauma in a sample of patients with schizophrenia who did not report childhood trauma. Seventy female patients with schizophrenia participated in the study. Assessment included Traumatic Experiences Checklist, Positive and Negative Syndrome Scale and Calgary Depression Scale for Schizophrenia. The rates of traumatic events were as follows: physical abuse (81.4%), emotional abuse (78.6%), emotional neglect (55.7%), sexual harassment (28.6%), and sexual abuse (24.3%). Positive and Negative Syndrome Scale hallucinations, blunted affect, emotional withdrawal hostility, anxiety and affective lability item scores were significantly higher for patients who reported a history of sexual harassment. Patients who were exposed to sexual assault as adults had significantly higher scores in the Positive and Negative Syndrome Scale, anxiety, anger and difficulty in delaying gratification items. We concluded that traumatic life events and exposure to violence were common among female patients with schizophrenia and sexual trauma in adulthood was associated with particular clinical symptoms.

The role of ethnicity, sexual attitudes, and sexual behavior in sexual revictimization during the transition to emerging adulthood.

An experience of child sexual abuse (CSA) substantially increases women's risk of adult sexual assault (ASA), but the mechanisms underlying this relationship are unclear. Previous research often has not examined the full range of ASA experiences or included the influence of ethnicity, sexual behavior, and sexual attitudes on CSA and severity of ASA. The current study utilized path analysis to explore the relationships among ethnicity, sexual attitudes, number of lifetime sexual partners, CSA, and severity of ASA in emerging adult women. Results indicated a significant relationship between CSA and more severe ASA that was partially explained by having more lifetime sexual partners. Additionally, European American women, relative to Hispanic women, reported more severe victimization, which was fully explained by more positive attitudes toward casual sex and having more lifetime sexual partners. These results have implications in the design and implementation of universal and selective prevention programs aimed at reducing ASA and revictimization among emerging adult women.

Lifetime victimization and physical health outcomes among lesbian and heterosexual women.

BackgroundLifetime victimization experiences, including child sexual abuse (CSA), child physical abuse (CPA), adult sexual assault (ASA), and adult physical assault (APA), are associated with health problems.PurposeTo examine relationships between cumulative victimization and physical health among heterosexual and lesbian women and determine whether these relationships differ by sexual identity.MethodsLarge samples of heterosexual (n = 482) and lesbian women (n = 394) were interviewed. Questions included lifetime victimization experiences and physical health problems.ResultsCompared to women who reported no childhood victimization, those who reported experiencing both CSA and CPA were 44% more likely to report health problems and women who experienced all four types of victimization (CSA, CPA, APA, ASA) were nearly 240% as likely to report physical health problems. Interaction analyses revealed the association between victimization and physical health did not differ by sexual identity.ConclusionsAlthough lesbians were more likely to report all types of victimization, results suggest that victimization conferred increased physical health risks regardless of sexual identity.

Safer in Jail? A Comparison of Victimization History and Psychological Adjustment Between Previously Homeless and Non-Homeless Incarcerated Women

Homelessness and incarceration are closely linked among women, and rates of these marginalizing circumstances are increasing. Nonetheless, few studies have examined differences between female inmates who were previously homeless and female inmates who were not homeless prior to incarceration. Results indicated that women who were homeless prior to incarceration were more likely (relative to their non-homeless counterparts) to have experienced childhood molestation, adult sexual assault, and arrests for prostitution and to have been in treatment for substance misuse. Homeless and non-homeless women did not differ significantly on measures of psychological adjustment. Implications, limitations, and suggestions for future research will be discussed.

Traumatic Revictimization of Men Who Have Sex With Men Living With HIV/AIDS

Abuse in childhood has been established as a predictor of adult abuse, with the strongest associations found between childhood sexual abuse (CSA) and adult sexual victimization. Revictimization has been demonstrated among women, and there is a growing literature on revictimization experiences among men who have sex with men (MSM). No studies have assessed revictimization among MSM living with HIV, despite strong evidence for disproportionately high rates of life span abuse among this group, along with the added vulnerability of living with HIV and sexual minority stress. In this study, we contribute to the literature by exploring associations between multiple types of childhood and adult abuse experiences (physical, sexual, and psychological; perpetrated by partners and non-partner), rather than examining sexual victimization alone. A sample of 166 HIV-positive MSM attending primary HIV health care clinics in Seattle, Washington, completed a one-time questionnaire. Results of regression analyses revealed associations between experiencing CSA and adult sexual abuse, and experiencing childhood physical abuse and adult physical and sexual abuse. Childhood psychological abuse was associated with adult physical and psychological abuse and partner psychological abuse. At higher frequencies, childhood psychological abuse was associated with all forms of adult abuse. These findings suggest that various forms of childhood abuse experiences confer broad vulnerability to adult abuse experiences and point to potentially different pathways to revictimization based on childhood abuse type.

Trauma, posttraumatic stress disorder, and depression among sexual minority and heterosexual women veterans.

This study examined the impact of various traumas across the life span on screening positive for current posttraumatic stress disorder (PTSD) and depression among heterosexual and sexual minority women veterans. Women veterans were recruited over the Internet (N = 706, 37% lesbian or bisexual) to participate in an anonymous, online survey. We assessed childhood trauma; adult sexual assault and adult physical victimization before, during, and after the military; combat exposure; perceived sexist discrimination during military service; sexual minority military stressors; past-year sexist events; and whether participants screened positive for PTSD or depression. Binary logistic regressions were used to generate odds ratios and 95% confidence intervals for PTSD and depression, stratified by sexual orientation and controlling for demographic characteristics. Lesbian and bisexual women reported higher rates of trauma across the life span, although in some instances (e.g., sexual assault during and after military service, combat exposure), they did not differ from their heterosexual counterparts. Childhood trauma and traumas that occurred during military service added the most variance to both PTSD and depression models. Sexual assault during military service appeared to be especially harmful with respect to screening positive for PTSD for both sexual orientation groups. Results revealed a number of other predictors of mental health status for women veterans, some of which differed by sexual orientation. Findings indicate a significant burden of interpersonal trauma for both heterosexual and lesbian/bisexual women veterans and provide information on the distinct association of various traumas with current PTSD and depression by sexual orientation.

Annex to Report of the Response Systems to Adult Sexual Assault Crimes Panel

This volume contains the reports completed by the Subcommittees of the Response Systems Panel (RSP), presented to the full Panel for their consideration in preparing the Report of the RSP.

Labeling of sexual assault and its relationship with sexual functioning: the mediating role of coping.

Little research has examined the relationship between women's labeling of their sexual assault experiences and sexual functioning, as well as identification of variables that may mediate the labeling-trauma outcome relationship. The purpose of this study was to fill this gap in the literature, by examining the potential mediating role of coping strategies in response to sexual assault in the relationship between labeling and sexual functioning. The sample included 135 college women with a history of adolescent/early adulthood sexual assault. Labeling was not bivariately related to sexual functioning outcomes; however, anxious coping mediated the relationships between labeling and both sexual lubrication and sexual satisfaction. This suggests that correlational analyses between labeling and trauma outcomes may not capture the complexity of this relationship, as it may be more indirect. Furthermore, results suggest that labeling is part of the coping process in response to sexual assault; some women who consider their experience to be sexual assault may engage in anxious coping efforts, contributing to difficulties with sexual lubrication and sexual dissatisfaction. Victims actively working to integrate their sexual assault experience with prior beliefs and self-concept may benefit from treatment focused on decreasing anxious coping, especially as it relates to sexual functioning.

The Impact of Sexual Assault Nurse Examiner Programs on Criminal Justice Case Outcomes: A Multisite Replication Study.

To address the underreporting and underprosecution of adult sexual assaults, communities throughout the United States have implemented multidisciplinary interventions to improve postassault care for victims and the criminal justice system response. One such model is the Sexual Assault Nurse Examiner (SANE) Program, whereby specially trained nurses provide comprehensive psychological, medical, and forensic services for sexual assault. In this study, we conducted a multisite evaluation of six SANE programs (two rural programs, two serving midsized communities, two urban) to assess how implementation of SANE programs affects adult sexual assault prosecution rates. At each site, most sexual assaults reported to law enforcement were never referred by police to prosecutors or were not charged by the prosecutor's office (80%-89%). Individually, none of the sites had a statistically significant increase in prosecution rates pre-SANE to post-SANE. However, when the data were aggregated across sites, thereby increasing statistical power, there was a significant effect such that cases were more likely to be prosecuted post-SANE as compared with pre-SANE. These findings suggest that the SANE intervention model does have a positive impact on sexual assault case progression in the criminal justice system. Nevertheless, there is still a pressing need for improvement as the vast majority of both pre-SANE and post-SANE resulted in nonreferral/no charges filed.

An Exploratory Study of Trauma and Religious Factors in Predicting Drinking Outcomes in African American Sexual Assault Survivors.

This exploratory study examined the relationships between religious factors, trauma histories and life satisfaction to alcohol-related outcomes in adult sexual assault survivors. A mail survey was administered to a community sample of African American survivors (N = 836) in the Chicago metropolitan area. Hierarchical regression analyses showed that for non-religious women, interpersonal trauma was related to greater frequency of heavy drinking. For moderately religious women, interpersonal and contextual traumas were related to more frequent heavy drinking. For highly religious women, religious coping was related to less frequent heavy drinking. Implications are drawn for research and treatment of female survivors.

Sexual abuse in adulthood: when psychic and somatic suffering merge

Sexual abuse is a traumatic event with heavy consequences in terms of clinical implications and quality or quantity of life. The mediation of the development of post-traumatic stress disorder accounts for many of the presented symptoms, but not for the whole range of them, especially if violence is suffered during childhood. From the analysis of its epidemiology and consequences, it can be derived that this disorder is dramatically widespread and cannot be any longer ignored but preventive efforts and early intervention are required. Current therapeutic options that have been proven to be effective are discussed, though further research is warranted to improve treatment strategies.

Sexual Assault Risks Among Gay and Bisexual Men

The goal of this study was to examine lifetime patterns of sexual assault and associated risks among a purposive sample of gay and bisexual men (N = 183; 18 to 35 years old, M = 24.3). Cross-sectional data were collected via written, self-administered questionnaires and face-to-face, event-based qualitative interviews. Alcohol severity scores indicated high rates of hazardous drinking (53.0%) and possible dependence (14.2%) among participants. One-half of men (50.8%) reported childhood sexual abuse (CSA), and 67.2% reported adult sexual assault (ASA). Average age at most recent ASA was 21 years. Most perpetrators (83.9%) of recent ASA incidents were male; 67.0% of participants reported consuming alcohol and/or drugs prior to the most recent incident. Regression findings indicated more severe CSA experiences and past alcohol-related problems predicted recent severe ASA. Although we found similarities between gay and bisexual men in lifetime sexual assault history, we found some distinct differences in ASA risk factors. Bisexual men reported higher alcohol severity scores, more female ASA perpetrators, higher internalized homophobia scores, and fewer male sexual partners than gay men. Findings suggest the need for interventions that reduce ASA risk among sexual minority men—and the potential benefits of focusing on alcohol consumption in risk reduction efforts.

History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain

We sought to determine the relationship among a history of physical or sexual abuse, pain experience, and depressive symptoms among women with chronic pelvic pain (CPP). This was a cross-sectional study of women who presented to a tertiary referral center for evaluation of CPP (N = 273). All participants completed standardized questionnaires to assess a history of physical or sexual abuse, pain severity, pain disability, and depressive symptoms. Subjects were grouped by abuse category and compared to CPP participants without history of abuse. Multinomial logistic regression models were used to determine the association between adolescent or adult and childhood physical or sexual abuse with pain intensity, pain-related disability, and depressive symptoms. Logistic regression analyses indicated that, after controlling for age and education, none of the abuse categories was associated with pain severity. However, adolescent or adult sexual abuse predicted greater pain-related disability (odds ratio, 2.39; 95% confidence interval, 1.05-5.40), while both adolescent or adult physical and sexual abuse were associated with higher levels of depression (both P < .05). Level of education was significantly associated with pain intensity, pain disability, and depression. For our sample of women with CPP, a history of abuse during childhood or adulthood was not associated with differences in pain intensity, but adolescent or adult sexual abuse was associated with greater pain-related disability. A history of physical abuse or sexual abuse appears to hold a stronger relationship with current depressive symptoms than pain experience for women with CPP. Educational achievement holds a robust relationship with pain morbidity and depression for this population.

Coping, Emotion Regulation, and Self-Blame as Mediators of Sexual Abuse and Psychological Symptoms in Adult Sexual Assault

This study examined whether coping, emotion regulation, and self-blame mediate relationships of trauma histories with post-traumatic stress disorder and depression in adult sexual assault victims (N = 1863). A path analysis showed that theorized mediators partially mediated associations between trauma history variables and psychological symptoms. Specifically, child sexual abuse severity was related to greater post-traumatic stress disorder and depression indirectly through maladaptive coping and decreased emotion regulation but not self-blame. Other traumas had direct relationships with symptoms and partially mediated effects through maladaptive coping and emotion regulation. Child sexual abuse was unrelated to self-blame, but other traumas were related to greater self-blame. Results differed according to whether women had counseling post-assault. Implications are drawn for future research and clinical treatment of adult sexual assault victims.

Report of the Response Systems to Adult Sexual Assault Panel

This report represents the culmination of a twelve-month review and assessment of the systems used to investigate, prosecute, and adjudicate adult sexual assault crimes in the military and recommendations to improve the effectiveness of such systems.

The role of alcohol use during sexual situations in the relationship between sexual revictimization and women's intentions to engage in unprotected sex.

Research has demonstrated relationships among childhood sexual abuse, adult sexual assault, and sexual risk taking. This study proposes that one mechanism through which the victimization-sexual risk-taking relationship works is through an increased likelihood of drinking during sexual situations. Using path analysis, this study explores this hypothesis in a sample of 230 women. The model illustrates that women with a history of child and adult sexual victimization reported greater intentions to engage in unprotected sex and that this relationship is in part accounted for by an increased likelihood of drinking in sexual situations. The results suggest that sexual risk reduction programs and sexual assault treatment programs should educate women about the alcohol-involved sexual risk taking that often follows sexual assault victimization.

Correlates of Perceived Helpfulness of Mental Health Professionals Following Disclosure of Sexual Assault

A diverse sample of more than 365 adult sexual assault survivors, recruited from college and community sources, was surveyed about sexual assault experiences, post-assault factors, and perceived helpfulness of and satisfaction with mental health professionals. Regression analyses were conducted to identify factors associated with perceived helpfulness of and satisfaction with mental health professionals. Older age, higher posttraumatic stress disorder (PTSD), greater control over recovery, and more emotional support reactions were associated with positive perceptions of mental health professionals. Stranger offenders, greater resistance during assault, high victim post-assault upset, and blaming social reactions from others were associated with negative perceptions of mental health professionals.

Predicting risky sexual behavior in emerging adulthood: examination of a moderated mediation model among child sexual abuse and adult sexual assault victims.

Although having a sexual victimization history is associated with engaging in sexual risk behavior, the mechanisms whereby sexual victimization increases risk behavior are unclear. This study examined use of sex as an affect regulation strategy as a mediator of the relationship between depressive symptoms and sexual risk behavior among 1,616 sexually active college women as well as examined having a history of child sexual abuse (CSA), adolescent/adult sexual assault (ASA), or both (CSA/ASA) as moderators. Results supported the mediated model as well as moderated mediation, where depressive symptoms were more strongly associated with use of sex as an affect regulation strategy among ASA victims, and sex as an affect regulation strategy was more strongly related to sexual risk behavior for CSA/ASA victims.

The RESTORE Program of Restorative Justice for Sex Crimes

The article reports empirical evaluation of RESTORE, a restorative justice (RJ) conferencing program adapted to prosecutor-referred adult misdemeanor and felony sexual assaults. RESTORE conferences included voluntary enrollment, preparation, and a face-to-face meeting where primary and secondary victims voice impacts, and responsible persons acknowledge their acts and together develop a re-dress plan that is supervised for 1 year. Process data included referral and consent rates, participant characteristics, observational ratings of conferences compared with program design, services delivered, and safety monitoring. Outcome evaluation used 22 cases to assess (a) pre-post reasons for choosing RESTORE, (b) preparation and conference experiences, (c) overall program and justice satisfaction, and (d) completion rates. This is the first peer-reviewed quantitative evaluation of RJ conferencing for adult sexual assault. Although the data have limitations, the results support cautious optimism regarding feasibility, safety, and satisfactory outcomes. They help envision how conferencing could expand and individualize justice options for sexual assault.