Sexual Assault Survivors' Experiences with Mental Health Professionals: A Qualitative Study.

An interview study of 15 sexual assault survivors' narratives examined positive and negative post-assault experiences with mental health professionals. Survivors who told one professional had more positive experiences than those who told multiple professionals. Qualitative analyses revealed how help seeking experiences were related to the context and nature of disclosures, survivors' readiness to disclose, trust building, social reactions received from providers, type of therapy, perceived control over recovery, and mental health system factors impacting access and quality of care. Themes from survivor's accounts illustrate how survivors perceived therapists, which can be used in training mental health professionals encountering survivors in clinical settings.

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.

Exploring the relationships of women's sexual assault disclosure, social reactions, and problem drinking.

The goal of this exploratory study was to examine correlates of sexual assault disclosure and social reactions in female victims with and without drinking problems. An ethnically diverse sample of sexual assault survivors was recruited from college, community, and mental health agencies. Ethnic minority women were less likely to disclose assault, and women with a greater number of traumatic life events disclosed assault more often. Although there were no differences in disclosure likelihood by drinking status; of those disclosing, problem drinkers told more support sources and received more negative and positive social reactions than nonproblem drinkers. Correlates of receiving negative social reactions were similar for normal and problem drinkers; however, negative social reactions to assault disclosure were related to more problem drinking for women with less frequent social interaction. Implications for future research and possible support interventions with problem-drinking victims are provided.

Psychosocial correlates of PTSD symptom severity in sexual assault survivors.

This study's goal was to assess the effects of preassault, assault, and postassault psychosocial factors on current posttraumatic stress disorder (PTSD) symptoms of sexual assault survivors. An ethnically diverse sample of over 600 female sexual assault survivors was recruited from college, community, and mental health agency sources (response rate = 90%). Regression analyses tested the hypothesis that postassault psychosocial variables, including survivors' responses to rape and social reactions from support providers, would be stronger correlates of PTSD symptom severity than preassault or assault characteristics. As expected, few demographic or assault characteristics predicted symptoms, whereas trauma histories, perceived life threat during the assault, postassault characterological self-blame, avoidance coping, and negative social reactions from others were all related to greater PTSD symptom severity. The only protective factor was survivors' perception that they had greater control over their recovery process in the present, which predicted fewer symptoms. Recommendations for intervention and treatment with sexual assault survivors are discussed.

Women's experiences of male-perpetrated sexual assault by sexual orientation.

This study examined differences in male-perpetrated adult sexual assault experiences among women of various sexual orientations using a large urban convenience sample (N = 1,022). Results showed many similarities in disclosure to others, perceived helpfulness, and attributions of blame, but there were also differences by sexual orientation. Heterosexual women were more likely to experience completed sexual assault than lesbian or bisexual women. Lesbians were more likely to be assaulted by relatives than bisexual or heterosexual women. Finally, bisexual women disclosed the assault to the greatest number of formal support sources, were most likely to tell a romantic partner about the assault, received the fewest positive social reactions overall, and had higher posttraumatic stress disorder (PTSD) symptomatology.

The role of victim-offender relationship in women's sexual assault experiences.

This study's goal is to identify differences in background, assault, and postassault factors according to the victim-offender relationship. A mail survey is conducted with more than 1,000 female sexual assault survivors (response rate 90%) recruited from college, community, and mental health agency sources. Stranger assailants are associated with a greater victim perceived life threat, more severe sexual assaults, and ethnic minority victims. Positive social reactions do not vary according to the victim-offender relationship, but stranger victims report more negative social reactions from others than do victims of acquaintances or romantic partners. Assaults by strangers and relatives are associated with more posttraumatic stress disorder (PTSD) symptoms than assaults by acquaintances and romantic partners. As expected, survivors' social cognitive responses to rape and social reactions from support providers are stronger correlates of PTSD symptoms than demographic or assault characteristics in general, but correlates vary across victim-offender relationship groups.

Correlates of comorbid PTSD and drinking problems among sexual assault survivors.

Numerous studies show that sexual assault victims are likely to develop PTSD and have a greater risk of drinking problems than nonvictims. However, little is known about what differentiates survivors with PTSD only from those with comorbid PTSD and drinking problems. In this study, a large, diverse sample of community-residing women who had experienced adult sexual assault was surveyed. Logistic regression analyses were conducted to identify pre-assault, assault, and post-assault factors differentiating survivors with PTSD only from those with PTSD and drinking problems. Results showed that survivors with less education, histories of other traumas, who blamed their character more for the assault, believed drinking could reduce distress, drank to cope with the assault's effects, and received negative social reactions were more likely to have comorbid PTSD and drinking problems than those with PTSD only. Implications for future research and treatment with sexual assault victims are discussed.

Correlates of comorbid PTSD and polysubstance use in sexual assault victims.

A diverse sample of community-residing women in a large metropolitan area who had experienced adult sexual assault was surveyed using standardized measures in an NIAAA-funded study (2003-2004). Four groups (N = 503) of victims: (1) post-traumatic stress disorder (PTSD)-only, (2) PTSD and illicit drug use, (3) PTSD and drinking problems, and (4) PTSD and polysubstance use were compared using bivariate analyses. Victims with PTSD/polysubstance use had lower socioeconomic status, more extensive trauma histories, worse current psychological functioning, more problematic post-assault psychosocial experiences, and more sexual revictimization at follow-up than those with PTSD only. Implications for future research are discussed.

Trauma exposure, posttraumatic stress disorder and problem drinking in sexual assault survivors.

OBJECTIVE: Sexual assault history is associated with higher risk of problem drinking in women, yet little is known about mechanisms linking trauma histories to women's problem drinking. This study examined how trauma histories, alcohol-related cognitive mediators and posttraumatic stress disorder (PTSD) relate to past-year problem drinking in adult female sexual assault survivors. METHOD: Data from self-report questionnaires completed by a large, diverse sample (N = 865) of community-residing women who had experienced adult sexual assault were analyzed. Structural equation modeling was used to test a theoretical model examining the relationship between trauma exposure, alcohol-related cognitive mediators, PTSD symptoms and past-year problem drinking. RESULTS: These analyses suggested that trauma exposure, drinking to cope with distress and tension-reduction expectancies are the most consistent factors associated with problem drinking, whereas PTSD symptoms are not. Drinking to cope and tension-reduction expectancies were both related to greater PTSD symptoms, consistent with self-medication theory. CONCLUSIONS: These results suggest that trauma histories, drinking to cope and tension reduction may be important risk factors distinguishing sexually assaulted women who develop problem drinking from those who do not. Screening women for trauma histories even within samples of victims and assessment of women's ways of coping and beliefs about alcohol's effects may help to identify those at greater risk for problem drinking.

Correlates of women's sexual assault disclosure to informal and formal support sources.

Deciding which people to tell about sexual assault is an important and potentially consequential decision for sexual assault survivors. Women typically receive many different positive and negative reactions when they disclose sexual assault to social support sources. A diverse sample of adult sexual assault survivors in the Chicago area was surveyed about sexual assault experiences, social reactions received when disclosing assault to others, attributions of blame, coping strategies, and PTSD. Analyses were run to identify demographic, assault, and postassault factors differentiating women disclosing to informal support sources only from those disclosing to both informal and formal support sources. Women disclosing to both formal and informal support sources experienced more stereotypical assaults, had more PTSD symptoms, engaged in less behavioral self-blame, and received more negative social reactions than those disclosing to informal support sources only. Implications for future research and intervention are discussed.