This article provides a comprehensive review of the current literature available on factors which increase vulnerability for victimization, impacts of rape and other sexual violence, and approaches to prevent sexual violence. Vulnerability factors include specific demographics, history of child maltreatment, and substance use and abuse. Physical, sexual, and psychological impacts as well as social and relationship impacts are examined. The economic impact of sexual violence is also reviewed citing that women with a history of sexual victimization generally use more medical services than their counterparts and have been found to show a 56% increase of medical visits in the second year after rape. Authors discuss the importance and current practices of primary prevention to reduce prevalence. Health care settings should be used to assess women for vulnerabilities, educate and train young men who display risk factors on bystander intervention strategies, and educate adolescent patients on the risks associated with alcohol.
These summaries were written by SVPEP staff and are based on original papers published within the last 6 years. The information available on this web site is provided as a public service and does not necessarily reflect the opinion of the U.S. Centers of Disease Control and Prevention, the Arizona Department of Health Services, or the University of Arizona. To conduct an individual search or locate older articles use the Search Summary Database which includes over 600 articles related to sexual violence.
Effects
Basile, K. C. & Smith, S. G. (2011). Sexual violence victimization of women: Prevalence, characteristics, and the role of public health and prevention. American Journal of Lifestyle Medicine. DOI:10.1177/1559827611409512.
Primary prevention methods focused on health care settings and did not examine community based interventions.
Brecklin, L. R., & Ullman, S. E. (2010). The roles of victim and offender substance use in sexual assault outcomes. Journal of Interpersonal Violence, (online).
This study examined the impact of victim and offender substance use on sexual assault outcomes among 970 females in a large Midwestern city. Data was obtained from the first wave of a longitudinal study on sexual assault recovery among a community sample. Findings indicated that offender substance use resulted in more victim injuries and more medical attention. Physical force and verbal threats resulted in greater odds of completed rape and injury. Physical resistance by the victim resulted in more injures. Prevention programs should target men and women separately, focus on the role of substance use, offender aggression, and other situational factors.
The sample included women’s reports of the most serious sexual assault experienced, which, may result in more reports of severe assaults than other studies.
Bryant-Davis, T., Chung, H., & Tillman, S. (2009). From the margins to the center. Ethnic minority women and the mental health effects of sexual assault. Trauma, Violence, & Abuse, 10, 330-357.
This review article examined sexual assault experiences of African America, Asian American, Latina, and Native American women. Prevalence, risk factors, mental health effects, barriers to disclosure, cultural beliefs, community attitudes, and social support are discussed. Authors concluded that minority women reported greater psychological impacts and barriers to obtaining protection orders and support services. Implications for policy, practice, and research are presented.
The studies reviewed for the article included varying rates and definitions of sexual assault.
Chang, B. H., Skinner, K. M., & Boehmer, U. (2001). Religion and mental health among women veterans with sexual assault experience. International Journal of Psychiatry in Medicine, 31, 77-95.
Connop, V., & Petrak, J. (2004). The impact of sexual assault on heterosexual couples. Sexual & Relationship Therapy, 19, 29-38.
The purpose of this study was to examine how male partners react to their partner’s sexual assault and what happens to the couples’ interactions. Participants were recruited through a sexual assault clinic and through press advertisements. Semi-structured interviews were conducted with 6 males whose previous or current partners had been sexually assaulted and with 3 females who had been sexually assaulted and had disclosed their assault to their partners. Interviews revealed that 8 of the 9 participants had a partner who had experienced acquaintance rape – or, in the case of the female participants, had been the victim of acquaintance rape. In analyzing the interviews, four themes were identified: (a) the male partner’s role in providing support, (b) communication, (c) anger and blame, and (d) the impact of the assault on the sexual relationship. Many of the male participants indicated that they felt they should put their partner’s needs first and felt exhausted by their role in supporting their partner. Men also revealed a common assumption relating to socio-cultural scripts concerning heterosexual relationships; namely, the idea that they ought to protect their women. Relationship disturbances and communication problems were also reported to have increased in the aftermath of the assault. While at times the men enunciated rape myths, they could not be categorized either as viewing the rape as a sexual act or as a violent act (as the prior research study had indicated). A final issue noted by participants was how the sexual assault increased their difficulty in performing and enjoying sexual activity. Suggested implications of the findings for service provision include the benefit of couple-based counseling and counseling to support male partners’ support needs and psychosexual issues.
Fitzgerald, M.M., Danielson, C.K., Saunders, B., & Kilpatrick, D.G. (2007).Youth victimization: Implications for prevention, intervention, and public policy. The Prevention Researcher, 14, 3-7.
The authors review national prevalence rates of youth victimization, including: sexual, emotional or physical abuse; witnessing domestic or community violence; property crime; and excessive punishment. They note gender and race/ethnicity differences in prevalence rates as well as mental health effects. Specific recommendations for assessing risk and resiliency factors as well as screening for victimization in clinical settings are given. The authors discuss the importance of targeted interventions for specific groups, and urge adoption of an ecological model. Finally, the authors discuss how public and organizational policies can help decrease the impact of victimization and increase the availability of supportive services for youth and their families.
Hart, T. C., & Miethe, T. D. (2008). Exploring bystander presence and intervention in nonfatal violent victimization: When does helping really hurt? Violence and Victims, 23, 637-651.
The purpose of this study was to identify the situational contexts in which bystanders are present during a violent crimes and the prevalence of helping and hurting responses to them. Data for this study were taken from National Crime Victimization Surveys conducted from 1995 through 2004. Findings indicated that it was common that bystanders were present during physical assaults in public locations. Their presence was less likely during sexual assaults and rape in private locations. Bystanders are more likely to help than hurt the situation during a sexual assault when a weapon is not present. Overall, some situations are related to a high level of helping responses while others are not. Some situations resulted in more damaging outcomes for the victims.
The data did not include violent crimes that were stopped by the presence or actions of a bystander and did not include information on the role or type of help the bystander offered.
Howard, D. E., & Wang, M. Q. (2005). Psychosocial correlates of U.S. adolescents who report a history of forced sexual intercourse. Journal of Adolescent Health, 36, 372-379.
Participants were given the 2001 national school-based Youth Risk Behavior Survey (YRBS). Results showed that 7.7% of high school adolescents had experienced forced sexual violence. Moreover, girls reported a 10.2% lifetime prevalence whereas boys reported a 5.1% lifetime prevalence of forced sex. Additional results yielded associations between a history of forced sexual violence and suicidal thoughts and behaviors as well as substance abuse and other risky behaviors. The authors emphasize the need for clinical applications of these findings and recognize the issue of forced sexual intercourse among adolescents as a growing public health concern.
Kelly, P. J., Lesser, J., Cheng, A., Oscos-Sanchez, M., Martinez, E., Pineda, D., & Mancha, J. (2010). A prospective randomized controlled trial of an interpersonal violence prevention program with a Mexican American community. Family & Community Health, 33, 207-215.
This study examined the effects of El Joven Noble, a gender-based social bond theory intervention, on violence related attitudes among 31 students in a predominately Mexican American community in South Texas. El Joven Noble was originally designed for high-risk males in Latino communities in California. The curriculum consists of 10 sessions implemented weekly during an after school program. Findings indicated no significant differences between the intervention and control groups. High-risk students in the intervention group reported changes in non-violence self-efficacy scores post intervention and 3 months post intervention. El Joven Noble showed secondary violence prevention effects, but not primary prevention effects. Community participation helps programs address discrimination, historical context of the impact of oppression, and intergenerational trauma.
Students had negative attitudes towards gangs and high violence self-efficacy at baseline which makes it difficult to show changes as a result of the intervention. Adaptation of the program may not be suitable for other racial/ethnic communities.
McFarlane, J., Malecha, A., Watson, K., Gist, J., Batten, E., Hall, I. et al. (2005). Intimate partner sexual assault against women: Frequency, health consequences, and treatment outcomes. Obstetrics & Gynecology, 105, 99-108.
Women who had requested orders of protection against abusive partners participated in this descriptive study (N=148). Sixty-eight percent (n=100) reported being sexually assaulted at least once by their partner. Women who were sexually assaulted multiple times reported significantly higher levels of gynecologic problems, including sexually transmitted diseases, than non-sexually assaulted women. Higher PTSD scores were found in women who were sexually assaulted than among those who were only physically assaulted. For either type of assault Latina/Hispanic women had higher PTSD scores than African American or White women. Women were less likely to be reassaulted if they told someone about the assault, contacted police, applied for protection orders, or received medical care. The researchers recommend the adoption of cooperative models that increase victims’ ability to access justice and medical services.
Participants were recruited from a group of women who had applied for protective orders, and may differ from women who do not seek assistance from the justice system. The study relied on self-reports, which are subject to recall errors and omissions.
Miller, A. K., Markman, K. D., & Handley, I. M. (2007). Self-blame among sexual assault victims prospectively predicts revictimization: A perceived sociolegal context model of risk. Basic and Applied Social Psychology, 29, 129-136.
The study explores relationships between sexual assault, self-blame and sexual revictimization (SRV). Participants of the study consisted of 144 undergraduate females at a Midwestern University who reported adolescent sexual assault experiences occurring after age 14. Each participant was administered the SRV version of the SES and the Posttraumatic Cognitions Inventory. Participants also completed interviews about their sexual assault experiences and a survey on legal perceptions of heterosexual interaction resulting in intercourse. All participants completed the SRV version of the SES 4.2 months later. This investigation found that the degree of self-blame women experience following a sexual assault can influence subsequent victimization. Women who have greater perceptions that the law permits men’s behavior of engaging in nonconsensual sex are more likely to blame themselves for their assault or that they failed to prevent their assaults.
The study included a sample that was primarily Caucasian (96.4%). Caucasian women may have different legal perceptions of sexual assault than women from different ethnic, racial, and socioeconomic backgrounds.
Spitzberg, B. H. & Cupach, W. R. (2007). The state of the art of stalking: Taking stock of the emerging literature. Aggression & Violent Behavior, 12, 64-86.
This meta-analysis summarizes the results of 175 studies of stalking. In addition to looking at variations in prevalence between studies, the authors considered the definitions of stalking and described the closely-related set of behaviors termed “obsessive relational intrusion.” The authors created systematic typologies of types of stalkers, stalkers’ motivations, and types of stalking behaviors. Victims’ coping responses and the effects of stalking are also categorized. The majority of stalking victims are women. Because the majority of victims (79%) were acquainted with the stalker, and because half of all stalking was related to romantic relationships, the authors recommended looking at most stalking not only as criminal behavior or psychopathology, but as a type of “relationship terrorism” similar to other types of domestic violence.
Walker, J., Archer, J., & Davies, M. (2005). Effects of rape on men: A descriptive analysis. Archives of Sexual Behavior, 34, 69-80.
To describe the experiences of male rape victims who were not in a clinical setting, men who had been anally raped were recruited to participate in a mail-in survey. Forty men provided details of the assault, their immediate reactions, and the long-term effects. Seventy percent of the men were between the ages of 16-25 when the incident occurred. Only 10% of the rapes were committed by strangers. Most men (87%) felt frozen fear, helplessness, or submission during the attack, although some (27%) were able to fight back at least somewhat. The majority of men reported that feeling helpless and out of control was worse than the sexual aspects of the assault. Almost all of the men reported long-term depression as a consequence of the assault, and most experienced long-term confusion about their sexual identity. Recommendations included providing male victims the same support services offered to women, and more community education and outreach to increase awareness of the prevalence and impact of male rape.
Wolfe, D. A., Crooks, C., Jaffe, P., Chiodo, D., Hughes, R., Ellis, W., et al. (2009). A school-based program to prevent adolescent dating violence. A cluster randomized trial. Archives of Pediatrics & Adolescent Medicine, 163, 692-699.
The purpose of this study was to determine if an interactive curriculum that integrated dating violence prevention with lessons on healthy relationships, sexual health, and substance use reduced PDV 2.5 years later among 1, 722 students in Ontario, Canada. The secondary purpose of the study was to reduce risk behaviors of peer violence, substance use, and condom use. In 2004, schools were randomly assigned to intervention or control groups and the program was implemented among 9th grade students. Findings indicated: by the end of 11th grade PDV increased for all students from approximately 1% to 8%, PDV was higher for students in control group (9%) than the intervention group (7%), the effect of the intervention was different between boys and girls. No significant differences between the groups were reported for physical peer violence, substance use, or condom use. Authors suggested that methods developed for single-focused interventions can be combined from a core relationship perspective and teachers with training can implement evidenced-based prevention programs.
Dating violence was limited to physical acts and did not include sexual violence or coercion.