Sexual assault victimization and psychopathology: A review and meta-analysis

Abstract

Sexual assault (SA) is a common and deleterious form of trauma. Over 40 years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970–2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges’ g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. Broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) were not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.

Predictors of remission from PTSD symptoms after sexual and non-sexual trauma in the community: A mediated survival-analytic approach

“…Thus, a recent meta-analysis has shown that sexual abuse experience more than other trauma types has clear ties to a higher incidence of mood, anxiety or substance use disorders, even independently from PTSD (Dworkin et al, 2017). Interestingly, these conditions were also found to be more likely among individuals with chronic PTSD than among those with faster symptom improvement (Chapman et al, 2012;McFarlane, 2000;Zlotnick et al, 2004;Zlotnick et al, 1999).…”

The unique associations of sexual assault and intimate partner violence with PTSD symptom clusters in a traumatized substance-abusing sample.

“…For example, in a representative sample, Forbes and colleagues (2014) found that violence by an intimate perpetrator (including caregivers and romantic partners) was linked to greater PTSD symptom severity relative to both interpersonal traumatic events by non-intimates and to non-interpersonal event exposure. However, a recent meta-analysis of the psychological impact of SA suggested that stranger-perpetrated SA may be associated with greater symptom severity than SA perpetrated by a known assailant (Dworkin et al, 2016). Experiencing traumas committed by different perpetrators (as in SA revictimization) is associated with the passive avoidance and arousal symptoms of PTSD (Matlow & DePrince, 2012).…”

Life trajectories towards suicide: developmental role and specificities of adolescence

“…Almost 25% of individuals who died as young adults (vs 10% in class 2) were victims of intrafamily sexual violence between ages 10 and 14. The literature presents robust evidence that childhood sexual assault pervasively undermines the mental health equilibrium 45 and leads to higher risk of suicidal outcomes 32,33 . Much scarcer is the evidence about the consequences of intrafamily sexual violence occurring during adolescence.…”