The Sexual Assault Symptom Scale: Measuring self-reported sexual assault trauma in the emergency room.

Abstract

To test the utility of a new self-report measure of trauma in the immediate aftermath of sexual assault, 253 women were interviewed with the 32-item Sexual Assault Symptom Scale (SASS) in a hospital emergency room within 72 hr of assault. Factor analysis with oblique rotation yielded a simple structure with 4 common factors: Disclosure Shame, Safety Fears, Depression, and Self-Blame. Cronbach alpha coefficients indicated high internal consistency for each factor subscale. Intercorrelalions between factor scores of the victims' self-report symptoms and assessments by crisis workers suggest that the SASS has construct validity, as a multitrait-multimcthod matrix demonstrated both convergent and discriminant validity.Extensive research has been conducted on the sexual assault trauma syndrome (SATS) and variables affecting recovery (for recent reviews of this literature, see Burgess & Holmstrom, 1985;Ruch & Leon, 1986;Sales, Baum, & Shore, 1984). Early studies measured trauma fairly crudely in terms of the presence or absence of symptoms (e.g., Holmstrom & Burgess, 1975; McCombie, 1976), but measurement has become increasingly rigorous in recent years as researchers (e.g., Becker, Skinner, & Abel, 1983;Kilpatrick, Veronen, & Best, 1985) have used standardized psychological assessment instruments, such as the Beck Depression Inventory (Beck, 1978) and the revised Symptoms Checklist-90 (SCL-90-R;Derogatis, 1977).A few studies have used scales developed for sexual assault victims. Kilpatrick, Veronen, and Resick (1979) developed the 120-item Veronen-Kilpatrick Modified Fear Survey (MFS) to measure self-reported fear. Content analysis of data on 46 victims and 35 nonvictims yielded three types of fears; Rape Cues, Rape-Precipitated Fears, and Attack Vulnerability Cues. Victims scored higher than nonvictims on all three dimensions in the first month but only on Vulnerability Cues at later assessments. Resick, Veronen, Calhoun, Kilpatrick, and Atkeson

Lifetime physical and sexual abuse and substance use treatment outcomes in men

“…Findings are consistent with population-based research demonstrating that child sexual abuse is associated with a broader array of mental health problems and accounts for greater variance in mental health problems relative to child physical abuse (Briere & Elliott, 2003). Child and adult sexual abuse have been linked to both deficits in adaptive coping (e.g., greater reliance on wishful thinking) and increases in shame and self-blame, all of which may function to heighten risk for psychopathology (cf., Lisak, 1994;Ruch, Gartrell, Amedeo, & Coyne, 1991;Valentiner, Foa, Riggs, & Gershuny, 1996). However, more work is needed to understand the long-term sequelae of physical and sexual abuse and the mechanisms that underlie relations between different abuse types and the development of psychopathology.…”

Against their will: Young women's nonagentic sexual experiences

“…Self-blame. The four-item self-blame subscale of the SASS (Ruch et al, 1991) was used to assess the extent to which respondents felt guilty following their nonagentic experience (e.g., 'did you blame yourself for things?'). Cronbach's alpha for self-blame was .89.…”

Characterological and Behavioral Blame in Conversations about Female and Male Rape

“…Not surprisingly, this theory has generated a large volume of research predominantly exploring the maladaptive nature of engaging in any type of self-blame, whether characterological or behavioral (Frazier, 1990(Frazier, , 1991Frazier & Schauben, 1994;Katz & Burt, 1988;Meyer & Taylor, 1986;Pitts & Schwartz, 1993;Ruch et al, 1991;Ward, 1995;Wyatt, Notgrass, & Newcombe, 1990). These studies have shown how the trauma and distress caused by self-blame often leads to the onset of prolonged negative cognitive, affective, behavioral, and physiological responses in the survivor such as psychological distress, major depression, substance abuse/dependence, generalized anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder (Davis & Breslau, 1994;Frazier, 1991;Schwartz & DeKeseredy, 1997;Ward, 1995).…”

“…Men also attributed more characterological blame to the female than to the male survivor, whereas female participants attributed equal amounts of characterological blame to both survivors.Studies have revealed many similarities in survivors' reactions to rape. Rape survivors typically experience a variety of reactions following their rape such as the shame of disclosure and safety fears (Ruch, Gartrell, Amedeo, & Coyne, 1991), and many of these experiences impede recovery. However, the attribution made by the survivor about the cause of his or her rape, usually in the form of self-blame, is thought to be particularly closely associated with postrape distress and recovery.…”