Blackwell, L. M., et al. (2004). "Sexual assault revictimization: Toward effective risk-reduction programs." Koenig, Linda J [Ed]: 269-295.
(from the chapter) In recent years, evidence has accumulated that women who report a history of child sexual abuse or victimization appear to be at particular risk for being revictimized. This chapter reviews the available literature on sexual assault risk-reduction programs. The authors highlight studies that address the issue of high-risk women in general, and revictimization in particular, with a focus on college student populations, which have been the target of the majority of interventions to date. Finally, they present a summary and critique of the literature, followed by recommendations for future sexual assault prevention programming for both a general population of women and for women who report a history of sexual victimization.
Combs-Lane, A. M. (2001). "Risk factors associated with sexual revictimization in college women." Dissertation Abstracts International: Section B: The Sciences and Engineering 61(9-B): 4976.
The phenomenon of sexual revictimization has received increased attention in the sexual assault literature following studies documenting its prevalence in women. Efforts to prevent sexual assault have led to the identification of factors associated with increased risk of victimization. A prior history of sexual victimization, either occurring as a child or adolescent, has been identified as the strongest predictor of adult sexual assault (ASA). In addition, a variety of personality, cognitive, and behavioral factors have been examined in relation to risk of victimization and revictimization. The present study examined the contribution of child sexual abuse (CSA), sensation seeking, expectancies of involvement in risky activities, cognitions regarding the risks and benefits associated with risk-taking behaviors, and alcohol consumption to risk of sexual victimization in a prospective study involving 190 college women over the course of six months. In addition, the reliability of sexual assault reports were examined and the constructs of risk-taking behavior and sensation seeking compared. History of sexual victimization was assessed during Time 1 and Time 2 and cases of new sexual victimization identified. Results indicated that a history of CSA was associated with a higher prevalence of ASA cross-sectionally, but not predictive of new sexual victimizations at Time 2. Time 1 alcohol use, expectations of involvement in risky activities, and sensation seeking were related to risk of new sexual victimization over the subsequent six months. In addition, Time 1 alcohol use and expectations of involvement in risky activities were predictive of frequency of involvement in risky sexual behaviors six months later. Data on the reliability of sexual assault reports and the relation of risk-taking behavior to sensation seeking are presented. Implications of these findings for prevention programming are discussed.
Daigle, L. E., et al. (2008). "The violent and sexual victimization of college women: is repeat victimization a problem?" J Interpers Violence 23(9): 1296-1313.
Little attention has been given to repeat violent and sexual victimization among college women. Using two national-level data sets, the authors find that a small proportion of college women experience a large proportion of violent and sexual victimizations. Women are more likely to experience repeat sexual victimization than repeat violence incidents. Repeat victimization tends to happen in the same month of the initial victimization, and the most likely next type of victimization is by far the same type of victimization. Comparing incident-level characteristics of repeat incidents to single incidents, there are few differences, with the exception that, in a larger proportion of single incidents, women took self-protective action. Implications for prevention and educational programs are discussed.
Macy, R. J., et al. (2007). "Latent profiles among sexual assault survivors: implications for defensive coping and resistance." J Interpers Violence 22(5): 543-565.
Rape resistance trainings need to prepare women to recognize and resist sexual assault across a range of experiences and contexts. To help address this need, this research used an investigation of 415 college women who completed a survey about their situational responding to an experience of acquaintance sexual assault. A previously established person-centered analysis model of four distinct risk and protective factor profiles was used to investigate the variability in women's responding. The profiling factors included women's prior victimization, alcohol consumption, relationship expectancies of the assailant, and assertive precautionary habits. Multivariate ANOVA was used to test for differences among the four profile groups on their cognitive, emotional, and behavioral responding. Results showed that the profile groups significantly differed in their assault responses. The findings highlight the utility of holistic, multivariate analyses for understanding women's sexual assault responses and help inform tailored resistance and empowerment trainings.
Marx, B. P., et al. (2001). "Sexual revictimization prevention: An outcome evaluation." Journal of Consulting and Clinical Psychology 69(1): 25-32.
This investigation tested a program to reduce women's risk for sexual revictimization. Participants were 66 women with histories of sexual victimization as adolescents or adults who were randomly assigned to a preventive intervention group or a no-treatment control group. They completed initial measures assessing history of sexual assault, self-efficacy, and psychological functioning, returning approximately 2 months later for follow-up assessment using the same measures. Results suggest that the prevention program may be effective in reducing the incidence of sexual assault revictimization in this population. In addition, participants in the intervention group displayed significant improvement in psychological adjustment and self-reported self-efficacy.
Messman-Moore, T. L., et al. (2010). "Emotion dysregulation and risky sexual behavior in revictimization." Child Abuse & Neglect 34(12): 967-976.
Objective: The current study examined emotion dysregulation as a mechanism underlying risky sexual behavior and sexual revictimization among adult victims of child sexual abuse (CSA) and child physical abuse (CPA). Methods: Participants were 752 college women. Victimization history, emotion dysreguladon, and risky sexual behavior were assessed with anonymous, self-report surveys utilizing a cross-sectional design. Results: Approximately 6.3% of participants reported CSA, 25.5% reported CPA, and 17.8% reported rape during adolescence or adulthood. CSA and CPA were associated with increased risk for adolescent/adult rape; 29.8% of CSA victims and 24.3% of CPA victims were revictimized. Path analytic models tested hypothesized relationships among child abuse, emotion dysregulation, adolescent/adult rape and three forms of risky sexual behavior (e.g., failure to use condoms, contraception, or having sex with someone under the influence of alcohol/drugs), including frequency of risky sexual behavior with a regular dating partner, with a stranger, and lifetime number of intercourse partners. Emotion dysregulation mediated revictimization for both CSA and CPA. Emotion dysregulation also predicted lifetime number of sexual partners and frequency of risky sex with a stranger, but not frequency of risky sex with a regular dating partner. Conclusions: Findings suggest that emotion dysregulation is a distal predictor, and risky sex, particularly with lesser known partners, is a proximal predictor of sexual revictimization. Because emotion dysregulation also maintained a significant direct path to revictimization, risky sexual behavior appears to be one of several proximal risk factors for revictimization. Practice implications: Findings confirm that emotion dysregulation is a critical pathway to more proximal risk factors such as risky sexual behavior, and suggest that clinical interventions aimed at improving emotion dysregulation may help reduce risky sexual behavior and risk for revictimization. (C) 2010 Elsevier Ltd. All rights reserved.
Messman-Moore, T. L., et al. (2009). "Substance use and PTSD symptoms impact the likelihood of rape and revictimization in college women." J Interpers Violence 24(3): 499-521.
The present study utilized a mixed retrospective and prospective design with an 8-month follow-up period to test a model of revictimization that included multiple childhood (i.e., child sexual, physical, and emotional abuse) and situational variables (i.e., substance use, sexual behavior) for predicting rape among 276 college women. It was of particular interest to determine whether traumatic responses (e.g., posttraumatic symptomatology or risky behavior) increased vulnerability for revictimization. During the 8-month follow-up period, 9% of participants were raped; 88% of assaults involved substance use by the victim. Posttraumatic stress disorder (PTSD) symptomatology predicted rape, substance use, and sexual behavior. Substance use, but not sexual behavior, mediated the relation between PTSD symptomatology and rape during the follow-up period. Sexual behavior indirectly impacted risk for rape via substance use. Results suggest that college women with PTSD symptomatology may be at greater risk for rape if they use substances to reduce distress.
Miller, A. K., et al. (2011). "Stigma-Threat Motivated Nondisclosure of Sexual Assault and Sexual Revictimization: A Prospective Analysis." Psychology of Women Quarterly 35(1): 119-128.
The purpose of the study was to assess sexual assault survivors' nondisclosure motivations, including stigma threat, and their impact on revictimization risk. The authors describe data from a prospective study of 144 female, undergraduate sexual assault survivors, most of whom had been assaulted by acquaintances and only one of whom had officially reported her experience to police. As part of a large-scale investigation, participants described during individual interviews why they had not reported their experiences to law enforcement authorities. Open-ended responses were coded into five reliable content themes, one of which was stigma-motivated nondisclosure, or stigma threat. Results indicated that stigma threat prospectively predicted sexual revictimization during a 4.2-month follow-up period. Moreover, results of mediation analyses suggested that decreased posttraumatic growth during the course of the study accounted for the relationship between stigma threat and survivors' revictimizations. Discussion focuses on advances to the sexual revictimization research (e. g., the importance of assessing subjective/perceptual in addition to objective/factual characteristics of assaults and their social repercussions) and to posttraumatic growth research, with data highlighting for the first time an important health correlate (i.e., sexual revictimization) of sexual assault survivors' perceived (lack of) posttraumatic growth. In addition, recommendations are provided for primary (social-level) prevention as well as for secondary prevention, that is, formal and informal support provided to sexual assault survivors.
Smith, P. H., et al. (2003). "A longitudinal perspective on dating violence among adolescent and college-age women." American Journal of Public Health 93(7): 1104-1109.
We investigated physical assault in dating relationships and its co-occurrence with sexual assault from high school through college. Methods. Two classes of university women (n=1569) completed 5 surveys during their 4 years in college. Results. Women who were physically assaulted as adolescents were at greater risk for revictimization during their freshman year (relative risk=2.96); each subsequent year, women who have experienced violence remained at greater risk for revictimization than those who have not. Across all years, women who were physically assaulted in any year were significantly more likely to be sexually assaulted that same year. Adolescent victimization was a better predictor of college victimization than was childhood victimization. Conclusions. There is a need for dating violence prevention/intervention programs in high school and college and for research on factors that reduce revictimization.
Ullman, S. E. and C. J. Najdowski (2009). "Revictimization as a moderator of psychosocial risk factors for problem drinking in female sexual assault survivors." J Stud Alcohol Drugs 70(1): 41-49.
Adult sexual assault (ASA) survivors report greater levels of problem drinking than do other women, and research suggests that their coping strategies, reactions from their social networks, and traumatic life events affect their problem drinking. The links between these factors and problem drinking may be moderated by whether survivors are revictimized, yet research has not examined this possibility. Therefore, the current study examined psychosocial factors, problem drinking, and revictimization in women ASA survivors. METHOD: Community-dwelling urban women (n = 555) who had experienced an ASA completed a mail survey at Time 1 (T1) and were resurveyed 1 year later to examine how revictimization between survey waves moderated the effects of coping strategies, social reactions to assault disclosures, and traumatic life events on problem drinking at Time 2 (T2). RESULTS: The findings showed that recent revictimization that occurred between surveys was related to increased problem drinking at T2, after T1 problem drinking was controlled for. Moderated hierarchical multiple regressions showed that survivors who engaged in drinking to cope with distress, who received negative social reactions in response to recent assault disclosures, or who experienced additional traumatic events had increased T2 problem drinking only if they were revictimized since T1. CONCLUSIONS: Psychosocial factors relate to increases in problem drinking for sexually revictimized women but not for nonrevictimized women. Interventions to reduce problem drinking in women ASA survivors should target drinking to cope with assault-related symptomatology, informal social networks to improve their supportiveness, and safety issues through risk-reduction education and self-defense training for women when appropriate.
Walsh, K., et al. (2013). "Perceived sexual control, sex-related alcohol expectancies and behavior predict substance-related sexual revictimization." Child Abuse Negl 37(5): 353-359.
Although numerous studies have documented linkages between childhood sexual abuse (CSA) and later sexual revictimization, mechanisms underlying revictimization, particularly assaults occurring in the context of substance use, are not well-understood. Consistent with Traumagenic Dynamics theory, the present study tested a path model positing that lowered perceptions of sexual control resulting from CSA may be associated with increased sex-related alcohol expectancies and heightened likelihood of risky sexual behavior, which in turn, may predict adult substance-related rape. METHODS: Participants were 546 female college students who completed anonymous surveys regarding CSA and adult rape, perceptions of sexual control, sex-related alcohol expectancies, and likelihood of engaging in risky sexual behavior. RESULTS: The data fit the hypothesized model well and all hypothesized path coefficients were significant and in the expected directions. As expected, sex-related alcohol expectancies and likelihood of risky sexual behavior only predicted substance-related rape, not forcible rape. CONCLUSIONS: Findings suggested that low perceived sexual control stemming from CSA is associated with increased sex-related alcohol expectancies and a higher likelihood of engaging in sexual behavior in the context of alcohol use. In turn these proximal risk factors heighten vulnerability to substance-related rape. Programs which aim to reduce risk for substance-related rape could be improved by addressing expectancies and motivations for risky sexual behavior in the context of substance use. Implications and future directions are discussed.
Walsh, K., et al. (2014). "Patterns of drug and alcohol use associated with lifetime sexual revictimization and current posttraumatic stress disorder among three national samples of adolescent, college, and household-residing women." Addict Behav 39(3): 684-689.
Sexual revictimization (experiencing 2 or more rapes) is prevalent and associated with increased risk for posttraumatic stress disorder (PTSD) and substance use. However, no national epidemiologic studies have established the prevalence or relative odds of a range of types of substance use as a function of sexual victimization history and PTSD status. Using three national female samples, the current study examined associations between sexual revictimization, PTSD, and past-year substance use. Participants were 1763 adolescent girls, 2000 college women, and 3001 household-residing women. Rape history, PTSD, and use of alcohol, marijuana, other illicit drugs, and non-medical prescription drugs were assessed via structured telephone interviews of U.S. households and colleges in 2005-2006. Chi-square and logistic regression were used to estimate the prevalence and odds of past-year substance use. Relative to single and non-victims: Revictimized adolescents and household-residing women reported more other illicit and non-medical prescription drug use; revictimized college women reported more other illicit drug use. Past 6-month PTSD was associated with increased odds of drug use for adolescents, non-medical prescription drug use for college women, and all substance use for household-residing women. Revictimization and PTSD were associated with more deviant substance use patterns across samples, which may reflect self-medication with substances. Findings also could be a function of high-risk environment or common underlying mechanisms. Screening and early intervention in pediatric, primary care, and college clinics may prevent subsequent rape, PTSD, and more severe substance use.
Wasco, S. M. (2004). "An ecological study of repeated sexual victimization among college women." Dissertation Abstracts International: Section B: The Sciences and Engineering 65(3-B): 1565.
Five hundred and two ethnically diverse college women reported their experiences of sexual victimization in childhood, adolescence and adulthood. Approximately one in five participants revealed a history of some sort of sexual victimization; and of those women, nearly one in five had experienced two or more separate instances of sexual violence in their lifetimes. To better understand the processes that link one instance of sexual victimization to another, three theoretical models proposed in the literature were tested using path analysis. Results suggested that self-blame, posttraumatic stress, and number of sexual partners did not mediate repeated experiences of sexual victimization; rather, there was a direct effect between childhood sexual assault and rape after age 14. Hierarchical multiple regression was conducted to test the relative importance of individual, interpersonal and environmental risk factors in predicting repeated sexual victimization. Each block of variables (demographic characteristics, family context, individual differences, interpersonal relationships, and climate of social and physical environments) significantly improved the regression model's ability to explain variance in the number of developmental time periods in which a participant experienced completed or attempted rape. Number of children, number of siblings, having lived with a nonbiological father figure, posttraumatic stress symptoms, number of romantic partners, and gender harassment across five settings were each associated with increased number of victimizations. Implications for prevention and treatment interventions and future research are discussed.