College Women's Experiences with Physically Forced,Alcohol- or Other Drug-Enabled,and Drug-Facilitated Sexual Assault Before and Since Entering College

Objective: Research has shown associations between college women's alcohol and/or drug consumption and the risk of sexual assault, but few studies have measured the various means by which sexual assault is achieved.

Participants: The authors' Campus Sexual Assault Study obtained self-report data from a random sample of undergraduate women (N = 5,446).

Methods: The authors collected data on sexual assault victimization by using a cross-sectional, Web-based survey, and they conducted analyses assessing the role of substance use. The authors also compared victimizations before and during college, and across years of study.

Results: Findings indicate that almost 20% of undergraduate women experienced some type of completed sexual assault since entering college. Most sexual assaults occurred after women voluntarily consumed alcohol, whereas few occurred after women had been given a drug without their knowledge or consent.

Conclusions: The authors discuss implications for campus sexual assault prevention programs, including the need for integrated substance use and sexual victimization prevention programming.     

Does Drinking Alcohol Prior to Sexual Activity Influence College Students’ Consent?

Objectives: This study assessed the extent to which consuming alcohol prior to sexual activity influenced college students' verbal/behavior cues utilized to communicate consent (external consent) as well as their feelings associated with consent (internal consent). Methods: Data was collected via paper-and-pencil surveys administered to heterosexual college students (N = 794) in the United States. Results: After controlling for gender, relationship status, rape myth acceptance, and alcohol expectancies, findings indicated that alcohol consumption prior to sexual activity was associated with both internal and external consent. Conclusions: Current findings can help inform sexual assault prevention education programming given the high rates of sexual assault occurring on college campuses that involve alcohol consumption.     

Facial emotion identification and sexual assault risk detection among college student sexual assault victims and nonvictims

Objective: High rates of sexual victimization among college students necessitate further study of factors associated with sexual assault risk detection. The present study examined how social information processing relates to sexual assault risk detection as a function of sexual assault victimization history. Participants: 225 undergraduates (M_age = 19.12, SD = 1.44; 66% women). Methods: Participants completed an online questionnaire assessing victimization history, an emotion identification task, and a sexual assault risk detection task between June 2013 and May 2014. Results: Emotion identification moderated the association between victimization history and risk detection such that sexual assault survivors with lower emotion identification accuracy also reported the least risk in a sexual assault vignette. Conclusions: Findings suggest that differences in social information processing, specifically recognition of others' emotions, are associated with sexual assault risk detection. College prevention programs could incorporate emotional awareness strategies, particularly for men and women who are sexual assault survivors.     

Perceptions of,and Assistance Provided to,a Hypothetical Rape Victim: Differences Between Rape Disclosure Recipients and Nonrecipients

Abstract

Objective: Undergraduate rape disclosure recipients’ and nonrecipients’ sociodemographic and life experience variables, attitudes towards rape, and responses to a hypothetical rape disclosure were compared to determine differences between them. Participants: One hundred ninety-two undergraduates at 3 universities participated in this online survey between November 2011 and April 2012. Methods: Participants reported on their rape myth acceptance (RMA) and personal direct and indirect (ie, disclosure receipt) experiences with sexual assault. Participants also responded to a hypothetical rape disclosure. Results: Disclosure recipients were more likely to report a victimization history, and less confusion and perceived ineffectiveness in helping the hypothetical victim. RMA and nonrecipient status predicted perceived victim responsibility; these variables and childhood victimization predicted confusion about helping. RMA also predicted perceived ineffectiveness of one's helping behaviors. Victimization history and female gender predicted victim empathy. Conclusions: These findings can inform sexual assault–related programming for undergraduates through the provision of targeted assistance and corrective information.     

Problematic alcohol use and sexting as risk factors for sexual assault among college women

ABSTRACT

Sexual assault is a major public health concern and college women are four times more likely to experience sexual assault than any other group. We investigated whether sexting is a mechanism by which alcohol use increases risk for college women to be targeted for sexual assault. We hypothesized that sexting would mediate the relationship between problem drinking and sexual assault, such that drinking (T1 = beginning fall semester) would contribute to increased sexting (T2 = end fall semester), and in turn increase the risk of being targeted for sexual assault (T3 = end spring semester). Results: Among 332 undergraduate women (M(SD)age = 19.15(1.69), 76.9% Caucasian), sexting (T2) predicted sexual assault (T3; b = 3.98, p = .05), controlling for baseline sexual assault (b = 0.82, p < .01). Further, sexting (T2) mediated the relationship between problem drinking (T1) and sexual assault (T3) (b = 0.04, CI[.004,.12]). Conclusion: Findings suggest that sexting is one mechanism through which drinking increases the risk of college women being targeted for sexual assault.     

Differential perceptions of a hypothetical sexual assault survivor based on race and ethnicity: Exploring victim responsibility,trauma, and need for social support

Objective: Explore the ways in which a sample of college women interpret racially/ethnically coded vignettes to understand their perceptions of responsibility and trauma experienced by a hypothetical female sexual assault survivor and her need for social support. Participants: Convenience sample of college women (N?=?51) attending a large, predominately white university in the Southeastern United States recruited between January and March 2013. Methods: Participants were randomly assigned one of three vignettes describing a hypothetical date rape scenario. Vignette scenarios were identical except for discrete statements coded to signify either an African American, Latina, or white female student. Participants responded to open-ended questions that gauged their interpretations of responsibility, trauma, and social support. Results: Qualitative analysis of open-ended responses revealed six overarching themes, including overt victim blaming/shaming, justification of the sexual assault, and perceived need for social support. Conclusions: Findings point to the significance of including race in discussions about and programs that address sexual assault on college campuses to ensure that all women who experience sexual violence receive the support that they need.     

Patient Problems Encountered at a Student Health Service

Abstract

Objective: To assess how Ohio colleges conform to recommendations that address barriers to reporting sexual assault. Participants: A study sample of Ohio 4-year colleges (N = 105). Methods: College Web sites were examined between March and November 2011 for their availability of sexual assault policies using 8 measures. Results: Of the colleges in the sample, 66% had an online sexual assault policy. Less than 1% of colleges included definitions for applicable sexual offenses in the Ohio Revised Code. All colleges with a policy included on-campus personnel to whom a victim could report. Approximately 25% and 31% of colleges included confidential or 24/7 reporting options, respectively. Conclusions: Many colleges are failing to offer basic reporting options to victims of sexual assault. Having a clearly labeled sexual assault policy on a campus Web site that includes 24/7 reporting options and defines acts of sexual assault can aid victims in the reporting process.     

Contributions of Child Sexual Abuse,Self-Blame,Posttraumatic Stress Symptoms,and Alcohol Use to Women’s Risk for Forcible and Substance-Facilitated Sexual Assault

Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women’s risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self-blame predicts increased alcohol use. Implications for future research and intervention are discussed.     

Drinking Patterns,Problems, and Motivations Among Collegiate Bisexual Women

Objective and Participants: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). Methods: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. Results: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. Conclusions: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.     

Associations among trauma,depression, and alcohol use profiles and treatment motivation and engagement in college students

ABSTRACT

Objective: This study examined how profiles of alcohol use and symptoms of common mental health disorders (depression and posttraumatic stress disorder [PTSD]) influenced the perceived need for and actual seeking of different types of treatment (for alcohol versus psychological distress) in college student drinkers. Participants: Undergraduate students (n = 164) were assessed between September 2009 and August 2015. Methods: We classified students into different symptom profiles using model-based clustering and compared these profiles on a variety of variables. Results: The cluster model yielded three profiles: Low Risk (n = 66), Concomitant (n = 35), and Heavy Drinking (n = 63). Students in these profiles significantly differed in alcohol consumption, alcohol-related cognitions and problems, and perceptions of need and prior engagement in treatment. Conclusion: A variety of strategies can be used to engage students experiencing heavy drinking and/or mental health problems into treatment on campus.     

Sexual Assault Risks Among Gay and Bisexual Men

The goal of this study was to examine lifetime patterns of sexual assault and associated risks among a purposive sample of gay and bisexual men (N = 183; 18 to 35 years old, M = 24.3). Cross-sectional data were collected via written, self-administered questionnaires and face-to-face, event-based qualitative interviews. Alcohol severity scores indicated high rates of hazardous drinking (53.0%) and possible dependence (14.2%) among participants. One-half of men (50.8%) reported childhood sexual abuse (CSA), and 67.2% reported adult sexual assault (ASA). Average age at most recent ASA was 21 years. Most perpetrators (83.9%) of recent ASA incidents were male; 67.0% of participants reported consuming alcohol and/or drugs prior to the most recent incident. Regression findings indicated more severe CSA experiences and past alcohol-related problems predicted recent severe ASA. Although we found similarities between gay and bisexual men in lifetime sexual assault history, we found some distinct differences in ASA risk factors. Bisexual men reported higher alcohol severity scores, more female ASA perpetrators, higher internalized homophobia scores, and fewer male sexual partners than gay men. Findings suggest the need for interventions that reduce ASA risk among sexual minority men—and the potential benefits of focusing on alcohol consumption in risk reduction efforts.     

Quantifying the magnitude and potential influence of missing data in campus sexual assault surveys: A systematic review of surveys, 2010–2016

Objective: To understand how missing data may influence conclusions drawn from campus sexual assault surveys. Methods: We systematically reviewed 40 surveys from 2010–2016. We constructed a pseudo-population of the total population targeted across schools, creating records proportional to the respective response rate and reported sexual assault prevalence. We simulated the effects of 9 scenarios where the sexual assault prevalence among nonresponders differed from that of responders. Results: The surveys represented a total female undergraduate population of 317,387 with only 77,966 (24.6%) survey responses. Among responders, 20.4% reported experiences of sexual assault. However, prevalence of sexual assault could theoretically range from 5.0 to 80.4% under extreme assumptions about prevalence in nonresponders. Smaller, but still significant differences were observed with less extreme assumptions. Conclusions: Missing data are widespread in campus sexual assault surveys. Conclusions drawn from these incomplete data are highly sensitive to assumptions about the sexual assault prevalence among nonresponders.     

Unplanned Sexual Activity as a Consequence of Alcohol Use: A Prospective Study of Risk Perceptions and Alcohol Use Among College Freshmen

Objective: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption.

Participants: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. Methods: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. Results: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. Conclusions: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.     

Gender attitudes,sexual violence,and HIV/AIDS risks among men and women in Cape Town,South Africa

This study examined gender attitudes and sexual violence‐supportive beliefs (rape myths) in a sample of South African men and women at risk for HIV transmission. Over 40% of women and 16% of men had been sexually assaulted, and more than one in five men openly admitted to having perpetrated sexual assault. Traditional attitudes toward women's social and gender roles, as well as rape myths, were endorsed by a significant minority of both men and women. Multivariate analyses showed that for men, sexual assault history and rape myth acceptance, along with alcohol and other drug use history, were significantly related to cumulative risks for HIV infection. In contrast, although we found that women were at substantial risk for sexually transmitted infection (STI), including HIV, women's risks were only related to lower levels of education and alcohol use history. We speculate that women's risks for STI/HIV are the product of partner characteristics and male‐dominated relationships, suggesting the critical importance of intervening with men to reduce women's risks for sexual assault and STI/HIV.     

College Women's Sexual Decision Making: Cognitive Mediation of Alcohol Expectancy Effects

Abstract

Objective: Alcohol has been linked to a variety of risky sexual practices, including inconsistent condom use. Due to the high rates of alcohol consumption among underage college women, greater understanding of the role of alcohol in young women's sexual decision making is warranted. Participants and Methods: Female underage (18- to 20-year-old) social drinkers (N = 94) participated in an experiment in which they projected themselves into a written hypothetical sexual situation with a new partner. One half of the situations portrayed alcohol consumption; one half did not involve alcohol consumption. Their appraisals of the situation's sexual potential, impelling and inhibiting cognitions, and sexual behavior intentions were assessed. Results: Results revealed that alcohol's expectancy effects on young women's unprotected sexual intentions were mediated by their cognitive appraisals of the situation. Conclusions: These findings indicate that alcohol expectancies and their influence on women's sexual decisions should be incorporated into sexual risk reduction efforts.     

Post-Traumatic Stress Disorder Among College Student Victims of Acquaintance Assault

Summary

Post-traumatic stress disorder symptomatology was evaluated among 316 college women who reported coercive sexual experiences. History of victimization, attributions of blame, and current symptoms were assessed. Acquaintance assault victims reported significantly higher levels of Post-Traumatic Stress Disorder (PTSD) symptoms than non-victims, and one-third exceeded criteria for clinical levels of distress. Situational variables, including the type of assault, were not associated with PTSD status or symptoms. Cognitive appraisals, however,'were significantly associated with PTSD symptomatology. Attributions of blame were all associated with PTSD status, with characterological self-blame also being associated with level of current symptomatology. The results document the negative psychological consequences of acquaintance assaults among college students and help to focus the efforts of treatment programs for acquaintance assault victims. In addition, the results highlight the importance of cognitive appraisals in mediating effects of sexual victimization.     

Reporting Rape in a National Sample of College Women

Abstract

Background: Studies indicate that a small percentage of rapes are reported to law enforcement officials. Research also suggests that rapes perpetrated by a stranger are more likely to be reported and that rapes involving drugs and/or alcohol are less likely to be reported. College women represent a unique and understudied population with regard to reporting rape. Methods: In the current study, the authors interviewed a national sample of 2,000 college women about rape experiences in 2006. Results: Only 11.5% of college women in the sample reported their most recent/only rape experience to authorities, with only 2.7% of rapes involving drugs and/or alcohol reported. Minority status (ie, nonwhite race) was associated with lower likelihood of reporting, whereas sustaining injuries during the rape was associated with increased likelihood of reporting. Discussion: Reporting, particularly for rapes involving drugs and alcohol, is low among college women. Implications for policy are discussed.     

Intimate partner violence,trauma, and mental health need among female community college students

ABSTRACT

Objective: The impact of interpersonal violence on college students has received considerable attention, yet no studies have been conducted among community college students, who comprise 40% of all American college students, and have unique risk factors and needs. Community College students are more likely to be women, people of color, working, parenting, and first generation college students. Participants: Data were collected from a simple random sample from four community colleges (n=435). Methods: A cross-sectional quantitative survey was used to assess the extent of intimate partner violence, trauma exposure, sexual violence, and associated mental health consequences among female students. Results: Over 27% of participants reported IPV in the past year, while 25% reported sexual assault and 34% reported other uncomfortable sexual experiences in their lifetime. Nearly 20%of participants were currently reporting PTSD symptoms. Conclusions: Community Colleges should work with service providers to build their capacity to respond to students' needs.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

College women's experiences of psychological maltreatment and sexual assault

A sample of 648 college women recruited from undergraduate psychology classes was examined to explore the relationship between past psychological maltreatment and sexual assault. Based on responses to the Sexual Experiences Survey and the Psychological Maltreatment Inventory, women were classified by level of unwanted sexual contact (i.e., vaginal or anal intercourse; oral genital contact and/or object penetration; or kissing and/or fondling), by method used to obtain the sexual assault (i.e., women were classified as experiencing coerced assaults, forced assaults, or both), and by identity of perpetrator (i.e., acquaintances or strangers). Results pointed to significant differences in the amount of past psychological maltreatment reported by women experiencing any type of assault as compared to women without assault experiences, regardless of perpetrator identity. Moreover, higher levels of psychological maltreatment were associated with having experienced any type of coerced sexual activities. There were no differences by type of assault. Finally, a series of ANOVAs was conducted to examine the interaction between coercion and force in the psychological maltreatment reported by women experiencing different forms of assault. With few exceptions, greater maltreatment was associated both with the occurrence of coerced assaults and with the occurrence of forced assaults. A significant interaction was seen with one form of assault, unwanted kissing and/or fondling perpetrated by an acquaintance. This interaction may suggest that, at least for this one form of contact perpetrated by acquaintances, the presence of past psychological maltreatment is uniquely associated with experiencing adult sexual assaults involving both force and coercion.