What Makes a Rape Victim More Likely to Be Assaulted Again in Her Lifetime

Violence Against Women. Writer manuscript; available in PMC 2018 Oct 1.

Published in final edited grade every bit:

PMCID: PMC5323368

NIHMSID: NIHMS815377

Predicting Sexual Attack Revictimization in a Longitudinal Sample of Women Survivors

Variation by Type of Assault

Mark Relyea

¹Academy of Illinois at Chicago, United states

Sarah E. Ullman

^aneUniversity of Illinois at Chicago, Us

Abstract

This study used a big community sample of women sexual assault survivors to prospectively assess 17 theorized predictors across 4 types of sexual attack revictimization: unwanted contact, compulsion, substance-involved assault (SIA), and force. Results indicated that predictors varied across types of revictimization: Unwanted contact and coercion appeared more common in social contexts more than hostile toward survivors, whereas forcible assaults and SIAs occurred in circumstances where survivors were vulnerable to being targeted past perpetrators. Overall, the strongest predictors were social environments hostile to survivors, race, childhood sexual abuse, decreased refusal assertiveness, and having more than sexual partners. We discuss implications for intervention and research.

Keywords: sexual assail, revictimization, women

The majority of female sexual assault survivors are sexually revictimized in their lifetimes (Classen, Palesh, & Aggarwal, 2005). Preventing this revictimization requires agreement the links between prior and future assaults. We use an ecological framework to discuss theorized predictors, focusing primarily on findings from prospective studies. We so compare the ability of these factors to longitudinally predict sexual assault revictimization in a diverse community sample of female survivors.

An Ecological Framework of Revictimization

An ecological framework conceptualizes revictimization occurring through an coaction between individual, situational, structural, and cultural factors (Heise, 1998). To understand predictors, nosotros apply a revised version of the ecological model for revictimization created by Grauerholz (2000) and make adaptations based on other related models (see Figure 1; Campbell, Dworkin, & Cabral, 2009; Messman-Moore & Long, 2003; White, 2009). In our model, predictors consist of ontogenic or individual factors (survivors' historical and internal experiences), the microsystem (interactions between survivors and others too as characteristics of those interactions), the meso/exosystem (processes, such as income, that bear upon survivors' potential connections to breezy and formal social systems, likewise as the systems themselves), the macrosystem (characteristics of the broader culture), the chronosystem (life transitions and effects of time), and meta-constructs (factors stemming from all levels of the social environmental). Every bit perpetrators are ultimately responsible for victimization, we talk over how each of these survivor-centered predictors affects vulnerability or exposure to perpetrators.

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Social ecological model.

Source. Adjusted from White (2009).

Ontogenic Factors

A history of interpersonal violence is i of the most robust predictors of revictimization (Classen et al., 2005;Mason, Ullman, Long, Long, & Starzynski, 2009). Both childhood sexual abuse (CSA) and adolescent/adult interpersonal violence tin can affect psychological functioning, beliefs nearly sexual beliefs, coping strategies, health, and economic well-existence (Cloitre & Rosenberg, 2006; Messman-Moore, Long, & Siegfried, 2000; Orcutt, Cooper, & Garcia, 2005; Ullman, Najdowski, & Filipas, 2009; Ullman, Peter-Hagene, & Relyea, 2014; Walsh, DiLillo, Klanecky, & Mcchargue, 2013), which can in turn increment take chances of assault. Alternatively, previous assaults and revictimization may share mutual causes, such as social contexts that tolerate interpersonal violence.

Researchers have oft studied assail sequelae as potential mediators leading to revictimization. Studies bear witness that psychological distress from assail, such as posttraumatic stress disorder (PTSD) or cocky-blame, increases chance of revictimization (Arata, 2000; Littleton & Ullman, 2013; Mason et al., 2009; Miller, Canales, Amacker, Backstrom, & Gidycz, 2011; Ullman & Najdowski, 2011). These factors may increase vulnerability if perpetrators accept reward of survivors whose numbing or self-blame decreases run a risk recognition or resistance (Messman-Moore, Ward, & Brownish, 2009; Ullman et al., 2009). In addition, distress may increment maladaptive coping strategies associated with revictimization, such every bit using substances or sex to cope with negative emotions (Katz, May, Sörensen, & DelTosta, 2010; Najdowski & Ullman, 2011; Sigurvinsdottir & Ullman, 2014). These appraisals, behaviors, and distress symptoms should exist assessed in models simultaneously to identify the nigh useful targets for preventing revictimization. So far, studies that have included more than one factor have found mixed results, possibly because the constructs share conceptual overlap and may interact (Arata, 2000; Filipas & Ullman, 2006; Ullman & Najdowski, 2011).

Difficulties with emotion regulation may play a strong part in revictimization by increasing both vulnerability and exposure to perpetrators. For instance, emotion dysregulation both mediates the path from betrayal traumas (such equally interpersonal violence) to PTSD and the path from PTSD to substance use and sexual behaviors (Bonn-Miller, Vujanovic, Boden, & Gross, 2011; Goldsmith, Chesney, Heath, & Barlow, 2013; Weiss, Tull, & Gratz, 2014). Besides, emotion dysregulation may increase compliance with sexual action, impulsive behaviors, and maladaptive coping strategies, too as decrease sexual refusal assertiveness, relationship stability, and the ability to utilise emotions as information to detect chance (Bonn-Miller et al., 2011; Cloitre & Rosenberg, 2006; Goldsmith et al., 2013; Marx, Heidt, & Gilded, 2005; Messman-Moore, Walsh, & DiLillo, 2010; Orcutt et al., 2005; Walsh, DiLillo, & Messman-Moore, 2012;Walsh, Galea, & Koenen, 2012; Weiss et al., 2014; Zerubavel & Messman-Moore, 2013). Revictimized women report college rates of emotion regulation difficulties (Walsh, DiLillo, & Scalora, 2011), and emotional dysregulation predicts revictimization (Messman-Moore et al., 2010; Messman-Moore, Ward, & Zerubavel, 2013; Messman-Moore, Ward, Zerubavel, Chandley, & Barton, 2015).

Microsystem Factors

While individual characteristics may create vulnerability, factors affecting interactions with others may confer a more proximal adventure to perpetration. As near assaults are perpetrated by people known to survivors, researchers have studied survivors' sexual behaviors and institute that the risks vary depending on the type of behavior (Messman-Moore & Long, 2003). Activities that increase exposure to potential perpetration (eastward.g., having more sexual partners), vulnerability (eastward.thou., difficulty refusing unwanted sexual activity), or both (e.g., prostitution) seem to predict revictimization (Arata, 2000; Katz, May, Sörenson, & DelTosta, 2010; Krahé, Scheinberger-Olwig, Waizenhöfer, & Kolpin, 1999; Livingston, Testa, & VanZile-Tamsen, 2007; Messman-Moore & Long, 2003; Messman-Moore et al., 2010; Orcutt et al., 2005; Testa, VanZile-Tamsen, & Livingston, 2004; West, Williams, & Siegel, 2000).

Similarly, researchers accept studied substance use as many sexual assaults involve substances, particularly alcohol (Abbey, Zawacki, Buck, Clinton, & McAuslan, 2004). In general, substance use predicts substance-involved assaults (SIAs) and not forcible rape (Littleton & Ullman, 2013; Messman-Moore et al., 2013; Testa et al., 2003). All the same, this depends on the substance. Alcohol problems and coping have a stiff relationship with booze-involved assaults (Classen et al., 2005; Mason et al., 2009; Messman-Moore et al., 2013, 2015), while illicit drugs, specially hard drugs such equally cocaine and heroin, are related to both substance-involved and forcible assaults (McCauley, Ruggiero, Resnick, & Kilpatrick, 2010; Messman-Moore et al., 2013; Raghavan, Bogart, Elliott, Vestal, & Schuster, 2004; Testa et al., 2003; Walsh, Resnick, et al., 2013). Although combining sexual activity and booze would seem to confer greater risk, one written report constitute that engaging in sex while under the event of alcohol did not predict revictimization (Orcutt et al., 2005).

The social surroundings may also influence the chances of revictimization. Survivors fearing stigma or who have been blamed take higher rates of revictimization (Mason et al., 2009; Miller et al., 2011). Conversely, those receiving emotional or tangible back up written report less revictimization (Stonemason et al., 2009; Ullman & Najdowski, 2011). Social environments that tolerate sexual assault may increment exposure to perpetrators. Also, social environments that blame victims may increase distress and brand survivors experience unable to refuse sexual advances, report, or seek help (Smith & Freyd, 2013).

Meso/Exosystem

Economic and contextual factors that influence survivors' interactions with systems may also touch revictimization. Economic hardship and victimization may have a cyclical relationship as a survivor'south low economic status tin decrease access to services, create distress, increment pressure level to engage in risky behaviors to acquire money (e.k., selling drugs or exchanging sex activity), and go along the survivor disempowered in relation to others upon whom they depend economically (Loya, 2014). Low economic status may also mean living in areas with customs violence that may increase distress, substance use, sexually risky behaviors, and exposure to perpetrators (for a review, see Voisin & Berringer, 2014). However, customs violence may not involve the betrayal of interpersonal violence and the subsequent emotion regulation and coping bug associated with revictimization (Goldsmith et al., 2013). In a national sample of adolescent women, by-year violence exposure was non associated with sexual assault controlling for other factors (Raghavan et al., 2004).

Race as Meta-Construct

We include race as a multilevel construct post-obit White'south (2009) argument that social identities, and associated historical and social inequalities, are situated within all levels of social ecology. Sociocultural factors and economic condition may intersect to put women of colour at risk of victimization, every bit women of color face up greater economic disparities and lack linguistic and culturally appropriate services (Loya, 2014). Black women in particular may be less likely to access rape crisis and mental health services (Weist et al., 2014). Also, Donovan and Williams (2002) contend that Blackness women are less probable to be believed and face cultural rape myths that increment risk of victimization. Conversely, White women face fewer barriers to services and have economic and social privileges that may protect confronting revictimization (Loya, 2014). Some studies have constitute higher rates of revictimization for Black women and lower rates of revictimization for White women (Mason et al., 2009; Orcutt et al., 2005; Urquiza & Goodlin-Jones, 1994); yet, one study establish no differences (Messman-Moore et al., 2013). The only written report to explore racial disparities in multiple types of revictimization plant that African American women had higher rates of forcible rape merely equal rates of incapacitated rape (Littleton & Ullman, 2013).

Macrosystem

Every bit each of our predictors comes from survivors, we unfortunately lack the data on the broader macrosystemic predictors exogenous to survivors that may contribute to violence, and hence volition not focus on them here. However, it is likely that larger cultural myths and systems are partially reflected in social reactions (east.grand., victim blaming and adherence to rape myths), economic conditions (e.k., structural and systemic racial inequalities that prohibit access to resources), and contextual stressors.

Chronosystem Factors

Finally, time since the near recent sexual assault is strongly associated with revictimization (Classen et al., 2005). The more recent the assault, the more likely survivors are to have similar levels of exposure to perpetrators and like vulnerabilities. Recent assaults also could mean that survivors have increased vulnerabilities, such every bit trauma, and are engaging in coping behaviors that may increment exposure to perpetrators. Therefore, time may non be predictive once decision-making for other factors (Miller et al., 2011).

Although studies have uncovered many predictors of revictimization, research has been limited in ii regards. Offset, researchers have ofttimes combined multiple types of assaults into one metric of revictimization or studied only i grade of revictimization, rather than comparing predictors across different types. Equally reported higher up, the few studies that have looked at revictimization past blazon have found different predictors. Withal, fifty-fifty these studies have tended to but look at differences between forcible and substance-related assaults (Littleton & Ullman, 2013; Testa et al., 2003; Walsh, Messman-Moore, et al., 2013), leaving a gap in the literature on unwanted sexual contact and compulsion. 2nd, prospective studies take seldom included more than than a few predictors, prohibiting analysis of the relative risks of unlike factors.

Current Study

To overcome these limitations, the current study examines multiple predictors of attack across different kinds of revictimization in a longitudinal study of women sexual assault survivors. Nosotros country the post-obit hypotheses:

Hypothesis i: Different forms of assault (contact, coercion, attempted or completed force, and attempted or completed SIA) will accept differential predictors.
Hypothesis 2: Unwanted contact will be more likely in contexts where general violence is more common (i.e., more dangerous contexts), violence against women is normalized (i.e., more experiences with interpersonal violence, more negative reactions to survivors, and less sexual refusal assertiveness), women are in positions of decreased ability (i.eastward., using substances during sex or exchanging sex for drugs or money), and women have greater exposure to potential perpetrators (i.e., more than sexual partners).
Hypothesis 3: Similarly, survivors volition be more than likely to confront coercion in contexts where violence against women is normalized, when in positions of decreased power, and with greater exposure to perpetrators. In addition, survivors are more likely to be targeted for coercion when they are more vulnerable (i.e., have greater self-blame and emotional regulation difficulties).
Hypothesis 4: Forced assaults will be more mutual when women are in violent contexts (i.e., dangerous contexts and interpersonal violence), have greater exposure to perpetrators, and may be less probable to written report (i.eastward., in a social environs negative to survivors or later on exchanging money for sex). Although illicit drug use may make survivors hesitant to report forceful assaults, incapacitation may subtract the chances of force; and so, we brand no predictions about this relationship. Similarly, decreased refusal assertiveness may indicate fearfulness of forcefulness and has been associated with revictimization in general (Livingston et al., 2007). Yet, 1 study found that decreased assertiveness is but related to sexual coercion and not forcible assault (Testa & Dermen, 1999); and so, we make no predictions about this relationship.
Hypothesis 5: SIAs are expected to be higher in situations where women employ substances, take greater exposure to perpetrators, and are more than vulnerable to the effects of intoxication through emotion dysregulation and decreased refusal assertiveness.
Hypothesis half-dozen: Although time and childhood assault have been found in past studies to exist common predictors of revictimization, nosotros believe that these are likely mediated through 1 if not many of the included potential predictors; so, we exercise not wait them to exist predictive one time controlling for other variables.

Method

Participants

Female volunteers (N = ane,863) from the Chicago metropolitan expanse were recruited for a 3-year survey study using print and online advertisements as well as flyers. Recruitment materials stated that we were recruiting women for a written report to "sympathise women'southward reactions to unwanted sexual experiences" and were looking for women who were "at least 18 years old," "had an unwanted sexual experience since historic period xiv," and had told "someone about the feel." Research administration sent a post survey to all women who called expressing involvement and confirmed the above 3 criteria during a brief telephone screening. All materials were in English language. If the survey was not returned within iv–6 weeks, research assistants chosen participants to confirm if they received the survey and see if they had any questions. If women had misplaced or not received the survey, we sent some other. If women no longer wished to participate, they were thanked for their time. Women who returned surveys were paid Usa$25. The return rate of surveys was 85%. Of the women who participated in Wave 1, 72% participated in Wave 2 and 56% in Wave 3.

The electric current analyses focus on the longitudinal sample n = one,012 (54%) who completed all iii waves of data. This longitudinal sample was slightly older (M = 37.88, SD = 12.72) than the participants who left prior to Moving ridge 3 (M= 34.89, SD = 12.xiii). Otherwise, the ii samples were similar across demographics (race, Latina/Hispanic ethnicity, sexual orientation, income, employment status, education, parental status, or marital status). The sample was ethnically diverse (47% Black or African American, 35% White, two% Asian, 6% multiracial, and 10% Other; xiii% were Latina or of Hispanic origin, assessed separately). The bulk had some college education (32.6% with college degree or higher, 42.0% with some college education), and 23.6% had a high school didactics or less (one.8% missing). Slightly less than half (41.8%) were currently employed, and 67.7% of women had household incomes of less than US$30,000.

Measures

All predictors were measured during the Wave 1 survey and are listed in survey order. Revictimization was assessed during Waves 2 and 3.

Substance apply

Problem drinking over the by 12 months was assessed using the 25-item Michigan Alcoholism Screening Examination (MAST; Selzer, 1971). Items were summed (M = 3.49, SD = four.34, α = .89). Participants who reported not drinking in the past 12 months were given a 0. The nineteen% of women with five or more than symptoms were rated as problem drinkers (Selzer, 1971). To assess drug use, nosotros asked the frequency of multiple drugs used in the last 12 months on a scale from 0 (never) to 5 (every day). Hard drug use was dichotomized every bit 0 (no cocaine or heroin) or 1 (whatever cocaine or heroin); 18.three% reported some hard drug use.

Stressful life events

We assessed history of dangerous contexts and interpersonal violence with the Stressful Life Events Screening Questionnaire–Revised (Goodman, Corcoran, Turner, Yuan, & Green, 1998; Green, Chung, Daroowalla, Kaltman, & DeBenedictis, 2006), which includes child and adult stressful and vehement experiences, stalking (T. Logan, personal communication, March five, 2007), and a question we added on neighborhood/community violence, "Have you ever lived in a neighborhood or community where you felt threatened or your life was in danger?" Nosotros excluded sexual set on every bit that was assessed separately. Given that the measure assessed various types of traumas, we performed a main components analysis with promax rotation and found results similar to past research dividing traumas into interpersonal and not-interpersonal (Ehring, 2010; Freyd, Klest, & Allard, 2005; Light-green et al., 2000). Both scales were summed. In our analyses, interpersonal trauma included concrete child abuse, corruption from a romantic partner, abuse from someone else, emotional abuse, and stalking (M = 2.84, SD = 1.53). Not-interpersonal traumas, which we have called unsafe contexts, included being in a military gainsay/war zone, living in a unsafe neighborhood, witnessing extreme violence, having a close friend/family unit dice violently, being threatened with a knife or gun, and having force used confronting y'all in a robbery (M = 2.17, SD = 1.57).

CSA

CSA was measured using the modified version of the 11-item revised Sexual Experiences Survey (SES-R; Testa, VanZile-Tamsen, Livingston, & Koss, 2004). Responses were dichotomized as 0 (no CSA) or 1 (whatsoever CSA) with threescore.7% reporting CSA.

Psychological symptoms

We assessed posttraumatic stress numbing symptoms related to participants' nearly serious sexual set on using the five numbing symptoms from the Posttraumatic Stress Diagnostic Calibration (PDS; Foa, 1995). Participants rated how oft they experienced symptoms over the by 12 months on a scale from 0 (never or only one time) to 3 (well-nigh always). Items are summed (M = 5.38, SD = 4.31, α = .83). Nosotros measured characterological self-blame with the Rape Attribution Questionnaire (RAQ; Frazier, 2003), a five-item scale assessing whether participants over the past 12 months felt their own grapheme traits were to blame for their attack. Items, rated from 1 (strongly disagree) to five (strongly agree), are averaged (M = two.56, SD = 0.98, α = .77). Emotional dysregulation was assessed with a modified six-item version of the Difficulties in Emotion Regulation Calibration (DERS; Gratz & Roemer, 2004; T. Messman-Moore, personal advice, May 4, 2010). Participants rated how ofttimes over the past 12 months they had experienced emotional difficulties (e.g., defoliation almost how they felt) in relation to their assault. Items, assessed with a 5-point scale from 0 (almost never) to iv (almost always), were averaged with college scores indicating greater difficulties (Grand = 2.72, SD = 0.94, α = .74).

Maladaptive coping

Post-obit a factor analysis (encounter Relyea & Ullman, 2015, for details), we used viii items from Carver'south (1997) Brief COPE calibration to assess maladaptive coping. Participants rated how often over the past 12 months they used four types of strategies (denial, behavioral detachment, substance use, and self-blame) to cope with sexual set on. Items were rated on a calibration from one (I didn't practice this at all) to 4 (I did this a lot) and were summed. Higher scores bespeak more maladaptive coping (One thousand = sixteen.05, SD = five.75, α = .81).

Negative social environment

We measured social reactions participants received subsequently disclosing sexual set on using the Social Reactions Questionnaire (SRQ; Ullman, 2000). Survivors reported how often they received reactions over the past 12 months on a scale from 0 (never) to 4 (always). Although the scale is frequently divided into the 20 positive and 26 negative social reactions, we were interested in assessing a global rating of how non-supportive social environments were toward survivors. Therefore, nosotros created a composite variable by assessing the percentage of negative reactions received out of all reactions received. On average, 37.6% of the reactions survivors received were negative (M = 0.38, SD = 0.20). The novel way of calculating survivors' social environment had skew less than 1.five and kurtosis less than 2.0.

Sexual behaviors

Nosotros assessed four sexual behaviors. Participants indicated their sexual refusal assertiveness on the half dozen-detail Refusal Assertiveness subscale of the Sexual Assertiveness Scale (SAS; Morokoff et al., 1997). Participants rated items reflecting their likelihood of refusing unwanted sexual contact from their partner on a scale from i (strongly disagree) to iv (strongly concur). Items were averaged (M = 3.35, SD = 0.98, α = .81). Number of sexual partners in the past 12 months was assessed on a scale from 0 (no partners) to v (v or more; Thou = 1.98, SD = 1.71). Participants' frequency of using alcohol and/or drugs during sexual activity was assessed on a calibration from 0 (never) to five (every time) (M = 0.90, SD = one.15). Finally, participants rated how often they exchanged sex for money from 0 (never) to five (every time) (M = 0.31, SD = 0.81).

Time

Time since the almost serious sexual attack was calculated based on the age at Moving ridge 1 minus the historic period of their most serious sexual attack (K = 15.86, SD = 12.35, range = 0–59).

Race

Participants were asked what race(south) they consider themselves to be out of six categories (White, Blackness/African American, Asian, Pacific Islander/Native Hawaiian, American Indian or Alaska Native, Other). Due to sample size and ability, race was dummy coded with the largest group, Blackness or African American (n = 473), as the reference group with dummy codes for White (n = 358) and Other (n = 181), a combined category of other groups.

Income

Total household income earlier taxes was assessed in vi ordinal categories of "$10,000 or less" to "over $50,001."

Revictimization

Revictimization was assessed at Waves 2 and iii using the xi-particular revised Sexual Experiences Survey (SES-R; Testa, VanZile-Tamsen, Livingston, & Koss, 2004). We created five dichotomized outcomes to tape whether participants at Moving ridge 2 or 3 reported whatsoever revictimization (sexual contact, sexual compulsion, attempted or completed forcible attack, and attempted or completed SIA). Contact (three items) and coercion (two items) were coded as usual on the SES-R. Typically, the remaining items are divided into attempted and completed assaults; force and SIA are not divided. Yet, as force and SIA likely occur in different contexts, we separated these perpetrator tactics. Also, equally nosotros had no information on why assaults were completed versus attempted, and reasons may non chronicle to the survivor (due east.g., did a bystander preclude it); we combined attempts and completed assaults to more conservatively assess for risk of revictimization. Strength was recorded equally whatever sexual practice acts, sexual intercourse, or attempts when the perpetrator threatened or used bodily force. SIA was coded as any sexual practice acts, sexual intercourse, or attempts when the perpetrator gave the survivor alcohol or drugs without their knowledge or consent, or when the survivor was incapacitated due to alcohol or drugs.

Data Analysis Programme

Kickoff, we calculated frequencies of revictimization across Waves ii and 3 and ran chi-foursquare analyses to assess for differences across race. We and then performed correlations of all predictor variables. Finally, to run prospective analyses, we performed logistic regressions using Wave 1 variables to predict revictimization across Waves two and three. Revictimization was coded 1 if they reexperienced that grade of revictimization beyond Waves 2 or 3, and 0 if they did not. Carve up logistic regressions were run for each blazon of revictimization (unwanted contact, compulsion, attempted or completed SIA, and attempted or completed forcible attack) every bit well as for revictimization in general.

Results

Frequency of Revictimization

The rates of diverse forms of revictimization are provided in Table ane. Notably, about one-half (49%) of female survivors experienced some class of revictimization over the 2 years since completing Wave 1. The rates of assault were slightly lower at Wave three than at Wave 2 for all forms of revictimization. Beyond both waves, unwanted sexual contact was the most common, followed by coercion, then attempted or completed forcible assail, and finally attempted or completed SIA. Chi-foursquare tests showed that White women showed much lower rates of all forms of revictimization than other women, with 39% of White women revictimized, compared with 55% of Blackness women and 52% of Other women. All the same, it is important to note that at that place was great variation in the Other category. Although very minor sample sizes mean that results should be interpreted with great caution, Native American women (northward = 5/8, 63%) and those that marked some other race or left race blank (n = 51/81, 63%) had college rates than Asian women (n = 8/xix, 42%) and those who marked more than than ane race (n = 28/61, 46%). Ethnicity was not included in regressions as chi-foursquare tests showed no divergence betwixt Hispanic and non-Hispanic women in rates of revictimization (50–48%, respectively).

Tabular array 1

Revictimization at Wave 2 or three.

	Wave ii	Wave three	Either
Whatsoever revictimization	367 (37%)	310 (32%)	474 (49%)
Contact	304 (30%)	254 (27%)	413 (43%)
Compulsion	283 (28%)	223 (23%)	369 (38%)
Force	181 (18%)	123 (13%)	236 (25%)
Substance involved	139 (14%)	106 (11%)	196 (21%)

Correlations

Correlations are reported in Table 2. Due to sample size, nigh correlations were significant. Using Cohen'due south (1988) criteria (.10 = weak, .30 = moderate, .50 = strong), most predictors had weak to moderate correlations. The only strong associations were between numbing symptoms and both emotion dysregulation (r = .56) and maladaptive coping (r = .54); emotion dysregulation with maladaptive coping (r = .64); and interpersonal traumas with dangerous contexts (r = .fifty). None were loftier enough to betoken collinearity. Maladaptive coping had the highest average bivariate association (.26) with all four forms of revictimization, while fourth dimension since the almost serious assault had the lowest average correlation (−.03).

Table 2

Pairwise Naught-Lodge Correlations Between Predictors.

	two	3	4	5	vi	7	8	9	10	11	12	xiii	14	15	16	17	18	19	20	21
one. Revictimization	.90	.81	.59	.53	−.14	−.07	.19	.twenty	.14	.19	.20	.17	.21	−.25	.25	.17	.11	.19	.12	.09
2. Contact		.77	.58	.46	−.14	−.05	.18	.19	.17	.19	.17	.18	.17	−.23	.22	.14	.11	.18	.14	.08
iii. Coercion			.61	.50	−.16	.00	.20	.21	.sixteen	.19	.sixteen	.17	.21	−.23	.25	.19	.09	.22	.12	.07
iv. Force				.59	−.18	−.01	.22	.22	.21	.15	.20	.17	.23	−.17	.28	.13	.06	.24	.14	.11
5. SIA					−.18	−.07	.14	.xviii	.14	.thirteen	.22	.thirteen	.25	−.14	.thirty	.16	.eighteen	.30	.24	.18
6. Income						.06	−.18	−.23	−.25	−.08	−.17	−.eighteen	−.17	.00	−.21	−.05	−.06	−.18	−.11	−.13
7. Time							.14	.12	.14	.01	−.06	−.xi	−.11	−.01	−.08	−.21	−.14	.01	−.08	.06
8. CSA								.29	.30	.10	.xix	.xv	.18	−.12	.22	.02	.08	.xix	.ten	.06
ix. Int viol									.50	.23	.34	.22	.28	−.14	.32	.08	.13	.19	.20	.xiv
10. Danger cont										.17	.21	.11	.18	−.05	.24	.00	.x	.23	.fourteen	.16
11. Neg react											.35	.29	.28	−.15	.38	.03	.x	.11	.12	.06
12. Numbing												.37	.56	−.15	.54	.05	.17	.sixteen	.twenty	.11
13. Self-blame													.43	−.23	.46	.07	.09	.09	.xvi	.05
14. DERS														−.21	.64	.13	.15	.xviii	.23	.08
15. Refusal															−.24	−.xi	−.13	−.xv	−.08	−.07
sixteen. Mal coping																.16	.33	.29	.33	.26
17. # Partners																	.35	.28	.14	.09
eighteen. Sub use sex																		.35	.30	.32
nineteen. Transact sex																			.24	.35
20. Alc prob																				.22
21. Hard drugs

Predicting Revictimization

In support of hypotheses, the pattern of predictors varied by type of set on (meet Table 3). Only i predictor was significant across all four types of revictimization; in comparing with Blackness women, White women had lower rates of set on. Two predictors (less sexual refusal assertiveness and more sexual partners) increased odds of experiencing 3 forms of revictimization, yet did non predict SIA. Notably, 7 predictors were non meaning across whatsoever forms of assault: years since the near serious assault, household income, numbing symptoms, maladaptive coping, difficult drug apply, interpersonal violence, and characterological self-blame.

Tabular array iii

Logistic Regression Predicting Revictimization.

	Contact (n = 618)		Coerce (north = 617)		Force (due north = 613)		SIA (n = 610)		Whatsoever SA (n = 621)
	OR	CI	OR	CI	OR	CI	OR	CI	OR	CI
Chronosystem
Time	0.99	[0.98, one.01]	1.00	[0.98, ane.02]	1.00	[0.98, 1.02]	ane.00	[0.98, 1.02]	0.99	[0.97, 1.00]
Meta-construct
Race: White	0.55^**	[0.35, 0.84]	0.37^***	[0.23, 0.59]	0.24^***	[0.14, 0.44]	0.35^***	[0.19, 0.63]	0.49^**	[0.32, 0.76]
Race: Other	0.85	[0.50, one.44]	0.74	[0.43, one.29]	0.47^*	[0.24, 0.91]	0.61	[0.thirty, 1.22]	0.81	[0.48, 1.38]
Meso/exosystem
Income	0.94	[0.84, 1.05]	0.94	[0.84, ane.06]	i.01	[0.88, i.17]	0.95	[0.82, 1.11]	0.95	[0.85, 1.05]
Danger cont	1.16^*	[ane.01, 1.34]	i.03	[0.89, one.nineteen]	i.19^t	[1.00, i.42]	one.05	[0.88, ane.25]	i.05	[0.92, 1.21]
Microsystem
Neg react	3.95^**	[1.49, 10.52]	5.51^**	[1.96, 15.53]	two.56	[0.77, 8.51]	2.12	[0.62, 7.30]	3.15^*	[ane.xx, eight.30]
# Partners	1.15^*	[1.02, 1.30]	i.26^***	[1.xi, i.43]	1.21^*	[i.04, 1.forty]	1.14^t	[0.99, 1.32]	one.xvi^*	[1.04, one.31]
Sub use sex activity	0.91	[0.76, 1.09]	0.81^*	[0.66, 0.98]	0.68^***	[0.54, 0.86]	0.92	[0.75, ane.14]	0.91	[0.76, 1.09]
Transact sexual activity	one.19	[0.90, i.56]	1.27	[0.95, ane.68]	1.48^**	[i.12, 1.97]	one.41^*	[1.07, 1.86]	1.29^t	[0.95, 1.75]
Refusal	0.66^***	[0.55, 0.80]	0.66^***	[0.54, 0.lxxx]	0.70^**	[0.55, 0.89]	0.83	[0.66, 1.06]	0.66^***	[0.55, 0.79]
Prob. drink	1.52^t	[0.94, 2.45]	1.32	[0.fourscore, two.xviii]	1.83^*	[1.06, three.18]	2.10^**	[i.23, 3.61]	1.12	[0.69, 1.83]
Hard drugs	1.38	[0.82, ii.31]	1.38	[0.80, 2.38]	one.24	[0.67, 2.29]	1.53	[0.84, two.eighty]	1.22	[0.72, 2.05]
Ontogenic
Mal. coping	0.97	[0.93, 1.02]	0.99	[0.94, 1.04]	1.01	[0.95, one.06]	1.01	[0.96, one.07]	0.98	[0.94, ane.03]
Numbing	1.02	[0.96, i.07]	0.99	[0.93, 1.04]	1.05	[0.98, 1.12]	1.05	[0.98, 1.12]	ane.03	[0.98, i.08]
Self-arraign	1.08	[0.87, ane.34]	1.01	[0.81, i.27]	0.97	[0.75, one.26]	0.79^t	[0.61, ane.03]	0.95	[0.77, 1.xviii]
DERS	1.twenty	[0.92, 1.56]	i.48^**	[one.11, i.96]	1.34^t	[0.96, 1.87]	1.63^**	[i.16, 2.29]	one.30^t	[0.99, ane.69]
CSA	ane.57^*	[1.03, ii.39]	1.94^**	[1.22, iii.06]	ane.79^t	[0.99, 3.25]	0.98	[0.55, 1.74]	i.65^*	[1.10, two.50]
Int violence	0.96	[0.83, 1.10]	1.06	[0.91, 1.23]	i.02	[0.85, 1.23]	ane.05	[0.88, ane.27]	1.06	[0.92, i.22]
Nagelkerke R ²	.23		.31		.34		.29		.25

Significant risk factors for unwanted sexual contact included a history of CSA, exposure to dangerous contexts, a greater number of sexual partners, and, the strongest predictor, receiving a greater proportion of negative reactions when disclosing assault. In improver to White women having lower rates of set on, protective factors included having greater sexual refusal assertiveness. Results were in mixed back up of hypotheses. Although social and contextual factors were significant take chances factors, a greater history of interpersonal violence was non predictive of unwanted sexual experiences.

Predictors of coercion were in partial support of hypotheses. As expected, emotion dysregulation and negative reactions predicted coerced assault; yet, confronting hypotheses neither numbing, a history of interpersonal violence, nor self-arraign predicted coercion. Other take chances factors included CSA history and a greater number of sexual partners. In addition to White participants having lower rates or coercion, protective factors included sexual refusal assertiveness and being nether the influence of substances during sex. While using substances during sex was not expected to exist protective, information technology may be that those using substances were more vulnerable due to intoxication, and thus the perpetrators did not take to use pressure or arguments.

Results for predicting attempted or completed forcible assault were again in mixed support of hypotheses. A history of interpersonal violence was not associated with a greater gamble of force. Dangerous contexts were but marginally (p = .051) associated with force, yet such contexts were significant when we ran a model that did not include income (the strongest correlate of dangerous contexts). So, income and a history of contextual traumas may both signal dangerous contexts. Other run a risk factors included having alcohol problems, participating in more than transactional sex, and having a greater number of sexual partners. Sexual refusal assertiveness and using substances during sexual activity were protective factors. Again, this last finding was not anticipated, even so it stands to reason that perpetrators were less probable to use force on those incapacitated. Finally, results showed that Blackness women had higher chances of forcible assault in comparison with White women or survivors of other races.

Predictors for SIA were also in partial support of hypotheses. Although alcohol issues increased the chances of set on, neither hard drug apply nor using substances during sex were significant predictors. Other risk factors included greater emotion dysregulation and transactional sexual practice. Being White was the just protective factor. In contrast to other types of assaults, sexual refusal assertiveness and number of sexual partners did not impact the likelihood of SIA.

Finally, results for experiencing whatsoever course of revictimization were in line with hypotheses. Revictimization was predicted by experiencing CSA, a more than negative social environment, and having more than sexual partners, while greater sexual refusal assertiveness was a protective factor. Emotion dysregulation was marginally significant (p = .055). Against hypotheses, interpersonal violence and dangerous contexts were not associated with revictimization.

Word

This is the first report to assess multiple prospective predictors across 4 types of sexual attack revictimization in community-residing women sexual set on victims. Results indicate that different types of revictimization are associated with different predictors. Take chances factors were nowadays at multiple levels of social ecology, yet occurred predominantly at the microsystem level. Broadly speaking, risks included increased exposure to potential perpetrators (a dangerous context, having more sexual partners, transactional sex), social environments more hostile to survivors, and increased vulnerability to existence targeted by perpetrators (emotional dysregulation, sexual refusal assertiveness, trouble drinking). Notably, several psychological and behavior factors, including posttraumatic numbing, cocky-arraign, and maladaptive coping, were non meaning decision-making for other variables. Overall, the predictors from the literature show a bias toward predicting force (Nagelkerke R ² = .34) and the least power to predict unwanted sexual contact (.23), despite information technology being the nearly mutual grade of revictimization survivors reported.

Our prospective report of survivors finds very similar findings to a recent longitudinal study of male person higher perpetrators (Zinzow & Thompson, 2015). In that study, college men who perpetrated compulsion and unwanted contact were more likely to exist single-fourth dimension offenders. Such offenders reported higher rates of harmful norms and beliefs, compared with non-offenders, every bit well as more adverse events in babyhood, compared with repeat offenders. Similarly, nosotros institute that the factors that predicted these forms of revictimization seemed to reverberate contexts where such violence was more normative: more negative social reactions to survivors, high rates of contextual violence, college CSA, and survivors' decreased likelihood of refusing sexual advances. Therefore, programs that target social norms seem warranted. While researchers oftentimes search for factors that mediate the link betwixt CSA and later assault, CSA was predictive after decision-making for individual factors in both Zinzow and Thompson's (2015) report of perpetrators and our sample of survivors. Either important individual variables were non included (east.thousand., risk recognition), or CSA and these forms of assault are related through mutual causes, such as familial or social contexts, that normalize sexual assault. Nevertheless, fifty-fifty in such environments, greater exposure to perpetrators through more sexual partners and greater vulnerability through both emotional dysregulation and decreased refusal assertiveness were still predictive and may be useful targets for intervention, a call similarly echoed by Gidycz and Dardis (2014).

The results concerning strength and SIA also echo Zinzow and Thompson'due south (2015) work. In their study, force and SIA were more likely to be perpetrated past echo offenders who had more than antisocial traits. As repeat offenders may be more likely to target vulnerable women (Lisak & Miller, 2002; Zinzow & Thompson, 2015), it is not surprising that women who had more than sexual action, alcohol problems, or transactional sex were more likely to be assaulted. Unlike unwanted contact or coercion, CSA was not predictive of strength or SIA later controlling for other potentially mediating factors.

Although SIA was the least common type of set on in our sample, studies testify that women with booze-involved assaults accept greater rates of revictimization than women with not-alcohol-involved assaults (Bedard-Gilligan, Kaysen, Desai, & Lee, 2011). The reciprocal relationship between alcohol-involved assault and alcohol may leave such women open to revictimization by perpetrators who target inebriated women (Messman-Moore et al., 2015). In support of this, booze issues were predictive of SIA. Although we expected using substance during sex activity to exist predictive of SIA, the zero finding could signal that at least some of those who report using substances during sex are indicating consensual substance-involved sex rather than simply being under the influence of substances. Furthermore, SIA was the only form of assault that was not predicted past having more than sexual partners or sexual refusal assertiveness. This combination of findings seems to imply that those who perpetrate SIA target someone in an intoxicated state who has not consented to substance-involved sexual activeness. Such findings stand up in support of bystander programs that teach customs members to look for perpetrators targeting inebriated women (McMahon & Banyard, 2012).

Only one predictor was meaning beyond all four types of revictimization—White women had lower rates of revictimization compared to Black women. While the rates of revictimization were high for all survivors in our sample, this disparity calls for a greater demand for research. Every bit stated in a higher place, women of color may have decreased admission to services that are culturally or linguistically advisable (Weist et al., 2014). Conversely, White women may have greater privilege and admission to resources that confer greater protection. It is possible our results are specific to the Chicago surface area, where historical and de facto neighborhood segregation mean that many women of color live in contexts with numerous systemic risk factors (e.m., decreased access to services, greater neighborhood poverty, reported police mistreatment). Although national statistics on revictimization are non available by race, the National Intimate Partner and Sexual Violence Survey (Black et al., 2011) found rates of lifetime rape victimization (in decreasing order of rate) for multiracial (34%), Native American or Alaska Native (27%), Black (22%), White (nineteen%), and Hispanic women (15%). Given that much sexual set on research occurs in predominantly White college campuses, more quantitative studies are disquisitional in diverse community samples to determine whether these disparities be elsewhere. Qualitative or mixed methods studies could aid uncover the structural, social, and systemic factors related to such victimization.

Several commonly discussed predictors of assault were non significant predictors of whatever form of revictimization. Time since the most recent assault and interpersonal violence are normally considered robust predictors (Classen et al., 2005). It is possible that our metric of time since the nearly "serious" assault, rather than "contempo," was responsible for this difference as the most recent assault could be more predictive of current functioning and context. Even so, given that time has small to moderate correlations with revictimization, we may have included all mediating factors. The null findings for interpersonal violence were surprising; however, in a written report of college women, a history of emotional corruption, concrete corruption, rape, and CSA did not fit in a model predicting prospective rape and/or revictimization (Messman-Moore et al., 2009). Interpersonal violence may not be pregnant as a predictor once controlling for other factors. Alternatively, emotional and physical violence may only be a concurrent risk factor, such equally being in a violent human relationship, rather than a prospective risk cistron. Finally, it is possible that our sample of survivors of sexual attack that disclosed attack had such high rates of distress that interpersonal violence did not have an additive effect.

Notably, neither numbing, maladaptive coping, nor self-blame were predictive of revictimization. Given that these mutual sequelae of assault are often theorized as mediators, this was surprising. However, it is possible that these factors are mediated by more proximal factors such as sexual refusal assertiveness, having more sexual partners, or problem drinking (Walsh, Galea, & Koenen, 2012). This is a likely explanation at to the lowest degree for maladaptive coping, which had the strongest bivariate correlations to nearly all forms of revictimization in comparison with other predictors. Futurity studies should examine the links between these factors and potential mediators across different types of revictimization.

Confronting hypotheses and contrary to prior inquiry, household income and difficult drug use were not predictive of revictimization. We may have included other variables that mediated this risk. Hard drug use may expose survivors to dangerous contexts and make them vulnerable through increased financial reliance on others. For instance, transactional sex predicted SIAs. In our sample, 44% of hard drug users engaged in transactional sex activity compared with only xi% of those not using. Advocacy organizations and case workers should screen for and help survivors transition out of more exploitative or violent circumstances, and notice alternative routes of economic resources. Similarly, household income may not be predictive once accounting for dangerous contexts. Women's income relative to their partners may exist a more than useful metric for chance of violence (Schewe, Riger, Howard, Staggs, & Bricklayer, 2006).

In that location are several limitations to the present study. The written report used Wave i predictors to predict revictimization beyond Waves 2 and iii. Although such prospective analysis is a strength, the predictors were measured during the same time bespeak at Wave i. Predictors may be more proximally or distally related to the assault, vary in predictive strength over fourth dimension, or collaborate with each other. For instance, while emotional dysregulation may brand one more vulnerable, the principal effect on assault might be mediated through coping strategies to deal with bear on, such equally engaging in sexual activity to cope with negative affect. Therefore, future studies should tease out how these factors relate to each other over fourth dimension. Also, we combined attempted and completed assaults for SIA and force because we practise non accept information on what occurred that prevented attempts from being completed. Although this may more than conservatively predict take chances of perpetrators attempting assault, some variables such every bit refusal assertiveness may differentially affect the chances of completion and attempts. Also, nosotros should note that SIA was assessed using the SES and relied on survivors' reports of whether substances were related to their assault. Many more survivors may take been targeted while drinking only did not study this on the SES considering they consumed the alcohol voluntarily and did not know this is why they were targeted. Finally, the present sample used a population of survivors of adult sexual assault who disclosed assaults and therefore may non represent survivors of CSA or survivors who did non disembalm.

Our study connected to show that sexual assault survivors confront high rates of revictimization. As risk varied by the type of revictimization, researchers should continue to look at predictors past type. Our findings as well bespeak a need to uncover more predictors of unwanted sexual contact, the most common form of set on experienced, and sympathize factors that identify women of colour at higher risk of revictimization. Promisingly, our findings support the contempo increment in programs that target social norms for violence and encourage bystanders to intervene in situations where women may be vulnerable to targeting past perpetrators. Likewise, our findings support healthy sexuality programs and programs aimed at increasing women's sexual refusal assertiveness. Hopefully, past understanding which factors are predictive for which women in which circumstances, interventionists can begin to decrease the rates of revictimization.

Acknowledgments

The authors admit Cynthia Najdowski, Liana Peter-Hagene, Amanda Vasquez, Meghna Bhat, Rannveig Sigurvinsdottir, Rene Bayley, Gabriela Lopez, Farnaz Mohammad-Ali, Saloni Shah, Susan Zimmerman, Diana Acosta, Shana Dubinsky, Brittany Tolar, and Edith Zarco for assistance with data drove.

Funding: The author(s) disclosed receipt of the following fiscal support for the research, authorship, and/or publication of this article: This research was supported by the National Institute on Booze Abuse and Alcoholism (NIAAA) Grant R01 #17429 to Sarah E. Ullman.

Footnotes

Annunciation of Alien Interests

The writer(s) alleged no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323368/