PhD in Nursing Science Program

Rape Trauma: A Study of Preferred Rape Disclosure Methods and Factors Influencing Psychological Outcomes in Rape Victims

Dissertation under the direction of Professor Sheila H. Ridner, PhD, RN, FAAN

This project is concerned with factors influencing psychological outcomes in rape victims, including factors that may be protective of psychological sequelae (depression, anxiety, post-traumatic stress disorder) known as rape trauma, and further explores the possible impact of disclosure history and preferences. In this dissertation I explore these factors through a conceptual framework, derived from theories of hope, coping, and rape trauma in female adult survivors of rape via an anonymous online survey.

Few studies to date have attempted to examine the effect of the perpetrator/victim relationship on rape trauma (RT), and those that have did not clearly delineate appropriate possible categories. This is the first known study that has attempted to provide a group difference based on RT (depression, anxiety, PTSD), delineating specific perpetrator categories. Findings from this study found no statistically significant differences among the groups – highlighting that rape is a traumatic experience irrespective of the perpetrator.

Findings relative to the type of rape shed light on the significance between the type of rape experience and rape trauma related to depression, anxiety and PTD. Post-hoc analysis of the overall difference in depression revealed that the multiple rape group (p = .010) and the forcible sex group (p = .016) had higher levels of depression than did the group experiencing sex stress.  There was also a statistically significant difference among the type of rape trauma groups in the rates of PTSD (Likelihood Chi-Square p = .044). Thus, consideration of type of rape may play a potential integral role in informing future interventions.

Additionally, this study explored possible protective factors of rape relative to psychological outcomes. Both hope and present perceived control were inversely statistically significantly associated at 0.33 or above (10% of the shared variance) with all three RT outcome measure (depression, anxiety, PTSD). Findings from this study have illuminated the significance of hope to both present and future perceived control and coping, as well as demonstrated that hope is the most integral of the possible protective factors related to RT outcomes. Further, canonical analysis revealed that lower levels of hope, present perceived control, and decreased use of acceptance coping, along with an increased tendency toward substance use for coping, higher propensity for self-blame, higher levels of behavioral disengagement, and a tendency to sue denial and self-distraction for coping was associated with higher levels of depression and trait anxiety.

Finally, disclosure history and preferences were found to play a key role relative to victim treatment seeking and self-blame, and validated that participants overwhelmingly preferred follow-up contact online rather than face-to-face or by telephone. The study found that 24% of participants admitted this was their first disclosure, with79% of those citing first time disclosure, and 70% who had previously disclosed preferring the online venue.  Thus, victims may be more readily reached, and thus be more open to disclosure and pursuit of treatment via an online vehicle. These factors therefore, warrant further and more in depth exploration.