Characteristics of rural communities affecting victims’ ability to seek and access response services include lack of telephone service, public transportation, and privacy. Attitudes contributing to barriers include mistrust toward “outsider” interventions (e.g., law enforcement or social service agencies) and acceptance of traditional gender roles. Health and social services tend to be limited in rural areas, and victims must travel long distances to access them or wait a long time for emergency response. Victims may be less aware of services available to them. Existing victim and offender services are often managed by volunteers from the community, and confidentiality may be compromised. To address these barriers, the authors suggest a collaborative approach involving partnerships between different organizations and agencies, and encourage practitioners to obtain training to improve their ability to work with rural communities.
These summaries were written by SVPEP staff and are based on original papers published within the last 6 years. The information available on this web site is provided as a public service and does not necessarily reflect the opinion of the U.S. Centers of Disease Control and Prevention, the Arizona Department of Health Services, or the University of Arizona. To conduct an individual search or locate older articles use the Search Summary Database which includes over 600 articles related to sexual violence.
View Research Summaries by Year
Averill, J. B., Padilla, A. O., & Clements, P. T. (2007). Frightened in isolation: Unique considerations for research of sexual assault and interpersonal violence in rural areas. Journal of Forensic Nursing, 3, 42-46.
The article focuses on recommendations for forensic nurses.
Basile, K. C., Black, M. C., Simon, T. R., Arias, I., Brener, N. D., & Saltzman, L. E. (2006). The association between self-reported lifetime history of forced sexual intercourse and recent health-risk behaviors: Findings from the 2003 National Youth Risk Behavior Survey. Journal of Adolescent Health, 39, 752.e1-752.e7
In a nationally representative sample of 13,080 high school students, 1 in 8 girls and 1 in 16 boys reported a history of forced sexual intercourse. Female and male victims were more likely to also have experienced recent dating violence and engage in health risk behaviors compared to non-victims.
This study used data from the 2003 Youth Risk Behavior Survey. Students provided information on a range of health risk behaviors. Both female and male victims of forced sex were more likely than non-victims to have been physically abused by a dating partner and to have considered or attempted suicide in the previous 12 months. Female and male victims were more likely to have engaged in recent unhealthy eating behaviors and substance abuse. Because the survey asked about only one type of sexual violence (forced intercourse), it is likely that the rates of sexual victimization were higher than reported in the study. The researchers recommend increasing both primary and secondary prevention efforts to reduce the harm of sexual violence.
Basile, K. C., Swahn, M. H., Chen, J., & Saltzman, L. E. (2006). Stalking in the United States: Recent national prevalence estimates. American Journal of Preventive Medicine, 31, 172-175.
Researchers analyzed data from the second national Injury Control and Risk Survey (ICARIS-2; N=9684). Respondents were considered victims of stalking if they had been followed and described the experience as “somewhat dangerous” or “life-threatening.” Based on this definition, an estimated 7 million women and 2 million men in the United States have been stalked. Significant factors associated with having been stalked included being female, white, not married or living as a couple, being employed, and being less than 55 years old. The authors recommended research to develop prevention interventions that can be used jointly by criminal justice and public health to reduce the prevalence of stalking and provide services to victims.
Lack of information on the relationship of the stalker to the victim. Description of stalking was limited to two questions, and stalking tactics used were not assessed.
Campbell, R. & Raja, S. (2005). The sexual assault and secondary victimization of female veterans: Help-seeking experiences with military and civilian social systems. Psychology of Women Quarterly, 29, 97-106.
The study sample consisted of 268 primarily low income, African-American (77%) female veterans and reservists seeking medical care at a VA clinic. Out of 104 sexual assaults described, 38% occurred while a woman was in military service, and 82% of those were committed by a military peer or supervisor. Similar numbers of victims of military and non-military assault sought medical treatment after an attack. Although military medical providers engaged in fewer secondary victimization behaviors than non-military providers, victims were more likely to have negative feelings after treatment by military medical personnel. Military victims were more likely to have reported the assault to legal personnel (59%) than non-military victims (26%). Both groups experienced similar overall levels of legal secondary victimization. All victims who encountered any secondary victimization behaviors reported more post-traumatic stress symptoms. In light of the high prevalence rates, the researchers recommended that the VA expand services such as the Women Veterans’ Comprehensive Health Centers to create environments where women can receive respectful and appropriate treatment.
Chisholm, J. F. (2006). Cyberspace violence against girls and adolescent females. Annals of New York Academy of Science, 1087, 74-89.
This article summarized types of “cyberviolence” (online bullying and other forms of exploitation). The ability to send messages anonymously and instantly through text messaging or email has created a new set of potential benefits and dangers for young people. Online culture evolves rapidly and can vary dramatically by age group. Adults who are not as technologically savvy as youth may not be aware of bullying and other damaging online behavior and thus not able to protect young people from online dangers.
Several projects working to prevent or mitigate victimization are presented. The author recommended that research be done to examine the effects of online socializing on adolescent development, and how the Internet continues to change patterns of communication. She also recommended training for mental health practitioners who work with youth to recognize signs of online victimization.
Collier, B., Ghie-Richmond, D., Odette, F., & Pyne, J. (2006). Reducing the risk of sexual abuse for people who use augmentative and alternative communication. Augmentative and Alternative Communication, 22, 62-75.
Augmentative and alternative communication (AAC) is used by people who have difficulty speaking, and includes signing systems as well as communication devices and tablets. This article describes “Speak Up – Safeguarding People who use Augmentative Communication from Sexual Abuse/Victimization,” a 3-year program to identify and address issues related to intimate relationships, sexuality, and abuse. Most of the 26 participants (14 males, 12 females) requested information on healthy sexuality and disability as well as dealing with sexual abuse. Most reported that they had not received this information from parents, schools, or helping professionals. Other types of abuse were also discussed. Initially, some participants did not recognize abusive experiences in their lives because the behavior was so common that it was not considered unusual. Over the study period, half of participants requested counseling services to address issues of past or on-going abuse. Barriers to education and services were considerable for this population, as most legal and health system professionals have limited understanding of AAC, and many AAC systems did not include vocabulary that would allow people to discuss sex or abuse. To meet the identified needs of the participants, the researchers prepared educational materials for their use (available online) and developed resources and recommendations for families and service providers (available online and appended to the article).
This was not a representative study; participants were both self-selected and selected by researchers for their ability to communicate in group settings. The researchers deliberately chose not to ask participants about their experiences of sexual abuse. For these reasons, the information shared by participants should be considered anecdotal.
Davis, K. C., Norris, J., George, W. H., Martell, J., & Heiman, J. R. (2006). Men’s likelihood of sexual aggression: The influence of alcohol, sexual arousal, and violent pornography. Aggressive Behavior, 32, 581-589.
A total of 84 male social drinkers between 21-45 years old were randomly assigned to a group that received alcohol or a group that did not. Both groups were then asked to read one of two rape scenarios which differed by whether the victim experienced pleasure during the rape. Three factors related to sexual response were measured: alcohol intoxication; belief that intoxicated women were vulnerable to sexual coercion; and a victim’s positive sexual response to rape. The single factor that predicted reporting likelihood of sexual aggression was a high level of sexual arousal. Intoxication and belief in drinking women’s vulnerability were not directly linked to increased aggression, although they were related to arousal. Both sober and intoxicated men reported greater arousal when the victim’s response in the scenario was positive. If any of the factors were present without increased arousal, they were not related to increased aggression.
Testing only two levels of intoxication (sober or drunk), self-report of arousal without physiological measures, and lack of measurement of men’s actual aggressive behavior. The study did not look at how likely men were to report the probability of aggressive sexual behavior if they were not exposed to violent pornography.
Decker, M. R., Raj, A., & Silverman, J. G. (2007). Sexual violence against adolescent girls: Influences of immigration and acculturation. Violence Against Women, 13, 498-513.
Researchers looked at data from Massachusetts Youth Risk Behavior Surveys conducted in 1999, 2001, and 2003 to identify associations between immigrant status, acculturation, and sexual assault among adolescent girls (N = 5,919). Fifteen percent of girls in the sample had experienced sexual violence (defined as “sexual contact against your will”). Immigrant girls had twice the risk for recurrent sexual violence compared with non-immigrant girls. Compared with the total sample (including other immigrants), immigrant girls aged 15 or younger and Black adolescent immigrant girls were at increased risk for recurrent sexual assault. Although researchers found significant sexual violence risks for all sexually active girls, sexually active immigrant Hispanic girls were at greater risk compared with nonimmigrant sexually active Hispanic girls. Recommendations for further studies included a break down of ethnic identification and country of origin (this study collapsed both); exploring the relationship of the perpetrators and victims; and separating and quantifying measures of consensual and non-consensual sexual activity.
Respondents may not have distinguished between having had intercourse voluntarily or through force or coercion, which may have resulted in girls who had only experienced abuse being labeled sexually active. Researchers were unable to identify the relationship of the perpetrator to the victim. Highest-risk adolescents may not have been in school and may not have been represented in the study.
Decker, M. R., Raj, A., & Silverman, J. G. (2007). Sexual violence against adolescent girls: Influences of immigration and acculturation. Violence Against Women, 13, 498-513.
Researchers looked at data from Massachusetts Youth Risk Behavior Surveys conducted in 1999, 2001, and 2003 to identify associations between immigrant status, acculturation, and sexual assault among adolescent girls (N = 5,919). Fifteen percent of girls in the sample had experienced sexual violence (defined as “sexual contact against your will”). Immigrant girls had twice the risk for recurrent sexual violence compared with non-immigrant girls. Compared with the total sample (including other immigrants), immigrant girls aged 15 or younger and Black adolescent immigrant girls were at increased risk for recurrent sexual assault. Although researchers found significant sexual violence risks for all sexually active girls, sexually active immigrant Hispanic girls were at greater risk compared with nonimmigrant sexually active Hispanic girls. Recommendations for further studies included a break down of ethnic identification and country of origin (this study collapsed both); exploring the relationship of the perpetrators and victims; and separating and quantifying measures of consensual and non-consensual sexual activity.
Respondents may not have distinguished between having had intercourse voluntarily or through force or coercion, which may have resulted in girls who had only experienced abuse being labeled sexually active. Researchers were unable to identify the relationship of the perpetrator to the victim. Highest-risk adolescents may not have been in school and may not have been represented in the study.
Del Bove, G., Stermac, L., & Bainbridge, D. (2005). Comparisons of sexual assault among older and younger women. Journal of Elder Abuse & Neglect, 17, 1-18.
This study compared sexual assault of older and younger women by reviewing medical records of those treated at a sexual assault care center in Ontario, Canada. The authors divided women into three groups by age: young (15-30 years; n=78), mid-age (31-54 years; n=73), and eldest (55-87; n=61). Elder women were more likely to be cognitively disabled than women in the younger groups. Older women were more socially isolated: they were more likely to live alone and significantly less likely to be accompanied to the care center by a friend than either of the other groups. More than half (51%) of elders were attacked in their homes, compared with 20% of mid-age women and 19% of young women. There was no significant difference found between the groups in the relationship of the attacker to the victim: about 40% of all assailants were strangers, and acquaintances were responsible for between 35-48% of attacks. Significant differences were not found in the type(s) of assault, injuries sustained, or need for hospitalization, although there was a trend toward increased vaginal injuries in older women. Weapons were used more frequently on younger women; however, the same levels of physical violence and restraint were used against older and younger women. To develop preventive strategies, the authors recommended that further research be done with women in assisted care facilities (almost 15% of elder victims were living in group settings). They also suggested identifying the actual relationship of acquaintances to their victims, as this may differ by age group.
Fitzgerald, M.M., Danielson, C.K., Saunders, B., & Kilpatrick, D.G. (2007).Youth victimization: Implications for prevention, intervention, and public policy. The Prevention Researcher, 14, 3-7.
The authors review national prevalence rates of youth victimization, including: sexual, emotional or physical abuse; witnessing domestic or community violence; property crime; and excessive punishment. They note gender and race/ethnicity differences in prevalence rates as well as mental health effects. Specific recommendations for assessing risk and resiliency factors as well as screening for victimization in clinical settings are given. The authors discuss the importance of targeted interventions for specific groups, and urge adoption of an ecological model. Finally, the authors discuss how public and organizational policies can help decrease the impact of victimization and increase the availability of supportive services for youth and their families.
Hassouneh-Phillips, D., & Curry, M. A. (2002). Abuse of women with disabilities: State of the science. Rehabilitation Counseling Bulletin, 45, 96-104.
This review article evaluated quantitative and qualitative research on all kinds of abuse of women with disabilities. Despite the preliminary nature of most of the studies and some methodological issues, there is evidence that abuse rates are higher among people with disabilities, and some barriers to services are unique to this group (e.g., lack of physical access to victim service sites). Across studies, friends, family members, caregiving staff, and other service users (in institutional settings) were the most common perpetrators; the majority of victims were female and the majority of offenders were male. The authors provide information on abuse screening tools for use with disabled populations. Several prevention programs developed for people with developmental disabilities are also described. The authors recommend including routine screening for abuse in all medical and rehabilitation settings. More research is needed to determine if groups with different disabilities have different risk factors.
This is a review article, and it is not clear that the literature review was complete.
Hokoda, A., Galvan, D. B., Malcarne, V. L., Castenda, D. M., & Ulloa, E. M. (2007). An exploratory study examining teen dating violence, acculturation, and acculturative stress in Mexican-American adolescents. Journal of Aggression, Maltreatment & Trauma, 14, 33-49.
This exploratory study examined Mexican-American high school students’ experiences with and attitudes towards dating violence and the relationship they may have with acculturation and acculturative stress. Eighty-two students from a large urban area located near the US and Mexican border participated in the study. Results indicated that those that were medium acculturated, compared to low and high levels, reported less tolerant attitudes towards male dating violence (psychological, physical, sexual) and female dating violence (psychological and sexual). Acculturation was measured by language use and preference. Higher levels of acculturative stressors were related to more tolerant attitudes and higher rates of perpetration of dating violence. The results may be helpful in designing dating violence intervention programs for Mexican immigrant teens that may include information about the process of acculturation, social problem solving, and stress management skills for acculturative stressors.
Small sample size and limited ability to make causal inferences.
Kisiel, C., Blaustein, M., Spinazzola, J., Schmidt, C. S., Zucker, M., & van der Kolk, B. (2006). Evaluation of a theater-based youth violence prevention program for elementary school children. Journal of School Violence, 5, 19-36.
Four classrooms of fourth-grade students (n=77) participated in Urban Improv (UI), a youth violence prevention program incorporating theater and education. The program consisted of nine weekly sessions, and incorporated experiential learning and discussion. Students in participating classrooms were compared with students in four classrooms that did not participate in UI (controls: n=63). Students and teachers completed pre- and post-program evaluations. Students completed self-report on measures on their social skills, problem behaviors, coping style, and attitudes and beliefs about aggression. Teachers reported on their students’ demonstration of pro-social skills (cooperation, self-control, and assertiveness) and problem behaviors. Though student self-reports did not indicate changes between pre- and post-tests, teacher post-program assessments showed significant positive differences between participants and controls. Participants were found to maintain baseline levels of aggression, while controls’ aggressive behavior increased. Pro-social behaviors increased in the participant group and decreased in the control group. Additionally, students who participated in the program showed an improvement in attention/ engagement behaviors, while non-participants showed a decrease in those behaviors.
Lacasse, A. & Mendelson, M. J. (2007). Sexual coercion among adolescents: Victims and perpetrators. Violence Against Women, 22, 424-437.
Students in a suburban Quebec school were asked if other students had verbally harassed them, made non-coercive sexual contact (e.g., unwanted kissing) or attempted to obtain sexual favors using blackmail or force in the previous 3 months. They were also asked if they had perpetrated those acts on another student. The study included 37 students who reported being victimized and 21 who reported perpetrating the behavior. These groups were then compared with a matched control sample of students. Female students who were victims (n=27) were more likely to endorse sexist attitudes than other girls; boys who were perpetrators were more likely to endorse sexist attitudes than other boys. All victims were more likely to use drugs and alcohol than controls or perpetrators. Both victims and perpetrators were involved with more deviant behaviors than controls.
A small sample size; students were only asked about peer-related behaviors outside of romantic relationships, which may have resulted in underreporting of victimization; and the perceived severity of the experiences was not assessed.
Lee, D.S., Guy, L., Perry, B., Sniffen, C.K., & Mixson, S.A. (2007). Sexual violence prevention. The Prevention Researcher, 14, 15-20.
The authors reviewed the feminist theoretical basis for sexual violence prevention programs, which states that cultural norms and unequal gender roles lead inevitably to violence against women. They argue that education efforts that address attitudes about gender roles and seek to build relationship skills can be made more effective by incorporating them into comprehensive and community change models. Several comprehensive programs developed using the Ecological Model and the Spectrum of Prevention model are described. Examples of programs based on community mobilization, changing social norms, and social marketing illustrate community level prevention strategies. The importance of promoting policy changes at local and national levels is emphasized. Finally, the authors call for more funding and research into cultural causes of and responses to sexual violence.
McFarlane, J., Malecha, A., Watson, K., Gist, J., Batten, E., Hall, I. et al. (2005). Intimate partner sexual assault against women: Frequency, health consequences, and treatment outcomes. Obstetrics & Gynecology, 105, 99-108.
Women who had requested orders of protection against abusive partners participated in this descriptive study (N=148). Sixty-eight percent (n=100) reported being sexually assaulted at least once by their partner. Women who were sexually assaulted multiple times reported significantly higher levels of gynecologic problems, including sexually transmitted diseases, than non-sexually assaulted women. Higher PTSD scores were found in women who were sexually assaulted than among those who were only physically assaulted. For either type of assault Latina/Hispanic women had higher PTSD scores than African American or White women. Women were less likely to be reassaulted if they told someone about the assault, contacted police, applied for protection orders, or received medical care. The researchers recommend the adoption of cooperative models that increase victims’ ability to access justice and medical services.
Participants were recruited from a group of women who had applied for protective orders, and may differ from women who do not seek assistance from the justice system. The study relied on self-reports, which are subject to recall errors and omissions.
Messman-Moore, T. L. & Brown, A. L. (2006). Risk perception, rape, and sexual revictimization: A prospective study of college women. Psychology of Women Quarterly, 30, 159-172.
In this longitudinal study, 262 women completed a series of questionnaires four times over eight months. Rates of sexual victimization and rape experienced by participants were assessed over time. At baseline, 56.8% of the women had already experienced some form of sexual victimization in their lifetime. Participants were asked to read two scenarios ending in rape, one involving a male acquaintance and the other a male stranger (scenarios are presented in the Appendix). Women indicated at what point during the scenario they would feel uncomfortable and when they would leave the situation. During the eight month follow-up period, 43.4% of participants reported some type of unwanted sexual experience, and 10% of the women were raped. Prior victimization and delayed risk response (i.e., leaving the hypothetical situation later in the scenario) were associated with increased likelihood of sexual victimization during the course of the study. The researchers recommended that prevention programs place more emphasis on risk-reduction behaviors rather than risk identification, and that acquaintance rape scenarios should be used more than stranger rape scenarios in sexual violence education programs.
Moracco, K. E., Runyan, C. W., Bowling, J. M., & Earp, J. A. (2007). Women's experiences with violence: A national study. Women's Health Issues, 17, 3-12.
During 1997, telephone interviews were conducted with 1800 US women aged 18 years and over. Women were asked about stalking behaviors, physical assault, and sexual assault that they had experienced both during their adult lives and during the previous year. Data were weighted to account for demographic variations. Consistent with other national surveys such as the National Violence Against Women Survey, about one in six women reported having been sexually assaulted, and the perpetrator was three times more likely to be someone known to them than a stranger. Racial/ethnic differences were also similar to other national findings, with Asian American and white women being less likely to experience violence than all other groups. Other risk factors for having experienced sexual violence included being less than 55 years old (young women aged 18-24 reported the most violence), living in a household that received public assistance, and being lesbian/bisexual.
The sample was restricted to women living in households with telephones. Because the study was cross-sectional, the causal relationship of risk factors to types of violence experienced cannot be explored.
Schad, M. M., Szwedo, D. E., Antonishak, J., Hare, A., & Allen, J. P. (2007). The broader context of relational aggression in adolescent romantic relationships: Predictions from peer pressure and links to psychosocial functioning. Journal of Youth and Adolescence, 37, 346-358.
Relational aggression can be defined as an attempt to inflict harm on another person through manipulation or by damaging other social relationships by indirect or covert means (e.g., gossiping, lies, betrayal, isolation). It can occur in peer relationships as well as intimate relationships. This study looked at the association between experiencing relational aggression in best friend relationships and peer groups during adolescence and perpetrating or being a victim of relational aggression in later romantic relationships. Observational and written data was collected from a group of 15-year-olds (n=97) and their best friends; in the second wave of data collection three years later, target youth and their romantic partners completed written questionnaires. Youth were more likely to exhibit relational aggression in future romantic relationships if their best friends and peer groups used pressuring behaviors. Those who had experienced peer pressure from their social groups were also more likely to report feeling victimized by relational aggression in later romantic relationships. Higher levels of alcohol use and depression were reported among youth in romantic relationships characterized by relational aggression.
The study used a small sample, and some of the measurements need to be replicated and validated. The links between peer pressure, relational violence, alcohol use, and depression should be further investigated.
Spitzberg, B. H. & Cupach, W. R. (2007). The state of the art of stalking: Taking stock of the emerging literature. Aggression & Violent Behavior, 12, 64-86.
This meta-analysis summarizes the results of 175 studies of stalking. In addition to looking at variations in prevalence between studies, the authors considered the definitions of stalking and described the closely-related set of behaviors termed “obsessive relational intrusion.” The authors created systematic typologies of types of stalkers, stalkers’ motivations, and types of stalking behaviors. Victims’ coping responses and the effects of stalking are also categorized. The majority of stalking victims are women. Because the majority of victims (79%) were acquainted with the stalker, and because half of all stalking was related to romantic relationships, the authors recommended looking at most stalking not only as criminal behavior or psychopathology, but as a type of “relationship terrorism” similar to other types of domestic violence.
Wolak, J., Mitchell, K., & Finkelhor, D. (2007). Unwanted and wanted exposure to online pornography in a national sample of young Internet users. Pediatrics, 119, 247-257.
The 2005 Youth Internet Safety Survey conducted phone interviews with 1,422 youth to measure exposure to online pornography during the previous year and the characteristics of those most at risk of being exposed. Online pornography was defined as pictures on a website or as a downloaded image of naked people or people having sex. Youth were divided into three groups: those with wanted exposure (they wanted to see the image); unwanted exposure (they did not want to see the image); and those with both types of exposures. Youth were also asked about how they used the Internet. The only type of Internet use related to unwanted exposure was the use of file-sharing programs to download images. More than half of all boys 14-15 years old and two-thirds of 16-17 year olds had some exposure to online pornography. As boys aged, they were more likely to want exposure than not. Among girls, wanted exposure increased slightly with age but unwanted exposure strongly increased. Depressed youth were slightly more likely to be exposed to wanted and unwanted pornography. Filtering, blocking, or monitoring software and law enforcement presentations reduced unwanted exposure to online pornography.
Young, A., Young, A. & Fullwood, H. (2007). Adolescent online victimization. The Prevention Researcher, 14, 8-9.
In a review of three recent studies, the authors estimated national prevalence of online victimization of youth at 13% for sexual solicitation; 34% for exposure to unwanted sexual material; and 9% for any type of harassment. The majority of incidents was not distressing and was not reported to adults. Risk factors for online victimization included older age (youth 14-17 were at higher risk than younger children) and gender (girls were more likely to experience sexual solicitation or harassment than boys). In one study, 60% of youth gave out personal information in an online questionnaire or form. About 45% gave that information to someone they had met online. Possible prevention strategies include frank discussion by adults about Internet victimization so that youth are better equipped to avoid it and deal with it if it happens. The authors recommended making youth aware of the possible consequences of sharing personal information online. Adults can also prepare youth to take action if they are victimized: removing themselves from the situation; changing screen name; and reporting the incident to prevent others from being victimized.