Associations Between Sexual Assault Severity and Psychological and Physical Health Outcomes: Similarities and Differences Among African American and Caucasian Survivors

Abstract

There are well-established associations between sexual assault victimization and deleterious psychological and physical health outcomes. The present study contributes to the emerging health disparities literature by examining similarities and differences in relationships between the severity of the sexual assault and health in a community sample of African American and Caucasian survivors. Although the overall pattern of relationships was expected to be comparable for all survivors, some associations were hypothesized to be stronger for African American survivors as compared with Caucasian survivors based on theories of chronic stress. Single, African American, and Caucasian women were recruited for a study of dating experiences through random digit dialing in one large metropolitan area. Participants who experienced a sexual assault since age 14 were included in this study (121 African American and 100 Caucasian women). Multigroup path analyses indicated that for both African American and Caucasian survivors, sexual assault severity was significantly positively associated with posttraumatic stress disorder (PTSD) symptoms, and depressive symptoms were significantly positively associated with physical health symptoms. Among African American survivors, sexual assault severity affected physical health symptoms indirectly through its impact on depressive symptoms, and assault severity indirectly affected drinking problems through its impact on PTSD symptoms; these relationships were not found for Caucasian survivors. These findings highlight the need for additional research that focuses on health disparities in sexual assault survivors' recovery process, so that treatment programs address culturally relevant issues.

Keywords: drinking problems; ethnicity; health disparities; posttraumatic stress; sexual assault.

Figure 1.

Hypothesized Model of Sexual Assault Severity as it Relates to PTSD Symptoms, Depressive Symptoms, Physical Health Symptoms, and Drinking Problems (N = 221)

Figure 2.. Revised Model of Sexual Assault Severity as it Relates to PTSD Symptoms, Depressive Symptoms, Physical Health Symptoms, and Drinking Problems (N = 221): Multi-group Comparison

Note: Standardized loadings shown. Path coefficients for African Americans appear first; path coefficients for Caucasians appear second. Pathways that are significantly different between groups have a bolded arrow. ^†p = .06. *p < .05. **p < .01. ***p < .001.