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Cited by 825Sexual Assault and Victimization StudiesChild Abuse and TraumaPosttraumatic Stress Disorder Research

The DOI matches its Crossref record; 233 of the 243 references it cites were found in a registry or an index; 8 of the 107 sources its claims cite were checked for support.

Sexual assault victimization and psychopathology: A review and meta-analysis

Open access
Dworkin, Emily R., Menon, Suvarna V., Bystrynski, Jonathan, Allen, Nicole E.·2017·Clinical Psychology Review
DOI 10.1016/j.cpr.2017.06.002PMC PMC5576571
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Abstract

Sexual assault (SA) is a common and deleterious form of trauma. Over 40years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970 to 2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges' g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and relatively stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. The use of broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) was not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.cpr.2017.06.002

Cites

233 of 233 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

8 of 107 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Probably not a substantial claim. 33
  • It may state two separate claims as one. 44
  • The quote only partly states this claim. 6
73 of 73

  • The paper relies on this without support.

    Qualitative reviews in this area tend to be unsystematic.

    “Qualitative reviews on this topic tend to be unsystematic, and as such, do not offer a rigorous, thorough picture of the state of the science in this area.”

  • The paper relies on this without support.

    Most research on SA and psychopathology has found associations, but some exceptions exist and studies vary in the strength of the association.

    “Although the bulk of the research on this topic has identified associations between SA and various forms of psychopathology, exceptions exist, and studies differ with regard to the strength of the association that they identify.”

  • The paper relies on this without support.

    The trauma literature has mainly focused on PTSD, with less attention to other conditions.

    “The psychological literature on trauma has primarily focused on posttraumatic stress disorder, although other conditions often observed in traumatized populations (e.g., depression, anxiety, substance use disorders) have received relatively less attention (aside from their co-occurrence with PTSD).”

  • The paper relies on this without support.

    There is substantial variation in how SA is assessed in the field.

    “There is significant variation in the field regarding the assessment of SA.”

  • The paper relies on this without support.

    Researchers using the Sexual Experiences Survey differ in which items they use to define SA for analysis.

    “However, researchers using the Sexual Experiences Survey vary in terms of the items they use to operationalize SA for analytic purposes.”

  • The paper relies on this without support.

    Other researchers create their own measures with different operational definitions.

    “Other researchers create their own measures that include varying operational definitions across these dimensions.”

  • The paper relies on this without support.

    Some studies use single-item SA measures that leave the definition to participants.

    “Still, other studies use single-item measures of SA that refer broadly to “sexual assault” or “rape” and leave the operational definition of these terms to study participants.”

  • The paper relies on this without support.

    Assessments of psychopathology have similar quality issues.

    “Similar quality issues are present in assessments of psychopathology.”

  • The paper relies on this without support.

    Any trauma exposure is an environmental stressor that likely raises psychopathology risk.

    “Experiencing any trauma is an environmental stressor that is likely to increase risk for psychopathology, therefore, sexually assaulted people should evidence high levels of psychopathology relative to people who have never experienced trauma.”

  • The paper relies on this without support.

    The SA literature is largely divided into childhood SA and adolescent/adult SA research.

    “Unlike the broader trauma literature, which generally assesses lifetime exposure to a number of forms of trauma (including SA), the SA literature has been largely siloed into research on childhood SA and adolescent/adult SA (i.e., at or after age 12–15, depending on study definitions).”

  • The paper relies on this without support.

    No meta-analysis has tested the link between race/ethnicity and SA-related psychopathology.

    “but no meta-analysis has tested this relationship.”

  • The paper relies on this without support.

    SA is disproportionately experienced by women and young people.

    “Generally, because SA is— unlike many other forms of trauma—disproportionately experienced by women and young people”

  • The paper relies on this without support.

    SA survivors who remain in college or professional roles likely represent a higher-functioning subset than the general population.

    “it is likely that SA survivors who are able to maintain college enrollment or some other professional role despite trauma exposure are likely to reflect a somewhat higher-functioning subset of survivors relative to the general population (i.e., those most affected by SA may be more likely to withdraw from employment or college enrollment and thus not be reflected in group comparisons).”

  • The paper relies on this without support.

    More eligible unpublished data existed than the review was able to identify.

    “Despite our extensive efforts to include unpublished work and the significant number of unpublished effects in our sample (175/500 effects), it is likely that there was still more that we were unable to identify.”

  • The paper relies on this without support.

    Methods for assessing publication bias in multilevel meta-analysis had not yet been developed.

    “Because methods for assessing publication bias in multilevel meta-analysis have not yet been developed and so this test treats effect sizes as independent observations, we randomly selected one effect size from every study in our sample to include in this test to avoid unduly weighting studies that contributed more effects.”

  • The paper relies on this without support.

    No-assault comparison groups are mostly composed of people who experienced some other form of trauma.

    “It is likely that no-assault comparison groups are comprised mostly of people who experienced some other form of trauma, even though they were not selected for this quality”
16 of 16

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(443.74) = 4.3reported p < .0001 · recomputed p < .001

    “t(443.74) = 4.30, p < .0001”

  • Consistentz = 1.69reported p = .09 · recomputed p = .091

    “z = 1.69, p = .09”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Stranger-perpetrator result is described as positive despite a nonsignificant test

    Major

    The abstract says larger effects were observed when more assaults involved strangers, but the results explicitly say this characteristic was unrelated to group differences.

  • Suicidality contrast has the wrong sign

    Major

    The reported average effect for suicidality is 0.74, versus 0.71 for the referent category. That makes the suicidality contrast +0.03, not −0.03, reversing which category has the larger effect.

    Reported -0.03 · recomputed 0.03

  • Publication-bias section uses a different total effect count

    Minor

    The publication-bias section gives 500 total effects, whereas the sample description and other sections give 497. Both refer to the analysis's effect-size dataset.

  • General-population samples are called the largest despite a larger mixed-sample contrast

    Minor

    The discussion calls general-population differences the greatest, but the reported contrast against college samples is larger for mixed samples (0.20) than for general-population samples (0.12).

4 of 4

Citations

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Metadata

Authors
Dworkin, E. R., Menon, S. V., Bystrynski, J., & Allen, N. E.
Affiliations
  • University of Washington (US)
  • University of Illinois Urbana-Champaign (US)
Corresponding author
Dworkin, Emily R.
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2017-08
Volume
56
Pages
65-81
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2017.06.002
PMC
PMC5576571
OpenAlex
W2729334788
Cited by
825
References
243
Citations by year
2026: 114 · 2025: 100 · 2024: 106 · 2023: 97 · 2022: 100 · 2021: 102 · 2020: 123 · 2019: 58 · 2018: 17 · 2017: 5
FWCI
23.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism (T32AA007455)
Topics
  • Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
sexual assault, sexual victimization, psychopathology, post-traumatic stress disorder, suicidality, trauma, psychological dysfunction, weapons, personal injury, risk factors
MeSH terms
Psychological Trauma, Humans, Sex Offenses, Stress Disorders, Post-Traumatic, Suicide, Crime Victims

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