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Cited by 263Sexual Assault and Victimization StudiesIntimate Partner and Family ViolenceChild Abuse and Trauma

Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis

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Dworkin, Emily R., Brill, Charlotte D., Ullman, Sarah E.·2019·Clinical Psychology Review
DOI 10.1016/j.cpr.2019.101750PMC PMC6716998
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Abstract

Public attention has been increasingly paid to how friends, family members, and others can best support survivors of sexual assault and other forms of violence. The broader social support literature posits that perceiving social support positively is more important to mental health than the degree to which social support is actually received, and that negative interactions with social supporters are more harmful than positive interactions are helpful (potentially because negative reactions violate survivors' expectations of their social supporters). This may be especially true after a crisis, such as interpersonal violence. Thus, this systematic review and meta-analysis summarizes the literature on social reactions to interpersonal violence. Meta-regression analyses were performed on 1871 correlations from 51 studies reflecting the degree to which receiving specific reactions more frequently, or perceiving reactions more positively, was associated with psychopathology. Results indicated that negative social reactions to disclosure-especially reactions involving controlling, distracting, and treating survivors differently-were associated with worse psychopathology, whereas positive social reactions did not appear to be protective. Perceiving reactions more positively was associated with less severe psychopathology, but (although causation cannot be concluded) positive perceptions' potential benefit appeared to be smaller than the potential risk conveyed by negative reactions. These findings indicate that interventions which reduce the degree to which survivors receive negative social reactions are needed.

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  • Harmful effects of negative social reactions on psychopathology, including PTSD symptoms, are more impactful than the salubrious effects of positive forms of social support.

    “Several meta-analyses have shown that harmful effects of negative social reactions (e.g. blame, treating the person differently, social constraint, making demands) on psychopathology, including PTSD symptoms, are more impactful than the salubrious effects of positive forms of social support (Blais et al., 2021; Dworkin et al., 2019; Zalta et al., 2021).”

    From The association between social support and posttraumatic stress symptoms among survivors of betrayal trauma: a meta-analysis (2021) · cites this paper as Dworkin et al., 2019

    The Results (‘Are perceived or received social reactions more strongly associated with psychopathology?’, page unavailable) find a stronger association with psychopathology for negative than for positive received reactions; the paper also reports an association between negative reactions and PTSD. But it does not establish harmful or beneficial causal effects, and positive received reactions were not protective in its analysis, so the claim’s ‘salubrious effects’ comparison overstates the finding. (LLM, conf=0.86)

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  • When disclosing to professionals, trauma survivors are less likely to perceive altruistic motives and more likely to receive negative responses than when disclosing to close others.

    “Further, there is evidence that when disclosing to professionals, trauma survivors are less likely to perceive altruistic motives and more likely to receive negative responses than when disclosing to close others (see Dworkin et al., 2019;Ullman, 2023, for reviews).”

    From Feeling pressured to talk about trauma: How pressure to disclose alters the association between trauma disclosure and posttraumatic growth (2023) · cites this paper as Dworkin et al., 2019

    The ‘Differences by source of perceived reaction’ section reports that victims tend to rate formal support providers more negatively than informal supporters, and that negative reactions from close supporters may be interpreted more positively. It does not say survivors perceive professionals as having less altruistic motives, or establish that professionals deliver negative responses more often than close others. The Results section compares associations with psychopathology, not how frequently each group responds negatively. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Societal stigma and negative social reactions may explain higher PTSD prevalence and severity after sexual assault versus other traumas.

    “Given prior research suggesting that societal stigma and negative social reactions may explain higher PTSD prevalence and severity after sexual assault versus other traumas (Dworkin et al., 2019; Kennedy & Prock, 2018)”

    From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin et al., 2019

    The paper’s ‘Social Reactions to Interpersonal Violence’ section reports that negative social reactions are associated with greater PTSD severity, including among sexual-assault survivors. It does not establish that societal stigma and negative reactions explain higher PTSD prevalence or severity after sexual assault than after other traumas; the section says it is unclear whether the effects of negative reactions differ across types of violence. Page numbers were not available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Dworkin et al. (2019) found that received positive reactions to trauma disclosure were associated with more psychopathology cross-sectionally with a very small effect (r = 0.06), but were not associated with psychopathology longitudinally (r = 0.00).

    “Similarly, Dworkin et al. (2019) found that received positive reactions to trauma disclosure, such as those measured by the Social Reactions Questionnaire (Ullman, 2000), were associated with more psychopathology cross-sectionally with a very small effect (r = 0.06), but were not associated with psychopathology longitudinally (r = 0.00).”

    From The association between social support and posttraumatic stress symptoms among survivors of betrayal trauma: a meta-analysis (2021) · cites this paper as Dworkin et al., 2019

  • Negative social reactions are cross-sectionally and prospectively associated with PTSD symptom severity.

    “Meta-analytic findings indicate that these negative social reactions are cross-sectionally and prospectively associated with PTSD symptom severity (Dworkin et al., 2019).”

    From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin et al., 2019

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Research works printed but not linked: 1

  1. Golding JM, Siegel JM, Sorenson SB, Burnam MA, Stein JA, Siege JM, … Stein JA (1989). Social support sources following sexual assault. Journal of Community Psychology, 17(1), 92– 107.

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Authors
Dworkin, E. R., Brill, C. D., & Ullman, S. E.
Affiliations
  • University of Washington (US)
  • University of Illinois Chicago (US)
Corresponding author
Dworkin, Emily R.
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2019-08
Volume
72
Pages
101750
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2019.101750
PMC
PMC6716998
OpenAlex
W2955024481
Cited by
263
References
90
Citations by year
2026: 54 · 2025: 52 · 2024: 27 · 2023: 43 · 2022: 33 · 2021: 26 · 2020: 23 · 2019: 5
FWCI
4.61
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism
Topics
  • Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
  • Social Sciences › Health › Intimate Partner and Family Violence
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
interpersonal violence, disclosure, social reactions, psychopathology, sexual assault survivors, social support, perceived social support, controlling behavior, stigma, mental health outcomes
MeSH terms
Mental Disorders, Humans, Interpersonal Relations, Social Support, Violence, Disclosure

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