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Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis
Open accessAbstract
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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“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
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“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
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“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
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“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
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“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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“and examined a broader group of interpersonal trauma survivors, including those that did not involve physical or sexual abuse (e.g. survivor of a violent crime).”
From The association between social support and posttraumatic stress symptoms among survivors of betrayal trauma: a meta-analysis (2021) · cites this paper as Dworkin, Brill, & Ullman, (2019)
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“However, this meta-analysis focused exclusively on responses to disclosure, rather than social support more broadly, and examined a broader group of interpersonal”
From The association between social support and posttraumatic stress symptoms among survivors of betrayal trauma: a meta-analysis (2021) · cites this paper as Dworkin, Brill, & Ullman, (2019)
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“Negative responses to disclosure of trauma (e.g. blame, treating someone differently after disclosure) were associated with more severe PTSD symptoms, consistent with previous research (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
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Carter‐Snell, C. (2025) · Journal of the Academy of Forensic Nursing · doi:10.29173/jafn862
Child Abuse and Family Social Support: The Practice of Resolutions Approach
Sepers, A. J. W., Marić, M., & Mooren, T. T. M. (2025) · Children · doi:10.3390/children12050580
Reeves, J. W., Simler, A. B., & Dworkin, E. R. (2025) · Journal of Interpersonal Violence · doi:10.1177/08862605251345464
Self-citationUllman, S. E., O’Callaghan, E. T., Bailey, C., & Harris, C. (2025) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2025.2530403
Self-citationHaugen, T., Kjelsvik, M., Friborg, O., Schei, B., Hagemann, C. T., & Halvorsen, J. Ø. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2524892
Powers, R. A., Simmons, A. K., Hayes, B. E., Weller, K., McKingsley, L. A., Maher, C. A., & Burckley, J. (2025) · British Journal of Learning Disabilities · doi:10.1111/bld.70000 · Cited by 1
Metadata
- 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.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 72
- Pages
- 101750
- ISSN
- 0272-7358 (ISSN-L)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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