Risk for mental disorders associated with sexual assault: a meta-analysis
Open accessAbstract
Sexual assault (SA) is a common form of trauma that is associated with numerous deleterious outcomes. Understanding the relative prevalence of psychiatric diagnoses in people who have been sexually assaulted versus people who have not been assaulted could help to prioritize assessment and intervention efforts, but there has been no quantitative review of this topic. A search of PsychINFO, ProQuest Digital Dissertations and Theses, and Academic Search Premier for articles dated between 1970 and 2014 was conducted, and unpublished data were obtained. Eligible studies used diagnostic interviews to assess Diagnostic and Statistical Manual of Mental Disorders diagnoses in both individuals experiencing adolescent/adult and/or lifetime SA and unassaulted individuals. The search yielded 171 eligible effects from 39 studies representing 88,539 participants. Meta-regression was used to aggregate the prevalence of psychiatric diagnoses in sexually assaulted and unassaulted samples as well as calculate odds ratios reflecting the difference between these prevalence estimates. Results indicated that most disorders were more prevalent in survivors of SA, and depressive disorders and posttraumatic stress disorder (PTSD) were especially prevalent. Disorder-specific differences in odds ratios were observed as a function of sample type, type of comparison group, and time frame of SA. Service providers should be prepared to address depressive disorders and PTSD in survivors of SA, and interventions that prevent the development of these disorders are especially needed.
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The comparisons of findings to prior meta-analyses indirectly corroborate that sexual assault may be associated with greater prevalence and symptom severity of PTSD relative to other forms of trauma.
“these comparisons of our findings to prior meta-analyses indirectly corroborate extant literature suggesting sexual assault may be associated with greater prevalence and symptom severity of PTSD relative to other forms of trauma”
From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin, 2020
The Discussion section on comparison group type (page unavailable) reports that sexual assault is associated with higher PTSD risk than other forms of trauma, supporting the prevalence portion of the claim. The paper analyzes PTSD diagnoses, not symptom severity, so it does not support that portion. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe 12-month PTSD prevalence of 41.49% in this prospective meta-analysis is higher than the lifetime prevalence of PTSD (36.2%, 95% CI: 31.4%-41.1%) identified in a prior retrospective meta-analysis (Dworkin, 2020).
“the 12-month prevalence of 41.49% identified in this prospective meta-analysis—which is the lowest rate observed in the year post-assault—is still higher than the lifetime prevalence of PTSD (36.2%, 95% CI: 31.4%-41.1%) identified in a prior retrospective meta-analysis on this topic (Dworkin, 2020).”
From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin, 2020
The Results section (Prevalence Estimates and Odds Ratios by Diagnostic Category; page unavailable) reports a pooled lifetime PTSD prevalence of 36% among sexual-assault survivors, with a 95% CI of 31%–41%. This supports the cited comparison in rounded terms, but our copy does not report the attributed values of 36.2% and 31.4%–41.1%. The 41.49% estimate is presented as the citing authors’ own result, not Dworkin’s. (LLM, conf=0.83)
Experimental — accuracy not yet measuredSexual assault is associated with higher rates of PTSD than other traumas.
“Sexual assault is associated with higher rates of PTSD than other traumas (Brewin et al., 2000; Dworkin, 2020; Kessler et al., 2014; Kilpatrick et al., 2003)”
From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin, 2020
Sexual assault appears to carry relatively greater risk for PTSD than other potentially traumatic events.
“Compared to other potentially traumatic events (e.g., physical assault, accidents, natural disasters), for which only a minority of survivors experience significant levels of PTSD (Galatzer-Levy et al., 2018; Lowe et al., 2020), sexual assault appears to carry relatively greater risk for PTSD (Brewin et al., 2000; Dworkin, 2020; Kessler et al., 2014; Kilpatrick et al., 2003), and may be associated”
From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin, 2020
36% of sexual assault survivors meet criteria for lifetime PTSD.
“Studies assessing PTSD in relation to any trauma exposure (not necessarily due to sexual assault) indicate that 36% of sexual assault survivors meet criteria for lifetime PTSD (Dworkin, 2020) and 12-25% meet criteria for current PTSD (Kilpatrick et al., 2007; Resnick et al., 1993; Zinzow et al., 2012).”
From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin, 2020
No prior work has quantitatively summarized the natural course of PTSD recovery specifically for adolescent and adult sexual assault survivors.
“Second, despite evidence that sexual assault is more strongly associated with PTSD than other forms of trauma (Brewin et al., 2000; Dworkin, 2020; Kessler et al., 2014; Kilpatrick et al., 2003), no prior work has quantitatively summarized the natural course of PTSD recovery specifically for adolescent and adult sexual assault survivors.”
From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Dworkin, 2020
The aggregated lifetime PTSD prevalence rate in survivors of sexual assault is 36.2%.
“A recent review and meta-analysis reported an aggregated lifetime PTSD prevalence rate of 36.2% in survivors of sexual assault (Dworkin, 2020).”
From Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape (2022) · cites this paper as Dworkin, 2020
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Sorted by citations
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Self-citationPTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies
Dworkin, E. R., Jaffe, A. E., Bedard-Gilligan, M., & Fitzpatrick, S. (2023) · Trauma, Violence, & Abuse · doi:10.1177/15248380211032213 · Cited by 209 · see citing works
“…of our findings to prior metaanalyses indirectly corroborate extant literature suggesting sexual assault may be associated with greater prevalence and symptom severity of PTSD relative to other forms of trauma (Brewin et al., 2000; Dworkin, 2020; Kessler et al., 2014; Kilpatrick et al., 2003).”
BackgroundResultInfluentialSelf-citationNöthling, J., Abrahams, N., Jewkes, R., Mhlongo, S., Lombard, C., Hemmings, S. M. J., & Seedat, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.032 · Cited by 28 · see citing works
- Authors
- Dworkin, E. R.
- Affiliations
- University of Washington (US)
- Corresponding author
- Dworkin, Emily R.
- ORCID
- Dworkin, Emily R.
- Venue
- Trauma, Violence, & Abuse
- Publisher
- SAGE Publications
- Published
- 2018-12-25
- Volume
- 21
- Issue
- 5
- Pages
- 1011-1028
- ISSN
- 1524-8380 (ISSN-L)
- 1552-8324
- PMC
- PMC6707905
- OpenAlex
- W2906288904
- Cited by
- 347
- References
- 105
- Citations by year
- 2026: 71 · 2025: 81 · 2024: 67 · 2023: 52 · 2022: 43 · 2021: 17 · 2020: 7 · 2019: 9
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Trauma Violence & Abuse (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (K99AA026317)
- 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, mental illness, psychiatric comorbidity, post-traumatic stress disorder, depressive disorders, trauma survivors, adolescent sexual assault
- MeSH terms
- Depressive Disorder, Female, Humans, Male, Risk Factors, Sex Offenses, Stress Disorders, Post-Traumatic, Prevalence, Crime Victims
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