Sexual assault survivors often turn to other people for support following an assault. Although the help survivors receive is often beneficial, a substantial number of sexual assault survivors receive negative social reactions such as being blamed or doubted (Campbell, Ahrens, Sefl, Wasco, & Barnes, 2001; Filipas & Ullman, 2001; Starzynski, Ullman, Filipas, & Townsend, 2005). Such negative social reactions have a detrimental impact on survivors' levels of posttraumatic stress and depression. However, not all survivors perceive social reactions in the same way. Reactions such as taking control, egocentrism, and distraction are considered negative by some survivors but positive by others (Campbell et al., 2001; Filipas & Ullman, 2001). The purpose of the current study was to examine whether social reactions are perceived differently depending on the identity of the support provider. To ground this study in the existing research, we first review literature on disclosure and social reactions among sexual assault survivors. A mixed-method study is then outlined to examine sexual assault survivors' perceptions of the social reactions they received upon disclosure.
Sexual assault survivors often receive both positive and negative reactions to the disclosure of their assault. Although positive reactions are typically more common from informal support providers and negative reactions are typically more common from formal support providers, not all formal and informal support providers react the same way. To help clarify the nature of social reactions received from specific support providers, 103 female sexual assault survivors participated in interviews about their disclosure experiences. These interviews resulted in detailed descriptions of 250 disclosure interactions. Results indicated that counselors and friends engaged in the most emotional support, fairly high levels of tangible aid, and fairly low levels of most types of negative reactions. Romantic partners provided only moderate support, the lowest amount of tangible aid, and the highest amount of blame, control, and egocentric behaviors. Romantic partners also treated survivors differently more often than other support providers. Qualitative analysis of survivors' descriptions of these reactions are used to help interpret survivors' ratings of reactions as healing or hurtful.
Disclosure of Sexual Assault
Recent studies suggest that anywhere from 65% to 92% of sexual assault survivors disclose the assault to at least one person (Ahrens, Campbell, Ternier-Thames, Wasco, & Sefl, 2007; Fisher, Daigle, Cullen, & Turner, 2003; Golding, Siegel, Sorenson, & Burnam, 1989; Starzynski et al., 2005; Ullman & Filipas, 2001). On average, sexual assault survivors tell three people (Filipas & Ullman, 2001). Overall, disclosure to informal support providers, such as friends and family, is more common than disclosure to formal support providers such as police or medical personnel (Filipas & Ullman, 2001; Starzynski et al., 2005). However, rates of disclosure to different types of support providers vary widely across studies, ranging from 60 to 94% of survivors who disclose to friends and family, 8 to 18% who disclose to romantic partners, 1 to 52% who disclose to mental health professionals, 9 to 43% who disclose to physicians, 10 to 39% who disclose to personnel, 2 to 21% who disclose to rape crisis centers, and 4 to 18% who disclose to clergy (Campbell et al., 2001; Filipas & Ullman, 2001; Fisher et al., 2003; Golding et al., 1989; Ullman, 1996). Such wide ranges may result from differences in samples and recruitment methodology, both of which may be affected by the types of assaults survivors experience (Starzynski et al., 2005) and survivors' reasons for disclosing (Ahrens et al., 2007). More stable estimates may emerge as additional research is conducted.
Types of Social Reactions
When sexual assault survivors disclose, they often receive a mixture of positive and negative social reactions (Filipas & Ullman, 2001; Starzynski et al., 2005). Positive social reactions include emotional support and tangible aid, whereas negative social reactions include both overtly negative reactions, such as blaming or doubting victims (Davis, Brickman, & Baker, 1991; Golding et al., 1989; Ullman, 2000), as well as well-intentioned support efforts that are nonetheless experienced as negative (e.g., encouraging secrecy, patronizing behavior; Herbert & Dunkel-Schetter, 1992; Sudderth, 1998). Ullman (2000) has proposed seven distinct types of social reactions: (1) Emotional support, which includes supportive reactions such as listening, believing, or telling survivors it wasn't their fault; (2) Tangible aid, which includes providing information or actual assistance; (3) Blame, which involves telling survivors that they are at fault or accusing them of not being cautious enough; (4) Taking control, which includes making decisions for the survivor or treating the survivor like a child; (5) Distraction, which includes trying to get the survivor to stop thinking or talking about the assault; (6) Treating differently, which includes pulling away from the survivor or acting like the survivor is “damaged goods”; and (7) Egocentric reactions, which pertain to support providers who focus on their own needs or become so emotionally upset that they cannot support the survivor.
Overall, sexual assault survivors receive high levels of both positive and negative social reactions. Between 74 and 97% of survivors receive at least one positive reaction, and 80 to 98% receive at least one negative reaction (Campbell et al., 2001; Filipas & Ullman, 2001; Golding et al., 1989; Ullman, 1996). Although survivors receive more types of positive social reactions, they receive negative social reactions more frequently (Filipas & Ullman, 2001), and the types of social reactions they receive differ by support provider. Overall, negative social reactions toward sexual assault survivors are more common from formal support providers, such as police and medical personnel, than from informal support providers, such as friends, family, and romantic partners (Ahrens et al., 2007; Filipas & Ullman, 2001; Starzynski et al., 2005). Positive social reactions are more common from informal than formal support providers (Ahrens et al., 2007; Filipas & Ullman, 2001; Golding et al., 1989).
When examined at a greater level of specificity, however, the picture is less clear. This lack of clarity results from the lack of research on specific types of social reactions provided by specific support providers. Whereas the studies reviewed above draw conclusions about general categories (i.e., formal and informal support providers, negative and positive reactions), only two studies to date have attempted to measure specific social reactions toward sexual assault survivors from specific support providers (Filipas & Ullman, 2001; Ullman, 1996). Unfortunately, the results of these two studies are inconsistent. Ullman's (1996) study found that emotional support was most common from rape crisis centers, whereas Filipas and Ullman (2001) found that emotional support was most common from romantic partners, an unexpected finding given research indicating high levels of anger, frustration, and uncertainty among male partners of sexual assault survivors (Ahrens & Campbell, 2000; Emm & McKenry, 1988; Smith, 2005). Similar discrepancies exist for each type of social reaction: Tangible aid was most common from rape crisis centers in the Ullman (1996) study and from friends in the Filipas and Ullman (2001) study; blame was most common from police personnel or physicians in the Ullman (1996) study and family members in the Filipas and Ullman (2001) study; egocentric responses were most common from friends in the Filipas and Ullman (2001) study and not reported in the Ullman (1996) study; and distraction techniques were most common from police personnel or physicians in the Ullman (1996) study and family members in the Filipas and Ullman (2001) study. Additional research is clearly needed to determine whether specific types of social reactions are more common from specific support providers.
Survivors' Interpretation of Social Reactions
Additional research is also needed to more fully understand how sexual assault survivors interpret the social reactions they receive. Previous research has suggested that not all sexual assault survivors perceive social reactions in the same way. In an examination of a reduced version of Ullman's Social Reactions Questionnaire (SRQ), Campbell and colleagues (2001) discovered that some rape survivors perceive distracting, egocentric, and controlling reactions positively, whereas others perceive these reactions negatively. One reason for these differences may lie in the identity of the support provider. Previous research suggests that specific social reactions have a differential impact on recovery depending on the identity of the support provider. For example, emotional support from friends and romantic partners has been associated with more beneficial recovery outcomes than emotional support from other sources, whereas negative reactions from romantic partners have been associated with worse recovery outcomes than negative reactions from other sources (Davis et al., 1991; Filipas & Ullman, 2001; Ullman, 1996). Similarly, Filipas and Ullman (2001) found that survivors who receive egocentric responses from romantic partners have worse recovery outcomes than survivors who receive egocentric reactions from other support providers. On the other hand, survivors whose partners treated them differently after the assault were more satisfied with the interaction than when they were treated differently by other support providers.
These findings suggest that survivors may be interpreting the same reaction differently depending on the identity of the support provider. Indeed, Filipas & Ullman (2001) suggest that sexual assault survivors may take into account the nature of the relationship when inferring support providers' intentions. As a result, egocentric and controlling reactions may be viewed in a negative light when received from some sources but may be viewed more positively when received from other sources (Filipas & Ullman, 2001). The purpose of the current study was to test this hypothesis more directly.
The current study was guided by three main research questions: (1) Do specific support providers engage in specific social reactions more often? (2) Do sexual assault survivors rate social reactions differently depending on the identity of the support provider? (3) How do survivors' interpretations of the social reactions they received affect their feelings about the reactions? Based on the literature reviewed above, we generally expected friends to have more positive social reactions than other support providers and for these positive reactions to be rated as more healing when coming from friends than when coming from other sources. We also expected romantic partners and police personnel to engage in more negative social reactions and for these reactions to be rated as more harmful when coming from romantic partners. Given the variability that has emerged in past studies, however, we expected that these ratings would vary widely. To help understand why such variability exists, the current study sought to complement the quantitative findings by examining survivors' qualitative interpretations of the social reactions they received.
Participants and Procedure
Female sexual assault survivors were recruited from a large West Coast city to participate in interviews about their postassault experiences. Recruitment procedures were identical to a similar study that was conducted in Chicago, involving a modified form of adaptive sampling (Campbell, Sefl, Wasco, & Ahrens, 2004) that involved systematic sampling from locations frequented by women during their daily lives (e.g., churches, laundromats, coffee shops). The distribution of posters, brochures, and in-person presentations was tracked on a ZIP code map to ensure breadth of coverage. Depth of coverage was achieved by engaging in intensive recruitment efforts of traditionally overlooked populations (e.g., women of color, low-income neighborhoods). Recruitment flyers and brochures were posted throughout the city and sent to local organizations serving women. These flyers and brochures invited survivors of sexual assault to participate in a private, one-on-one, confidential interview even if they had never reported the assault or spoken about it before. Recruitment letters and in-person presentations were also conducted at social service agencies and churches throughout the community. To be consistent with most research on this topic (e.g., Testa, VanZile-Tamsen, Livingston, & Koss, 2004), a phone screening procedure was used to identify sexual assault survivors who were currently 18 years old or older and whose most recent sexual assault occurred after age 14. Participants were also asked to confirm that they had had a sexual experience that had occurred without their consent and were asked about psychiatric diagnoses. Respondents who were under 18 (n= 0), whose most recent assault occurred before the age of 14 (n= 8), who had not experienced a sexual assault (n= 8), or who had been diagnosed with schizophrenia (n= 2) were removed. Qualified participants were then interviewed by a trained interviewer at a location of their choosing. Each interview lasted an average of 2.64 hours (SD= 50.45 minutes), and participants received $30 and an extensive list of referrals for their time.
These procedures resulted in a total of 103 completed interviews. In comparison to Census Bureau data, the current study included more African American (37%) and fewer Asian (7%), Latina (11%), and White (38%) participants than the general population of the recruitment city (15%, 12%, 36%, and 45%, respectively). Higher rates of participation by African American women may have resulted from intensive efforts to recruit traditionally overlooked populations; lower rates of participation by Asian and Latina women may have occurred because all recruitment materials were written in English. Participants averaged 37.55 years of age (SD= 10.65) at the time of the interview. The majority of participants were currently single (56%), had children (76.7%), received at least a high school education (80.2%), and were employed (55.9%). Over 56% of the survivors had been sexually assaulted in both childhood and adulthood. The majority of survivors' most recent assaults qualified as rape (64%), although an additional 14% experienced unwanted sexual contact that did not involve penetration, 15% experienced sexual coercion, and 7% experienced an attempted rape. Most survivors knew their most recent assailant (71.9%). Some of these assaults involved a weapon (31.1%), and most resulted in either minor injuries, such as cuts and bruises (46.6%), or major injuries, such as broken bones or internal bleeding (10.7%).
The in-person interview was designed to cover a range of topics about sexual assault survivors' experiences of violence, postassault help seeking, use of coping strategies, and health outcomes. Both quantitative and qualitative data were collected. For the current study, the focus was on the types of social reactions survivors received from various support providers.
Participant and assault characteristics Participants were asked to indicate their race, age, marital status, education status, and whether they were currently employed. Participants also completed the Sexual Experiences Survey (SES), as modified by Testa and colleagues (2004). Upon completion of the SES, survivors were asked to describe in detail their most recent incident of sexual assault. A series of questions about the nature of the relationship with the perpetrator (stranger, acquaintance, marital, etc.), the use of weapons, the presence of injuries, and use of alcohol and drugs were used to elicit information that survivors did not spontaneously provide.
Identity of support provider Survivors were asked to identify everyone they had ever told about the assault. The identity of these support providers was recorded on a disclosure timeline. The nature of the relationship was coded as one of seven types of relationships: (1) romantic partner; (2) close or casual friend; (3) acquaintance or coworker; (4) family, including parents, siblings, and other relatives; (5) legal personnel, including police officers and prosecutors; (6) counselors, including therapists, rape crisis advocates, social service agency staff, and religious personnel; and (7) medical personnel, including doctors and nurses.
Survivors were then asked to identify the five people whose reaction to their disclosure had the biggest impact on them, either positively or negatively. For each support provider identified, survivors answered a series of questions about the disclosure interaction. Questions assessed survivors' reasons for disclosing, expectations of disclosure, what survivors said, how support providers reacted, how survivors interpreted these reactions, and how these reactions made survivors feel. Survivors also completed Ullman's (2000) SRQ for each support provider. Limiting the focus to the five most impactful disclosures helped reduce the fatigue and methodological error that would have resulted had we asked survivors to answer identical questions about an even larger number of support providers.
Social reactionsUllman's (2000) SRQ was repeated up to five times to measure the types of social reactions survivors received during each of the most impactful disclosures. This scale contains 48 items that are divided into seven subscales, including: (1) emotional support/belief (e.g., told you it was not your fault), (2) tangible aid (e.g., helped you get medical care), (3) blame (e.g., told you that you were to blame), (4) took control (e.g., tried to take control of what you did/decisions you made), (5) egocentric reactions (e.g., expressed so much anger at the perpetrator that you had to calm him/her down), (6) distraction (e.g., distracted you with other things), and (7) treat differently (e.g., pulled away from you). For each item, participants indicated how often they received that reaction from a specific support provider on a 5-point Likert-type scale, ranging from never to always. According to Ullman (2000), internal consistency for each subscale ranges from .77 to .93, and test-retest reliability ranges from .64 to .80. Consistent with the modifications employed by Campbell et al. (2001), we modified the original SRQ slightly by asking survivors to also rate each item on a 5-point Likert-type scale, ranging from very hurtful to very healing.
Interpretations of reactions Survivors were also asked several open-ended questions about the social reactions they received from the five (or fewer) support providers they chose to discuss in detail. Responding to prompts about one support provider at a time, survivors were first asked to describe the support provider's reaction. They were then asked for their interpretation of the social reaction they received from this support provider using these questions: (1) Why do you think [support provider's name] reacted this way? and (2) How did [support provider's name]'s reaction make you feel? These questions were repeated for each of the five support providers survivors referenced in the SRQ. Content analysis was then used to derive themes from survivors' qualitative responses to these questions. Following the recommendations of Miles and Huberman (1994), open coding was used to develop an initial codebook that was then used to code the disclosure interactions. Further details about these procedures are covered in the corresponding section below.
Rate of Disclosure by Type of Support Provider
Overall, 81.6% (n= 84) of the total sample of 103 sexual assault survivors told at least one person about the assault. On average, survivors told three people (M= 3.37, SD= 3.07). The most common disclosure recipients were friends, counselors, and family members: 48.5% of the 103 survivors disclosed to friends, 43.7% disclosed to counselors, and 36.9% disclosed to family members. The least common disclosure recipients were acquaintances (17.5%) and medical personnel (9.7%). Disclosures to legal personnel (23.3%) and romantic partners (24.3%) were also less common than for friends and family members.
Although the above rates of disclosure included everyone the survivor told about the assault, the remaining analyses are limited to the five most impactful people the survivor told. As described in the Method section, survivors who told more than five people were asked to select the five people who had the greatest impact on them, either positively or negatively. Survivors then completed detailed questionnaires about their disclosures to these five (or fewer) people. This procedure led to detailed data about 259 different disclosures, including 28 disclosures to partners (as described by 25 different survivors), 69 disclosures to friends (as described by 49 different survivors), 22 disclosures to acquaintances (as described by 18 different survivors), 52 disclosures to family members (as described by 37 different survivors), 28 disclosures to legal personnel (as described by 23 different survivors), 9 disclosures to medical personnel (as described by 8 different survivors), and 51 disclosures to counselors (as described by 43 different survivors). Due to the fairly low number of disclosures to medical and legal personnel, these groups were combined to form a “legal and medical personnel” group (n= 37). Similarly, acquaintances were combined with friends to form a “friends and acquaintances” group (n= 91).
The remaining analyses are based on separate ratings about each of these 259 disclosure experiences. These analyses treat each disclosure experience as a separate case and focus on the support providers as the unit of analysis, rather than individual survivors. The current study seeks to understand how often specific support providers engage in different types of social reactions and how the identity of the support provider affects perceptions of social reactions. Thus, the focus of this study is on the identity of the support provider, not characteristics of the survivor. Focusing on the target of disclosure as the unit of analysis admittedly has some weaknesses, particularly regarding nonindependence of ratings (i.e., the same survivor may provide ratings about multiple support providers), but it is our hope that the inclusion of both quantitative and qualitative findings will help triangulate and further substantiate these descriptive and exploratory results.
Social Reactions Provided by Specific Support Providers
Our first research question sought to examine differences in how often specific support providers engaged in specific social reactions. A one-way between-subjects multivariate analysis of variance (MANOVA) was used to answer this question. The identity of the support provider (romantic partners, friend/acquaintances, family members, legal/medical personnel, and counselors) was used as the independent variable. Participant ratings of how often each support provider engaged in each social reaction (0 =never, 4 =always) were used as the dependent variables. Pooled within-group correlations were calculated to determine the degree of intercorrelation among dependent variables. In the current study, all of the pooled within-group correlations were moderate or low (range =−.019–.686), meeting the requirements for MANOVA and suggesting that common rater variance did not overly influence the data.
Results suggested that participants rated some support providers as engaging in specific social reactions more often than other support providers, Λ= .51, F(28, 895) = 6.61, p < .001, 2= .16. To control for Type I error, a Bonferroni-type adjustment was used to evaluate between-subjects effects. Using a more rigorous alpha level of p < .007, tests of between-subjects effects revealed significant main effects for six of the seven subscales: emotional support, F(4, 254) = 5.03, p= .001, η2= 07; tangible aid, F(4, 254) = 9.85, p < .001, η2= .13; blame, F(4, 254) = 4.37, p= .002, η2= .06; controlling reactions, F(4, 254) = 6.79, p < .001, η2= .10; egocentric reactions, F(4, 254) = 8.26, p < .001, η2= .12; and treat differently, F(4, 254) = 5.25, p < .001, η2= .08. Distraction was the only subscale that did not meet the more stringent alpha level, F(4, 254) = 3.29, p= .012, η2= .05.
Tukey's Honestly Significant Difference (HSD) test was then used to evaluate differences in the means. As can be seen in Table 1, counselors provided the most overall emotional support. Levels of emotional support provided by counselors were significantly higher than levels of emotional support provided by either family members or legal/medical personnel. Friends/acquaintances also provided more emotional support than legal/medical personnel. The pattern for tangible aid was somewhat different. Here, it was legal/medical personnel and counselors who provided the most aid, significantly exceeding the amount of tangible aid provided by romantic partners, friends/acquaintances, and family members.
|Partners M (SD) (Range)||Friends & acquaint M (SD) (Range)||Family M (SD) (Range)||Legal & medical M (SD) (Range)||Counseling M (SD) (Range)|
Negative social reactions also differed by support provider. Romantic partners engaged in the most victim blame, significantly exceeding levels of blame from friends/acquaintances and counselors. Partners and family members also engaged in the most controlling behaviors, exceeding the amount of controlling behaviors exhibited by friends/acquaintances and counselors. Partners also engaged in the most egocentric behaviors, exceeding the amount of egocentric behaviors exhibited by friends/acquaintances and counselors. Finally, romantic partners and family members treated survivors differently more often than friends/acquaintances.
Ratings of Social Reactions as Healing or Hurtful
Our second research question was whether ratings of social reactions as healing or hurtful were related to type of support provider. Ideally, one would want to perform a MANOVA to test a composite DV of all seven types of social reactions simultaneously. Unfortunately, this technique is very sensitive to missing data. If a case does not have data on all of the dependent variables, that case must either be deleted listwise or a value must be imputed for the missing variable. In the current case, it would not be appropriate to impute a mean because the support provider did not engage in that type of social reaction. However, when cases are deleted listwise, we are left with only 38 cases in which a support provider engaged in all seven types of social reactions in one disclosure interaction. To avoid this problem, we undertook a series of one-way, between-subjects analyses of variance (ANOVAs), with type of support provider as the independent variable and healing ratings for each of the seven types of social reactions (emotional support, tangible aid, blame, control, egocentric, distraction, treat differently) as the dependent variable. A Bonferroni-type adjustment was used to control for type I error; the resulting alpha level required for significance was set to p < .007.
The first ANOVA examined the relationship between support provider identity and emotional support. The 247 cases that involved emotional support were used in this analysis. Results suggested that support provider identity significantly affected ratings of emotional support, F(4, 242) = 5.81, p < .001, η2= .09. Tukey's HSD test was used to evaluate differences in the means. Results suggested that emotional support from counselors was rated as the most healing (M= 4.43, SD= 0.95). Emotional support from counselors was considered significantly more healing than emotional support from romantic partners (M= 3.64, SD= 0.98), family members (M= 3.77, SD= 1.23), and the legal/medical system (M= 3.77, SD= 1.16). Emotional support from friends (M= 4.28, SD= 0.81) was also considered more healing than emotional support from romantic partners and family members.
The second ANOVA examined the relationship between support provider identity and tangible aid. The 200 cases that involved tangible aid were used in this analysis. Results suggested that support provider identity significantly affected ratings of tangible aid, F(4, 195) = 3.92, p= .004, η2= .07. Tukey's HSD test was used to evaluate differences in the means. Results suggested that tangible aid from counselors was rated as significantly more healing (M= 4.50, SD= 0.71) than tangible aid from family members (M= 3.78, SD= 1.20). The third ANOVA examined the relationship between support provider identity and victim blame. The 107 cases that involved victim blame were used in this analysis. Although results suggested that support provider identity was not significantly related to ratings of victim blame, F(4, 102) = 2.18, ns, η2= .08, it is interesting to note that survivors' ratings of blame were close to the midpoint of the healing/hurtful scale when coming from counselors (M= 3.18, SD= 1.33) and friends (M= 2.76, SD= 1.36) but much closer to the hurtful end of the scale when coming from other support providers.
The fourth ANOVA examined the relationship between support provider identity and controlling behavior. The 191 cases that involved controlling behavior were used in this analysis. Results suggested that support provider identity significantly affected ratings of controlling reactions, F(4, 186) = 5.45, p < .001, η2= .11. Tukey's HSD test suggested that controlling behaviors from counselors (M= 3.64, SD= 1.27), which were considered somewhat healing, were rated as significantly more healing than controlling behaviors from romantic partners (M= 2.59, SD= 1.11), family members (M= 2.61, SD= 1.19), and the legal/medical system (M= 2.50, SD= 1.25), all of which were on the more hurtful end of the rating scale.
The fifth ANOVA examined the relationship between support provider identity and egocentric reactions. The 151 cases that involved egocentric reactions were used in this analysis. Although results suggested that support provider identity was not significantly related to ratings of egocentric reactions, F(4, 146) = 2.11, ns, η2= .06, it is interesting to note that survivors considered egocentric reactions to be at least somewhat healing from all support providers (range = 3.01–3.95).
The sixth ANOVA examined the relationship between support provider identity and distraction. The 187 cases that involved distraction were used in this analysis. This analysis just met our more stringent requirement for significance, F(4, 182) = 3.61, p= .007, η2= .07. Tukey's HSD test indicated that being distracted from thinking about the assault was considered somewhat healing when coming from counselors (M= 3.70, SD= 1.29) and friends/acquaintances (M= 3.47, SD= 1.16), but somewhat hurtful when coming from romantic partners (M= 2.58, SD= 1.05).
Finally, the seventh ANOVA examined the relationship between support provider identity and treated differently. The 142 cases that involved being treated differently were used in this analysis. Results suggested that support provider identity significantly affected ratings of being treated differently, F(4, 137) = 4.55, p= .002, η2= .12. Tukey's HSD test suggested that being treated differently was considered significantly more hurtful when coming from a romantic partner (M= 1.89, SD= 0.80) than from a friend/acquaintance (M= 2.97, SD= 1.17) or counselor (M= 3.02, SD= 1.50).
Survivors' Interpretations of Social Reactions From Specific Support Providers
To help understand why survivors rated social reactions differently depending on their relationship with the support provider, we now turn to the qualitative data. Following the recommendations of Miles and Hubermann (1994), the qualitative analyses proceeded in several steps. In the first step, survivors' descriptions of the social reactions they received from each support provider, how the provider's reaction affected them, and why they thought the provider reacted as he/she did were transcribed.
In the second step, the principal investigator identified text that described the specific social reactions survivors received and how these reactions made survivors feel. Two of the authors then independently coded survivors' interpretations as healing, hurtful, or both. Interrater reliability was calculated on these codes. In most cases, disagreements involved cases in which one person applied a code that was overlooked by the other person. When these omissions were counted as disagreements, the kappa coefficient was .86. When these omissions were not included in the calculations, kappa increased to .96, indicating that there were few outright disagreements in coding. The final step then involved identifying emergent themes and relationships between the codes. This process was facilitated by the construction of various matrices. These matrices simultaneously displayed information about the survivor, the support provider, the type of reaction provided by each support provider, and survivors' interpretation of each reaction, using actual quotations from survivors' transcripts. Because these matrices were often spread over dozens of pages, we have condensed these matrices into a simple summary table for the purposes of this article (see Table 2); this summary table provides counts of the number of social reactions from different support providers that were deemed healing, hurtful, or mixed in survivors' qualitative descriptions. Reducing and organizing a vast amount of qualitative data in these types of data displays facilitates the drawing of conclusions (Miles & Huberman, 1994) and was used to organize the findings described below. Existing theory was also used to help organize and interpret these findings. Detailed explanations of these findings are provided below.
|Healing & hurtful||2||0||1||2||0||0||0||5|
|Healing & hurtful||0||0||0||0||1||0||0||1|
|Healing & hurtful||0||0||0||1||0||0||0||1|
|Healing & hurtful||1||0||0||0||0||1||0||2|
|Healing & hurtful||2||1||1||2||0||0||0||6|
|Healing & hurtful||1||0||0||0||0||0||0||1|
|Healing & hurtful||1||0||0||0||0||0||0||1|
|Healing & hurtful||0||0||0||0||0||0||0||0|
|Healing & hurtful||0||0||0||0||0||0||0||0|
|Healing & hurtful||1||0||0||0||0||0||0||1|
Emotional support Nearly half (48.6%) of the 259 disclosure interactions described in survivors' narratives involved emotional support. These interactions were characterized by supportive listening, expressions of care and concern, and assurances that the survivor was not at fault. For example, one survivor described her friends' reaction to her disclosure: “They were like there for me. You know, just any time you want to talk or, you know, if you feel bad, call me up.” Another survivor described her therapist's reaction: “He helped me get clear on that it wasn't my fault.” Survivors described emotional support from friends and counselors most often, and emotional support from friends, counselors, and medical personnel was almost always considered to be healing. After receiving a sympathetic reaction from her doctor, one survivor said: “It made me feel good, like I, wow, it's not the end, you know?” Another survivor received a supportive reaction from her supervisor and said: “It made me feel um, really, like relieved, like, like some big weight was lifted off my shoulders.” On the other hand, nearly one fourth of the survivors who described receiving emotional support from partners, family, and legal personnel described this reaction as at least somewhat harmful. Negative evaluations of emotional support tended to occur when the support provider did not appear upset enough (e.g., “Here's the man that I was going to marry and I'm telling him this thing that this other guy did and he wasn't really upset”) and when the support provider was so upset the survivor felt guilty about causing him or her pain (e.g., “I felt guilty for making my mom upset. She was genuinely hurt by what happened”). Survivors also evaluated emotional support negatively when the support provider was unable to overcome the survivor's sense of shame. For example, one survivor said she “still felt stupid and ashamed” after telling a male friend who had tried to be supportive.
Tangible aid Only 14.3% of the disclosure interactions involved the provision of tangible aid, and the nature of this assistance was wide ranging, involving everything from research, to child care, to advocacy. For example, one survivor's friend “talked about my therapy and she took me to do the police report and she said when you're ready, tell me, and I'll go with you.” Another survivor described how her sister “offered to care for my kids while I was in the shelter.” Further analysis suggested that survivors described tangible aid from friends, legal personnel, and counselors most often. Tangible aid was generally considered healing (e.g., “Just for [those strangers] to take time out of their routine to really be concerned and say let's help her, you know, that was a good thing”; “I guess it's a good choice because it, you know, [my teacher] helped”), but over half of the survivors who described receiving tangible aid from legal personnel felt that this reaction was at least somewhat harmful. Negative evaluations of tangible aid tended to occur when survivors felt the police blamed them or when the police did not provide any emotional support when providing tangible aid. For example, one survivor stated that the police “had no empathy or feeling.” A second survivor was upset by the lengthy questioning involved in obtaining legal assistance: “You'll get a lot better response [by providing emotional support] than you do with ‘why did you do this?’‘Why did you do that?’”
Blame/doubt Only 16.2% of survivors described being blamed or doubted by support providers. One survivor who experienced a completed rape described her aunt doubting the seriousness of the crime: “She's like, I don't think its rape, it's just a sexual assault, its not considered rape because you shouldn't have been drinking.” Another survivor said that her dad blamed her for the assault: “He said this happens when you invite a guy to your house.” Survivors described being blamed or doubted by partners, family members, and legal personnel most often, and these reactions were generally considered to be quite hurtful. One survivor described how it felt when her mother blamed her: “Oh, I felt like slime. Like it was all my fault.” Another survivor described the impact of being blamed by the police: “Again like hopeless, like what's the point?” But differences in how survivors perceived blame and doubt from different support providers did emerge. Whereas blaming/doubting reactions from partners, family members, and legal personnel were almost always considered to be hurtful, blaming/doubting reactions from friends, counselors, and medical personnel were often considered to be healing. Positive assessments of blame/doubt tended to occur when survivors interpreted the reactions as being aimed at protecting them from future harm. For example, one survivor interpreted her therapist's focus on what she did wrong during the assault as helping protect her from future assaults:
A lot of times a person, third party, will see things that maybe you don't quite see, or makes sense, or just that make you think about what you are doing or your behavior, or shed some light on the situation, you know, this is what really happened.
A second survivor also interpreted her counselor's reaction as positively helpful:
There were times when counselors don't give you, they don't say what you want to hear. But I don't construe that as negative … I heard some things there that I did not like to hear. But I did not take them as being negative. They were just sometimes you have to have a little bit of discomfort to get where you need to go.
Controlling reactions Controlling reactions were described in 8.1% of the disclosure interactions. Most of these controlling behaviors involved trying to get the survivor to call the police (e.g., “[The nurse] was very involved in what was going on and, like I was saying, she was trying to encourage me to press charges”) or leave the relationship (e.g., “[My friend] said I'd be stupid if I went back”). Survivors described controlling reactions from friends, family members, and counselors most often, and these reactions were often described as at least partially healing. For example, the survivor who had a nurse encourage her to press charges said: “I felt supported, and I felt that if I wanted to go ahead and go through this, that she would support me in doing so.” This is inconsistent with the SRQ, which categorizes controlling reactions as negative. Closer examination of survivors' interpretations help explain this discrepancy. In most of the cases in which controlling reactions were interpreted as healing, survivors believed that the support provider was motivated by love and concern. For example, one survivor said that her boyfriend had started being overprotective, but she felt that this was “good 'cause it shows he cares about me and, um, and wants me to be safe, and so it's more positive than negative.” On the other hand, the cases that survivors considered to be hurtful tended to involve support providers who acted as though the survivor could not take care of herself. For example, one survivor was less happy with her partner's insistence on protecting her: “Not always but sometimes, he makes me feel helpless, because he's always saying to watch out for people.”
Distraction Consistent with the SRQ, efforts designed to keep the survivor from thinking about the assault were classified as distraction. Such reactions were described in 4.2% of the disclosure interactions. One survivor said that her mother “sometimes said she didn't want to hear it.” Another survivor described a friend who “would tell me to let it be in the past.” Survivors described being distracted from thinking about the assault by partners and family most often, and these reactions were generally considered to be hurtful, particularly when survivors interpreted these reactions as signs of impatience. For example, one survivor was upset by her mother's reaction:
’Cause she was so tired of hearing about it, ’cause it should have been something I got over. But my life got worse, my life didn't take on, it didn't go down any paths. It just stopped, and it just stopped, and I got let go at work and nobody would hire me, and I leaned on her and she would get tired of this.
Another survivor described her friend's reaction:
She wanted to move on. She didn't want me to be sad anymore. She wanted me to go back into my party girl mode where I used to be always smiling and carrying on. She wanted the old me back. She didn't want the sexually assaulted me.
But not all efforts to distract survivors were interpreted negatively. Efforts to distract survivors were often considered positive when survivors felt that their friends and counselors were trying to help them heal. For example, one survivor found her counselor's attempts to help her stop ruminating as healing: “The most positive thing … probably, that I can get beyond it. That life was bigger than this one single thing.” Survivors also considered distracting reactions to be healing when the support provider was doing what the survivor wanted. For example, one survivor was pleased by her family's willingness to distract her: “They know I just didn't want to talk about it anymore.”
Egocentric reactions Consistent with results from the SRQ, many survivors described support providers who were upset, angry, and shocked. Nearly a fifth of the disclosure interactions (19.7%) involved extreme emotional reactions on the part of support providers. One survivor's boyfriend “lost his temper and kept saying the rapist would never touch me again.” Another survivor's friend “was scared that it might happen to her.” Survivors described egocentric reactions from partners, friends, and family most often and were more likely to describe these reactions as healing than hurtful. Survivors tended to consider these reactions to be healing when the reaction helped validate the importance of the assault. For example, one acquaintance became very angry with the rapist:
It helped me a little that she was so angry. Up until that point no one had acted quite like that. It mirrored what I was feeling and a lot of times whenever I talked about this before, I talked more in terms of grief and fear than anger and that was probably the first time I felt “How dare he.”
Another survivor appreciated her coworker's shock:
I was glad that she felt shocked because that made me feel like it was bigger than what I was making it out to be. ’Cause I needed somebody that, to make me feel like it was a bigger thing than what I thought. I was trying to brush it off as some little incident, but by her acting shocked it, it made me feel better, like I was actually going through something, because that's what I had felt.
Survivors also interpreted egocentric reactions as indicators of belief and concern. For example, one survivor appreciated how upset her husband became:
And that's when I saw the tears and stuff coming out of his eyes. Just to think that he had that much compassion for what happened to me that he feel like it was his responsibility to protect me … I got a wonderful husband.
Still, other survivors felt safer when the support provider vowed revenge. For example, when one survivor's boyfriend vowed revenge, it made her feel safer: “Oh I felt safe with him. He would protect me.” A second survivor interpreted her partner's desire for revenge as an indicator of belief and felt relief that her partner did not blame her:
It's—it's this total man reaction. But, you know what, there's a part of you that, you feel safe and protected when they act that way too. I felt protected. Especially in the light of the fact that I was expecting him to be pissed at ME! Maybe it really wasn't my fault. Maybe it really was going to be OK.
Another survivor was thankful for her partner's distress and appreciated the distraction this provided:
In a way it made me feel, um, more secure and more cared about that someone wanted to hurt this guy instead of blaming, instead of wanting to hate me or hurt me. Made me feel like, made me feel more protected. And it was nice because it distracted me away from the pain that I was feeling. I could now concentrate on this person and on, um, what I thought at the time was positive feelings, instead of dealing with just pain.
But although many survivors considered egocentric reactions to be healing, many others considered these reactions to be at least partially hurtful. This interpretation occurred most often when the support provider was a family member. In these cases, egocentric reactions were hurtful because the survivors were concerned for the support provider and felt guilty for causing their loved one emotional distress. For example, one survivor “felt ashamed, guilty for making mom upset.” Another survivor felt “hurt ’cause [my mother] was crying.” In other cases, survivors were concerned that the support provider was going to seek revenge and would get into trouble as a result. For example, one survivor was afraid that her sister would seek revenge:
Afraid because she was cursing him out when I told her. She is capable of doing something. I'm just afraid of the consequences that might happen to her that she might have to face. Her thinking is real devious when it comes to her loved ones. She'll do it and I was worried about her doing something negative and she would have to face the consequences.
Treated differently A few disclosure interactions (4.2%) involved support providers who treated survivors differently after the assault. For example, one survivor told her stepmother who “didn't want to see me anymore.” Another survivor described her mother's reaction: “She wouldn't let me come home. She didn't want it coming back to her.” Survivors most often described being treated differently by romantic partners. Being treated differently was described as hurtful by every survivor who chose to discuss these incidents, regardless of support provider. One survivor described what it was like to have her partner say he wanted nothing to do with her anymore: “Horrible. I felt like I did something wrong. Like I shouldn't have told anybody.” These reactions were particularly hurtful when survivors felt that romantic partners and family reacted this way out of shame over what had happened to the survivor. For example, the survivor described above felt that her boyfriend reacted as he did because “he was worried what his friends would think.” Being treated differently was also hurtful when the police treated the survivor differently after hearing her story. For example, one survivor described how the police treated her differently when they found out she had been looking for crack: “They actually thought it was consenting, they thought it was something that was consenting and turned sour.”
Minimizing reactions Although the SRQ includes minimizing reactions as a component of the treated differently scale, a full 4.2% of the disclosure interactions involved efforts to minimize the assault, so we decided to analyze minimizing reactions separately. These reactions refer to efforts to minimize what survivors have been through. For example, one survivor told some acquaintances who told her that “it was no big deal. They brushed it off.” Another survivor told her counselor who “just heard it like it was nothing. She acted like she didn't care.” Efforts to minimize their experience were almost always considered hurtful, regardless of support provider. One survivor told a friend who acted like it was nothing: “It was very hurtful for me to tell her because she went on [as if nothing happened].” Another survivor told the police who did not seem to care. She felt “betrayed.” Minimizing reactions were particularly hurtful because survivors tended to interpret this reaction to mean that their support providers did not care about them or what happened to them. For example, one survivor told her counselor who acted “like what had happened to me wasn't important.”
Did nothing In addition to the categories included in the SRQ, the current study also found that 6.2% of the disclosure interactions involved support providers who had no reaction or did nothing after hearing about the assault. For example, one survivor told her romantic partner who “didn't say much of anything.” Another survivor told her mother who “didn't react or acknowledge that I said anything at all.” Survivors who received this reaction considered it exclusively hurtful. For example, one survivor described telling her aunt who acted like it was no big deal. When asked how this made her feel, the survivor said: “You mean her lack of reaction? Hurtful.” Another survivor's mother did not even acknowledge that she had said anything. She found this to be “very hurtful. Very hurtful. Get up, do something.” Among informal support providers, family members were most likely to do nothing. Survivors interpreted this reaction as indicating a lack of concern or overt dislike of the survivor. For example, one survivor told her in-laws, who gave her the silent treatment: “They didn't like me. They never asked me anything. You know, nobody cared, you know? Nobody cared that I had been raped.” Among formal support providers, counselors and legal personnel were most likely to do nothing. Most often, survivors believed this reaction stemmed from disbelief and blame. For example, one survivor went to a homeless shelter. Although she was let into the shelter, the worker did not even respond to her disclosure. The survivor interpreted this to mean that the worker did not believe her because of “the way I looked, no credibility.”
Shared own story Finally, 5% of the disclosure interactions involved support providers who shared their own story of assault. One survivor told her friend who “said, me too, and shared her story.” It was most common for friends and counselors to share their own story. Most survivors considered this reaction to be healing because it helped them blame themselves less and made them feel less alone. For example, after one survivor's roommate shared her own story, the survivor said that “it made me feel better, like it wasn't my fault.” Similarly, another survivor appreciated hearing about her friend's assault because it helped her feel that “it could happen to anybody. It wasn't just me, you know.” But, some survivors considered hearing about a support providers' assault to be hurtful, particularly when they felt that the support providers were minimizing the survivor's experience or taking attention away from the survivor. This happened most often when friends and romantic partners shared their stories. For example, one survivor was annoyed when her friend tried to compare their stories: “I fought with her, I told her it wasn't my fault and that her story was not the same as mine.” Another survivor was annoyed when her friend usurped all of the time: “So she kind of opened up her situation, so we didn't really deal with mine a whole lot.” Similarly, another survivor described how telling her husband about her assault led him to discuss his own history instead of hers:
I think that hearing my situation made him reassess his own. I was waiting for him, it was mixed feelings, I felt fine about telling him about my situation but because it brought up his, it, it brought not conflict, but more discussion that I wasn't expecting. I still kind of wonder how I really truly feel about it. I think I'm still a little hurt that it happened.
Sexual assault is an extremely traumatic event that leads many survivors to seek help from others. In the current study, 81.6% of the survivors had previously disclosed the assault, supporting a growing body of literature that suggests that most survivors tell at least one person about the assault (Ahrens et al., 2007; Fisher et al., 2003; Koss, Dinero, Seibel, & Cox, 1988; Ullman & Filipas, 2001; Starzynski et al., 2005). Consistent with past research, the current study also found relatively high rates of disclosure to friends, family, and counselors and relatively low rates of disclosure to romantic partners, physicians, and police personnel (Ahrens et al., 2007; Campbell et al., 2001; Filipas & Ullman, 2001; Fisher et al., 2003; Golding et al., 1989; Ullman, 1996, 1999).
The current study also examined the types of social reactions survivors receive from support providers and how the identity of the support provider affects survivors' interpretations of these social reactions. In support of our hypotheses, specific support providers did engage in specific reactions more frequently, survivor ratings of specific reactions did differ by support provider, and survivors' qualitative narratives did provide insight into why the same reaction was interpreted differently when coming from different support providers. Consistent with previous research, formal support providers, such as counselors, police, and medical personnel, provided the most tangible aid (Herbert & Dunkel-Schetter, 1992; Ullman, 1996; Ullman & Filipas, 2001), but such aid was not always considered healing. According to our qualitative analyses, over half of the survivors who received tangible aid from legal personnel felt that the police blamed them or did not provide any emotional support when providing help, thereby lessening the positive impact of tangible aid. This is consistent with research that suggests that assistance without emotional support is not always viewed in positive terms (Ahrens et al., 2007). This finding adds to research that suggests that negative reactions may trump positive reactions (Borja, Callahan, & Long, 2006; Ullman & Filipas, 2001) and suggests that the perception of negative intent may be as important as the receipt of negative reactions.
Tangible aid from counselors, on the other hand, was almost always viewed positively. In fact, nearly every social reaction was viewed more positively when coming from counselors and friends, supporting previous research that suggests that disclosure to friends and counselors may be particularly beneficial (Campbell et al., 2001; Davis et al., 1991; Filipas & Ullman, 2001; Ullman, 1996). Social reactions from romantic partners and family members, on the other hand, were often viewed more negatively than the same reactions from other sources. For example, emotional support was considered less healing while being distracted, being treated differently, and controlling behaviors were considered more hurtful when coming from romantic partners or family members. This pattern is consistent with findings from previous research that suggests that negative reactions from romantic partners are associated with worse recovery outcomes than negative reactions from other sources (Davis et al., 1991; Filipas & Ullman, 2001; Ullman, 1996).
The inclusion of a qualitative component allowed for a greater understanding of why different social reactions are interpreted differently when coming from different support providers. Whereas emotional support is generally considered healing, survivors tended to rate emotional support more negatively when the support provider did not appear upset enough, the support provider was so upset that the survivor felt guilty about causing the support provider pain, or the support provider was not able to overcome the survivor's sense of shame, situations that were far more common during disclosures to partners and family members. Typically negative reactions, such as blaming, controlling, or distracting reactions, on the other hand, tended to be viewed more positively when interpreted as a sign of caring, an attempt to help survivors heal, or an attempt to protect survivors from future harm (situations that occurred more often with friends and counselors) and more negatively when interpreted as a sign of blame, impatience, or condescension (situations that happened more often with partners and family).
Taken together, these results suggest that the same reaction may be viewed differently depending on the identity of the support provider. Future research is clearly needed to further understand how the identity of the support provider affects survivors' interpretations of social reactions. For example, it is quite likely that the nature and history of relationships may be affecting survivors' interpretations. If a survivor's mother has always been critical, is the survivor more likely to interpret her mother's response as critical this time as well? It is also possible that survivors interpret reactions from partners and family members differently because of the sheer amount of time spent with these support providers. Or maybe survivors' expectations of support from these sources are greater, leading to exhaustion on the part of support providers and disappointment on the part of survivors. In-depth, qualitative studies aimed at examining such nuances are needed to examine these and other complexities inherent in understanding survivors' interpretations of social reactions from others.
In the meantime, there are a number of methodological and statistical limitations that temper the current findings. First and foremost, design limitations limit the types of conclusions we can draw from this study. Although steps were taken to ensure that the current sample was representative of the ZIP codes from which participants were drawn, random sampling was not used. As a result, the participants in this study may be quite different from survivors who either do not acknowledge their experiences to have been sexual assault or who do not choose to participate in a study. The current study also failed to ask about the gender of the support provider. The current study found that friends and counselors were the most supportive, but these support providers are also more likely to be women (particularly because all of the survivors were women), introducing a possible confound that was not accounted for in the current study. Romantic partners and formal support providers, on the other hand, were found to be the least supportive, but they may also be more likely to be men. Given that the gender of the support provider may affect rates of disclosure (Cortina, 2004; Yoshioka, Gilbert, El-Bassel, & Baig-Amin, 2003) and types of social reactions (Ahrens & Campbell, 2000; Davis & Brickman, 1996), future research that can tease apart the role of gender and support provider role is needed. Future research is also needed to understand how the identity of the perpetrator affects social reactions received from friends and family. Are friends and family less supportive when they know and like the assailant? Do survivors interpret social reactions differently when they are concerned about existing relationships between their support providers and the assailant? Future research is needed to explore these issues.
There are also several statistical limitations, primarily stemming from the fact that a single survivor provided information on up to five different support providers. This meant that the same rater often provided ratings for more than one case, thereby violating statistical assumptions of independence. Similarly, the size of the comparison groups was not always similar (with 91 disclosures to friends/acquaintances and only 28 disclosures to romantic partners). The statistical findings reported in this manuscript should, therefore, be regarded as primarily descriptive and exploratory, offering support for the qualitative findings described here, but not offering conclusive evidence of a statistical relationship on their own.
The findings on counselors should also be interpreted with caution. To reduce fatigue and response error, the current study asked survivors to discuss only the five most impactful disclosures in depth. Further examination of the 24 disclosures that were not discussed in detail suggests that survivors often chose to talk about only one of multiple counselors. If survivors chose to discuss the counselor who was the most helpful, this could skew the results toward more favorable outcomes for disclosing to counselors. If survivors chose to discuss the counselor who was the most unhelpful, this could skew the results negatively. It should also be noted that our study combined therapists, rape crisis counselors, and religious personnel into one group to preserve statistical power. Given that previous research has suggested that rape crisis centers may be particularly helpful, whereas religious personnel are not (Golding et al., 1989; Sheldon & Parent, 2002; Ullman, 1996), future research that examines reactions from these three groups separately is recommended.
Despite these limitations, the results from this study have important practical implications. First, these results suggest that sexual assault survivors may be best served by disclosures to counselors and friends. These two types of support providers appear to provide the greatest amount of emotional support, fairly high levels of tangible aid, and fairly low levels of most negative reactions. Disclosing to romantic partners, on the other hand, appears to have its costs. Romantic partners provided only moderate support, the lowest amount of tangible aid, and the highest amount of blame, control, egocentric behaviors, and tendency to treat the survivor differently. Such negative reactions from partners is consistent with previous research that suggests male partners often experience high levels of anger, frustration, and uncertainty about how to respond to sexual assault survivors (Ahrens & Campbell, 2000; Emm & McKenry, 1988; Smith, 2005). Interventions aimed at educating male partners about how to effectively help sexual assault survivors and counseling programs to assist male partners in dealing with their own emotional reactions are clearly warranted. Similarly, education and support for family and friends may also be in order. Survivors often felt guilty for causing their loved one's harm or neglected when their loved one reacted so emotionally that the survivor had to comfort the support provider. Educating informal support providers on how to support survivors may go a long way toward reducing the additional distress survivors experience after an assault. Continued efforts to train legal personnel are also needed to reduce levels of blame and increase levels of emotional support. In the current study, survivors often interpreted positive reactions negatively when they inferred negative intent, particularly when legal personnel provided tangible aid. This finding suggests that survivors are wary of the reactions they are likely to receive from the legal system and may need additional assurances from officers, detectives, and prosecutors that the survivor is not to blame and that her case is being taken seriously. Training legal personnel to take the time to offer explicit support to survivors may not only decrease survivor distress but may increase reporting rates in the future.