Differences in psychological health and family dysfunction by sexual victimization type in a clinical sample of African American adolescent women

Journal of Sex Research, August, 2005 by Heather Cecil, Steven C. Matson

According to the Federal Criminal Code, sexual victimization exists along a continuum that includes behaviors ranging from threats/pressures to engage in vaginal, anal, or oral sex to physical violence to force a woman or man to engage in sexual activity against her or his will (Kilpatrick, Whalley, & Edmunds, 2000). Since 1973, the U.S. Department of Justice has been collecting data on personal and household victimization from a nationally representative sample, which then is reported in the National Crime Victimization Survey (NCVS). Examination of the most recent trends for the NCVS from 1993 through 2001 reveals that, although the national crime rate has decreased substantially during this time period, the rate of rape and sexual assault has remained relatively unchanged (Rennison, 2001; 2002).

National survey data further reveal that the rate of sexual victimization is higher among youth as compared to adults (Bureau of Justice Statistics, 2001; Fisher, Cullen, & Turner, 2000; Hashima & Finkelhor, 1999; Kilpatrick, Edmunds, & Seymour, 1992; Kilpatrick & Saunders, 1997; Rennison 2001; 2002; Tjaden & Thoennes, 1998; 2000). For example, rates of sexual assault and verbal threat of rape/sexual assault were 2.0 and 3.3 times higher among youth between the ages of 12 to 17 years than among young adults 18 to 24 years of age (Hashima & Finkelhor). Similarly, data from the National Survey of Adolescents (NSA) indicate that although almost 30% of the youth surveyed reported that the assault occurred prior to age 11, the majority of cases (57.9%) occurred between the ages of 11 and 16 (Kilpatrick, 1996).

Closer inspection of sexual victimization data from national surveys indicates that the number of such cases are disproportionately high among adolescent women (Grunbaum et al., 2002; Rennison, 2001; 2002). Slightly more than half of all rape and sexual assault victims are women less than 25 years of age (Perkins, 1997). In the NSA, 13.1% of the adolescent women reported being sexually assaulted, as compared to 3.4% for adolescent men (Kilpatrick & Saunders, 1997). Comparable rates were reported by Boney-McCoy and Finkelhor (1995a), who found that among a nationally representative sample of 10-to 16-year-olds, 15.3% of the women and 5.9% of the men had experienced some form of sexual victimization. Moreover, adolescent women are more likely to be the targets of sexual victimization than are older women (Finkelhor & Hashima, 2001; Hashima & Finkelhor, 1999; Humphrey & White, 2000).

Although it is clear that adolescent women are more likely to be victims of sexual assault as compared to older women and their male counterparts, there is not a consensus as to how much rates vary by ethnicity. On the one hand, some studies find slightly higher sexual victimization rates among African Americans (Ackard & Neumark-Sztainer, 2002; Erickson & Rapkin, 1991; Hashima & Finkelhor, 1999). For example, in a large school-based sample of youth in grades 9 through 12, Ackard and Neumark-Sztainer found that 2.3% of African American adolescent women reported rape, as compared to 1.8% among White women. In contrast, other studies report very high rates among African Americans as compared to youth of different ethnicities (Kilpatrick & Saunders, 1997; Kilpatrick, Saunders, & Smith, 2003; Wordes & Nunez, 2002). The most recent data from the youth risk behavior surveillance (YRBS) (Grunbaum et al., 2002) reveal significantly higher rates of forced sex among African American women (9.6%) as compared to White women (6.9%). Similarly, in their study of dating violence among youth participating in a randomized controlled trial, Howard, Qiu, and Boekeloo (2003) found that reports of sexual victimization were significantly more likely among the African American adolescents as compared to the non-African American youth.

To be consistent with the federal Criminal Code, we defined sexual victimization as "the use of physical violence, threats of bodily harm, or psychological, economic, or evaluative pressure to force you, or to attempt to force you, into engaging in sexual intercourse, oral sex, or anal sex" (Allgeier, 1987, p. 13). This more inclusive definition was used to address the void identified by Fisher et al. (2000) and by Belknap, Fisher, and Cullen (1999), who noted that many of the measures of sexual victimization have been of limited value because they lacked detailed items that would more accurately measure the extent and type of sexual victimization. In other words, a major limitation of much existing research is the failure to measure the different ways in which a woman can be victimized. It has been suggested that in order to understand the impact of sexual victimization, as well as the likelihood of negative sequelae, one needs to know the severity of the sexual victimization experienced by the woman (Belknap et al.; Leidig, 1992; Maxwell, Robinson, & Post, 2003).

The question of whether or not there is a relationship between the type of sexual victimization and specific sequelae has not received much attention. The majority of research in this area has focused on documenting the negative consequences that may develop in diverse domains, ranging from psychological health to eating disorders and substance abuse problems. The general consensus is that adolescent women often experience adverse outcomes as a result of being sexually victimized (Boney-McCoy & Finkelhor, 1996; Finkelhor & Hashima, 2001; Kilpatrick et al., 1992; 2003). Some of these consequences are short-term, but others become lifelong problems. Commonly reported sequelae include psychiatric problems, homelessness, HIV, eating disorders, suicide, substance abuse, and unplanned pregnancies (Ackard & Neumark-Sztainer, 2002; Biglan, Noell, Ochs, Smolkowski, & Metzler, 1995; Boney-McCoy & Finkelhor, 1995a; Goodman, Koss, & Russo, 1993; Kaminer, Seedat, Lockhat, & Stein, 2000; Kilpatrick & Saunders, 1997; Kilpatrick et al., 2003; Messman-Moore, Long, & Siegfried, 2000).