Emotional Dysregulation and Psychological Sequelae in Drug-Facilitated Sexual Assault Survivors

Abstract

Although drug-facilitated sexual assault (DFSA) cases account for a significant portion of sexual assaults (SA), their psychological and emotional consequences—beyond Post-traumatic stress disorder (PTSD)—remain underexplored. The current study addresses this gap by examining the psychopathological symptoms and emotion regulation difficulties in DFSA and non-DFSA survivors, identifying emotional dysregulation as a potential predictor of psychological sequelae. The sample included 39 women SA survivors from a clinical sample who experienced an isolated assault within the past year (20 non-DFSA, 19 DFSA) and 35 control participants comparable in sex, age, nationality, and educational level. To prevent confounding variables, cases with a history of childhood sexual abuse, prior SA, other traumatic events, or pre-existing mental health diagnoses were excluded. The results revealed that, while both survivor groups exhibited higher psychological symptoms than controls (i.e., somatization, obsessive-compulsive, interpersonal sensitivity, depression, hostility, phobic anxiety, and paranoid ideation), the non-DFSA group reported significantly higher anxiety and psychoticism symptoms than the DFSA one. Furthermore, whereas non-DFSA survivors demonstrated greater difficulties than controls in all emotional regulation domains (i.e., lack of emotional control, non-acceptance of emotional distress, daily life interference, inattention to one’s emotions, and emotional confusion), the differences in DFSA survivors were restricted to difficulties with non-acceptance of emotional distress. Regression analyses identified non-acceptance of emotional distress and lack of emotional control as key predictors of anxiety and psychoticism in SA survivors. These findings suggest that differences in assault-related contextual factors, such as substance use, may lead to distinct psychological and emotional profiles, although having comparable rates of PTSD. Clinically, the results underscore the importance of tailoring interventions mainly focused on reducing the non-acceptance of emotional distress and enhancing emotional control, as these two components have been identified as significant predictors of anxiety and psychoticism symptoms among both DFSA and non-DFSA survivors.