An Association Between Perceived Social Support and Posttraumatic Stress Symptom Severity Among Women With Lifetime Sexual Victimization: The Serial Mediating Role of Resilience and Coping

Abstract

This study examined the association between perceived social support and severity of posttraumatic stress symptoms, serially mediated by resilience and coping among women exposed to different patterns of sexual victimization experiences: childhood sexual abuse (CSA) only, adult sexual assault (ASA) only, and sexual revictimization (SR). A total of 255 sexually victimized women recruited from four U.S. universities completed self-report measures online; 112 participants reported provisionally diagnosable levels of symptoms of posttraumatic stress disorder (PTSD). The proposed model was largely supported in the CSA only group and the SR group. Different patterns of mediational effects were found across the three groups. Clinical and theoretical implications are discussed.

Keywords

sexual victimization perceived social support resilience coping trauma

Get full access to this article

View all access options for this article.

References

Bagwell-Gray

M. E.

Messing

J. T.

Baldwin-White

(2015). Intimate partner sexual violence: A review of terms, definitions, and prevalence. Trauma, Violence, & Abuse, 16(3), 316–335. https://doi.org/10.1177/1524838014557290

Bedard-Gilligan

Cronce

J. M.

Lehavot

Blayney

J. A.

Kaysen

(2014). The relationship between assault and physical health complaints in a sample of female drinkers: Roles of avoidant coping and alcohol use. Journal of Interpersonal Violence, 29(8), 1359–1379. https://doi.org/10.1177/0886260513507139

Besser

Weinberg

Zeigler-Hill

Neria

(2014). Acute symptoms of posttraumatic stress and dissociative experiences among female Israeli civilians exposed to war: The roles of intrapersonal and interpersonal sources of resilience. Journal of Clinical Psychology, 70, 1227–1239. https://doi.org/10.1002/jclp.22083

Blevins

C. A.

Weathers

F. W.

Davis

M. T.

Witte

T. K.

Domino

J. L.

(2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489–498. https://doi.org/10.1002/jts.22059

Bonanno

G. A.

Galea

Bucciarelli

Vlahov

(2007). What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. Journal of Consulting and Clinical Psychology, 75, 671–682. https://doi.org/10.1037/0022-006X.75.5.671

Brewin

C. R.

Andrews

Valentine

J. D.

(2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–766.

Carey

K. B.

Durney

S. E.

Shepardson

R. L.

Carey

M. P.

(2015). Incapacitated and forcible rape of college women: Prevalence across the first year. Journal of Adolescent Health, 56(6), 678–680. https://doi.org/10.1016/j.jadohealth.2015.02.018

Carver

C. S.

(1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92–100. https://doi.org/10.1207/s15327558ijbm0401_6

Carver

C. S.

(1998). Resilience and thriving: Issues, models, and linkages. Journal of Social Issues, 54, 245–266. https://doi.org/10.1111/0022-4537.641998064

10.

Classen

C. C.

Palesh

O. G.

Aggarwal

(2005). Sexual revictimization: A review of the empirical literature. Trauma, Violence, & Abuse, 6, 103–129.

11.

Cole

A. S.

Lynn

S. J.

(2010). Adjustment of sexual assault survivors: Hardiness and acceptance coping in posttraumatic growth. Imagination, Cognition and Personality, 30(1), 111–127.

12.

Conley

A. H.

Overstreet

C. M.

Hawn

S. E.

Kendler

K. S.

Dick

D. M.

Amstadter

A. B.

(2017). Prevalence and predictors of sexual assault among a college sample. Journal of American College Health, 65(1), 41–49. https://doi.org/10.1080/07448481.2016.1235578

13.

Connor

K. M.

Davidson

J. R.

(2003). Development of a new resilience scale: The Connor–Davidson Resilience Scale (CD-RISC). Depression & Anxiety, 18, 76–82. https://doi.org/10.1002/da.10113

14.

Cutrona

C. E.

Russell

(1987). The provisions of social relationships and adaptation to stress. In Jones

W. H.

Perlman

(Eds.), Advances in personal relationships (Vol. 1, pp. 37–67). JAI Press.

15.

Dong

Liu

Kong

Fang

Kang

(2017). The mediating role of resilience in the relationship between social support and posttraumatic growth among colorectal cancer survivors with permanent intestinal ostomies: A structural equation model analysis. European Journal of Oncology Nursing, 29, 47–52. https://doi.org/10.1016/j.ejon.2017.04.007

16.

Dworkin

E. R.

Menon

S. V.

Bystrynski

Allen

N. E.

(2017). Sexual assault victimization and psychopathology: A review and meta-analysis. Clinical Psychology Review, 56, 65–81. https://doi.org/10.1016/j.cpr.2017.06.002

17.

Ehlers

Clark

D. M.

(2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345.

18.

Evans

S. E.

Steel

A. L.

DiLillo

(2013). Child maltreatment severity and adult trauma symptoms: Does perceived social support play a buffering role? Child Abuse & Neglect, 37(11), 934–943. https://doi.org/10.1016/j.chiabu.2013.03.005

19.

Foa

E. B.

Kozak

M. J.

(1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35.

20.

Greene

R. R.

Galambos

Lee

(2003). Resilience theory: Theoretical and professional conceptualizations. Journal of Human Behavior in the Social Environment, 8, 75–91.

21.

Gutner

C. A.

Rizvi

S. L.

Monson

C. M.

Resick

P. A.

(2006). Changes in coping strategies, relationship to the perpetrator, and posttraumatic distress in female crime victims. Journal of Traumatic Stress, 19, 813–823. https://doi.org/10.1003/jts.20158

22.

Haden

S. C.

Scarpa

Jones

R. T.

Ollendick

T. H.

(2007). Posttraumatic stress disorder symptoms and injury: The moderating role of perceived social support and coping for young adults. Personality and Individual Differences, 42(7), 1187–1198.

23.

Hayes

A. F.

(2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press.

24.

Hines

D. A.

Armstrong

J. L.

Reed

K. P.

Cameron

A. Y.

(2012). Gender differences in sexual assault victimization among college students. Violence and Victims, 27, 922–940. https://doi.org/10.1891/0886-6708.27.6.922

25.

Hirai

Skidmore

S. T.

Clum

G. A.

Dolma

(2012). An investigation of the efficacy of online expressive writing for trauma-related psychological distress in Hispanic individuals. Behavior Therapy, 43, 812–824. https://doi.org/10.1016/j.beth.2012.04.006

26.

Johnson

J. G.

Cohen

Dohrenwend

B. P.

Link

B. G.

Brook

J. S.

(1999). A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders. Journal of Abnormal Psychology, 108(3), 490–499. https://doi.org/10.1037/0021-843X.108.3.490

27.

Jose

Novaco

R. W.

(2016). Intimate partner violence victims seeking a temporary restraining order: Social support and resilience attenuating psychological distress. Journal of Interpersonal Violence, 31(20), 3352–3376. https://doi.org/10.1177/0886260515584352

28.

Kaniasty

Norris

F. H.

(2008). Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection. Journal of Traumatic Stress, 21, 274–281. https://doi.org/10.1002/jts.20334

29.

Koss

M. P.

Abbey

Campbell

Cook

Norris

Testa

, et al. (2007). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization. Psychology of Women Quarterly, 31, 357–370.

30.

Leiner

A. S.

Kearns

M. C.

Jackson

J. L.

Astin

M. C.

Rothbaum

B. O.

(2012). Avoidant coping and treatment outcome in rape-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 80, 317–321. https://doi.org/10.1037/a0026814

31.

Littleton

H. L.

(2010). The impact of social support and negative disclosure reactions on sexual assault victims: A cross-sectional and longitudinal investigation. Journal of Trauma & Dissociation, 11, 210–227. https://doi.org/10.1080/15299730903502946

32.

Littleton

H. L.

Horseley

John

Nelson

D. V.

(2007). Trauma coping strategies and psychological distress: A meta-analysis. Journal of Traumatic Stress, 20, 977–988.

33.

Luthar

S. S.

Cicchetti

Becker

(2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562.

34.

Marriott

Hamilton-Giachritsis

Harrop

(2014). Factors promoting resilience following childhood sexual abuse: A structured, narrative review of the literature. Child Abuse Review, 23, 17–34. https://doi.org/10.1002/car.2258

35.

Norris

F. H.

Kaniasty

(1996). Received and perceived social support in times of stress: A test of the social support deterioration deterrence model. Journal of Personality and Social Psychology, 71(3), 498–511.

36.

Ozer

E. J.

Best

S. R.

Lipsey

T. L.

Weiss

D. S.

(2003). Predictors of posttraumatic distress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129, 52–73.

37.

Roth

Cohen

L. J.

(1986). Approach, avoidance, and coping with stress. American Psychologist, 41, 813–819. https://doi.org/10.1037/0003-066X.41.7.813

38.

Schumm

J. A.

Briggs-Phillips

Hobfoll

S. E.

(2006). Cumulative interpersonal traumas and social support as risk and resiliency factors in predicting PTSD and depression among inner-city women. Journal of Traumatic Stress, 19, 825–836.

39.

Scott

K. M.

Koenen

K. C.

King

Petukhova

M. V.

Alonso

Bromet

E. J.

, et al. (2018). Post-traumatic stress disorder associated with sexual assault among women in the WHO World Mental Health Surveys. Psychological Medicine, 48(1), 155–167. https://doi.org/10.1017/S0033291717001593

40.

Smith

H. L.

Summers

B. J.

Dillon

K. H.

Cougle

J. R.

(2016). Is worst-event trauma type related to PTSD symptom presentation and associated features? Journal of Anxiety Disorders, 38, 55–61. https://doi.org/10.1016/j.janxdis.2016.01.007

41.

Steine

I. M.

Winje

Skogen

J. C.

Krystal

J. H.

Milde

A. M.

Bjorvatn

, et al. (2017). Posttraumatic symptom profiles among adult survivors of childhood sexual abuse: A longitudinal study. Child Abuse & Neglect, 67, 280–293. https://doi.org/10.1016/j.chiabu.2017.03.002

42.

Stevens-Watkins

Sharma

Knighton

J. S.

Oser

C. B.

Leukefeld

C. G.

(2014). Examining cultural correlates of active coping among African American female trauma survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 6(4), 328–336. https://doi.org/10.1037/a0034116

43.

Ullman

S. E.

Peter-Hagene

(2014). Social reactions to sexual assault disclosure, coping, perceived control, and PTSD symptoms in sexual assault victims. Journal of Community Psychology, 42, 495–508. https://doi.org/10.1002/jcop.21624

44.

Ullman

S. E.

Townsend

S. M.

Filipas

H. H.

Starzynski

L. L.

(2007). Structural models of the relations of assault severity, social support, avoidance coping, self-blame, and PTSD among sexual assault survivors. Psychology of Women Quarterly, 31, 23–37. https://doi.org/10.1111/j.1471-6402.2007.00328.x

45.

van der Walt

Suliman

Martin

Lammers

Seedat

. (2014). Resilience and post-traumatic stress disorder in the acute aftermath of rape: A comparative analysis of adolescents versus adults. Journal of Child & Adolescent Mental Health, 26, 239–249. https://doi.org/10.2989/17280583.2014.923433

46.

Wagner

A. C.

Monson

C. M.

Hart

T. L.

(2016). Understanding social factors in the context of trauma: Implications for measurement and intervention. Journal of Aggression, Maltreatment & Trauma, 25(8), 831–853. https://doi.org/10.1080/10926771.2016.1152341

47.

Walsh

Blaustein

Knight

W. G.

Spinazzola

van der Kolk

B. A.

(2007). Resiliency factors in the relation between childhood sexual abuse and adulthood sexual assault in college-age women. Journal of Child Sexual Abuse, 16, 1–17.

48.

Weathers

F. W.

Litz

B. T.

Keane

T. M.

Palmieri

P. A.

Marx

B. P.

Schnurr

P. P.

(2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD.

49.

Wilson

L. C.

Scarpa

(2014). Childhood abuse, perceived social support, and posttraumatic stress symptoms: A moderation model. Psychological Trauma: Theory, Research, Practice, and Policy, 6(5), 512–518. https://doi.org/10.1037/a0032635

50.

Wisco

B. E.

Marx

B. P.

Wolf

E. J.

Miller

M. W.

Southwick

S. M.

Pietrzak

R. H.

(2014). Posttraumatic stress disorder in the U.S. veteran population: Results from the National Health and Resilience in Veterans Study. Journal of Clinical Psychiatry, 75, 1338–1346. https://doi.org/10.4088/JCP.14m09328