Post-trauma Relationship Processes and Trauma-related Disclosure in Female Survivors of Sexual Assault

Jennifer DiMauro

Advisor: Keith D Renshaw, PhD, Department of Psychology

Committee Members: Lauren Cattaneo, Sarah Fischer

David J. King Hall, #2073A
April 28, 2017, 09:30 AM to 06:30 AM


Approximately one in five women in the United States will experience unwanted sexual contact during her lifetime. Relative to survivors of other traumatic events, survivors of sexual assault have an increased likelihood of meeting criteria for posttraumatic stress disorder (PTSD) and higher levels of PTSD symptom severity. Recent research has highlighted the importance of social support – particularly within the context of intimate relationships – in post-trauma functioning and recovery. To date, however, the vast majority of this research has focused exclusively on male combat veterans and their female partners.

This dissertation addresses the need for additional empirical information regarding the intimate relationships of sexual assault survivors in two separate but related manuscripts. Both projects utilize data from a diverse sample of 157 adult women with a lifetime history of sexual assault who were in committed, monogamous relationships with someone other than their assailant at the time of their participation. Participants were recruited through two sources: (1) online through ads on sexual assault survivor resource websites, and (2) via advertisements and flyers at university- and community-based trauma centers and outpatient psychological clinics, all of which are frequented by women presenting subsequent to a sexual assault. Participants reported on variables of interest via online questionnaires.

The first manuscript investigates the strength of the association between PTSD symptoms and intimate relationship satisfaction, as well as the role of three relationship processes that have been identified as potential mechanisms of distress in male combat veterans and their partners: (1) impaired communication, (2) greater hostility, and (3) dissatisfaction with sexual relationship. Counter to hypotheses and previous research with combat veteran samples, PTSD and relationship satisfaction were not significantly correlated. Also, in models of direct and indirect effects, the direct effect of PTSD on relationship satisfaction was actually positive, while indirect effects through negative communication, positive communication, and sexual satisfaction were all significantly negative. Post-hoc analyses suggested that results for those who indicated that they were not currently participating in treatment (n = 109) were more similar to results from prior combat veteran samples. Specifically, results demonstrated a negative overall association of PTSD and relationship satisfaction for these individuals. Moreover, in the model of indirect and direct effects, there was a near-zero direct effect of PTSD but significant negative indirect effects via communication and sexual satisfaction variables. In contrast, for those who were currently in treatment (n = 48), the direct effect of PTSD on relationship satisfaction was positive, with nonsignificant indirect effects. Of note, these differences between those who were and were not currently in treatment were not statistically significant, as the sample was underpowered to detect such interactions. However, the results offer preliminary evidence to suggest that communication and sexual satisfaction may be particularly salient issues for sexual assault survivors’ post-trauma psychopathological and relationship functioning, but participation in treatment may be associated with reduced impact of PTSD on interpersonal functioning.

The second manuscript explores differences in shame, trauma-related disclosure to partners, and perceptions of partners’ responses to these disclosures in survivors of childhood assault only (n = 55), adulthood assault only (n = 64), and both childhood and adulthood assault (n = 34). The groups did not differ in terms of relationship satisfaction, but those who experienced assault during both childhood and adulthood reported significantly higher levels of PTSD symptoms than the other two groups. Accordingly, PTSD symptom severity was entered as a covariate in subsequent analyses. Counter to hypotheses, the groups did not differ in terms of level of engagement in trauma-related disclosure, negative responses to disclosure, or positive responses to disclosure. However, those who had experienced assault during both childhood and adulthood reported significantly higher levels of shame than those who were assaulted in adulthood only. Finally, regression analyses found no evidence of moderation of the association of trauma-related disclosure with shame, negative responses, or positive responses by developmental period at the time of assault. These results present initial evidence that those who have experienced sexual assault in both childhood and adulthood may experience greater PTSD symptom severity and trauma-related shame relative to those who were assaulted during only one of those developmental periods. However, these differences do not appear to extend to engagement in or perceived response to trauma-related disclosure.