Psychology of Women Quarterly, 31 (2007), 38–49. Blackwell Publishing, Inc. Printed in the USA. C 2007 Division 35, American Psychological Association. 0361-6843/07 Copyright
DECIDING WHOM TO TELL: EXPECTATIONS AND OUTCOMES OF RAPE SURVIVORS’ FIRST DISCLOSURES Courtney E. Ahrens California State University
Rebecca Campbell Michigan State University
Sharon M. Wasco University of Massachusetts–Lowell
N. Karen Ternier-Thames Chicago School of Professional Psychology
Tracy Sefl University of Illinois at Chicago
In this study, 102 female rape survivors were interviewed regarding their first post-assault disclosure. Qualitative analysis revealed that nearly 75% of first disclosures were to informal support providers and over one third of the disclosures were not initiated by the survivors themselves. Over half of the survivors received positive reactions and less than one third felt the disclosure had a detrimental impact on their recovery. Loglinear analysis suggested that survivors who actively sought help from informal support providers were more likely to receive positive than negative reactions. In contrast, survivors who actively sought help from formal support providers were more likely to receive negative than positive reactions. When disclosure to formal support providers was initiated by the formal support providers themselves, however, survivors received exclusively positive reactions. Implications for future research are discussed.
Many survivors of sexual assault disclose their experiences to others in an effort to gain postassault support and assistance. Although survivors are less likely to disclose to professionals such as the police or medical personnel (e.g., Bachman, 1998; Fisher, Daigle, Cullen, & Turner, 2003; Ullman & Filipas, 2001a), the majority of survivors do disclose to informal support providers such as friends and family (e.g., Fisher et al., 2003; Golding, Siegel, Sorenson, Burnam, & Stein, 1989; Ullman, 1996a; Ullman & Filipas, 2001a). Survivors typically reach out to others for support when they believe doing so will help them feel better, provide needed assistance, or result in justice (Bachman, 1993,
Courtney E. Ahrens, Department of Psychology, California State University at Long Beach; Rebecca Campbell, Department of Psychology, Michigan State University; N. Karen Ternier-Thames, Department of Psychology, Chicago School of Professional Psychology; Sharon M. Wasco, Department of Psychology, University of Massachusetts–Lowell; Tracy Sefl, Department of Sociology, University of Illinois at Chicago. We would like to thank the members of the UIC Women & Violence Project for their assistance in data collection. This research was supported by a grant from the Program for Mental Health Services Research on Women and Gender (National Institute of Mental Health Grant # R24 MH54212-02). Address correspondence and reprint requests to: Courtney Ahrens, Department of Psychology, California State University at Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840. E-mail:
[email protected]
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1998; Feldman-Summers & Norris, 1984; Golding et al., 1989). Although most rape survivors receive positive reactions when they disclose to others, the impact of negative social reactions can be quite profound. Indeed, negative reactions have an extremely detrimental impact on recovery whereas positive reactions have little effect (e.g., Ahrens, in press; Campbell et al., 1999; Ullman, 1996b; Ullman & Filipas, 2001b). Taken together, this research implies that most rape survivors turn to informal support providers, are seeking support and assistance, receive positive social reactions, and do not experience negative outcomes from disclosure. What is not clear is how these constructs are related to one another. Are rape survivors looking for different types of support from different types of support providers? How do survivors’ expectations of support affect the impact that disclosure has on them, particularly when those expectations are violated? If survivors’ expectations from friends and family are not met, is the impact different from what it would be if survivors’ expectations from formal support providers were not met? These types of questions can only be answered by a study that examines both the decisionmaking process that precedes disclosure and the outcomes that follow disclosure simultaneously. To date, such a study has not been conducted. To address this gap in the literature, we will first review literature on rape survivors’ reasons for disclosing and the impact of social reactions on rape survivors’ recovery. We present a study that builds from these distinct lines of literature to provide a more
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holistic examination of rape survivors’ experiences with disclosure.
et al., 1999; Davis, Brickman, & Baker, 1991; Ullman, 1996b).
Decision-Making Process That Precedes Disclosure
Bridging the Divide: Bringing the Disclosure Puzzle Together
Efforts to understand crime victims’ reasons for disclosing have focused on the decision-making process that precedes disclosure. This literature suggests that victims first evaluate the nature of the incident to determine whether they have been victimized (Greenberg & Ruback, 1985). Victims then weigh the pros and cons of various options. Such a cost/benefit analysis may include the effectiveness of disclosing, social norms (Greenberg & Ruback, 1985), accessibility of options, and anticipated reactions (Browne, 1991). If victims perceive the benefits to outweigh the costs, disclosure is more likely (Browne, 1991; Greenberg & Ruback, 1985). Among sexual assault survivors, reporting the assault is more likely when they believe doing so would be personally beneficial (e.g., result in help and/or feeling better) and would deter future crimes (Bachman, 1993, 1998; FeldmanSummers & Norris, 1984). Indeed, survivors experiencing higher levels of psychological distress are more likely to turn to others for help than those with lower levels of psychological distress (Golding et al., 1989; Ullman, 1996a; Ullman & Filipas, 2001a). On the other hand, survivors do not disclose when they believe doing so would be ineffective or would result in negative consequences such as endangering themselves or loved ones, causing emotional distress, or resulting in stigma/blame (Bachman, 1993, 1998; Fisher et al., 2003; McAuslan, 1998; Neville & Pugh, 1997; Sudderth, 1998; Washington, 2001). Outcomes Following Disclosure Other studies have focused on the impact of disclosure. Pennebaker and colleagues have written extensively on the relationship between written disclosure and health outcomes. Known as the PsychoImmunology Model of Disclosure, this research suggests that written disclosure of traumatic events is related to improved psychological and physical health (Pennebaker, 1997; Pennebaker & Seagal, 1999). A related body of research suggests that discussing emotional events with others, referred to as “social sharing,” can be equally beneficial (Rime, 1995). The positive effects of such disclosures are theorized to result from cognitively and emotionally processing the trauma, which eventually leads to assimilation and decreased distress (Pennebaker, Zech, & Rime, 2001). The benefits of talking to others, however, may be contingent on the types of social reactions one receives. Disclosure may not always be met by positive support, and negative social reactions adversely impact survivors’ physical and emotional well-being (Abbey, Abramis, & Caplan, 1985; Dunkel-Schetter & Bennett, 1990). Indeed, rape survivors who receive negative reactions are more traumatized than those who do not receive negative reactions whereas positive reactions have little effect on recovery (Campbell
Although previous research has provided rich information about the decision-making process that precedes disclosure and outcomes following disclosure, little is known about how these processes are connected. For example, do survivors’ reasons for disclosing affect the types of outcomes they experience? It is quite possible that survivors who expect support but are instead blamed for the assault may feel more traumatized than survivors whose expectations were not so violated. Integrating what happens before, during, and after disclosure may provide greater insight into how and why disclosure affects recovery. To this end, the current study sought to examine the relationship between survivors’ reasons for disclosing, the disclosure event itself, and the impact disclosure had on survivors’ well-being. Current Study Using a community sample of 102 rape survivors, the current study uses both qualitative and quantitative methods to examine survivors’ first disclosure experiences. Content analysis was used to examine survivors’ qualitative narratives about their first disclosure. This analysis identified the type of support provider to whom survivors first disclosed, their reasons for disclosing, how this person reacted to their disclosure, and how this reaction affected them. These descriptive analyses were then followed by loglinear analysis to determine whether each of these four components of disclosure were related in systematic ways that exceeded chance relationships. This study builds on several quantitative findings we previously published about the detrimental impact of negative social reactions (Campbell et al., 1999; Campbell, Ahrens, Sefl, Wasco, Barnes, 2001). Unlike our previous publications, the current study uses more in-depth qualitative data about survivors’ first disclosures to provide a more holistic view of the disclosure process. Whereas our previous publications substantiated a quantitative relationship between social reactions and recovery, the current study uses survivors’ own descriptions to provide a more complex picture of how and why disclosure unfolds and how these disclosures ultimately make the survivors feel. METHOD Participants and Procedure Participants were recruited for a larger project on the impact of community services on rape survivors’ well-being (Campbell et al., 1999). Recruitment procedures for this larger study were modeled after techniques of adaptive sampling (Thompson & Seber, 1996) whereby researchers
40 systematically sample from locations that are frequented by the population of interest (see also Campbell, Sefl, Wasco, & Ahrens, 2004, for a detailed review of this recruitment strategy). We sought to ensure both breadth of coverage by systematically recruiting from the 69 ZIP codes in Chicago and depth of coverage by targeting locations frequented by women during their daily lives (e.g., laundromats, bookstores, churches). The distribution of posters/flyers and in-person presentations was systematically plotted and tracked; intensive efforts were made in ZIP codes with high concentrations of traditionally overlooked populations (e.g., women of color, low-income neighborhoods). These recruitment methods resulted in 102 in-person interviews with adult rape survivors. These interviews were conducted at a location of the survivors’ choosing and lasted an average of 2.27 hours (SD = 54.96 min). The women were paid $30, were provided with public transportation tokens, and received a referral packet for their participation. Participants averaged 34.29 years of age (SD = 10.05). The majority were African American (51%) with the remaining identifying as White (37%), Latina (6%), multiracial (5%), and Asian American (1%). Most participants were not currently married (70%) but did have children (53%), and most had at least a high school education (82%) and were currently employed (61%). Univariate analyses did not reveal any significant differences by type of rape, race/ethnicity, or age on any of the disclosure variables. Measures Survivors participated in face-to-face interviews that covered many topics (e.g., the rape itself, social system contact, psychological health, physical health). The current study focused on participants’ first postassault disclosure. Although 80% of survivors ultimately told more than one person, the current study focused exclusively on the first person the survivors chose to tell to gain a more in-depth picture about how and why survivors initially chose to disclose. Survivors responded to four open-ended questions about these firstdisclosure experiences: (1) Who was the first person you told about the assault? (2) Why was this the first person you told? (3) How did this person react? and (4) How did this person’s reaction affect you? Analysis Strategy Analyses proceeded in two stages. First, the participants’ open-ended responses were coded by two members of the research team. The coders worked separately to develop lists of codes. Following the open-coding strategies advocated by Miles and Huberman (1994) and Strauss and Corbin (1990), text pertaining to each variable of interest was examined separately. Each coder then noted key concepts and themes and labeled them in the margins next to the corresponding text. The resulting labels were then compared and a consensus approach was used to resolve
AHRENS ET AL. disagreements and to create a final list of codes that functioned as a codebook. After developing this coding scheme, each coder then independently re-reviewed participant responses and assigned mutually exclusive codes to each statement. To meet requirements of the planned quantitative analysis, only one code was assigned to each question for each case. In most cases, the survivors’ descriptions reflected only one code. In the few cases where participant responses reflected more than one code, each coder made a determination of which code appeared most salient to the victim. The surrounding text was used to make a determination of saliency. For example, one participant described a support provider who became angry and did not console her. The survivors’ explanation of how the support providers’ reaction affected her focused exclusively on the lack of support rather than the support provider’s anger: “It made me feel worse. The next day I’m laying there waiting for her to ask me about it.” Determinations of saliency were thus based on what the survivors themselves emphasized in their descriptions. Once both coders had completed their independent coding, these independent codes were then compared. Disagreements were noted and then discussed until consensus was reached. The kappa coefficient was .98 for identity of the support provider, .96 for reasons for disclosure, .84 for support providers’ reactions, and .83 for impact on survivors. These kappa values indicate excellent inter-rater agreement (Fleiss, 1971, as cited in Pett, 1997). The second stage of analysis used loglinear analysis to detect patterns among the disclosure variables. Loglinear analysis is an exploratory technique that can detect patterns of frequencies among three or more categorical variables. This technique is a multivariate extension of chi-square analysis that compares observed and expected frequencies in each cell to detect patterns that are significantly different from what would be expected by chance (Siegel & Castellan, 1988).
RESULTS Phase One: Qualitative Findings Identity of first person told. Survivors first disclosed to a variety of support providers. As can be seen in Table 1, most survivors initially told informal support providers. The most common support providers were friends (38.2%) and family members (22.5%). Disclosures to other types of informal support providers (e.g., partners, coworkers, neighbors, strangers) were less common, accounting for an additional 16.6% of first disclosures. Disclosures to formal support providers such as police, doctors, therapists, and clergy who provide services as part of their job were the least common, accounting for only 14.7% of all first disclosures. Furthermore, eight of the survivors in this sample had never disclosed to anyone prior to participation in this study. These survivors were dropped
Deciding Whom to Tell
41 Table 1
Identify of First Person Told (N = 102) Descriptive code Informal support providers Friend Partner Family Coworker Neighbor Strangers Formal support providers Police Doctor Therapist Clergy No one
Percentage
Loglinear code
74.6 38.2 5.9 22.5 3.9 3.9 2.9 14.7 5.9 4.9 2.9 1.0 7.8
Informal Informal Informal Informal Informal Informal Formal Formal Formal Formal
from the remaining analyses, resulting in a final sample of 94 rape survivors who had disclosed to at least one person. Survivors’ reasons for disclosing. The remaining 94 participants described a variety of reasons for disclosing the sexual assault. Only the most salient reason was coded for each survivor. Eight primary reasons for disclosing were identified. As can be seen in Table 2, most of these reasons could be categorized as active help seeking. Activehelp-seeking disclosures were characterized by conscious decision making on the part of the survivor to reach out and actively seek support from others. Specific examples of active help seeking included survivors who were actively seeking emotional support (38.3%). Survivors who cited this reason described turning to people close to them for emotional support following the trauma. These survivors often described relationships characterized by mutual support and disclosure: “She was closest to me. We were in the same circle of friends. I wanted her to know.”; “We are very close. There are no secrets between us.” Survivors also described simply needing to tell someone about what happened. Nearly 13% emphasized the importance of catharTable 2 Reasons for Disclosure (N = 94) Descriptive code Help seeking Emotional support Catharsis Tangible aid Catch rapist Initiated by others Explain behavior Discussion about rape Asked what’s wrong Person present at scene
Percentage 63.8 38.3 12.8 7.4 5.3 36.2 12.8 8.5 7.4 7.4
Loglinear code Help seeking Help seeking Help seeking Help seeking Other initiated Other initiated Other initiated Other initiated
sis or getting it off her chest. These survivors focused on the need to talk: “I didn’t want to keep it bottled up. I wanted a sense of talking.” “I needed to tell her. Let it out.” Survivors also described wanting tangible aid (7.4%). These survivors wanted specific information or assistance from support providers. For example, one survivor first disclosed to her doctor: “I wanted information, to know that I was physically and emotionally all right.” Another first told a neighbor: “I knocked on my neighbor’s door. I wanted to clean up so my kids wouldn’t see what had happened.” Finally, some survivors actively disclosed to help catch the rapist (5.3%). These survivors described wanting the perpetrators to be caught and prosecuted: “It was a crime. I wanted them caught and prosecuted.”; “I wanted it documented to be able to take him to court.” Most survivors were actively seeking help; however, other survivors felt that their disclosures were initiated by others. These disclosures occurred because the situation warranted disclosure, they were directly asked what was wrong, the disclosure recipient was present at the scene, or someone else initiated a conversation about rape. Although these survivors clearly made a decision to disclose (e.g., they could have lied or said nothing), they did not actively seek out these disclosures and did not have clearly articulated expectations of disclosure. Specific examples of disclosures initiated by others included situations where survivors needed to explain their behavior (12.8%). These survivors described awkward situations in which they felt they needed to explain where they had been or what they had done. For example, one survivor had been at a bar with a friend when the rape occurred. She felt she needed to explain where she had been: “I had this one friend and she was so mad at me for going away for a couple of hours, having no idea where I went . . . that’s why I finally was like, OK, this is what happened.” Another survivor was raped at a party. While fighting back, she destroyed some household objects and felt she had to explain: “I told my friend that was hosting the party. It was at her parents’ house. I kinda had to explain the mess. That’s the only reason I said anything.” Survivors also described being directly asked what was wrong (7.4%). These survivors described direct questions about why they were so upset or why they were acting strangely. In most of these cases, the support provider kept asking until the survivor finally disclosed. For example, one survivor’s roommate wanted to know why she was crying: “When I got home, I was just so upset about it and I was crying and she asked me what was wrong.” A similar situation happened when one survivor participated in a mock rape trial and became extremely emotional: I had this huge reaction. And my three friends sort of sat me down and they said what happened? And I was like, oh, nothing happened. No, I’m just really upset. Aren’t you upset? And they were like, no, your reaction is out of control . . . sit down because we’re going to be here for awhile.
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Other survivors decided to disclose during a discussion about rape (8.5%). These survivors described spontaneously disclosing during conversations about rape initiated by other people. For example, one survivor was participating in a women’s caucus on campus when several other women began discussing their own assaults: “At that moment, people spoke out about being raped, and so I talked about it there.” Another survivor was attending a marriage fellowship at her church. The discussion turned to rape, incest, and abortion and “the whole thing came back like a flashback.” Without thinking, the survivor shared her story. Finally, 7.4% of survivors described not having a choice about disclosure because the person was present at the scene and knew what happened. In some cases, this referred to the police who were called to the scene. In other cases, this referred to people who were in the vicinity during the rape itself. For example, one survivor was raped in her apartment and her landlady saw her open door: “My landlady had seen my door was open and brought her family back with her to check. The landlady’s brother asked me are you all right and I said, yes, he raped me, but I’m OK.” Social reactions. The survivors described a variety of reactions to their disclosure of sexual assault. Only the most salient reaction was coded for each survivor. This coding process resulted in 10 main reactions being identified in the narratives. As can be seen in Table 3, positive reactions were more common than negative reactions. These categorizations were based on both previous literature on social reactions (Davis & Brickman, 1996; Golding et al., 1989; Ullman, 2000) and the survivors’ own descriptions of the reactions they received. Specific positive reactions included being supportive (29%). These support providers listened to the survivors, told them it was not their fault, and provided reassurance. One survivor described her roommate’s reaction: “She put her arms around me and gave me a hug. She was sympathetic.” Another survivor described her therapist’s reaction: “She was calm, very supportive. She told me it wasn’t my Table 3 Social Reactions Received (N = 93) Descriptive code Positive reactions Empathetic Supportive Mobilized support Gave tangible aid Sought revenge Negative reactions Blamed Doubted Cold/detached Refused to help Unsupportive
Percentage 61.3 19.4 29.0 5.4 5.4 2.2 38.7 10.8 7.5 5.4 2.2 12.9
Loglinear code Positive Positive Positive Positive Positive Negative Negative Negative Negative Negative
fault, encouraged me, gave me strength.” Support providers were also described as being empathetic (19.4%). Here, the emphasis was on understanding what the survivor was going through and sharing the survivor’s emotional distress. These survivors described friends and family members who became upset after hearing about the assault: “She cried and grabbed me. She was more visibly upset than I was”; “He looked like he wanted to puke. After 45 minutes, he had to leave.” Other support providers focused on providing tangible aid (7.4%). For example, one survivor told a friend who “took me to the hospital and spent the night.” Another survivor told her roommate who “gave me names of people, services I could go to.” Support providers also helped to mobilize support (5.4%). These support providers contacted others for support or took survivors to professionals who could offer support. For example, one survivor’s grandmother “sent my uncle to call the police” after finding her bloody and unconscious on her lawn. Another survivor was raped by an acquaintance. When her mother came over the following morning, she “took me to the police station.” A couple of survivors also described support providers who wanted to seek revenge (2.2%). Although previous research has indicated that seeking revenge can be viewed both positively and negatively by survivors (Campbell et al., 2001), both of the survivors in the current cases appeared to view this positively. One of the survivors was raped by an acquaintance. She told her brother who knew the assailant and her brothers tracked down the assailant and “beat him up.” The second survivor was raped by a stranger. When she told her partner, “he was really upset and angry. He wanted to resort to violence against the rapist.” Although it was more common for support providers to react in a fairly positive manner, many survivors described negative reactions. Specific negative reactions included being blamed for the assault (10.8%). One survivor was raped by two strangers. She told her mother who “blamed me. I was informed by my mother not to tell anybody what I did.” Another survivor was assaulted in the context of a domestically violent relationship. Her sister “had no sympathy. She asked why I went out with him.” A number of survivors also described support providers who did nothing to help. These support providers were often unsupportive (13%). These support providers did nothing to help often because they were so shocked by the disclosure that they became immobilized. For example, one woman disclosed to her church group. After her disclosure, there was a long silence: “They were shocked . . . It’s like nobody had anything to say, just about, you know, what I said in the group.” Another survivor told a friend about being raped by a stranger. Her friend didn’t know how to help: “She was confused. She didn’t know what to do or say.” Some support providers also appeared to doubt survivors’ stories (7.5%). These survivors described support providers who questioned the veracity of their story or questioned whether their experience qualified as rape. For example, one survivor told her friend about being assaulted by an acquaintance. Her friend “laughed; she didn’t believe it; she laughed.” Other support providers
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43 Table 4
Impact on Survivor (N = 94) Descriptive code Healing Felt better Comforted Supported Validated Unburdened No identifiable impact Hurtful Hurt Angry Responsible
Percentage 46.8 7.4 11.7 9.6 6.4 9.6 20.2 33.0 25.5 5.3 4.3
Loglinear code Not detrimental Not detrimental Not detrimental Not detrimental Not detrimental Not detrimental Detrimental Detrimental Detrimental
knew the assailant and did not believe the assailant would do such a thing: “She was more protecting him. She didn’t believe me. She thought he was nice, charming.” Still other support providers did not think the assault qualified as rape. For example, when one survivor told her coworker about being raped by an acquaintance, the coworker “questioned me about it. It didn’t seem like assault.” A handful of survivors also described support providers who maintained a very cold/detached demeanor (5.4%). These survivors described support providers who did their job but failed to communicate any sympathy or concern for the survivors’ well-being. For example, one survivor told her doctor about being raped by her husband. Her doctor did not express any sympathy: “He didn’t seem surprised . . . he didn’t really seem to give any reaction at all.” Another survivor disclosed a stranger rape to the police and described them as “polite, efficient.” Finally, two support providers actively refused to help. In one case, the survivor was raped by a stranger and ran out into the street to get help. When she approached two men on the street, “they said ‘go away, we don’t want to deal with it.’” In the second case, the survivor was a teacher who had been assaulted by a group of acquaintances. She disclosed to the principal at her school who was “annoyed because I had been crying before.” Impact on victim. The survivors were impacted by the disclosure in a variety of ways. Nine main reactions were identified in the narratives. As can be seen in Table 4, the impact of the disclosure on survivors can be categorized as healing, hurtful, or having had no identifiable impact on the survivors’ well-being. Specific outcomes that were categorized as healing included felt better (7.5%). One survivor told her therapist about a marital rape. The therapist was supportive which made the survivor “feel at ease. Now I don’t have to live with all the pain because someone else knows.” A second survivor told her friend about being raped on a date. Her friend was supportive, which was healing for the survivor: “She made me feel a whole lot better. She watched out for
me . . . she was there for me.” Other survivors described feeling comforted (11.6%). These survivors described feeling safer, calmer, and cared for as a result of their disclosure. For example, one survivor told a staff person at a halfway house about being raped by a stranger. The staff person was supportive. This made the survivor feel “comfortable, not so scared. It helped to tell somebody else.” A second survivor told her sister about being raped by a stranger and received an empathetic reaction. This made her feel cared about: “Talking to her made me feel better, having someone to talk to about it. My sister reinforced the feelings of her caring about me.” Other survivors described feeling validated (6.4%) by the support providers’ reaction. These survivors interpreted the support providers’ reaction as confirmation that the experience was in fact rape, that the experience was in fact serious, and that they had the right to be upset and angry. For many of these survivors, the support providers’ reactions helped normalize their feelings about the assault. For example, one survivor told her roommate about being raped on a date. Her roommate provided tangible aid, including resources and referrals. This reaction “made me feel like I wasn’t nuts, you know . . . her reaction was really great . . . she really validated it.” Still other survivors explained how talking about the assault made them feel like a burden was lifted off of them. These survivors discussed the relief that came with getting their story out in the open. Unlike others, survivors who described feeling unburdened (9.5%) appeared to focus on the act of disclosure more than on the specific reaction they received. For example, one survivor felt better after telling a friend about being raped on a date: “I felt better. It’s best to talk about it. Things shouldn’t build up.” Yet another survivor focused on the importance of telling a friend about her acquaintance rape: “I probably would have had a nervous breakdown without telling her.” Although most of the survivors felt better after disclosing the assault, nearly a third described feeling worse. Specific reactions that were categorized as hurtful included feeling hurt (25.5%) by the support providers’ reaction. These survivors described feeling betrayed by the support provider and feeling upset and disappointed by the support providers’ reaction. For example, one survivor told her roommate about being raped by an acquaintance. Her roommate blamed her for the assault; this hurt the survivor considerably: I actually felt worse by the fact that she didn’t talk to me about this, or never consoled me; that made me feel worse . . . I felt terrible, especially the next day I was just laying there waiting for her to say something. She said nothing . . . she made me feel bad. She made me feel like I did something bad. Another survivor described receiving an unsupportive reaction from the police: “It was painful. It felt like being raped again.” Survivors also described feeling angry (5.3%) at support providers for reacting as they did. These
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survivors appeared to externalize their pain and focus on what was wrong with the support provider. For example, one survivor told her sister about an acquaintance rape and received an unsupportive reaction. This reaction “made me angry and think she was stupid for saying that.” These survivors also described feeling so angry that their relationship with the support provider was effectively destroyed. For example, one survivor described feeling angry after receiving a doubting reaction from her friend: “I wanted to knock her out. I was very angry. I don’t have anything to do with her. I don’t trust her. I don’t want to be around her.” Other survivors described feeling responsible (4.3%) for the pain they caused the support provider by telling them about the assault. These survivors focused on how the support provider was feeling and felt that they had to comfort the support provider. These survivors worried that their friends and family could not handle seeing them so upset. In some instances, seeing their friends and family so upset made these survivors feel like they had to comfort the support providers: “It kind of made me feel like I had to comfort her because she was taking it so hard.” In other cases, survivors started restraining themselves to protect the support providers from feeling pain: Many of my friends had extreme emotional reactions. I started to feel guilty about inflicting this on them so I started to share information more carefully. It was hard when friends didn’t want to see me all weepy and crazy. I wished it could have been OK to be that way, but I felt restrained. I feel responsible for how they’re reacting. Although most of the survivors in this sample were able to articulate the impact that the support provider’s reaction had on them, just over one fifth of the survivors claimed that this first disclosure had no identifiable impact on them. Some of these survivors said they did not know what effect the support provider’s reaction had; however, most explained that the reaction did not have any impact at all. For some, this was because the support provider’s reaction was not important to them. For example, one survivor explained that her interaction with the strangers who refused to help her was too fleeting to matter: “It didn’t really affect me. I was in a blind panic. I was running for my life.” Other survivors described being in such a state of shock that nothing really mattered at the time: “No effect. I was in a cloud till about 10 days after the event.” Conclusions. The rape survivors in this study provided rich qualitative data about their first-disclosure experience, providing in-depth information about why survivors decided to disclose to specific support providers, what happened during that disclosure, and how the disclosure made them feel. Although qualitative data provide a vivid picture of what occurred during these disclosures, the survivors did not always draw specific connections between these vari-
ables. For example, it was rare for survivors to comment on how their expectations influenced how they felt about the disclosure. The connection between specific social reactions and the impact of the disclosure on survivors was also not always explicit. As a result, we felt that qualitative analysis was not the most appropriate method for noting patterns between these variables. We therefore opted to use loglinear analysis to quantitatively analyze the relationship between the identity of the support provider, reasons for disclosure, social reactions, and the impact on the survivor. We then return to the qualitative data to help explain the quantitative data, thereby integrating these two methods to arrive at a fuller understanding of rape victims’ experiences with disclosure. Phase Two: The Relationship Between Identity of Support Provider, Reasons for Disclosure, Social Reactions, and Impact of Disclosure Using the descriptive data described above, exploratory loglinear analysis was used to detect patterns among the disclosure variables. To maximize power and increase the number of cases per cell, only the dichotomous categories described above were used. Specifically, identity of support provider consisted of two categories: (1) informal support providers, which included friends, partners, family members, coworkers, neighbors, and strangers, and (2) formal support providers, which included police, doctors, therapists, and clergy. Survivors’ reasons for disclosing consisted of two categories: (1) help-seeking disclosures, which included seeking emotional support, catharsis, tangible aid, or wanting to catch the rapist, and (2) disclosures initiated by others, which included needing to explain behavior, being asked what was wrong, a discussion about rape, and disclosing to someone present at the scene. Support providers’ social reactions were also collapsed into two categories: (1) positive social reactions, which included supportive and empathetic responses, mobilizing support, providing tangible aid, and seeking revenge (which was described positively by the survivors in this sample), and (2) negative social reactions, which included being blamed, doubted, unsupported, treated in a cold/detached manner, and having support providers who refused to help. The final variable, impact on survivor, was also reduced to two categories. Here, it was decided to focus on detrimental outcomes or no detrimental outcomes. The reasoning behind this categorization comes from previous literature. Although it has been consistently shown that negative social reactions harm survivors, most research has found less impact of positive social reactions or social support (for a review, see Ullman, 1999). To frame the current study within these previous findings, outcomes such as feeling hurt, angry, and responsible were labeled as detrimental. These were all outcomes that made the survivor feel explicitly bad. Outcomes that did not appear to have an explicitly harmful impact were then labeled as not
Deciding Whom to Tell detrimental. These cases included both survivors who felt good after disclosing (e.g., healed, comforted, supported, validated, unburdened) and survivors who did not think the disclosure had any effect on them.1 Using these reduced categories, loglinear analysis was used to test the resultant 2 × 2 × 2 × 2 (Informal vs. Formal Support Providers × Help-Seeking vs. Other-Initiated Disclosures × Positive vs. Negative Social Reactions × Detrimental vs. Not Detrimental Impact) model. Loglinear analysis is a multivariate extension of chi-square analysis based on a comparison of observed and expected cell frequencies for three or more variables. This exploratory technique identifies patterns in the data that occur more or less often than would be expected by chance. Statistically, observed cell frequencies are compared to cell frequencies that would be expected by chance. If there are more cases than one would expect by chance in one cell, such as the cell looking at negative reactions and disclosure to formal support providers, and fewer cases than one would expect by chance in another cell, such as the cell combining positive reactions and detrimental impact on the survivor, a systematic relationship likely exists. The goal of loglinear analysis is to build the most parsimonious model that can still adequately characterize the data. Thus, a nonsignificant overall model is desired (indicating that the model does not significantly differ from the data) with the smallest number of significant interactions or main effects that can explain the observed frequencies. Loglinear analysis proceeds in a hierarchical fashion with the four-way interaction being tested first. If the four-way interaction is nonsignificant, a more parsimonious model that still adequately captures the data is sought. To identify the most parsimonious model, nonsignificant interactions are removed and analysis continues to the next level down (i.e., three-way interactions, then two-way interactions, then main effects) until significant effects are encountered. Once a significant effect is encountered, analysis stops and the final model is presented. In the current study, a nonsignificant, nonsaturated model was obtained, LR χ 2 (6, 93) = .94, ns, indicating that the model adequately explained the data (i.e., there is no difference between the observed data and the proposed model). One significant three-way interaction and one significant two-way interaction emerged in this model: (1) identity of support provider by reason for disclosure by social reaction, LR χ 2 (1, 93) = 5.58, p < .05, and (2) type of social reaction by impact on survivor, LR χ 2 (1, 93) = 65.60, p < .001. Observed cell frequencies were examined to interpret these interactions. For the three-way interaction, the difference between formal and informal support providers appeared to be driving the results. Specifically, an interaction between survivors’ reasons for disclosure and the type of reactions survivors received emerged for survivors who turned to formal support providers but not survivors who turned to
45 informal support providers. Among survivors who turned to formal support providers, survivors who engaged in helpseeking disclosures were more likely to receive negative reactions (n = 7) than positive reactions (n = 4). In contrast, survivors whose disclosures to formal support providers were initiated by others were more likely to receive positive reactions (n = 3) than negative reactions (n = 0). Such an interaction did not emerge for disclosures to informal support providers. Among survivors who disclosed to informal support providers, survivors who engaged in help-seeking disclosures were more likely to receive positive reactions (n = 32) than negative reactions (n = 16). Similarly, survivors whose disclosure to informal support providers was initiated by others were also more likely to receive positive reactions (n = 18) than negative reactions (n = 13). Taken together, these findings suggest that both the identity of the support provider and who initiates disclosure are related to the type of social reactions rape survivors receive. The significant two-way interaction suggests that the impact of disclosure on survivors is dependent on the type of reaction received. Not surprisingly, survivors who received negative reactions were more likely to report detrimental outcomes (n = 29) than nondetrimental outcomes (n = 7), whereas survivors who received positive reactions were more likely to report nondetrimental outcomes (n = 55) than detrimental outcomes (n = 2). This finding suggests that the type of social reactions received by survivors strongly affects how survivors feel about their disclosure experiences. DISCUSSION The primary goal of this study was to bridge the gap between research on the decision-making process preceding disclosure and the outcomes following disclosure. In the current study, the links among the identity of the first person told, rape survivors’ reasons for disclosure, support providers’ reactions to the disclosure, and the impact this reaction had on the survivors were examined. The qualitative data yielded several themes that both support and expand on previous findings. First, descriptive data suggested that the vast majority of rape survivors initially disclose to informal support providers. Nearly 70% of the sample first disclosed to friends, partners, or family members. This finding is consistent with much of the literature on social reactions that has found similarly high rates of disclosure to informal support providers (Fisher et al., 2003; Golding et al., 1989; Ullman, 1996a; Ullman & Filipas, 2001a). The descriptive data also supported literature that suggests rape survivors often disclose to receive support and assistance from others (Bachman, 1993, 1998; Feldman-Summers & Norris, 1984; Golding et al., 1989; Ullman & Filipas, 2001a). Contrary to previous research, however, the current results also suggest that some rape survivors initially disclose without having actively sought
46 assistance from others. Whereas previous research suggests that survivors choose to disclose after determining that the benefits outweigh the costs (Bachman, 1993, 1998; Binder, 1981; Browne, 1991; Greenberg & Ruback, 1985), results from the current study suggest that some survivors may not have the opportunity to engage in such a conscious cost/benefit analysis. For some survivors, their first disclosure occurred automatically because support providers were present at the scene. For others, direct questions about their whereabouts or emotional state gave survivors little option other than lying. These results expand on Ullman and Brecklin’s (2003) finding that survivors may initially turn to formal support providers for other reasons, but end up disclosing the assault in the process. In both cases, the disclosure was initiated by the situation and was not generally premeditated. This study also adds to the literature on social reactions. The qualitative data revealed a variety of social reactions that ranged from explicitly negative (e.g., blaming, doubting, refusing to help) to explicitly positive (e.g., emotionally supportive, empathic, offering tangible aid) that align well with social reactions previously identified in the literature (Davis & Brickman, 1996; Filipas & Ullman, 2001; McAuslan, 1998; Ullman, 1996c). This study also noted several cases in which the support provider reacted in a cold/detached manner. Although these survivors were helped by the support providers, they did not describe assistance without emotional support in positive terms. This suggests that the manner in which help is provided is at least equally as important as the type of assistance rendered. Future research on social reactions could benefit from a multifaceted approach that considers type of assistance as well as manner of delivery. Finally, the descriptive data suggested that the impact these social reactions had on survivors ranged from healing to hurtful. However, this study also identified a sizable number of cases for which the survivor thought the reactions had no impact on them. Closer examination of these cases revealed three main reasons for this lack of effect. In some cases, the survivors described primarily negative or unhelpful reactions from the first person they disclosed to but dismissed them as inconsequential. In other cases, the survivors described being in such a state of shock or emotional turmoil that nothing really touched them. In still other cases, the survivors were simply unable to identify the impact the social reactions had on them. This finding opens up an interesting line of research on how rape survivors evaluate, weigh, and explain the social reactions they receive. The loglinear results also showed some intriguing findings. As indicated by the significant three-way interaction, survivors who actively sought help from informal support providers tended to receive positive reactions whereas survivors who sought help from formal support providers tended to receive negative reactions. These find-
AHRENS ET AL. ings are consistent with several other studies that have found high levels of supportive reactions from informal support providers and high levels of negative reactions from formal support providers (Campbell, Wasco, Ahrens, Sefl, & Barnes, 2001; Filipas & Ullman, 2001; Ullman, 1996c). It has been suggested that such high levels of negative reactions from formal support providers may be a function of organizational demands (e.g., building airtight cases for prosecution) that run counter to victims’ needs (e.g., being believed; Martin & Powell, 1994). The finding that rape survivors receive high rates of negative social reactions when seeking help from formal support providers is therefore not surprising. What is surprising is the finding that survivors received exclusively positive reactions from formal support providers when the disclosure was initiated by the support providers themselves. Closer examination of these cases revealed that these positive reactions came exclusively from therapists and the police. In the case of the therapists, the survivors were in therapy for other issues, but the survivors needed to explain something about their history. These therapists immediately reassured the survivors that the rape was not their fault. In the case of the police, they had already been called to the scene and were able to immediately validate the survivors’ story and take action. Unlike police responses to survivor-initiated reports, these police were able to ascertain the veracity of the report and did not blame or doubt the survivor. These results add to the literature positing a link between negative reactions and disclosure to formal support providers (Filipas & Ullman, 2001; Golding et al., 1989) by suggesting that the context of the disclosure is an important factor in determining the types of social reactions received. Future research from the support provider’s point of view would help identify the most salient contextual factors that lead to different reactions. Results of the two-way interaction revealed that survivors felt that negative reactions from the first person they told were detrimental to their well-being whereas positive reactions were not. However, there were a few cases in which positive reactions were considered to be detrimental. Closer examination of these cases suggested that this occurred exclusively in situations in which the support provider reacted in a highly empathic manner. These support providers appeared extremely upset by the news, a reaction that is not uncommon among informal support providers (Ahrens & Campbell, 2000). This reaction made the survivors feel responsible for the well-being of the support provider, shifting the focus away from the survivor and onto the support provider. This finding parallels the “egocentric reaction” construct first proposed by Ullman (1996a, b, c). According to Filipas & Ullman (2001), some support providers respond emotionally based on their own needs rather than the survivors’ needs. The current research expands on this idea by suggesting that rape survivors who receive such egocentric reactions may feel compelled to prioritize their loved ones’ well-being over their own. Future research on the impact of
Deciding Whom to Tell egocentric reactions on rape survivors’ disclosure behavior is needed. The lack of a relationship between either the identity of the support provider or reasons for disclosure and the impact on survivors is also important to note. Although both of these variables were related to the type of social reactions survivors received, they were not directly related to the impact on survivors. Only social reactions were related to impact in the final model. This could be an artifact of the statistical technique. It is possible that social reactions mediated the relationship between identity of support provider (or reasons for disclosure) and impact on survivors. Unfortunately, loglinear analysis cannot test for mediation, and the categorical nature of the data in the current study does not lend itself to techniques for testing mediation. Future research would therefore benefit from using continuous, quantitative measures to determine whether such a mediational relationship exists. There are several limitations to this research that are important to note. First, the relatively small sample size precluded more complex analysis. To reduce the number of cells with a low cell count, each variable was reduced to two categories. It is possible that this reduction obscured more complex relationships between the variables. This is particularly true in the case of the impact on survivors. To meet statistical requirements, this variable was reduced to detrimental versus not detrimental. Even though this emphasis on the harmful impact of social reactions is consistent with previous research (and removing survivors who reported no impact from analyses did not substantively change the findings), it would have been interesting to know if some reactions resulted in explicitly healing outcomes while others resulted in no impact. Similarly, the selection of a single reason for disclosure may have obscured the relationship between survivors’ expectations and the impact of disclosure. Although the current study was able to identify the most salient reason for survivors’ decision to disclose, this does not mean that survivors did not have multiple reasons for disclosing. For example, survivors could want and expect both tangible aid and emotional support from support providers. If survivors receive one form of support, but not the other, they may ultimately evaluate the disclosure as positive yet nonetheless remain somewhat dissatisfied. A larger sample size may help unravel such complex relationships. A larger sample might also help bolster findings about disclosures to formal support providers. In the current study, survivors who actively sought out formal support providers for their first disclosures received more negative reactions than survivors whose disclosures to formal support providers were initiated by the formal support providers. However, only 15% of the total sample actually disclosed to formal support providers, making this finding somewhat tentative. Future research with a larger sample is needed to confirm these findings.
47 It is also important to note that the inductive, qualitative nature of category development may make precise duplication of these findings difficult. Qualitative analysis is particularly good at providing a rich, in-depth picture of what is happening in a particular data set; however, the rather subtle distinctions that were captured in the current study may not be replicable in other studies. For example, the difference between feeling comforted and feeling better may not emerge in every study. Finally, it should be noted that all of the loglinear variables came from the same narrative source. This makes it more likely that relationships between the types of reactions and the impact of these reactions on survivors will be systematically related, a finding that was indeed upheld in the current study. In spite of these limitations, this study has many practical implications. The fact that most rape survivors first turn to friends and family highlights the importance of community education for potential support providers. Combating rape myths, educating the public about sexual assault, and training potential support providers to avoid negative reactions may help reduce the trauma of the assault and increase the likelihood that victims receive the support they are seeking. The current findings also suggest that community education efforts should emphasize attending to survivors’ needs so survivors do not feel compelled to silence themselves in the face of their loved ones’ distress. Simultaneously, continued efforts to train legal, medical, and mental health professionals on how to effectively support rape survivors is essential. Continued efforts to reduce victim blaming and doubting responses are still needed; however, the results of the current study suggest that explicit training on how to interact with victims in a supportive and empathic manner is also important. Finally, the current study also highlights the importance of protocols that ask women about their experiences with sexual assault. Many of the survivors in the current sample disclosed only after being directly asked about the assault. These disclosures were met by positive reactions from formal support providers. It may therefore be beneficial to incorporate screening questions into medical and mental health intake procedures as a first step toward opening the door to disclosure. Initial submission: July 25, 2005 Initial acceptance: June 1, 2006 Final acceptance: August 3, 2006
NOTE 1. A second set of analyses were performed to ensure that categorizing survivors who did not think that the disclosure had any effect on them as “not detrimental” was not driving the results reported below. This second set of analyses removed survivors who did not believe the reaction had any impact on them from the analysis. Results were comparable to the results from the full sample.
48
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