Prevalence and correlates of service utilization and help seeking in a national college sample of female rape victims

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Abstract

This study examines prevalence and correlates of help seeking for emotional problems among undergraduate female rape victims. A national college sample of women endorsing a lifetime history of rape (N = 228) were interviewed in 2006 to assess demographic characteristics, rape history, rape characteristics, psychopathology, and substance abuse. Participants were asked if they ever sought help for emotional problems, and what type(s) of services were sought (medical professional, religious figure, or mental health professional). Prevalence of help seeking was 52%. Of help-seekers, 93% went to a mental health professional, 48% went to a medical doctor, and 14% sought religious counsel. Only PTSD was related to ever seeking help (OR = 2.35). Findings suggest that university-based mental health and medical facilities should be well prepared to identify and treat PTSD and other rape-related sequelae. Health promotion campaigns are needed to target substance abusing and depressed rape victims, who were less likely to seek help.

Introduction

Data from epidemiological studies published over the last two decades suggest that a high percentage of adults with mental health disorders do not utilize mental health services (Narrow et al., 1993, Wang et al., 2005). A similar pattern has been found among rape victims, despite the fact that sexual assault is associated with increased risk of psychiatric disorder (Ullman, 2007).

Although researchers estimate that as many as 3% of college women are sexually assaulted on campus each academic year (Fisher, Cullen, & Turner, 2002), no studies have examined correlates of post-assault help seeking behavior in a national sample of college women. Investigations of this nature are important because: (a) women ages 18–34, which covers the average age of college students, are at higher risk of sexual assault than women from other age groups (Kilpatrick, Edmunds, & Seymour, 1992), (b) college women are less likely to report sexual assault to authorities than women in the general population; this may be because victimized college women report high rates of alcohol-facilitated rape which is associated with reduced likelihood of disclosure to authorities (Kilpatrick et al., 1992, Fisher et al., 2003), and (c) educational attainment is associated with higher likelihood of help seeking (Coker, Derrick, Lumpkin, Aldrich, & Oldendick, 2000) and therefore accurate estimates of forms of help seeking behavior in college students has the potential to inform policy and practice at the national level.

The present study examined prevalence of distinct categories of help seeking behavior using a national college sample of female rape victims. We also examined demographic, rape history, incident characteristics, psychopathology, and substance abuse variables in relation to formal help seeking.

Section snippets

Participants

The list sample for college women was purchased from the American Student List (ASL). Respondents were stratified by region of the country, randomly selected, then released to be dialed via random digit dial methodology in proportion to the national census representation of college women. In 2006, 2000 interviews were conducted via telephone by a national surveying firm, SRBI (Schulman, Ronca, Bucuvalas, Incorporated). Of these women, those endorsing history of at least one rape experience were

Results

Sample characteristics for the subsample of rape victims extracted from the national sample are described in Table 1. More than half of the sample endorsed lifetime help seeking (52%). Regarding specific types of help sought, the most common form of help seeking was from a mental health specialist (93%). The next common type of help seeking was from a medical doctor (48%), followed by religious counsel (14%).

None of the demographic characteristics (age, race/ethnicity, year in school, income)

Discussion

This study discovered relatively high rates of help seeking (52%) among a national sample of undergraduate female rape victims, similar to rates among a comparable community sample (4). Interestingly, 93% of help-seekers sought help from a mental health specialist, a rate much higher than that within the community (54%) (4), perhaps reflecting higher family income and education levels, greater access to mental health care, and lower levels of stigma related to mental health treatment among this

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Note: This research was supported by National Institute of Justice (NIJ) Grant #2005-WG-BX-0006. Views expressed in this article do not necessarily represent those of NIJ. Dr. Amstadter is supported by NIMH Grant MH083469. Dr. Resnick is supported by NIDA Grant R01DA023099.

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