Post-Trauma Relationship Processes and Trauma-Related Disclosure in Female Survivors of Sexual Assaul

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 153 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 several specific interpersonal processes: positive and negative communication, hostility, and frequency of and satisfaction 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 positive and negative communication and sexual satisfaction. 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 examines the association of PTSD symptom severity with disclosure related to the experience of sexual assault to one's intimate partner, as well as the association of trauma-related shame and perception of partners' negative and positive responses to trauma-related disclosure. A subsample of 104 participants who had disclosed their experience of sexual assault to their current romantic partner was utilized to address these aims. These participants reported a moderate amount of trauma-related disclosure, with the vast majority of participants' responses clustered near the midpoint between "not at all" and "a great deal." Counter to hypotheses, level of engagement in trauma-related disclosure was unrelated to PTSD symptom severity. PTSD, shame, negative responses, and positive responses were all significantly positively correlated with each other, except for positive and negative responses, which were unrelated. Of these variables, only positive responses demonstrated a significant, bivariate association with level of disclosure, but when trauma-related shame, negative responses, and positive responses were accounted for simultaneously, both shame and positive responses were related (in expected directions). That shame was significant only in the multivariate analysis suggests that, within the context of female sexual assault survivors' romantic relationships, positive responses from partners may overpower any individual experiences of shame in predicting engagement in trauma-related disclosure. When the effects of negative and positive responses are controlled, shame demonstrates the expected negative association with disclosure to one's partner.