What happens when you tell: Disclosure, attributions, and recovery from sexual assault.

This retrospective, questionnaire study explored patterns in the recovery of survivors of sexual assault. The relationships between women's disclosures to others about the rape, their own attributions about the assault, and their efforts to form coherent accounts of what had happened to them were examined. A cognitive processing framework was used as a theoretical basis. A sample of 87 women who had received a forensic medical exam following sexual assault in the last five years was studied. Characterological and behavioral self-blame were highly correlated, and both were associated with increased depression, more severe trauma-related symptoms, and poorer physical health. Women who evidenced greater disruptions in core schemas related to intimacy, power, safety, esteem, and trust reported substantially greater psychological and physical health difficulties. They also evidenced higher levels of self-blame. Women who reported more intense efforts to make sense of what had happened to them also had more intrusive trauma-related symptoms, more depression, and more physical health complaints. Higher levels of general social support were positively correlated with better recovery, and those women who reported being able to talk more freely about the assault evidenced fewer symptoms. Initial disclosure experiences, including the forensic exam, did not correlate with recovery variables, nor with rape-related attributions. Women reported consistent patterns in terms of how freely they confided in others about experiences of traumatic victimization, including experiences of childhood physical and sexual abuse and subsequent adult traumas. They also reported generally supportive disclosure experiences, both immediately after the rape and subsequently. A qualitative analysis of woman's responses to questions about disclosure experiences and attributions revealed the complicated nature of such attributions. Women reported that their beliefs about why they had been raped had changed over time, and they linked these changes with their own recovery. It was also evident that such cognitions are highly affect-laden and often overlapping. It is suggested that further research is needed to explore the relationship between cognitive processing and emotional responses after trauma.PhDClinical psychologyPsychologySocial SciencesWomen's studiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/130811/2/9811171.pd