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is a common form of trauma experienced by women on college campuses, with research indicating that roughly 1 in 5 females will experience sexual assault while in college (Krebs, Lindquist, Warner, Fisher, & Martin, 2009). Further, sexual assault often leaves a substantial, negative impact on victim's mental health, with an extensive body of literature highlighting the high prevalence of PTSD and depression among sexual assault victims. For example, half of female undergraduate rape survivors will meet the criteria to be diagnosed with PTSD at some point in their lifetime. (Kilpatrick, Resnick, Ruggiero, Conoscenti, & Mccauley, 2012).Further, the National Comorbidity Survey (N=5,877) found that nearly half of women exposed to sexual assault met criteria for PTSD, with rape being the most common cause of PTSD in women . Further, a review on prevalence of mental health disorders among sexual assault victims indicated that between 17%-65% of sexual assault victims developed PTSD while 13%-51% met diagnostic criteria for depression (Campbell, Dworkin, & Cabral, 2009). Further, sexual assault victims are not only more vulnerable to psychological distress when compared to non-trauma victims, but they are also more vulnerable to distress compared to victims of other types of trauma (Breslau, Davis, & Andreski, 1991;Zinzow et al., 2010Zinzow et al., , 2012. Given the high prevalence of PTSD and depression, it is important to investigate factors that may confer risk of these negative outcomes among women who experienced rape. Two such factors may be blame and shame. Therefore, this study seeks to evaluate the association between blame (victimblaming social reactions to disclosure of rape and self-blame) and psychological distress, as explained by shame.Researchers have increasingly adopted an ecological lens when investigating factors leading to distress among sexual assault victims (see Campbell et al., 2009 for a review). An ecological approach emphasizes that our understanding of sexual assault's impact is significantly limited if we view sexual assault as an isolated event (Wasco, 2003). Rather, the subjective experiences of sexual assault often extend beyond the act of assault itself. Sexual assault and recovery are embedded in a multilevel social context that shapes how victims may judge themselves and are evaluated by others. In this social context, sexual assault is and remains a highly stigmatized experience (Kennedy &

Bisexual women experience worse mental health outcomes than lesbian and heterosexual women, which may be explained by greater rates of sexual violence among bisexual women. The current comprehensive literature review aimed to synthesize research on mental health and substance use outcomes related to lifetime sexual violence among bisexual women. A comprehensive literature search was conducted within the PsycINFO and Medline databases (final search conducted in August, 2021). Inclusion criteria required articles to examine a mental health or substance use correlate/outcome of lifetime sexual victimization experiences among bisexual women. Fifteen studies met inclusion criteria and were reviewed. Results indicate that there are significant gaps in this literature, including limited research on psychological distress outcomes. Most notably, there is a limited focus on the experiences of bisexual women specifically and the role of bisexual minority stress. Findings indicate that lifetime sexual victimization experiences are linked with increased posttraumatic stress, depression, and alcohol (and other substance) use and consequences. It appears that bisexual women are vulnerable to cumulative victimization, which may further exacerbate outcomes. Clinicians working with bisexual women should provide bisexual-affirmative care, help bisexual women access positive social supports, and build more effective coping strategies for managing post-trauma distress. Future research on outcomes of violence among bisexual women would benefit from contextualizing adjustment following sexual assault within a bisexual minority stress-informed approach for a more comprehensive understanding of this process.

Bisexual women experience high rates of sexual victimization, receive more negative social reactions from others upon disclosing experiences of sexual assault, and report greater hazardous alcohol use compared to heterosexual and lesbian women. The current study examined how experienced and internalized binegativity and bisexual identity affirmation relate to these disparities among a sample of 130 bisexual women who disclosed their sexual assault experience to at least 1 person. A moderated-mediation model was tested, which specified that experienced binegativity would indirectly relate to increased alcohol use via the impact of negative social reactions to assault disclosure, and that this indirect effect would be moderated by internalized binegativity and identity affirmation. Results indicated greater experienced binegativity predicted greater negative reactions to sexual assault disclosure, which predicted increased hazardous alcohol use. This indirect effect was qualified by internalized binegativity, such that negative social reactions to disclosure predicted hazardous alcohol use only in the context of higher internalized binegativity. Bisexual identity affirmation did not moderate the link between reactions to disclosure and drinking. Findings identify experienced and internalized antibisexual stigma as important targets for intervention efforts and highlight the need for campaigns that reduce binegativity at the individual and population level. Public Significance StatementBisexual women with histories of sexual assault who encounter negative stereotypes of bisexuality may be more likely to receive unsupportive responses from others when they disclose sexual assault. These unsupportive responses in turn may contribute to increased risk for hazardous alcohol use especially for women who have internalized negative attitudes toward bisexuality to a greater extent. Results highlight the need to reduce antibisexual stereotypes and attitudes in efforts to prevent the detrimental impact of unsupportive responses on alcohol use and to improve bisexual women's wellbeing.