Beyond the Force–Substance Dichotomy: Examining the Experience of Combined and Incapacitated Type Rapes and Their Relation to PTSD Symptoms

Abstract

Prior research has examined how posttraumatic stress disorder (PTSD) symptoms are influenced by the experience of different types of rape, defined according to the method of coercion used. This work, which classifies rape experiences as either forcible or substance-involved, has yielded mixed findings regarding differences in PTSD symptoms as a function of rape type. Based on recent evidence indicating significant heterogeneity within substance-involved rapes, the present study utilized a novel four-group conceptualization of rape type to examine differences in PTSD symptom severity and associated factors across rape type. Using a sample of 161 community women with experiences of adult rape, we examined four rape types based on method of coercion: forcible-only rape (i.e., involving only force/threat of force; n = 48), impaired rape (i.e., substance-related impairment was present, but the participant remained conscious; n = 56), combined rape (i.e., both force/threat of force and substance-related impairment were present; n = 29), and incapacitated rape (i.e., the participant was intoxicated to the point of unconsciousness; n = 28). We compared these groups on PTSD symptom severity within each symptom cluster, as well as on assault characteristics and consequences, including peritraumatic fear and injury, acknowledgment, and self-blame. Combined type rapes were associated with significantly more severe PTSD symptoms than forcible-only and impaired type rapes. Differences among the groups were also found for peritraumatic fear and injury, and rape acknowledgment. Utilizing a dichotomous approach to rape type overlooks the complexity of women's experiences. Differences in PTSD symptom severity as a function of the proposed four-group conceptualization of rape type highlight the importance of assessing method of coercion when treating rape-related PTSD. Likewise, differences across rape types in peritraumatic fear and rape acknowledgment highlight the potential utility of type-specific targets of intervention.

Typologies of Rape Victimization Experiences Among Women Attending College: A Latent Class Analysis

“…Of note, there existed two substance-facilitated assault type classes characterized by a high probability of inclusion of binge drinking/substance-related impairment by the survivor and a low to moderate probability of inclusion of force or resistance in the assault, as well as a combined force/substance-facilitated class characterized by both a high probability of inclusion of binge drinking/substance-related impairment by the survivor and perpetrator and a high probability of inclusion of the different types of force by the perpetrator and resistance by the survivor. This is consistent with McConnell and colleagues (2020) who classified the rape experiences of a community-recruited group of young adults into forcible, substance-facilitated (impaired or incapacitated), and combined forcible/substance-facilitated types. It is also similar to Peter-Hagene and Ullman (2015) who found a combined forcible/substance facilitated assault group (labeled as alcohol-related).…”

“…We also sought to identify multiple correlates of membership into the identified assault type classes, including the survivor’s relationship with the perpetrator (e.g., stranger/just met, friend/acquaintance, romantic partner), whether the survivor acknowledged the rape as a crime/victimization, and their prior history of engaging in consensual sex with the perpetrator. These correlates were chosen given their association with different sexual assault typologies (e.g., forcible assault, incapacitated assault) in prior research (Littleton, Grills-Taquechel, & Axsom, 2009; McConnell et al, 2020; Zinzow et al, 2010). We also evaluated current symptoms of depression, rape-related PTSD, and hazardous drinking as correlates of assault type class membership.…”

“…We also evaluated current symptoms of depression, rape-related PTSD, and hazardous drinking as correlates of assault type class membership. These three symptom classes were chosen given prior work supporting their association with sexual assault typologies (Masters et al, 2015; McConnell et al, 2020; Peter-Hagene & Ullman, 2015; Zinzow et al, 2010).…”

Differences in Women’s Substance-Related Sexual Assaults: Force, Impairment, and Combined Assault Types

“…To date, few studies have examined combinations of behaviors that typically occur in SAs, which further complicates understanding differences in post-assault outcomes as reviewed above (Littleton et al., 2009; McConnell et al., 2017). One study of college SA victims using latent profile analysis showed that survivors of assaults characterized by alcohol and violence were uniquely vulnerable, showing less resistance to assault and greater self-blame (Macy et al., 2007a, 2007b).…”

“…For example, few studies of victims have looked at perpetrator substance use and how this may impact victims’ SA experiences from victims’ perspectives. In addition, only looking at use or non-use of substances is too simplistic as the amount of substances consumed and resulting impairment and/or incapacitation due to substance use may impact assault outcomes (see Littleton et al., 2009; McConnell et al., 2017, for exceptions). For example, Jaffe et al.…”