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TRAUMA, VIOLENCE, & ABUSE

2019, Vol. 20(1) 67-80
The Prevalence of Sexual Revictimization: ª The Author(s) 2017
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A Meta-Analytic Review DOI: 10.1177/1524838017692364
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Hannah E. Walker1, Jennifer S. Freud1, Robyn A. Ellis1,

Shawn M. Fraine1, and Laura C. Wilson1

Abstract
The literature consistently demonstrates evidence that child sexual abuse survivors are at greater risk of victimization later in life
than the general population. This phenomenon is called sexual revictimization. Although this finding is robust, there is a large
amount of variability in the prevalence rates of revictimization demonstrated in the literature. The purpose of the present meta-
analysis was to calculate an average prevalence rate of revictimization across the literature and to examine moderators that may
potentially account for the observed variability. Based on a review of PsycINFO and PILOTS, 1,412 articles were identified and
reviewed for inclusion. This process resulted in the inclusion of 80 studies, which contained 12,252 survivors of child sexual abuse.
The mean prevalence of sexual revictimization across studies was 47.9% (95% confidence intervals [43.6%, 52.3%]), suggesting that
almost half of child sexual abuse survivors are sexually victimized in the future. The present study failed to find support for any of
the examined moderators. Potential explanations of and implications for the results are offered, including suggestions for
therapists.

Keywords
child sexual abuse, sexual assault, rape, revictimization, meta-analysis

Sexual victimization is an area of growing concern and increas-
ing attention not only in the field of psychological science but
also in other populations and settings including the military,
college campuses, and the political arena. A plethora of diffi-
culties and negative outcomes have been linked to childhood
sexual victimization (e.g., post-traumatic stress disorder, anxi-
ety, depression, and sleep difficulties), and one of the most
consistently demonstrated is sexual revictimization (for
reviews, see Beitchman, Zucker, Hood, DaCosta, & Akman,
1991, 1992; Kendall-Tackett, Williams, & Finkelhor, 1993;
Maniglio, 2009; Paolucci, Genuis, & Violato, 2001; Spataro,
Mullen, Burgess, Wells, & Moss, 2004). Specifically, survivors
of child sexual abuse have been found to be at significantly
greater risk of future sexual victimization than individuals
without a history of abuse (Arata, 2002; Classen, Gronskaya
Palesh, & Aggarwal, 2005; Messman-Moore & Long, 1996,
2003). This line of research is particularly important because
not only is revictimization associated with many of the same
adjustment difficulties as single incident victimization (e.g.,
post-traumatic stress disorder, dissociation, self-blame), but
victims’ levels of risk for these difficulties are in fact heigh-
tened (Arata, 2002). Roodman and Clum (2001) conducted a
meta-analysis of 19 studies and demonstrated an overall mod-
erate effect size, which suggested “a definite relationship
between childhood victimization and adult victimization
experiences” (p. 183). However, this same meta-analysis found
that the prevalence rates of sexual revictimization in the liter-
ature ranged from 15% to 79%. Roodman and Clum (2001)
only included studies with female participants and reported an
effect size rather than an event rate. In addition, a substantial
amount of literature has been produced in the 15 years since
that meta-analysis was published. Although this prior meta-
analysis offers a glimpse at the issue of sexual revictimization,
a more comprehensive and current quantitative review that
yields an event rate of revictimization including both men and
women is needed to truly understand the scale of the problem.
There is strong consensus in the field that there is a correla-
tion between child sexual abuse and adult sexual victimization,
but the exact percentage of survivors who are revictimized is
unknown. The existing literature (e.g., Arata, 2002; Classen
et al., 2005; Messman-Moore & Long, 1996, 2003; Roodman
& Clum, 2001) has suggested that the large amount of hetero-
geneity observed among the documented rates of revictimiza-
tion likely stems from “methodologically based variance”
1
Department of Psychological Science, University of Mary Washington,
Fredericksburg, VA, USA
Corresponding Author:
Laura C. Wilson, Department of Psychological Science, University of Mary
Washington, 1301 College Ave., Fredericksburg, VA 22401, USA.
Email: lwilson5@umw.edu
68
(Roodman & Clum, 2001, p. 184). One of the purposes of the
meta-analysis conducted by Roodman and Clum (2001) was to
systematically investigate potential sources of the variability;
however, the results should be interpreted with caution due to
the small number of studies (i.e., 19) included in the analysis.
In fact, in several situations, the moderator analysis compared
groups that contained only one study. Thus, a more robust
examination of moderator variables in this area of the literature
is warranted.
Several potential moderator variables stand out as the most
likely candidates as explanations for the observed variability
because they are the most consistently offered explanations and
have the most preliminary empirical evidence supporting them.
Although the literature has almost exclusively focused on
women, Desai, Arias, Thompson, and Basile (2002) found that,
in a sample of nationally representative participants, the
adjusted odds ratio of predicting adult sexual victimization
from child sexual abuse was greater for men (4.9) when com-
pared to women (3.0). In one of the more comprehensive
reviews of the literature, Classen, Gronskaya Palesh, and
Aggarwal (2005) concluded that sexual victimization during
adolescence was a more robust risk factor for revictimization
when compared to childhood sexual abuse. Roodman and Clum
(2001) found a rather considerable effect of sample type, with
college samples yielding smaller effect sizes (.49) than other
types of samples (.70). Finally, Mayall and Gold (1995) found
that using strict definitions (e.g., only including contact sexual
victimization, such as touching) resulted in a stronger revicti-
mization effect, whereas broad definitions (e.g., also including
noncontact victimization such as exhibitionism) can result in a
failure to find evidence of a revictimization effect. Therefore,
we hypothesized that including male participants, an age cutoff
that includes adolescence, noncollege samples, and stricter def-
initions of sexual victimization would be associated with
higher prevalence rates.
Due to the considerable, yet inconsistent, empirical evi-
dence supporting the heightened risk for sexual revictimization
among child sexual abuse survivors, the goal of the present
meta-analysis was to inform the field about the scope of this
phenomenon as a step toward increasing awareness of this issue
with the hopes of informing prevention strategies and treatment
planning. The present meta-analysis is the first known pub-
lished meta-analysis to calculate a mean event rate of revicti-
mization and examine sources of method variance in both male
and female participants.
Method
A computerized database search was completed using
PsycINFO and PILOTS. The key words were “revictimization”
OR “retraumatization” OR “repeat victimization” OR “poly-
victimization” OR “poly-trauma” OR “multiple trauma.” The
systematic literature search resulted in 1,410 unique citations
for review. Our process of obtaining full document copies of all
of the identified papers included electronically through the
computerized databases, from the library stacks, and through
TRAUMA, VIOLENCE, & ABUSE 20(1)
interlibrary loan. Therefore, our process of obtaining manu-
scripts was rather exhaustive and should not have impacted our
analysis. For any thesis or dissertation abstracts that were iden-
tified in the literature search, the full-text documents were
located and reviewed for inclusion. We did not complete a
review of the reference lists of relevant articles; however, two
additional articles did become apparent while reading articles
for potential inclusion. This resulted in a total of 1,412 articles.
The researchers e-mailed five of the most published authors in
this area of the literature to request any relevant unpublished
results, but none of the authors provided additional data to be
included. The primary coders (HEW, JSF, RAE, and SMF)
examined the full document of the 1,412 articles to determine
whether the studies met the inclusion criteria. One pair of
coders (JSF and SMF) examined the first 706 articles and the
second pair of coders (HEW and RAE) examined the second
706 articles to double-code the inclusion decisions. As a relia-
bility check, when a pair of coders did not agree, these articles
were brought to a joint discussion between the four coders and
the primary investigator (LCW). All final decisions about arti-
cles to be included and the extraction of data for the analysis
were made jointly by the four coders and the primary investi-
gator. The raters had 100% agreement on all final decisions.
To be included, the studies were required to be available for
review, printed in English, use human participants, not selec-
tively sample participants who were revictimized, and include
empirical data (e.g., not a case study, book review, literature
review, or treatment manual).
In addition, studies were required to measure sexual victi-
mization at two distinct time points. To be as inclusive as
possible, the Time 1 victimization had to satisfy the definition
of engaging a child or adolescent in a sexual act. The Time 2
victimization had to satisfy the definition of unwanted, forced,
or nonconsensual sexual contact, activity, or experience. There
is no consensus in the trauma literature in regard to the age
cutoffs that represent childhood, adolescence, and adulthood.
Some studies limit childhood abuse to experiences prior to age
12 years (e.g., Fargo, 2008; Miron & Orcutt, 2014), whereas
others include any forced or unwanted sexual activity that
occurred up to age 18 (e.g., Campbell, Greeson, Bybee, & Raja,
2008; Davis, DeMaio, & Fricker-Elhai, 2004). Because Clas-
sen et al. (2005) argued that sexual victimization during ado-
lescence heightens women’s risk of revictimization compared
to childhood, we wanted to test age cutoff as a moderator
variable. To do so, we took the range of age cutoffs most often
used in the literature to denote the upper boundary of childhood
(i.e., 12–17 years old) and divided it to create two categories.
To be included in the meta-analysis, the studies had either (a) to
define the Time 1 victimization as at or before age 12, 13, or
14, with revictimization categorized as events at or after age
13, 14, or 15, or (b) to define the Time 1 victimization as at or
before age 15, 16, or 17, with revictimization categorized as
events at or after 16, 17, or 18.
As a final requirement of inclusion, the studies needed to
include adequate information for the researchers to identify or
calculate a prevalence rate of sexual revictimization. The data
Walker et al. 69

Figure 1. Flow diagram of the review and input study selection process.

needed to calculate a prevalence rate of revictimization Data Analysis

included the number of participants who were victimized at
The meta-analysis was conducted with Comprehensive Meta-
Time 1 (i.e., survivor sample size) and the number of partici-
Analysis Version 2 (Borenstein, Hedges, Higgins, & Rothstein,
pants who were victimized at both Time 1 and Time 2 (i.e.,
2011) and followed the analytic methodology suggested by
revictimized survivors).
Borenstein, Hedges, Higgins, and Rothstein (2009). The anal-
If multiple studies used the same or overlapping sam-
yses were conducted as two-tailed tests, with a statistical sig-
ples, then one of the articles was selected and included. If
nificance threshold of .05. The prevalence rates were calculated
one of the duplicates was a dissertation or thesis, then the
based on the number of survivors who experienced sexual vic-
peer-reviewed published article was included. If all of the
timization at both Time 1 and Time 2, and the number of
duplicates were published, then the newest article was
survivors who experienced victimization at Time 1. A
included to be consistent. The following articles were
random-effects model was used because this approach is rec-
selected, and the duplicate samples are listed in parenth-
ommended when studies use varying methodologies (e.g.,
eses: Siegel and Williams, 2003 (West, Williams, & Siegel,
diverse samples, measures, study designs; Schmidt, Oh, &
2000); Randall and Haskell, 1995 (Haskell, 1999); Kessler
Hayes, 2009).
and Bieschke, 1999 (Kessler, 1996); Mayall and Gold, 1995
The results presented in the current article include the pre-
(Gold, Milan, Mayall, & Johnson, 1994); Yiaslas et al.,
valence rates and 95% confidence intervals (CI) for each input
2014 (Yiaslas, 2010); Messman-Moore and Garrigus,
study, the weighted mean prevalence and mean 95% CI across
2007 (Messman-Moore, Brown, & Kuelsch, 2005); and
studies, I2 (i.e., measure of inconsistency among the input stud-
Wager, 2013 (Wager, 2012a, 2012b).
ies; Higgins, Thompson, Deeks, & Altman, 2003) and
Of the 1,412 identified studies, 80 studies met the inclu-
Cochran’s Q (i.e., degree of homogeneity among input studies).
sion criteria for the meta-analysis. The 80 studies contained
The impact of publication bias was assessed using rank corre-
12,252 individuals who reported being sexual victimization
lation (Begg & Mazumdar, 1994) and Egger regression (Egger,
survivors at Time 1, with an average of 153.15 survivors per
Davey Smith, Schneider, & Minder, 1997) tests. Rank correla-
study (standard deviation [SD] ¼ 239.67). See Figure 1 for a
tion represents the correlation between the rankings of the
flow diagram of the search procedures and inclusion
standardized effect size and the variances of those effects and
decisions.
70 TRAUMA, VIOLENCE, & ABUSE 20(1)

has been found to be powerful for meta-analyses with 75 or Results

more studies (Begg & Mazumdar, 1994). Egger regression
The prevalence rates of sexual revictimization among survivors
differs from rank correlation in that it uses the actual values
across the 80 studies ranged from 10.0% to 90.3% (see Table
of the effect sizes and the inverse of the standard error of those
1). The mean prevalence of sexual revictimization across stud-
effects rather than the ranks of those values (Egger et al., 1997).
ies was 47.9% (95% CI [43.6%, 52.3%]). See Figure 2 for a
Both of these tests quantify the funnel plot, which is a graphical
forest plot of studies that used a child measurement cutoff (k ¼
depiction of the relationship between effect size and variance.
39) and Figure 3 for a forest plot of studies that used an ado-
The funnel plot is based on the assumption that smaller, less
lescent measurement cutoff (k ¼ 41). The studies are presented
precise studies tend to have more random variance than larger
in two separate forest plots for ease of review due to the large
studies. This means that the plot should resemble a funnel since
number of studies included in the meta-analysis.
smaller studies, which are more subject to random variation, will
There was significant heterogeneity, Q(79) ¼ 1504.83, p <
be spread out at the bottom of the graph. Conversely, larger
.001, and a large amount of inconsistency, I2 ¼ 94.75%, among
studies, which have less variation, should cluster at the top of
the included studies. Sensitivity analysis tested what the pooled
the graph around the mean effect size. If publication bias is
effect size would be excluding each input study in the analysis.
present, you would expect smaller studies that found negative
The exclusion of any input study resulted in a very small
results not to be represented and therefore the plot would be
change in the mean prevalence rate (mean prevalence ranging
asymmetrical. These two significance tests are preferred because
from 47.3% to 48.6%); therefore, it was determined that no
they quantitatively test for symmetry and are therefore less sub-
single study was the primary determinant of the mean preva-
jective (Borenstein, Hedges, Higgins, & Rothstein, 2009).
lence rate. Because the p values of the rank correlation (t ¼
To examine factors that may impact the prevalence of revic-
.06, p ¼ .43) and the regression (intercept ¼ 1.37, p ¼ .18)
timization across studies, moderator analyses were conducted
tests were both greater than .05, both results suggested that
(see Table 1). First, measurement age was examined as a cate-
publication bias did not significantly impact the meta-analysis.
gorical moderator based on the two time points used to assess
The between-class effect for participant gender was not sta-
revictimization in each input study. Studies in which the first
tistically significant, Qb(1) ¼ 1.81, p ¼.18, with a mean pre-
incident of victimization occurred at or before the age of 12, 13,
valence rate of 46.5% (k ¼ 67) for female-only samples and
or 14 years and the second victimization occurred at or after the
55.5% (k ¼ 13) for samples including male participants. The
age of 13, 14, or 15 years were coded as 1 (referred to as the
between-class effect for measurement age was not statistically
child measurement cutoff). Studies in which the first incident
significant, Qb(1) ¼ 0.16, p ¼ .69, with a mean prevalence rate
of victimization occurred at or before the age of 15, 16, or 17
of 48.8% (k ¼ 39) for the child measurement cutoff and 47.0%
years old and the second victimization occurred at or after the
(k ¼ 41) for the adolescent measurement cutoff. The between-
age of 16, 17, or 18 years were coded as 2 (referred to as the
class effect for recruitment source was not statistically signif-
adolescent measurement cutoff).
icant, Qb(1) ¼ 0.01, p ¼ .93, with a mean prevalence rate of
Second, gender was examined as a categorical moderator.
48.1% (k ¼ 42) for the samples including college students as
The original intent was to compare studies that examined only
participants and 47.8% (k ¼ 38) for the samples that exclu-
female, only male, and both male and female participants.
sively included participants other than college students. The
However, due to the small number of studies that included male
between-class effect for victimization definitions was not sta-
participants, it was decided it would be best to compare studies
tistically significant, Qb(2) ¼ 1.19, p ¼ .55, with a mean pre-
that included only female participants (coded as 1) to studies
valence rate of 50.5% (k ¼ 20) for studies that used two broad
that included male participants (i.e., either male only or a com-
definitions, 50.4% (k ¼ 18) for studies that used one broad
bination of male and female participants; coded as 2).
definition and one strict definition, and 45.6% (k ¼ 42) for
Next, recruitment source was examined as a categorical
studies that used two strict definitions. See Table 1 for the
moderator variable. Studies that used complete or partial col-
moderator information for each input study.
lege recruitment (coded 1) were compared to studies that relied
on entirely noncollege recruitment (e.g., military, clinical,
community; coded as 2).
Lastly, the definitions used to identify sexual victimization
Discussion
at Time 1 and Time 2 were coded as a categorical moderator Sexual revictimization is a disturbingly common experience
variable. A broad definition was one that included noncontact for child sexual abuse survivors, with estimates suggesting that
incidents (e.g., voyeurism, exhibitionism) or used vague lan- prior sexual victimization can double or even triple an individ-
guage (e.g., sexual abuse, unwanted sexual experiences, sexual ual’s risk for future victimization (Classen et al., 2005).
assault). A strict definition was one that restricted the definition Although this phenomenon is well documented, the present
to contact incidents (e.g., sexual intercourse) or used the word meta-analysis highlights the inconsistencies in the literature
“rape.” If both the Time 1 and Time 2 definitions were broad by finding that the prevalence rates across the 80 identified
the study was coded as 0, if one of the definitions was broad studies varied greatly, ranging from 10.0% to 90.3%. These
and the other was strict the study was coded as 1, and if both of discrepancies across studies highlight the need for this study.
the definitions were strict then the study was coded as 2. The findings of the current meta-analysis found that, on
Walker et al. 71

Table 1. Survivor Sample Size, Prevalence Rates (Prev), 95% Confidence Intervals (CIs), and Methodological Characteristics of 80 Studies
Included in a Meta-Analysis of Sexual Revictimization.

Studies N Prev 95% CI Gender Age Cutoff Sample Definition

Aberle (2001) 61 75.40 [63.1, 84.6] 2 1 1 1

Arata (2000) 221 63.30 [56.7, 69.4] 1 1 1 1
Balsam, Lehavot, and Beadnell (2011) 1,805 19.70 [17.9, 21.6] 2 2 2 2
Banyard, Williams, and Siegel (2001) 128 48.40 [39.9, 57.0] 1 2 2 2
Barbo (2003) 290 14.50 [10.9, 19.0] 1 1 1 0
Barrett-Model (2010) 31 38.70 [23.5, 56.5] 1 2 1 2
Brenner (1995) 162 47.53 [40.0, 55.2] 2 1 1 2
Brenner and Ben-Amitay (2015) 60 70.00 [57.3, 80.2] 1 2 2 2
Bundrick (2004) 71 39.40 [28.8, 51.1] 1 1 1 1
Campbell, Greeson, Bybee, and Raja (2008) 75 47.40 [36.4, 58.6] 1 2 2 1
Carter-Visscher (2008) 52 61.50 [47.7, 73.6] 1 1 1 0
Cloitre, Cohen, and Scarvalone (2002) 44 59.10 [44.2, 72.5] 1 2 2 2
Combs-Lane (2000) 21 61.90 [40.2, 79.7] 1 1 1 2
Copeland (1996) 113 33.60 [25.5, 42.8] 1 1 1 2
Craig (2002) 53 41.50 [29.1, 55.1] 1 1 2 0
Davis, DeMaio, and Fricker-Elhai (2004) 67 26.90 [17.7, 38.7] 1 2 1 2
de Haas, van Berlo, Bakker, and Vanwesenbeeck (2012) 640 46.70 [42.9, 50.6] 2 2 2 2
Dietrich (2003) 166 65.60 [58.1, 72.4] 2 2 2 2
Fargo (2008) 87 28.70 [20.2, 39.0] 1 1 2 2
Fergusson, Horwood, and Lynskey (1997) 90 12.20 [6.9, 20.7] 1 2 2 1
Filipas and Ullman (2006) 166 42.20 [34.9, 49.8] 1 1 1 1
Fite (2006) 110 53.60 [44.3, 62.7] 1 1 1 1
Ford and Smith (2008) 114 55.30 [46.1, 64.2] 2 1 2 2
Fortier et al. (2009) 99 85.90 [77.6, 91.5] 1 2 1 2
Gidycz, Coble, Latham, and Layman (1993) 462 69.90 [65.6, 73.9] 1 1 1 2
Heidt, Marx, and Gold (2005) 133 55.60 [47.1, 63.8] 2 2 2 2
Hequembourg, Livingston, and Parks (2013) 105 79.00 [70.2, 85.7] 1 1 2 2
Hetzel and McCanne (2005) 77 26.00 [17.4, 36.9] 1 1 1 0
Holmgreen (2014) 31 90.30 [73.9, 96.8] 1 1 1 1
Hughes et al. (2010) 400 35.80 [31.2, 40.6] 1 2 2 0
Jankowski, Leitenberg, Henning, and Coffey (2002) 174 23.00 [17.3, 29.8] 1 2 1 2
Kessler and Bieschke (1999) 154 68.80 [61.1, 75.6] 1 2 1 2
Lehn (2003) 54 59.30 [45.8, 71.5] 1 2 2 2
Leonard (1991) 42 28.60 [17.0, 43.9] 1 2 2 2
Livingston, Testa, and VanZile-Tamsen (2007) 289 53.00 [47.2, 58.7] 1 1 2 2
Maker, Kemmelmeier, and Peterson (2001) 32 65.60 [47.9, 79.8] 1 2 1 0
Mandoki and Burkhart (1989) 37 43.20 [28.4, 59.3] 1 1 1 1
Mayall and Gold (1995) 127 24.40 [17.7, 32.6] 1 1 1 2
Mejı́a, Zea, Romero, and Saldı́var (2015) 68 54.40 [42.5, 65.8] 1 2 2 0
Merrill et al. (1999) 426 61.00 [56.3, 65.5] 1 1 2 2
Messman-Moore (1999) 131 44.30 [36.0, 52.9] 1 2 1 2
Messman-Moore and Garrigus (2007) 23 32.00 [16.4, 53.1] 1 2 1 2
Messman-Moore and Long (2002) 136 36.00 [28.4, 44.4] 1 2 2 2
Messman-Moore, Walsh, and DiLillo (2010) 47 29.80 [18.5, 44.2] 1 1 1 2
Miron and Orcutt (2014) 46 45.70 [32.0, 60.0] 1 1 1 2
Morris and Balsam (2003) 955 55.00 [51.8, 58.1] 1 2 2 0
Murphy et al. (1988) 120 28.30 [21.0, 37.0] 1 2 2 0
Noll, Horowitz, Bonanno, Trickett, and Putnam (2003) 70 20.90 [12.9, 32.0] 1 1 2 2
Pantalone, Horvath, Hart, Valentine, and Kaysen (2014) 121 61.20 [52.2, 69.5] 2 2 2 0
Paul, Catania, Pollack, and Stall (2001) 593 48.10 [44.1, 52.1] 2 2 2 0
Pope (1999) 107 45.80 [36.6, 55.3] 1 1 1 1
Proulx, Koverola, Fedorowicz, and Kral (1995) 98 44.90 [35.4, 54.8] 1 2 1 2
Randall and Haskell (1995) 182 61.00 [53.7, 67.8] 1 2 2 1
Reese-Weber and Smith (2011) 39 61.50 [45.6, 75.3] 1 2 1 1
Reig (1998) 48 29.20 [18.1, 43.5] 1 2 2 2
Rich (2003) 36 75.00 [58.5, 86.4] 1 1 1 1
Roodman (2000) 50 54.00 [40.2, 67.2] 1 1 1 2
(continued)
72 TRAUMA, VIOLENCE, & ABUSE 20(1)

Table 1. (continued)

Studies N Prev 95% CI Gender Age Cutoff Sample Definition

Rubien (1995) 91 38.50 [29.1, 48.9] 1 2 2 1

Schaaf and McCanne (1998) 58 51.70 [39.0, 64.2] 1 1 1 0
Schroeder (2005) 79 69.60 [58.6, 78.7] 1 2 2 2
Siegel and Williams (2003) 114 28.10 [20.6, 37.0] 1 1 2 2
Simoni and Ng (2002) 87 69.00 [58.6, 77.8] 1 2 2 0
Stanley (2010) 28 57.00 [38.5, 73.7] 1 1 1 0
Stevenson and Gajarsky (1992) 93 72.00 [62.1, 80.2] 2 2 1 1
Teustsher (2014) 46 34.80 [22.5, 49.5] 1 1 1 1
Van Bruggen, Runtz, and Kadlec (2006) 54 56.00 [42.6, 68.5] 1 1 1 2
VanZile-Tamsen, Testa, and Livingston (2005) 165 36.40 [29.4, 44.0] 1 1 2 2
Wager (2013) 183 66.10 [58.9, 72.6] 2 1 1 0
Walsh (2009) 219 28.00 [22.5, 34.3] 1 2 1 2
Walsh, DiLillo, Klanecky, and McChargue (2013) 226 10.00 [6.70, 14.6] 1 2 1 1
Walsh, DiLillo, and Scalora (2011) 84 70.20 [59.6, 79.0] 1 1 2 0
Walsh, Messman-Moore, et al. (2013) 34 21.40 [10.7, 38.2] 1 1 1 0
Wasco (2004) 30 50.00 [32.8, 67.2] 1 1 1 2
Weinberg (2008) 120 50.00 [41.1, 58.9] 1 2 2 0
Whetsell (1990) 99 63.00 [53.1, 71.9] 1 2 2 1
Wilson, Calhoun, and Bernat (1999) 50 42.00 [29.2, 55.9] 1 1 1 2
Wyatt, Guthrie, and Notgrass (1992) 89 73.00 [62.9, 81.2] 1 2 2 0
Yeater and O’Donohue (2002) 61 70.49 [57.9, 80.5] 1 1 1 0
Yiaslas et al. (2014) 57 21.05 [12.3, 33.5] 2 2 2 2
Zinzow, Grubaugh, Frueh, and Magruder (2008) 46 48.00 [34.1, 62.2] 1a 2 2 2
Mean prevalence 47.90 [43.6, 52.3]

Note. Moderator variable of age cutoff coded as 1 ¼ Time 1 of at or before 12, 13, 14 years old and Time 2 of at or after 13, 14, 15 years old; 2 ¼ Time 1 of at or
before 15, 16, 17 years old and Time 2 of at or after 16, 17, 18 years old. Moderator variable of gender was coded as 1 ¼ only female participants; 2 ¼ included
male participants. Moderator variable of sample recruitment coded as 1 ¼ included college; 2 ¼ only noncollege. Moderator variable of victimization definitions
coded as 0 ¼ two broad definitions, 1 ¼ one broad, one narrow definition, and 2 ¼ two narrow definitions.
a
Although male and female participants were included in the sample, the rate of revictimization was only reported for female participants.

average, almost half (i.e., 47.9%) of the 12,252 sexual victimi-
zation survivors were sexually victimized at a later time. These
results confirm the considerable magnitude of this risk and
further support the importance of increased awareness about
this issue across many populations (e.g., colleges, military) and
contexts (e.g., prevention strategies, treatment planning).
The existing literature base has suggested numerous vari-
ables as potential explanations for the variability observed
among the prevalence rates, including participant gender, mea-
surement age cutoff, recruitment source, and sexual victimiza-
tion definitions. However, without a comprehensive
meta-analysis to quantitatively test the roles of these potential
moderators, it has been unclear what impact these variables
have on the prevalence rate of revictimization. Interestingly,
this meta-analysis failed to find support for any of these fre-
quently discussed factors as explanations for the huge discre-
pancies seen across studies.
Gender
The prevalence of sexual revictimization was not found to
significantly differ based on participant gender; however, this
finding could largely be explained by the uneven class sizes
due to the majority of existing studies using strictly female
participants. When the results are examined, it can be seen that
there was a 9% difference in the average event rates, with
studies that included men reporting higher prevalence rates,
on average, than those that included only female participants.
This was consistent with our hypothesis and the minimal exist-
ing literature on male revictimization (e.g., Desai, Arias,
Thompson, & Basile, 2002).
Because so few studies have examined sexual revictimiza-
tion among men, it is unclear exactly what is driving this find-
ing. One potential interpretation is that the majority of studies
that included men recruited their participants from high-risk
populations, such as lesbian, gay, bisexual, and transgender
organizations (e.g., Balsam, Lehavot, & Beadnell, 2011),
human immunodeficiency virus (HIV) clinics (e.g., Pantalone,
Horvath, Hart, Valentine, & Kaysen, 2014), and child abuse
agencies (e.g., Brenner, 1995). Therefore, it is unclear whether
this increased risk of revictimization is due to participant gen-
der, recruitment source, or both. Another potential interpreta-
tion is that men may truly be at increased risk of revictimization
when compared to their female counterparts. This is consistent
with literature suggesting that sexual victimization is especially
distressing and associated with particularly troubling outcomes
for male survivors, in part because the experience may violate
gender stereotypes (e.g., men as strong and domineering) and
challenges the male survivor’s self-concept and sexual identity
(e.g., sexual orientation; Elliott, Mok, & Briere, 2004). It would
Walker et al. 73

Study name Event rate and 95% CI

Event Lower Upper

rate limit limit

Aberle, 2001 0.754 0.631 0.846

Arata, 2000 0.633 0.567 0.694
Barbo, 2003 0.145 0.109 0.190
Brenner, 1995 0.475 0.400 0.552
Bundrick, 2004 0.394 0.288 0.511
Carter-Visscher, 2008 0.615 0.477 0.736
Combs-Lane, 2000 0.619 0.402 0.797
Copeland, 1996 0.336 0.255 0.428
Craig, 2002 0.415 0.291 0.551
Fargo, 2008 0.287 0.202 0.390
Filipas, & Ullman, 2006 0.422 0.349 0.498
Fite, 2006 0.536 0.443 0.627
Ford, & Smith, 2008 0.553 0.461 0.642
Gidcyz et al., 1993 0.699 0.656 0.739
Hequembourg et al., 2013 0.790 0.702 0.857
Hetzel, & McCanne, 2005 0.260 0.174 0.369
Holmgreen, 2014 0.903 0.739 0.968
Livingston et al., 2007 0.530 0.472 0.587
Mandoki & Burkhart, 1989 0.432 0.284 0.593
Mayall & Gold, 1995 0.244 0.177 0.326
Merrill et al., 1999 0.610 0.563 0.655
Messman-Moore et al., 2010 0.298 0.185 0.442
Miron & Orcutt, 2014 0.457 0.320 0.600
Noll et al., 2003 0.209 0.129 0.320
Pope, 1999 0.458 0.366 0.553
Rich, 2003 0.750 0.585 0.864
Roodman, 2000 0.540 0.402 0.672
Schaaf & McCanne, 1998 0.517 0.390 0.642
Siegel, 2003 0.281 0.206 0.370
Stanley, 2010 0.570 0.385 0.737
Teutscher, 2014 0.348 0.225 0.495
Van Bruggen et al., 2006 0.560 0.426 0.685
VanZile-Tamsen et al., 2005 0.364 0.294 0.440
Wager, 2013 0.661 0.589 0.726
Walsh et al. , 2011 0.702 0.596 0.790
Walsh, Messman-Moore et al., 2013 0.214 0.107 0.382
Wasco, 2004 0.500 0.328 0.672
Wilson et al., 1999 0.420 0.292 0.559
Yeater, & O'Donohue, 2002 0.705 0.579 0.805
0.488 0.429 0.547
-1.00 -0.50 0.00 0.50 1.00

Figure 2. Forest plot of prevalence rates (prev) and 95% confidence intervals for the input studies in a meta-analysis of revictimization that used
a child measurement cutoff (k ¼ 39).

be premature to make any conclusions based on the results
presented here, particularly because of the uneven class sizes.
It is imperative that future research focuses on the issue of
revictimization among men because it is clear that this phe-
nomenon is not unique to women. This article should serve as a
call for such empirical work.
Age Cutoff
There are great discrepancies in the literature in terms of the
cutoff ages used to define victimization that occurs during
childhood, adolescence, and adulthood (Pereda, Guilera, Forns,
& Gomez-Benito, 2009), and it has been suggested that this
significantly impacts the prevalence rate of revictimization.
Numerous researchers (e.g., Classen et al., 2005; Gidycz,
Coble, Latham, & Layman, 1993; Gidycz, Hanson, & Layman,
1995) have suggested that sexual victimization during adoles-
cence places survivors at greater risk of revictimization than
childhood sexual abuse, thus resulting in a larger prevalence
rate. However, the current meta-analysis failed to find support
for any relationship between age cutoff and prevalence rate.
This is consistent with the results of Roodman and Clum
(2001), who also found that the age cutoff was not significantly
related to the prevalence rate of revictimization. Roodman and
Clum (2001) suggested that the impact of age cutoff may be
more complex than simply examining the ages used in the
74 TRAUMA, VIOLENCE, & ABUSE 20(1)

Study name Event rate and 95% CI

Event Lower Upper

rate limit limit

Balsam et al., 2011 0.197 0.179 0.216

Banyard et al., 2001 0.484 0.399 0.570
Barrett-Model, 2010 0.387 0.235 0.565
Brenner & Ben-Amitay, 2015 0.700 0.573 0.802
Campbell et al., 2008 0.474 0.364 0.586
Cloitre et al., 2002 0.591 0.442 0.725
Davis et al., 2004 0.269 0.177 0.387
de Haas et al., 2012 0.467 0.429 0.506
Dietrich, 2003 0.656 0.581 0.724
Fergusson et al., 1997 0.122 0.069 0.207
Fortier et al., 2009 0.859 0.776 0.915
Heidt et al., 2005 0.556 0.471 0.638
Hughes et al., 2010 0.358 0.312 0.406
Jankowski et al., 2002 0.230 0.173 0.298
Kessler & Bieschke, 1999 0.688 0.611 0.756
Lehn, 2003 0.593 0.458 0.715
Leonard, 1991 0.286 0.170 0.439
Maker et al., 2001 0.656 0.479 0.798
Mejia et al., 2015 0.544 0.425 0.658
Messman-Moore, 1999 0.443 0.360 0.529
Messman-Moore & Garrigus, 2007 0.320 0.164 0.531
Messman-Moore & Long, 2002 0.360 0.284 0.444
Morris & Balsam, 2003 0.550 0.518 0.581
Murphy et al., 1988 0.283 0.210 0.370
Pantalone et al., 2014 0.612 0.522 0.695
Paul et al., 2001 0.481 0.441 0.521
Proulx et al., 1995 0.449 0.354 0.548
Randall, & Haskell, 1995 0.610 0.537 0.678
Reese-Weber & Smith, 2011 0.615 0.456 0.753
Reig, 1998 0.292 0.181 0.435
Rubien, 1995 0.385 0.291 0.489
Schroeder, 2005 0.696 0.586 0.787
Simoni & Ng, 2002 0.690 0.586 0.778
Stevenson, & Gajarsky, 1992 0.720 0.621 0.802
Walsh, 2009 0.280 0.225 0.343
Walsh, DiLillo et al., 2013 0.100 0.067 0.146
Weinberg, 2008 0.500 0.411 0.589
Whetsell, 1990 0.630 0.531 0.719
Wyatt et al., 1992 0.730 0.629 0.812
Yiaslas et al., 2014 0.210 0.123 0.335
Zinzow et al., 2008 0.480 0.341 0.622
0.470 0.410 0.532
-1.00 -0.50 0.00 0.50 1.00

Figure 3. Forest plot of prevalence rates (prev) and 95% confidence intervals for the input studies in a meta-analysis of revictimization that used
an adolescent cutoff (k ¼ 41).

measurement of sexual victimization at Time 1 and Time 2. For Recruitment Source

example, they found that the younger age cutoffs tended to be
A large percentage (53%) of the studies relied on college sam-
used with younger samples. Therefore, the mean age of the
ples. Roodman and Clum (2001) found that noncollege samples
sample may be a confounding variable. Additionally, many
yielded significantly larger effect sizes than college samples.
studies placed age restrictions on the perpetrator as well (e.g.,
However, the present larger and more comprehensive meta-
must be at least 5 years older than the victim). Therefore, it is
analysis failed to find that recruitment source was related to
premature to conclude that age cutoff is irrelevant when it
prevalence rates. Because the current meta-analysis includes
comes to understanding variability in prevalence rates, but it
more studies, as well as both male and female participants, this
suggests that the role of age may be more complex than orig-
result brings into question the previously demonstrated finding
inally suggested.
Walker et al.
regarding the effect of recruitment source. It should be noted
that it is difficult to tease apart the influence of age, gender, and
recruitment source, as college samples tended to be more
female and younger than noncollege samples. One interpreta-
tion of the result is that approximately half of child sexual
abuse survivors, regardless of the recruitment setting, experi-
ence sexual victimization at a later point in time. This is impor-
tant because it provides support for high external validity in
regard to the finding demonstrated here, and means this phe-
nomenon is a noteworthy issue for a wide range of institutions
and organizations, including colleges and the military. How-
ever, it should be kept in mind that the implications of the
results discussed here are limited to the comparison of college
versus noncollege samples, and did not examine more nuanced
differences in recruitment source (e.g., lesbian, gay, bisexual,
transgender, and queer organizations, HIV clinics).
Victimization Definitions
Prior research has found that the victimization definitions (i.e.,
strict vs. broad) used in revictimization research significantly
impacts the prevalence rate. Specifically, stricter definitions
have been found to be associated with a stronger relationship
between child and adult victimization (Mayall & Gold, 1995;
Roodman & Clum, 2001). Again, the findings presented here
do not support this variable as a statistically significant mod-
erator. The most common approach was to use strict definitions
of sexual victimization at both Time 1 and Time 2, with over
half (i.e., 53%) of the studies doing so. These studies found a
slightly lower prevalence rate (i.e., less than 5% difference)
than those studies that used one strict definition and one broad
definition, or two broad definitions, but the difference was not
statistically significant. It should be noted though, that the
uneven class sizes may have impacted our ability to detect a
difference based on victimization definition. Although the
revictimization literature has suggested that the definition of
victimization may impact the rate of revictimization, studies
conducted on related topics within the field of sexual victimi-
zation would suggest otherwise. For example, a meta-analysis
conducted by Pereda, Guilera, Forns, and Gomez-Benito
(2009) found that the definition of child sexual abuse was not
significantly associated with the prevalence rate of child sexual
abuse within the literature. They suggested that this could, at
least in part, be explained by the fact that broad definitions of
victimization include incidents that would also satisfy the strict
definitions. This explanation could also help explain the find-
ing demonstrated here. It is possible that the prevalence rates
did not significantly differ based on the victimization definition
types because the types overlap substantially.
Limitations
The findings presented here should be interpreted within the
context of several limitations. First, the majority of the studies
identified and included in the present meta-analysis relied on
retrospective data collection, and therefore could be impacted
75
by recall bias or errors as this approach requires participants to
remember events that happened, in some situations, years ago.
Second, most of the studies used self-report questionnaires to
determine victimization status at Time 1 and Time 2. Self-
report assessment is problematic because this methodology
depends on participants recognizing and endorsing that they
have been sexually victimized. A recent meta-analysis found
that 60.4% of female rape survivors failed to recognize that the
incident they experienced was in fact rape (i.e., unacknow-
ledged rape; Wilson & Miller, 2016). Third, due to huge varia-
bility in the age cutoffs used to measure revictimization, we
created our own age cutoffs as an inclusion criteria and mod-
erator variable. Although these represent standard cutoffs used
in the literature, it resulted in many studies being excluded,
such as studies that examined revictimization following sexual
assault during adulthood. Therefore, the prevalence rate of
revictimization demonstrated here may not generalize beyond
the specific age ranges examined in the current meta-analysis.
Lastly, the present meta-analysis did not take into account
whether the sexual victimization was ongoing in nature and
perpetrated by the same perpetrator. This was not possible
because most studies in this area of the literature fail to include
questions to differentiate these types of trauma. It is possible
that the mean prevalence rate demonstrated here is artificially
inflated because it may include studies that unknowingly
detected ongoing sexual victimization rather than
revictimization.
Conclusions
Despite the identified limitations, the findings of the present
meta-analysis have important and far-reaching implications.
This meta-analysis examined a large number of studies includ-
ing both men and women, college and noncollege recruitment,
various age cutoffs, and a range of sexual victimization defi-
nitions. The results indicate that the present meta-analysis was
not likely impacted by publication bias; therefore, there is
strong evidence that the mean prevalence rate from this
meta-analysis is a good representation of the event rate of
revictimization in the population as a whole. With approxi-
mately half of child sexual abuse survivors experiencing later
victimization, sexual revictimization is a serious and pervasive
problem.
The present meta-analysis failed to find evidence that the
prevalence rates were significantly related to any of the exam-
ined methodological moderator variables. This is surprising
given the general consensus in the literature that these factors
impact the rate of revictimization detected in any given study.
Because we included both male and female victims in this
large-scale, comprehensive meta-analysis, the evidence pre-
sented here should be interpreted with some confidence.
Rather than the prevalence rates within the literature sys-
tematically varying based on the examined participant charac-
teristics (e.g., gender) or measurement differences (e.g., age
cutoff), perhaps other factors account for the large amount of
variability, such as methodological quality (e.g., retrospective
76
vs. prospective data collection, self-report vs. clinician inter-
view). As previously mentioned, unacknowledged rape may
have also played a role in the results of the current meta-
analysis. Wilson and Miller (2016) suggested that rates of vic-
timization are higher when participants are asked behaviorally
descriptive questions rather than questions that contain words
such as rape. Therefore, the type of victimization questions
used across the studies could help explain the variability among
the prevalence rates. Although the results presented here are
based on a thorough review of the literature and appear to be a
good representation of revictimization among child sexual
abuse survivors, additional research to further corroborate
these results is strongly encouraged. Follow-up research should
particularly focus on replicating these results with male survi-
vors recruited from noncollege populations, as a large number
of the input studies used female college samples.
In terms of clinical implications, therapists who work with
child sexual abuse survivors should be aware of the high risk of
future victimization. Specifically, the findings may inform sec-
ondary prevention efforts (i.e., prevention targeted at those who
have been victimized to reduce revictimization). It is strongly
encouraged that treatment planning be tailored to incorporate
strategies to enhance future safety. Trauma-focused cognitive-
behavioral therapy (Cohen, Mannarino, & Deblinger, 2006) is
an evidence-based treatment model for trauma-exposed chil-
dren and adolescents that, if deemed suitable based on the
client’s specific needs, may be appropriate for addressing the
risk of revictimization through the development of safety skills.
Safety skills are individualized based on the patient’s needs and
typically involve the development and practice of a safety plan
to help the child feel and be safer. This could include compo-
nents of healthy sexuality and appropriate boundaries. Treat-
ment planning, regardless of the age of the survivor, should
assess for and address potential risk factors for revictimization.
Additionally, an area of ongoing research is the mechanisms
behind revictimization. Although there is no consensus within
the existing literature, some evidence suggests that factors such
as emotion regulation, risky behaviors, risk perception, and
substance use are associated with the risk of revictimization
(Gidycz, Loh, Lobo, Rich, & Lynn, 2007; Gidycz, McNamara,
& Edwards, 2006; Messman-Moore, Walsh, & DeLillo, 2010).
Future meta-analytic research should examine potential indi-
vidual differences on these variables that may help us better
understand risk for revictimization.
The goal of the present meta-analysis was to calculate an
average event rate of sexual revictimization across the litera-
ture, and include both male and female survivors. Through this
process, we have highlighted that although a few prior studies
have examined revictimization in male survivors, the focus, up
to this point, has been on female survivors. This is particularly
important given that the preliminary evidence presented here
suggests that men may be at greater risk of revictimization,
although follow-up research is needed. Regardless, this study
provides strong support for the importance of sexual victimiza-
tion research, particularly in terms of efforts surrounding pre-
vention strategies and treatment planning. Sexual
TRAUMA, VIOLENCE, & ABUSE 20(1)
victimization, and subsequently revictimization, is a serious
public health problem that merits increased attention.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
References
References marked with an asterisk (*) indicate studies included in the
meta-analysis.
*Aberle, C. C. (2001). Revictimization and resilience: The relation-
ship with childhood emotional support and traumatic sexualiza-
tion. Unpublished doctoral dissertation, Texas Woman’s
University, Denton.
*Arata, C. M. (2000). From child to adult victim: A model for pre-
dicting sexual revictimization. Child Maltreatment, 5, 28–38. doi:
10.1177/1077559500005001004
Arata, C. M. (2002). Child sexual abuse and sexual revictimization.
Clinical Psychology: Science and Practice, 9, 135–164.
*Balsam, K. F., Lehavot, K., & Beadnell, B. (2011). Sexual revicti-
mization and mental health: A comparison of lesbians, gay men,
and heterosexual women. Journal of Interpersonal Violence, 26,
1798–1814. doi:10.1177/0886260510372946
*Banyard, V. L., Williams, L. M., & Siegel, J. A. (2001). The long-term
mental health consequences of child sexual abuse: An explanatory
study of the impact of multiple traumas in a sample of women.
Journal of Traumatic Stress, 14, 697–715. doi:10.1023/A:
1013085904337
*Barbo, E. J. (2003). The effects of child sexual abuse, child physical
abuse, and combined child sexual and physical abuse on adult
sexual revictimization and adult post-traumatic stress disorder.
Unpublished doctoral dissertation, Northern Illinois University,
DeKalb, IL.
*Barrett-Model, H. M. (2010). Understanding revictimization: The
impact of emotion suppression, acceptance, and PTSD symptoma-
tology on risk detection abilities in sexual assault survivors.
Unpublished doctoral dissertation, University of Massachusetts
Boston, Boston.
Begg, C. B., & Mazumdar, M. (1994). Operating characteristics of a
rank correlation test for publication bias. Biometrics, 50,
1088–1101. doi:10.2307/2533446
Beitchman, J. H., Zucker, K. J., Hood, J. E., DaCosta, G. A., &
Akman, D. (1991). A review of the short-term effects of child
sexual abuse. Child Abuse & Neglect, 15, 537–556.
Beitchman, J. H., Zucker, K. J., Hood, J. E., DaCosta, G. A., Akman,
D., & Cassavia, E. (1992). A review of the long-term effects of
child sexual abuse. Child Abuse & Neglect, 16, 101–118.
Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2009). Intro-
duction to meta-analysis. West Sussex, England: Wiley.
Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2011). Com-
prehensive Meta-Analysis Version 2. Englewood, NJ: Biostat.
Walker et al.
*Brenner, L. (1995). The adult patterns of men and women who were
sexually abused as children: Is there risk of becoming a victim or
perpetrator? Unpublished doctoral dissertation, University of
Kansas, Lawrence.
*Brenner, I., & Ben-Amitay, G. (2015). Sexual revictimization: The
impact of attachment anxiety, accumulated trauma and response to
childhood sexual abuse disclosure. Violence and Victims, 30,
49–65. doi:10.1891/0886-6708.VV-D-13-00098
*Bundrick, J. (2004). The sexual revictimization hypothesis: An
empirical evaluation of the Gold, Sinclair, and Balge (1999) model
of sexual revictimization. Unpublished doctoral dissertation,
Auburn University, Auburn, AL.
*Campbell, R., Greeson, M. R., Bybee, D., & Raja, S. (2008). The co-
occurrence of childhood sexual abuse, adult sexual assault, inti-
mate partner violence, and sexual harassment: A meditational
model of posttraumatic stress disorder and physical health out-
comes. Journal of Consulting and Clinical Psychology, 76,
194–207. doi:10.1037/0022-006X.76.2.194
*Carter-Visscher, R. M. (2008). Unwanted sexual experiences: Pre-
liminary development and validation of a behavior analog measure
for risk perception, response appraisal, and response. Unpublished
doctoral dissertation, Western Michigan University, Kalamazoo.
Classen, C. C., Gronskaya Palesh, O., & Aggarwal, R. (2005). Sexual
revictimization: A review of the empirical literature. Trauma, Vio-
lence, & Abuse, 6, 103–129. doi:10.1177/1524838005275087
*Cloitre, M., Cohen, L. R., & Scarvalone, P. (2002). Understanding
revictimization among childhood sexual abuse survivors: An inter-
personal schema approach. Journal of Cognitive Psychotherapy,
16, 91–112. doi:10.1891/jcop.16.1.91.63698
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating
trauma and traumatic grief in children and adolescents. New
York, NY: The Guilford Press.
*Combs-Lane, A. (2000). Risk factors associated with sexual revicti-
mization in college women. Unpublished doctoral dissertation,
University of Arkansas, Fayetteville.
*Copeland, K. R. (1996). The effects of childhood abuse and family
environment on attitudes, behaviors, and adult revictimization.
Unpublished doctoral dissertation, University of Southern Califor-
nia, Los Angeles.
*Craig, M. C. (2002). The mediating role of safety, trust, and esteem in
explaining the relationship between childhood sexual abuse and
adult revictimization. Unpublished doctoral dissertation, Texas
A&M University, College Station.
*Davis, J. L., DeMaio, C. M., & Fricker-Elhai, A. E. (2004). Sexual
assault prevention targeting involvement in risky behaviors: A
three-month follow-up. Journal of Trauma Practice, 3, 1–22.
doi:10.1300/J189v03n04_01
*de Haas, S., van Berlo, W., Bakker, F., & Vanwesenbeeck, I.
(2012). Prevalence and characteristics of sexual violence in the
Netherlands, the risk of revictimization and pregnancy: Results
from a national population survey. Violence and Victims, 27,
592–608.
Desai, S., Arias, I., Thompson, M. P., & Basile, K. C. (2002). Child-
hood victimization and subsequent adult revictimization assessed
in a nationally representative sample of women and men. Violence
and Victims, 17, 639–653.
77
*Dietrich, A. (2003). PTSD and associated features as predictors of
revictimization and perpetration with samples of adults abused
during childhood. Unpublished doctoral dissertation, The Univer-
sity of British Columbia, Vancouver, Canada.
Egger, M., Davey Smith, G., Schneider, M., & Midner, C. (1997). Bias
in meta-analysis detected by a simple, graphical test. British Med-
ical Journal, 315, 629–634. doi:10.1136/bmj.315.7109.629
Elliott, D. M., Mok, D. S., & Briere, J. (2004). Adult sexual assault:
Prevalence, symptomatology, and sex differences in the general
population. Journal of Traumatic Stress, 17, 203–211.
*Fargo, J. D. (2008). Pathways to adult sexual revictimization: Direct
and indirect behavioral risk factors across the lifespan. Unpub-
lished masters thesis, University of Cincinnati, Cincinnati, OH.
*Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1997). Child-
hood sexual abuse, adolescent sexual behaviors and sexual revic-
timization. Child Abuse & Neglect, 21, 789–803. doi:10.1016/
S0145-2134(97)00039-2
*Filipas, H. H., & Ullman, S. E. (2006). Child sexual abuse, coping
responses, self-blame, posttraumatic stress disorder, and adult sex-
ual revictimization. Journal of Interpersonal Violence, 21,
652–672. doi:10.1177/0886260506286879
*Fite, R. A. (2006). A prospective analysis of the variables predicting
sexual victimization in college-age women: An extension of previ-
ous findings. Unpublished doctoral dissertation, Binghamton Uni-
versity, Binghamton, NY.
*Ford, J. D., & Smith, S. F. (2008). Complex posttraumatic
stress disorder in trauma-exposed adults receiving public
sector outpatient substance abuse disorder treatment. Addic-
tion Research and Theory, 16, 193–202. doi:10.1080/
16066350701615078
*Fortier, M. A., DiLillo, D., Messman-Moore, T. L., Peugh, J.,
DeNardi, K. A., & Gaffey, K. J. (2009). Severity of child sexual
abuse and revictimization: The mediating role of coping and
trauma symptoms. Psychology of Women Quarterly, 33,
308–320. doi:10.1111/j.1471-6402.2009.01503.x
*Gidycz, C. A., Coble, C. N., Latham, L., & Layman, M. J. (1993).
Sexual assault experiences in adulthood and prior victimization
experiences: A prospective analysis. Psychology of Women Quar-
terly, 17, 151–168. doi:10.1111/j.1471-6402.1993.tb00441.x
Gidycz, C. A., Hanson, K., & Layman, M. J. (1995). A prospective
analysis of the relationships among sexual assault experiences.
Psychology of Women Quarterly, 19, 5–29.
Gidycz, C. A., Loh, C., Lobo, T., Rich, C., & Lynn, S. J. (2007).
Reciprocal relationships among alcohol use, risk perception, and
sexual victimization: A prospective analysis. Journal of American
College Health, 56, 5–14. doi:10.3200/JACH.56.1.5-14
Gidycz, C. A., McNamara, J. R., & Edwards, K. M. (2006). Women’s
risk perception and sexual victimization: A review of the literature.
Aggression and Violent Behavior: A Review Journal, 11, 441–456.
Gold, S. R., Milan, L. D., Mayall, A., & Johnson, A. E. (1994). A
cross-validation study of the Trauma Symptom Checklist. Journal
of Interpersonal Violence, 9, 12–26.
Haskell, L. (1999). Revictimization in women’s lives: An empirical
and theoretical account of the links between child sexual abuse and
repeated sexual violence. Unpublished doctoral dissertation, Uni-
versity of Toronto, Toronto, Canada.
78
*Heidt, J. M., Marx, B. P., & Gold, S. D. (2005). Sexual revictimiza-
tion among sexual minorities: A preliminary study. Journal of
Traumatic Stress, 18, 553–540. doi:10.1002/jts.20061
*Hequembourg, A. L., Livingston, J. A., & Parks, K. A. (2013). Sex-
ual victimization and associated risks among lesbian and bisexual
women. Violence Against Women, 19, 634–657. doi:10.1177/
1077801213490557
*Hetzel, M. D., & McCanne, T. R. (2005). The roles of peritraumatic
dissociation, child physical abuse, and child sexual abuse in the
development of posttraumatic stress disorder and adult victimiza-
tion. Child Abuse & Neglect, 29, 915–930. doi:10.1016/j.chiabu.
2004.11.008
Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003).
Measuring inconsistency in meta-analyses. British Medical Jour-
nal, 327, 557–560. doi:10.1136/bmj.327.7414.557
*Holmgreen, L. (2014). Child sexual abuse, attachment, dating beha-
viors, and sexual assault. Unpublished doctoral dissertation, Mar-
quette University, Milwaukee, WI.
*Hughes, T. L., Szalacha, L. A., Johnson, T. P., Kinnison, K. E.,
Wilsnack, S. C., & Cho, Y. (2010). Sexual victimization and hazar-
dous drinking among heterosexual and sexual minority women.
Addictive Behaviors, 35, 1152–1156. doi:10.1037/t28631-000
*Jankowski, M. K., Leitenberg, H., Henning, K., & Coffey, P.
(2002). Parental caring as a possible buffer against sexual revic-
timization in young adult survivors of child sexual abuse.
Journal of Traumatic Stress, 15, 235–244. doi:10.1023/A:
1015259412746
Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993).
Impact of sexual abuse on children: A review and synthesis of
recent empirical studies. Psychological Bulletin, 113, 164–180.
Kessler, B. L. (1996). A retrospective analysis of shame, dissociation,
and adult victimization in survivors of childhood sexual abuse.
Unpublished doctoral dissertation, Pennsylvania State University,
State College.
*Kessler, B. L., & Bieschke, K. L. (1999). A retrospective analysis of
shame, dissociation, and adult victimization in survivors of child-
hood sexual abuse. Journal of Counseling Psychology, 46,
335–341. doi:10.1037/0022-0167.46.3.335
*Lehn, L. J. (2003). The relationship between explanatory style and
revictimization in women sexually abused in childhood. Unpub-
lished doctoral dissertation, The University of Iowa, Iowa City.
*Leonard, W. (1991). Incest and revictimization: The relationship
between aspects of the incest experience, self-efficacy, interperso-
nal dependency, interpersonal trust, sexual self-esteem, sexual
behavior, sexual behavior and revictimization. Unpublished doc-
toral dissertation, Temple University, Philadelphia, PA.
*Livingston, J. A., Testa, M., & VanZile-Tamsen, C. (2007). The
reciprocal relationship between sexual victimization and sexual
assertiveness. Violence Against Women, 13, 298–313. doi:10.
1177/1077801206297339
*Maker, A. H., Kemmelmeier, M., & Peterson, C. (2001). Child sex-
ual abuse, peer sexual abuse, and sexual assault in adulthood:
A multi-risk model of revictimization. Journal of Traumatic Stress,
14, 351–368. doi:10.1023/A:1011173103684
*Mandoki, C. A., & Burkhart, B. R. (1989). Sexual victimization: Is
there a vicious cycle? Violence and Victims, 4, 179–190.
TRAUMA, VIOLENCE, & ABUSE 20(1)
Maniglio, R. (2009). The impact of child sexual abuse on health: A
systematic review of reviews. Clinical Psychology Review, 29,
647–657.
*Mayall, A., & Gold, S. R. (1995). Definitional issues and mediating
variables in the sexual revictimization of women sexually abused
as children. Journal of Interpersonal Violence, 10, 26–42. doi:10.
1177/088626095010001002
*Mejı́a, B., Zea, P., Romero, M., & Saldı́var, G. (2015). Traumatic
experiences and re-victimization of female inmates undergoing
treatment for substance abuse. Substance Abuse Treatment, Pre-
vention, and Policy, 10, 1–8.
*Merrill, L. L., Newell, C. E., Thomsen, C. J., Gold, S. R., Milner, J. S.
, Koss, M. P., & Rosswork, S. G. (1999). Childhood abuse and
sexual revictimization in a female navy recruit sample. Journal of
Traumatic Stress, 12, 211–225. doi:10.1023/A:1024789723779
*Messman-Moore, T. L. (1999). Alcohol use by survivors of child
sexual abuse: One possible explanation for revictimization.
Unpublished doctoral dissertation, Oklahoma State University,
Stillwater.
Messman-Moore, T. L., Brown, A. L., & Kuelsch, L. E. (2005). Post-
traumatic symptoms and self-dysfunction as consequences and
predictors of sexual revictimization. Journal of Traumatic Stress,
18, 253–261.
*Messman-Moore, T. L., & Garrigus, A. S. (2007). The association of
child abuse and eating disorder symptomatology: The importance
of multiple forms of abuse and revictimization. Journal of Aggres-
sion, Maltreatment & Trauma, 14, 51–72. doi:10.1300/
J146v14n03_04
Messman-Moore, T. L., & Long, P. L. (1996). Child sexual abuse and
its relationship to revictimization: A review. Clinical Psychology
Review, 16, 397–420.
*Messman-Moore, T. L., & Long, P. J. (2002). Alcohol and substance
use disorders as predictors of child to adult sexual revictimization
in a sample of community women. Violence and Victims, 17,
319–340. doi:10.1891/vivi.17.3.319.33662
Messman-Moore, T. L., & Long, P. J. (2003). The role of childhood
sexual abuse sequelae in the sexual revictimization of women: An
empirical review and theoretical reformulation. Clinical Psychol-
ogy Review, 23, 537–571.
*Messman-Moore, T. L., Walsh, K. L., & DiLillo, D. (2010). Emo-
tional dysregulation and risky sexual behavior in revictimization.
Child Abuse & Neglect, 34, 967–976. doi:10.1016/j.chiabu.2010.
06.004
*Miron, L. R., & Orcutt, H. K. (2014). Pathways from childhood
sexual abuse to prospective revictimization: Depression, sex to
reduce negative affect, and forecasted sexual behavior. Child
Abuse & Neglect, 38, 1848–1859. doi:10.1016/j.chiabu.2014.10.
004
*Morris, J. F., & Balsam, K. F. (2003) Lesbian and bisexual women’s
experiences of victimization: Mental health, revictimization, and
sexual identity development. In K. F. Balsam (Ed.), Trauma,
stress, and resilience among sexual minority women: Rising like
a Phoenix (pp. 67–85). New York, NY: Routledge. doi:10.1300/
J155v07n04_05
*Murphy, S. M., Kilpatrick, D. G., Amick-McMullan, A., Veronen, L.
J., Paduhovich, J., & Best, C. L., . . . Saunders, B. E. (1988).
Walker et al.
Current psychological functioning of child sexual assault survi-
vors: A community study. Journal of Interpersonal Violence, 3,
55–79. doi:10.1177/088626088003001005
*Noll, J. G., Horowitz, L. A., Bonanno, G. A., Trickett, P. K., &
Putnam, F. W. (2003). Revictimization and self-harm in females
who experienced childhood sexual abuse: Results from a prospec-
tive study. Journal of Interpersonal Violence, 18, 1452–1471. doi:
10.1177/0886260503258035
*Pantalone, D. W., Horvath, K. J., Hart, T. A., Valentine, S. E., &
Kaysen, D. L. (2014). Traumatic revictimization of men who have
sex with men living with HIV/AIDS. Journal of Interpersonal
Violence, 30, 1459–1477. doi:10.1177/0886260514540802
Paolucci, E. O., Genuis, M. L., & Violato, C. (2001). A meta-analysis
of the published research on the effects of child sexual abuse. The
Journal of Psychology, 135, 17–36.
*Paul, J. P., Catania, J., Pollack, L., & Stall, R. (2001). Understanding
childhood sexual abuse as a predictor of sexual risk-taking among
men who have sex with men: The Urban Men’s Health Study.
Child Abuse & Neglect, 25, 557–584. doi:10.1016/S0145-
2134(01)00226-5
Pereda, N., Guilera, G., Forns, M., & Gomez-Benito, J. (2009). The
prevalence of child sexual abuse in community and student sam-
ples: A meta-analysis. Clinical Psychology Review, 29, 328–338.
doi:10.1016/j.cpr.2009.02.007
*Pope, J. A. (1999). Revictimization among female survivors of child-
hood sexual abuse: Risk and protective factors. Unpublished doc-
toral dissertation, University of Memphis, Memphis, TN.
*Proulx, J., Koverola, C., Fedorowicz, A., & Kral, M. (1995). Coping
strategies as predictors of distress in survivors of single and mul-
tiple sexual victimization and nonvictimized controls. Journal of
Applied Social Psychology, 25, 1464–1483. doi:10.1111/j.1559-
1816.1995.tb02627.x
*Randall, M., & Haskell, L. (1995). Sexual violence in women’s lives:
Findings from the women’s safety project, a community-based
survey. Violence Against Women, 1, 6–31. doi:10.1177/
1077801295001001002
*Reese-Weber, M., & Smith, D. M. (2011). Outcomes of child sexual
abuse as predictors of lifetime sexual victimization. Journal of
Interpersonal Violence, 26, 1884–1905. doi:10.1177/0886260510
372935
*Reig, M. E. (1998). Child sexual abuse and related symptomatology:
Revictimization among inner-city women. Unpublished doctoral
dissertation, Temple University, Philadelphia, PA.
*Rich, C. L. (2003). Evaluation of a model of sexual revictimization: A
prospective study. Unpublished doctoral dissertation, Ohio Univer-
sity, Athens.
*Roodman, A. A. (2000). A test of a model of sexual victimization: A
latent variable path analysis. Unpublished doctoral dissertation,
Virginia Polytechnic Institute and State University, Blacksburg.
Roodman, A. A., & Clum, G. A. (2001). Revictimization rates and
method variance: A meta-analysis. Clinical Psychology Review,
21, 183–204.
*Rubien, R. (1995). Disclosure of incest: The effect on the lives of
adult female survivors. Unpublished doctoral dissertation, Adelphi
University, Garden City, NY.
79
*Schaaf, K. K., & McCanne, T. R. (1998). Relationship of child-
hood sexual, physical, and combined sexual and physical abuse
to adult victimization and posttraumatic stress disorder. Child
Abuse & Neglect, 22, 1119–1133. doi:10.1016/S0145-
2134(98)00090-8
Schmidt, F. L., Oh, I. S., & Hayes, T. L. (2009). Fixed- versus random-
effects models in meta-analysis: Model properties and an empirical
comparison of differences in results. British Journal of Mathemat-
ical and Statistical Psychology, 62, 97–128. doi:10.1348/
000711007X255327
*Schroeder, J. M. (2005). Sexual victimization: An examination
of variables predicting psychological measurement. Unpub-
lished doctoral dissertation, Western Michigan University,
Kalamazoo.
*Siegel, J. A., & Williams, L. M. (2003). Risk factors for sexual
victimization of women. Violence Against Women, 9, 902–930.
doi:10.1177/1077801203255130
*Simoni, J. M., & Ng, M. T. (2002). Abuse, health locus of control,
and perceived health among HIV-positive women. Health Psychol-
ogy, 21, 89–93. doi:10.1037//0278-6133.21.1.89
Spataro, J., Mullen, P. E., Burgess, P. M., Wells, D. L., & Moss, S. A.
(2004). Impact of child sexual abuse on mental health: Prospective
study in males and females. British Journal of Psychiatry, 184,
416–421.
*Stanley, J. L. (2010). The pathway to revictimization: An attachment
perspective. Unpublished doctoral dissertation, Simon Fraser Uni-
versity, British Columbia, Canada.
*Stevenson, M. R., & Gajarsky, W. M. (1992). Unwanted childhood
sexual experiences relate to later revictimization and male perpe-
tration. Journal of Psychology & Human Sexuality, 4, 57–70. doi:
10.1300/J056v04n04_05
*Teustsher, J. M. (2014). Victimization history and its effect on
women’s use of rape avoidance behaviors. Unpublished masters
thesis, California State University, Fullerton.
*Van Bruggen, L. K., Runtz, M. G., & Kadlec, H. (2006). Sexual
revictimization: The role of sexual self-esteem and dysfunctional
sexual behaviors. Child Maltreatment, 11, 131–145. doi:10.1177/
1077559505285780
*VanZile-Tamsen, C., Testa, M., & Livingston, J. A. (2005). The
impact of sexual assault history and relationship context on apprai-
sal of and responses to acquaintance sexual assault risk. Journal of
Interpersonal Violence, 20, 813–832. doi:10.1177/08862605052
76071
Wager, N. M. (2012a). Respondents’ experiences of completing a
retrospective web-based, sexual trauma survey: Does a history of
sexual victimization equate with risk for harm? Violence and Vic-
tims, 27, 991–1004. doi:10.1891/0886-6708.27.6.991
Wager, N. M. (2012b). Psychogenic amnesia for childhood sexual
abuse and risk for sexual revictimisation in both adolescence and
adulthood. Sex Education, 12, 331–349. doi:10.1891/0886-6708.
27.6.991
*Wager, N. M. (2013). Sexual revictimization: Double betrayal
and the risk associated with dissociative amnesia. Journal of
Child Sexual Abuse, 22, 878–899. doi:10.1080/10538712.2013.
830666
80
*Walsh, K. (2009). Sexual risk recognition deficits: The role of prior
victimization and emotion dysregulation. Unpublished doctoral
dissertation, University of Nebraska, Lincoln.
*Walsh, K., DiLillo, D., Klanecky, A., & McChargue, D. (2013).
Posttraumatic stress disorder symptoms: A mechanism in the rela-
tionship between early sexual victimization and incapacitated/
drug-or-alcohol-facilitated and forcible rape. Journal of Interper-
sonal Violence, 28, 558–576. doi:10.1177/0886260512455511
*Walsh, K., DiLillo, D., & Scalora, M. J. (2011). The cumulative
impact of sexual revictimization on emotion regulation difficulties:
An examination of female inmates. Violence Against Women, 17,
1103–1118. doi:10.1177/1077801211414165
*Walsh, K., Messman-Moore, T., Zerubavel, N., Chandley, R. B.,
DeNardi, K. A., & Walker, D. P. (2013). Perceived sexual control,
sex-related alcohol expectancies and behavior predict substance-
related sexual revictimization. Child Abuse & Neglect, 37,
353–359. doi:10.1016/j.chiabu.2012.11.009
*Wasco, S. M. (2004). An ecological study of repeated sexual victi-
mization among college women. Unpublished masters thesis, Uni-
versity of Illinois at Chicago, Chicago.
*Weinberg, J. C. (2008). Long term effects of child sexual abuse in a
clinical sample of women who were molested as children. Unpub-
lished doctoral dissertation, York University, Toronto, Canada.
West, C. M., Williams, L. M., & Siegel, J. A. (2000). Adult sexual
revictimization among black women sexually abused in childhood:
A prospective examination of serious consequences of abuse.
Child Maltreatment, 5, 49–57.
*Whetsell, M. S. (1990). The relationship of abuse factors and revic-
timization to the long-term effects of childhood sexual abuse in
women. Unpublished doctoral dissertation, University of Ken-
tucky, Lexington.
*Wilson, A. E., Calhoun, K. S., & Bernat, J. A. (1999). Risk recog-
nition and trauma-related symptoms among sexually revictimized
women. Journal of Consulting and Clinical Psychology, 67,
705–710.
Wilson, L. C., & Miller, K. E. (2016). Meta-analysis of the prevalence
of unacknowledged rape. Trauma, Violence, & Abuse, 17,
149–159. doi:10.1177/1524838015576391
*Wyatt, G. E., Guthrie, D., & Notgrass, C. M. (1992). Differential
effects of women’s child sexual abuse and subsequent sexual revic-
timization. Journal of Consulting and Clinical Psychology, 60,
167–173.
*Yeater, E. A., & O’Donohue, W. (2002). Sexual revictimization: The
relationship among knowledge, risk perception, and ability to
respond to high-risk situations. Journal of Interpersonal Violence,
17, 1135–1144. doi:10.1177/088626002237398
Yiaslas, T. A. (2010). The relationship between sexual trauma, peri-
traumatic dissociation, PTSD, and HIV-related health among
TRAUMA, VIOLENCE, & ABUSE 20(1)
HIV-positive men. Unpublished doctoral dissertation, Palo Alto
University, Palo Alto, CA.
*Yiaslas, T. A., Kamen, C., Arteaga, A., Lee, S., Briscoe-Smith, A.,
Koopman, C., & Gore-Felton, C. (2014). The relationship between
sexual trauma, peritraumatic dissociation, PTSD, and HIV-related
health in HIV-positive men. Journal of Trauma & Dissociation,
15, 420–435. doi:10.1080/15299732.2013.873376
*Zinzow, H. M., Grubaugh, A. L., Frueh, B. C., & Magruder, K. M.
(2008). Sexual assault, mental health, and service use among male
and female veterans seen in Veterans Affairs primary care clinics:
A multi-site study. Psychiatry Research, 159, 226–236. doi:10.
1016/j.psychres.2007.04.008
Author Biographies
Hannah E. Walker recently graduated with a BS in Psychological
Science from the University of Mary Washington. Currently, she is
working as a research assistant of traumatic brain injury at Walter
Reed National Military Medical Center, and she hopes to pursue
graduate school in the near future. Her research interests focus on the
topic of trauma, including combat and sexual assault, and psychoso-
cial adjustment among survivors and their families.
Jennifer S. Freud recently graduated with a BS in Psychological
Science from the University of Mary Washington. She is currently
working as a research assistant for the Defense and Veterans Brain
Injury Center at Walter Reed National Military Medical Center and
she hopes to pursue graduate school in the near future. Her research
interests focus around the topic of sexual trauma and she hopes to
further pursue this topic throughout her career.
Robyn A. Ellis recently graduated with a BS in Psychological Science
from the University of Mary Washington. Currently, she is pursuing a
PhD in Clinical Psychology at Northern Illinois University. Her
research interests focus on the topic of sexual trauma, particularly
psychological outcomes among survivors.
Shawn M. Fraine recently graduated with a BLS in Psychological
Science from the University of Mary Washington. He is currently
pursuing an MA in Clinical Psychology at Southern Illinois University
Edwardsville. His research interests focus around the topic of sexual
trauma, particularly within LGBTQ populations.
Laura C. Wilson is an assistant professor in the Department of Psy-
chological Science at the University of Mary Washington. She earned
a PhD in Clinical Psychology from Virginia Tech and MA in General/
Experimental Psychology from The College of William & Mary. Her
main area of research and clinical expertise is posttrauma functioning,
particularly in survivors of sexual violence or mass trauma (e.g., ter-
rorism, mass shootings, and combat). She also has interest in predic-
tors of violence and aggression including psychophysiological and
personality factors.