Article Journal of Interpersonal

Violence
Volume 24 Number 10

Does Acknowledgment as October 2009 1595-1614

© 2009 Sage Publications

an Assault Victim Impact

10.1177/0886260509331486
http://jiv.sagepub.com
hosted at
Postassault Psychological http://online.sagepub.com

Symptoms and Coping?

Caroline M. Clements
Richard L. Ogle
University of North Carolina Wilmington

Psychological symptoms, abuse characteristics, abuse disability, and coping

were assessed in college women who either did or did not acknowledge vic-
tim status relative to rape or intimate partner violence. Women were asked
directly whether they had experienced intimate partner violence or rape.
They also completed the Conflicts Tactic Scale (CTS) and the Sexual
Experience Survey (SES). Participants were then classified into groups
depending upon whether their answer, when directly asked, was consistent
with their self-report on the CTS or SES. Overall, women who met the expe-
riential criteria for either assault, but who did not acknowledge victimization,
reported greater disability, more psychological symptoms, and impaired cop-
ing. This effect was particularly strong for the rape groups, where those who
did not acknowledge victimization reported far more psychological distress,
disability, and impaired coping than controls and other victim groups. The
authors discuss the results in terms of their methodological implications for
studies of assault victims and in terms of the clinical implications for victim
identification and treatment.

Keywords:  intimate partner violence; rape; acknowledgment; psychological

status; coping

S exual and physical assault against women are disturbing and pervasive
social problems. College-aged women should be considered at high
risk for such violence. This age cohort reports 5 to 7 times more intimate
partner violence (IPV), abuse that occurs between two people in a close

Authors’ Note: Please direct all correspondence to Caroline Clements, PhD, Department of
Psychology, University of North Carolina Wilmington, Wilmington, NC 28403-5612; phone:
(910) 962-4297; fax: (910) 962-7010; e-mail: clementsc@uncw.edu.

1595
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1596   Journal of Interpersonal Violence

relationship, than either younger or older female cohorts (Bureau of Justice

Statistics [BJS], 2002). Women in this age group show disproportionately
high rates of sexual victimization as well. The percentage of women report-
ing rape, that is, forced sexual interaction against the will of the victim, or
attempted rape at some point in their college years, is estimated at 20% to
25% (BJS, 2001). When inclusion criteria for sexual victimization are
broadened to include sexual assault through coercion or threats of physical
harm, prevalence rates are even higher (BJS, 1998).
These rates are alarming not only because of physical harm associated
with victimization, but because rape and IPV result in increased psychological
symptoms, health complaints, and alcohol/drug use (Katz & Arias, 1999;
LeJeune & Follette, 1994; Williams & Smith, 1994). Psychological symptoms
following an assault include anxiety, depression, lowered self-esteem,
perceived loss of control, and posttraumatic stress symptoms (Acierno,
Resnick, Kilpatrick, Saunders, & Best, 1999; Arata, 1999; Frazier, 1990;
Frazier, Tix, Klein, & Arikian, 2000; Kessler, Browning, Hatfield, & Choo,
1999; Resick, 1993). These symptoms are concerning in their own right but
also play a significant role for future victimization risk (Dunmore, Clark, &
Ehlers, 2001; Follingstad, Brennan, Hause, Polek, & Rutledge, 1991; Katz
& Arias, 1999).
Researchers recognize that prevalence rates regarding victimization are
likely to be low estimates of actual occurrences. This is particularly well
studied in rape victims, where studies show less than half of rapes are
reported (Fisher, Daigle, Cullen, & Turner, 2003; Harned, 2005; Koss,
1985). One obvious and troubling reason a woman would not report a rape
is she does not acknowledge her experience as rape (Harned, 2005, Pitts &
Schwartz, 1997). More than half the college women categorized in one
national survey as rape victims answered “no” when asked to classify their
own experiences as a rape (BJS, 1998). More recent studies show even
greater discrepancy rates between acknowledged and unacknowledged rape
(Bondurant, 2001; Harned, 2004; Kahn, Jackson, Kully, Badger, &
Halvorson, 2003). These studies show women are more likely to label their
sexual assault experience as rape when they have experienced stranger rape
and/or severe physical force during the rape. Women who are intoxicated
or who experience acquaintance rape are less like to acknowledge the
experience as rape (Kahn et al., 2003).
There is relatively less research assessing acknowledgment in victims of
IPV. Hamby and Gray-Little (2000) found that 38% of a sample of women
who reported experiencing physical violence in their relationship did not
label themselves as IPV victims. They found that more frequent and more
severe assault was associated with a greater tendency to acknowledge, as

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1597

was lower relationship commitment. These findings are similar to the

findings in the rape literature in that increased force (severity) and less
relationship involvement predicted acknowledgment.
Similarly, there is little research focusing on the differences in psychological
adjustment of those who do and do not acknowledge victimization. Botta and
Pingree (1997) found that women who acknowledged rape scored better on
psychological adjustment variables. Layman, Gidycz, and Lynn (1996) found
just the opposite pattern of results. In their study, acknowledged rape victims
reported greater posttraumatic stress disorder (PTSD) symptoms than
unacknowledged victims, who in turn reported greater symptoms than
controls. These two studies used different measures of psychological status,
and the measures used were narrow in focus (PTSD only), perhaps accounting
for the inconsistent findings. To our knowledge, within the IPV literature,
there are no published studies comparing the psychological adjustment of
acknowledged versus unacknowledged IPV victims.
The purpose of this study was twofold. The first purpose was to clarify
contradictions in the literature relative to rape acknowledgment and
psychological adjustment. To accomplish this, participants were assessed
on a broad range of emotional status measures including abuse disability,
psychopathology, PTSD symptoms, and coping. The second purpose was
to extend the growing literature on discrepancies in rape acknowledgment
to IPV, using the same broad array of measures. Given the literature on rape
and IPV in regard to acknowledgment, we hypothesized that we would find
discrepancies in acknowledgment rates and assault rates based on
endorsement of behavioral experience. Because of the inconsistencies in
the rape literature, and the lack of studies in the IPV literature, we had no
a priori hypotheses about the direction of the differences we would find
between those who did and did not acknowledge victimization.

Method

Participants
A total of 328 women enrolled in introductory psychology courses at a
southeastern university participated. Students were given credit toward their
class research requirements for participation. Participants were female and
currently involved in a romantic relationship. Participants ranged in age from
17 to 47 years of age (M = 18.98, SD = 2.80). Most were 18 to 19 years old
(80.8%) and Caucasian (89%). Fifty-three percent of participants had been in
their current relationship 1 month or less (M = 7.96 months, SD = 17.09).

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1598   Journal of Interpersonal Violence

Table 1
Demographic Variables by Group
IR (n = 14) CR (n = 18) IIPV (n = 81) CIPV (n = 19) C (n = 185)

M SD M SD M SD M SD M SD

CTS 6.80 8.90 2.30   3.20 5.60 5.91 16.37 14.57 0.17 0.52
SES 2.60 0.53 2.70   0.21 0.53 0.28 0.67 0.00 0.00 0.00
Age 18.47 0.99 18.53   0.94 18.53 0.89 18.84 1.86 19.13 2.89
Relationship 8.20 8.10 7.80 12.90 9.40 26.80 12.50 11.70 6.70 13.30
length
(months)

n % n % n % n % n %

Marital status
Dating 11 79 15 83 36 44 17 89 112 61
Married 0 — 0 — 0 — 0 — 4 2
Cohabiting 0 — 0 — 6 — 1 — 2 1
Race
Caucasian 12 86 17 94 60 74 16 84 168 91
African 1 7 0 — 5 6 2 11 7 4
  American
Asian 0 — 0 — 2 2 0 — 2 1
Hispanic 1 7 0 — 2 2 1 5 4 2
Other 1 7 0 — 2 2 1 5 4 —
Employment
Employed 5 36 7 39 25 31 7 39 68 37
Unemployed 9 64 10 61 46 69 12 61 117 63

Note: Numbers may not add up to cell size due to lack of reporting; numbers may not add up
to 100% due to lack of reporting. IR = Inconsistent Rape; CR = Consistent Rape; IIPV =
Inconsistent Intimate Partner Violence; CIPV = Consistent Intimate Partner Violence,
C = Controls; CTS = Conflict Tactics Scale; SES = Sexual Experiences Survey.

Ninety-eight percent were unmarried, and 63% were unemployed. Twelve

participants reported currently receiving psychological services. Chi-square
analyses showed no differences in number of participants in each groups
receiving services (p > .05). Other demographic data can be seen in Table 1.

Materials
Participants completed questionnaires assessing a variety of abuse
characteristics and psychological variables. The assessment took approxi-
mately 45 minutes.

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1599

Demographics/History Questionnaire (DHQ). The DHQ is a 14-item

self-report inventory developed for the purposes of this study. The DHQ
assesses demographic (e.g., age and years of education) and relationship
characteristics (e.g., length of relationship).

Conflict Tactics Scale (CTS; Straus, 1979). The CTS is a 30-item self-
report inventory developed to assess the extent to which individuals use
physical and verbal aggression to resolve interpersonal conflict. Participants
were asked how frequently in the past year their partner engaged in abusive
behaviors on a 7-point Likert scale (ranging from 0 = never to 6 = six or
more times). Only the 16 CTS physical abuse items were used for classifi-
cation purposes (e.g., burned you, kicked you, shook you). A conservative
criterion for labeling someone as an IPV victim was used, in that women
scoring greater than 1 on the CTS were classified as victims. A score
greater than 1 meant that the participant had endorsed experiencing a single
type of physical violence more than one time, or multiple types of physical
violence one time. This was done to ensure that the abused group included
only those who had experienced more than one significant episode of
physical abuse and could confidently be labeled as IPV victims. This is
especially important in a study on acknowledgment. This criterion has been
used in past research using IPV samples, and the physical abuse items sub-
scale has demonstrated good reliability (α ≥ .90; Clements & Ogle, 2007;
Clements, Sabourin, & Spiby, 2004; Clements & Sawhney, 2000).

Abuse Disability Questionnaire (ADQ; McNamara & Brooker, 2000).

The ADQ is a 30-item self-report instrument that measures impairment in
eight different life areas (e.g., life restriction, psychological dysfunction,
health concerns). Participants rate items on a 1 (none) to 5 (excessive) scale.
All eight subscales have demonstrated adequate internal consistency (αs
range from .53 for concern with physical harm to .90 for relationship dis-
ability; McNamara & Brooker, 2000). Reliability in this study was quite
good with the exception of the substance abuse (α = .53), anxiety (α = .55),
and concerns about physical harm (α = .54) subscales. These scales were
dropped from subsequent analyses. The alpha for the total scale excluding
the dropped subscales was .90. Other subscale scores ranged from .80 (life
restriction) to .83 (psychological dysfunction).

Sexual Experiences Survey (SES; Koss & Oros, 1982). The SES is a
13-item self-report inventory that identifies five types of sexual victimiza-
tion: none, sexual contact, sexual coercion, attempted rape, and rape. Items

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1600   Journal of Interpersonal Violence

are answered on a yes-or-no scale. Because conservative criteria for sexual

assault were applied, only questions assessing physical force of sexual acts
were used to assign rape status (e.g., used physical force to make you have
sexual intercourse when you didn’t want to).

Symptom Checklist 90–Revised (SCL-90-R: Derogatis, Rickels, & Rock,

1976). The SCL-90-R is a 90-item self-report inventory developed to
screen for psychological symptoms on 10 subscales. Participants were
asked to indicate the degree of distress they experienced from each symp-
tom (e.g., nervousness, headaches) in the past 2 weeks using a 5-point
scale. The subscales of the SCL-90-R have demonstrated good internal
consistency (α = .75-.90; Derogatis & Lazarus, 1994).

Impact of Events Scale (IES; Horowitz, Wilner, & Alvarez, 1979). The IES
is a widely used 15-item scale measuring symptoms of PTSD (Sundin &
Horowitz, 2002). Participants were asked to think of either their sexual
assault or most recent abusive episode, and indicate how often they experi-
enced each symptom on a 0 (not at all) to 3 (often) Likert-type scale. Sundin
and Horowitz (2002) found the intrusion scales and avoidance scales were
highly reliable (intrusion α =.86, avoidance α = .80). Good reliabilities for
the entire scale (α = .91) and for each subscale (intrusion α = .88, avoidance
α = .85) were demonstrated in this study.

Coping Orientation to Problems Encountered–Brief Version (COPE-B;

Carver, 1997). The COPE-B is a 28-item self-report measure of 14 forms of
coping. The 14 subscales include problem-focused and emotion-focused
activities. Participants rated how often they used each strategy to cope on
a 1 (I haven’t been doing this a lot) to 4 (I have been doing this a lot)
Likert-type scale. COPE-B subscales have shown moderate to good reli-
ability in past research (denial α = .54; drug use α = .90; behavioral dis-
engagement α = .66; self-blame α = .64; Carver, 1997; Clements et al.,
2004). Alphas ranged from .56 for venting to .85 for religion. Venting was
removed from subsequent analyses due to inadequate reliability.

Procedure
All procedures were approved by the Institutional Review Board of the
university at which the study took place and adhered to ethical guidelines.
Experimenters obtained informed consent at the beginning of the experiment.
Women were told that they would be taking part in a study of college
student relationships and were instructed to complete all questionnaires

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1601

in an open and honest manner. Participants were fully debriefed after

completing the study.
All women first completed all assessments except the COPE-B and two
measures of perceived control. The latter two measures were part of a larger
database and were not used in this study. They were then given a face page
with two questions. One question asked whether they had ever been a
victim of rape. The other asked whether they had ever been physically
abused by an intimate partner. This manipulation was used to obtain
acknowledgment status. Participants then completed the COPE-B and other
assessments regarding the assault experience they had endorsed. Participants
who did not endorse experiencing either rape or interpersonal violence
were told to fill out the assessments (e.g., COPE-B) in regards to their most
severe relationship stressor.

Assignment of Victim Status

Thirty-two individuals met experiential (SES) criteria for rape, and 100
participants met experiential criteria (CTS) for IPV. Five groups were created
based on acknowledged victim status together with scores on the SES and
CTS. The groups were consistent rape (CR; n = 18, 5.8%), inconsistent rape
(IR; n = 14, 4.4%), consistent IPV (CIPV; n = 19, 6%), inconsistent IPV
(IIPV; n = 81, 25.4%), and controls (n = 185, 58%). Women who endorsed
on the questionnaire face sheet as having experienced rape or physical assault
by a partner met the acknowledgment criterion. Women marking “yes” on
any physical force sexual intercourse question on the SES or any physical
force question on the CTS met the experiential criteria (e.g., twisting your
arm to make you have sexual intercourse or stabbed you). All women
acknowledging IPV or rape victim status were classified as IPV or rape
victims on the CTS and SES, respectively. Women who reported experiencing
either type of violence only as children were excluded from analyses (n = 9).
A very small number of women (8) met the experiential criteria for both types
of assault. These women acknowledged being raped and were put in the CR
group. No women acknowledged being victims of both types of assault. This
led to an analysis sample of 319 participants.
In sum, CR individuals both acknowledged rape victimization and endorsed
at least one physical force item on the SES. CIPV individuals both acknowledged
IPV victimization and endorsed at least one physical force item on the CTS. IR
and IIPV individuals did not acknowledge victim status of either assault type
but did meet the SES or CTS experiential criteria. Controls neither acknowledged
victimization nor endorsed any experiential criteria. CTS, SES, and demographic
information can be seen in Table 1.

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1602   Journal of Interpersonal Violence

Results

Demographics
A multivariate analysis of variance (MANOVA) on demographic variables
using group as the fixed factor indicated no significant group differences for
the variables of age, income, length of relationship, number of children, or
years of education, Wilks’s Lambda, F(16, 1,186) = 1.22, p > .05. Chi-
square analyses indicated no significant group differences for race,
employment status or marital status (all ps > .05).
Two analyses of variance (ANOVAs) were calculated to examine
differences in sexual assault and IPV based on the grouping algorithm. There
were significant univariate effects for the CTS, F(4, 311) = 36.99, p < .001,
and the SES, F(4, 310) = 98.74, p < .001. Tukey’s HSD (which corrects for
multiple comparisons) showed that all victim groups scored higher on the
CTS than controls. CIPV reported greater CTS violence than all victim
groups except IR. IIPV reported less physical violence than IR. Tukey’s
HSD on the SES indicated that CR and IR were greater than all other
groups but not different from each other. There were no other differences.
Means for CTS and SES by group can be seen in Table 1.

Emotional Status
Three MANOVAs were calculated to examine between group differences
on reliable ADQ, SCL-90, and IES subscales. Group membership was the
fixed factor. Table 2 presents means and standard errors for these scales by
group. The MANOVA on ADQ subscales showed a significant multivariate
effect of group, Wilks’s Lambda, F(20, 963) = 2.56, p < .001. Univariate
ANOVAs indicated significant differences for all subscales (relationship
disability, life restriction, psychological dysfunction, health concerns, and
inadequate life control). The general pattern on Tukey’s HSD post hoc
analyses was that IR and IIPV reported higher abuse disability scores than
controls. This was true for life restriction, psychological dysfunction
health concerns, and total abuse disability. CIPV and IIPV were greater
than controls on inadequate life control. IR was greater than CR on health
concerns. Post hoc differences are presented in Table 3.
A significant multivariate effect was found for SCL-90 subscales, Wilks’s
Lambda, F(40, 1,150) = 2.64, p < .001. Univariate ANOVAs indicated
significant differences for all 10 SCL-90 subscales (all ps < .001). Tukey’s
HSD post hoc tests indicated two general patterns of between-group

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1603

Table 2
Means and Standard Deviations
for Psychological Status Variables by Group
IR CR IIPV CIPV C

M SD M SD M SD M SD M SD

ADQ
Life restriction 3.6 4.9 2.0 5.0 1.8 2.4 3.2 3.4 1.2 2.1
Relationship 7.3 7.3 6.5 7.5 4.9 5.1 7.2 5.9 3.6 5.7
   disability
Psychological 8.0 5.1 5.1 5.1 6.3 4.7 6.5 4.4 3.8 3.8
   dysfunction
Health concerns 6.0 3.8 2.5 2.2 4.2 3.6 3.7 3.3 2.4 2.6
Substance abuse 1.5 2.1 1.7 2.7 1.2 1.9 1.8 2.7 0.6 1.3
Anxiety 2.5 1.6 1.5 1.9 2.1 1.7 2.1 2.0 1.1 1.4
Physical harm 0.33 0.61 0.29 0.77 0.13 0.45 0.21 0.42 0.03 0.18
SCL-90
Somatic 0.84 0.58 0.58 0.69 0.97 0.66 0.83 0.66 0.54 0.53
   complaints
Obsessive 1.50 0.96 0.69 0.76 1.20 0.84 1.28 0.85 0.85 0.64
   compulsive
Interpersonal 1.45 0.94 0.69 0.76 1.30 0.73 1.30 0.85 0.70 0.61
   sensitivity
Depression 1.50 1.00 0.86 0.57 1.31 0.73 1.30 0.85 0.77 0.61
Anxiety 1.10 0.78 0.46 0.67 0.84 0.72 0.63 0.57 0.42 0.50
Hostility 1.20 0.71 0.55 0.84 0.81 0.66 0.95 0.86 0.55 0.61
Phobic anxiety 0.72 0.94 0.29 0.44 0.38 0.49 0.49 0.71 0.20 0.36
Paranoia 1.00 0.76 0.61 0.57 1.00 0.84 1.00 0.94 0.54 0.57
Psychosis 1.10 1.00 0.36 0.45 0.69 0.65 0.71 0.71 0.33 0.41
Global 1.20 0.77 0.60 0.54 0.99 0.57 0.94 0.68 0.57 0.45
   symptom index
COPE-B
Active 4.6 1.7 4.5 1.8 5.2 1.9 4.3 1.7 5.0 1.8
Planning 4.6 2.1 3.8 1.8 4.9 1.9 4.2 2.0 4.6 1.8
Positive 5.7 1.9 3.5 1.6 4.5 2.0 4.1 2.0 4.5 1.8
   reinterpretation
Acceptance 5.9 1.3 6.1 1.6 5.2 1.8 5.3 2.0 5.1 1.9
Humor 4.9 2.0 2.9 1.6 3.5 1.7 3.8 2.0 3.5 1.7
Religion 4.1 2.1 4.3 2.4 4.1 2.0 3.7 2.4 4.0 2.1
Emotion 5.3 2.3 4.9 2.1 4.6 1.7 4.0 2.0 4.8 1.9
Instrumental 5.2 2.1 4.8 2.0 4.7 1.9 4.2 2.0 4.7 1.8
Behavioral 6.3 2.0 4.4 1.7 4.6 1.7 4.1 1.9 4.7 1.8
   distraction
Denial 3.9 2.3 3.1 1.8 3.0 1.4 2.6 1.6 2.6 1.2
Substance abuse 3.5 1.6 3.3 2.2 2.9 1.5 3.0 1.8 2.6 1.2
Avoidance 3.5 2.0 3.3 1.6 3.1 1.4 2.7 1.0 2.7 1.2
Self-blame 4.6 2.6 3.7 2.1 4.2 2.0 3.5 1.7 3.6 1.7

Note: IR = Inconsistent Rape; CR = Consistent Rape; IIPV = Inconsistent Intimate Partner Violence; CIPV =
Consistent Intimate Partner Violence; C = Controls; ADQ = Abuse Disability Questionnaire; SCL-90 =
Symptom Checklist 90; COPE-B = Coping Orientation to Problems Encountered–Brief Version.

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1604   Journal of Interpersonal Violence

Table 3
Post Hoc Comparisons for Abuse
Disability Questionnaire (ADQ) Subscales
Scale Group Differences Univariate F Ratio (4, 304)

Relationship disability n.s. 3.52**

Life restriction IR** and CIPV* > C 4.27**
Psychological dysfunction IR** and IIPV** > C 6.59***
Health concerns IR*** and IIPV*** > C 5.10***
IR** > CR***
Inadequate life control CIPV* and IIPV > C 7.34***
ADQ total IR,*** IIPV,*** and CIPV*** > C 9.69***

Note: IR = Inconsistent Rape; CR = Consistent Rape; IIPV = Inconsistent Intimate Partner

Violence; CIPV = Consistent Intimate Partner Violence; C = Controls; n.s. = not significant.
* Significant at < .05. ** Significant at < .01. *** Significant at < .001.

differences. In one pattern, IR and IIPV were more symptomatic than

controls. This was the pattern for the obsessive compulsive, interpersonal
sensitivity, depression, anxiety, hostility, paranoia, and psychosis subscales
as well as the global symptom index. In the other pattern, IR was more
symptomatic than CR. This was the pattern for the obsessive compulsive,
anxiety, hostility, phobic anxiety, and psychosis subscales as well as the
global symptom index. Post hoc results are presented in Table 4.
A significant multivariate effect was found for the IES, Wilk’s Lambda, F(8,
596) = 3.1, p < .002. A significant univariate effect was found for the
avoidance subscale, F(4, 299) = 5.09, p < .001. Tukey’s HSD on the
avoidance subscale indicated that CR reported greater avoidance than
controls (p < .002) and a trend for CIPV to report more avoidance than
controls (p < .064).

Coping
A MANOVA on COPE-B subscales showed a significant multivariate
effect of group, Wilks’s Lambda, F(72, 1140) = 3.15, p < .001. Univariate
analyses showed significant between-group effects for positive reframing,
F(1, 309) = 2.98, p < .02; humor, F(1, 309) = 3.16, p < .01; behavioral
distraction, F(4, 309) = 3.88, p < .01; denial, F(4, 309) = 3.58, p < .01;
avoidance, F(4, 309) = 2.71, p < .03; and self-blame, F(4, 309) =
2.67, p < .04. Post hoc analyses (Tukey’s HSD) revealed that IR was
greater than CR on positive reframing (p < .01). IR was greater than

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1605

Table 4
Post Hoc Comparisons
for Symptom Checklist 90 (SCL-90) Subscales
SCL-90 Subscale Group Differences Univariate F Ratio (4, 312)

Somatic complaints IIPV*** > C 9.45***

Obsessive compulsive IR** > CR and C 9.10***
IIPV*** > CR and C
Interpersonal sensitivity IR*** and IIPV > C 11.10***
Depression IR,*** IIPV,*** and CIPV*** > C 11.62***
Anxiety IR*** > CR and C 10.57***
IIPV*** > C
Hostility IR*** and IIPV*** > C 6.26***
Phobic anxiety IR*** > CR and C 6.80***
IIPV* > C
Paranoia IIPV*** and CIPV* > C 9.76***
Psychosis IR*** > CR and C 12.46***
IIPV*** and CIPV*** > C
Global symptom index IR,*** IIPV,*** and CIPV*** > C 13.10***
IR** > CR

Note: IR = Inconsistent Rape; CR = Consistent Rape; IIPV = Inconsistent Intimate Partner

Violence; CIPV = Consistent Intimate Partner Violence; C = Controls.
* Significant at < .05. ** Significant at < .01. *** Significant at < .001.

CR (p < .01), CIPV (p < .05), and controls (p < .05) on humor. IR was
greater in behavioral distraction than CR (p < .05), IIPV (p < .01), CIPV
(p < .01), and controls (p < .01). IR was greater than CIPV (p < .05) and
controls (p < .01) on denial. There were no other significant post hoc
effects on the other subscales in which significant univariate differences
were found.

Discussion

The results of this study support the current literature on discrepancy

rates in rape acknowledgment and extend that literature to IPV. In
addition, these data support those studies that demonstrate that not
acknowledging rape is associated with poorer psychological functioning.
These data also demonstrate, for the first time, that such lack of
acknowledgment is also associated with poorer functioning in IPV
victims, albeit to a lesser extent.

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1606   Journal of Interpersonal Violence

Discrepancies Between
Acknowledgment and Behavioral Report
The percentage of college women in this sample who acknowledged the
experience of rape is consistent with published prevalence rates in national
samples (Fisher, Cullen, & Turner, 2000), as is the percentage who reported
IPV (Caetano, Field, Ramisetty-Mikler, & McGrath, 2005; Leonard,
Quigley, & Collins, 2002). Approximately 6% of women acknowledged
experiencing rape, and another 6% acknowledged experiencing IPV.
When experiential criteria were used, almost 26% of women who did
not acknowledge IPV reported experiences consistent with IPV. Another
4% of the sample reported experiences consistent with rape but did not
acknowledge having been raped. When both experiential criteria and
acknowledgment were used to categorize participants, the IPV rate in this
sample was 32% and the rape prevalence was approximately 10%. Thus,
using experiential criteria, the rape rate almost doubled and the IPV rate
quadrupled. The magnitude of the discrepancy between acknowledged and
unacknowledged rape victims in this study is somewhat smaller than past
studies; however, it is still quite large (e.g., 56% vs. 27% in Layman et al.,
1996, and approximately 27% in Harned, 2004).
It is possible that the higher acknowledgment rate in this study reflects
the fact that prevalence rates vary as a function of methodology (BJS, 2002;
Straus, 2004; Waltermaurer, 2005). Whether a woman acknowledges
victimization may be affected by the type of label researchers use. In the
present study, the use of the term rape as opposed to sexual assault may
have contributed to part of the difference.
Simply asking women whether they are a victim appears to produce the
lowest prevalence rates, whereas surveys including detailed descriptions of
specific acts yield higher rates (Gilbert, 1997; Koss, 1992). This has led
some investigators to call for consistent operational definitions to be used
in victim protocols. Much of the research using consistent operational
definitions has been done with rape victims. Data from this study support
the utility of including specific behaviors in assessments of sexual assault
victims and suggest that such an approach may be useful in assessments of
IPV victims as well (BJS, 2002).
Investigators have theorized that willingness to self-identify as an
assault victim may depend on a variety of psychosocial factors, ranging
from embarrassment to fears of reprisal (Pitts & Schwartz, 1997). There are
some data, including the present study, indicating that assault severity is a
factor in acknowledgment (Hamby & Gray-Little 2000). Moreover, lack of

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1607

acknowledgment may reflect lack of awareness of the constituents of

victimization (BJS, 2002). Finally, acknowledgment may be a gradual
process, influenced by information seeking and social support (Harned,
2005). This study cannot address the determinants of such differences.
Rather, it was designed to examine the magnitude of the difference in
acknowledgment rates and differences in psychological status related to
acknowledgment.

Group Comparisons of Psychological Functioning

Abuse characteristics. Regardless of the process by which acknowledg-
ment occurs, there appear to be important differences in abuse characteris-
tics between individuals who acknowledge victimization and those who do
not. CIPV women had higher CTS abuse severity scores than IIPV women.
IR and CR women reported higher CTS scores than controls but did not dif-
fer from each other. This is consistent with research among both rape and
IPV victims, demonstrating that acknowledgment increases as victimization
severity increases (Hamby & Gray-Little, 2000; Kahn et al., 2003).
In general, women who acknowledged victimization showed less abuse
disability relative to controls than those who did not. This seems particularly
true for rape victims where those who acknowledged victimization reported
the least disability relative to controls. In the rape group, those who did not
acknowledge were most disabled relative to controls. Research with rape
victims indicates that acknowledgment often occurs through continued
reflection on the incident as well as social support seeking (Harned, 2005;
Kahn & Mathie, 2000). These two processes may be part of the overall
mechanism by which the process of acknowledgment and decreased abuse-
related disability occur. It is important to follow women over time to
determine the nature of the relationship between acknowledgment as a rape
victim and abuse disability. Qualitative research would also be helpful in
elucidating these processes (e.g., Harned, 2005). This would allow a test of
the alternative interpretation that less disabled women are more likely to
seek social support and acknowledge victimization as a result of their
overall better adjustment.

Emotional status. There were three general patterns observed in the

emotional status variables. First, victimization was associated with increased
reporting of psychological symptoms for assault victims in both IPV groups
and the IR group. IIPV, CIPV, and CR participants reported higher SCL
scores than controls on a number of subscales. These findings are consistent

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1608   Journal of Interpersonal Violence

with a large body of research showing high levels of psychological symptoms

in IPV victims and suggest that these deficits appear whether or not the IPV
victim acknowledges her victimization (Acierno et al., 1999; Clements &
Sawhney, 2004; Katz & Arias, 1999). Harned (2004) found that the experi-
ence of unwanted sexual behavior, rather than acknowledgment, accounted
for psychological distress in her sample of rape victims. Harned’s data sug-
gest that it may be important to examine the relative contributions of the
experience of assault itself versus acknowledgment to fully understand the
psychological sequelae of assault.
The next general pattern observed was that victims who did not
acknowledge evidenced greater symptoms relative to controls than victims
who did. This finding held for both the IPV and the IR groups and is consistent
with at least one previous study of college student sexual assault victims (Botta
& Pingree, 1997). Layman et al. (1996) found exactly the opposite pattern of
results. Victims in their study who acknowledged victimization reported greater
PTSD symptoms. These results were contradictory despite the fact that the
samples were very similar and the experiential criteria were the same (SES
items). One important difference between the two studies was that Layman et al.
asked victims whether they labeled the particular assault they described on the
SES as rape. Botta and Pingree asked the more general question “Have you
ever experienced sexual assault?” Thus, it appears to make a difference
whether you ask victims to label the experiences they report in the SES as
assault rather than their experiences in general. It is also important to note
that our psychological assessment was focused on a much broader array of
symptoms than either of the above studies. It is important to replicate
Layman et al.’s methodology using a broader array of symptom measures
to see if this inconsistency holds across symptom measures, or is just
specific to PTSD.
The final pattern in these data was that the inconsistent/consistent
differences in psychological symptoms manifested in the rape groups to a
far greater extent than in the IPV groups. The IR group showed more
psychopathology than controls on every SCL subscale and was more
symptomatic than the CR group on every SCL subscale except somatic
complaints. The CR group did not differ from controls on any SCL
subscale. This pattern did not appear in the IPV groups. There were no
differences between the CIPV group and the IIPV group on the SCL. Given
the differences in CTS scores between the IPV groups and the known
association between abuse severity and psychopathology, one might have
expected to find that IPV groups show a similar pattern to the rape groups
(Coid et al., 2003).

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1609

One way to interpret these data is that lack of acknowledgment has

greater psychological consequences for rape victims than IPV victims.
Alternatively, acknowledgment as a rape victim may be associated with
greater reduction in psychological symptoms or greater service seeking
compared to IPV victims. Finally, the act of help seeking alone may play a
role in the process of acknowledgment. Harned (2005) found that support
seeking was associated with a greater tendency to acknowledge rape. If the
process of acknowledgment has beneficial effects, then one should see
sharp decreases in symptom reporting once victims acknowledge their
status. One might also be able to detect whether such decreases are different
depending on assault type.
It is important to note that preexisting psychopathology itself may be
influencing the acknowledgment process, a possibility that cannot be
addressed in cross-sectional studies. This is particularly relevant in studies
of college students. Severe psychological symptoms make it less likely
individuals will attend or remain in college. Our sample of victims is one
in which level of pathology is likely to be more circumscribed than the
general population of victims (Layman et al., 1996). Researchers examining
the dynamic nature of acknowledgment should include longitudinal
assessments as part of their protocols to determine the role that psychological
variables, such as emotional status, play in acknowledgment (Harned,
2005). It would also be important to assess noncollege samples of victims
to determine whether the relationship between acknowledgment and
psychological status follows a similar dynamic as in college students.
It is possible the range restriction for sexual assault might have
resulted in the pattern of differences. Sexual assault was defined according
to yes-or-no criteria, whereas IPV was defined by frequency data. This
may have dichotomized the rape groups to a greater extent than the IPV
groups. Comparisons using similar grouping metrics would address this
issue. Most studies do not employ such comparisons because rape
victimization does not typically occur with the frequency that IPV occurs
(Watts & Zimmerman, 2002).

Coping. The only group differing from controls in coping was the IR
group. The IR group reported greater use of behavioral distraction than all
other groups and greater use of denial than controls. These findings are
consistent with the overall trend in this study for the IR group to show
greater deficits than other groups. Denial and behavioral distraction sub-
scales are thought to measure ineffective coping in assault victims and are
associated with greater depression in IPV samples (Clements et al., 2004).

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1610   Journal of Interpersonal Violence

These data suggest that it may be useful to assess the impact of impaired
forms of coping such as denial on the development of depressive symptoms
in rape victims as well.
The lack of between-group differences in the IPV groups is inconsistent
with a number of studies showing high levels of behavioral distraction,
denial, and drug use in these participants (Clements et al., 2004; Clements
& Ogle, 2007). One difference between this study and those cited is that
this study assessed abusive college student relationships whereas the
previous two studies utilized shelter-living participants. It is likely that
abuse severity is related to problematic coping. One possibility is that
women who cope more effectively are less likely to go to shelter (Clements
& Sawhney, 2000). Alternatively, college students may have access to
support services unavailable to community abused women, thus enabling
them to avoid the use of ineffective strategies (BJS, 2002).
Research with rape victims demonstrates inconsistent findings regarding
coping and acknowledgment. Cross-sectional studies tend to demonstrate
that those who do not acknowledge victimization cope more ineffectively
than those who do (e.g., Littleton, Axsom, Breitkopf, & Berenson, 2006;
Mcauslan, 1999). Recent longitudinal research suggests that such differences
may be most apparent immediately postassault. McMullin and White
(2006) found greater psychological distress and increased alcohol use in
those who did not acknowledge right after being raped but few differences
between the groups 10 months later. It was not possible to conduct such
analyses with the cross-sectional data in this study. Harned (2005) used a
stratified random sample design to demonstrate the association between
social support seeking and the decision to acknowledge. It would be
interesting to assess whether social support may interact with psychological
distress and coping in the acknowledgment process.

Limitations
These data are a compelling step to a more complete understanding of
the impact of victimization. However, our ability to generalize these
findings to abuse victims may be limited to the extent that college students
are not representative of all abuse victims. Students in this sample were
primarily Caucasian and had been in relationships, abusive or not, for a
shorter time than typically reported in noncollege abuse samples (Clements
& Sawhney, 2000). This limitation seems less important for rape, where the
severity criteria were the same as those seen in noncollege samples.

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 Clements, Ogle / Victim Acknowledgment and Psychological Symptoms   1611

Furthermore, self-report instruments may not represent the best methods

of obtaining acknowledgment or emotional status information. Investigative
techniques aimed at increasing rapport (e.g., structured interviews) may
enable researchers to develop a more complete picture of college students
who experience victimization.
The number of abuse victims in this study may have been underestimated if
some individuals did not acknowledge and did not endorse assault items they
did indeed experience. Although this may have attenuated potential group
differences, the group difference were robust. Furthermore, it underscores the
importance of investigations of this type. Again, interview techniques designed
to establish better rapport may enable us to explore the magnitude of this
underestimation.

Conclusion

This study contributes to the literature in four important ways. First, it

replicates the data on discrepancies in rape acknowledgment. Second, it
addresses an inconsistency in the literature concerning the relationship
between rape acknowledgment and psychological adjustment, showing that
lack of acknowledgment is related to poorer psychological adjustment.
Third, it extends this literature to IPV. Finally, it addresses the relationship
between victimization acknowledgment and coping in both IPV and rape.

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Caroline M. Clements, PhD, is a professor of psychology at the University of North Carolina

Wilmington. She received her doctorate in clinical psychology from Northwestern University.
Her program of research focuses on vulnerability to depressive disorders in high-risk popula-
tions including abused women.

Richard L. Ogle, PhD, is an associate professor of psychology at the University of North

Carolina Wilmington. He received his doctorate in clinical psychology from the University of
New Mexico. His program of research involves the effects of alcohol intoxication on various
forms of aggressive behavior including sexual aggression and intimate partner violence.

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