Sabina 2014

Article
TRAUMA, VIOLENCE, & ABUSE

2014, Vol. 15(3) 201-226
Campus and College Victim Responses ª The Author(s) 2014
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to Sexual Assault and Dating Violence: DOI: 10.1177/1524838014521322
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Disclosure, Service Utilization,
and Service Provision
Chiara Sabina1 and Lavina Y. Ho1
Abstract
After sexual assault or dating violence occurs, a college victim may disclose the event to formal and informal sources as well as seek
services. The current review explores empirical research on formal disclosure, informal disclosure, service utilization, and service
provision among college students. Forty-five empirical articles and reports that met certain criteria were reviewed. Overall, rates of
informal disclosure were considerably higher than rates of formal disclosure. Characteristics of the incident, victim, and offender
were associated with disclosure. Rates of service utilization were varied but appear to be low among those victimized in the past
year. When services were used, physical and mental health services were most often utilized. Available services, policies for dating
violence and sexual assault, and judicial processes varied according to the type of institution, and indicate several areas for improve-
ment. A number of research, practice, and policy implications emerge from this critical review of the literature.
Keywords
sexual violence, rape, dating violence, disclosure, help seeking, services, college students, policies
Sexual assault and dating violence are more prevalent during term disclosure and focus specifically on telling formal and
early adulthood than other life stages. According to Centers for informal sources about their victimization and the responses
Disease Control, 37% of women who were raped in their lifetime received (Filipas & Ullman, 2001; Rodriguez, Sheldon,
experienced their first rape during the ages of 18–24, which is Bauer, & Pérez-Stable, 2001; Starzynski, Ullman, Townsend,
also the period in life when 47% of women who experienced Long, & Long, 2007; Sylaska & Edwards, 2013; Ullman,
intimate partner violence (IPV) reported having their first expe- Starzynski, Long, Mason, & Long, 2008). Research indicates
rience (Black et al., 2011). Moreover, recent National Crime that the majority of victims neither report to the police nor
Victimization Survey data show that the highest rate of serious seek other forms of formal assistance such as mental health
violent crimes is also during the ages of 18–24 compared to other services (McCart et al., 2010), but many do disclose to family
age categories (Truman, Langton, & Planty, 2013). Thus, it is and friends (Sylaska & Edwards, 2013). Although disclosures
not surprising that the estimated past-year prevalence rate for and subsequent social support are associated with improved
rape among college women (5.15%) is substantially higher than mental health (Sylaska & Edwards, 2013), negative reactions
for the rape of women in the general population (.94%; Kilpatrick, could impede victims’ well-being (Goodkind, Gillum, Bybee,
Resnick, Ruggiero, Conoscenti, & McCauley, 2007). Given that & Sullivan, 2003). Likewise, poor treatment from legal, med-
victimization is associated with negative psychological function- ical, and mental health systems could be so damaging to vic-
ing, substance use, and physical health consequences (Ackard, tims that some regard the treatment as a second victimization
Eisenberg, & Neumark-Sztainer, 2007; Briere & Jordan, 2004; (Campbell, 2008).
Burnam et al., 1988; DuRant et al., 2007; Plichta, 2004; Sabina
& Straus, 2008; Shorey, Stuart, & Cornelius, 2011), it is important
to examine the ways in which victims seek assistance for their 1
Penn State Harrisburg, School of Behavioral Sciences and Education, Mid-
victimization. dletown, PA, USA
Research on help seeking in the aftermath of victimization
generally covers formal help seeking (e.g., law enforcement, Corresponding Author:
Chiara Sabina, Penn State Harrisburg, School of Behavioral Sciences and
medical services, mental health services), informal help seek- Education, 777 West Harrisburg Pike, Olmsted Building W-311, Middletown,
ing (e.g., family and friends), and associated factors and bar- PA 17057, USA.
riers (McCart, Smith, & Sawyer, 2010). Other studies use the Email: sabina@psu.edu
202 TRAUMA, VIOLENCE, & ABUSE 15(3)
This review adds to the current research by highlighting 2005). The recent model makes explicit the individual, inter-
empirical studies specifically on college victims. College stu- personal, and sociocultural influences that impact seeking help
dents warrant specialized attention given the specific contexts and support, which is depicted in three main stages—problem
in which they operate (e.g., highly social, close-knit environ- recognition and definition, decision to seek help, and support
ments) and, of course, their age, which points to higher victimi- selection (Liang et al., 2005). The model also acknowledges
zation rates and likely influences disclosure and service that these processes are not linear and instead, influence each
utilization. The college campus is one that provides a micro- other in a dialectical process. Several studies have used ecolo-
cosm of the services available in the larger community. For gical levels to guide their conceptualization of help seeking and
example, campuses may have their own health center, counsel- service utilization (Amar, 2008; Garcia, Lechner, Frerich, Lust,
ing center, police officers, policies, and judicial process. This & Eisenberg, 2012; Karjane, Fisher, & Cullen, 2002; Walsh,
review will examine empirical studies on formal disclosure, Banyard, Moynihan, Ward, & Cohen, 2010). A symbolic inter-
informal disclosure, and service utilization among college stu- action model has also been described (Konradi, 2003), focusing
dents as well as service provision on campuses. Developing a on the individual meaning attached to a situation, which is
comprehensive understanding of campus and college victim derived from the interaction with others, and undergoes an
responses to sexual assault and dating violence will provide interpretive process (Blumer, 1969).
insights into future directions for research in this area, services Models focused more on the micro-level (e.g., transtheore-
for college victims, and policies that govern campus responses. tical model) and macro-level (e.g., feminist theory, interna-
tional comparative perspective) have also been called upon to
understand postassault behaviors and public attitudes toward
Method services (Edwards, Dardis, & Gidycz, 2012; Wu, Button, Smol-
To identify studies relevant to responses to sexual assault and ter, & Poteyeva, 2013). The macro-level perspectives highlight
dating violence among college victims and colleges, four how patriarchy is associated with the minimization of violence
research databases were searched. Search terms included three against women, thus leading to nondisclosure; and the macro-
components: (1) use of the term dating violence, sexual assault, level differences between countries that could lead to differ-
rape, IPV, partner abuse, interpersonal violence, or victim in ences in public support for violence interventions. Addition-
the title or abstract, (2) use of the word college, university, or ally, the transtheoretical model (Prochaska, DiClemente, &
campus in the title or abstract, and (3) use of the words services, Norcross, 1992) originated from addiction research and focuses
help seeking, report, policy, intervention, treatment, disclosure, on the process of intentional change by individuals. Individuals
or resource in the title or abstract. Four major databases were progress from precontemplation (no intention to change, no
used: PsycInfo, Criminal Justice Abstracts, Educational Reso- problem identified), to contemplation (aware of a problem, but
urces Information Center, and PubMed. References matching no commitment to change), to preparation (intention and beha-
these criteria were each reviewed to determine relevance for vior combined, reduction in problem behavior), to action (elim-
the current review. The criteria were that the study (1) utilize ination of problem behavior), and maintenance (prevention of
an exclusive college sample or present analyses for this group problem recurrence).
separately, (2) be empirical and provide detail about results Models for examining service provision are more varied in
(e.g., model policies, guidelines, literature summaries, and edi- the literature, as studies tend to focus on different aspects of
torials were omitted), and (3) pertain to disclosure, service use, service provision. For example, a community readiness model
or service provision about incidents of sexual assault or dating was applied to a needs assessment for IPV services on campus
violence (e.g., studies focused on prevention, mental health (Barco & Reel, 2011), but another campus used a community
treatment modalities, educational programs, and disclosure prevention approach to a similar question (Lichty, Campbell,
receipt were excluded). Databases yielded 35 studies for inclu- & Schuiteman, 2008). The community readiness model applies
sion. These were supplemented by 10 additional studies located some concepts of the transtheoretical model of change to the
via Google Scholar to yield a total of 45 articles and reports community level, such as problem awareness and readiness for
included in this summary. change (Plested, Jumper Thurman, Edwards, & Oetting, 1998).
The community prevention framework makes use of ecological
levels of analysis and lays emphasis on the interrelationships
Theoretical Models of Disclosure, Service
between community units and individuals (Kelly, 1968). When
Utilization, and Service Provision looking at how services are communicated to potential users,
There are myriad influences pertaining to postassault decisions other models have been used; specifically, the elaboration like-
of victims, ranging from internal dynamics and personal history lihood model of persuasion and social marketing (Hayes-Smith
to cultural contexts. Although the vast majority of studies do & Levett, 2010; Konradi, 2003). Social marketing employs mar-
not apply theoretical models of disclosure and service use, keting principles for the social good as indicated by specific
some theories have been explored to understand potential influ- behavioral goals (French & Blair-Stevens, 2010). Further, the
ences on behavior. The most common of these is an ecological elaboration likelihood model (Petty, Cacioppo, Strathman, &
model that has been utilized to explain help seeking among vic- Priester, 2005) is a social psychological model concerned with
tims of IPV (Liang, Goodman, Tummala-Narra, & Weintraub, central (careful thinking and examination) versus peripheral
Sabina and Ho 203
(low effort) processing of information. Central processing is not at all supportive by those who reported to the police (Koss,
more likely, according to the model, when one possesses moti- 1998). This set of studies gives no indication, however, of what
vation and is able to elaborate on the information presented happened once the report was made to the police.
(Petty et al., 2005).
Parts of these theoretical models have been used in some
studies to guide research questions and aid in the interpretation
Rate of Disclosure to Other Formal Sources
of results, although most studies have been atheoretical. The Rates of reporting to campus authorities or other formal
following review details the specific empirical findings for resources (e.g., victim crisis center, health services, professor)
each of four sections: formal disclosure, informal disclosure, varied across studies from 0% for campus services (Tamborra
service utilization, and service provision. Later, a discussion & Narchet, 2011) to 15.8% for victim’s, crisis, or health care
of research, practice, and policy implications is provided. centers (Krebs et al., 2007), but it is important to recognize
studies measured disclosure to varying resources. For exam-
ple, Tamborra and Narchet (2011) queried contacting campus
Formal Disclosure services (e.g., campus police, counseling center, residential
Research on formal disclosure focused on rates of formal dis- services), while Fisher, Daigle, Cullen, and Turner (2003)
closure (i.e., reporting to the police or campus authorities, and defined campus authorities as campus law enforcement, resi-
other formal sources), factors associated with disclosure or dent hall advisors, deans, professors, other college authorities,
reporting, and barriers to reporting (see Table 1). All studies, and on-campus bosses, employers, or supervisors. Other stud-
except two (Edwards et al., 2012; Thompson, Sitterle, Clay, ies asked about contacting a victim’s, crisis, or health center
& Kingree, 2007), focused on sexual assault. (Krebs et al., 2007; Lindquist et al., 2013). Findings from
three studies indicate that residence life is unlikely to be con-
tacted postsexual assault (Fisher et al., 1999; Orchowski et al.,
Rate of Reporting to the Police 2009; Tamborra & Narchet, 2011). Again, as with reporting to
Studies uniformly found low rates of reporting to police police, those who were assaulted by force were more likely to
(Edwards et al., 2012; Finkelson & Oswalt, 1995; Fisher, Dai- contact a victim’s, crisis, or health center than those who were
gle, Cullen, & Turner, 2003; Kilpatrick et al., 2007; Koss, incapacitated during their assault (Krebs et al., 2007; Lind-
1998; Krebs, Lindquist, Warner, Fisher, & Martin, 2007; Lind- quist et al., 2013). Also, findings from the CSA study (Krebs
quist et al., 2013; Littleton, 2010; Wolitzky-Taylor et al., et al., 2007) indicated that on-campus services were not con-
2011), except when hypothetical reporting was probed (Amar, tacted as often as off-campus services. The study also gives
2008; Orchowski, Meyer, & Gidycz, 2009; Tamborra & some indication of postreporting experiences—over 70%
Narchet, 2011). Rates of reporting to police varied from 0% for reported being satisfied with the way the report was handled
sexual coercion, date rape, and dating violence (Edwards et al., (Krebs et al., 2007).
2012; Finkelson & Oswalt, 1995; Fisher et al., 2003) to 12.9%
for forced sexual assault (Krebs et al., 2007), although one
study with a small sample found a rate of 42% (Guerette & Factors Associated With Reporting to the Police
Caron, 2007). Three large-scale studies differentiated between Characteristics of the victimization incident, victim, and offen-
forced sexual assaults and sexual assaults that included drug or der were associated with formal disclosure. The focus of this
alcohol use (e.g., victim voluntarily or involuntarily becomes section is consistent with most studies that tend to look exclu-
incapacitated; Kilpatrick et al., 2007; Krebs et al., 2007; Lind- sively at factors associated with reporting to the police (cf.
quist et al., 2013). All three studies showed that rates of report- Fisher et al., 2003; Orchowski et al., 2009) as opposed to other
ing to the police were substantially lower when substances formal supports. More severe victimizations as indicated by
were involved. Some studies did not specify who made the presence of a weapon, physical force, injury, peritraumatic
report to the police (Kilpatrick et al., 2007; Krebs et al., fear, and perceived fear of death/injury during assault were
2007) and others did not indicate which police unit (e.g., cam- associated with higher levels of reporting to the police (Fisher
pus, local, city) was reported to (Kilpatrick et al., 2007; Lind- et al., 2003; Kilpatrick et al., 2007; Wolitzky-Taylor et al.,
quist et al., 2013; Orchowski et al., 2009). However, data from 2011). Assaults that occurred on-campus versus off-campus
the National College Women Sexual Victimization (NCWSV) were more likely to be reported to the police (Fisher et al.,
study (Fisher, Cullen, & Turner, 1999) indicated that most inci- 2003). Alcohol use and being too drunk or high to control beha-
dents reported to the police were reported by the victim (85%). vior were associated with not reporting the sexual assault to the
Generally reports were made to municipal, local, or city police police (Kilpatrick et al., 2007). Forms of sexual assault categor-
(Fisher et al., 1999; Krebs et al., 2007) except for incapacitated ized as less severe, such as sexual contact and threats, were
sexual assaults that were reported mainly to campus police, associated with lower levels of reporting to the police (Fisher
when reports were made, according to the Campus Sexual et al., 2003; Kilpatrick et al., 2007).
Assault (CSA) study (Krebs et al., 2007). Only one-third of those Characteristics of the victim associated with higher levels of
who reported to police were satisfied with the way the report was reporting to the police include acknowledging the incident as
handled (Krebs et al., 2007) and police were generally rated as rape, a higher degree of memory about the assault, high levels
204
Table 1. Studies on formal and informal disclosure by college victims, service utilization, and service provision among campuses.
Dating Violence Relevant Sections

Reference Sample Characteristics Pertinent Findings and/or Sexual Assault of Review
Amar (2008) 114 African American college 71% of college women would report sexual violence Sexual assault Formal disclosure;
students (100% female) to campus health services within 2 weeks if they factors associated with
experienced sexual violence, and 56% would report formal disclosure
it to campus administrators or campus security
within 2 weeks;
having injuries, having time to report, and having a
designated campus individual to handle sexual assault
were associated with reporting to health care
providers;
having injuries, having the time to go, how they
would be treated, and if the victim had been drinking
at the time of the assault were associated with
reporting to campus administrators and security
Amar and Gennaro 863 College students from a HBCU Over half of victims told someone about the Dating violence Informal disclosure;
(2005) and a private college (100% female) violence, mostly friends; service utilization
about 40% who reported injuries from a dating
partner sought health care for their injuries
Amstadter et al. 228 College students who had a 52% of participants sought help, of these 93% saw a Sexual assault Service utilization;
(2010) lifetime history of rape (100% mental health professional, 48% saw a medical factors associated with
female) doctor, and 14% sought religious counsel; service use
no demographic characteristics (age, race/ethnicity,
year in school, income), rape history, or rape
characteristics were related to help seeking;
only PTSD was related to increased likelihood of
seeking help
Banyard et al. 633 Undergraduate students (64% 33% of men told no one and 15% of women told no Sexual assault Informal disclosure;
(2007) female; 36% male) one about their unwanted sexual contact, and a service utilization;
significant gender difference remained in knowledge of services
nondisclosure rates after controlling for drinking and
relationship involvement;
women were more likely to report knowing where
to get information or help for sexual assault, knowing
the location of rape crisis center and being willing to
use the rape crisis center than men if they
experienced an unwanted sexual experience;
women (5%) were more likely than men (1%) to have
ever used crisis center services; non-significant dif-
ference in levels of usage for counseling center (13%
women; 11% men)
(continued)
Table 1. (continued)

Barco and Reel 5 University key informants Sexual violence is generally addressed in Dating violence Service provision
(2011) programming while other forms of violence have not
been addressed;
funding was identified as a barrier to service
implementation;
campus community was rated as ‘‘in preparation’’ for
IPV services
Breitenbecher and 94 Students who completed Treatment (sexual assault education program) and Sexual assault Factors associated with
Scarce (2001) 7-month follow-up (100% female) control groups did not differ with respect to self- formal disclosure;
blame, disclosure to a friend or family member, or factors associated with
reporting of the assault to the police or campus informal disclosure;
security; factors associated with
no participants in the treatment and control groups service use
reported that they sought professional counseling or
crisis intervention related to an assault that occurred
during the follow-up period
Carmody et al. Focus group of 17 campus sexual Sexual assault crisis center advocates discussed areas Sexual assault Service provision
(2009) assault advocates for improvement including funding and a need to
increase education/awareness programs, offer more
services for international students, and have a
statewide coordinator for sexual assault and
prevention efforts of campuses
Edwards, Dardis, 44 College students reporting Approximately 75% of the sample disclosed to at Dating violence Formal disclosure;
and Gidycz dating violence of 107 students least one source, most often friends; informal disclosure;
(2012) (100% female) 5% told a counselor and 0% told a medical doctor, factors associated with
law enforcement or priest/minister; informal disclosure
disclosure related to greater levels of stress, greater barriers to informal
levels of partner blame, and thinking about ending the disclosure
relationship;
80% of women who did not disclose stated that it was
because the incident was ‘‘no big deal’’
Finkelson and 140 College students (100% female) None of the women who were date raped reported Sexual assault Formal disclosure;
Oswalt (1995) the rape; barriers to formal
victims did not report due to the belief that their disclosure
own actions would be judged negatively, feeling
embarrassed, feeling some personal responsibility for
the rape, and being under the influence of alcohol
(continued)
205
206
Fisher, Cullen, and 4,446 College students (100% Reports to police varied from 0% to 10% across the Sexual assault Formal disclosure;
Turner (1999) female) 12 types of sexual victimization measured; barriers to formal
primary reasons for not reporting rape to the police disclosure;
were not thinking it was serious enough, not wanting Informal disclosure
other people to know, and not being clear that a
crime or that harm was intended;
rates of disclosure to someone besides the police
about the incident ranged from 20% to 42% across
the 12 types of sexual victimization measured
Fisher, Daigle, 4,446 College students (100% 2% of incidents of sexual victimization were reported Sexual assault Formal disclosure;
Cullen, and female) to the police, 3% to campus authorities, and 70% to factors associated with
Turner (2003) someone else; formal disclosure;
primary reasons for not reporting to the police were barriers to formal
not thinking it was serious enough to report, not disclosure;
being sure that a crime or harm was intended, and informal disclosure;
thinking that the police would not think it was factors associated with
serious enough; informal disclosure
reporting to the police was associated with a threat
versus a sexual contact victimization, the presence of a
weapon, the victim considering the incident rape, a
stranger offender, the victim and offender being of
different ethnicities/ races, the victim being African
American, and the incident occurring on campus;
reporting to campus authorities was associated with
injury, the offender being a known other, lower
family class, the incident occurring on campus, and
the offender and the victim not taking drugs and/or
alcohol prior to the incident;
disclosing to someone other that the police or
campus authorities was associated with sexual
contact victimization versus a threat, injury, known
other offender, the offender and the victim taking
drugs and/or alcohol prior to the incident, and either
the offender or the victim taking drugs and/or
alcohol prior to the incident
Garcia, Lechner, 78 College students (49% female, Sexual violence-related sources (or lack thereof) was Sexual assault Suggestions for services
Frerich, Lust, and 51% male) mentioned by 60% of the participants;
Eisenberg (2012) the primary themes identified were sexual assaults
on campus, sexual violence culture on campus,
sexual violence matters to us, substance use and
sexual violence go hand in hand, provide us with
security, and educate us about sexual violence
(continued)

Gidycz and Koss 44 Group sexual assault victims and None of the victims assaulted by one perpetrator Sexual assault Factors associated with
(1990) 44 individual sexual assault victims sought crisis services or reported the incident to the formal disclosure;
(100% female) police while 19% of victims assaulted by more than factors associated with
one perpetrator sought crisis services and 17% of service utilization
them reported the incident to the police;
women assaulted by more than one perpetrator
were also more likely to seek therapy after the
assault (55%) in comparison to women assaulted by
one perpetrator (20%)
Guerette and 12 Women with history of 50% sought medical attention, 42% reported to law Sexual assault Formal disclosure;
Caron (2007) acquaintance rape in college enforcement, 42% sought help from counselor, 0% barriers to formal;
called a rape crisis hotline; disclosure
reasons for not seeking counseling included being in facilitators to formal
denial, having a large informal network, and thinking disclosure;
it was too late; informal disclosure;
reasons for seeking professional help included service utilization
encouragement from family and friends, knowing
what happened was wrong, and wanting to prevent
future date rapes;
100% disclosed to someone in support network,
generally a female friend and someone they have since
dated
Hayes-Smith and Websites of 60 universities 33% of university websites stated that they had some Sexual assault Service provision
Hayes-Smith form of women’s resource center;
(2009) 35% of universities had poor literature, 32% of
universities had basic literature, 17% had adequate
information, and 15% had excellent information
Hayes-Smith and 224 Undergraduate students 54% of students reported receiving sexual assault Sexual assault Knowledge of services;
Levett (2010) (61% female, 38% male) resource information and of these 39% reported suggestions for services
knowing where to get sexual assault information on
campus; no significant gender difference;
students knew about an average of four of nine
available resources; no significant gender difference;
receiving information was related to more
knowledge;
students most often suggested a full course for
distributing sexual assault information
(continued)
207
208

Holtfreter and 15 Service providers of a campus- Most service providers were satisfied with the Dating violence Service provision
Boyd (2006) based coordinated community current response to IPV on the college campus
response program for IPV though a few reported frustration with the existing
circumstances;
service providers reported a need for violence
prevention programs that address associated risk
factors (e.g., alcohol abuse) and more training and
availability of resources (e.g., additional/more
advanced training for staff and victim advocates)
Karjane, Fisher, and 1,001 administrators Sexual assault is defined differently across Sexual assault Service provision;
Cullen (2002) Sexual assault materials from 1,015 institutions; a third of sexual assault policies only barriers to services;
campuses mention the generic term sexual assault; policies;
8 campuses selected for field visits the percentage of institutions with written polices on judicial process
yielding an average of 15 interviews sexual assault varied according to the type of
per campus institution; details of the policies were reviewed such
Focus group with 9 campus safety as reporting procedures and whom to contact;
and law enforcement officers, 58% of institutions notify victims of available services
5 resident life administrators, and in published documentation;
50þ student mental health 42% of the schools provided sexual assault response
professionals training to students, 37.6% make training mandatory
Legislative review for officers, and 49% provided no training for faculty
and staff;
38% of campuses covered sexual assault issues in
their new student orientations;
29% of campuses had victim assistance services;
about 25% of campus administrators indicated they
provided victim-related support services to specific
student groups;
Reporting options across institutions include:
confidential reporting (84%), anonymous reporting
(46%), and third-party reporting (35%);
more than half (55%) of the institutions did not
include any statement about legal and disciplinary
options available in their sexual assault policies;
70% of institutions report having disciplinary
procedures or the like, although aspects of those
procedures vary greatly
(continued)

Kilpatrick, Resnick, 2,000 College students attending 4- 12% of those raped reported the incident to the Sexual assault Formal disclosure;
Ruggiero, year colleges and universities (100% police; reporting was associated with physical force, factors associated with
Conoscenti, and female) verbal threat, injury, perceived fear of death/injury, formal disclosure;
McCauley (2007) concern about family knowing, alcohol use, being too barriers to formal
high or drunk to control behavior, degree of disclosure;
memory, and rape acknowledgment; facilitators of formal
main reason for not reporting DAFR/IR was that it disclosure;
was unclear a crime or harm was intended; main service utilization;
reason for not reporting FR was not wanting others factors associated with
to know; informal disclosure;
main reason for reporting to police was to prevent suggestions for services
crimes against others;
public education and expanded counseling and
advocacy services would increase reporting,
according to participants;
19% of DAFR/IR incidents and 14% of FR incidents
resulted in medical care; 15% and 22% respectively
were followed by seeking help from a victim agency
Konradi (2003) 1,051 College students (65% female, Students exposed to more sexual assault service Sexual assault Advertisement of services
35% male) information were more knowledgeable about SANE
services, however men’s knowledge was lower than
women’s knowledge at Time 1
Koss (1998) 3,187 students asked about sexual 42% of women disclosed the assault to no one; Sexual assault Formal disclosure;
victimization (100% female) 5% of rape victims reported to the police and 5% informal disclosure;
visited a crisis center; service utilization
victims who disclosed to the police rated the
reactions of police officers as ‘‘not at all supportive’’;
victims who disclosed to family members and campus
agency workers rated both their reactions as
supportive
Krebs, Lindquist, 5,446 Undergraduate students 69% of FSA victims and 64% of ISA victims disclosed Sexual assault Formal disclosure;
Warner, Fisher, (100% female) the incident to family or friends; barriers to formal
and Martin significantly more FSA victims (16%) than ISA victims disclosure;
(2007) (8%) contacted a victim’s, crisis, or health care center informal disclosure
after the incident;
significantly more FSA victims (13%) reported the
incident to police or campus security than ISA
victims (2%);
the top reason for not reporting FSA incidents (56%)
and ISA incidents (67%) was not thinking it was
serious enough to report
(continued)
209
210
Krivoshey, Adkins, Websites of 105 colleges 66% of colleges had an online sexual assault policy Sexual assault Policies
Hayes, Nemeth, available;
and Klein (2013) 0.03% of colleges included the definition of all six
applicable sexual offenses in the Ohio Revised Code
listed on their website;
25% of colleges provided confidential reporting
options; 31% provided 24/7 reporting options; 13%
had a third-party option, and 1% allowed for anon-
ymous reporting
Lichty, Campbell, Case study for developing a Process included conducting an environmental scan Sexual assault; Service provision
and Schuiteman university response to sexual assault of current response services, performing a needs dating violence
(2008) and relationship violence assessment regarding gaps in current response,
prioritizing needs, and deciding which methods best
addressed those needs, and making
recommendations to administrators
Lindquist et al. 358 Undergraduate students Of students who experienced FSA, 69% told Sexual assault Formal disclosure;
(2013) attending HBCUs who were someone else, 14% contacted a victim’s, crisis, or informal disclosure;
sexually assaulted since entering health care facility, 10% reported it to law service utilization
college (100% female) enforcement (i.e., police or campus security), and
13% sought psychological counseling;
of students who experienced ISA, 56% told someone
else, 8% contacted a victim’s, crisis, or health care
facility, 3% reported it to law enforcement (i.e.,
police or campus security), and 4% sought
psychological counseling
Littleton (2010) 262 College rape victims, 74 of 83% disclosed to a friend, 56% disclosed to a Sexual assault Formal disclosure;
whom completed follow-up romantic partner, 32% disclosed to a relative; 16% informal disclosure;
6-months later (100% female) disclosed to a therapist/counselor, 11% disclosed to responses to informal
a health care provider, 6% disclosed to the police, disclosure
and other disclosures were infrequent;
median number of individuals disclosed to was three;
negative disclosure reactions were rare;
negative reactions were associated with PTSD
symptoms, disengagement coping, engagement
coping, and self-cognition longitudinally
Littleton, Axsom, 256 College students who Acknowledged victims (91%) were significantly more Sexual assault Informal disclosure
Breitkopf, and experienced unwanted sex likely to disclose their experience compared to
Berenson (2006) (100% female) unacknowledged victims (80%);
acknowledged victims reported receiving egocentric
reactions more often than unacknowledged victims
(continued)

Meilman, Hacker, 50 University counseling center 4% of on-call cases were sexual assaults, but sexual Sexual assault Service utilization
and Kraus- on-call visits assault situations took the most time (M ¼ 4.25 hrs)
Zeilmann (1993)
Nasta et al. (2005) 234 Undergraduate students (100% 97% reported being aware of any campus-based Sexual assault Service utilization;
female) resources and this did not significantly vary by sexual barriers to services;
assault history; knowledge of services
hypothetical use of campus based resources was high
(97%), but actual use was substantially lower (20%);
anticipated barriers to resource utilization included
concerns about confidentiality, issues of fear, and
embarrassment or guilt
Orchowski and 342 Undergraduate students who Of the women who reported experiencing some Sexual assault Informal disclosure;
Gidycz (2012) were assigned to control condition form of sexual victimization during the follow-up factors associated with
and completed follow-up session session, 55% disclosed this experience to someone, informal disclosure;
(100% female) generally to a female peer; responses to disclosure
female peers responded to disclosure of sexual
victimization over the follow-up with more emo-
tional support than other reactions;
controlling for history of sexual assault, victim
substance use, perpetrator substance use, coping via
emotional support, attachment to others, and a
tendency to disclose were associated with higher levels
of disclosure over the follow-up period; being highly
acquainted with the perpetrator was associated with
lower levels of disclosure over the follow-up period
Orchowski, Meyer, 300 Undergraduate college students In order from most to least, women perceived Sexual assault Formal disclosure;
and Gidycz (100% female) themselves to be likely to report sexual victimization factors associated with
(2009) on a survey, to friends, to the police, to the formal disclosure;
counseling center, and then to their resident advisor, informal disclosure;
regardless of history of sexual victimization; factors associated with
personal characteristics (i.e., self-efficacy, sexual informal disclosure
communication, self-protective behavior) and attri-
butions of blame (i.e., behavioral self-blame, and
characterological self-blame) were each correlated
with the likelihood to report;
college women with a history of moderate and
severe sexual victimization stated that they were less
likely to report sexual victimization to a friend, the
police, the counseling center, or a resident advisor
compared to college women without a history of
sexual victimization
(continued)
211
212

Orchowski, Untied, 374 Freshman college students in 75% discussed victimization with someone; Sexual assault Informal disclosure;
and Gidycz control group (100% female) social reactions to disclosure that attempted to responses to disclosure
(2013) control the survivor’s decisions were associated with
higher symptoms of posttraumatic stress,
depression, and anxiety as well as lower reassurance
of worth;
social reactions to disclosure that included victim
blame were associated with lower levels of self-
esteem and lower problem-focused coping
engagement
Ottenritter (2002) 406 Community college About 75% of participating colleges had written Sexual assault; Service provision;
administrators sexual assault policies and about 25% of colleges had dating violence policies
written domestic violence policies;
more than 75% of participating colleges said that it
was a priority to address sexual assault and domestic
violence through classes and presentations
Paul, Gray, Elhai, 229 Undergraduate students (83% Number disclosed to was associated with rape myth Sexual assault Factors associated with
and Davis (2009) female, 27% male) acceptance; informal disclosure
disclosure did not mediate the relationship between
peer rape myth acceptance and PTSD symptoms
Payne (2008) 5 Focus group interviews (32 Campus advocates discussed collaboration issues Sexual assault Service provision
community-based advocates and 17 with sexual assault centers, law enforcement,
college advocates) administration, and faculty and staff;
campus advocates reported collaboration issues
regarding working with campus police;
campus advocates also work with other groups to
prevent and respond to sexual assault, as many
advocates state that victims often disclose to faculty
first
Payne, Ekhomu, and 5 Focus group interviews (32 Campus and community advocates both work with Sexual assault Service provision;
Carmody (2009) community-based advocates and 17 victims to cope with sexual assault, navigate the barriers
college advocates) criminal justice process, and seek services;
campus sexual assault advocates state that barriers
included the demographic and sociocultural makeup
of college students (i.e., age and a culture of sex,
drugs, and alcohol use), the transient nature of
student population, and competition for funding
(continued)

Próspero and 200 Undergraduate college students 42% of participants stated that they would talk to Dating violence Informal disclosure;
Vohra-Gupta (69% female, 31% male) friends/family about emotions and mental health; service utilization;
(2008) 16% of IPV victims reported using mental health factors associated with
services; service utilization;
barriers to seeking mental health services included barriers to service
being too embarrassed to use a mental health utilization
professional, services being too expensive, thinking
that services would not help, and believing they
would be viewed as crazy for utilizing mental health
services;
participants who experienced physical and
psychological IPV, but not sexual IPV, were more
likely to have utilized mental health services
Sable, Danis, Mauzy, 215 First-year college students (55% Shame, guilt, and embarrassment, fear of retaliation, Sexual assault Barriers for formal
and Gallagher female, 45% male) confidentiality concerns, fear of being judged as gay disclosure
(2006) (for men), and fear of not being believed were the
barriers rated as most important;
ratings of importance for barriers differed by gender
Tamborra and 114 College students (49% female, If raped or sexually assaulted, 60% of the total sample Sexual assault Formal disclosure;
Narchet (2011) 47% male), 30 of who experienced of students agreed that they would feel comfortable service utilization
nonconsensual sexual interactions contacting campus police, 80% agreed that they
would feel comfortable contacting the campus
counseling center, and 33% agreed that they would
feel comfortable contacting residential life;
however, of those who experienced sexually
aggressive experiences, none reported it to any
campus service or utilized services
Thompson, Sitterle, 492 Undergraduate college students The most common reason not to report sexual and Sexual assault; Factors associated with
Clay, and (100% female) physical victimization was the belief that it was not physical assault formal disclosure;
Kingree (2007) serious enough; barriers to formal
reasons for not reporting victimizations to police disclosure
differed for sexual and physical victimizations;
reasons for not reporting sexual victimizations varied
by victim’s race, location of incident, and severity of
victimization;
reasons for not reporting physical victimizations
varied by substance use at the time of the incident,
victim-offender relationship, offender substance use
at the time of the incident, location of incident, and
severity of victimization
(continued)
213
214

Tiefenthaler, 3,142 Counties Regression analyses showed that the presence of a Dating violence Service provision
Farmer, and top-ranked college/university within a county was a
Sambira (2005) significant predictor of the number of domestic vio-
lence programs in the county
National Institute of 238 Police departments including 12 100% of university participants stated that special Sexual assault Service provision
Law university police agencies with 60þ medical services were available for rape victims in
Enforcement and police employees their jurisdiction;
Criminal Justice 91% of university jurisdictions provided counseling
(1977) services for rape victims;
46% of university jurisdictions had special rape
investigation units
Walsh, Banyard, 1,230 College students (61% female; Men (44%) were less likely to disclose USC than Sexual assault Informal disclosure;
Moynihan, Ward, 39% male) women (79%); disclosures were generally to close service utilization;
and Cohen friends; barriers to services;
(2010) 41% of USI victims told someone; knowledge of services
there was no association between characteristics of
USC (where it had occurred, when, who had been
involved, or whether alcohol/drugs had been used)
and disclosure;
97% of USC victims did not use services and 94% of
USI victims did not use services;
the top reason for not using services among USC
victims was that they didn’t think the incident was
serious; the top reasons for not using services among
victims of USI was that they felt it was a private
matter;
women were more likely to know where the sexual
assault center was located (50%) and to say they
would be very likely (21%) to use the center than
men (40% and 10%, respectively)
(continued)

Wolitzky-Taylor 2,000 College students (100% 12% of women who experienced rape reported it to Sexual assault Formal disclosure;
et al. (2011) female) law enforcement officials; factors associated with
19% of victims received medical attention, and 18% formal disclosure
sought help or advice from an agency that provides
aid to victims of crime;
reporting to the police was associated with medical
attention and victim assistance from an agency;
reports to law enforcement was associated with
being Caucasian, being raped prior to the age of 10,
peritraumatic fear, injury, and being forcibly raped;
in a multivariate model only being Caucasian and
having an injury as a result of the rape were
associated with reporting to law enforcement
Wu, Button, 561 Chinese students from Beijing U.S. students were more supportive of law Dating violence Factors associated with
Smolter, and and Hong Kong and 531 U.S. enforcement and social services interventions than service utilization
Poteyeva (2013) students from Detroit, MI and Chinese students;
Newark, DE support for law enforcement intervention in the
United States was related to seeing IPV as a crime
and supporting a pro-arrest policy;
support for social service intervention in the United
States was related to being female, supporting pro-
arrest policies, seeing IPV as caused by alcohol and
drugs, low levels of tolerance for IPV, and knowing
domestic violence victims
Note. HBCU ¼ historically Black colleges and university; PTSD ¼ posttraumatic stress disorder; IPV ¼ intimate partner violence; DAFR/IR ¼ drug and alcohol-facilitated rape and incapacitated rape; FR ¼ forcible rape;
SANE ¼ sexual assault nurse examiner; ISA ¼ incapacitated sexual assault; FSA ¼ forced sexual assault; USC ¼ unwanted sexual contact; USI ¼ unwanted sexual intercourse.
215
of self-efficacy, being able to have open sexual communica- to control their lives, connotations of labeling oneself a victim,
tion, and being concerned about family members knowing confidentiality issues, and a potential lack of evidence, all work
about the assault (Fisher et al., 2003; Kilpatrick et al., 2007; together to reduce the likelihood of reporting (Karjane et al.,
Orchowski et al., 2009). Also, victims who reported to the 2002).
police indicated the main reason for doing so was to prevent While most studies reported frequencies only, those that
crimes against others (Kilpatrick et al., 2007). Characteristics tested for differences in reasons for not reporting to the police
of the victim associated with lower levels of formal disclosure found that reasons varied by type of sexual assault, victim race,
included attributions of blame for rapes centered on the vic- location of incident, and severity (Krebs et al., 2007; Thomp-
tim’s behavior or character (Orchowski et al., 2009). Sexual son et al., 2007). For example, severe victimizations were asso-
assault education appeared to be unrelated to reporting to the ciated with not reporting the sexual assault because the police
police or campus security (Breitenbecher & Scarce, 2001). would believe it is the victim’s fault, shame and embarrass-
Some studies offered conflicting associations between victim ment, and not wanting others to know about the incident com-
characteristics and reporting to the police. For example, the pared to less severe victimizations (Thompson et al., 2007).
NCWSV study (Fisher et al., 2003) found that assaults against Further, not wanting anyone to know was more common
African American women were more likely to be reported among forced sexual assault victims (42%) than victims of
to the police, while another large-scale study found sexual incapacitated sexual assault (29%; Krebs et al., 2007). Ratings
assaults against Caucasian women were more likely to be of perceived barriers also varied by gender such that some bar-
reported to the police (Wolitzky-Taylor et al., 2011). More- riers (e.g., fear of retaliation, financial dependence, and lack of
over, one study found a negative association between a previ- resources) were rated as more important among women, and
ous victimization history and likelihood to report (Orchowski others (e.g., shame, concerns about confidentiality, and fear
et al., 2009), but another found a nonsignificant association of not being believed) were rated as more important among
(Wolitzky-Taylor et al., 2011). men (Sable et al., 2006). Moreover, reasons for not reporting
Offender characteristics associated with the incident being physical assaults varied from reasons for not reporting sexual
reported to police included being of a different race/ethnicity assaults. For example, shame and embarrassment was not one
than the victim, multiple offenders versus a single offender, and of the top five reasons for reporting physical assaults, but it
being a stranger (Fisher et al., 2003; Gidycz & Koss, 1990), in the top five for sexual assault. Reasons for not reporting
although another study found a nonsignificant association physical assaults varied by alcohol use (e.g., being scared of the
between a stranger offender and reporting the incident to the offender was associated with alcohol use at time of incident),
police (Wolitzky-Taylor et al., 2011). It is important to note that relationship to offender (e.g., not wanting anyone to know was
most studies focused on bivariate relationships between report- associated with being physically assaulted by an intimate),
ing and related variables. Only two studies that examined report- location (e.g., thinking the incident was not serious enough was
ing to police postassault tested multivariate models (Fisher et al., associated with being victimized off-campus), and severity
2003; Wolitzky-Taylor et al., 2011). (e.g., shame and embarrassment were associated with severe
victimizations; Thompson et al., 2007).
Barriers to Reporting to the Police
Facilitators to Reporting to the Police
Across several studies, the assault not being serious enough
was the top reason endorsed by victims to explain why the inci- One study (Krebs et al., 2007) asked participants what would
dent was not reported to the police (Fisher et al., 2003; Krebs increase willingness to report to the police. The main facilitators
et al., 2007; Thompson et al., 2007). Other reasons that were that were identified included public education about acquain-
included in the top three reasons for not reporting a sexual tance rape, expansion of counseling and advocacy services, free
assault to the police were being unclear that it was crime or that health services (e.g., pregnancy counseling if the rape victim
harm was intended, not having proof the incident occurred, becomes impregnated, HIV/AIDS testing), and laws around pro-
not wanting others/family to know, not wanting the police tection of confidentiality. Karjane, Fisher, and Cullen (2002)
involved, believing that the police would not think it was seri- also assessed facilitators of students’ disclosure according to col-
ous enough, fear of reprisal, and the victim thinking she was lege officials. The administrators indicated that on-campus vic-
partially or fully responsible (for incapacitated sexual assault tim assistance offices, campus law enforcement protocols, a
and date rape; Finkelson & Oswalt, 1995; Fisher et al., 2003; confidential reporting option, and coordinated crisis responses
Kilpatrick et al., 2007; Krebs et al., 2007; Thompson et al., across campuses and communities, would facilitate reporting
2007). A study of perceived barriers also included similar rea- of sexual assault.
sons, except that shame and embarrassment were the top rated
barriers (Sable, Danis, Mauzy, & Gallagher, 2006). School
officials shared their own perspectives on barriers to reporting.
Informal Disclosure
First, students who are newly independent may feel a sexual Studies of informal disclosure focused on rates of informal
assault is a failure in their efforts to protect themselves (Kar- disclosure, chosen confidants for disclosure, factors associated
jane et al., 2002). Additionally, traumatic responses, a desire with informal disclosure, and responses to disclosure (see
Sabina and Ho 217
Table 1). Three studies focused on informal disclosure of dat- men (67%; Banyard et al., 2007), those who acknowledged
ing violence (Amar & Gennaro, 2005; Edwards et al., 2012; their unwanted experience as a victimization (91%) tended to
Próspero & Vohra-Gupta, 2008), and the remainder focused disclosure more frequently than those who do not acknowledge
on sexual assault. the incident as a victimization (80%; Littleton et al., 2006), and
those with higher levels of rape myth acceptance disclosed to
more people than those with lower levels of rape myth acc-
Rates and Characteristics of Informal Disclosure eptance (Paul, Gray, Elhai, & Davis, 2009). Dating violence
Rates of informal disclosure ranged from 41% for victims of victims were more likely to informally disclose when they
unwanted sexual intercourse (Walsh et al., 2010) to 100% of placed blame on themselves and their partners for the violence,
a convenience sample recruited for a study about sexual assault exhibited high levels of stress, and thought about ending the
(Guerette & Caron, 2007). While estimates of informal dis- relationship (Edwards et al., 2012). Additionally, a past history
closure of sexual assault and dating violence were generally of sexual victimization appeared to restrict future disclosures
high (65% or above; Banyard, Ward, Cohn, & Plante, 2007; of sexual violence (Orchowski & Gidycz, 2012; Orchowski
Edwards et al., 2012; Fisher et al., 2003; Krebs et al., 2007; et al., 2009). Personal characteristics positively associated
Lindquist et al., 2013; Littleton, 2010; Littleton, Axsom, Breit- with informal disclosure of sexual assault included coping via
kopf, & Berenson, 2006; Orchowski, Untied, & Gidycz, 2013; emotional support, attachment to others, and a tendency to dis-
Walsh et al., 2010), lower rates of disclosure were found in close events in a study of actual disclosure (Orchowski &
some samples. Two possible factors accounting for the lower Gidycz, 2012) and self-efficacy, ability to openly communi-
rates are inclusion of men in the sample (Walsh et al., 2010) cate about sexual matters, and engaging in self-protective
and short reference periods (e.g., less than a year; Orchowski behaviors in a study measuring hypothetical disclosure (Orch-
& Gidycz, 2012; Walsh et al., 2010). Across all studies that owski et al., 2009). However, self-blame regarding behaviors
asked who the victim disclosed to, friends, especially female in a hypothetical event was associated with not disclosing
friends, were the primary confidants for sexual assault and dat- informally (Orchowski et al., 2009). Both offender and victim
ing violence victims (Amar & Gennaro, 2005; Edwards et al., substance use prior to the sexual violence incident were asso-
2012; Fisher et al., 2003; Guerette & Caron, 2007; Littleton, ciated with informal disclosure (Fisher et al., 2003; Orchowski
2010; Orchowski & Gidycz, 2012; Walsh et al., 2010). Studies & Gidycz, 2012), in contrast to the findings for formal disclo-
that measured hypothetical disclosure also found friends were sure that showed the opposite relation. With regard to the rela-
the most likely confidants. (Orchowski et al., 2009; Próspero tionship between victim and offender, Fisher et al. (2003)
& Vohra-Gupta, 2008). Family members were told about the found that informal disclosure was highest for known others
incident substantially less often than friends (Fisher et al., (e.g., professors, teachers, graduate assistants, teaching assis-
2003; Orchowski & Gidycz, 2012). Some women disclosed tants, employers, supervisors, bosses, coworkers, stepfathers,
their sexual victimization directly after it occurred, but others and other male relatives), and Orchowski and Gidycz (2012)
disclosed up to two years later (Guerette & Caron, 2007; Orch- found that as level of acquaintance with the perpetrator
owski & Gidycz, 2012). The median number of people dis- increased, informal disclosure decreased.
closed to was three (Littleton et al., 2006). One study examined barriers to informal disclosure of dat-
ing violence. Edwards, Dardis, and Gidycz (2012) probed
women who experienced dating violence in their relationships
Factors Associated With Informal Disclosure but did not disclose to anyone. The majority of these women
Research on factors associated with disclosing victimization to (80%) felt that the behaviors in their relationship were ‘‘no big
friends, family members, and other sources of support tended to deal.’’ Additionally, some women felt no one would understand
focus on differences between groups, with only a few studies (10%) or were worried about reactions if they told (20%;
using multivariate models (Fisher et al., 1999; Orchowski & Edwards et al., 2012).
Gidycz, 2012). These factors pertain to the incident (e.g.,
severity, type of victimization), victim characteristics (e.g.,
gender, victimization history, acknowledgment of victimiza-
Responses to Informal Disclosure
tion, substance use, coping methods, attachment, rape myth A few studies examined reactions to disclosures and how these
acceptance), and offender characteristics (e.g., relationship to responses were related with the psychological functioning of
victim, substance use). With regard to the type of victimization, victims (Edwards et al., 2012; Littleton, 2010; Orchowski &
while rape and sexual coercion were not associated with infor- Gidycz, 2012; Orchowski et al., 2013). Negative reactions to
mal disclosure in logit models, sexual contact was positively sexual assault disclosure were received rarely to very rarely
associated with informal disclosure when compared with and female peers often responded with emotional support (Lit-
threats (Fisher et al., 2003). Injury was also associated with tleton, 2010; Orchowski & Gidycz, 2012). A mixed methods
informal disclosure (Fisher et al., 2003), indicating that more study on dating violence disclosures (Edwards et al., 2012)
severe sexual victimizations are disclosed more often than less found that disclosures were viewed as helpful by victims if good
severe sexual victimizations. Findings related to victim charac- advice was gained, it was an opportunity to vent, and emotional
teristics showed that women (85%) disclosed more often than support was offered. However, reactions to disclosures were
viewed as negative when the confidant gave bad advice, told the incident level, 18.7% of those raped in their lifetime sought
victim to end the relationship, did not understand, or joked about medical attention after their rape (Wolitzky-Taylor et al.,
the incident. Negative reactions to sexual violence disclosure 2011). With regard to dating violence, rates of service utiliza-
were associated with poorer psychological functioning (Little- tion appear to be similar, as 16% talked to mental health profes-
ton, 2010; Orchowski et al., 2013). Negative reactions could sionals (Próspero & Vohra-Gupta, 2008) and 40% of injured
include controlling the decisions of victims, which was associ- women sought health care (Amar & Gennaro, 2005).
ated with posttraumatic stress symptoms, depressive symptoms, Studies also measured other forms of service utilization such
and anxiety; and blaming the victim, which was associated with as victim services (Kilpatrick et al., 2007), crisis centers (Ban-
poor self-esteem and lower levels of reassurance of worth in yard et al., 2007; Gidycz & Koss, 1990; Koss, 1998), religious
multivariate models (Orchowski et al., 2013). Studies examin- counsel (Amstadter et al., 2010), hotlines (Guerette & Caron,
ing informal disclosure reactions and psychological functioning 2007), court (Guerette & Caron, 2007), restraining orders (Lind-
for dating violence are not currently available. quist et al., 2013), filing a campus grievance (Lindquist et al.,
2013), women’s centers, and student life (Nasta et al., 2005). The
most common of these was victim service utilization by women
Service Utilization, Knowledge of Services, who were raped in their lifetime (14.7% of drug and alcohol
and Perception of Services facilitated rapes/incapacitated rape victims and 21.6% of forci-
Studies regarding service use probed topics such as rates of ble rape victims; Kilpatrick et al., 2007). Also relevant to the
utilization and associated factors, barriers and facilitators of review, 4.3% of victims of forced rape since entering college
service utilization, knowledge of services and associated fac- filed a grievance with university officials, but none of the inca-
tors, perception of services and suggestions for services (see pacitated rape victims did so (Lindquist et al., 2013). Finally, 0%
Table 1). Three studies examined dating violence (Amar & of sexual assault victims within the academic year used a
Gennaro, 2005; Próspero & Vohra-Gupta, 2008; Wu et al., women’s center and only 3% utilized student life deans (Nasta
2013) and the remainder focused on sexual assault. et al., 2005). It is important to note that when students were
asked whether they would use services, almost 100% respond
affirmatively (Nasta et al., 2005); however, the reality is that few
Rates of Service Use college victims actually utilize campus or other services.
Rates of service utilization varied by type of service and refer-
ence period for the victimization. Data from one study showed
that 52% of rape victims sought help from professionals (e.g.,
Factors Associated With Service Utilization
medical doctor, priest, minister or rabbi, lawyer, psychiatrist, Types of service use may be related to each other as reporting to
psychologist, social worker, or other therapist) in their lifetime the police was associated with receiving medical attention and
for emotional problems (Amstadter et al., 2010). Two studies victim services (Wolitzky-Taylor et al., 2011), thus indicating
showed that the use of services for victimizations that had that some victimizations may require multiple help seeking
occurred within the past year was substantially lower. Nasta efforts. However, one of the few studies that investigated factors
et al. (2005) found that 20% of sexual assault victims used any related to service utilization found no significant associations
on-campus service and 6% used any off-campus service for between individual-level and incident-level characteristics and
sexual assault–related help. Walsh et al. (2010) found that 3% service use (Amstadter et al., 2010). The only variable associated
and 6% of victims of unwanted sexual contact and unwanted with service use was posttraumatic stress disorder symptoms
sexual intercourse used any service, respectively. (Amstadter et al., 2010), pointing to distress motivating service
With regard to specific types of service utilization, physical use. Nonetheless, Banyard, Ward, Cohn, and Plante (2007)
and mental health services appeared to be the most utilized, documented that women were significantly more likely to use
according to research findings. Over 90% of those who sought a crisis center for unwanted sexual experiences than men, and
professional services in Amstadter and colleagues’ (2010) Gidycz and Koss (1990) found heightened rates of therapy use
study sought help from a mental health professional. In other among those assaulted by a group, as opposed to one individual.
studies, 42% of victims of sexual assault during college went The one study on dating violence service use indicated that phys-
to a counselor (Guerette & Caron, 2007); 13.2% of those who ical and psychological dating violence were associated with
were sexually assaulted by force since entering college and mental health services but not sexual dating violence (Próspero
4.4% of those who were sexually assaulted while incapacitated & Vohra-Gupta, 2008). Finally, the study by Wu and colleagues
since entering college sought psychological counseling (Lind- (2013) indicated that U.S. students were more supportive of law
quist et al., 2013); and 8% of those sexually victimized in the enforcement and social service intervention in cases of domestic
academic year used psychological services (Nasta et al., violence than Chinese students.
2005). Medical services were utilized by 12% of those sexually
victimized in the academic year (Nasta et al., 2005); 50% of
women who experienced sexual assault in college (Guerette
Knowledge of Services
& Caron, 2007); and 48% of rape victims who used profes- Unfortunately, studies regarding knowledge of services do not
sional services in their lifetime (Amstadter et al., 2010). At the show a substantial level of knowledge about campus services
Sabina and Ho 219
among students. While students, especially female students, brought up issues of sexual violence and wanted services that
tended to know where to get information (Banyard et al., were easily accessible. One student explained how even though
2007), only about 40% knew where the crisis center was located services are available, they are not central to the functioning of
(Banyard et al., 2007; Walsh et al., 2010). On another campus, the campus:
40% knew where to get information about sexual assault and
only 7% agreed with the statement, ‘‘I know where to go to . . . especially the rape thing, because a month ago we had three
receive help if I or someone I know were sexually assaulted at girls raped in the [fraternity house part of campus], so if you had
[the university]’’ (Hayes-Smith & Levett, 2010). Studies show resources for students who happen to get sexually assaulted that
mixed relationships between gender and knowledge of services would be nice because they’re kind of hidden around here.
(e.g., nonsignificant difference and women are more knowledge- (Garcia et al., 2012, p. 65)
able about services) as well as sexual assault history and knowl-
edge of services (e.g., victims are more and less aware of Students also made suggestions such as safety lights, security
services than nonvictims; Hayes-Smith & Levett, 2010; Nasta officers and escorts, orientation programs, awareness events,
et al., 2005; Walsh et al., 2010). There were no studies examin- and improved print and online material (Garcia et al., 2012).
ing the knowledge of dating violence services on campuses.
Service Provision, Policies, and Campus
Barriers and Facilitators of Service Utilization Judicial Processes
Only shame and embarrassment were mentioned in all studies
Research in this area has been varied focusing on service
examining barriers to service utilization (Guerette & Caron,
provision, including a number of topics such as development of
2007; Nasta et al., 2005; Walsh et al., 2010). Other top barriers
services, perceptions of services, types of services, and sugges-
were feeling that it was a private matter, thinking it was not seri-
tions for services; policies, including enumeration of polices and
ous, concerns around confidentiality, fear, not wanting to deal
components; and the campus judicial process (see Table 1). Stud-
with it, and denial (Guerette & Caron, 2007; Nasta et al., 2005;
ies included dating violence (Barco & Reel, 2011; Holtfreter
Walsh et al., 2010). Barriers appear to be more prominent in
& Boyd, 2006; Tiefenthaler, Farmer, & Sambira, 2005), sexual
cases of unwanted intercourse, as opposed to unwanted sexual
assault (Carmody, Ekhomu, & Payne, 2009; Hayes-Smith &
contact (Walsh et al., 2010). A participant in a qualitative study
Hayes-Smith, 2009; Karjane et al., 2002; Konradi, 2003;
shared the varied reasons she did not seek services:
Krivoshey, Adkins, Hayes, Nemeth, & Klein, 2013; National
Institute of Law Enforcement and Criminal Justice, 1977; Payne,
I didn’t want to be labeled as a victim. I weighed telling versus
the implications on all the other parts of my life: the reactions of 2008; Payne, Ekhomu, & Carmody, 2009), and both dating vio-
my family, the fact that I was accusing someone in my imme- lence and sexual assault (Lichty et al., 2008; Ottenritter, 2002).
diate circle of acquaintances of rape, the pity I would be sure to
receive. I also knew that people would be forced to pick sides Service Provision
between me and the rapist, and I didn’t want that. Basically
Services researched in the literature include direct services for
everything in my life besides this was going really great, and
I decided that it wasn’t worth risking all of that to confess or sexual assault and dating violence victims (Karjane et al., 2002;
to seek legal action. (Guerette & Caron, 2007, p. 39) National Institute of Law Enforcement and Criminal Justice,
1977; Payne et al., 2009; Tiefenthaler et al., 2005); communi-
The same study queried facilitators for service utilization cations about services, including websites (Hayes-Smith &
and found encouragement from friends and family, knowing Hayes-Smith, 2009), training (Karjane et al., 2002), and classes
what happened was wrong, and wanting to prevent the incident (Ottenritter, 2002); and the process of providing services (e.g.,
from happening to someone else all helped women get help for development, collaboration, barriers; Barco & Reel, 2011;
their sexual assault victimization (Guerette & Caron, 2007). Holtfreter & Boyd, 2006; Lichty et al., 2008; Payne, 2008).
With regard to dating violence, one study found that embarrass- With regard to direct services, large campus police departments
ment, thinking services would not help, and people’s percep- reported in the mid-1970s that health services (100%) and
tions (e.g., people would think the participant was crazy) counseling services (91%) were largely available to rape vic-
hindered mental health service use among dating violence victims, which was not the case for other types of police depart-
tims (Próspero & Vohra-Gupta, 2008). ments (National Institute of Law Enforcement and Criminal
Justice, 1977). This indicated that campuses are resource rich
in comparison to other localities. A study in 2005 corroborated
Suggestions for Services this trend for domestic violence by reporting that the existence
Most students supported a full course, a campus event, student of a top-ranked college or university in a county was a signif-
orientation, and informative publications as ways of distribut- icant predictor of a domestic violence program in that county
ing information about sexual assault (Hayes-Smith & Levett, (Tiefenthaler et al., 2005). This, however, does not mean that
2010). A qualitative study queried students about campus sex- all universities have myriad resources for dating violence and
ual resources generally and found that students repeatedly sexual assault.
Indeed, available estimates indicated that 20% of colleges of vulnerable situations, further improvement is possible
have a women’s resource facility (Hayes-Smith & Hayes- (Holtfreter & Boyd, 2006).
Smith, 2009) and 29% had victim assistance services (Karjane Structural barriers reported by campus-based advocates
et al., 2002). Sexual assault policies indicated that 58% of cam- include competition for funding and a young, transient popula-
puses notified students of services, mostly counseling and cam- tion that is embedded in a sexualized culture punctuated with
pus police (Karjane et al., 2002), but this number dropped to drug and alcohol use (Payne et al., 2009). Suggestions for
less than 40% when limited to 2-year institutions, historically improvement consistently included more funding and resources
Black colleges and universities (HBCUs), and Native Ameri- and more awareness of violence issues (Barco & Reel, 2011;
can colleges and universities, indicating that these services are Carmody et al., 2009; Holtfreter & Boyd, 2006). Other sugges-
likely not available at some institutions. Moreover, only about tions for improving services included statewide coordination of
25% of campus administrators (Karjane et al., 2002) indicated sexual assault services, better services for international students,
they provided victim-related support services to specific stu- assessment of needs, promotion of victim advocate programs,
dent groups. Studies have not enumerated the services avail- and information sharing and research (Carmody et al., 2009;
able for dating violence on campus, but a needs assessment Holtfreter & Boyd, 2006).
of a university that applied the community readiness model
found that the university was best identified as ‘‘in prepara-
tion’’ for dating violence services, as most of their efforts had
Policies
been directed to sexual assault (Barco & Reel, 2011). The first finding of note with regard to policies is that not all
Communication about services and how to respond to sexual campuses have written polices for sexual assault and dating
assault may occur through websites, posters, classes, or train- violence. Among community colleges, 25% had a written pol-
ings. However, a study of 60 websites (Hayes-Smith & icy on domestic violence and 75% had a written policy on sex-
Hayes-Smith, 2009) found many websites were poor and only ual assault (Ottenritter, 2002). In another study, only 66% of
15% were excellent with regard to sexual assault information. colleges had publically available sexual assault policies (Kri-
On one hand, poor websites had no information, perpetuated voshey et al., 2013). Karjane and colleagues’ large-scale study
victim-blaming attitudes, narrowly focused on vaginal–penile (Karjane et al., 2002) was able to examine sexual assault poli-
rape, or told female students what to do to not get raped cies in detail. Half of the polices included specific goals (such
(e.g., don’t drink). Excellent websites, on the other hand, con- as no tolerance, having a campus free from violence) and half
tained detailed and victim-friendly information and identified did not (Karjane et al., 2002), missing an important opportunity
programs on campus for sexual assault. Another modality of to send a signal to the campus community. Another basic
advertising services included posters and they have been found aspect of sexual assault policies is explicating what is meant
to increase students’ knowledge of sexual assault nurse exam- by sexual assault. However, a third of sexual assault policies
iners as a resource (Konradi, 2003). Courses are another way to only mentioned the generic term sexual assault or sexual
deliver information about services and 78% of community col- offense, and the remainder mentioned specific types of sexual
leges identified sexual assault and 75% identified dating vio- assault, most commonly penile–vaginal rape (93.4%), possibly
lence as an important topic to address in class (Ottenritter, leading to confusion among those anally, orally, or digitally
2002). Other methods were shown not to be as popular. Slightly raped. About 70% of policies indicated whom to contact after
more than 35% of campuses covered sexual assault in their new an assault, leaving 30% of the campuses uninformed about
student orientations and 42% of schools provided sexual assault whom to contact. According to campus administrators, confi-
response training to students (Karjane et al., 2002). dential reporting was offered in 84% of colleges, anonymous
With regard to the process of service development and reporting in 46% of colleges, and third-party reporting in
delivery, Lichty, Campbell, and Schuiteman (2008) explicated 35% of colleges (Karjane et al., 2002). Another study found
an inclusive way of determining what services are already somewhat lower rates for these options, but also found that only
available, what services are needed, and how these could be 38% of Ohio colleges allowed 24/7 reporting (Krivoshey et al.,
prioritized into a university-wide response. Indeed, successful 2013). This is an important service given that these crimes tend
collaboration is an important part of service provision for vic- to occur after hours.
tims. Collaborations between sexual assault crisis centers,
police, administration, faculty, and staff included both many
accomplishments and tensions (Payne, 2008). For example,
Judicial Processes
although local police are involved with victimizations on Although filing a grievance with judicial affairs is an important
campus, they may not be equipped to handle situations of option for victims of dating violence and sexual assault, only one
incapacitated rape. Also, while faculty and staff may be sup- study examined this. Karjane and colleagues (Karjane et al.,
portive of efforts for victims, they may not know the regula- 2002) offered the following insights into the campus judicial sys-
tions universities must follow (Payne, 2008). Similar tensions tem. First, more than half of the sexual assault policies did not
were reported in a qualitative study of a campus-coordinated mention legal or disciplinary options, limiting the amount of
response for dating violence—that is, while advances have information victims have access to (Karjane et al., 2002). About
been made, including police involvement and understanding 70% of schools had disciplinary procedures for sexual assault
Sabina and Ho 221
and of those, half had a written description of the hearing pro- process have not been researched. For example, what influences
cess, 58% had a process to file a written complaint, 51% dis- college students’ understanding of their victimization experience
closed the composition of the judicial hearing board, 53% as violence? What meaning do victims give to their victimization
notified the complainant of procedures and/or outcomes, 46% experience and how does this influence behavioral decisions?
provided a written description of the hearing process (e.g., hav- How is awareness of the problem then translated into a decision
ing others present, evidence, testimony cross examination), and to seek assistance/disclose? How does one go about choosing
22% indicated the burden of proof used in the hearings. Given from viable alternatives for assistance? How do interpersonal and
these percentages, it is likely that many victims who may file sociocultural factors shape each of these processes? How do deci-
a grievance are not given information on what to expect. sions at each of these stages influence each other? The current
body of work is unable to answer these questions. Another limita-
tion in the current research that hinders understanding is relying
Implications for Research, Practice, on one victimization (e.g., the most severe) for follow-up ques-
and Policy tions. This skews the victimization experiences to the most severe
and thus responses to other victimizations are unknown. While a
Refining Measurement person may have a general proclivity to help seeking, the subtle
The review of extant research on formal disclosure, informal nuances between their victimization experiences and how they
disclosure, and service utilization revealed vast diversity in oper- responded are missed when only one victimization experience
ationalization and measurement of central concepts, distracting is asked about in detail. Intrapersonal variation in responses to
from the ability to make precise statements about these concepts. dating violence and sexual assault could also be informative.
One of the first sources of variation is the time period used to
assess for victimization. The time period used in studies include
Understanding the Outcomes of Disclosure
in the current relationship (Edwards et al., 2012), since the
beginning of the year (Banyard et al., 2007; Breitenbecher &
and Service Utilization
Scarce, 2001; Fisher et al., 1999; Walsh et al., 2010), during a A focus on dichotomous conceptualization of disclosure and
follow-up period (Breitenbecher & Scarce, 2001; Littleton, help seeking also excludes outcomes. Studies included in this
2010; Orchowski & Gidycz, 2012), in the past year (Amar & review provided limited insight into the aftermath of disclosure
Gennaro, 2005; Próspero & Vohra-Gupta, 2008), since attending and service utilization. While some studies included responses to
college (Krebs et al., 2007; Lindquist et al., 2013; Thompson informal disclosure, this was focused on understanding how pos-
et al., 2007), while in college (Finkelson & Oswalt, 1995; Guer- itive and negative reactions affect psychological functioning
ette & Caron, 2007), over the past 5 years (Paul et al., 2009), (Edwards et al., 2012; Littleton, 2010; Orchowski & Gidycz,
since the age of 14 (Koss, 1998; Littleton et al., 2006; Orchowski 2012; Orchowski et al., 2013). However, questions regarding the
et al., 2013), and lifetime (Kilpatrick et al., 2007). Such varied utility of disclosure and/or service use for deterring future vio-
time periods likely affects the constructs of interest as those fur- lence and coping with the aftermath of violence were not asked.
ther from the victimization had more time to process and dis- That is, it is unknown how effective these efforts were. Asking
close the victimization, possibly yielding higher disclosure about satisfaction is not sufficient for understanding how lives
rates in those studies. Another source of variation was the way are reconstructed after severe violence. These are especially
in which disclosure was queried. While most studies asked this important questions for services such as counseling, crisis cen-
as a yes/no question, there was little precision and uniformity in ters, and health centers. In what ways is service utilization help-
aspects such as who reported it and to whom it was reported. ful for victims? How can services be tailored to be responsive to
Most studies designed their own questions for disclosure and ser- college students’ needs? Such evaluative questions were largely
vice utilization, detracting from comparisons across studies and missing from the extant research. Further, it is important to
mudding understanding of these concepts. Research in this field include the viewpoints of students in improving services, as few
would be largely advanced through the development of a com- studies queried their perspectives on services.
prehensive measure of disclosure and service utilization.
Accounting for Diversity
Expanding the Research on Disclosure
The studies in this review have largely relied on White, hetero-
and Service Utilization sexual, female samples. White women are not as common on
Beyond standardizing the measurement of disclosure and ser- college campuses as the demographics of a large number of
vice utilization, research questions can seek to understand these these studies would indicate, even those that used national sam-
concepts more fully. As it stands, research has generally relied pling frames. Notably, in 2010, 60% of undergraduate students
on dichotomous, cross-sectional data without theoretical under- were White (National Center for Education Statistics, 2012);
pinnings. Theoretical models such as the transtheoretical model, however, a large number of the studies reviewed here relied
ecological model applied to the help-seeking process, and sym- on samples that were largely White. Current research has
bolic interactionism view help seeking as a process, but this not adequately addressed disclosure and service utilization
has been excluded from studies in this area. Many stages of the among lesbian, gay, bisexual, transgender, and queer, African
American, Latino, Asian American, Native American, disabled service utilization is due to student decisions and a potential
male, and international students. As reported in Karjane et al. disinterest in services. However, one could also contend that
(2002), few offer specialized services for these groups. It is a reason for a lack of service utilization is a lack of appropriate
important, however, for research to examine influences on and helpful services that are responsive to the needs and life-
disclosure and service utilization such as discrimination, religi- styles of students. It is important to shift focus from an individ-
osity, belonging to a small community, language use, immi- ual level of analysis to a contextual level of analysis. The
grant status, heterosexism, and racism, possibly through campus community is also responsible for how services are uti-
qualitative studies. Further, the current student body does not lized. They have a duty to seek ways of enhancing the safety,
fit the image of the student who has just graduated high school both physically and psychologically, of students on their cam-
and moves off to college, financially supported by mom and puses. It is important to remember that some students do not
dad. The Washington Post reports that only one third of today’s have access to victim services and are not notified of services
college students fit that description (Johnson, 2013, September that are available. Some colleges do not have policies for sex-
14). Research in this area needs to be much more attentive to ual assault and dating violence or do not provide clear guidance
working students, part-time students, those in community col- about steps to take after a victimization. By focusing on stu-
leges, and those with families of their own, as these groups are dents’ decisions, the role of the campus is diminished. Colleges
becoming more and more representative of college students. need to develop service systems so that victims have alterna-
tives, craft informative polices, make students aware of their
options after experiencing either dating violence and/or sexual
Busting Silos in Disclosure and Service assault, and deal with sexual assault and dating violence inci-
Utilization Research dents in a swift and definite manner.
While the vast majority of research available on disclosure and
services for college victims focused on sexual assault and more
research is needed on dating violence, this compartmentaliza- Conclusion
tion of victimization types obscures the fact that these victimiza- While societal attention to issues of sexual assault and dating
tions overlap in many ways. First, sexual violence is a part violence has been heightened through legislation such as the
of dating violence. Sexual violence was part of dating violence Clery Act and Campus SaVE, widespread student access and use
for 58% of college women who reported any dating violence of services is far from achieved. This review found that the gen-
(Sabina & Straus, 2008). Second, intimates account for 24% eral response to sexual assault and dating violence is nondisclo-
of perpetrators of forcible rape (Kilpatrick et al., 2007) and sure to formal sources and disclosure to informal sources. While
38% of forced sexual assault perpetrators (Krebs et al., 2007). this trend is not unique to the campus environment, these rates
In fact, 19% of forced sexual assaults occurred while on a date may be lower than for the general population. Alcohol and drug
(Krebs et al., 2007). Thus, it is not accurate to treat these two vic- use appears to be an especially important factor influencing dis-
timizations as unique. One way to better grapple with the over- closure. Findings, which indicate low levels of help seeking,
laps between victimizations (including those beyond physical along with the general perception that sexual assault and dating
and sexual) would be for studies to ask about a range of violence violence are not serious crimes, indicate that much work remains.
experiences (e.g., unwanted touching, forced sexual, assault, Areas for improvement on campuses include making high-quality
aggravated assault, stalking, psychological abuse) and then ask services available to all students, revising policies so they are
about perpetrators (Hamby & Grych, 2013). This approach clear and informative, and increasing awareness of services. The
would potentially capture many victimization experiences college years are an especially important time to intervene in
among college students and would allow examination by perpe- potentially violence-laden developmental trajectories.
trator type, which is an important variable for disclosure and
service utilization. Measurement of violence in the current
studies does not allow disentangling of the differences between
Major Findings
victimization types (e.g., physical, sexual) and, at the same 1. Both rates of reporting sexual assaults and dating vio-
time, differences by victim–offender relationship. Service and lence to the police and disclosure to other formal sources
policy implications of silo busting include comprehensive were low across studies. Characteristics of the incident,
services, revised polices that address differing forms of vio- victim, and offender were associated with reporting to
lence in tandem, and collaboration across programs/services. the police. Most often those who did not report indicated
that the assault was not serious enough to report.
2. Informal disclosure was much more common than for-
Shifting the Focus mal disclosure. Female friends were the primary confi-
Viewing disclosure and service utilization as the responsibility dants of victims. Characteristics of the incident, victim,
not only of the individual but also of the campus shifts the focus and offender were associated with informal disclosure.
in research and practice from service utilization to service Responses to informal disclosure tended to be suppor-
availability. An implicit assumption in the current research tive, but negative reactions were associated with poorer
seems to be that the general lack of formal disclosure and psychological functioning.
Sabina and Ho 223
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from a national-level study of college women. Criminal Justice Laboratory, University of New Hampshire, during her postdoctoral
and Behavior, 30, 6–38. doi:10.1177/0093854802239161 fellowship. Her research centers on interpersonal victimization, espe-
Karjane, H. M., Fisher, B. S., & Cullen, F. T. (2002). Campus sexual cially partner violence and related help seeking. She received three
assault: How American institutions of higher education respond National Institute of Justice grants to study the lifetime victimization
(Document No. 196676). Retrieved from https://www.ncjrs.gov/ history of adult Latino women and male and female Latino adoles-
cents, their help-seeking responses, psychological and behavioral out-
pdffiles1/nij/grants/196676.pdf
comes, and relevant cultural factors. She also received a Pennsylvania
Kilpatrick, D. G., Resnick, H. S., Ruggiero, K. J., Conoscenti, L. M.,
Commission on Crime and Delinquency grant to conduct a statewide
& McCauley, J. (2007). Drug-facilitated, incapacitated, and forci- needs assessment of victim services. She teaches courses on research
ble rape: A national study (Document No. 219181). Retrieved from methods, quantitative methods, and race, gender, class, and sexual
https://www.ncjrs.gov/pdffiles1/nij/grants/219181.pdf identity diversity.
Krebs, C. P., Lindquist, C. H., Warner, T. D., Fisher, B. S., & Martin,
S. L. (2007). The campus sexual assault (CSA) study (Document Lavina Y. Ho is a graduate fellow at Penn
No. 221153). Retrieved from https://www.ncjrs.gov/pdffiles1/nij/ State Harrisburg in the applied clinical psy-
grants/221153.pdf chology program. She earned her bachelor
of arts in cognitive sciences (psychology)
and anthropology from the University of
California, Irvine. Her research focuses on
cross-cultural factors, stigma, and clinical
Author Biographies
disorders such as schizophrenia, depres-
Chiara Sabina is an assistant professor of sion, and autism spectrum disorder. She has
social sciences and contributes to the applied been a teaching assistant for various
behavioral science and sociology majors. courses including introduction to psychol-
She is also a graduate faculty of the Commu- ogy, lifespan development, directed research, quantitative research
nity Psychology and Social Change master’s methods, and introduction to women’s and gender studies. She is
program. She earned her doctorate in applied also a member of the APA’s Division 45 of Ethnic Minority Issues
social psychology from Loyola University and Division 52 of International Psychology. She is actively
Chicago with a certificate in women’s stud- involved as the President of the Applied Psychological Association
ies. She later worked on the International of Penn State Harrisburg and the Vice President of the local Penn
dating violence study at the Family Research State Harrisburg Psi Chi chapter.
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TRAUMA, VIOLENCE, & ABUSE

Chiara Sabina1 and Lavina Y. Ho1

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3. Rates of service utilization varied widely across studies, References

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