Although prevention efforts aimed at eliminating the occurrence of sexual assault are clearly needed, it is also important to consider how we can prevent further trauma among those already victimized. Prior research suggests that rape survivors may experience victim-blaming treatment from system personnel (termed secondary victimization or the second rape). This research examined how postassault contact with community systems exacerbated rape victims' psychological and physical health distress. Findings revealed that the majority of rape survivors who reported their assault to the legal or medical system did not receive needed services. These difficulties with service delivery were associated with both perceived and objective measures of negative health outcomes. Contact with the mental health system, rape crisis centers, or religious communities was generally perceived by victims as beneficial. This study suggests that the trauma of rape extends far beyond the assault itself, as negative community responses can significantly elevate distress.

Ahrens, C. E. , Campbell, R., Wasco, S. M., Grubstein, L., Aponte, G. A., & Davidson, W. S. (2000). Sexual assault nurse examiner programs: An alternative approach to medical service delivery for rape victims. Journal of Interpersonal Violence, 15, 921-943. Google Scholar, SAGE Journals, ISI
Atkeson, B. M. , Calhoun, K. S., Resick, P. A., & Ellis, E. M. (1982). Victims of rape: Repeated assessment of depressive symptoms. Journal of Consulting and Clinical Psychology, 50, 96-102. Google Scholar, Crossref, Medline, ISI
Bart, P. B. , & O'Brien, P. H. (1984). Stopping rape: Effective avoidance strategies. Signs, 10, 83-101. Google Scholar, Crossref, ISI
Berger, R. J. , Searles, P., & Neuman, W. L. (1988). The dimensions of rape reform legislation. Law and Society Review, 22, 329-357. Google Scholar, Crossref, ISI
Best, C. L. , Dansky, B. S., & Kilpatrick, D. (1992). Medical students' attitudes about female rape victims. Journal of Interpersonal Violence, 7, 175-188. Google Scholar, SAGE Journals, ISI
Boles, A. B. , & Patterson, J. C. (1997). Improving the community response to crime victims: An eight-step model developing protocol. Thousand Oaks, CA: Sage. Google Scholar
Campbell, R. (1998). The community response to rape: Victims' experiences with the legal, medical, and mental health systems. American Journal of Community Psychology, 26, 355-379. Google Scholar, Crossref, Medline, ISI
Campbell, R. , & Ahrens, C. E. (1998). Innovative community services for rape victims: An application of multiple case study methodology. American Journal of Community Psychology, 26, 537-571. Google Scholar, Crossref, Medline, ISI
Campbell, R. , Baker, C. K., & Mazurek, T. (1998). Remaining radical? Organizational predictors of rape crisis centers' social change initiatives. American Journal of Community Psychology, 26, 465-491. Google Scholar, Crossref, ISI
Campbell, R. , & Bybee, D. (1997). Emergency medical services for rape victims: Detecting the cracks in service delivery. Women's Health, 3, 75-101. Google Scholar, Medline
Campbell, R. , & Johnson, C. R. (1997). Police officers' perceptions of rape: Is there consistency between state law and individual beliefs? Journal of Interpersonal Violence, 12, 255-274. Google Scholar, SAGE Journals, ISI
Campbell, R. , & Martin, P. Y. (2001). Services for sexual assault survivors: The role of rape crisis centers. In C. M. Renzetti, J. L. Edleson, & R. K. Bergen (Eds.), Sourcebook on violence against women (pp. 227-241). Thousand Oaks, CA: Sage. Google Scholar
Campbell, R. , & Raja, S. (1999). Secondary victimization of rape victims: Insights from mental health professionals who treat survivors of violence. Violence & Victims, 14, 261-275. Google Scholar, Medline
Campbell, R. , Sefl, T., Barnes, H. E., Ahrens, C. E., Wasco, S. M., & Zaragoza-Diesfeld, Y. (1999). Community services for rape survivors: Enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67, 847-858. Google Scholar, Crossref, Medline, ISI
Campbell, R. , Sefl, T., Wasco, S. M., & Ahrens, C. E. (2001). Doing community research without a community: Creating safe space for rape survivors. Paper submitted for publication. Google Scholar
Cluss, P. A. , Boughton, J., Frank, E., Stewart, B. D., & West, D. (1983). The rape victim: Psychological correlates of participation in the legal process. Criminal Justice and Behavior, 10, 342-357. Google Scholar, SAGE Journals, ISI
Eby, K. K. , Campbell, J. C., Sullivan, C. M., & Davidson, W. S. (1995). Health effects of experiences of sexual violence for women with abusive partners. Health Care for Women International, 16, 563-576. Google Scholar, Crossref, Medline
Foa, E. B. , & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guilford. Google Scholar
Frazier, P. A. , & Haney, B. (1996). Sexual assault cases in the legal system: Police, prosecutor, and victim perspectives. Law & Human Behavior, 20, 607-628. Google Scholar, Crossref, ISI
Frohmann, L. (1991). Discrediting victims' allegations of sexual assault: Prosecutorial accounts of case rejections. Social Problems, 38, 213-226. Google Scholar, Crossref, ISI
Kilpatrick, D. G. , Best, C. L., Veronen, L. J., Amick, A. E., Villeponteaux, L. A., & Ruff, G. A. (1985). Mental health correlates of criminal victimization: A random community survey. Journal of Consulting and Clinical Psychology, 53, 866-873. Google Scholar, Crossref, Medline, ISI
Konradi, A. (1996). Rape survivors negotiating the criminal justice process. Gender & Society, 10, 404-432. Google Scholar, SAGE Journals, ISI
Koss, M. P. , Gidycz, C. A., & Wisniewski, N. (1987). The scope of rape: Incidence and prevalence of sexual aggression and victimization in a national sample of higher education students. Journal of Consulting and Clinical Psychology, 55, 162-170. Google Scholar, Crossref, Medline, ISI
Koss, M. P. , Goodman, L. A., Browne, A., Fitzgerald, L. F., Keita, G. P., & Russo, N. F. (1994). No safe haven: Male violence against women at home, at work, and in the community. Washington, DC: American Psychological Association. Google Scholar
Ledray, L. (1999). Sexual assault nurse examiners (SANE): Development and operating guide. Washington, DC: Department of Justice. Google Scholar
Long Island College Hospital and Junior League of Brooklyn. (1998). Restoring dignity: Frontline response to rape [Video]. Newbury Park, CA: Sage. Google Scholar
Lonsway, K. A. (1997). Police training in sexual assault responses: Comparison of approaches. Unpublished dissertation, University of Illinois, Urbana. Google Scholar
Madigan, L. , & Gamble, N. (1991). The second rape: Society's continued betrayal of the victim. New York: Lexington Books. Google Scholar
Martin, P. Y. (1997). Gender, accounts, and rape processing work. Social Problems, 44, 464-482. Google Scholar, Crossref, ISI
Martin, P. Y. , & Powell, M. (1994). Accounting for the “second assault”: Legal organizations' framing of rape victims. Law & Social Inquiry, 19, 853-890. Google Scholar, ISI
Matoesian, G. M. (1993). Reproducing rape: Domination through talk in the courtroom. Chicago: University of Chicago Press. Google Scholar
National Victim Center . (1992). Rape in America: A report to the nation. Arlington, VA: Author. Google Scholar
Parrot, A. (1991). Medical community response to acquaintance rape: Recommendations. In L. Bechhofer & A. Parrot (Eds.), Acquaintance rape: The hidden victim (pp. 304-316). New York: Wiley. Google Scholar
Patterson, J. C. , & Boles, A. B. (1992). Looking back, moving forward: A guidebook for communities responding to sexual assault. Arlington, VA: National Victim Center. Google Scholar
Pett, M. A. (1997). Nonparametric statistics for health care research: Statistics for small samples and unusual distributions. Thousand Oaks, CA: Sage. Google Scholar
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. Google Scholar, SAGE Journals
Russell, D. E. H. (1984). Sexual exploitation: Rape, child sexual abuse, and workplace harassment. Beverly Hills, CA: Sage. Google Scholar
Saunders, B. E. , Arata, C. M., & Kilpatrick, D. G. (1990). Development of a crime-related posttraumatic stress disorder scale for women within the Symptom Checklist 90 Revised. Journal of Traumatic Stress, 3, 439-448. Google Scholar, Crossref
Schmitt, F. , & Martin, P. Y. (1999). Unobtrusive mobilization by an institutionalized rape crisis center: “All we do comes from victims.” Gender & Society, 13, 364-384. Google Scholar, SAGE Journals, ISI
Shepard, M. , & Pence, E. (1999). Coordinating community responses to domestic violence: Lessons learned from the Duluth model. Thousand Oaks, CA: Sage. Google Scholar
Siegel, S. , & Castellan, N. J. (1988). Nonparametric statistics for the behavioral sciences. New York: McGraw-Hill. Google Scholar
Sloan, L. M. (1995). Revictimization by polygraph: The practice of polygraphing survivors of sexual assault. Medicine and Law, 14, 255-267. Google Scholar, Medline
Spencer, C. C. (1987). Sexual assault: The second victimization. In L. L. Crites & W. L. Hepperle (Eds.), Women, the courts, and equality. Newbury Park, CA: Sage. Google Scholar
Thompson, S. K. , & Seber, G.A.F. (1996). Adaptive sampling. New York: Wiley. Google Scholar
Tjaden, P. , & Thoennes, N. (1998). Prevalence, incidence, and consequences of violence against women: The National Violence Against Women Survey. Washington, DC: Department of Justice. Google Scholar
U.S. Department of Justice . (1994). The criminal justice and community response to rape. Washington, DC: Author. Google Scholar
Ward, C. (1988). The attitudes toward rape victims scale: Construction, validation, and cross-cultural applicability. Psychology of Women Quarterly, 12, 127-146. Google Scholar, SAGE Journals, ISI
Williams, J. E. (1984). Secondary victimization: Confronting public attitudes about rape. Victimology, 9, 66-81. Google Scholar
Williams, J. E. , & Holmes, K. A. (1981). The second assault. Westport, CT: Greenwood. Google Scholar
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Although prevention efforts aimed at eliminating the occurrence of sexual assault are clearly needed, it is also important to consider how we can prevent further trauma among those already victimized. Prior research suggests that rape survivors may experience victim-blaming treatment from system personnel (termed secondary victimization or the second rape). This research examined how postassault contact with community systems exacerbated rape victims' psychological and physical health distress. Findings revealed that the majority of rape survivors who reported their assault to the legal or medical system did not receive needed services. These difficulties with service delivery were associated with both perceived and objective measures of negative health outcomes. Contact with the mental health system, rape crisis centers, or religious communities was generally perceived by victims as beneficial. This study suggests that the trauma of rape extends far beyond the assault itself, as negative community responses can significantly elevate distress.

Ahrens, C. E. , Campbell, R., Wasco, S. M., Grubstein, L., Aponte, G. A., & Davidson, W. S. (2000). Sexual assault nurse examiner programs: An alternative approach to medical service delivery for rape victims. Journal of Interpersonal Violence, 15, 921-943. Google Scholar, SAGE Journals, ISI
Atkeson, B. M. , Calhoun, K. S., Resick, P. A., & Ellis, E. M. (1982). Victims of rape: Repeated assessment of depressive symptoms. Journal of Consulting and Clinical Psychology, 50, 96-102. Google Scholar, Crossref, Medline, ISI
Bart, P. B. , & O'Brien, P. H. (1984). Stopping rape: Effective avoidance strategies. Signs, 10, 83-101. Google Scholar, Crossref, ISI
Berger, R. J. , Searles, P., & Neuman, W. L. (1988). The dimensions of rape reform legislation. Law and Society Review, 22, 329-357. Google Scholar, Crossref, ISI
Best, C. L. , Dansky, B. S., & Kilpatrick, D. (1992). Medical students' attitudes about female rape victims. Journal of Interpersonal Violence, 7, 175-188. Google Scholar, SAGE Journals, ISI
Boles, A. B. , & Patterson, J. C. (1997). Improving the community response to crime victims: An eight-step model developing protocol. Thousand Oaks, CA: Sage. Google Scholar
Campbell, R. (1998). The community response to rape: Victims' experiences with the legal, medical, and mental health systems. American Journal of Community Psychology, 26, 355-379. Google Scholar, Crossref, Medline, ISI
Campbell, R. , & Ahrens, C. E. (1998). Innovative community services for rape victims: An application of multiple case study methodology. American Journal of Community Psychology, 26, 537-571. Google Scholar, Crossref, Medline, ISI
Campbell, R. , Baker, C. K., & Mazurek, T. (1998). Remaining radical? Organizational predictors of rape crisis centers' social change initiatives. American Journal of Community Psychology, 26, 465-491. Google Scholar, Crossref, ISI
Campbell, R. , & Bybee, D. (1997). Emergency medical services for rape victims: Detecting the cracks in service delivery. Women's Health, 3, 75-101. Google Scholar, Medline
Campbell, R. , & Johnson, C. R. (1997). Police officers' perceptions of rape: Is there consistency between state law and individual beliefs? Journal of Interpersonal Violence, 12, 255-274. Google Scholar, SAGE Journals, ISI
Campbell, R. , & Martin, P. Y. (2001). Services for sexual assault survivors: The role of rape crisis centers. In C. M. Renzetti, J. L. Edleson, & R. K. Bergen (Eds.), Sourcebook on violence against women (pp. 227-241). Thousand Oaks, CA: Sage. Google Scholar
Campbell, R. , & Raja, S. (1999). Secondary victimization of rape victims: Insights from mental health professionals who treat survivors of violence. Violence & Victims, 14, 261-275. Google Scholar, Medline
Campbell, R. , Sefl, T., Barnes, H. E., Ahrens, C. E., Wasco, S. M., & Zaragoza-Diesfeld, Y. (1999). Community services for rape survivors: Enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67, 847-858. Google Scholar, Crossref, Medline, ISI
Campbell, R. , Sefl, T., Wasco, S. M., & Ahrens, C. E. (2001). Doing community research without a community: Creating safe space for rape survivors. Paper submitted for publication. Google Scholar
Cluss, P. A. , Boughton, J., Frank, E., Stewart, B. D., & West, D. (1983). The rape victim: Psychological correlates of participation in the legal process. Criminal Justice and Behavior, 10, 342-357. Google Scholar, SAGE Journals, ISI
Eby, K. K. , Campbell, J. C., Sullivan, C. M., & Davidson, W. S. (1995). Health effects of experiences of sexual violence for women with abusive partners. Health Care for Women International, 16, 563-576. Google Scholar, Crossref, Medline
Foa, E. B. , & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guilford. Google Scholar
Frazier, P. A. , & Haney, B. (1996). Sexual assault cases in the legal system: Police, prosecutor, and victim perspectives. Law & Human Behavior, 20, 607-628. Google Scholar, Crossref, ISI
Frohmann, L. (1991). Discrediting victims' allegations of sexual assault: Prosecutorial accounts of case rejections. Social Problems, 38, 213-226. Google Scholar, Crossref, ISI
Kilpatrick, D. G. , Best, C. L., Veronen, L. J., Amick, A. E., Villeponteaux, L. A., & Ruff, G. A. (1985). Mental health correlates of criminal victimization: A random community survey. Journal of Consulting and Clinical Psychology, 53, 866-873. Google Scholar, Crossref, Medline, ISI
Konradi, A. (1996). Rape survivors negotiating the criminal justice process. Gender & Society, 10, 404-432. Google Scholar, SAGE Journals, ISI
Koss, M. P. , Gidycz, C. A., & Wisniewski, N. (1987). The scope of rape: Incidence and prevalence of sexual aggression and victimization in a national sample of higher education students. Journal of Consulting and Clinical Psychology, 55, 162-170. Google Scholar, Crossref, Medline, ISI
Koss, M. P. , Goodman, L. A., Browne, A., Fitzgerald, L. F., Keita, G. P., & Russo, N. F. (1994). No safe haven: Male violence against women at home, at work, and in the community. Washington, DC: American Psychological Association. Google Scholar
Ledray, L. (1999). Sexual assault nurse examiners (SANE): Development and operating guide. Washington, DC: Department of Justice. Google Scholar
Long Island College Hospital and Junior League of Brooklyn. (1998). Restoring dignity: Frontline response to rape [Video]. Newbury Park, CA: Sage. Google Scholar
Lonsway, K. A. (1997). Police training in sexual assault responses: Comparison of approaches. Unpublished dissertation, University of Illinois, Urbana. Google Scholar
Madigan, L. , & Gamble, N. (1991). The second rape: Society's continued betrayal of the victim. New York: Lexington Books. Google Scholar
Martin, P. Y. (1997). Gender, accounts, and rape processing work. Social Problems, 44, 464-482. Google Scholar, Crossref, ISI
Martin, P. Y. , & Powell, M. (1994). Accounting for the “second assault”: Legal organizations' framing of rape victims. Law & Social Inquiry, 19, 853-890. Google Scholar, ISI
Matoesian, G. M. (1993). Reproducing rape: Domination through talk in the courtroom. Chicago: University of Chicago Press. Google Scholar
National Victim Center . (1992). Rape in America: A report to the nation. Arlington, VA: Author. Google Scholar
Parrot, A. (1991). Medical community response to acquaintance rape: Recommendations. In L. Bechhofer & A. Parrot (Eds.), Acquaintance rape: The hidden victim (pp. 304-316). New York: Wiley. Google Scholar
Patterson, J. C. , & Boles, A. B. (1992). Looking back, moving forward: A guidebook for communities responding to sexual assault. Arlington, VA: National Victim Center. Google Scholar
Pett, M. A. (1997). Nonparametric statistics for health care research: Statistics for small samples and unusual distributions. Thousand Oaks, CA: Sage. Google Scholar
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. Google Scholar, SAGE Journals
Russell, D. E. H. (1984). Sexual exploitation: Rape, child sexual abuse, and workplace harassment. Beverly Hills, CA: Sage. Google Scholar
Saunders, B. E. , Arata, C. M., & Kilpatrick, D. G. (1990). Development of a crime-related posttraumatic stress disorder scale for women within the Symptom Checklist 90 Revised. Journal of Traumatic Stress, 3, 439-448. Google Scholar, Crossref
Schmitt, F. , & Martin, P. Y. (1999). Unobtrusive mobilization by an institutionalized rape crisis center: “All we do comes from victims.” Gender & Society, 13, 364-384. Google Scholar, SAGE Journals, ISI
Shepard, M. , & Pence, E. (1999). Coordinating community responses to domestic violence: Lessons learned from the Duluth model. Thousand Oaks, CA: Sage. Google Scholar
Siegel, S. , & Castellan, N. J. (1988). Nonparametric statistics for the behavioral sciences. New York: McGraw-Hill. Google Scholar
Sloan, L. M. (1995). Revictimization by polygraph: The practice of polygraphing survivors of sexual assault. Medicine and Law, 14, 255-267. Google Scholar, Medline
Spencer, C. C. (1987). Sexual assault: The second victimization. In L. L. Crites & W. L. Hepperle (Eds.), Women, the courts, and equality. Newbury Park, CA: Sage. Google Scholar
Thompson, S. K. , & Seber, G.A.F. (1996). Adaptive sampling. New York: Wiley. Google Scholar
Tjaden, P. , & Thoennes, N. (1998). Prevalence, incidence, and consequences of violence against women: The National Violence Against Women Survey. Washington, DC: Department of Justice. Google Scholar
U.S. Department of Justice . (1994). The criminal justice and community response to rape. Washington, DC: Author. Google Scholar
Ward, C. (1988). The attitudes toward rape victims scale: Construction, validation, and cross-cultural applicability. Psychology of Women Quarterly, 12, 127-146. Google Scholar, SAGE Journals, ISI
Williams, J. E. (1984). Secondary victimization: Confronting public attitudes about rape. Victimology, 9, 66-81. Google Scholar
Williams, J. E. , & Holmes, K. A. (1981). The second assault. Westport, CT: Greenwood. Google Scholar