Gender Differences in Sexual Assault Survivors in PTSD & Alcohol Use
Jocelyn Covarrubias
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07/27/2021
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Experiencing sexual assault can increase risk for posttraumatic stress disorder (PTSD; Dworkin, 2020). PTSD has also proven to be highly comorbid with alcohol use in college students (Read, et al., 2014). Although gender differences have been studied regarding PTSD and alcohol use separately, gender differences in comorbidity are less well understood, especially after a sexual assault – a research area that has focused on women. To build on prior research, we examined if PTSD symptom severity and alcohol misuse after a sexual assault were associated and how this association differed by gender.
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- [00:00:01.270]Hello, my name is Jocelyn Covarrubias,
- [00:00:03.290]and today I will be presenting my research done
- [00:00:05.180]on gender differences in sexual assault survivors
- [00:00:07.430]regarding post-traumatic stress disorder and alcohol use.
- [00:00:10.440]My faculty mentor is Dr. Anna Jaffe,
- [00:00:12.410]and I'm a psychology student
- [00:00:13.520]at the University of Nebraska-Lincoln.
- [00:00:15.760]Today, we will discuss the introduction,
- [00:00:17.840]purpose and hypothesis, materials and methods,
- [00:00:20.150]results, discussion featuring the limitations
- [00:00:22.510]and future work, and acknowledgments.
- [00:00:24.620]Now, some background information on sexual assault.
- [00:00:27.100]Sexual assault is a problem on college campuses.
- [00:00:29.600]1 out of 5 women and 1 out of 16 men
- [00:00:31.580]are sexually assaulted in college,
- [00:00:32.990]and much of the research surrounding sexual assault
- [00:00:35.040]has focused on women victims and male perpetrators,
- [00:00:37.560]causing a lack of representation of male survivors
- [00:00:39.880]in sexual assault.
- [00:00:41.330]Alcohol use has also proven to be associated
- [00:00:43.640]with post-traumatic stress disorder
- [00:00:44.990]in sexual assault victimization.
- [00:00:46.880]PTSD has also been proven to be highly comorbid
- [00:00:49.300]with alcohol use in college students,
- [00:00:50.890]and PTSD has shown the (indistinct) stages of alcohol use,
- [00:00:53.980]such as occasional use to regular use.
- [00:00:56.850]So the purpose of this study was to examine the association
- [00:01:00.260]of post-traumatic stress disorder and alcohol misuse
- [00:01:02.570]in sexual assault survivors,
- [00:01:03.870]and how this association differed by gender.
- [00:01:06.710]We hypothesized that women would display higher rates
- [00:01:09.240]of PTSD than men.
- [00:01:10.710]This being because based on previous literature,
- [00:01:12.960]they have more exposure to sexually-related traumas.
- [00:01:15.890]For our second hypothesis,
- [00:01:17.100]we hypothesized that men would have higher rates
- [00:01:19.230]of high-risk drinking compared to women.
- [00:01:21.210]We hypothesize this because this is consistent
- [00:01:23.410]with prior literature in the general college population.
- [00:01:26.260]As for our third hypothesis,
- [00:01:27.506]we hypothesized that women would report more co-morbidity
- [00:01:31.172]in PTSD and high-risk drinking than men.
- [00:01:34.337]We hypothesized this because drinking has shown to maintain
- [00:01:38.110]and worsen PTSD symptoms and severity over time.
- [00:01:41.460]Now for our materials and methods,
- [00:01:43.442]quantitative data for this study was acquired
- [00:01:46.190]from a larger study examining life experiences
- [00:01:48.740]called the Life Experiences Study.
- [00:01:50.720]Data analyzed for this,
- [00:01:52.322]for this research was from fall 2016 to fall 2020.
- [00:01:56.310]We had 820 undergrad cis-gender students with history
- [00:01:59.670]of sexual assault who are at least 19 years old.
- [00:02:02.478]Participants consented to an online survey
- [00:02:06.010]regarding gender identity, sexual assault victimization,
- [00:02:08.960]PTSD severity, and high-risk drinking.
- [00:02:11.960]To assess for unwanted sexual experiences,
- [00:02:14.430]we used the Modified Sexual Experiences survey.
- [00:02:17.130]For PTSD measure, we had used the PTSD checklist
- [00:02:20.270]for DSM-V PCL,
- [00:02:21.680]where participants answered the questionnaire
- [00:02:23.500]regarding the most distressing sexual assault experience
- [00:02:26.880]they had experienced.
- [00:02:28.450]Probable PTSD was assessed with the cut score of 33.
- [00:02:32.060]Now for alcohol use measures,
- [00:02:33.860]we had used the Alcohol Use Disorders Identification Test,
- [00:02:36.910]also known as The AUDIT,
- [00:02:38.310]which assessed for past-year alcohol use,
- [00:02:40.210]and high risk drinking was determined
- [00:02:41.690]with the cut score of 6.
- [00:02:43.640]Now, for our statistical analysis,
- [00:02:45.260]we conducted an independent sample t-test
- [00:02:47.410]done to compare gender differences
- [00:02:48.960]in PCL scores and AUDIT scores.
- [00:02:51.120]We also conducted a chi-squared test,
- [00:02:52.840]where all participants were categorized into four groups.
- [00:02:55.640]Those four groups being PTSD only,
- [00:02:58.210]high-risk drinking only, both, and neither.
- [00:03:00.610]Gender differences across these four categories were
- [00:03:02.830]analyzed using a chi-square test.
- [00:03:05.460]And, finally, we conducted further analyses
- [00:03:07.620]with the multiple linear regression,
- [00:03:09.230]where PCL score was the independent variable.
- [00:03:11.729]AUDIT score was the dependent variable,
- [00:03:14.270]and gender was the moderator.
- [00:03:16.430]Now, for our preliminary analysis,
- [00:03:18.800]PTSD had a total mean score of 15.38.
- [00:03:22.460]Although the mean was below the cut score of 33.
- [00:03:25.291]147 out of the 828 participants had a score
- [00:03:28.970]greater than or equal to 33, indicating probable PTSD.
- [00:03:32.930]As for the AUDIT score,
- [00:03:34.160]the AUDIT score had a total mean score of 7.32,
- [00:03:37.286]which was above our cut score of 6.
- [00:03:39.372]We had 59.4% of our participants, well over half,
- [00:03:43.880]indicate a score greater than or equal to 6.
- [00:03:45.940]on the AUDIT, indicating high-risk drinking.
- [00:03:48.330]Now for our results regarding the independent sample t-test
- [00:03:51.240]done to compare gender and PCL scores and audit scores
- [00:03:54.154]showed that there was no significant difference
- [00:03:57.260]in gender for PCL scores.
- [00:03:59.030]This can be shown in this graph right here.
- [00:04:00.880]As you can see, mean scores are reported for men and women.
- [00:04:05.164]And our p-value is greater than 0.05,
- [00:04:08.300]so our hypothesis one stating that women would display
- [00:04:10.910]higher rates of PTSD than men was not supported.
- [00:04:14.120]As for our second hypothesis,
- [00:04:15.640]stating that men would display higher rates
- [00:04:17.370]of high-risk drinking than women.
- [00:04:19.041]As you can see,
- [00:04:20.500]mean scores are reported for both men and women,
- [00:04:23.050]and men are reporting more mean scores than women.
- [00:04:25.670]And, as you can see, our p-value is greater than 0.05.
- [00:04:28.960]I mean less than 0.05,
- [00:04:30.560]so we do have a significant difference
- [00:04:32.850]in gender for AUDIT scores,
- [00:04:34.070]so hypothesis two was supported.
- [00:04:36.480]As for our chi-square results, as mentioned before,
- [00:04:38.750]all participants were categorized into four groups,
- [00:04:41.090]those being PTSD only, high-risk drinking only,
- [00:04:43.740]both, and neither.
- [00:04:45.010]We had 7% of women, and 5% of men indicate PTSD only.
- [00:04:49.600]47% of women and 59% of men indicate high-risk drinking only
- [00:04:53.591]11% of women, and 9% of men indicate both,
- [00:04:56.990]and 35% of women, and 27% of men indicate neither.
- [00:05:01.080]However, there was no significant association
- [00:05:03.730]between gender and group.
- [00:05:05.070]As you can see, our p-value is greater than 0.05,
- [00:05:07.970]so our hypothesis stating that women would display more
- [00:05:10.650]co-morbidity compared to men was not supported.
- [00:05:14.820]We also conducted further analysis
- [00:05:16.830]with the multiple linear regression
- [00:05:18.510]done to predict AUDIT score based on PCL score and gender.
- [00:05:22.300]AUDIT scores were higher for women.
- [00:05:24.130]As you can see, they're higher for women,
- [00:05:25.590]and individuals with higher PCL scores.
- [00:05:28.320]However, as PTSD severity increased for women,
- [00:05:31.840]there was really no change in AUDIT scores for women.
- [00:05:36.330]However, as PCL scores increased for men,
- [00:05:39.419]it increased in AUDIT scores as well,
- [00:05:42.360]Greater PTSD severity seemed
- [00:05:43.920]to only impact men's high-risk drinking.
- [00:05:46.059]However, there was no significant interaction of this.
- [00:05:49.320]Now, for our discussion,
- [00:05:50.500]several limitations should be considered.
- [00:05:52.420]Although the sample does represent experiences of men,
- [00:05:55.139]it limits the ability to generalize results
- [00:05:58.190]to other gender identities, such as trans and non-binary.
- [00:06:01.460]We were going to analyze a sample
- [00:06:03.690]with other gender identities,
- [00:06:04.960]but sadly, our sample was too small.
- [00:06:07.620]Along with the sample, it was not a balanced one
- [00:06:10.600]since 90.7% of the participants were women.
- [00:06:13.617]This could be though, as mentioned before,
- [00:06:16.320]sexual assault does occur to men,
- [00:06:17.750]but occurs to women a lot more frequently.
- [00:06:19.840]The time of assault was also not controlled in this study.
- [00:06:23.180]Results could differ between those who were victimized more
- [00:06:25.990]recently versus those who were victimized longer ago.
- [00:06:30.010]So recommendations for future work
- [00:06:31.810]could be expanding the sample to other gender identities,
- [00:06:35.180]examine the effect of assault characteristics in PTSD
- [00:06:38.560]and alcohol misuse,
- [00:06:39.460]such as controlling for the time of assault.
- [00:06:41.435]And lastly investigating at the association
- [00:06:44.610]between high-risk drinking
- [00:06:45.770]and severity-specific PTSD clusters, such as intrusion,
- [00:06:48.970]hyperarousal, and avoidance differ by gender.
- [00:06:52.660]Lastly, my acknowledgements,
- [00:06:54.050]I'd like to give a big thank you to my UNL faculty mentor,
- [00:06:56.920]Dr. Anna Jaffe, my graduate student mentor, Rebecca Howard,
- [00:07:00.870]the UNL McNair faculty and the UNL McNair Scholars Program.
- [00:07:04.340]Thank you.
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