Correlates of Support Utilization After Experiencing a Sexual Assault Among College Women and Men

Abstract

Though previous research has examined survivors’ use of formal and informal services, less research has looked at whether sexual orientation, race, and different sexual assault types (e.g., coercive) are associated with seeking support services. The purpose of this study is to examine factors associated with utilizing services or support from informal sources (e.g., telling a friend) and formal sources (e.g., psychological counseling) following a sexual assault. Data were gathered in Fall and Spring of 2019–2020 from undergraduate students at a Midwestern university. Logistic regression results showed that heterosexual students had 56% lower odds of using informal supports, while females were 2.05 times more likely to have used informal supports compared to their counterparts. Students who reported more heavy drinking had 37% lower odds of using informal supports compared to their counterparts. Those who experienced physical and incapacitated sexual assault were 2.09 times and 3.60 times more likely to have used informal supports, respectively. Additionally, older students were 1.35 times more likely to have used formal supports compared to younger students, whereas heterosexual students had 67% lower odds of using formal supports compared to sexual minority students. Those with greater PTSD symptoms were 1.07 times more likely to access formal services. Finally, students with greater depressive symptoms had 8% lower odds of using formal supports. Identifying college students who are less likely to access support services following a sexual assault has important implications for targeted prevention and intervention.

Keywords

service use formal supports informal supports college students sexual assault

Sexual assault on college campuses is widespread in the United States. Studies have shown that rates of sexual assault among college women range from 25% to 33% (Stephens & Eaton, 2014), while among college men, the prevalence rate is 12% to 14% (Aosved et al., 2011; Mellins et al., 2017). Though some research finds that college students who access formal services such as mental health counseling following a sexual assault tend to report fewer negative mental health consequences (Russell & Davis, 2007; Ullman, 2007), some studies have found that the use of formal services among this group following a sexual assault is quite low (Orchowski & Gidycz, 2012; Sabina & Ho, 2014). In fact, one study found that only 8% of sexual assault survivors utilized formal resources (Orchowski & Gidycz, 2012) following a sexual assault. Though previous research has examined college sexual assault survivors’ use of formal and informal supports (Fisher et al., 2003; Fleming et al., 2021; Orchowski & Gidycz, 2012; Sabina & Ho, 2014), less research has examined how factors such as sexual orientation, race, and sexual assault types (e.g., coercive) influence whether college sexual assault survivors will seek services and supports. This is important because some research finds that those who access support services following a sexual assault tend to report fewer negative mental health consequences compared to those who do not use support services (Russell & Davis, 2007; Ullman, 2007). As such, the current study uses a service utilization framework, which focuses on barriers to service use such as accessibility (Logan et al., 2005), to examine what factors are associated with utilizing support from informal sources and formal sources following a sexual assault. Identifying who is less likely to access support services following a sexual assault has important implications for targeted prevention and intervention.

Literature Review

Sexual Assault Survivors’ use of Formal and Informal Supports

Formal support. After experiencing a sexual assault, some survivors may report their sexual assault to formal resources, including law enforcement, Title IX office, or counseling services. Overall, the literature suggests that formal service use following a sexual assault is low (Fleming et al., 2021; Sabina & Ho, 2014); only 8% of sexual assault survivors utilized formal resources (Orchowski & Gidycz, 2012). However, formal resource utilization varies by resource type (Fisher et al., 2016; Fleming et al., 2021; Orchowski et al., 2009). For example, sexual assault survivors have been found to utilize university counseling services more than other formal services (Krebs et al., 2007; Nasta et al., 2005).

Informal support. Research finds that sexual assault survivors are more likely to disclose their assault to informal supports, such as a friend or family member compared to using formal services (Fisher et al., 2016). For example, Krebs et al. (2007) reported that most sexual assault survivors disclosed their assault to a family member, friend, roommate, or romantic partner. Furthermore, studies have found that survivors were most likely to disclose their sexual assault to a friend (Cantor et al., 2015; Sabina & Ho, 2014) and less likely to disclose to a family member or romantic partner because they do not want them to know about the assault (Fisher et al., 2003; Sabina & Ho, 2014). Specifically, Fisher et al. (2003) found that only 10% and 8% of survivors disclosed their sexual assault to a family member and intimate partner, respectively. Even though informal supports are also used infrequently by sexual assault survivors, such supports are more likely to be utilized compared with formal services.

Type of Sexual Assault and Support Utilization

Studies have explored how sexual assault type impacts the likelihood of disclosing to formal and informal sources (Graham et al., 2021; Krebs et al., 2007; Sabina & Ho, 2014). For example, studies have shown that survivors who experienced a forced physical assault were more likely to utilize formal services (Graham et al., 2021; Krebs et al., 2007). Furthermore, survivors of a physically forced sexual assault were also more likely to have reported the assault to police or campus security (12.9%) and to a family member or friend (68.9%) than survivors of an incapacitated sexual assault (2.1% and 63.7%, respectively; Krebs et al., 2007). Similarly, Fisher et al. (2003) reported that survivors of an assault that involved a weapon or a stranger were more likely to have reported the incident to police, while survivors of sexual assaults involving drugs or alcohol were less likely to have reported the incident to campus authorities and more likely to have reported to friends. In sum, survivors of physically forced sexual assaults are more likely to utilize formal supports than survivors of an incapacitated sexual assault. Finally, one study on coercive sexual assault found that only 28% of survivors of this type of sexual assault sought help from any source (Ogletree, 1993).

Demographic Characteristics and Support Utilization

Gender. While fewer studies have examined gender as a factor in support utilization, some studies have found that men are less likely than women to utilize formal and informal supports (Walsh et al., 2010). Banyard et al. (2007), for example, found that 33% of male survivors did not disclose their sexual assault to anyone, compared to 15% of women who did not disclose. Additionally, Masho and Alvanzo (2010) found that only 17.6% of the male survivors sought professional help. As such, male sexual assault survivors may be less likely to utilize formal resources than female sexual assault survivors.

Race. In addition to gender, some studies have examined race and support utilization (Amstadter et al., 2008; Tillman et al., 2010). Specifically, studies have found that individuals of certain races/ethnicities are less likely to utilize formal resources than White individuals (Amstadter et al., 2008; Wolitzky-Taylor et al., 2011). For example, studies have shown that Caucasian women were more likely to report their sexual assaults to authorities (Woltizky-Taylor et al., 2011) and mental health providers (Starzynski et al., 2007) than women of other races. Starzynski et al. (2007) suggest that this is because African American women are faced with more negative responses after disclosure than White women. Additionally, Hamby (2008) found that American Indians are less likely to seek help from authorities after experiencing a sexual assault due to fears of prejudice and suspicion of law enforcement. In sum, past research (Amstadter et al., 2008; Hamby, 2008; Starzynski et al., 2007; Woltizky-Taylor et al., 2011) has found that racial minorities are less likely to utilize support systems after experiencing a sexual assault.

Sexual orientation. Some studies have also identified sexual orientation as a factor determining support utilization after a sexual victimization (Ollen et al., 2017; Richardson et al., 2015). In one study Richardson et al. (2015) found that lesbian, gay, bisexual, and queer (LGBQ) students were significantly less likely to utilize formal on-campus services after experiencing sexual violence than heterosexual students because they believed that they would be blamed for the assault. Richardson et al. (2015), however, did not find a significant difference between sexual minority and heterosexual students’ rates of informal disclosure. Furthermore, Ollen et al. (2017) note that sexual minority students feared further marginalization, felt the need to protect the reputation of the sexual minority community, and struggled to navigate support systems because of heteronormative views of sex. Furthermore, sexual minority students felt intimidated by campus authorities, anticipated stigmatization, feared being “outed” in the process of help seeking, and felt shame for being victimized (Ollen et al., 2017). Conversely, Eisenberg et al. (2017) found no significant differences between sexual minority and heterosexual students in reporting sexual assault to formal sources.

Other Characteristics and Support Utilization

Greek affiliation. There is a paucity of research that has examined characteristics like Greek affiliation and support utilization. The one study we did find examined the association between Greek affiliation, participation in athletics, and affiliation with other student organizations (e.g., student government) and the likelihood to report a sexual assault to formal on-campus services (Mennicke et al., 2019). Mennicke et al. (2019) found that 83% of students who utilized formal services on campus were affiliated with a student organization, but they were not Greek affiliated. None of the students in the sample who were Greek affiliated reported their sexual assault to a formal resource (Mennicke et al., 2019).

Risk behaviors. Like Greek affiliation, few studies have examined risk behaviors (i.e., heavy drinking) and support utilization. Ullman et al. (2008) analyzed the relationship between problematic drinking and sexual assault survivors’ disclosure rates. There were no significant differences between the sexual assault disclosure rates of survivors who engaged in problematic drinking behaviors and survivors who were nonproblematic drinkers (Ullman et al., 2008). Additionally, in a national sample of college women, Amstadter et al. (2010) found that binge drinking was not associated with seeking help from formal services after experiencing sexual assault. Though no research has examined the association between how often someone engages in hooking up (i.e., has casual sexual encounters without the expectation of future encounters) and their likelihood to utilize supports and services after experiencing a sexual assault, this is an area in need of further study as these individuals may be less likely to seek support if assaulted if they believe others will blame them for the assault.

Mental health. Some studies have also examined some mental health measures and their association with support utilization (Amstadter et al., 2010; Fleming et al., 2021; Starzynski et al., 2007). Starzynski et al. (2007) found a significant association between a diagnosis of PTSD and depression and seeking formal help from a mental health provider. These findings were further supported by Fleming et al. (2021) who found that survivors with PTSD symptoms and depression were more likely to utilize resources and/or seek help (Fleming et al., 2021).

Theoretical Framework

The service utilization framework developed by Logan et al. (2005) is used to understand the factors that influence sexual assault survivors’ support utilization. Drawing on work from Penchansky and Thomas (1981), Logan et al. (2005) analyzed the reasons why women who had been victimized did not utilize health or criminal justice services. Logan et al. (2005) developed a conceptual framework with four main barriers to service use: availability, affordability, accessibility, and acceptability. Availability refers to the existence of resources in the community, affordability refers to how much those resources cost, accessibility refers to barriers to accessing the resources, and acceptability refers to feelings or beliefs about accessing resources (Logan et al., 2005). Some concerns about acceptability included shame and blame about the incident, lack of sensitivity, the possibility of backlash from family or the community, confidentiality concerns, loss of trust of others, fears of revictimization by the system, police and criminal justice attitudes, and feeling that they do not need help.

Applied to the current study, while most college students have both access to and availability of formal resources at no cost, the acceptability of utilizing support varies. Men, racial and ethnic minorities, and sexual minorities may be less likely than their counterparts to seek support formally and informally due to acceptability concerns. Men, for example, often feel more shame about the incident due to the stigma of male sexual assault (Mezey & King, 1987), racial and ethnic minorities have more mistrust of the criminal justice system (Hamby, 2008), and sexual minorities have fears of being “outed” (Ollen et al., 2017) that prevent them from utilizing support systems. Furthermore, survivors who participate in more risk behaviors (i.e., heavy drinking and hooking up) may have acceptability concerns such as fears of perceptions by others and the criminal justice system that may make them less likely to seek support. Conversely, some factors may make survivors more likely to seek support such as experiencing a physically forced sexual assault or suffering from higher PTSD symptoms and/or depression symptoms. Survivors who experience a forced sexual assault may experience less shame and blame than survivors of other types of assaults and, thus, seeking help may seem more acceptable. Additionally, survivors with more PTSD symptoms or more depression symptoms may feel that they need help to cope with their symptoms (e.g., counseling) and may be more likely to utilize support.

Hypotheses

Based on the above literature review and theoretical framework, the following were hypothesized: Hypothesis 1: Women would be more likely to utilize support than men. Hypothesis 2: Those who identify as heterosexual would be more likely to utilize support than those who identify as sexual minority. Hypothesis 3: Those who identify as White would be more likely to utilize support than those who identify as Black or African American, Hispanic or Latino, Asian, American Indian, other race/ethnicity. Hypothesis 4: Those who are Greek affiliated would be less likely to utilize support than those who are not Greek affiliated. Hypothesis 5: Those who engage in more heavy drinking and those who hook up more frequently would be less likely to utilize support. Hypothesis 6: Those with greater PTSD symptoms or those with greater depression symptoms would be more likely to utilize support. Hypothesis 7: Those who experienced a coerced sexual assault would be less likely to utilize support. Hypothesis 8: Those who experienced a forced sexual assault would be more likely to utilize support. Hypothesis 9: Those who experienced an incapacitated sexual assault would be less likely to utilize support. Due to the lack of research on different types of sexual assault with service utilization, Hypotheses 7–9 are considered exploratory.

Methods

Study Site and Sample Size

Data presented here were gathered in Fall and Spring 2019–2020 at a large public university in the Midwestern United States. Undergraduate enrollment is approximately 25,000 students and the racial composition at this university is approximately 80% White. The total sample consisted of 783 undergraduate college women and men.

Procedure

Undergraduate students enrolled in social science courses completed a paper-and-pencil survey of family histories, risk behaviors, sexual assault, mental health, and support services. All students were given a survey packet, which included a handout listing various campus resources (e.g., counseling) available to students. Every student was eligible to participate. Students were informed that their participation was voluntary and their responses were anonymous. Students were given the option of extra credit for filling out the survey. If a student did not wish to complete the survey, they were given another option for extra credit. Students were told that if they chose not to fill out the survey or do the alternative extra credit assignment, it would not affect their course grade. The overall response rate across all classes was approximately 96%. The Institutional Review Board at the University of Nebraska–Lincoln approved this study.

Measures

Independent Variables

Respondents were asked, “what is your sex” with the response options: male, female, transgender. Only one respondent identified as transgender. This variable was coded as 0 = male and 1 = female. Age was the respondent’s current age. Sexual orientation was recoded as 0 = lesbian, gay, bisexual, other and 1 = straight/heterosexual. Race was recoded as 0 = Black or African American, Hispanic or Latino, Asian, American Indian, other race/ethnicity and 1 = White. Greek affiliated was coded 0 = not Greek affiliated and 1 = Greek affiliated.

Heavy drinking included two items (adapted from Testa et al., 2003), which asked respondents, during the past 12 months, “how many times have you gotten drunk on alcohol” and “how many times have you consumed five or more (if you are a man)/four or more (if you are a woman) drinks in a single sitting” (1 = never to 5 = five or more days per week). The two items were averaged such that a higher score indicates more frequent heavy drinking (Testa et al., 2003). The correlation between the two items was .80. These items have been shown to be reliable predictors of support utilization among college students (Amstadter et al., 2010).

Hooking up was a single item measure, which asked respondents, “How many times in the past 12 months have you hooked up?” (1 = never to 5 = 10 or more times).

PTSD symptoms included 14 items from the PTSD Checklist for DSM−5 (PCL−5) (Weathers et al., 2013). Respondents were provided with a list of problems “that people sometimes have in response to a very stressful experience” and asked to circle the number that indicates how much they had been bothered by that problem in the past month. For example, “feeling very upset when something reminded you of the stressful experience,” and “avoiding external reminders of the stressful experience (e.g., people, places, conversations…or situations?”; 1 = not at all to 5 = extremely). The 14 items were summed such that higher scores indicated more PTSD symptoms (α = .94). The PCL− 5 was reduced from its original 20 items to 14 items due to time constraints of filling out surveys in class. For example, the item “repeated, disturbing dreams of the stressful experience” was not included but “repeated, disturbing and unwanted memories of the stressful experience” was included. Also, the item, “avoiding memories, thoughts, or feelings related to the stressful experiences” was not included but “avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)” was included. Similar items have been shown to be reliable predictors of formal and informal support use among college students (Starzynski et al., 2007).

Depressive symptoms included the 10-item Center for Epidemiological Studies Depression short form (CES-D−10), which is a widely used self-report measure of depression symptomatology (Radloff, 1977). The CES-D, which requires respondents to reflect upon their experiences during the past week, included items such as “I was bothered by things that don’t usually bother me” and “I had trouble keeping my mind on what I was doing” (1 = never to 4 = 5–7 days). Certain items were reverse coded and then summed such that higher scores indicated more symptoms of depression (α = .68). Similar items have been shown to be reliable predictors of formal and informal support use among college students (Starzynski et al., 2007).

Types of sexual assault were assessed using a modified version of the Revised Sexual Experiences Scale (R-SES; Testa et al., 2004). There are three subscales, coercive, physical, and incapacitation, which were examined individually. The three variables examined here include: coercive sexual assault (four items), physical sexual assault (four items), and incapacitated sexual assault (four items).

Both women and men were asked the following 12 questions: How often has anyone: (a) “overwhelmed you with arguments about sex or continual pressure for sex in order to…”, (b) “threatened to physically harm you or used physical force (such as holding you down) in order to…”, and (c) “When you were incapacitated (e.g., by drugs or alcohol) and unable to object or consent how often has anyone ever…” within the past 12 months? Within each of these three sections, the following four questions were asked: (a) fondle, kiss, or touch you sexually; (b) try to have sexual intercourse with you (but it did not happen); (c) succeed in making you have sexual intercourse; and (d) make you have oral or anal sex or penetrate you with a finger of objects “when you indicated you didn’t want to?” Response categories ranged from 0 = never to 4 = more than four times. For each of the three subscales (i.e., coercive, physical, incapacitation), the individual items were first dichotomized (0 = never happened and 1 = happened at least once), and then a count variable was created for each subscale. The count variables for each subscale were then dichotomized due to skew such that 0 = have never experienced that type of sexual assault and 1 = have experienced that type of sexual assault one or more times. The R-SES has also been shown to have good validity as a theoretical predictor of service use (Campbell & Raja, 2005; Graham et al., 2021).

Dependent Variables

Immediately following the sexual assault items listed earlier, respondents were asked about both formal and informal services and supports (Holland et al., 2021). Informal support utilization was measured using three items that asked respondents if they told other people about the incident that they had experienced in the past 12 months including a friend, family member, or significant other (yes/no). The final variable was dichotomized such that 0 = did not tell any of these individuals and 1 = told one or more of these individuals.

Formal support utilization was assessed by asking respondents if they had ever sought help from one or more of several resources on campus related to the incident in the past 12 months. Specifically, respondents were asked if they sought help from the following formal resources: counseling center, victim advocacy, women’s center, the Title IX office, campus police, and university housing (e.g., resident assistant; yes/no). The final variable was dichotomized such that 0 = did not use any formal supports and 1 = used one or more formal supports.

Data Analytic Procedure

First, percentages are displayed for each of the variables that comprise informal and formal supports. Second, Pearson’s correlations were run to examine the bivariate relationship between all study variables. Third, two logistic regressions were performed to examine correlates of informal supports and formal supports. The models were run in four separate steps to see the influence of different variable types. For example, Model 1 in Tables 2 and 3 includes demographic/social variables, Model 2 includes risk behavior variables, Model 3 includes mental health variables, and Model 4 includes the three sexual assault variables. All models control for respondent age. Analyses were performed using IBM SPSS Statistics version 25.

Sample Characteristics

The total sample consisted of 783 respondents. Of these, only those who had experienced a sexual assault in the past 12 months were selected for the current analyses, resulting in a sample size of 317 respondents. Of these, 75.0% were female, 76.9% were White, and 13.2% identified as a sexual minority. The median age was 19 years and just over one-third of respondents (34.7%) had a Greek affiliation.

Results

Table 1 presents percentages for the different forms of informal and formal supports. As indicated in column 1, 36.6% of students who experienced a sexual assault told a friend about it, 20.5% told a partner, and only 13.2% told a family member. Overall, 39.4% of students reported the incident to one or more of these informal supports. The second column shows the percentage of students who used formal supports. Specifically, 9.8% of students used counseling services in response to a sexual assault, whereas 7.3% of students told a housing resident advisor about the incident. Very few students reported the incident to police (2.5%), a victim advocate (0.9%), the women’s center (0.6%), or a Title IX office (1.6%). Overall, 16.1% of college students reported the sexual assault to one or more formal supports.

Table 1.

Percentages for Informal and Formal Support Types.

	Informal Supports		Formal Supports
	N	%	N	%
Friend	116	36.6%	–	–
Family	42	13.2%	–	–
Partner	65	20.5%	–	–
Counseling services	–	–	31	9.8%
Housing	–	–	23	7.3%
Police	^–	–	8	2.5%
Victim advocate	^–	–	3	0.9%
Women’s center	^–	–	2	0.6%
Title IX office	^–	–	5	1.6%
Total per column	¹125	39.4%	¹51	16.1%

Note: N = 317. ¹Numbers do not add up as respondents may have used more than one source of support.

Pearson’s bivariate correlations for all study variables are shown in Appendix A. Students who reported using informal services were more likely to be female (r = .18, p < .01), and have greater PTSD symptoms (r = .23, p < .01) and greater depressive symptoms (r = .14, p < .05). Experiencing physical (r = .23, p < .01) and incapacitated sexual assault (r = .23, p < .01) were positively correlated with using informal supports. Heterosexual students were less likely to have reported using both informal (r = –.15, p < .01) and formal services (r = –.21, p < .01) compared to sexual minority students. Those who reported using formal services were older (r = .14, p < .05), and had greater PTSD symptoms (r = .27, p < .01).

Logistic regression model results for “informal” support use, which includes friends, family, and partner, is shown in Table 2. Model 1 revealed that female students were over two and a half times more likely to have used informal support compared to male students (OR = 2.62; CI = 1.40–4.90), while heterosexual students had 64% lower odds of using informal support compared to sexual minority students (OR = 0.36; CI = 0.17–0.73). Model 2 added the risk behaviors of heavy drinking and hooking up, but neither was significant. The variables female and heterosexual remained significant correlates of using informal support. Model 3 revealed that students with greater PTSD symptoms were 1.04 times more likely to access informal support compared to students with fewer PTSD symptoms (OR = 1.04; CI = 1.00–1.06). The variables female and heterosexual remained significant correlates in Model 3. The addition of the different sexual assault types in Model 4 revealed that students who experienced physical sexual assault were over two times more likely (OR = 2.09; CI = 1.08–4.06) and those who experienced incapacitated sexual assault were over three and a half times more likely to have used informal supports (OR = 3.60; CI = 1.94–6.67). Finally, students who had higher levels of heavy drinking had 37% lower odds of using informal support compared to those with lower levels of heavy drinking (OR = 0.63; CI = 0.44–0.90). The final model explained 24% of the variance in using informal supports.

Table 2.

Logistic Regression Models for Correlates of Informal Supports.

	Model 1		Model 2		Model 3		Model 4
	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Female	2.62**	1.40–4.90	2.50**	1.33–4.72	2.54**	1.25–5.51	2.05*	1.04–4.05
Age	1.02	0.83–1.24	1.02	0.83–1.25	1.03	0.83–1.30	0.99	0.79–1.23
Heterosexual	0.36**	0.17–.73	0.37**	0.18–0.76	0.46*	0.23–1.11	0.44*	0.20–0.96
White	1.02	0.56–1.88	1.07	0.58–1.99	1.17	0.69–2.95	1.20	0.61–2.34
Greek affiliated	1.16	.68–1.97	1.23	0.71–2.14	1.36	0.69–2.42	1.21	0.67–2.18
Heavy drinking			0.77	0.57–1.05	0.81	0.56–1.12	0.63**	0.44–0.90
Hooking up			1.12	0.95–1.31	1.08	0.88–1.28	1.05	0.88–1.25
PTSD symptoms					1.04**	1.00–1.06	1.02	1.00–1.05
Depressive symptoms					1.00	0.97–1.08	1.01	0.95–1.07
Coercive SA							1.23	0.65–2.32
Physical SA							2.09*	1.08–4.06
Incapacitated SA							3.60**	1.94–6.67
LRχ²	386.40**		382.63**		371.10**		347.40**
d.f.	5		7		9		12
Nagelkerke R²	.08		.10		.14		.24

Note. OR = odds ratio; CI = confidence interval; SA = sexual assault. **p ≤ .01; *p ≤ .05; +p < .10

Logistic regression model results for “formal” support use is shown in Table 3. Model 1 revealed that older college students were 1.29 times more likely to have utilized formal supports compared to younger students (OR = 1.29; CI = 1.02–1.62), while heterosexual students had 71% lower odds of accessing formal supports compared to students who identified as sexual minority (OR = 0.29; CI = 0.13–0.63). Model 2 added the risk behaviors of heavy drinking and hooking up, but neither was significant. The variables age and heterosexual remained significant. Model 3 revealed that students with greater PTSD symptoms were 1.07 times more likely to access formal supports compared to students with fewer PTSD symptoms (OR = 1.07; CI = 1.04–1.11). Additionally, students with fewer depressive symptoms were 7% less likely to use formal supports compared to their counterparts (OR = 0.93; CI = 0.86–1.00). Age and sexual orientation remained significant correlates in this model. The addition of the different sexual assault types in Model 4 revealed that none of them were significant. Like Model 3, age, sexual orientation, PTSD symptoms and depressive symptoms remained significant correlates. The final model explained 20% of the variance in using formal supports.

Table 3.

Logistic Regression Models for Correlates of Formal Supports.

	Model 1		Model 2	Model 4	Model 3		Model 4
	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Female	1.57	0.71–3.44	1.58	0.72–3.48	1.67	0.73–3.86	1.64	0.69–3.89
Age	1.29*	1.02–1.62	1.28*	1.02–1.62	1.36*	1.06–1.74	1.35*	1.05–1.74
Heterosexual	0.29**	0.13–0.63	0.29**	0.13–0.63	0.33**	0.14–0.76	0.33**	0.14–0.76
White	0.83	0.39–1.77	0.81	0.37–1.75	1.00	0.44–2.29	0.96	0.42–2.22
Greek affiliated	0.86	0.40–1.84	0.84	0.39–1.82	0.95	0.43–2.12	0.97	0.43–2.17
Heavy drinking			1.03	0.69–1.52	1.09	0.72–1.65	1.08	0.70–1.65
Hooking up			1.04	0.84–1.29	0.99	0.79–1.24	0.99	0.78–1.24
PTSD symptoms					1.07**	1.04–1.11	1.07**	1.04–1.11
Depressive symptoms					0.93*	0.86–1.00	0.92*	0.86–1.00
Coercive SA							1.28	0.53–3.10
Physical SA							0.76	0.33–1.78
Incapacitated SA							1.11	0.52–2.36
LRχ2	250.95**		250.76*		230.80**		230.10**
d.f.	5		7		9		12
Nagelkerke R²	.09		.09		.20		.20

Note. OR = odds ratio; CI = confidence interval; SA = sexual assault. **p ≤ .01; *p ≤ .05; +p < .10

Discussion

The purpose of this article was to examine what factors were associated with utilizing support from informal sources and formal sources following a sexual assault. The current study results show that 39.4% of sexual assault survivors sought support from informal sources, including a friend, family member, or partner, and 16.1% sought support from formal sources. These prevalence rates of support utilization from formal and informal sources are consistent with past research (DeLoveh & Cattaneo, 2017; Walsh et al., 2010, respectively). Gender, sexual orientation, heavy drinking, and physical and incapacitated sexual assault are associated with the likelihood of students utilizing informal support, while age, sexual orientation, PTSD symptoms, and depressive symptoms are associated with the likelihood of students seeking formal support.

Consistent with previous literature (Banyard et al., 2007; Masho & Alvanzo, 2010; Walsh et al., 2010), the current study found partial support for Hypothesis 1. There is a significant association between gender and the likelihood of using informal support. Specifically, women are more likely to utilize informal support compared to men. One possible explanation for this finding is that men may feel more shame about sexual victimization due to the stigma of male sexual assault (Mezey & King, 1987) and thus may feel it is less acceptable for them to utilize support or services even if they need them (Logan et al., 2005). Furthermore, gender role socialization that stereotype men as strong may make them less likely to label their experiences as sexual assault and thus less likely to utilize support or services (Banyard et al., 2007). When it comes to formal supports, however, it is possible that both men and women are reluctant to use such services because they fear they may get into trouble, or they might not be believed. Moreover, survivors who participate in more risk behaviors (i.e., heavy drinking and hooking up) may have acceptability concerns like fears of perceptions by others and the criminal justice system that may make them less likely to seek support. Therefore, they may feel that it is not acceptable to utilize support services, which is consistent with the service utilization framework (Logan et al., 2005). This finding is also consistent with the fact that we found no significant gender difference for formal support use.

For Hypothesis 2, though there is a significant association between sexual orientation and using informal and formal support, the relationship was in the opposite direction of what was expected. That is, heterosexual students were less likely to utilize informal and formal supports than sexual minority students, which is contrary to the literature (Richardson et al., 2015). One possible explanation for why students who identify as sexual minority were more likely to seek services and support may be because they experience higher rates of depression and suicidality than heterosexual students (Burton et al., 2013). The poorer mental health outcomes experienced by sexual minority students may cause them to seek out services or support at greater rates than heterosexual students (McNair & Bush, 2016) to cope with poorer mental health. Thus, they may find service seeking as more acceptable if they have previously obtained services and support, which is also consistent with the service utilization framework (Logan et al., 2005).

Hypothesis 3, which stated that White students would be more likely to seek services and supports compared to racial/ethnic minority students, was not supported. In fact, no association between race and support utilization was found, which is inconsistent with previous research (Amstadter et al., 2008; Starzynski et al., 2007; Woltizky-Taylor et al., 2011). One possible explanation for this lack of a significant finding may be because 80% of respondents in the current study were White while prior studies have utilized larger community samples (Amstadter et al., 2008; Starzynski et al., 2007), which are likely more diverse. Furthermore, it is also possible that students of all races are equally likely to seek support. For example, in a study examining race and general help-seeking tendencies, Cheatham et al. (1987) found that individuals of different races were similar in their help-seeking behaviors. It is also possible that students of all races may be reluctant to utilize support for varying reasons such as it may not be seen as acceptable or they may worry about getting in trouble or being rejected by their peers. These findings and explanations are consistent with the service utilization framework, which focuses on perceptions and acceptability when it comes to assessing services (Logan et al., 2005).

Though Greek-affiliated students were expected to be less likely to utilize services and support compared to their counterparts, this Hypothesis 4 was not supported. The lack of a significant finding is consistent with the work of Mennicke et al. (2019). As Mennicke et al. (2019) explain, male-dominated spaces like fraternities have been shown to cultivate sexual violence, and this negative space (i.e., a space that is not supportive of survivors) could discourage male survivors of sexual violence from seeking support or services when they need them (Mennicke et al., 2019). As such, seeking support may be viewed as less acceptable for members of fraternities (Logan et al., 2005). Furthermore, females involved in Greek life may fear that their sorority would face disciplinary action if a sexual assault were reported, and this may make them reluctant to utilize support or services after experiencing a sexual assault.

Additionally, the current findings show partial support for Hypothesis 5. Specifically, students who report more heavy drinking have lower odds of informal support utilization compared to students who report less heavy drinking. One possible explanation is that survivors of sexual assault who drink heavily may fear that they will be blamed for the assault and thus they may be less likely to seek out services or support. Furthermore, if they are drinking alcohol and are underage, they may fear disciplinary actions or even expulsion, which may be an additional reason for why they may not seek services or support. The current findings reveal no significant association between hooking up and support or service utilization contrary to expectations. One possible explanation for this is that hooking up is pervasive on college campuses and is part of the mainstream college culture (Allison & Risman, 2014). As such, a sexual assault that occurs within the context of a hookup may not involve any more or any less self-blame or fear of being blamed than a sexual assault that occurs in any other context and, therefore, there is no difference in the survivor’s likelihood of utilizing support or services.

Results show partial support for Hypothesis 6: students with greater PTSD symptoms are more likely to access services than those with fewer symptoms. This finding is consistent with Fleming et al. (2021) who found that survivors with PTSD symptoms were more likely to seek help and/or utilize resources than survivors without PTSD symptoms. Additionally, Starzynski et al. (2007) also found a significant association between having PTSD symptoms and formally disclosing a sexual assault. As Starzynski et al. (2007) suggest, it is logical that survivors with PTSD symptoms would be more likely to disclose their sexual assault, as they may need to disclose to cope with their symptoms. The current study found an association between depressive symptoms and formal support, but in the opposite direction of what was expected. That is, survivors with more depressive symptoms are less likely to formally disclose their sexual assault than individuals with less depressive symptoms. It is possible that the symptoms of depression (i.e., low motivation, social isolation) make utilizing support more difficult. Thus, experiencing more depressive symptoms is associated with a lower likelihood of utilizing support.

Hypothesis 7, which stated that those who experienced a coerced sexual assault would be less likely to utilize support is not supported. Because coerced sexual assault is the most prevalent form of sexual assault on college campuses, many students may not label it as sexual assault because it often occurs as a result of arguments or pressure (Fedina et al., 2018). Therefore, students may not access services or support even when they need to because they do not label their experience as a sexual assault. Additionally, survivors of a coerced sexual assault may not perceive support utilization as acceptable (Logan et al., 2005). They may believe that their assault is not serious enough to warrant help because it occurred as a result of arguments or pressure and, therefore, do not see support seeking as acceptable. Furthermore, if they know their assailant, they may be pressured by their peers not to seek services as this may result in the assailant getting into trouble. Thus, one’s acceptability and one’s perceptions are influential when it comes to assessing services (Logan et al., 2005).

Consistent with previous research (Fisher et al., 2003; Krebs et al., 2007), students who experience physical sexual assault are more likely to utilize informal support, which is supportive of Hypothesis 8. Sexual assault incidents that are like “classic rapes” (i.e., physical force is used) are more likely to be reported because survivors see them as more believable (Fisher et al., 2003). This may explain why survivors are more likely to seek support after experiencing this type of sexual assault. Contrary to Hypothesis 9, students who experience incapacitated sexual assault are more likely to utilize informal support. Though this finding was significant, it was in the opposite direction of what was predicted. It is possible that these students are more likely to seek support from friends (i.e., informal support) because they do not have to be concerned about the perception that their drinking may somehow diminish their credibility, which may be the case with authorities (Logan et al., 2005). Thus, students may be more likely to report incapacitated sexual assault to informal supports but still may be reluctant to solely use formal services, which is consistent with some prior literature (Fisher et al., 2003). According to Fisher et al. (2003), survivors of an assault involving drugs or alcohol were more likely to have reported the assault to informal sources of support like friends. Due to the limited research on the different types of sexual assault and the likelihood of support utilization, current results surrounding Hypotheses 7–9 should be considered exploratory.

Limitations

There are limitations with the current study. First, data are based on self-reports. Despite this, participants were informed that their answers would be anonymous so it is less likely that respondents would be motivated to bias their responses. Second, the retrospective nature of measures (i.e., past 12 months), may have resulted in some over- or underreporting if respondents misremembered their behavior or experiences. Third, this study was cross-sectional and cannot be generalized to the whole college population given the sample was not randomly selected. Fourth, the PTSD symptom measure asked about responses to a “very stressful experience” but it is possible that this experience was something other than, or in addition to, a sexual assault. Fifth, though respondents were reporting on an incident of sexual assault in the past 12 months, it is possible that they were thinking of one incident or possibly more than one incident when asked about help seeking behavior. Sixth, given that the sample was 80% White, we were unable to examine different race/ethnic groups separately due to small sample sizes. Finally, due to time constraints of administering the surveys in classes, the PTSD scale was shortened. Cronbach’s alpha for this scale, however, still showed excellent reliability.

Conclusion

This study has many strengths and adds to our current understanding of utilization of services and support after experiencing a sexual assault. This study focused on lesser studied variables such as sexual orientation and race, and their association with service and/or support utilization. Additionally, this study examined whether different types of sexual assault (e.g., coerced sexual assault) were uniquely associated with service use and supports instead of combining sexual assault into a single measure. Furthermore, this study focused on both informal and formal supports as students may be more likely to access one over the other. Overall, the results contribute to our current understanding of support by demonstrating who is likely and unlikely to utilize support and services after a sexual assault.

The finding that sexual minority students are more likely to utilize services or support than heterosexual students suggests the need for further research given the mixed results in the literature. For example, while some research has found that sexual minorities are less likely to use resources after a sexual assault (Richardson et al., 2015), the current study, with data collected in 2019–2020, found that sexual minorities are more likely to use resources. This suggests that perhaps services are becoming more LGBQ friendly. Furthermore, there is no association between racial identity and service utilization. Because the sample was 80% White, this finding suggests the need for larger and more diverse samples to better understand the potential differences among racial identities and service utilization. Although service and support utilization varied by sexual assault type, these hypotheses were exploratory, thus, more research is needed to see whether current results can be replicated with more diverse college samples. If the type of sexual assault influences whether students seek services or supports, some students may be unwilling to access formal services for incapacitated sexual assault, even if they need services, for fear of being blamed. More work is needed to make interventions more accessible and helpful to all sexual assault survivors. Future studies may also wish to examine sexual assault histories beyond the past 12 months, as students’ sexual assault histories have been shown to influence service usage (Burgess-Proctor et al., 2016).

Appendix A.

Table A1.

Correlation Matrix for All Study Variables.

	1	2	3	4	5	6	7	8	9	10	11	12	13	14
Informal services	–
Formal services	.27**	–
Female	.18**	.02	–
Age	–.04	.14*	–.25**	–
Heterosexual	–.15**	–.21**	.03	–.04	–
White	.03	–.06	.13*	–.24**	.03	–
Greek affiliated	.04	–.09	.21**	–.21**	.21**	.25**	–
Heavy drinking	–.10	–.03	–.09	–.02	.10	.20**	.23**	–
Hooking up	.06	.02	.01	–.02	.00	.12*	.11	.23**	–
PTSD symptoms	.23**	.27**	.00	.01	–.22**	–.10	–.15**	–.12*	.09	–
Depressive sympt.	.14*	.06	.00	.03	–.19**	–.06	–.12*	–.10	.03	.56**	–
Coercive SA	.05	.07	.14*	–.04	–.09	–.02	–.05	–.16**	.03	.13*	.11	–
Physical SA	.23**	.07	.14*	–.09	–.12*	–.10	.00	–.08	.08	.32**	.13*	.14*	–
Incapacitated SA	.23**	.05	.08	.03	.04	.11	.15**	.33**	.14*	.09	.03	–.34**	.04	–
Mean	.39	.16	.75	1.99	.87	.77	.36	2.12	2.66	31.21	21.63	.75	.21	.54
SD	.49	.37	.43	1.28	.34	.42	.48	.88	1.54	12.58	5.51	.43	.40	.50

Note. **p < .01, *p < .05. SD = standard deviation. SA = sexual assault.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Lora K. McGraw

Kimberly A. Tyler

Author Biographies

Lora K. McGraw, MA, is a phD student in the Department of Sociology at the University of Nebraska–Lincoln. Her research interests include gender and sexuality, partner violence, and sexual assault.

Kimberly A. Tyler, PhD, is Willa Cather professor of Sociology at the University of Nebraska–Lincoln. Her research interests include homelessness, child abuse and neglect, partner violence, substance use, and other high-risk behaviors among adolescents and youth.

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