University of Illinois Urbana-Champaign

A longitudinal examination of posttraumatic growth (PTG) and posttraumatic stress disorder among female adult sexual assault survivors: exploring the roles of demographic factors, trauma history, social support, and institutional betrayal

Hsieh, Wan-Jung Wendy

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HSIEH-DISSERTATION-2022.pdf

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https://hdl.handle.net/2142/115892

Description

Title
A longitudinal examination of posttraumatic growth (PTG) and posttraumatic stress disorder among female adult sexual assault survivors: exploring the roles of demographic factors, trauma history, social support, and institutional betrayal
Author(s)
Hsieh, Wan-Jung Wendy
Issue Date
2022-07-13
Director of Research (if dissertation) or Advisor (if thesis)
Garthe, Rachel
Doctoral Committee Chair(s)
  • Tabb Dina, Karen
  • Garthe, Rachel
Committee Member(s)
  • Powell, Tara
  • Allen, Nicole
Department of Study
School of Social Work
Discipline
Social Work
Degree Granting Institution
University of Illinois at Urbana-Champaign
Degree Name
Ph.D.
Degree Level
Dissertation
Keyword(s)
  • post-traumatic growth (PTG)
  • Sexual assault survivors
  • Post-Traumatic Stress Disorder (PTSD)
  • institutional betrayal
Abstract
Sexual violence is a serious public health concern, and it can trigger psychological distress and adverse psychological outcomes such as post-traumatic stress disorder (PTSD) among survivors. Sexual assault survivors, however, may also experience post-traumatic growth (PTG), which is defined as an individual’s positive transformation following a traumatic event. In recent years, although a growing body of literature has shifted its focus on the positive transformation following sexual assault, there is a lack of research examining the longitudinal trajectory and development of this PTG among sexual assault survivors. On the other hand, although several existing studies examine sexual assault survivors’ PTSD symptoms longitudinally, the developmental course and the rate of recovery from PTSD symptoms remain inconclusive. In addition, the construct of institutional betrayal (IB), has not yet been thoroughly investigated in its application to traumatic responses to female adult sexual assault (ASA) survivors, and IB also requires more longitudinal research in the examination of its relationship with PTG and PTSD symptoms. Thus, in this dissertation, I will make contributions by exploring: (a) the longitudinal trajectories of PTG and PTSD symptoms among female ASA survivors, (b) how social ecological factors are associated with the trajectories of PTG and PTSD symptoms, and (c) the construct of IB within the sexual assault context and its association with PTG and PTSD symptoms longitudinally. This dissertation utilized data from Inter-university Consortium for Political and Social Research (ICPSR) that examined social reactions to sexual assault disclosure (2013-2016). The analytical sample consisted of 228 female ASA survivors in the United States. I conducted Growth Mixture Modeling (GMM) using Mplus 8.4 to explore heterogeneous trajectories of PTG and PTSD symptoms across a 9-month span, and examine associations between social ecological factors and PTG and PTSD trajectories. Logistic regression analyses were also conducted to explore the associations between IB, PTG, and PSTD. Through GMM, distinct PTG and PTSD trajectories were identified across the four-time points spanning 9 months. For PTG, the three-class, partially constrained model with linear trajectories, was specified. These three classes included: 1) a High Stable PTG group, 2) a Moderate Stable PTG, and 3) a Low Stable PTG. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the assault remained stable. Overall, the results suggest that female ASA survivors are impeded from experiencing significant longitudinal growths following the sexual assault. For PTSD symptoms, heterogeneity was not identified in PTSD symptoms and a linear decelerating trajectory of PTSD symptoms was established (Intercept = 29.93, Slope = -2.96). This result suggests that natural recovery from PTSD is an ongoing process that may continue, however slowly, beyond the immediate aftermath of a sexual assault trauma. In terms of factors contributing to the distinctive trajectories of PTG symptoms among female ASA survivors, findings indicate that being a racial minority and with less education (equal or less than 12 years) was 3.5 times and 6.8 times, respectively, more likely to be assigned to the High Stable PTG class than the Low Stable PTG. For characteristics associated with the PTSD trajectory, findings indicate that female ASA survivors who identified as an ethnic minority (i.e., Latina) reported significantly more severe PTSD symptoms than those who identified as non-Latina, but the rate of change did not differ across time. Additionally, female ASA survivors with a higher level of social support reported less severe PTSD symptoms at the starting point, but the rate of change did not differ over time. In terms of female ASA survivors’ IB experiences, the result from the multivariate logistic regression analysis suggests that older survivors are less likely to experience IB compared to younger survivors. The GMM results further suggest that female ASA survivors reporting experiencing IB at baseline do not significantly predict either trajectory of PTG or PTSD symptoms. Thus, no matter with or without IB experiences, female ASA survivors’ trajectories of PTG and PTSD symptoms were not impacted by experiences of IB in this study sample. Taken together, the findings of this dissertation highlight that additional resources and long-term support for female ASA survivors are crucial. The findings further highlight survivors may concurrently experience both PTSD symptoms and growth outcomes following sexual assault trauma, and thus when implementing trauma interventions, it may be beneficial for providers and clinicians to adopt a growth framework.
Graduation Semester
2022-08
Type of Resource
Thesis
Handle URL
https://hdl.handle.net/2142/115892
Copyright and License Information
Copyright 2022 Wan-Jung Wendy Hsieh

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