Note: The following post, written by Dr. Michelle Lee (Ph.D. ’18), describes findings from her dissertation research.
Sexual assault and harmful alcohol use are significant problems among women attending college, with approximately 20% of women experiencing forced sexual contact, attempted rape, and/or rape as college students (Fisher et al., 2003; Krebs et al., 2007; SAMHSA, 2015). Sexual assault places women at risk for heavy alcohol use, and both sexual assault and heavy alcohol use are associated with negative physical and psychosocial outcomes, such as physical and mental health issues and impaired academic performance (NIAAA, 2002; Wechsler et al., 2002).
While research has established sexual assault as a risk factor for heavy alcohol use, the mechanisms underlying this association in college women continues to require research attention. For my dissertation study, I examined the relationship between sexual assault and later alcohol use across a four-month period and the role of executive function (EF; cognitive abilities such as attention, planning, and working memory) in this relationship.
Sexual assault has been shown to negatively impact cognitive functioning, including EF, which may increase risk of alcohol use following sexual assault due to associated difficulties monitoring and regulating behavior. For instance, college women who have difficulty blocking alcohol-related stimuli and executing healthy coping behaviors when encountering alcohol may be more at risk of heavy alcohol use compared to women who are better able to regulate emotions and psychological distress, skills associated with EF.
Participants were 176 women undergraduate students receiving course credit in psychology classes for research participation. Participation involved answering questions about previous sexual assault and alcohol use as well as a battery of EF tasks. Women who agreed to be contacted were emailed in four months with an invitation to complete an optional second survey asking about sexual assault and alcohol use within the last four months. Eighty-five women completed this second survey.
Results indicated that women experienced on average 2.13 experiences of forced sexual contact, attempted rape, and/or rape since the age of 18 and .42 experiences in the four months between the first and second research participation. Participants in this study demonstrated a low to moderate risk of alcohol problems as measured by a frequently used assessment of alcohol use (Alcohol Use Disorders Identification Test; Saunders et al., 1993). Younger college students in their first and second years demonstrated more risky alcohol use behaviors than students in their third and fourth years. Sexual assault was positively associated with alcohol use and both the first and second interviews. Additionally, EF significantly predicted alcohol use four months later, even after controlling for previous alcohol use and age.
Given the negative consequences of heavy alcohol use and sexual assault among women in college, better understanding the relationship between alcohol use and sexual assault is needed to guide prevention and intervention efforts on campuses in the future.
Women may drink more heavily following sexual assault as a method to cope with negative emotions and regulate assault-related responses. As a mechanism of emotional and behavioral regulation, EF was shown to have additive effects in predicting alcohol use following sexual assault among college women. The results of this study may inform alcohol- and sexual assault-related intervention on college campuses. For instance, campus outreach programs may educate students on the risk of heavy alcohol use following sexual assault, but that cognitive skills such as information processing may mitigate such risks. Outreach programs may also specifically target younger students in their first or second years and those with known histories of heavy alcohol use. The relationship between alcohol use and sexual assault is complex and further work is needed to understand the individual and contextual factors that link this relationship. Given the negative consequences of heavy alcohol use and sexual assault among women in college, better understanding the relationship between alcohol use and sexual assault is needed to guide prevention and intervention efforts on campuses in the future.
Fisher, B. S., Daigle, L. E., Cullen, F. T., & Turner, M. G. (2003). Reporting sexual victimization to the police and others: Results from a national-level study of college women. Criminal Justice and Behavior, 30(1), 6-38. https://doi.org/10.1177/0093854802239161
Krebs, C. P., Lindquist, C. H., Warner, T. D., Fisher, B. S., & Martin, S. L. (2007). The campus sexual assault (CSA) study: Final report. Washington, DC: National Institute of Justice, US Department of Justice.
National Institute on Alcohol Abuse and Alcoholism College Task Force. (2002). A Call to Action: Changing the Culture of Drinking at U.S. Colleges. Retrieved from https://www.collegedrinkingprevention.gov/niaaacollegematerials/publications/calltoaction.aspx.
Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption‐II. Addiction, 88(6), 791-804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x
Substance Abuse and Mental Health Services Administration. (2015). Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf.
Wechsler, H., Lee, J. E., Kuo, M., Seibring, M., Nelson, T. F., & Lee, H. (2002). Trends in college binge drinking during a period of increased prevention efforts: Findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993–2001. Journal of American College Health, 50(5), 203-217. https://doi.org/10.1080/07448480209595713