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Psychological Trauma: Theory, Research, Practice, and Policy © 2016 American Psychological Association
2017, Vol. 9, No. 2, 166 –172 1942-9681/17/$12.00 http://dx.doi.org/10.1037/tra0000186

Assault-Related Shame Mediates the Association Between Negative Social

Reactions to Disclosure of Sexual Assault and Psychological Distress

Christopher R. DeCou, Trevor T. Cole, Kathleen C. Matthews

Shannon M. Lynch, and Maria M. Wong VA Central Iowa Health Care System, Des Moines, Iowa
Idaho State University

Objective: Several studies have identified associations between social reactions to disclosure of sexual
assault and psychological distress; however, no studies have evaluated shame as a mediator of this
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

association. This study evaluated assault-related shame as a mediator of the associations between
This document is copyrighted by the American Psychological Association or one of its allied publishers.

negative social reactions to disclosure of sexual assault and symptoms of posttraumatic stress disorder
(PTSD), depression, and global distress and hypothesized that there would be an indirect effect of social
reactions to disclosure upon symptoms of psychopathology via assault-related shame. Method: Partici-
pants were 207 female psychology undergraduates who reported past history of completed or attempted
sexual assault and had disclosed the assault to at least 1 other person. Participants completed self-report
measures of social reactions to sexual assault disclosure, assault-related shame, and symptoms of
psychopathology. Results: Participants reported significant histories of attempted or completed sexual
assault and indicated clinically significant symptoms of depression and subthreshold symptoms of PTSD
and global distress, on average. Evaluation of structural models confirmed the hypothesized indirect
effect of negative social reactions to sexual assault disclosure upon symptoms of PTSD (z ⫽ 5.85, p ⬍
.001), depression (z ⫽ 4.56, p ⬍ .001), and global distress (z ⫽ 4.82, p ⬍ .001) via assault-related shame.
Conclusions: These findings offer new insight concerning the intervening role of assault-related shame
and highlight the importance of shame as a target for therapeutic intervention. This study suggests the
need for future research concerning the role of shame in the etiology of PTSD and process of disclosure
among survivors of attempted or completed sexual assault.

Keywords: shame, sexual assault, PTSD, college women, structural equation modeling

Attempted or completed sexual assault remains a critical health
concern for college-age women in the United States (Sinozich &
Langton, 2014). Several definitions of sexual assault have been
utilized in previous research, and thus precise estimates of the
prevalence of sexual assault vary from study to study (Rennison &
Addington, 2014). The present study defined sexual assault to
include any form of unwanted sexual touching, attempted or com-
pleted sexual coercion, and/or attempted or completed rape. In a
previous study that employed a similar definition of sexual assault,
Krebs and colleagues (2007) found that nearly 30% (i.e., 28.5%) of
women in a nationally representative sample of college undergrad-
uates reported past history of attempted or completed sexual as-
sault. Of those who reported histories of sexual assault, approxi-
mately 16% reported experiencing attempted or completed assault
prior to entering college and approximately 19% reported experi-
encing attempted or completed assault since matriculating in col-
lege (Krebbs, Lindquist, & Warner, 2007). Given the myriad
This article was published Online First September 8, 2016.
Christopher R. DeCou, Trevor T. Cole, Shannon M. Lynch, and Maria
M. Wong, Department of Psychology, Idaho State University; Kathleen C.
Matthews, VA Central Iowa Health Care System, Des Moines, Iowa.
Correspondence concerning this article should be addressed to Christo-
pher R. DeCou, Department of Psychology, Idaho State University, 921
South 8th Avenue, Pocatello, ID 83209. E-mail: decochri@isu.edu
negative sequelae of attempted and completed sexual assault, it is
important to consider variables that may confer risk of negative
outcomes among women in college who suffer attempted or com-
pleted sexual assault. This study sought to evaluate the association
between negative and positive social reactions to disclosure of
sexual assault and psychological distress, as mediated by assault-
related shame. Such an evaluation of the indirect effect of social
reactions to sexual assault disclosure via shame may assist in
understanding the development of psychological distress among
women who survive attempted or completed sexual assault.
Previous studies have found that not all survivors of sexual
assault develop clinically significant symptoms of posttraumatic
stress disorder (PTSD), although many do experience significant
distress. For example, Kilpatrick and colleagues (2007) found that
half of rape survivors met lifetime criteria for PTSD in a nationally
representative sample of 2,000 female undergraduates. This find-
ing suggests the importance of understanding risk and protective
factors associated with experiences of sexual assault and subse-
quent psychological distress.
One factor that has been shown to predict psychological distress
among survivors of sexual assault is social reactions to disclosure
of sexual assault (Ullman, 1996). Social reactions to sexual assault
disclosure comprise the extent to which others respond to disclo-
sure of sexual assault in ways that are helpful or unhelpful and
often include overlap among specific positive and negative reac-
tions (Ullman, 1996). Previous studies have demonstrated the

166
 SHAME AND SOCIAL REACTIONS TO DISCLOSURE
potential for positive reactions to disclosure, such as emotional
support and tangible aid, to mitigate the potential negative out-
comes of sexual assault. For example, researchers have found that
positive social reactions to disclosure (e.g., emotional, tangible, or
informational support) predict greater adaptive coping (Ullman &
Peter-Hagene, 2014) and greater perceptions of social support over
time (Jonzon & Lindblad, 2004). In contrast, negative social re-
actions to disclosure (e.g., victim blaming, treating the victim
differently) have been associated with greater symptoms of PTSD
(Ullman & Filipas, 2001; Ullman, Filipas, Townsend, & Starzyn-
ski, 2007), depression (Orchowski, Untied, & Gidycz, 2013),
alcohol problems (Peter-Hagene & Ullman, 2014), and psycholog-
ical distress (Littleton, 2010).
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Specifically, in a study conducted by Ullman and colleagues
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(2007) with a large (N ⫽ 636) sample of female sexual assault
survivors, negative social reactions to sexual assault disclosure
were associated with higher levels of PTSD symptoms and also
self-blame and avoidance coping. This finding suggests the im-
portance of considering postassault experiences such as negative
social reactions to disclosure among sexual assault survivors as
potential contributing factors to subsequent psychological distress.
Similarly, a study by Orchowski and colleagues (2013) found that
one particular form of negative social reaction (i.e., treating the
victim as incompetent and taking control by making decisions)
significantly predicted higher levels of depression, PTSD, and
anxiety symptoms in a sample of 374 female undergraduates.
Taken together, these findings suggest the importance of consid-
ering negative social reactions to disclosure of sexual assault as
potent risk factors for psychological distress and psychopathology
among female trauma survivors.
Other studies have explored the implications of negative social
reactions to sexual assault disclosure for survivors. For example,
Thompson, Sitterle, Clay, and Kingree (2007) examined barriers to
formal disclosure of sexual assault relative to physical assault
among a sample of 492 college women. They found that shame
emerged as a barrier to reporting assault to the police for survivors
of sexual assault but not among those who suffered nonsexual
physical assault (Thompson et al., 2007). Thus, shame may be
more salient within the context of sexual victimization and disclo-
sure.
Shame is a multifaceted experience of negative self-evaluation
that occurs in tandem with perceived social threat, including fear
of negative judgment from others, and feelings of embarrassment
and inferiority (Budden, 2009). Budden (2009) noted that shame
comprises “part of both individual experience and collective
ethos” (p. 1033), highlighting the way in which shame is a syn-
thesis of perceptions of social threat and individuals’ own self-
appraisal. Thus, shame may be especially salient among survivors
of sexual assault given the potential for negative social reactions
(i.e., Ullman, 1996) that often occur in the wake of sexual trauma.
No previous studies have explicitly evaluated shame as a me-
diator of the association between negative social reactions to
sexual assault disclosure and psychological distress. However,
several studies have demonstrated an association between shame
and symptoms of psychopathology, including symptoms of PTSD
(Beck et al., 2011; La Bash & Papa, 2014), depression (e.g.,
Tangney, Wagner, & Gramzow, 1992), and global distress (e.g.,
Shorey et al., 2011). For example, in a sample of 99 predominantly
(i.e., 83.8%) female psychology undergraduates, La Bash and Papa
167
(2014) found that shame mediated the association between inter-
personal trauma (e.g., physical or sexual assault) and PTSD symp-
toms but not between unintentional traumatic experiences such as
natural disasters or serious illnesses and PTSD symptoms. These
findings indicate that shame may be more relevant to interpersonal
violence compared to other forms of victimization and also dem-
onstrate the association between shame and symptoms of PTSD
(La Bash & Papa, 2014). Similarly, a study by Beck and colleagues
(2011), which included a sample of 63 female interpersonal vio-
lence survivors, found that shame emerged as a significant predic-
tor of PTSD symptoms above and beyond guilt-related distress and
guilt-related cognitions. Notably, this study offered a clear theo-
retical distinction between guilt and shame, whereby guilt was
considered to be negative appraisal regarding past behavior and
shame was considered as negative appraisal toward oneself as a
person. This distinction was supported by the statistical findings
described earlier and highlights how shame represents a unique
construct with regard to symptoms of PTSD and trauma-related
distress (Beck et al., 2011). Despite these robust findings concern-
ing the significant association between shame and symptoms of
psychological distress, including PTSD, for survivors of interper-
sonal trauma, relatively few studies have explicitly addressed
shame as a predictor and/or mediator of trauma-related distress.
Present Study
Our study sought to address this gap in the literature and extend
previous research by evaluating assault-related shame as an inter-
vening variable (i.e., mediator) that might account for, in part, the
association between social reactions to disclosure of sexual assault
and psychological distress (i.e., symptoms of PTSD, depression,
and global distress). It was hypothesized that negative social
reactions to disclosure of sexual assault, broadly defined, would be
associated with greater symptoms of depression, PTSD, and global
distress and that this association would be mediated by assault-
related shame. Conversely, it was hypothesized that positive social
reactions would predict lower ratings on self-report measures of
psychological distress and that this association would also be
mediated by assault-related shame.
Method
Participants
Participants were 207 female undergraduate psychology stu-
dents who reported a history of attempted or completed sexual
assault victimization and disclosed the assault to at least one other
person. Participants ranged in age from 18 to 58 (M ⫽ 26.02, SD ⫽
9.00) and identified primarily as European American (n ⫽ 175;
84.5%) and multiethnic (n ⫽ 14; 6.8%). These characteristics were
generally representative of the university community, including a
relatively larger proportion of nontraditional undergraduate stu-
dents (e.g., one third of students were age 25 or older). Participants
reported multiple forms of attempted or completed sexual assault
victimization, including unwanted sexual contact (n ⫽ 191;
92.3%), attempted sexual coercion (n ⫽ 165; 79.7%), completed
sexual coercion (n ⫽ 176; 85%), attempted rape (n ⫽ 147; 71%),
and completed rape (n ⫽ 168; 81.2%).
 168 DECOU, COLE, LYNCH, WONG, AND MATTHEWS
Measures
Sexual assault victimization and disclosure. Participants’
experiences of sexual assault were assessed using the Sexual
Experiences Survey (SES; Koss et al., 2007). The SES is a seven-
item self-report inventory that assesses experiences of unwanted
sexual contact, sexual coercion, attempted sexual coercion, rape,
and attempted rape. Sexual assault disclosure was assessed via a
single yes or no item (“Did you tell ANYONE about your most
severe or well-remembered unwanted sexual experience?”) pre-
sented after completion of the SES. Participants were asked about
disclosure relative to the most severe or well remembered sexual
experience to frame responses to subsequent items that assessed
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assault-related shame within the context of a particular salient
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event.
Reactions to sexual assault disclosure. Positive and negative
social reactions to disclosure of sexual assault victimization were
assessed using the Social Reactions to Disclosure Questionnaire
(SRQ; Ullman, 2000). The SRQ is a 48-item self-report measure
that assesses a range of possible positive and negative reactions to
disclosure of sexual assault across several domains. Positive reac-
tions included subscales that assessed emotional support (e.g.,
“Told you it was not your fault”), tangible aid (e.g., “Helped you
get medical care”), and informational support (e.g., “Provided
information and discussed options”). Negative reactions included
subscales that assessed victim blame (e.g., “Told you that you were
irresponsible or not cautious enough”), egocentric reactions (e.g.,
“Wanted to seek revenge on the perpetrator”), taking control (e.g.,
“Told others about your experience without your permission”),
distraction (e.g., “Told you to go on with your life”), and treating
differently (e.g., “Avoided talking to you or spending time with
you”). Participants were invited to rate each type of reaction using
a 5-point Likert scale ranging from, for example, 1 (never) to 5
(always). Internal consistency for the present sample ranged from
acceptable (Positive Reactions Subscale: ␣ ⫽ .79) to excellent
(Negative Reactions Subscale: ␣ ⫽ .90).
Assault-related shame. Shame related to experiences of sex-
ual assault was assessed using the Abuse Specific Shame Ques-
tionnaire (ASSQ; Feiring, & Taska, 2005). The ASSQ is an eight-
item self-report scale that assesses one’s feelings of shame that are
specific to experiences of sexual assault (e.g., “What happened to
me makes me feel dirty”; “When I think about what happened, I
want to go away by myself and hide”). Respondents are instructed
to rate each item on a 3-point Likert scale ranging from 1 (not true)
to 3 (very true). Internal consistency for the present sample was
good (␣ ⫽ .87).
Psychological distress. Multiple self-report measures were
included as outcome variables to assess distinct forms of psycho-
logical distress. Symptoms of depression were assessed using the
Center for Epidemiological Studies—Depression Scale (CES–D;
Radloff, 1977). The CES–D is a 20-item self-report measure that
assesses one’s experience of depressive symptoms during the past
week using a 4-point Likert scale that ranges from, for example, 0
(rarely or none of the time) to 3 (most or all of the time). Internal
consistency for the present sample was adequate (␣ ⫽ .79). The
CES–D has a clinical cutoff of 16, which indicates clinically
significant symptoms of depression (Radloff, 1977). Symptoms of
PTSD were assessed using the PTSD Checklist—Civilian Version
(PCL–C; Weathers, Litz, Huska, & Keane, 1991). The PCL–C is
a 17-item self-report measure that assesses one’s experience of
PTSD symptoms according to the Diagnostic and Statistical Man-
ual of Mental Disorders (4th ed., text rev.; American Psychiatric
Association, 2000) during the past 30 days. Respondents rate each
symptom on a 5-point Likert scale ranging from, for example, 1
(not at all) to 5 (extremely). Internal consistency for the present
sample was excellent (␣ ⫽ .92). Scores that fall beyond the clinical
cutoff score of 35 on the PCL–C indicate significant symptoms of
PTSD in nonclinical samples (Weathers et al., 1991). Global
distress was assessed using the Outcome Questionnaire– 45.2 (OQ-
45.2; Lambert et al., 2011). The OQ-45.2 is a 45-item self-report
scale that assess overall functioning across domains of subjective
discomfort, problems in interpersonal relationships, and problems
in social role performance. Items are rated on a 5-point Likert scale
ranging from 0 (never) to 4 (almost always), and a total score is
calculated by summing all items. Internal consistency for the
present sample was good (␣ ⫽ .85). For the OQ-45.2, a total score
that falls beyond the recommended clinical cutoff of 63 is consid-
ered to indicate clinically significant global distress (Lambert et
al., 2011).
Demographics. Age, biological sex, relationship status, and
ethnicity were assessed using a demographic questionnaire devel-
oped specifically for this study.
Procedure
Participants were recruited from the psychology undergraduate
participants pool via announcements distributed to students en-
rolled in psychology courses and via inclusion in a database of
studies available to psychology undergraduates (i.e., SONA Sys-
tem). The study was labeled the “College Women’s Life Experi-
ence Study,” and the description stated we were interested in
learning about risk and resilience in women who have had un-
wanted sexual experiences. Prospective participants completed
self-report measures anonymously via an online survey platform
(i.e., www.surveymonkey.com). In total, 404 female psychology
undergraduates with unique identifiers participated in the online
survey. Of those, 307 (76%) reported histories of sexual assault,
and of those, 213 (67%) reportedly disclosed their assault to at
least one other person. Approximately 3% (n ⫽ 6) of the women
who met criteria for the full study declined to complete the survey
instrument. All participants completed written informed consent
and were provided with debriefing information, which included
mental health and community resources for survivors of sexual
assault, upon study completion. All methods and materials were
approved by the Idaho State University Institutional Review Board
prior to data collection.
Data Analytic Strategy
The hypothesized mediation model was evaluated using struc-
tural equation modeling. Overall model fit was evaluated via
review of the chi-square test of model fit and fit indices (i.e., CFI,
Tucker–Lewis index [TLI], RMSEA) to evaluate the concordance
between the hypothesized structural model and the observed data
(West, Taylor, & Wu, 2012). The model was considered to repre-
sent good fit when the chi-square test of model fit was nonsignif-
icant and the comparative fit indices fell beyond conventional
cutoffs (i.e., CFI and TLI ⱖ .95, RMSEA ⬍ .06; Hu & Bentler,
 SHAME AND SOCIAL REACTIONS TO DISCLOSURE 169

1995). Nested models were compared via the chi-square test of
model fit consistent with the procedure specified by West and
colleagues (2012). The significance of indirect (i.e., mediated)
effects was evaluated via the Sobel test (Sobel, 1982). Specifically,
the mediated effect was assumed to be normally distributed and
tested using a z test, ab/Sab, where a is the effect of negative social
reactions to disclosure on shame and b is the effect of shame on
psychological distress, while controlling for negative social reac-
tions to disclosure.
Results
Descriptive Statistics
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N ⫽ 207) ⫽ 16.91, p ⫽ .005, CFI ⫽ .97, TLI ⫽ .93, RMSEA ⫽
.11. The model was modified to include correlated error terms
among indicators of negative reactions (see Figure 1), which
resulted in a final measurement model with good fit, ␹2(3, N ⫽
207) ⫽ 3.34, p ⫽ .34, CFI ⫽ .99, TLI ⫽ 0.99, RMSEA ⫽ .02.
Given the poor and nonsignificant factor loadings observed for
indicators of positive social reactions to disclosure, the positive
reactions factor was dropped from the final structural model.
Structural model. Shame was evaluated as a mediator of the
association between negative reactions to disclosure and psycho-
logical distress via a single structural model (see Figure 1). The
final structural model indicated strong fit, ␹2(19, N ⫽ 207) ⫽
21.60, p ⫽ .30, CFI ⫽ .99, TLI ⫽ .99, RMSEA ⫽ .03, which

indicated that the identified model was consistent with the ob-
Descriptive statistics and zero-order correlations for study vari-
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served data. Assault-related shame significantly mediated the re-

ables are reported in Table 1. Participants’ average responses on
lationship between negative reactions to disclosure and symptoms
the PCL–C (M ⫽ 34.36, SD ⫽ 12.54) fell near the recommended
of depression (CES–D; ␤ ⫽ .19, z ⫽ 4.56, p ⬍ .001), PTSD
clinical cutoff (i.e., raw score ⫽ 35) for samples drawn from the
(PCL–C; ␤ ⫽ .27, z ⫽ 5.85, p ⬍ .001), and global distress
general population and suggested meaningful levels of subthresh-
(OQ-45.2; ␤ ⫽ .21, z ⫽ 4.82, p ⬍ .001), such that negative
old distress in this self-selected sample of sexual assault survivors.
reactions predicted higher levels of distress via assault-related
Similarly, average responses on the OQ-45.2 (M ⫽ 59.59, SD ⫽
shame. The identified model explained 17% to 40% of the variance
25.73) indicated subclinical global distress that approached the
in measures of psychological distress (i.e., CES–D, R2 ⫽ .17;
recommended clinical cutoff of 63. In addition, respondents’ av-
PCL–C, R2 ⫽ .40; OQ-45.2, R2 ⫽ .24). Given the overlap among
erage scores on the CES–D (M ⫽ 17.31, SD ⫽ 12.07) fell beyond
the distinct forms of psychological distress assessed in this study,
the recommended cutoff score (i.e., raw score ⫽ 16) and indicated
error variances for the three dependent variables were allowed to
clinically significant symptoms of depression on average.
correlate with one another.
In regard to social reactions to sexual assault disclosure, most
participants in this sample reported experiencing (at least “rarely”)
victim-blaming reactions (n ⫽ 114; 55%), being treated differently Discussion
(n ⫽ 133; 64.3%), experiencing others’ attempts to distract from
First, the severity of unwanted sexual experiences reported in
the assault (n ⫽ 189; 90.9%), experiencing others’ attempts to take
this self-selected group of female undergraduates is notable. Spe-
control of the situation (n ⫽ 175; 84.1%), and others’ egocentric
cifically, 71% reported an attempted rape and 81% a completed
reactions (n ⫽ 41; 80.3%). Only two participants (1.1%) from the
rape. Further, participants’ mean responses on measures of distress
present sample indicated they experienced no negative social re-
suggested that many reported symptoms that approached or sur-
actions to sexual assault disclosure. Concerning positive social
passed established clinical cutoffs for depression, PTSD, and
reactions to disclosure, the majority of participants reported re-
global distress. Thus, although this was an undergraduate sample,
ceiving (at least “rarely”) tangible aid and/or informational support
the participants also appear to represent a distressed sample.
(n ⫽ 149; 72.0%), and all respondents reported experiencing some
The findings from this study provide strong support for exam-
form of emotional support following disclosure of sexual assault.
ining shame as a mediator of the association between negative
Most, but not all, participants reported experiencing some degree
social reactions to disclosure and symptoms of PTSD, depression,
of assault-related shame on the ASSQ (n ⫽ 183; 88.4%)
and global distress. This is the first study to explicitly evaluate
shame as a mediator of the association between negative social
Structural Equation Modeling
reactions to disclosure and psychological distress, including the
Measurement model. The initial measurement model for evaluation of this indirect effect across three distinct domains of
negative reactions to disclosure demonstrated marginal fit, ␹2(5, psychological symptoms. The finding that shame significantly

Table 1
Zero-Order Correlations and Descriptive Statistics for Study Variables

Variable Range M (SD) 1 2 3 4 5

1. Positive reactions (SRQ) 31–84 57.92 (10.27) —

2. Negative reactions (SRQ) 26–92 45.88 (14.38) ⫺.01 —
3. Shame (ASSQ) 8–24 13.34 (4.01) .07 .47ⴱⴱⴱ —
4. PTSD (PCL–C) 17–76 34.36 (12.54) .05 .38ⴱⴱⴱ .58ⴱⴱⴱ —
5. Depression (CES–D) 0–49 17.31 (12.07) .02 .19ⴱⴱ .40ⴱⴱⴱ .70ⴱⴱⴱ —
6. Overall distress (OQ-45.2) 9–135 59.59 (25.73) ⫺.02 .27ⴱⴱ .50ⴱⴱⴱ .76ⴱⴱⴱ .78ⴱⴱⴱ
Note. N ⫽ 207. SRQ ⫽ Social Reactions to Disclosure Questionnaire; ASSQ ⫽ Abuse Specific Shame Questionnaire; PTSD ⫽ posttraumatic stress
disorder; PCL–C ⫽ PTSD Checklist—Civilian Version; CES–D ⫽ Center for Epidemiological Studies—Depression Scale; OQ-45.2 ⫽ Outcome
Questionnaire– 45.2.
ⴱⴱ
p ⬍ .01. ⴱⴱⴱ p ⬍ .001.
 170 DECOU, COLE, LYNCH, WONG, AND MATTHEWS
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This document is copyrighted by the American Psychological Association or one of its allied publishers.
Figure 1. N ⫽ 207. Final structural model demonstrating the indirect effect of negative social reactions to
disclosure of sexual assault via shame. Dashed lines represent nonsignificant paths. CES–D ⫽ Center for
Epidemiological Studies—Depression Scale; OQ ⫽ Outcome Questionnaire; PCL–C ⫽ PTSD Checklist—
Civilian Version. ⴱⴱⴱ p ⬍ .001.
mediated this association is consistent with results of previous
research that has identified shame as a predictor of PTSD symp-
toms (e.g., La Bash & Papa, 2014), as well as previous studies that
have found an association between negative social reactions to
disclosure of sexual assault and symptoms of psychological dis-
tress, including symptoms of PTSD (e.g., Ullman et al., 2007),
depression (e.g., Orchowski et al., 2013), and global distress (e.g.,
Littleton, 2010).
The indirect effect of negative social reactions via shame lends
support for the socio-interpersonal model of PTSD and trauma-
related distress proffered by Maercker and Horn (2013). Specifi-
cally, the mediating role of shame reflects the ways in which “the
course of an individual’s PTSD will be influenced by unfavorable
social or cultural feedback from both an individual’s close and
distant levels of social environments and by related intrapersonal
socio-cognitive changes” (Maercker & Horn, 2013; p. 477). In this
way, shame may account for some of the variation observed across
levels of trauma exposure, whereby some sexual assault survivors
experience clinically significant symptoms of trauma-related dis-
tress and others do not.
Limitations
The present study should be considered in view of several
limitations. First, these findings are limited by the self-report and
retrospective nature of the survey measures employed. Second, the
study is a correlational study adopting a cross-sectional design.
Thus, we cannot infer causal influence among variables or ascer-
tain their temporal relationships. Indeed, it may be that negative
social reactions to disclosure represent both a cause and conse-
quence of psychopathology, whereby trauma-related distress itself
precipitates negative reactions, which in turn exacerbate and com-
pound experiences of psychopathology. Ullman and colleagues
(2007) noted a similar possibility with regard to the potentially
recursive nature of negative social reactions and avoidance coping
reactions. Third, this sample of undergraduates may not generalize
to other samples of undergraduates, particularly given that this
sample was relatively older (i.e., M ⫽ 26.02 years) than typical
undergraduate samples. Furthermore, the identified model for the
present study is but one of many possible structural models and
should not be interpreted as the only viable solution.
Finally, the present study included only female sexual assault
survivors who had disclosed their experience of sexual assault to at
least one other person and thus may not generalize to other
samples of sexual assault survivors who have not disclosed previ-
ous sexual assault. This is notable both as a limitation of the
present study and as an implication for future studies, considering
that variables such as shame may limit survivors’ perceptions of
the safety and appropriateness of disclosure. Previous research has
offered compelling estimates of the ways in which disclosure of
sexual assault may be limited among survivors. Specifically, Or-
chowski and Gidycz (2012) found that although approximately
75% of undergraduate female trauma survivors disclosed experi-
ences of sexual assault that occurred during adolescence, only 55%
disclosed more recent experiences of sexual assault since matric-
ulating in college. This estimate is commensurate with recent
epidemiological estimates, which found that only 20% of female
college student sexual assault survivors reported their victimiza-
tion to campus authorities, compared to 32% of nonstudent women
(Sinozich & Langton, 2014). In addition, it is possible that sexual
assault survivors who experience more assault-related shame may
disclose experiences of assault differently and potentially elicit
greater levels of negative or unhelpful responses from others.
Related to this point, the single item used to screen for sexual
assault disclosure asked participants about disclosure related to the
most well remembered or severe incident of sexual assault they
experienced and thus may have excluded participants who dis-
closed incidents of sexual assault other than the one they perceived
as most well remembered or severe. It may even be that partici-
 SHAME AND SOCIAL REACTIONS TO DISCLOSURE
pants who experienced negative reactions to disclosure of less
severe forms of sexual assault would be less likely to have dis-
closed the more severe or well remembered incidents of sexual
assault as was queried in this study. Despite these limitations, this
study advances the importance of considering negative social
reactions to sexual assault disclosure, assault-related shame, and
symptoms of psychological distress within comprehensive models
among female sexual assault survivors.
Implications and Future Directions
There are several ways in which the present findings are rele-
vant to research and intervention with survivors of sexual assault
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within the context of a university setting. First, as noted in previ-
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ous research with sexual assault survivors, there may be marked
differences in the types of social reactions experienced within
formal (e.g., law enforcement, university administrators) and in-
formal (e.g., friends, family) contexts (Ahrens, Campbell, Ternier-
Thames, Wasco, & Sefl, 2007). Therefore, future research should
consider the ways in which negative social reactions to sexual
assault disclosure, shame, and psychopathology may vary across
different types of relationships and within distinct administrative,
relational, and legal contexts.
The present findings also support the consideration of treatment
modalities that specifically address the role of shame as a possible
barrier to short- and long-term recovery among sexual assault
survivors. Our findings demonstrate how shame may represent a
malleable point of therapeutic intervention (i.e., intervening vari-
able) across three distinct forms of psychological distress. Indeed,
several treatment paradigms address shame as a defined element of
therapy, including cognitive processing therapy (CPT; Resick et
al., 2008), skills training in affective and interpersonal regulation
(STAIR; Cloitre, Cohen, & Koenen, 2006), and dialectical behav-
ior therapy (DBT; Linehan, 2014). In this way, the present findings
support clinical assessment that explicitly addresses experiences of
shame and treatment planning that effectively appropriates treat-
ments designed to enhance awareness of shame and develop skills
to mitigate the distress associated with assault-related shame.
In regard to policy implications, the present study underscores
how institutional regulations and procedures that enact, whether
explicitly or implicitly, negative reactions to sexual assault survi-
vors’ disclosures may unnecessarily confer increased risk of psy-
chological distress for those navigating formal disclosure of sexual
assault. Moreover, it may be that assault-related shame remains an
intractable barrier to disclosure for some survivors of sexual as-
sault, and thus policy initiatives aimed at addressing assault-related
shame via trauma-informed approaches to reporting procedures
and due process may assist in increasing sexual assault reporting
among female undergraduates (e.g., Sinozich & Langton, 2014).
Furthermore, latency to disclosure of sexual assault has been found
to predict higher rates of clinically significant PTSD among
trauma survivors (e.g., Ruggiero et al., 2004), and thus it is
imperative that researchers, policymakers, and clinicians attend to
social reactions to disclosure that may exacerbate assault-related
shame, which may in turn predict greater levels of psychopathol-
ogy and ultimately thwart individual and institutional efforts to
identify and address incidents of completed and attempted sexual
assault.
171
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Received June 7, 2016
Revision received July 26, 2016
Accepted August 5, 2016 䡲
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

Correction to DeCou et al. (2017)

In the article “Assault-Related Shame Mediates the Association Between Negative Social Reactions
to Disclosure of Sexual Assault and Psychological Distress” by Christopher R. DeCou, Trevor T.
Cole, Shannon M. Lynch, Maria M. Wong, and Kathleen C. Matthews (Psychological Trauma:
Theory, Research, Practice, and Policy, 9, 166 –172. http://dx.doi.org/10.1037/tra0000186), there
was an error in the coding of missing values thus effecting the abstract, Methods, Results, and
Discussion sections.

The frequency counts for sexual assault victimization, reactions to social disclosure, and assault-
related shame were calculated incorrectly due to an error in the coding of missing values, and have
been corrected in the description of participants and in the results and discussion sections. In
addition, the sample size was incorrectly reported as N ⫽ 207, and should have appeared as “N ⫽
208.” The sample size and corresponding percentages have been corrected throughout the text. Two
transcription errors for the indirect effects via PTSD and global distress were also corrected. These
indirect effects were incorrectly reported as “PCL-C; ␤ ⫽ .27,” and “OQ-45.2; ␤ ⫽ .21,” and should
have appeared as “PCL-C; ␤ ⫽ .26,” and “OQ-45.2; ␤ ⫽ .20.”

http://dx.doi.org/10.1037/tra0000352