The main objectives of this project are to identify long-term physical- health-related correlates of sexual assault, and to identify psychosocial characteristics that may condition these associations. This research is significant because sexual assault is relatively common in general populations, and although its immediate and long-lasting social and psychological consequences and its immediate physical consequences have been documented, little is known about its potential long-term physical health effects. The proposed study will analyze six extant data sets. The Los Angeles Epidemiologic Catchment Area (LA-ECA) study is a longitudinal survey of 3,131 randomly-selected residents of two communities. the Piedmont Health Survey (Duke ECA) is a similar survey of 3,798 residents of one urban and four rural North Carolina counties. the National Survey of Health and Life Experienced of Women is a random sample of about 1200 women in the continental U.S. The Child ECA studies are two surveys (N = 248 and N = 300) of randomly-selected 9- to 17-year- old residents of the San Juan, Puerto Rich metropolitan area, with interviews of adult informants. The Adolescent Health Risk Study is a random sample of 958 female 13-to 19-year-old residents of Buffalo, New York. The UAMS somatization data are from a clinical sample of 129 persons with multiple unexplained physical symptoms. Large samples of Hispanic respondents in LA-ECA (n = 1428) and African-American respondents in Duke ECA (n = 1497) and Buffalo (n = 431) will allow race/ethnic comparisons. Dependent measures include long-term physical health (specific symptoms, chronic disease, health perceptions), physical functioning (bed and work loss days, activity limitations), illness behavior (general and symptom-specific medical care seeking), and health- compromising behaviors (alcohol use, drug use, suicidality). The study will identify demographic characteristics and circumstances of sexual assault associated with vulnerability to health outcomes. Circumstances of sexual assault include age at which the person was assaulted and other temporal aspects, relationship to the perpetrator, number and gender of assailants, type of sexual contact, degree of physical violence, disclosure, and others' responses to disclosure. Associations of sexual assault history with current social support and coping behavior will be estimated, as will the possible mediating roles of current stress, social support, and coping in relationships of sexual assault with health. Associations of physical-health and mental-health correlates of sexual assault history will also be examined, focusing on depression as measured by the Diagnostic Interview Schedule and the Center for Epidemiologic Studies Depression scale. A final phase of the project will be planning future research on health-related correlates of sexual assault.
