Prevalence and psychosocial correlates of alcohol-related sexual assault among university students.
Howard, Donna E. ; Griffin, Melinda A. ; Boekeloo, Bradley O. 等
INTRODUCTION
While there is a great deal of evidence linking personal alcohol
use with negative psychosocial consequences among college students, the
effect that others' heavy drinking has on non-drinkers or moderate
drinkers has only recently been explored (Hingson, Heeren, Winter, &
Wechsler, 2005; Perkins, 2002; Wechsler, Lee, Nelson, & Lee, 2001;
Langley, Kypri, & Stephenson, 2003). Those negative experiences that
students (whether drinking or abstaining) suffer which result from
someone else's drinking are termed "secondhand effects"
(Wechsler, Lee, Nelson, & Kuo, 2002; Wechsler et al., 2001; Langley
et al., 2003). There is concern that these alcohol-related effects may
be amplified on college campuses with high drinking rates and school
policies that require undergraduates, especially freshmen, to reside in
on-campus housing. One serious negative secondhand effect which warrants
more attention is alcohol-related sexual assault.
As defined by the National Center for Victims of Crime, sexual
assault takes many forms including attacks such as rape or attempted
rape, as well as any unwanted sexual contact or threats (NIAAA, 2007).
Integrating data from a number of national surveys of college students
in 1998 and 2001, Hingson et al. documented that over 400,000 students
(8%) reported unprotected intercourse as a result of their alcohol use,
and almost 100,000 students annually reported being victims of date rape or sexual assault (Hingson et al., 2005). This figure may not include
the over 100,000 students who reported having been too intoxicated to
know if they consented to having sex (Hingson et al., 2005; Hingson,
Heeren, Zakocs, Kopstein, & Wechsler, 2002). Thus, at least half of
college students' sexual assaults may be associated with alcohol
use (Abbey, Zawacki, Buck, Clinton, McAuslan, 2001; Collins &
Messerschmidt, 1993; Crowe & George, 1989). More specifically, over
one-half of all sexual assaults are committed by men who have been
drinking alcohol, while approximately 50% of victims also report alcohol
use at the time of the assault (Abbey et al., 2001). Furthermore, women
in college who use drugs, attend a university with high drinking rates,
belong to a sorority, and drank heavily in high school appear at greater
risk for rape while intoxicated (Mohler-Kuo, Dowdall, Koss, &
Wechsler, 2004). According to reports by the Centers for Disease
Control, roughly 1 in 4 adolescents suffer from sexual abuse in a dating
relationship (Choose Respect, 2007).
To compound the issue of alcohol-related sexual assault, in
overwhelming numbers, college students (including those under the legal
drinking age) report not only use of alcohol but binge drinking (Johnston, O'Malley, & Bachman, 1996; Shalala, 1995).
Furthermore, despite numerous intervention efforts, recent trend data
suggest that from 1999 to 2002 the proportion of college students who
engaged in heavy episodic or binge drinking remained high and relatively
constant, increasing from 41.7% to 43.2% (Hingson et al., 2005).
Corroborating evidence of the persistently high prevalence of heavy
alcohol use during a period of increased prevention efforts comes from
the Harvard School of Public Health study of trends in binge drinking
(Wechsler et al., 2002). The College Alcohol Study (CAS) surveyed
students at 119 four-year colleges in 1993, 1997, 1999, and 2001. Little
change in overall binge drinking was evidenced at the individual college
level; interestingly, the percentages of both abstainers and frequent
binge drinkers increased. Alcohol abuse thus remains a major health
problem on college campuses with serious negative consequences for
individual drinkers, and serious negative secondhand effects for those
around them (Wechsler et al., 2002).
The role of alcohol both as a precipitating and explanatory factor
for sexual aggression among males has been well-articulated, as has its
role in increasing female vulnerability and risk of victimization,
partially due to the lowered awareness of risky situations, impaired
judgment, and/or ability to resist assault (Larimer, Lydum, Anderson,
& Turner, 1999). Davis et al. found, in a study which used
hypothetical dating situations to examine how alcohol consumption
affects women's responses to unwanted sexual advances, that
intoxicated women were more likely to consent to their dating
partner's sexual advances and respond passively to such advances
(Davis, George, Norris, 2004). Yet, while these women may be willing to
consent to some sexual contact, their consent may be misinterpreted as
indicating a desire for sexual intercourse, particularly among men who
are intoxicated (Abbey et al., 2004).
Finally, at a time where heavy drinking seems to have become
embedded in the cultural transition to college, some interventionists
are advocating the adoption of a harm-reduction perspective. This
approach centers on reducing alcohol-related negative consequences
rather than stressing alcohol abstinence as the ultimate goal
(Schulenberg & Maggs, 2002; Howard, Griffin, Boekeloo, Lake, &
Bellows, 2007; Benton, Schmidt, Newton, Shin, Benton, & Newton,
2004; Delva, Smith, Howell, Harrison, Wilke, & Jackson, 2004;
Martens, Taylor, Damann, Page, Mowry, & Cimini, 2004). That is, by
adopting harm-reduction strategies, students may become empowered to
drink more responsibly and minimize negative consequences of their
alcohol-use decisions and enable them to protect themselves from others
or in potentially dangerous situations (Graham, Tatterson, Roberts,
& Johnston, 2004; McBride, Farringdon, Midford, Meuleners, &
Phillips, 2003; Marlatt & Witkiewitz, 2002; Single, 1996; Marlatt,
Somers, & Tapert, 1993; Marlatt, 1996). In recent years,
documentation of the effectiveness of such protective behavioral
strategies has been initiated; there is some support that it may
decrease students' experiences with negative alcohol-related
consequences. While the literature is scarce on the protective effect of
such behavioral strategies, it is thought that they may also decrease
students' experiences of alcohol-related sexual assault (Benton et
al., 2004; Delva et al., 2004; Martens et al., 2004).
Within this context, the aim of the present study was to estimate
the prevalence and examine the correlates of alcohol-related sexual
assault among predominately freshmen students attending a large public
university in the mid-Atlantic region. We hypothesized that engagement
in risk behaviors, i.e., use of various licit and illicit substances,
exposure to violence, and being in situations where alcohol was present,
including exposure to secondhand alcohol use, would be positively
associated with reports of alcohol-related sexual assault. We further
hypothesized that students who engaged in alcohol-related protective
behaviors would be less likely to report alcohol-related sexual assault.
To this end, we examined the extent to which personal alcohol use and
contextual factors, such as being in alcohol-use situations, increased
the odds of alcohol-related sexual assault and whether activation of
alcohol-related protective strategies moderated this risk.
METHOD
Design and Sample
As part of a larger National Institute of Alcohol Abuse and
Alcoholism (NIAAA) funded college alcohol intervention trial,
"Peers as Family: Preventing Problem Drinking" (Boekeloo,
2005), a survey was administered to students living in predominantly
freshmen residence halls at a large, mid-Atlantic university. This was a
sub-study of a larger NIAAA-funded college alcohol problem prevention
trial and was approved by the University's Institutional Review
Board (IRB). The larger three-arm trial (comparing single gender, mixed
gender, and control conditions) was conducted to determine whether a
series of three educational workshops targeted at freshmen dormitory
wings (wings were the unit of assignment) could effectively reduce
quantity and frequency of alcohol use as well as problems associated
with alcohol use.
The data for this study were obtained as part of the larger trial
as follows: A purposive sampling frame was constructed from wings of
students living in on-campus, traditional, high-rise, freshmen
dormitories. Of the eight on-campus freshman high-rise dormitories, with
wings supervised by a Resident Advisor, four dormitories had wings with
a preponderance of incoming freshmen (rather than upperclassmen) and
afforded balance across trial arms based on number of students per wing
and number of wings by student gender. Of 64 wings in the four
dormitories, 36 were chosen for the trial because they maximized the
number of incoming freshmen per wing and balanced dormitory, student
gender, and special wing-based learning programs across arms of the
trial. Approximately two months after the beginning of the school year
(Fall 2006) and 2 weeks after the final workshop in the trial, a
web-based follow-up survey was conducted with all students in the 36
trial wings. This follow-up survey provided the data for the study
described here.
Once the sampling frame was established and university IRB approval
was received, students were recruited to complete an online consent form
and a series of web-based surveys (baseline, two- and seven-month
follow-ups) via personalized emails and flyers hung in residence halls.
To minimize nonparticipation at the two-month follow-up, initial
non-respondents were sent letters and a paper version of the survey.
This study is based on a two-month follow-up wave of data collection
which was conducted approximately 60 days into the start of the Fall
2006 semester and 2 weeks following the third and final workshop.
Of 1,269 students (634 males, 635 females) recruited, 551 (227
males and 324 females) students supplied reliable and valid data for a
response rate of 43.4% (35.3% males, 51.0% females). Eleven paper
surveys were received and the remaining 540 cases were obtained via the
web-based survey. Among those students who completed surveys, the
majority were recent drinkers (defined as self-reported alcohol use in
prior 30 days (n = 333, 60.4%), white (n = 334, 60.6%), 18 years of age
(n = 418, 75.9%), living-learning members (n = 363, 65.9%), and
first-year freshmen (n = 509, 92.4%). Among the survey nonrespondents,
the majority were male (n = 407, 56.7%), white (n = 396, 55.2%), 18
years of age (n = 534, 74.4%), non-living-learning members (n= 436,
60.7%), and first-year freshmen (n = 649, 90.4%). Proportionately fewer
males, non-living-learning members, and black students completed the
survey.
Survey Procedures and Measures
All survey procedures explained are consistent with the procedures
of the parent study. As part of the personalized emails recruiting
students to complete a survey about college peer experiences, a link to
the web-based survey was included along with a unique study
identification number. Once students were directed to the survey
website, they were instructed to electronically sign a consent/assent
form and respond to each item in a confidential manner. An assent form
was included because 17-year-olds were permitted to participate in the
study without parental notification and was required by the university
IRB. Students were also assured that their responses would be linked
only to their unique study identification number. While the primary
focus of the survey was to assess alcohol-related behaviors, it
addressed a number of other areas related to personal well-being and
residence hall life.
The outcome variable for this study was alcohol-related sexual
assault. Alcohol-related sexual assault was a composite of 2 items which
measured how often within the 60 days prior to completing the survey,
students "experienced an unwanted sexual advance" or "was
the victim of sexual assault or date rape" due to the other
person's alcohol use. The response options were 0 = none, 1 = 1
time, 2 = 2 times, and 3 = 3 or more times. For analysis, the two items
were summed and recoded as a binary variable with 1 = ever experienced
alcohol-related sexual assault (sum of at least one) or 0 = never
experienced alcohol-related sexual assault. Independent variables
included use of illicit substances, contextual factors such as drinking
in social situations, secondhand interpersonal violence, alcohol-related
protective behavioral strategies, as well as sociodemographics.
The substance use items were continuous variables but recoded as
binary "ever" versus "never" variables. Students
were instructed to indicate how many days, in the previous 30 days, they
used the following substances: beer, wine or wine coolers, liquor or
spirits, prescription medication without a prescription (i.e., Vicodin,
Percoset, Oxycontin, Ritalin), other nonprescription drugs (i.e.,
marijuana, cocaine, amphetamines, hallucinogens), and combined drinking
alcohol with taking drugs. The alcohol-specific items were combined to
create a general "drinker" variable. That is, students who
responded positively to any of the alcohol use items were classified as
a recent drinker. Students were also instructed to indicate how often,
in the previous 30 days, they had engaged in a binge-drinking episode,
defined as 5 or more drinks in a row within a couple of hours for males
and 4 or more drinks for females. The binge-drinking item was also
recoded as binary "ever" versus "never" variable.
One additional item was included in the analysis which asked students to
report, on average since arriving on campus for the semester, "how
often were you in situations where there was alcohol?" The
definition of an alcohol situation was not included in the wording of
the survey. Therefore, the students would have had to subjectively
define it on their own prior to responding to this specific item.
Originally, this item was constructed as a continuous variable with
response options of never, less than once a week, once or twice a week,
three or four times a week, five or six times a week, and everyday. For
this study, the item was also recoded as a binary "ever"
versus "never" variable.
Drinking in social situations was included as a contextual measure
to capture where and why students consume alcohol. These items were
taken from the Social Facilitation sub-scale of the Social Context of
Drinking Scale, college version (Thombs, Beck, & Mahoney, 1993).
Students were instructed to indicate how often they drank alcohol in the
following situations since arriving on campus for the semester (2
months): at a bar or club, at a party with friends, to get drunk, with
wing-mates, as part of a drinking game, before "going out,"
and to make it easier to go to bed with someone. The original response
options to these social context items were "never,"
"seldom," "occasionally," and
"frequently." A "drank in social situations"
variable was created as follows: Students were assigned to the
"never" category if they responded "never" to
drinking in each situation. Students were assigned to the "high
frequency" category if they reported that they frequently drank in
at least one social situation. Those students who did not report
"never" to every item or "frequently" to at least
one item, were assigned to the "some frequency" category.
Thus, the three categories included in the logistic regression analysis
were never, some frequency, and high frequency.
Secondhand consequences related to other types of violence were
included as an independent variable. Secondhand interpersonal violence
was defined as violence victimization experienced due to another's
alcohol use. The four items were: "harassed, insulted, or
humiliated"; "had a serious argument or quarrel";
"pushed, hit, or assaulted"; and, "had my property
damaged." Response options were 0 = none, 1 = 1 time, 2 = 2 times,
and 3 = 3 or more times. The students were directed to respond to each
item based on how often they experienced the negative secondhand effect
since arriving on campus for the semester (2 months). The four items
were then summed and recoded with categories of never, once, and 2 or
more times.
Alcohol-related protective behavioral strategies are those
self-control or harm-reduction behaviors individuals practice prior to,
during, or after drinking to either limit consumption or the negative
consequences associated with alcohol use (Benton et al., 2004; Delva et
al., 2004; Martens et al., 2004). Enactment of alcohol-related
protective behavioral strategies was measured by having students respond
to five items borrowed from previous studies (Benton et al., 2004; Delva
et al., 2004; Martens et al., 2004). After factor analysis and
reliability testing, the five items were divided into two sub-scales
labeled "alcohol avoidance" and "alcohol
resistance." The "alcohol avoidance" items included:
"choose not to drink alcohol," "avoid situations where
there was alcohol," and "participate in activities that did
not include alcohol" (Cronbach's alpha coefficient of 0.80).
The "alcohol resistance" items were: "drink an alcohol
look-alike" and "carry around a cup but not drink any
alcohol" (Cronbach's alpha coefficient of 0.73). The response
options were "never," "rarely,"
"sometimes," "usually," and "always." The
students were directed to respond to each item based on how often they
engaged in the protective behaviors since arriving on campus for the
semester (2 months). Each sub-scale was, however, recoded as a binary
variable. One category included those that responded "usually"
or "always" to each item; the other category included all
other responses and was labeled "sometimes/never."
The sociodemographic items included age, ethnicity, living-learning
membership, and a question on whether the student had passed a web-based
alcohol education program; the latter two items were coded as
"yes" or "no" binary items. Living-learning
membership refers to university acceptance into one of several format
programs which include students who have similar academic interests and
was included as a demographic variable due to the parent study's
sampling frame and the method with which the university assigns
residential locations in dormitories. Age was originally coded as a
continuous item but recoded as a categorical variable. The original
ethnicity item allowed students to check all categories that applied to
them from a list that included: White-not Hispanic, Hispanic-not White,
Asian/Pacific Islander, and Black/African American; however, during
recoding, students were placed into single-race categories based on the
following rubric: If a student checked off only "Black" or
"Latino" s/he was coded as such. If a student checked off
"Black" or "Latino" and another category, s/he was
coded as "Other."
Data Analysis
All data were analyzed using SPSS version 14.0. Cross-tabulations
were computed to estimate the prevalence of alcohol-related sexual
assault by each independent variable for the total sample and by gender.
Univariate logistic regression models were run to identify the
relationships between alcohol-related sexual assault and each
independent variable. The unadjusted odds ratios (OR) and 95% confidence
intervals were examined. Multivariate logistic regression analysis was
conducted, including only the significant independent variables from the
univariate models, to identify significant predictors of alcohol-related
sexual assault. Adjusted odds ratios and 95% confidence intervals were
again examined from the multivariate models.
RESULTS
Prevalence
Demographic information regarding the sample has been provided. The
overall prevalence of alcohol-related sexual assault was 14.7% (n = 81);
however, there was a marked difference across gender with females more
than 3 times as likely as males to report alcohol-related sexual assault
(n = 66, 20.4% versus n = 15, 6.6%, respectively) (see Table 1). Being
17 years of age, a recent drinker and a binge drinker, using other
substances, being in and drinking in alcohol situations, experiencing
secondhand interpersonal violence, and rarely using protective
behavioral strategies were all associated with a higher prevalence of
alcohol-related sexual assault.
Bivariate Odds Ratios between Alcohol-related Sexual Assault and
Psychosocial Risk Factors
Table 2 presents the unadjusted odds ratios for relationships
between psychosocial factors and alcohol-related sexual assault. Among
females, alcohol and illicit drug use, alone or in combination, and
binge drinking were all significantly associated with alcohol-related
sexual assault. The odds of being a victim of alcohol-related sexual
assault were roughly three times greater if the female was a recent
drinker (OR = 2.94), four and one-half times greater if she used illicit
drugs (OR = 4.50), and somewhere in-between if she reported combining
alcohol with taking drugs (OR = 3.51). Binge drinking, however, was
associated with much greater odds of alcohol-related sexual assault (OR
= 6.04). Those females who were in alcohol situations and drank more
frequently in social situations were also more likely to experience
alcohol-related sexual assault (OR = 4.49 and 5.72, respectively). Males
who drank more frequently in social situations were more likely to
experience alcohol-related sexual assault (OR = 4.36). Being a victim of
other alcohol-related violence was associated with alcohol-related
sexual assault for both males and females; however, the magnitude of the
relationship was strikingly different. Reporting a single episode of
violence victimization was significantly related to alcohol-related
sexual assault for males, but not females, and the odds of
alcohol-related sexual assault were 7 times as great for males who
reported two or more violence experiences compared to females with
similar reports (OR = 49.84 and 6.94, respectively.
Use of alcohol avoidance protective strategies appeared protective
for females only. Specifically, women who infrequently or never used
alcohol-avoidance behavioral strategies were at least two and one-half
times more likely to experience alcohol-related sexual assault (OR =
2.64). Age, race, living-learning membership, online alcohol education,
using prescription medication without a prescription, and alcohol
resistance protective behavioral strategies were not significantly
related to experiencing alcohol-related sexual assault.
Multivariate Relationship between Alcohol-related Sexual Assault
and Psychosocial Risk Factors
All variables that were significant in the univariate logistic
models were entered into a multivariate logistic model. Table 3 presents
the adjusted odds ratios from the multivariate logistic model. For
females, the odds of being a victim of alcohol-related sexual assault
were seven times greater if they reported recent binge drinking and five
times greater if they had two or more other violence victimization
experiences (OR = 7.74 and 5.03, respectively). For males, the only
significant predictor of alcohol-related sexual assault was having
reported other violence victimization; there, a dose response
relationship was evident. That is, the odds of being a victim of
alcohol-related sexual assault were 12 times greater if the male had one
violence-related experience but 43 times greater if he had two or more
such experiences (OR = 12.58 and 43.45, respectively).
DISCUSSION
Alcohol-related sexual assault, defined as alcohol-related unwanted
sexual advances and/or sexual assault or date rape, appeared prevalent
among this sample of predominantly freshmen university students. That
is, almost 1 in 7 students reported having such experiences. Not
unexpectedly, females were much more likely to report alcohol-related
sexual assault than were males. Indeed, the experience of
alcohol-related sexual assault appeared almost commonplace among
females, with approximately 1 out of every 5 reporting such
victimization. Clearly, the scope of such experiences is alarmingly
high.
Our hypothesis that engagement in risk behaviors, i.e., use of
various licit and illicit substances, being in situations where alcohol
was present, and being a victim of secondhand alcohol-related effects
would be positively associated with reports of alcohol-related sexual
assault was only partially supported. Independently, substance use and
being in situations where alcohol was present was associated with
alcohol-related sexual assault; however, these findings were significant
only among females. The cross-sectional nature of the present data,
however, precludes our ability to determine whether drug use increases
females' vulnerability to alcohol-related sexual assault,
represents a coping mechanism, albeit maladaptive, to assuage the
physical and psychological effects of victimization, or whether some
additional factor or set of factors account for this observed
relationship.
We further hypothesized that students who engaged in
alcohol-related protective behaviors would be less likely to report
alcohol-related sexual assault. Again, for females, when examined
independent of other risk and protective factors, enactment of alcohol
avoidance strategies significantly decreased their risk of being
sexually victimized; however, this finding did not hold upon further
investigation. This lack of finding in the multivariate analysis may be
due to multi-collinearity among the predictor variables. That is, a
number of independent variables were significantly correlated and their
individual effects may have been washed out.
As noted, earlier, a number of researchers (ourselves included)
have argued that since heavy drinking seems to be embedded in the
cultural transition to college, a harm-reduction perspective, which
centers on decreasing the negative consequences of heavy drinking,
should be adopted (Schulenberg & Maggs, 2002; Howard et al., 2007;
Benton et al., 2004; Delva et al., 2004; Clapp, Shillington, &
Segars, 2000). That recommendation is based on findings from a growing
body of research that suggests college students have a repertoire of
coping strategies they employ in an attempt to safeguard themselves and
their friends from harm when consuming alcohol. These strategies
encompass preparatory planning to ensure a safe context for drinking,
safety measures to minimize harm when out drinking, and caretaking
strategies for when they or their friends have had too much to drink.
Clearly, more attention needs to be focused on the success or failure of
various initiatives in relation to different kinds of harm. A serious
concern is that while some protection may be afforded students, they may
develop a false sense of security and not objectively gauge their
potential vulnerability for certain types of harm, such as
alcohol-related sexual assault. We did examine whether activation of
alcohol-related protective strategies moderated the risk of
alcohol-related sexual assault violence among binge drinkers, but
results were not significant, possibly due to the students' lack of
control over others' behaviors.
Our findings offer further corroboration that alcohol may be at the
fulcrum of risk for female college students who report being victims of
alcohol-related sexual assault. Recent binge drinking was the most
potent predictor of victimization for females, and one of only two
factors that remained significant when a host of risk factors where
examined simultaneously. What is not evident is the motivation behind
binge drinking and whether these young women are aware of the increased
risk of victimization associated with this behavior.
Whether the sample consists of students in the mid-Atlantic region
of the U.S. or those attending a university in New Zealand, research
findings suggest that students who drink heavily experience more
unwanted sexual advances than those who do not. In the latter study, a
linear relationship was evidenced such that the risk of unwanted sexual
advances increased as drinking behavior changed to greater frequency
(Langley et al., 2003). This association may be due to a host of factors
that come into play in the context of heavy drinking. Research on the
ways in which alcohol distorts perceptions and alters refusal
communications is widely available; as an example, the alcohol myopia theory which suggests that compared to sober persons, drinkers may
attend to a restricted range of cues, and take longer to understand and
put them together in a cohesive way (Lannutti & Monahan, 2004).
Across gender, a strong significant relationship was evidenced
between the experience of interpersonal violence in the context of
another person's drinking, i.e., having had one's person or
property assaulted, fighting or harassment, and being a victim of
alcohol-related sexual assault. That is, there appears to be a
generalized risk of multiple victimization experiences and this was
markedly evident for the male college students. Males who reported a
single violent episode involving another's alcohol use were twelve
times as likely to report alcohol-related sexual assault whereas if they
experienced multiple violent episodes, their risk of alcohol-related
sexual assault increased almost four-fold. These males may represent a
subset of highly at-risk young adults who, for various reasons, find
themselves in social and relational contexts where Violence is prevalent
and victimization takes multiple forms, including sexual. Without
examination of contextual or developmental factors, it is difficult to
determine the origins or temporal relations of these findings. It can be
stated, however, that too little attention has been paid to identifying
and understanding the risks and consequences for these vulnerable young
men.
Limitations
The use of a purposive sampling frame to assure balance across
gender and living-learning membership limits the ability to generalize to other college students. Students were recruited heavily to complete
the survey but still may have self-selected into survey participation.
Thus, despite efforts to recruit a diverse sample of students that
reflected the socio-demographic and academic make-up of the freshman
class, logistical and selection factors affected the selection process.
Furthermore, the demographic information presented on the eligible but
nonparticipating students study sample was based on administrative data
received from the Department of Resident Life and thus cannot be
directly compared with the self-reported demographic information
presented for the survey respondents.
The reliance on self-report data is also an issue in that students
may have subjectively defined the outcome variables of interest of
"unwanted sexual advance" and "victim of sexual assault
or date rape" and reported frequency based on the subjective
interpretations of their meaning. Therefore, an under/over reporting of
experiences of alcohol-related sexual assault may have resulted.
Furthermore, lack of power might have made it difficult to find
significant relationships between risk factors and alcohol-related
sexual assault among the males.
CONCLUSIONS
Study findings suggest that alcohol-related sexual assault affects
a small, but significant number of college students, particularly
females. The experience of alcohol-related sexual assault is associated
with engagement in risky substance use and experiencing other secondhand
interpersonal violence. These individual and interpersonal factors and
the psychosocial sequelae of alcohol-related sexual assault deserve
further attention through longitudinal research and intervention
efforts, especially in the context of alcohol use prevention and
harm-reduction efforts.
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This study was supported by a grant from the National Institute on
Alcohol Abuse and Alcoholism, Grant #R01AA015139-01A1, to Bradley O.
Boekeloo Investigator.
Donna E. Howard, Melinda A. Griffin, and Bradley O. Bockeloo,
Department of Public and Community Health, University of Maryland College Park School of Public Health.
Requests for reprints should be sent to Donna E. Howard, DrPH,
Department of Public and Community Health, UMCPSPH, 2387 Valley Drive,
University of Maryland, College Park, MD 20742. E-mail:
[email protected]
Table 1. Prevalence of Recent Alcohol-related sexual assault Violence
among College Students Residing in Freshmen Dormitories by Personal
and Behavioral Risk Factors
Total
Sample Females Males
Risk Factors N=551 N=324 N=227
Age
19 or older 16.92 26.67 8.57
18 14.11 18.88 7.10
17 22.45 30.56 0.00
Ethnicity
Black 11.90 15.63 0.00
Asian/PI 15.45 19.72 7.69
Hispanic 18.75 20.00 16.67
White 14.93 21.84 6.51
Part of Living-Learning Community
Yes 14.71 20.11 4.30
No 15.19 21.58 8.40
Passed Online Alcohol Education
Yes 15.05 21.36 6.02
No 13.33 0.00 25.00
Recent Drinker
Yes 19.22 26.53 8.76
No 7.80 10.94 3.33
Rx without Prescription
Yes 21.43 25.00 16.67
No 14.67 20.19 6.57
Illicit Drug Use
Yes 32.81 47.37 11.54
No 12.42 16.67 6.22
Combined Alcohol and Drug Use
Yes 31.82 44.00 15.79
No 13.36 18.31 6.03
Recent Binge Drinking
Yes 24.89 38.52 9.35
No 7.45 9.41 4.17
Been in Alcohol Situations
Yes 16.63 22.46 7.89
No 3.08 6.06 0.00
Drank in Social Situations
High Frequency 29.71 39.53 13.46
Some Frequency 11.96 16.53 5.68
Never 7.35 10.26 3.45
Secondhand Interpersonal Violence
[greater than or equal to] 2 Times 38.83 48.33 25.58
1 Time 16.00 20.97 7.89
Never 7.18 11.88 0.68
Protective Behavioral Strategies
Alcohol Avoidance
Usually/Always 7.84 10.99 3.23
Sometimes/Never 17.69 24.56 8.02
Alcohol Resistance
Usually/Always 7.69 10.26 0.00
Sometimes/Never 15.68 22.14 7.11
Table 2. Unadjusted Odds Ratios for Relationships between Recent
Alcohol-related sexual assault Violence and Personal and Behavioral
Risk Factors among College Students Residing in Freshmen
Dormitories (95% Confidence Intervals)
Risk Factors Total Sample
Age
19 or older 0.70 (.28-1.79)
18 0.57 (.28-1.17)
17 1.00
Race
Black 0.81 (.30-2.15)
Asian/PI 1.09 (.60-1.99)
Hispanic 1.38 (.38-5.01)
White 1.00
Part of Living-Leaming Community
No 1.04 (.65-1.67)
Yes 1.00
Passed Online Alcohol Education
No 0.87 (.19-3.92)
Yes 1.00
Recent Drinker
Yes 2.81 (1.60-4.95) ***
No 1.00
Rx without Prescription
Yes 1.59 (.43-5.82)
No 1.00
Illicit Drug Use
Yes 3.44 (1.91-6.20) ***
No 1.00
Combined Alcohol and Drug Use
Yes 3.03 (1.53-6.01) **
No 1.00
Recent Binge Drinking
Yes 4.12 (2.47-6.87) ***
No 1.00
Been in Alcohol Situations
Yes 6.28 (1.51-26.22) *
No 1.00
Drank in Social Situations
High Frequency 5.33 (2.81-10.10) ***
Some Frequency 1.71 (.88-3.35)
Never 1.00
Secondhand Interpersonal Violence
[greater than or equal to] 2 Times 8.20 (4.65-14.48) ***
1 Time 2.46 (1.26-4.82) **
Never 1.00
Protective Behavioral Strategies
Alcohol Avoidance
Usually/Always 0.40 (.21-.75) **
Sometimes/Never 1.00
Resistance
Usually/Always 0.45 (.16-1.28)
Sometimes/Never 1.00
Risk Factors Females
Age
19 or older 0.83 (.28-2.42)
18 0.53 (.24-1.15)
17 1.00
Race
Black 0.67 (.24-1.85)
Asian/PI 0.89 (.45-1.76)
Hispanic 0.90 (.18-4.43)
White 1.00
Part of Living-Leaming Community
No 1.09 (.63-1.89)
Yes 1.00
Passed Online Alcohol Education
No 0.00 (.00-)
Yes 1.00
Recent Drinker
Yes 2.94 (1.55-5.57) **
No 1.00
Rx without Prescription
Yes 1.32 (.26-6.68)
No 1.00
Illicit Drug Use
Yes 4.50 (2.21-9.15) ***
No 1.00
Combined Alcohol and Drug Use
Yes 3.51 (1.51-8.15) **
No 1.00
Recent Binge Drinking
Yes 6.04 (3.23-10.96) ***
No 1.00
Been in Alcohol Situations
Yes 4.49 (1.05-19.27) *
No 1.00
Drank in Social Situations
High Frequency 5.72 (2.74-1 1.96) ***
Some Frequency 1.73 (.81-3.73)
Never 1.00
Secondhand Interpersonal Violence
[greater than or equal to] 2 Times 6.94 (3.58-13.45) ***
1 Time 1.97 (.93-4.15)
Never 1.00
Protective Behavioral Strategies
Alcohol Avoidance
Usually/Always 0.38 (.18-.78) **
Sometimes/Never 1.00
Resistance
Usually/Always 0.40 (.14-1.17)
Sometimes/Never 1.00
Risk Factors Males
Age
19 or older 0.00 (.00-)
18 0.00 (.00-)
17 1.00
Race
Black 0.00 (.00-)
Asian/PI 1.34 (.35-5.21)
Hispanic 3.22 (.34-30.58)
White 1.00
Part of Living-Leaming Community
No 2.04 (.63-6.62)
Yes 1.00
Passed Online Alcohol Education
No 5.21 (.96-28.37)
Yes 1.00
Recent Drinker
Yes 2.78 (.76-10.16)
No 1.00
Rx without Prescription
Yes 2.84 (.31-26.03)
No 1.00
Illicit Drug Use
Yes 1.97 (.52-7.50)
No 1.00
Combined Alcohol and Drug Use
Yes 2.92 (.75-11.43)
No 1.00
Recent Binge Drinking
Yes 2.37 (.78-7.17)
No 1.00
Been in Alcohol Situations
Yes 0.00 (.00-)
No 1.00
Drank in Social Situations
High Frequency 4.36 (1.07-17.67) *
Some Frequency 1.69 (.39-7.29)
Never 1.00
Secondhand Interpersonal Violence
[greater than or equal to] 2 Times 49.84 (6.21-400.01) ***
1 Time 12.43 (1.26-123.11) *
Never 1.00
Protective Behavioral Strategies
Alcohol Avoidance
Usually/Always 0.38 (.08-1.74)
Sometimes/Never 1.00
Resistance
Usually/Always 0.00 (.00-)
Sometimes/Never 1.00
* p <0.05, ** p <0.01, *** p <0.0001
Table 3. Adjusted Odds Ratios for Relationships between Recent
Alcohol-related sexual assault and Personal and Behavioral Risk
Factors among College Students Residing in Freshmen Dormitories
(95 % Confidence Intervals)
Risk Factors Total Sample
Recent Drinker
Yes 54 (.15-2.03)
No 1.00
Illicit Drug Use
Yes 1.49 (.55-4.02)
No 1.00
Combined Alcohol and Drug Use
Yes 0.67 (.22-2.10)
No 1.00
Recent Binge Drinking
Yes 3.29 (1.28-8.47) *
No 1.00
Been in Alcohol Situations
Yes 3.11 (.67-14.52)
No 1.00
Drank in Social Situations
High Frequency 1.97 (.52-7.40)
Some Frequency 1.10 (.34-3.61)
Never 1.00
Secondhand Interpersonal Violence
[greater than or equal to] 2 Times 5.66 (3.08-10.41) ***
1 Time 2.06 (1.02-4.14) *
Never 1.00
Protective Behavioral Strategies
Alcohol Avoidance
Usually/Always 1.15 (.50-2.65)
Sometimes/Never 1.00
Risk Factors Females
Recent Drinker
Yes 0.37 (.08-1.70)
No 1.00
Illicit Drug Use
Yes 2.14 (.67-6.86)
No 1.00
Combined Alcohol and Drug Use
Yes 0.51 (.13-2.02)
No 1.00
Recent Binge Drinking
Yes 7.74 (2.41-24.86) **
No 1.00
Been in Alcohol
Yes 2.37 (.47-12.01)
No 1.00
Drank in Social Situations
High Frequency 1.75 (.41-7.49)
Some Frequency 1.22 (.34-4.37)
Never 1.00
Secondhand Interpersonal
[greater than or equal to] 2 Times 5.03 (2.39-10.63) ***
1 Time 1.53 (.69-3.44)
Never 1.00
Protective Behavioral
Alcohol Avoidance
Usually/Always 1.26 (.48-3.32)
Sometimes/Never 1.00
Risk Factors Males
Recent Drinker
Yes N/S
No
Illicit Drug Use
Yes N/S
No
Combined Alcohol and Drug Use
Yes N/S
No
Recent Binge Drinking
Yes N/S
No
Been in Alcohol
Yes N/S
No
Drank in Social Situations
High Frequency 1.82 (.39-8.44)
Some Frequency 0.97 (.20-4.63)
Never 1.00
Secondhand Interpersonal
[greater than or equal to] 2 Times 43.75 (5.30-361.36) ***
1 Time 12.58 (1.25-127.03) *
Never 1.00
Protective Behavioral
Alcohol Avoidance
Usually/Always N/S
Sometimes/Never
Note. The last category was used as the reference.
N/S indicates non-significance in the univariate logistic model.
* p <.05, ** p < .01, *** p < .001