Peritraumatic reactions during Sexual Assault: Associations with Assault Characteristics and Mental Health

Background: Peritraumatic reactions during sexual assault are central to societal rape stereotypes and may play a role for post-trauma mental health. Nevertheless, existing research is limited. In this cross-sectional study, we explored a broad spectrum of emotional, cognitive, and behavioral peritraumatic reactions and investigated their associations with assault characteristics, sexual assault history, and symptoms of post-traumatic stress and depression/anxiety.Methods: Recent sexual assault victims (N=425, 96% female, M = 26.20 years old) completed a 23-item peritraumatic reactions questionnaire developed in collaboration with lived-experience experts. Exploratory factor analysis (EFA) was employed to identify latent peritraumatic reaction factors. Associations between factor scores, various assault characteristics, history of sexual assault, and current symptoms of posttraumatic stress and depression/anxiety were assessed with t-tests, ANOVA, correlations and linear regressions.Results: EFA revealed six factors: Dissociation & freeze, Cognitive strategies & thought processes, Active defense behavior, Negative emotions, Perceived life threat, and Reactive surrender. Feelings of helplessness and nonactive behavioral responses, captured by the Dissociation & freeze and the Reactive surrender factors, were much more pronounced than active resistance. Perpetrator strategies involving threats and physical violence were related to higher levels of most peritraumatic reactions, apart from Dissociation & freeze. A closer victim-perpetrator relationship was associated with lower Perceived life threat, whereas a history of sexual assault was associated with higher levels of Reactive surrender. All factors except Cognitive strategies & thought processes and Active defense behavior were positively correlated with post-traumatic stress and depression/anxiety symptoms, even when controlling for assault characteristics and sexual assault history.Conclusions: These findings highlight the heterogeneity of peritraumatic responses and challenge rape stereotypes of the actively resisting victim by identifying reactive surrender as a common survival strategy. The robust associations between diverse peritraumatic reactions and post-trauma mental health propose these acute responses as vital clinical indicators for post-trauma adjustment.