Authors: Anna E. Jaffe (aDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States), Rebecca L. Howard Valdivia (bDepartment of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States; cWomen’s and Gender Studies, University of Nebraska-Lincoln, Lincoln, NE, United States), Jessica A. Blayney (aDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States), Cynthia A. Stappenbeck (dDepartment of Psychology, Georgia State University, Atlanta, GA, United States)
Categories: Article, rape, sexual harassment, substance use, no advance notice, psychological distress
Source: Journal of sex research
Authors: Anna E. Jaffe, Rebecca L. Howard Valdivia, Jessica A. Blayney, Cynthia A. Stappenbeck
To date, most sexual assault research has focused on specific perpetrator tactics, including verbal coercion, substance-related incapacitation, and force. Responding to recent calls to assess a broader range of nonconsensual sexual experiences, we examined the occurrence and outcomes of sexual assault without warning—when a perpetrator “just does” a behavior without giving a chance to say “no.” Participants were 850 college students (Mage = 19.70; 70% cisgender women, 28% cisgender men, 2% transgender/gender expansive), including 38% (n = 325) who reported sexual assault since age 14. Among these survivors, 72% reported sexual assault without warning, including 18% for whom this was the only tactic experienced. Sexual assault without warning was most often used to obtain nonconsensual sexual contact (23% of the sample), but also attempted (11%) and completed penetration (13%). Relative to no such experience, sexual assault without warning was associated with more severe posttraumatic stress, depression, and anxiety, but fewer past-month drinks per week. Although more alcohol use and related consequences were better predicted by incapacitated sexual assault, sexual assault without warning was consistently associated with mental health problems. Findings support the integration of this tactic into sexual assault assessments for college students of diverse gender and sexual identities.
How does one decide what is or is not a sexual assault? The Centers for Disease Control and Prevention currently define sexual violence as “a sexual act that is committed or attempted by another person without freely given consent of the victim or against someone who is unable to consent or refuse” by way of force, alcohol or drug facilitation, pressure, or coercion (Basile et al., 2014). Definitions of sexual violence have been revisited and expanded over time (e.g., to include marital rape; Bennice & Resick, 2003), reflecting societal shifts in the recognition that sexual assault can be perpetrated by any individual, regardless of their gender or relationship with the victim. Following the mainstream popularization of the #MeToo movement, societal scripts for sexual assault have continued to expand, which has allowed increased recognition of cases where sexual boundaries are violated (Jaffe, Cero, et al., 2021; Kilimnik et al., 2024; Newins et al., 2021).
A shared, yet comprehensive understanding of what constitutes a “sexual assault” is a critical foundation for research on the topic. Behaviorally specific assessments are important for defining and measuring sexual assault (Cook et al., 2011; Krebs, 2014), yet some survivors still go unidentified on such measures (Marchewka et al., 2022; Testa et al., 2004). Given that prevention and intervention for sexual assault can only be understood to the extent that researchers can accurately identify instances of sexual assault, recent research efforts have focused on expanding the definition and measurement of sexual assault to increase inclusivity (Anderson et al., 2020; Anderson, Carstens Namie, et al., 2021; Canan et al., 2020). One such recommendation is to ask individuals if someone has attempted or completed sexual contact with them, without their consent, by just doing the behavior without giving a chance to say “no” (Canan et al., 2020)—henceforth referred to as sexual assault without warning. This would represent a perpetrator tactic not routinely assessed nor considered in prior conceptualizations of sexual assault, which have otherwise focused on verbal coercion, incapacitation due to alcohol or other drugs, and threats or use of force (e.g., Basile et al., 2014; Kilpatrick et al., 2007; Koss et al., 2007; Smith et al., 2018). Although emerging research suggests that sexual assault without warning is common (Anyadike-Danes et al., 2023; Canan et al., 2020; Kern et al., 2024), little is currently known about the associated consequences for survivor well-being. To address this gap, we seek to add to emerging research on this topic by examining the occurrence and impact of sexual assault without warning.
To identify instances of sexual assault, it is considered best practice to use behaviorally-specific assessments (Cook et al., 2011; Krebs, 2014). These self-report measures describe behavioral manifestations of sexual assault, which include descriptions of perpetrator tactics (e.g., verbal coercion) and specific, nonconsensual sexual acts (e.g., anal penetration). Using behavioral specifications is advantageous because participants are not required to determine if their experience matches a presumed definition of sexual assault or rape, as they would be in assessments with broader questions, such as “have you been raped?” (Cook et al., 2011). Indeed, many individuals who report experiences that meet the definition of sexual assault do not label their experience as such (Anderson, Tarasoff, et al., 2021; Artime et al., 2014; Wilson & Miller, 2016), suggesting that these experiences would go unidentified without behaviorally-specific assessments (Marchewka et al., 2022).
However, behaviorally-specific assessments are ultimately only as accurate as they are representative of survivors’ victimization experiences. Despite behaviorally-specific assessments identifying more instances of sexual assault than broader questions involving sexual violence terminology (e.g., rape, sexual assault), research has identified instances in which participants indicate they have experienced sexual assault but were not identified on a behaviorally-specific assessment (i.e., responded negatively to the assessment items; Marchewka et al., 2022; Testa et al., 2004). In these cases, participants often described nonconsensual sexual situations that occurred without warning, such as when a perpetrator exposed themselves to the participant or grabbed a participant in a bar (Testa et al., 2004).
Although not historically assessed in common survey assessments of sexual assault (e.g., Koss et al., 2007), sexual assault without warning has been identified in focus groups, interviews, and open-ended survey responses on a range of topics, including condom use (Davis et al., 2014), consent practices (Jozkowski & Peterson, 2013), unwanted sexual contact (Khan et al., 2018; Papp & McClelland, 2021), sexual coercion (Kern & Peterson, 2020), sexual assault (Littleton et al., 2020, 2024), and sexual aggression (Buday & Peterson, 2015). For example, unwanted touching or groping without warning has been commonly described (Khan et al., 2018; Littleton et al., 2020; Papp & McClelland, 2021), including surprise initiation in dancing settings (“‘I do hate the back sneak-up and then start grinding on you randomly’; Lucy, 21 years old [‘Ugh’; group agreement]”; Papp & McClelland, 2021, p. 494). Penetrative sexual acts without warning have also been identified (Buday & Peterson, 2015; Davis et al., 2014; Jozkowski & Peterson, 2013; Kern & Peterson, 2020; Littleton et al., 2024). Describing this surprise penetration, “a man wrote, ‘Just stick it in and if she objects, pretend like I had done it by mistake,’ and another male participant said, ‘Start having sex and then say oops, didn’t mean for it to go in, so too late now’” (Jozkowski & Peterson, 2013, p. 520). These instances of sexual assault without warning have additionally been identified across a number of contexts, including in drinking settings (e.g., parties, bars) and on dates, and by different types of perpetrators, including strangers and romantic partners (Khan et al., 2018; Littleton et al., 2020, 2024; Papp & McClelland, 2021). Taken together, this qualitative research suggests that sexual assault without warning is salient to survivors’ experiences across a range of sexual acts and contexts.
In light of this work, Canan et al. (2020) recommended including an item assessing “just doing the behavior without giving me the chance to say ‘no’ (e.g., surprising me with the behavior)” in the Sexual Experiences Survey (SES; Koss et al., 2007), a frequently used quantitative behavioral measure of sexual assault. Current working versions of the next SES iteration also include a new item involving “no advanced notice,” such that the respondent had no chance to consent (Koss et al., 2024). When assessed in emerging survey research, sexual assault without warning has been the perpetrator tactic most frequently reported (54 to 81%; Anyadike-Danes et al., 2023; Canan et al., 2020). In addition, this tactic identified sexual assault survivors who would not have been otherwise represented, including 50% of university students who reported a single tactic (Anyadike-Danes et al., 2023) and 9% of community women overall (Canan et al., 2020). Additionally, consistent with elevated rates of sexual assault among bisexual women (Blayney et al., 2023; Canan et al., 2022; Chen et al., 2020), sexual assault without warning was most frequently reported among bisexual survivors (i.e., 86 to 89%; Anyadike-Danes et al., 2023; Canan et al., 2020), suggesting that the inclusion of this tactic may be particularly beneficial for identifying instances of sexual assault among individuals who hold minoritized sexual identities. Overall, across this qualitative and quantitative research, sexual assault without warning appears to identify a unique aspect of survivor experiences not captured by traditional quantitative assessments.
In expanding definitions and measurements of sexual assault, some may question whether the scope may become so wide-reaching and the construct so diffuse, that associated outcomes are no longer well understood. Thus, when evaluating a new perpetrator tactic, it is important to consider whether it follows similar patterns to other well-established and commonly studied forms of sexual assault. Past research has established a robust association between sexual assault and negative mental health and substance use outcomes, including posttraumatic stress disorder (PTSD), depression, anxiety, and alcohol use (Dworkin et al., 2017). In this case, one would expect that relative to not having such an experience, a sexual assault without warning would be associated with similar negative outcomes to other forms of sexual assault.
How sexual assault perpetrator tactics differentially impact mental health outcomes is another question. Although findings are somewhat mixed, sexual assault involving physical force is most consistently associated with increased risk for PTSD, depression, and substance use relative to sexual assault involving incapacitation or verbal coercion (Brown et al., 2009; Kern & Peterson, 2020; Ullman et al., 2007; Zinzow et al., 2010). However, sexual assault involving incapacitation may also be associated with particularly long-lasting and difficult-to-treat PTSD symptoms (Gong et al., 2019; Jaffe et al., 2017; Jaffe, Kaysen, et al., 2021). Little is known, though, about how sexual assault without warning is associated with survivors’ mental health outcomes.
Sexual assault without warning may be particularly distressing because of the sudden, unexpected nature of the event. By threatening one’s perceived sense of safety and predictability in the world, sexual assault without warning may be especially likely to increase risk for PTSD (Janoff-Bulman & Frieze, 1983). On the other hand, depending on the specifics of the event, the sudden nature of sexual assault without warning may leave little time for one to recognize and process the threat to their safety until after the peak threat has passed. Given that perceived threat to life has been linked to greater PTSD severity (Holbrook et al., 2001), it is also possible that sexual assault without warning may be less strongly linked to mental health problems than other forms of sexual assault.
Preliminary research examining mental health outcomes of sexual assault without warning is limited and has yielded mixed findings. For example, Kern & Peterson (2020) considered outcomes of “non-resisted physically coerced sex”—a category which included both sexual assault without warning and sexual assault by incapacitation—and found no differences in posttraumatic stress symptoms between this group and those who reported experiences of forced or coerced sex. More recently, Kern et al. (2024) found that sexual assault without warning was associated with less severe posttraumatic stress than sexual assault by force or coercion. However, this study assigned each survivor a single perpetrator tactic (focusing on the single most upsetting perpetrator tactic from the most upsetting sexual assault experienced), instead of allowing for the possibility of co-occurring tactics within or across sexual assault experiences. Importantly, regardless of whether sexual assault without warning is the most distressing tactic experienced by a survivor, it may heighten perceptions of unpredictability and thereby increase distress for other index assaults. More research is therefore needed to understand the unique impact of sexual assault without warning on survivors’ mental health.
To cope with sexual assault-related distress, many survivors may turn to substances, consistent with the self-medication hypothesis (Khantzian, 2003; Miranda et al., 2002; Stappenbeck et al., 2023). Indeed, experiencing a sexual assault has been linked to increased alcohol use and related consequences (Bryan et al., 2016; Hughes et al., 2010; Parks et al., 2014; Rhew et al., 2017). However, research on relative comparisons of perpetrator tactics on alcohol use outcomes is limited, and generally highlights that survivors of incapacitated sexual assault tend to report heavier drinking and more alcohol misuse than survivors of other sexual assaults (Littleton et al., 2009; Lorenz & Ullman, 2016), both before and after the assault (Jaffe et al., 2022; Kaysen et al., 2006; Norris et al., 2019). To our knowledge, research on alcohol-related outcomes of sexual assault has not yet included sexual assault without warning. More research is therefore needed to examine if post-assault elevations in alcohol use and related consequences also extend to sexual assault without warning.
Behaviorally-specific sexual assault assessments are critical for identifying individuals who have had nonconsensual sexual experiences, and in turn, are at higher risk for negative mental health and substance use outcomes. Yet, a challenge of these assessments is that the behaviors constituting an assault must be pre-determined by researchers. If a perpetrator tactic is not assessed, then individuals who may be experiencing negative outcomes after a sexual assault may be underrepresented in research and targeted intervention efforts. Sexual assault without warning may be one such underrepresented tactic. Having been incorporated into recent adaptations of the SES (Canan et al., 2020; Holloway et al., 2024; Kern et al., 2024; Koss et al., 2024), emerging research suggests that this tactic uniquely identifies individuals’ experiences of sexual assault (Anyadike-Danes et al., 2023; Canan et al., 2020). Here, we investigate the extent to which new recognition of this tactic advances identification of individuals negatively impacted by nonconsensual sexual experiences.
First, we examine rates for which individuals report this new tactic, including for people with diverse gender and sexual identities. Second, we examine the extent to which this tactic is uniquely associated with negative health outcomes when controlling for sexual assault resulting from other tactics—force, incapacitation, and verbal coercion. We also control for minoritized gender and sexual identities, given that individuals who hold these identities may experience minority stress and in turn, more negative health outcomes following sexual assault (Blayney et al., 2023). Negative health outcomes examined here include those demonstrating robust associations with sexual assault broadly, including symptoms of posttraumatic stress, depression, and anxiety, as well as alcohol use and alcohol-related consequences (Dworkin et al., 2017). Although we generally expected these links between sexual assault and negative health outcomes to extend to sexual assault without warning, no specific hypotheses were made given the limited research on this tactic.
Participants were drawn from a larger multisite cross-sectional study to investigate the impact of the COVID-19 pandemic on mental health, substance use, and sexual experiences (see Jaffe, Graupensperger, et al., 2022; Jaffe et al., 2023). College students aged 18 and older were recruited from psychology subject pools across three public US universities in the spring 2021 semester. Participants completed a larger online survey estimated to take 90 minutes to complete (median actual duration = 70.1 minutes) and received research credit for their participation. All procedures were approved by institutional review boards of the respective universities.
A total of 875 students completed the study and passed validity check questions. Given that most participants (97.1%) were emerging adults (i.e., ages 18 to 25; Arnett, 2000), the remaining 25 participants aged 26 to 61 were excluded from analyses, resulting in a final sample of 850 participants, including 444 from a Midwestern university, 230 from a Southeastern university, and 176 from a Northwestern university.^1^
The analytic sample of 850 participants aged 18 to 25 (M = 19.70, SD = 1.37) included 70.2% cisgender women, 28.2% cisgender men, and 1.7% transgender and gender expansive (TGE) individuals (excluding n = 2 who declined to state a gender). Regarding sexual identity, participants were 72.1% exclusively heterosexual or straight, 12.7% mostly heterosexual or straight, 9.9% bisexual or pansexual, 1.4% mostly homosexual/gay/lesbian, 2.2% exclusively homosexual/gay/lesbian, 0.8% asexual, and 0.8% “something else” or “don’t know.” Considering both gender and sexual identity, the sample comprised 48.6% heterosexual cisgender women, 21.6% queer cisgender women, 23.5% heterosexual cisgender men, 4.7% queer cisgender men, and 1.7% TGE individuals (92.9% of whom also identified as queer). Regarding racial identity, 58.0% were White, 22.0% Asian, 16.9% Black or African American, 0.7% Native Hawaiian or Other Pacific Islander, and 6.4% “Other” (e.g., Middle Eastern; note that multiple categories could be endorsed). Regarding ethnicity, 16.4% identified as Latinx, Hispanic, or of Spanish origin.
Participants reported standard demographic information, including age, race, ethnicity, sex assigned at birth, gender, and sexual identity. Gender identity was recoded to represent three cisgender women (“female”), cisgender men (“male”), and TGE individuals (“transgender man,” “transgender woman,” “non-binary, gender queer, or gender non-conforming,” “other-please specify”). Sexual identity was recoded to represent those who identified as heterosexual (“exclusively heterosexual or straight”) and queer (“mostly heterosexual or straight,” “bisexual or pansexual,” “mostly homosexual or gay or lesbian,” “exclusively homosexual or gay or lesbian,” “something else,” “don’t know”). To characterize the sample, participants who answered, “something else” or “don’t know” received additional response options (e.g., “You do not think of yourself as having a sexuality or identify as asexual”; Institute of Medicine, 2013) or could write in a free response.
The Revised Sexual Experiences Survey (R-SES; Canan et al., 2020; Koss et al., 2007) was used to assess nonconsensual sexual experiences since the age of 14. First, to ensure that only relevant questions were shown to participants, they were asked, “Please select whether you have a vagina or a penis.” The R-SES then asks participants to indicate the number of times (0 = 0 times, 1 = 1 time, 2 = twice, 3 = 3–9 times, 4 = 10+ times) they experienced each type of sexual behavior without their consent (i.e., sexual contact, attempted or completed oral, vaginal, or anal penetration) based on different perpetrator tactics. Following the Canan et al. (2020) version, the following perpetrator tactic was added to represent sexual assault without “Just doing the behavior without giving me a chance to say ‘no’ (e.g., surprising me with the behavior).” Based on responses, any endorsement of each perpetrator tactic (e.g., without warning, coercion, incapacitation, force) was dichotomized (0 = none, 1 = any). Participants who reported any experience of sexual assault were then asked to clarify the number of unique events they had experienced, involving any “How many experiences of unwanted^2^ sexual activity (as indicated in the previous questions) have you had since the age of 14? (Consider events on different days to be separate events.)” with response options ranging from 1 to 20 or more (coded as 20).
The PTSD Checklist for the DSM-5 (PCL-5; Weathers, Litz, et al., 2013) was administered to assess for severity of posttraumatic stress symptoms. Specifically, participants who reported exposure to one or more potentially traumatic events on the Life Experiences Checklist for DSM-5 (Weathers, Blake, et al., 2013) were shown 20 items and asked how much they had been bothered by each in the past month. Response options ranged from 0 = not at all to 4 = extremely. Items were summed to create a severity score (α = .95).
Questions from the Brief Symptom Inventory (Derogatis, 2000) were used to assess depression (6 items) and anxiety (6 items). Participants were asked how distressed they were by each item in the past month. Response options ranged from 0 = not at all to 4 = extremely. Items were summed with higher scores reflecting more severe depression (α = .90) or anxiety (α = .91).
Participants first answered a screening question from the Alcohol Use Disorders Identification Test-Consumption questions (AUDIT-C; Bush et al., 1998): “In the past year, how often have you had a drink containing alcohol?” Those who responded “never” did not receive additional questions about alcohol use or consequences; those who indicated past-year drinking were administered additional questions about alcohol.
Alcohol use was assessed with the Daily Drinking Questionnaire (DDQ; Collins et al., 1985). Participants were asked to indicate the number of standard drinks consumed each day for a typical week in the past month. Response options ranged from 0 = 0 drinks to 25 = 25+ drinks. Responses were summed for a total number of drinks per week.
Alcohol-related consequences were measured using the Brief Young Adult Alcohol Consequences Questionnaire (Kahler et al., 2005). Participants were shown a list of 24 negative consequences of alcohol use and asked if they had experienced each in the past month. Example items included, “While drinking, I have said or done embarrassing things,” “I have woken up in an unexpected place after heavy drinking,” and “I have spent too much time drinking.” Response options were 0 = no and 1 = yes. Items were summed to represent the total number of consequences experienced.
Preliminary analyses included examining univariate and bivariate descriptive statistics to characterize the sample. Missingness was also investigated and found to be minimal at the item-level. Participants who declined to state their gender (n = 2) were not included in analyses involving gender. Some (n = 99) participants did not report experiencing any potentially traumatic events and therefore, were not given the PCL-5; n = 1 reported a potentially traumatic event but did not answer the PCL-5. Finally, 38 survivors did not indicate the number of unique sexual assaults that they had experienced.
The first set of analyses involved examining rates of sexual assault by tactic. Given that past research has suggested that plurisexual women, transgender, and gender non-conforming individuals are at the highest risk for experiencing sexual assault (Chen et al., 2023; Coulter et al., 2017), and the current sample was not collected to be representative of the US college population at large, rates were examined separately for each gender and sexuality grouping. Fishers’ exact tests were used to evaluate differences in rates by group and post-hoc tests were computed using Bonferroni-adjusted pairwise comparisons.
The second set of analyses involved examining unique associations between sexual assault by various perpetrator tactics and negative health outcomes. To do so, we examined separate regression models for each outcome. Posttraumatic stress, depression, and anxiety symptoms were examined via linear models; alcohol use (i.e., typical drinks per week in the past month) and number of alcohol-related consequences were examined via negative binomial regressions. Covariates included gender (cisgender man, cisgender woman, or TGE), sexual identity (queer or heterosexual), and site (i.e., university where the data were collected). All analyses were conducted in R version 4.3.2 (R Core Team, 2023) and included the following tidyverse (Wickham et al., 2019), gtsummary (Sjoberg et al., 2021), and MASS (Venables & Ripley, 2002).
Nearly two in five participants reported an experience of sexual assault (38.2%; n = 325), with an average of 3.11 (SD = 3.83) separate assault experiences each (7 survivors reported the maximum of 20 or more events). Although not mutually exclusive groups, the mean number of sexual assaults experienced were similar amongst those who reported any sexual assault without warning (M = 3.57, SD = 4.29), by coercion (M = 3.44, SD = 4.05), by incapacitation (M = 3.52, SD = 3.98), and by force (M = 3.84, SD = 4.32). Amongst survivors, 71.7% (n = 233) reported experiencing sexual assault without warning, including 17.5% (n = 57) who solely reported sexual assault without warning and 54.2% (n = 176) who reported both sexual assault without warning and sexual assault involving at least one other tactic. In addition, 28.3% (n = 92) of survivors solely reported sexual assault experiences involving another tactic (i.e., coercion, incapacitation, and/or force). See Table 1 for detailed rates of sexual assault by perpetrator tactic and acts.
To further characterize those who would not have otherwise been represented as survivors and whose experiences did not involve any other perpetrator tactics, we next examined the 57 individuals who solely reported sexual assault without warning. Most of these survivors were cisgender women (82.5%) and 17.5% were cisgender men; 43.9% held a minoritized sexual identity. Among these survivors of sexual assault without warning, 71.9% experienced contact, 31.6% experienced attempted penetration, and 22.8% experienced penetration.
Next, we examined sexual assault rates by tactic within each sexual and gender identity-related subgroups. As detailed in Table 2, queer cisgender women had the highest rates of sexual assault across all tactics—significantly higher than heterosexual cisgender women and men. Queer cisgender women also had higher rates of sexual assault than queer cisgender men for all tactics except incapacitation. The most common tactic reported by queer cisgender women was sexual assault without warning (51.4%). In fact, this rate was nearly double the rate of heterosexual cisgender women (26.2%) and queer cisgender men (25.0%), and more than six times the rate of heterosexual cisgender men (8.5%). Heterosexual cisgender men had the lowest rates of sexual assault, although 18.1% still reported at least one form of sexual assault, with the most common tactic being coercion (11.6%). There were few TGE individuals (n = 14), such that reliable group differences were not observed; in this sample, rates of sexual assault for TGE individuals generally appeared to be similar to heterosexual cisgender women.
Results of all linear regression models predicting mental health and alcohol-related outcomes are shown in Table 3. Controlling for gender, sexual identity, and site, unique associations between each of the four tactics and health outcomes were examined. Sexual assault without warning was uniquely associated with more severe posttraumatic stress, depression, and anxiety symptoms. The only other unique associations between sexual assault perpetrator tactics and mental health outcomes revealed that sexual assault by force was uniquely associated with more severe posttraumatic stress symptoms. As indicated by R^2^, the proportion of variance explained by the models was 21.4% in posttraumatic stress symptoms, 15.3% in depression symptoms, and 12.5% in anxiety symptoms.
Predictors of alcohol use and consequences were next examined amongst the 594 participants who reported past-month alcohol use. Those who experienced a sexual assault without warning reported consuming 30% fewer drinks per week than those who did not have this experience, controlling for sexual assault by other perpetrator tactics as well as the aforementioned covariates. Sexual assault by coercion and incapacitation were each associated with more drinks per week, and sexual assault by incapacitation was associated with more alcohol-related consequences. That is, controlling for other variables, those who had experienced a sexual assault by incapacitation reported 74% more drinks per week and 89% more alcohol-related consequences than those who had not experienced a sexual assault by incapacitation. Similarly, those who experienced a sexual assault by coercion (relative to those who did not have that experience) reported 62% more drinks per week. The overall models explained 19.2% of the variance in drinks per week and 12.2% of the variance in alcohol-related consequences.
The current study adds to a growing literature supporting the recognition of sexual assault without warning, in which a perpetrator initiates nonconsensual sexual contact by surprise. Though long represented in qualitative research with survivors, this behavior has only recently been incorporated into standard sexual assault questionnaires, such that a comprehensive examination of endorsement rates and associated outcomes was lacking. In our multisite study of college students, sexual assault without warning was both a commonly reported experience and linked to negative mental health outcomes, highlighting the importance of recognizing this perpetrator tactic in future research and intervention efforts.
Sexual assault was commonly reported by participants in this study with over a third reporting sexual assault since age 14. Amongst survivors, 71.7% reported that those experiences involved sexual assault without warning, with 57 survivors (17.5%) solely reporting this tactic. Thus, in a sample of 850 students, 57 (6.7%) would not have been accurately identified as survivors of sexual assault without the inclusion of this tactic. These findings are consistent with previous research among community women identifying high rates of sexual assault without warning, with the tactic reported by over half of survivors (54%) and uniquely identifying 9% of participants (Canan et al., 2020). Differences in overall rates of this tactic may be explained by the larger proportion of lesbian and bisexual women in previous research (about 63%; Canan et al., 2020) compared to the current study (21.6%). Indeed, when examining queer cisgender women in the current study, the rate of sexual assault without warning (51.4%) is similar. The high rates of sexual assault without warning in the current study lend additional support to recommendations to include this tactic in the SES (Canan et al., 2020; Koss et al., 2024). Coupled with frequent endorsement of sexual assault without warning as the most distressing tactic experienced by survivors (Kern et al., 2024), these findings indicate that this is an important aspect of survivors’ experiences.
Indeed, the high rates of sexual assault without warning among queer cisgender women and men, heterosexual cisgender women, and TGE participants may be indicative of the effects of social structures on minoritized populations. For example, under White supremacist cisheteropatriarchy, differential entitlement to people’s bodies is engrained (e.g., the policing, questioning, and social obsession with TGE individuals’ bodies; historical domination, colonization, and enslavement of women’s bodies, particularly women of Color; Armstrong et al., 2018; Puckett et al., 2023). In a culture that grants greater power and privilege to socially constructed dominant or “normative” groups (e.g., White heterosexual cisgender men), those with greater power and privilege may expect greater access to the bodies of those with relatively less power and privilege. In the current study, the high rates of sexual assault without warning among queer cisgender women in particular may reflect the hyper-sexualization of queer women (Tebbe et al., 2018; Watson et al., 2021), which may have contributed to a climate wherein perpetrators feel entitled to engage in sexual contact without warning. Although we did not assess whether perpetrators were aware (or had made assumptions) of participants’ current minoritized identities, or the extent to which participants perceived that awareness as being connected to the sexual assault experience, perpetrator knowledge of such identities can contribute to survivors’ sexual assault experience in harmful ways (e.g., hypersexuality stereotypes of bisexual women; Watson et al., 2021). Entitlement to minoritized and sexualized bodies may also partially explain why cisgender heterosexual men experienced relatively fewer instances of sexual assault without warning, as their bodies are granted greater privilege and, by extension, differential entitlement and access to their bodies. In sum, the inclusion of sexual assault without warning as a perpetrator tactic may be particularly important for representing experiences that disproportionally affect minoritized survivors.
Importantly, sexual assault without warning was associated with worse mental health outcomes, including more severe posttraumatic stress, depression, and anxiety symptoms. Although Kern et al. (2024) found less severe posttraumatic stress among participants who endorsed sexual assault without warning as the most distressing tactic, they did not control for the other tactics reported by participants, which may be important to isolate the impact of sexual assault without warning. Ultimately, more research is needed to not only parse out the unique effect of sexual assault without warning on mental health consequences, but to also examine the compounding effect of multiple sexual assault tactics either during a single event or across separate experiences. Nonetheless, current findings indicate that sexual assault without warning is a distressing experience associated with worse mental health, regardless of whether other sexual assault tactics are experienced or identified as more distressing.
Building on prior literature that has focused on how perpetrator tactics differentially impact mental health outcomes, we examined alcohol-related outcomes. Consistent with prior work demonstrating that heavy drinking can both precede and worsen after incapacitated sexual assault (Jaffe et al., 2022; Kaysen et al., 2006; Norris et al., 2019), we found that the perpetrator tactic of incapacitation was most strongly linked to heightened alcohol use and related consequences. However, contrary to past research linking sexual assault (broadly defined, but prior to the introduction of the “without warning” tactic) to alcohol use outcomes (Bryan et al., 2016; Hughes et al., 2010; Parks et al., 2014; Rhew et al., 2017), sexual assault without warning was related to fewer drinks per week amongst drinkers in our study. To understand why sexual assault without warning may be linked to less (not more) alcohol use, even in the presence of heightened psychological distress, consider a case in which a sexual assault without warning occurs in a drinking context (e.g., being groped in a bar), but is not accompanied by the heavy drinking patterns and intoxication level that often precede incapacitated sexual assault. In this case, a survivor of a sexual assault without warning may perceive drinking environments as unsafe or distressing and in turn, avoid these contexts or limit their drinking. Regardless of setting, the unpredictable nature of sexual assault without warning may also encourage hypervigilance, such that these survivors may limit their drinking to remain alert. More research is needed to examine these possibilities.
Our findings should be interpreted in the context of methodological limitations. First, although we allowed for the possibility of multiple tactics to be represented, our assessment of sexual assault did not allow us to differentiate whether multiple tactics were experienced within the same or different events. For example, some experiences of sexual assault without warning may also meet criteria for sexual assault by incapacitation and be represented in both categories. More research and improved assessment measures are needed to determine when sexual assault without warning co-occurs with other perpetrator tactics and the consequences of this co-occurrence. Relatedly, we did not collect event-level data about sexual assault characteristics (e.g., relationship with the perpetrator, prior sexual experience), which may have important implications for understanding the context and impact of sexual assault without warning. Future research may also consider how experiences of sexual assault without warning that occur in isolation differ from experiences that occur in combination with other perpetrator tactics. Second, given that sexual assault without warning appears to be an important perpetrator tactic that has been rarely represented in prior research, we recognize that there may still be other tactics that were not included in our assessment of sexual assault. Third, the findings should be interpreted in the context of the current mixed gender sample of college students enrolled in psychology courses, and may not generalize to community samples. Although we recruited college students from three universities to examine a more diverse sample than would be represented by any single university in isolation, there were site differences in participant demographics, rates of sexual assault by incapacitation and coercion, mental health symptoms, and alcohol-related outcomes. We controlled for site in our analyses, but more research is needed to determine if current findings extend to college students across a broader range of more diverse institutions. Finally, although we considered differences by gender and sexual identity, we did not stratify experiences of sexual assault without warning by race or ethnicity in the current study. Future research may further investigate the intersection of gender, sexuality, race, and ethnicity in experiences of sexual assault without warning, particularly as socially constructed entitlement and sexualization of bodies of Color may further impact survivors’ experiences.
Our understanding of the consequences of sexual assault are predicated on our ability to accurately identify when these experiences occur. In the current study, we investigated the frequency and consequences of sexual assault without warning (e.g., by surprise, not giving a chance to say “no”). Sexual assault without warning was the most frequently reported perpetrator tactic, uniquely identifying 17.5% of survivors whose experiences would not have otherwise been represented, and was particularly common among queer cisgender women. Moreover, sexual assault without warning was related to mental health consequences, including more severe posttraumatic stress, depression, and anxiety symptoms, but less alcohol use. The negative outcomes associated with sexual assault without warning highlights the impact of this perpetrator tactic, and underscores that all nonconsensual sexual experiences—even those which some might perceive as “mild” or “lower severity”—can have a wide-reaching impact on one’s well-being. Altogether, our findings extend calls to include sexual assault without warning as a perpetrator tactic in the SES (Canan et al., 2020). When sexual assault measurements are more inclusive of survivors’ experiences, including men and queer individuals, these measures become more representative, enabling a deeper understanding of sexual assault and related consequences.