NRSA Fellowship for Jessica Combs: Sexual Assault, Personality and Problem Drinking in College Women

I propose to address the significant impact that sexual assault has on the mental health of college-aged women, integrating personality factors and trauma to predict maladaptive behavioral consequences. One important and unexplained phenomenon is that some women respond to the trauma of sexual assault with symptoms of externalizing disorders, most notably heavy alcohol consumption, but others respond to the trauma with increases in internalizing dysfunction, such as major depression and generalized anxiety disorder (Kilpatrick et al., 2003; Ullman & Nadjowski, 2009a). It is crucial to identify which women are likely to respond to the trauma in which way, given that (a) heavy alcohol consumption is associated with many problems, including increased risk of re-victimization (Ullman & Nadjowski, 2009b); and (b) there are different empirically supported treatments for the two different kinds of dysfunction (Hayes et al., 1999; Linehan, 1993; Zapolski et al., 2010). The intent of the proposed research is to test this theoretical model: Women with elevations in personality traits that dispose them to engage in rash action when distressed (i.e., the trait of negative urgency) are more likely than other traumatized women to respond to the trauma with increases in rash actions such as heavy drinking. In contrast, women with elevations in personality traits that dispose them to internalizing dysfunction are more likely than other traumatized women to respond to the trauma with increased symptoms of depression and anxiety, but they are less likely to engage in increased heavy drinking. To date, there are no longitudinal studies that measure personality functioning prior to sexual assault victimization and investigate personality-based prediction of different forms of post-trauma distress. The proposed study fills this important gap in the literature. I will assess the personality functioning, drinking behavior, and sexual trauma histories of 1,000 women prior to their first year of college, and then again at the end of their first semester and then at the end of their first year in school. Prior research at my university suggests that approximately 17% of these women will experience sexual assault during their first year in college (Wilcox et al., 2007). Using a three-wave longitudinal design, I will conduct several regression equations using difference scores as dependent variable. In the first, the interaction of negative urgency with sexual assault will predict increased problem drinking across the first year of college, and that effect will be above and beyond the effect of initial problem drinking and initial trait depression. In the second, the interaction of personality traits that dispose individuals to internalizing dysfunction with victimization will predict increased depression and anxiety across the first year, above and beyond initial depression and anxiety and initial negative urgency. I will also test whether sexual assault is associated with increases in traits within the Neuroticism domain across the first year of college. A successful model test will guide clinical researchers to apply different interventions to different assault victims, based on their personality characteristics.