Doctoral Dissertation
University of Oregon

Title: Contextual Factors Influencing Posttraumatic Stress After Campus Sexual Assault


Alexis Avery Adams-Clark

Defended & Completed June 2023
PhD granted September 2024 after clinical internship

Advisor Freyd, Jennifer J.

Dissertation Abstract

Sexual assault has been repeatedly associated with multiple types of psychological distress, including posttraumatic stress. Post-assault outcomes are frequently linked to intrapersonal or psychological processes (e.g., cognitions, behaviors, biology), yet contextual factors also play important roles. In this dissertation, I examine how intrapersonal and contextual factors are associated with posttraumatic stress among student survivors of campus sexual assault – a specific type of sexual violence that occurs within the context of important interpersonal and institutional relationships. 

In Chapter I, I review the extant theory and research on psychological outcomes of sexual assault, with an emphasis on socioecological and betrayal trauma theories and their application to campus sexual assault. Using prior theory and research as justification, I then describe two components of one empirical project that investigate how intrapersonal and contextual factors influence posttraumatic stress among survivors of campus sexual assault at the University of Oregon. The first analysis (Chapter II) examines how factors at various layers of the social ecology are related cross-sectionally to posttraumatic stress in a large student sample. Results suggest that intrapersonal factors (e.g., self-blame cognitions, avoidance coping), relational factors (e.g., relationship with perpetrator, reactions to disclosure), and institutional betrayal each explain unique variance in posttraumatic stress.  The second analysis (Chapter III) examines the relationships between campus sexual assault victimization, institutional betrayal, and posttraumatic stress among a subsample of women and gender minority students across a period of six months. Results suggest that campus sexual violence victimization and institutional betrayal are consistently associated with posttraumatic stress across time, with the highest levels of posttraumatic stress experienced by sexual assault survivors in a context of institutional betrayal. Chapter IV closes by discussing the results and limitations of both analyses within the context of the larger empirical and theoretical literature.

Overall, this dissertation supports the feasibility and value of taking a socioecological and betrayal-informed approach to understanding and researching campus sexual assault and points to avenues for prevention and intervention efforts at multiple levels of the social ecology.

See full dissertation (pdf)

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