by A Abbey · Cited by 556 — women have experienced sexual assault, including rape. Approximately one-half of those cases involve alcohol consumption by the perpetrator, victim,

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Alcohol and SAntonia Abbey, Ph.D., Tina Zawacki, M.A., Philip O. Buck, M.A., A. Monique Clinton, M.A., and Pam McAuslan, Ph.D. Conservative estimates of sexual assault prevalence suggest that 25 percent of American women have experienced sexual assault, including rape. Approximately one-half of those cases involve alcohol consumption by the perpetrator, victim, or both. Alcohol contributes to sexual assault through multiple pathways, often exacerbating existing risk factors. Beliefs about alcoholÕs effects on sexual and aggressive behavior, stereotypes about drinking women, and alcoholÕs effects on cognitive and motor skills contribute to alcohol-involved sexual assault. Despite advances in researchersÕ understanding of the relationships between alcohol consumption and sexual assault, many questions still need to be addressed in future studies. KEY WORDS: sexual offense; assault and battery; aggressive behavior; AODR (alcohol or other drug [AOD] related) behavioral problem; AODR violence; AODR interpersonal and societal problems; personality trait related to social interaction; AOD expectancies; victim of abuse; social context; alcohol cue Sexual assault1 of adolescent and adult women has been called a silent epidemic, because it occurs at high rates yet is rarely reported to the authorities (Koss 1988). Several reasons contribute to the underreporting of sexual assault cases. Many victims do not tell others about the assault, because they fear that they will not be believed or will be derogated, which, according to research findings, is a valid concern (Abbey et al. 1996b). Other victims may not realize that they have actually ual assault, because the incident does not fit the prototypic scenario of Òstranger rape.Ó For example, in a study by Abbey and colleagues (1996b), a woman wrote, ÒFor years I believed it was my fault for being too drunk. I never called it ÔrapeÕ until much more recently, even though I repeatedly told him ÔnoÕ.Ó This article summarizes current knowledge about alcoholÕs rual assault and discusses questions that remain to be answered by future research. AlcoholÕs contribution to sexual assault ing the general characteristics of sexual assault; thus, this article alternates between providing information about sexual assault in general and contrasting this information with findings regaring alcohol-involved sexual assaults. The Prevalence of Sexual Assault and Alcohol-Involved Sexual Assault The prevalence of sexual assault, both involving and not involving alcohol use, cannot be accurately determined, because it is usually unrepormates of sexual assault prevalence have been based on a variety of sources, including police repordom samples of crime victims, interviews with incarcerated rapists, interviews with victims who seek hospital treatment, general population surveys of women, and surveys of male and female college ANTONIA ABBEY, PH.D., is an associate professor in the Deparity Medicine, Wayne State University, Detroit, Michigan. TINA ZAWACKI, M.A., PHILIP O. BUCK, M.A., and A. MONIQUE CLINTON, M.A., are research assistants in the Department of Community Medicine and doctoral students in the Department of Psychology, Wayne State University, Detroit, Michigan. PAM MCAUSLAN, PH.D., is an assistant professor in the Department of Behavioral Sciences, University of Michigan-Dearborn, Dearborn, Michigan. This work was supported by a grant to Dr. Abbey from the National Institute on Alcohol Abuse and Alcoholism. 1For a definition of this and other terms used in this article, see the glossary, p. 50. Vol. 25, No. 1, 2001 43

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students (Crowell and Burgess 1996). In such studies, the estimatesÕ adequacy varies with the sources of information used. Most researchers agree that the most reliable estimates derive from studies using multi-item scalesÑthat is, measures containing sevstitute sexual assault in simple, nonlegal language (Koss 1988). Based on such measures, conservative estimates suggest that at least 25 percent of American women have been sexually assaulted in adolescence or adulthood and that 18 percent have been raped. Furthermore, at least 20 percent of American men report having perpetrated sexual assault and 5 percent report having committed rape (Crowell and Burgess 1996; Spitzberg 1999; Tjaden and Thoennes 2000). Due to their accessibilityveys tend to employ the most thorough measures of sexual assault by including the largest number of behaviorally specific questions. These studies suggest that approximately 50 percent of college women have been sexually assaulted, and 27 percent have experienced rape or attempted rape; in contrast, 25 per- cent of college men have committed sexual assault, and 8 percent havmitted rape or attempted rape (Crowell and Burgess 1996; Koss 1988; Spitzberg 1999). At least one-half of all violent crimes involve alcohol consumption by the perpetrator, the victim, or both (Collins and Messerschmidt 1993). Sexual assault fits this pattern. Thus, acrparate populations studied, researchers consistently have found that approxmately one-half of all sexual assaults are committed by men who having alcohol. Depending on the sample studied and the measur tors have ranged from 34 to 74 percent (Abbey et al. 1994; Crowell and Burgess 1996). Similarly, approximately one-half of all sexual assault victims report that they were drinking alcohol at the time of the assault, with estimates ranging from 30 to 79 percent (Abbey et al. 1994; Crowell and Burgess 1996). It is important to emphasize, however, that although a womanÕstion may place her at increased risk of sexual assault, she is in no way rsible for the assault. The perpetrators are legally and morally responsible for their behavior. Finally, alcohol consumption by perpetrators and victims tends to co-occurÑ that is, when one of them is drinking, the other one is generally drinking as well (Abbey et al. 1998; Harrington and Leitenberg 1994). Rarely is only the victim drinking alcohol. This finding is tions (e.g., in bars or at paring tends to be a shared activity. However, this finding complicates researchersÕ efforts to disentangle the unique effects tratorsÕ versus the victimsÕ behavior. Common Characteristics of Non-Alcohol-Involved and Alcohol-Involved Sexual Assaults Sexual assault occurs most commonly among women in late adolescence and early adulthood, although infants, as well as women in their 80s, have been raped (Crowell and Burgess 1996). Most sexual assaults that are reported to the police occur between strangers. These assaults, however, represent only a small proportion of all sexual assaults. At least 80 percent of sexual assaults occur among persons who know each other (Crowell and Burgess 1996). Several studies in various populations have attempted to identify ÒtypicalÓ characteristics of sexual assault. Among college students, a typical sexual assault occurs on a date, at either the manÕs or the womanÕs home, and is preceded by consensual kissing. In addition, the assault involves a single assailant who uses no weapon, but twists the womanÕs arm or holds her down. The woman, who believsized her nonconsent, tries to resist through reasoning and by physically struggling (Koss 1988). In a representativple, the typical sexual assault scenario involved a woman who was assaulted by a single assailant who was either an acquaintance or a friend and who used both verbal and physical pressure, which the woman tried to resist (Sorenson et al. 1987). Although alcohol-involved and non-alcohol-involved sexual assaults share many characteristics, some differences exist. For example, sexual assaults involving alcohol consumption are more likely than other sexual assaults to occur between men and women who do not know each other well (e.g., strangers, acquaintances, or casual dates as opposed to steady dates or spouses). Furthermore, alcohol-involved sexual assaults tend to occur at parties or in bars, rather than in either personÕs home (Abbey et al. 1996a). Investigating the Relationship Between Alcohol Consumption and Sexual Assault Although alcohol consumption and sexual assault frequently co-occur, this phenomenon does not provhol use causes sexual assault. Thus, in some cases, the desirual assault may actually cause alcohol consumption (e.g., when a man drinks alcohol before committing a sexual assault in order to justify his behavior). Moreover, certain factors may lead to both alcohol consumption and sexual assault. For example, some fraternities encourage both heavy drinking and sexual exploitation of women (Abbey et al. 1996b). In fact, many pathways can prompt a man to commit sexual assault, and not all perpetrators are motivated by the same factors (Seto and Barbaree 1997). This article, therefore, describes several different ways in which alcohol consumption bypetrator and the victim can encourage sexual assault. Methods for Investigating AlcoholÕs Role in Sexual Assault Researchers have used two main approaches to examine alcoholÕs role in sexual assault: (1) surveys of victims and perpetrators of sexual assault and (2) laboratory studies that examine alcoholÕs effects on human behavior. 44 Alcohol Research & Health

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Alcohol and Sexual Assault Each approach has its strengths and limitations. Sexual assault is a particularly private, personal crime, and it is impossible for researchers to observe or fully simulate sexual assault. Thus, interviews with victims and perpetrators serve as the primary source of information regaring the circumstances under which the sexual assault occurred. Even the best-constructed surveys, however, have some limitations. When studies are conducted years after the sexual assault occurred, a personÕs rcially when the person was intoxicated at the time of the assault. Moreover, some participants may provide a some-what distorted account of the events in order to avoid personal embarrassment. Finally, the surveys conducted to date vary in quality (e.g., sample size and validity of measures). This article focuses on only the findings of surveys that used large, representative samples and measures with established reliability and validity. Laboratory studies are investigations in which participants consume either an alcoholic or a nonalcoholic beverage before their sexual or aggressivior is measured. The primary strength of this methodology is that it allows researchers to establish cause and effect for a certain behaviorticipants are randomly assigned to the alcohol or nonalcohol condition. The major disadvantage of these studies is that for obvious ethical reasons, re-searchers cannot study directly the vable of interest (i.e., sexual assault). Instead, they must use proxy measures that may not accurately represent sexual assault experiences. For example, some investigators have used the participantsÕ responses to pornography as a proxy for sexual assault. Other researchers have asked participants to read and respond to stories about sexual assault. Although it is important to understand hople react to sexual assault victims and perpetrators, responses to a story may not reflect how people would behave if actually in a sexual assault situation. In summary, surveys of victims and perpetrators cannot unequivocally demonstrate a cause-effect relationship betwual assault, whereas laboratory studies cannot measure actual rual assault. Consequently, researchers must conduct both types of studies. Similar results obtained with both approaches increase confidence in the studiesÕ conclusions. The explanations of alcoholÕs role in sexual assault reviewed in the following section havined in studies using such complementary methodologies. Much more research on this topic is needed, however, and specific suggestions for future research are presented at the end of the article. Pathways Through Which Alcohol Contributes to Sexual Assault Theoretical explanations of sexual assault and of alcoholÕs role in sexual assault consider both distal and proximal influences. Distal factors are influences that are temporally far removed from the assault; in contrast, proxtors are influences that are temporally close to the assault. Distal predictors of acteristics, attitudes, and general life experiences of both the perpetrator and the victim. When examining alcohol as a distal factor, researchers focus on the relationship between the perpetratorÕs and the victimÕssumption patterns (e.g., regular heavy drinking) and sexual assault history as well as on beliefs about alcoholÕs effects (i.e., expectancies) that may encourage alcohol-involved sexual assault. Proximal acteristics of the specific situations in which sexual assault occurs, such as whether alcohol consumption occurs, whether the setting is in an isolated area, and what the relationship is between the perpetrator and the victim. This section discusses both of these approaches (also see table). PerpetratorsÕ Personality Characteristics, Attitudes, and Experiences Several studies that comparacteristics of men who had committed sexual assault with those who had not noted the following differences (Seto and Barbaree 1997): ¥°With respect to personality traits, men who had committed sexual assault were more hostile toward women and lowpared with other men. ¥°With respect to attitudes, men who had committed sexual assault were more likely than other men to endorse traditional stereotypes about gender rolesÑfor example, that men are responsible for initiating sex and women are responsible for setting the limits. Perpetrators of sexual assault also were more likely to endorse statements that have been used to justify rapeÑfor example, Òwomen say ÔnoÕ when they mean ÔyesÕÓ and Òwomen enjoy forced sex.Ó Finally,ted sexual assaults were more likely to hold adversarial beliefs about rtionships between men and women (e.g., ÒallÕs fair in love and warÓ) and to consider the use of force in inter-personal relationships acceptable. ¥°With rriences, sexual assaulters were more likely than other men to havrienced abuse or violence as a child, to havcence, to have peers who viewed forced sex as acceptable, and to have had early and frequent dating and sexual experiences. Heavy alcohol consumption also has tion. In studies involving two different subject groups (i.e., incarcerated rapists and college students), men who reported that they drank heavily2 were more likely than other men to report having committed sexual assault (Abbey et al. 1994; Koss and Dinero 1988). General alcohol consumption could be related to sexual assault through multiple path-ways. Fily also likely do so in social situations 2The term Òheavy drinkingÓ is defined differently by each researcher and therefore is used here as in the original articles cited. Vol. 25, No. 1, 2001 45

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that frequently lead to sexual assault (e.g., on a casual or spontaneous date at a party or bar). Second, heavy drinkers may routinely use intoxication as an exable behavior, including sexual assault (Abbey et al. 1996b). Third, certain sivity and antisocial behavior) may increase menÕs propensity both to drink heavily and to commit sexual assault (Seto and Barbaree 1997). Certain alcohol expectancies have also been linked to sexual assault. For example, alcohol is commonly viewed as an aphrodisiac that increases sexual desire and capacity (Crowe and George 1989). Many men expect to feel more powerful, disinhibited, and aggressive after drinking alcohol. To assess the ceptions of sexual behavior, Norris and Kerr (1993) asked sober college men to read a story about a man forcing a date to have sex. Study participants reported that they would be more likely to behave like the man in the story when they were drunk, rather than when they were sober, suggesting that they could imagine forcing sex when intoxicated. Further-more, college men who had perpetrated sexual assault when intoxicated expected alcohol to increase male and female sexuality more than did college men who perpetrated sexual assault when sober (Abbey et al. 1996b). Men with these expectancies may feel morfortable forcing sex when they are drinking, because they can later justify to themselves that the alcohol made them act accordingly (Kanin 1984). Attitudes about womenÕs alcohol consumption also influence a perpetratorÕs actions and may be used to excuse sexual assaults of intoxicated women. Despite the liberalization of gender roles during the past few decades, most people do not readily approvsumption and sexual behavior among women, yet view these same behaviors among men with far more leniency (Norris 1994). Thus, women who drink alcohol are frequently perceived as being more sexually available and promiscuous compared with women who do not drink (Abbey et al. 1996b). Sexually assaultive men often describe women who drink in bars as Òloose,Ó immoral women who are appropriate targets for sexual aggression (Kanin 1984; Scully 1991). In fact, date rapists frequently report intentionally getting the woman drunk in order to have sexual intercourse with her (Abbey et al. 1996b). VictimsÕ Personality Characteristics, Attitudes, and Experiences Parallel to research on perpetrators, numerous studies have compared the personality characteristics, attitudes, and life experiences of women who were sexually assaulted with those of other women. Overall, those analyses found only few significant effects and explain only small amounts of variance, indicating that womenÕsacteristics are not strong predictors of victimization. Some differences exist, however, among women who have been victims of sexual assault and those who have not. Women who have been sexually assaulted are more likely than are other women to have experienced childhood sexual abuse, to have frequent sexual relationships, and to be heavy drinkers Summary of Explanations for Alcohol-Related Sexual Assault, Including Distal Factors, Which Are Temporarily Removed From the Assault, and Personal Factors, Which Are Temporarily Close to the Assault Perpetrators Victims Distal Factors General, heavy alcohol consumption General, heavy alcohol consumption Alcohol expectancies about sex, Childhood sexual abuse aggression, and disinhibition Stereotypes about drinking women being sexually available and appropriate targets Situational Factors Heavy drinkers spend time in bars Heavy drinkers spend time in bars and and at parties at parties Drinking is used as an excuse for socially AlcoholÕs cognitive impairments reduce unacceptable behavior ability to evaluate risk AlcoholÕs cognitive impairments enhance AlcoholÕs motor impairments reduce misperception of the womanÕs friendly ability to resist effectively cues as sexual AlcoholÕs cognitive impairments facilitate an aggressive response if the man feels he has been Òled onÓ 46 Alcohol Research & Health

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Alcohol and Sexual Assault (Abbey et al. 1996a; Koss and Dinero 1989). Explanations of these findings focus on the long-term effects of child-hood victimization (Wilsnack et al. 1997). Sual abuse cope with the resulting stress and negative emotions through early and frequent sexual relations and heavy drinking. These women may also be more ing with their ambivalent feelings about sex. Intial sexual situations increases womenÕs risk of being sexually assaulted, both because sexually assaultive men may view them as easy targets and because the women may be less able to resist effectively. Situational Factors Sexual assault involves both sexual behavior and aggression; accordingly, researchers must consider situational influences (i.e., cues) relevant to both behaviors, such as the location or social situation in which the assault occurs. These cues may differ someing on the type of sexual assault (i.e., stranger sexual assault versus date sexual assault). In the case of sexual assaults that occur among strangers or people who have just met, men who drink heavily may frequent settings, such as bars and parties, where women also tend to drink heavily and where a man can easily find an intoxicated woman to tar-get for a possible sexual assault. In these situations, alcohol may give men the Òliquid courageÓ required to act on their desires and may reinforce their stereotypes about drinking women. For example, an incarcerated rapist interviewed by Scully (1991) stated that, ÒStraight, I donÕt have the guts to rape. I could fight a man but not that.Ó (p. 124) Alcohol consumption is also used by date rapists to excuse their behavior. For example, 62 percent of the college date rapists interviewed by Kanin (1984) felt that they had committed rape because of their alcohol consumption. These rapists did not see themselves as Òreal criminals,Ó because real criminals used weapons to assault strangers. In fact, some men may purposely get drunk when they want to act sexually aggrsive, knowing that intoxication will provide them with an excuse for their socially inappropriate behavior. As described earlier, at least 80 per-cent of all sexual assaults occur during social interaction, typically on a date. The fact that sexual assault often hap- pens in situations in which consensual sex is a possible outcome means that a manÕs interpretation of the situation can influence his responses. Consequently, additional situational factors are rvant to these types of sexual assaults. For example, American men arized to be the initiators of sexual inter-actions. Consequently, if a man is interested in having sex with a woman, he is likely to feel that he should make the first move. Initial sexual moves are usually subtle in order to reduce the embarrassment associated with potential rejection. Both men and women are used to this indiring sexual interest and usually manage to make their intentions clear and save face if the other person is not interested (Abbey et al. 1996b). However, because the cues are subtle and sometimes vague, miscommunication can occur, particularly if communication skills are impaired by alcohol use. As male-female interaction progresses, a woman who has been misperceived as being interested in sex may realize that her companion is reading more into her friendliness than she intended. However, she may not feel comfortable giving a dirterder roles emphasize the importance of being nice and Òletting men down easy.Ó The man, in turn, may not take an indirect approach to expressing sexual disinterest seriously. Research on the power of stereotypes, expectancies, and self-fulfilling prophecies demonstrate that when people have an expectation about a situation or another person, they tend to observe and rily the cues that fit their hypothesis and to minimize or ignore the cues that contradict their hypothesis. Consequently, when a man hopes that a woman is interested in having sex with him, he will pay most attention to the cues that fit his expectation and disregard cues that do not support his expectation. Stims have confirmed that the manÕs misperception of the womanÕs degree of sexual interest is a significant predictor of sexual assault (Abbey et al. 1996a, 1998). The process just described can occur even in the absence of alcohol use. How-ever, bate the likelihood of misperception, thereby increasing the chances of sexual assault. Beforics, the laboratory research findings on alcoholÕs effects on aggressivual behavior should be reviewed. General Research on AlcoholÕs Effects on Aggressive and Sexual Behavior To determine which alcohol effects are attributable to alcoholÕs pharmacology and which are attributable to culturally learned beliefs, researchers have utilized the balanced placebo design or some of its recent modifications (Martin and Sayette 1993; Rohsenow and Marlatt 1981). In the standard balanced placebo study, participants are randomly assigned to one of the following four groups: ¥°Participants who expect and receive an alcoholic beverage ¥°Participants who expect an alcoholic beverage but receive a nonalcoholic beverage ¥°Parholic beverage but receivholic beverage ¥°Participants who expect and receive a nonalcoholic beverage. With this experimental design, effects that occur only in participants who received an alcoholic beverage, whether ered to result from alcoholÕlogical actions. Conversely, effects that occur only in participants who expect to receive alcohol, whether or not they actually consume an alcoholic bevage, can be considered to result from alcohol expectancies. Vol. 25, No. 1, 2001 47

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Researchers who have examined the pharmacological versus psychological effects of alcohol havent conclusions depending on whether the variable of interest in the outcome was aggression or sexuality. The effects of alcohol on aggression appear to be principally pharmacological. Thus, in studies using the balanced placebo design, alcoholÕs effects were usually observed in the parsumed alcohol, but not in the parpants who only expected to consume alcohol (Ito et al. 1996). In addition, aggressiveness incrhol dose (Taylor and Chermack 1993). Most investigators agrholÕs effects on aggressive behavior are mediated by alcohol-induced cognitive deficits. Alcohol consumption disrupts higher order cognitive processesÑ tion, planning, and problem-solvingÑ making it difficult for the drinker to interpret complex stimuli. Thus, when under the influence of alcohol, people have a narrower perceptual field and can attend only to the most obvious (i.e., salient) cues in a given situation (Taylor and Chermack 1993). In aggression-inducing situations, the cues that usually inhibit aggressive behavior (e.g., concerns about futurquences or a sense of morality) arcally less salient than feelings of anger and frustration. Therefore, when a per-son is intoxicated, inhibitory cues are ignored or minimized, making aggrsion seem like the most reasonable response. In contrast, studies of alcoholÕsence on sexual behavior have found more psychological effects. Inhol doses generally reduce physiological sexual responding, whereas low and moderate alcohol doses increase subjective sexual arousal. Many studies havstrated that men who believe they have consumed alcohol experience greater physiological and subjective sexual arousal in response to erotic materials depicting consensual and forced sex than do men who believe they have consumed a non-alcoholic beverage, regardless of what they actually drank (Crowe and George 1989). Fewer studies have examined alcoholÕs effects on sexual behavior in women, and the results have been inconsistent. This finding is generally explained in terms of societyÕs negative messages regarding womenÕstion and sexuality (Norris 1994). Thus, sexual behavior and drunken excess are considered less acceptable in women than in men, and unlike men, women must be concerned about being labeled as loose, or promiscuous. In addition, women are concerned about their increased vulnerability to sexual and nonsexual aggression when intoxicated. Consequently, womenÕs expectancies about alcoholÕs sexual effects are less positive than menÕs expectancies, because the social costs associated with alcohol use and sexual behavior are greater for women. In summary, research suggests that alcohol exerts its effects on aggressive behavior principally thrcological effects on cognitive pring, whereas alcoholÕs effects on sexual behavior occur through pharmacological processes as well as psychological expectancies. Crowe and George (1989) summarized the literature by arguing that expectancies reduce Òinhibitory nitivior. As inebriation increases, therefore, inhibition is reduced both bycies and by increasing inability to prcess inhibitory cues.Ó (p. 383) AlcoholÕs Effects in Sexual Assault Situations Abbey and colleagues (1994, 1996b) have developed a model to explain the rtrated by acquaintances. The model suggests that alcohol acts at two distinct points during the interaction between the perpetrator and the victim to increase the likelihood of sexual assault. The first point is during the early stages of the interaction, when the man is evpanion wants to have sex with him. This evaluation is an ongoing process. During a date or other social interaction, many points occur at which a man evaluates the potential sexual meaning of a female companionÕs verbal or non-verbal cues. Alcohol can contribute to the misperception of the womanÕs cues in such a way that the man perceives her as being more encouraging than she really is because of alcoholÕs effects on his cognitive functioning. The woman experiences the same cognitive deficits as the man does if the woman also consumes alcohol. Thus, if she feels that she has made it clear that she is not interested in sex at this point, alcohol consumption will make her less likely to process the manÕsing that he has misread her intentions. This model is difficult to test directly, however, because researchers must rely on participantsÕ retrospective recall of sexual assault situations. Nevertheless, a study among college men found that increased alcohol consumption in social situations increased the participantsÕ misperceptions of womenÕs cues (Abbey perceptions, in turn, was related to the frmitted sexual assault. In a parallel study uations in which men misperceived the womenÕs sexual intentions increased the tims of a sexual assault (Abbey et al. 1996a). In addition, Testa and Livingston (1999) found that women who had been drinking prior to being sexually assaulted reported that their intotion made them take risks that they normally would avoid. For example, the women felt comfortable accepting a ride home from a party with a man they did not know well or letting an intoxicated man into their apartment. The second point at which alcohol plays a role in sexual assault is when the man forces sex on a woman against the womanÕsary in this scenario, because some men feel entitled to force sex on women if they feel that they have been Òled onÓ or teased (Anitive deficits associated with alcohol consumption, however, can enhance a manÕs likelihood of behaving aggrsively, because an intoxicated man may have more difficulty generating non-aggressive solutions to gaining sexual satisfaction. Thus, when a man is intoicated, he can more easily focus on his immediate sexual gratification, sense of 48 Alcohol Research & Health

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GLOSSARY•Acquaintance rape: Rape tim knows, such as an acquaintance, friend, co-worker, date, or spouse. Most rapes are acquaintance rapes. Alcohol expectancies: A personÕs beliefs about the effects that alcohol consumption will have on himself or herself as well as on other people. Alcohol expectancy set: The practice in laboratory research of telling participants that they have consumed alcohol, regard- less of what the participants actually are given to drink. Alcohol-involved rape: Rape tim, or both are under the influence of alcohol at the time of the incident. Attempted rape: An act that fits the definition of rape, in terms of the strategies used, but does not result in penetration. Childhood sexual abuse: Sexual abuse that occurs to a child (the term ÒchildÓ is generally defined as age 13 or younger). Date rape: Rape ing. Among college students, approximately one-half of all Marital rape: Rape committed by the victimÕs spouse. Marital rape often is committed in association with verbal and physical abuse. Rape: A sexual assault involving some type of penetration (i.e., vaginal, oral, or anal) due to force or threat of force; lack of consent; or inability of the victim to provide consent due to age, intoxication, or mental status. Rape laws vary by State; however, the aforementioned description conforms to the definition used at the Federal level and by most States. Sexual assault: The full range of forced sexual acts, including forced touching or kissing; verbally coerced intercourse; and vaginal, oral, and anal penetration. Researchers typically include in this category only acts of this nature that occur during adolescence or adulthood; in other words, childhood sexual abuse is defined separately. Both men and women can be sexually assaulted and can commit sexual assault. The vast majority of sexual assaults, however, involve male perpetrators and female victims. Stranger rape: Rape committed by someone that the victim does not know. Less than 20 percent of rapes are committed by strangers, although most people believe that stranger rape is the prototypical rape.rapes are committed by a date. Additionally, because in most alcohol-involvpendent influences of the perpetratorÕs and the victimÕs alcohol consumption are difficult to examine. At a mini-mum, researchers must acknowledge this problem (Martin and Bachman 1998). Ideally, investigators should conduct studies with large enough samples to allorate effects of perpetratorsÕ and victimsÕ alcohol consumption. Fourth, qualitative research will enable researchers to understand more fully the mechanisms through which alcohol contributes to sexual assaultÑfor example, by addressing the following types of questions: ¥°How often do men select a woman as a target because she has been drinking, and what strategies do the men use to isolate and control her? ¥°Does alcoholÕs role differ in sexual ing partners? ¥°When a man is drinking alcohol, does he miss cues indicating that the woman is not interested in sex or does he simply not care about her feelings? ¥°What is the role of peer pressure in encouraging men both to drink heavily and to force sex? ¥°What types of warning signs occur (and which of those signs do women tend to observe) before a sexual assault, and do intoxicated women notice fewer cues or interpret them as less threatening than do sober women? ¥°What types of environmental factors encourage alcohol-induced sexual assault? Is it mortain types of bars or parties? Detailed interviews with victims and perpetrators from different ethnic and cultural backgrounds arter understand which pathways are most common under what circumstances. Finally, because even the best-constructed prospective interview study allows for alternativtions, further laboratory research also is needed. In such studies, researchers can randomly assign participants to groups rholic beverages, thereby insuring that differences in the participantsÕ behavior result from alcohol consumption, rather than from other factors, such ronmental circumstances. A major challenge is to develop reasonable yet ethical proxies for sexual assault that can be used in the laboratory. Further-more, most laboratory studies currently conducted on alcohol include only men. Consequently, more laboratory research with female participants is needed to increase understanding of alcoholÕs effects on womenÕsceptions and behavior and to allow for direct comparisons of menÕs and womenÕs responses. Such studies do not always need to simulate sexual assault to inform theory about it. Laboratory research that examines the processes through nication between women and men and influences the cognitive and affective responses of women and men to sexual disagreements can help guide prevtion programs. 50 Alcohol Research & Health

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