Before 1980, there were few published data on alcohol use and abuse as a precursor, concomitant, or consequence of sexual violence toward women. In the last 10–15 years the extent to which many women suffer sexual abuse and violence at the hands of a drinking perpetrator has been recognized, and researchers have attempted to understand the complex relationships between alcohol use and violence against women. Most theories consider alcohol consumption or alcohol abuse in victim or perpetrator as an antecedent or contributor to sexual abuse.
Incest and Childhood Sexual Abuse
The first national study of childhood sexual victimization reported a rate of 27% for women. Moreover, these estimates are probably low due to underreporting. There are only occasional references in the literature on childhood incest (or other childhood sexual abuse) to its role in the development of alcohol abuse in women, and studies of women alcohol abusers that examine history of childhood incest or other sexual abuse are still rare. The literature in this area suggests a strong association between childhood incest and sexual abuse and the development of alcohol abuse. The prevalence rates for a history of incest among alcoholic women range from 12% to 85% and vary according to the population being studied (i.e., AA meetings, treatment facility women). Most authors note that the rates of incest reported by alcoholic women are significantly higher than rates reported in the general population. The few studies– that compare the prevalence of childhood incest in alcoholic and nonalcoholic women controls support this finding. In a recent study, Miller et al. determined that not only did alcoholic women in treatment have higher rates of childhood sexual and physical abuse than women in a general population, they also had more childhood sexual and physical abuse than women receiving mental health services who had no alcohol problems. The findings persisted even after demographic characteristics and parents‘ drinking practices were controlled. The Wilsnack and Klassen national survey also suggested a strong association between childhood sexual abuse and problem drinking.
The personality profile of the women incest survivor bears a striking resemblance to that of the alcoholic woman. Hurley, in a review of the literature on women and incest and women and alcohol, illustrates the commonalities when these two areas of research are juxtaposed. For example, the alcoholic woman tries to conceal her drinking problem while the incest survivor frequently tries to conceal her incest experience. Both have a chaotic disruptive childhood and both groups frequently exhibit acting-out behavior during adolescence that results in school difficulties, drinking behavior, and “promiscuity.” Finally, the alcoholic woman as well as the incest survivor experiences difficulties related to sexual functioning and development of intimacy. These common characteristics frequently are hypothesized as significant for the development of alcoholism in women.
The increased rate of childhood sexual victimization reported among women alcoholics may be a consequence of the instability — often associated with parental alcoholism — frequently reported in their family of origin. Incest that occurs within the context of the alcoholic family is usually a result of the alcoholic father‘s behavior. Additionally, incest has also been shown to occur when an alcoholic mother is unavailable to her husband. As a result, her husband may turn to the daughter for the support and love he once received from his wife. A recent dissertation on adult adjustment of daughters of alcoholics found that incest was more likely to have occurred when the mother was the alcoholic parent.
As Hurley has noted, an important question is why some female incest survivors become alcoholic and others do not. In a small qualitative study using a semistructured interview with ten alcoholic and nine nonalcoholic incest survivors, both groups reported difficulties with sex and intimacy. The alcoholic incest survivors more often complained of sexual inhibition, lack of orgasm, and low sexual arousal and used alcohol to medicate these feelings and to lower sexual inhibition. In contrast, nonalcoholic incest survivors identified their major sexual problem as a lack of interest in sex and as a result tended to avoid sex.
A complementary approach has been to compare alcoholic women who do or do not have histories of childhood incest. Retrospective clinical studies report that alcoholic incest survivors experienced sexual dysfunction more frequently. Although limited by their retrospective methodology, these studies suggest that for this subgroup of women sexual dysfunction and alcohol problems may develop in tandem. For incest survivors, as for other women with sexual dysfunction, alcohol may be used to self-medicate sexual difficulties or other modes of functional or dysfunctional coping may be invoked. The development of alcoholism or alcohol abuse is most likely for those women who self-medicate with alcohol. The high rates of sexual dysfunction found in incest survivors may be an intervening variable that explains their high rates of alcohol abuse (and alcoholic women‘s high rates of childhood incest).
Finally incest experiences of alcoholic women and nonalcoholic women have been compared. Findings suggest that chemically dependent women report a younger age at first sexual incident; longer duration of abuse; and more violent abuse.
Studies of childhood incest and alcohol abuse have been limited by varying definitions of incest, lack of appropriate theoretical models, and failure to examine variations in incest experience that may be linked to level of adult adjustment and type of substance abuse or other psychiatric problems in adulthood. Important variables may include the age at which incest first occurred, type and severity of abuse, relationship of the perpetrator, the length of time that the abuse occurred, whether the woman disclosed the experience, and the reaction when she disclosed (i.e., was she believed). More studies are needed that link variation in childhood incest experiences to drinking patterns and problems and examine personal characteristics and social environments that protect childhood incest survivors from development of drinking problems and promote their healthy adult adjustment.
Sexual Assault and Alcohol Consumption
Researchers who focus on sexual assault have a difficult time with definitions. As reported by Abbey et al. legal definitions of rape and sexual assault can vary by state or by the particular legal enforcement organization. As a result of the variation in definitions of sexual assault and rape, prevalence rates must be interpreted with caution. In most cases an underestimation of the behavior in question is likely. Abbey et al. utilized the term sexual assault to describe any nonconsensual sexual contact, including penetration, whereas the term rape is reserved for sexual behaviors that involve penetration.
It is estimated that 50% of rapes are associated with alcohol use by perpetrator, victim, or both.– The direction of the relationship between alcohol and sexual assault cannot be clearly delineated. What can be stated is that women who experience sexual assault or rape are often the victims of intoxicated offenders. In a national study 60% of women respondents reported that someone who was drinking had become “sexually aggressive” toward them. Additionally, research suggests many women who have a history of alcohol abuse or who drink heavily concomitantly have a history of sexual assault. Wilsnack reported that 30 to 75% of women alcoholics have experienced incest or adult sexual assault. Kilpatrick reported that sexual assault victims were more likely than nonsexual assault victims to have a substance abuse disorder, and in a paper presented by Abbey, women who had histories of sexual assault drank more than women who had never been sexually assaulted. It is possible that women who abuse alcohol or other drugs or who simply are heavier drinkers are at a higher risk for sexual assault or rape because of their lifestyles. Further research is needed to determine the temporal ordering between sexual assault and heavy or problem drinking in adult women and to examine if such temporal relationships are causal ones.
Sexual assault is most common in younger women (late adolescence to early adulthood). Many women that fall into this age group are students on college campuses. Alcohol consumption is a major part of college life. Reported rates of alcohol consumption on college campuses is higher than in the general population and college women have been shown to be at increased risk for acquaintance rape.
Acquaintance Rape. Acquaintance rape is very common on American college campuses. From 15 to 30% of college women report they have experienced acquaintance rape, usually at the hands of a fellow student. Frequently, alcohol use is associated with acquaintance rape either by the assailant, the victim, or both. Kanin found that the second strongest factor of acquaintance rape was excessive alcohol use by college men. Koss and Dinero concurred that alcohol use was one of the strongest predictors of assault on college women victims. College women who have been sexually assaulted had more frequent alcohol consumption and drank more frequently during consensual sex than college women who had not experienced assault.
Abbey proposed seven explanations for the relationship between alcohol consumption and date rape on college campuses, three related to the male perpetrator and four related to the female victim. Many of these explanations are also applicable for the relationship between alcohol use and other kinds of sexual assault and to other victim populations. Explanations for the relationship between acquaintance rape and alcohol consumption for men include: (1) expectancies about the effects of alcohol; (2) misperception of women‘s intentions; and (3) the use of alcohol as a valid excuse for forced sexual interactions. Men‘s beliefs about the effects of alcohol can result in a self-fulfilling prophecy that concludes in what they believe to be consensual sex but legally is defined as acquaintance rape. Males expect alcohol to disinhibit behavior, especially sexual behavior, and these expectancies shape postdrinking behavior. The effects of alcohol on the cognitive system also can decrease a man‘s ability to accurately interpret a woman‘s intentions in a drinking environment.
Studies suggest that men interpret a variety of female behaviors including use of alcohol in dating situations as more indicative of a woman‘s willingness to have sex than do women. Men‘s beliefs about the types of women that consume alcohol can increase the risk of date rape in women. Garcia and Kushnier asked college students to rate a female student‘s sexuality based on three factors: academic performance, attractiveness, and drinking behavior. The female students who were attractive, drank, and had a low academic record were rated as more sexual than any of the other combination of the three variables of characteristics of females students. In another study, George et al. used a vignette depicting a woman on a date consuming alcoholic or nonalcoholic drinks to examine perceived sexual availability. They found that a woman who drank on a date was rated as more sexually predisposed, more sexually available, and more like to engage in foreplay and intercourse than a nondrinking female date. This study varied only women‘s drinking behavior, not that of their male partners, and did not include sexual aggression as a part of the vignette. Thus it appears that in college situations just the fact that a female student drinks can put her at risk.
Men are socialized to believe that if they wait long enough and persist hard enough, the woman‘s resistance to their sexual advances will eventually break down. The use of force in a sexual encounter often is consistent with male socialization practices in the United States, and men may use alcohol as a justification for their use of force. Koss et al. surveyed thousands of undergraduates and found that 25% of college men surveyed admitted to sexually aggressive behavior, with 75% of them using alcohol or drugs prior to the incident.
Abbey proposed four explanations regarding women that affect the relationship between alcohol use and date rape: (1) poor sending and receiving of sexual cues; (2) a diminished coping response due to the effects of the alcohol on the cognitive system; (3) existing stereotypes about women and drinking; and (4) an enhanced sense of responsibility. Much research on women‘s feelings, cognitions, and behaviors that may influence the relationship between alcohol and acquaintance rape focuses on the perception of enhanced responsibility. In a study in which college students given vignettes about a college woman who had been raped after a party, the woman was perceived as more responsible for the rape if she had been drinking but the male attacker was held less responsible if he had consumed alcohol. A more recent study that focused on judgments about an acquaintance rape scenario is one of the few that sampled young adults over 21 rather than only college students. The findings did not support the above contention that the woman is held more responsible if she had been drinking at the time of the rape. Their results show that acquaintance rape is not judged as negatively when both parties have been drinking and is judged more severely when only the victim was drinking. The beliefs held regarding the role that alcohol consumption, both by the assailant and victim, has on judgment, responsibility, and behavior may encourage harsh or lenient prosecution of offenders. In addition, the counseling and support offered victims may be influenced by such beliefs about the responsibility of the victim who consumes alcohol, and the involvement of alcohol in the assault may result in blaming the victim who is in need of help.
The social context in which drinking occurs can have differential effects on expectations and drinking patterns. College women and men have been shown to use and abuse alcohol for different reasons. It has been suggested that women may use alcohol to increase feelings of worth, reduce feelings of anxiety in social situations, and help them feel better about themselves. If these are some of the underlying factors involved in college women‘s drinking behavior, Abbey‘s proposed explanations for the relationship between alcohol and date rape can be further understood. The drinking woman in a more relaxed state sends sexual cues that confound with a man‘s expectations of a woman who drinks and can increase the risk of rape against a women who needed the drink to better enable herself to function socially. While the woman may view alcohol as helping her in social situations, in contrast it may be doing just the opposite. This is consistent with Brown et al. who, in studying self-report expectancies, found that women expected more global positive changes from drinking, while men expected more arousal and aggression.
Although most research on acquaintance rape involves college populations, more broadly defined populations occasionally have been studied. It is unfortunate that more attention has not been given to other groups of women, particularly poverty-level women in urban settings who are believed to be at greatest risk for sexual assault. Distinctions have been made in the literature regarding the degree of relationship between perpetrator and victim and how these affect sexual assault patterns. Marital status has been found to be a mediating variable between alcohol consumption and violence against women. For married women, a violent assault is usually preceded only by her spouse‘s drinking behavior, while for an unmarried women her own participation in drinking is more likely to be found when there was an assault. This implies that a married women may be viewed by her husband as property. She does not require any “loosening up” through alcohol consumption on her part in order for him to have sex with her. A man may feel more entitled to sexual behavior from an intimate partner than from a partner with whom he is less intimate. On the other hand, the unmarried woman requires more effort. If the perpetrator can get her drunk, he then may have his way. The consumption of alcohol by the man, in many cases, contributes to an excuse for his behavior. Morgan argues that the connection between disinhibition as a prerogative of power and drinking behavior can be used to uphold male domination over women; that is, the man is believed to have the right to his drinking (and sexually violent) behavior. Morgan‘s thesis is supported by several studies showing that men with stronger beliefs in traditional gender roles are more likely to commit sexual assault. Beliefs about the negative effects of alcohol on disinhibition allows men to invoke alcohol consumption as an excuse for sexual violence against their partners.
Selections from the book: “Recent Developments in Alcoholism. Volume 12: Alcoholism and Women.” Edited by Marc Galanter. An Official Publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism. 1995.