大專院校學生性侵害受害經驗調查：心理影響、求助行為與體制背叛感

Sexual Assault Victimization Among Taiwanese College Students: Psychological Impact, Help-Seeking Behavior, and Institutional Betrayal

校園性侵害近年來獲得許多關注，國內外皆開始重視此議題的嚴重性以及校方的處置狀況。校方的不當作為可能導致受害者的體制背叛感，使性侵害創傷更加惡化。本研究利用網路問卷調查全臺灣大專院校學生（含研究生）的性侵害受害現況，以及性侵害的心理影響、求助行為與體制背叛感。在617名學生中，有34名（6％）在上大學後有性侵害受害經驗，其中加害者多為校內、男性，受害者則沒有性別差異。在心理影響方面，性侵害受害者有較高的憂鬱及焦慮症狀，也有一定程度的創傷症狀。在求助行為方面，有70％的受害者曾經尋求身邊親友協助，但僅23％尋求正式管道協助，而對於校園通報體制的認知在其中扮演重要的角色。在體制背叛感方面，受害者最常感受到難以通報自身經驗、學校沒有足夠的預防措施以及校方否認自己的經驗，但體制背叛感與心理症狀之間的關聯仍有待更多研究。在此脈絡下，大學校園必須負起預防與處遇性侵害事件的體制性責任，以保障學生的心理健康與生涯發展。

Sexual assault on campus has received considerable media and academic attention. Sexual assault has substantial longterm impacts on mental health, including depression, anxiety, posttraumatic stress, substance abuse, sleep disturbance, and suicide (Black et al., 2011; Campbell et al., 2009; Smith & Freyd, 2013; Wang et al., 2014). Despite its psychological outcomes, relatively few survivors seek help from formal support networks (e.g., hospitals, sexual violence prevention centers, university counseling centers, and police), although many seek support from friends and family (Krebs et al., 2007, 2016; Sinozich & Langton, 2014; Wang et al., 2012). Furthermore, in response to coverage of the mistreatment of sexual assault survivors, researchers throughout the world have begun to examine how universities respond to sexual assault and its consequences (McCaskill, 2014). Institutional failures to respond to sexual assault cases (e.g., insensitive investigative practices) can result in secondary victimization, which may have serious impacts on a student’s mental health and career development (Campbell et al., 2009). In particular, institutional betrayal theory posits that wrongdoings perpetrated by university agencies (e.g., denying the survivor’s experiences or punishing them in some way) can cause feelings of institutional betrayal, exacerbating the sexual trauma experienced by survivors (Smith & Freyd, 2013, 2014). Approximately 20 years have passed since the implementation of the Gender Equity Education Act, which stipulates how schools at different levels should respond to sexual violence cases on campus. However, no study in Taiwan has systematically examined the psychological impacts of and university reactions to sexual assault among college students. The present study thus investigated (1) psychological impacts and (2) help-seeking behaviors with regard to sexual assault among college students, and, more crucially, (3) the prevalence and consequences of instances of institutional betrayal. In all, 617 Taiwanese undergraduate and graduate students (45% female students, 81% were heterosexual, mean age = 23.14 years) completed an online survey including measures of sexual assault experiences (Sexual Experiences Survey-Short Form Victimization; Koss et al., 2006), depression (Patient Health Questionnaire, Cronbach’s α = .89; Kroenke et al., 2001), anxiety (Generalised Anxiety Disorder Assessment, Cronbach’s α = .91; Spitzer et al., 2006), posttraumatic stress disorder (PTSD; Posttraumatic Stress Reaction Index-Short Form, Cronbach’s α = .95; Wang, 2010), their willingness to report future assault to the campus reporting system (i.e., “Would you report future sexual victimization to your university or teachers?”), and demographics (e.g., age, gender, and sexual orientation). They also responded to an open-ended question regarding factors that might encourage/discourage the reporting of sexual victimization to their university. The responses were categorized by two independent coders with high interrater reliability (mean Cohen’s κ = .84, range = .73- .93). Additional questions were administered if respondents reported being victimized, including their help-seeking behaviors after the assault (i.e., “Whom did you seek help from after the assault?”) as well as experiences of institutional betrayal by their university (Institutional Betrayal and Support Questionnaire Version 1, Cronbach’s α = .94; Rosenthal et al., 2016). In the survey, 34 (6%) respondents reported one or more experiences of sexual assault while attending college, and most of the cases were on campus and conducted by male perpetrators, with both genders equally likely to be victimized (χ2(1, N = 617) = 0.94, p = .33). Compared with heterosexuals (5%), nonheterosexual students (9%) were more likely to report sexual assault victimization (χ2(1, N = 617) = 4.20, p = .04). Regarding negative psychological outcomes, sexual assault survivors reported more anxiety and depression symptoms (both p < .001) than did nonsurvivors; survivors also experienced posttraumatic symptoms. Among the 30 survivors who answered questions regarding help-seeking behaviors, 21 (70%) had sought help from classmates (n = 13), friends (n = 7), family members (n = 5), or a partner (n = 1). By contrast, only seven (23%) had sought help from formal support networks, such as their university or teachers (n = 4), university counseling centers (n = 2), or the local domestic violence and sexual assault prevention center (n = 1). Six (20%) survivors had not told anyone about the event. Furthermore, female students and survivors were less willing to report future sexual victimization to their university or teachers (both p < .02). Through analysis of the open-ended responses, we identified five factors that influence colleges student willingness to report a case to their school, namely the characteristics of the case (12%), perpetrator’s identity (14%), survivor’s feelings (9%), characteristics of the university (50%), and social relationships and face (15%). For institutional betrayal, the most common inadequate reactions from the university included “making it difficult to report the experience” (60%), “not taking proactive steps to prevent this type of experience” (53%), and “denying his/her experience in some way” (50%). Unlike in previous research, we observed little evidence of the psychological consequences of institutional betrayal. Institutional betrayal was unrelated to depression (r = .36, p = .052), anxiety (r = .33, p = .08), PTSD (r = .30, p = .10), and willingness to report future assault (r = .06, p = .76). More studies are required to examine the relationship between institutional betrayal and psychological symptoms. Sexual assault is a serious problem for Taiwanese college students. Male students were equally likely to be victimized, which is at odds with previous findings (e.g., Conley et al., 2017; Hines et al., 2012). Most research in Taiwan has focused on female sexual survivors; more attention should be paid to male survivors. The situation of nonheterosexual students must also be considered, as they face higher risk of sexual assault. The psychological impacts of sexual assaults are significant, but survivors rarely formally report their case to the university. Creating a university reporting system with accessibility, confidentially, trust, and fairness as well as improving student attitudes toward the university are urgent concerns. Much research is required on this topic. Different types of institutional betrayal experiences were reported by the sexual survivors in this study. Even for those who did not seek help from the university, a hostile campus climate can cause a feeling of betrayal. However, the relationships between institutional betrayal and psychological symptoms or help-seeking behaviors are unclear, which may be due to the small sample size of survivors (n = 30). Colleges and universities should nevertheless be aware of these negative experiences and the feelings of sexual survivors. Future research should examine connections among the variables in larger representative samples. The study had limitations. First, the survey used convenience sampling; thus, our findings cannot be understood to indicate the “prevalence” of sexual assault among Taiwanese college students. Second, we did not examine the effects of the perpetrator-victim relationship on sexual trauma. If the perpetrator was a teacher, the unequal power relations may result in more severe institutional betrayal and frustration. Future research should examine the impacts of sexual assault in different interpersonal contexts. Third, this study did not conduct university-level analyses. The roles of campus climate and culture in a given university and how they influence survivor behaviors and attitudes should be considered. Finally, some respondents directly mentioned the word “face” in their open-ended responses. The fear of losing face may be a key cultural factor when Taiwanese survivors decide whether to formally report a case. Future research should examine the impacts of sexual assault in different contexts as well as consider the influences of culture.