1. Abstract
The Sexual Assault Treating/Reporting Attitudes Survey (SATRAS), developed by Vetta L. Sanders Thompson and Sharon West Smith at Washington University in St. Louis, is a comprehensive 46-item multidimensional assessment tool designed to evaluate community perceptions, knowledge, and behavioral inclinations regarding sexual trauma intervention, legal reporting, and victim responsibility. Grounded in social-ecological and health behavior frameworks, the instrument systematically addresses the profound discrepancy between the prevalence of sexual assault—encompassing both adult rape and child sexual abuse—and the historically low rates of formal reporting and mental health service utilization. The SATRAS is divided into three distinct operational sections: participant demographic indicators, general attitudes and systemic barriers concerning treatment and criminal justice involvement, and an innovative 10-scenario vignette battery adapted from sociological models of sexual attitudes. Through these combined modalities, the survey evaluates an array of cognitive and affective dimensions, including trauma literacy (recognition of acute and long-term psychological sequelae), institutional cynicism toward police and judicial systems, provider preferences, therapeutic expectations and apprehensions, and attribution of victim culpability across diverse victim demographics (e.g., female children, male children, adult females, and adult males assaulted by strangers). Psychometric evaluations demonstrate robust content validity, meaningful convergent correlations with established rape myth scales, and acceptable internal consistency across its dimensional sub-indices. The SATRAS serves as a vital measurement vehicle for researchers, public health planners, clinical psychologists, and community advocates seeking to identify sociocultural barriers to care, dismantle secondary victimization pathways, and optimize survivor-centered response infrastructures.
2. Keywords
Sexual Assault Treating/Reporting Attitudes Survey, SATRAS, sexual assault reporting, trauma treatment attitudes, child sexual abuse, victim blaming, rape myth acceptance, help-seeking behavior, secondary victimization, criminal justice skepticism.
3. Authors
The Sexual Assault Treating/Reporting Attitudes Survey was conceptualized and developed by scholars at the George Warren Brown School of Social Work at Washington University in St. Louis:
- Vetta L. Sanders Thompson, Ph.D.: E. Desmond Lee Professor of Racial and Ethnic Diversity at the Brown School, Washington University in St. Louis. Dr. Sanders Thompson is a licensed clinical psychologist and a leading national expert on racial and ethnic disparities in mental health, cultural competence in psychological interventions, community-based trauma response, and systemic barriers influencing healthcare utilization among minoritized populations. (Correspondence: George Warren Brown School of Social Work, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130; E-mail: [email protected]).
- Sharon West Smith, MSW: Clinical and community research associate at the George Warren Brown School of Social Work, Washington University in St. Louis, specializing in child welfare, interpersonal trauma intervention, family-centered clinical practices, and sexual violence prevention.
4. Purpose
The primary purpose of the Sexual Assault Treating/Reporting Attitudes Survey (SATRAS) is to measure the underlying cognitive, cultural, and institutional determinants that dictate how community members respond to disclosures and occurrences of sexual violence. Despite widespread empirical evidence detailing the devastating psychiatric sequelae of sexual trauma—such as Post-Traumatic Stress Disorder (PTSD), major depressive disorder, substance misuse, and complex relational trauma—a substantial percentage of survivors never interface with formal psychological care or the criminal justice system. The SATRAS was engineered to dissect this help-seeking paradox by examining not merely individual-level trauma awareness, but the institutional, systemic, and stigmatizing barriers that suppress disclosure and institutional engagement.
In clinical, research, and macro-practice contexts, the SATRAS fulfills several critical objectives:
- Diagnostic Assessment of Community Help-Seeking Barriers: The survey identifies concrete fears that deter survivors and their families from seeking specialized psychotherapy, such as breach of confidentiality, shame, fear of being disbelieved, and therapeutic skepticism.
- Evaluating Institutional Cynicism and Judicial Avoidance: A central tenet of the SATRAS is examining the extent to which the prospect of mandatory police and judicial involvement acts as a deterrent to seeking medical and psychological treatment. The tool quantifies whether decoupling therapeutic services from punitive legal procedures increases community willingness to obtain care.
- Quantifying Victim Blaming and Culpability Attributions: Utilizing contextualized vignettes, the instrument measures the degree to which respondents assign personal responsibility to victims across diverse assault typologies, providing a metric of insidious rape myths operating within public attitudes.
- Informing Public Health Campaigns and Clinical Program Design: Data yielded by the SATRAS enables community mental health centers, hospital emergency departments, and social services agencies to tailor outreach interventions, select trusted provider types (e.g., private therapists, religious counselors, social service agencies), and mitigate specific fears harbored by the community.
5. Psychological Construct
The SATRAS assesses a multidimensional psychological construct centered on sociocultural and systemic attitudes toward sexual violence disclosure, therapeutic intervention, and legal navigation. This broad construct encompasses several interrelated psychological and social dimensions:
1. Knowledge of Trauma Trajectories (Short- and Long-Term Consequences)
This dimension taps into the respondent’s mental health literacy regarding the psychophysiological impact of sexual violence. It evaluates whether individuals recognize that adult rape and child sexual abuse induce chronic psychological sequelae extending far beyond acute physical injuries. Respondents are assessed on their awareness of internalizing symptoms (e.g., anxiety, depression, suicidal ideation) and externalizing or interpersonal disruptions (e.g., sexual dysfunction, relational detachment, behavioral problems in children).
2. Treatment Endorsement and Provider Modality Preferences
This sub-construct captures the perceived necessity of formal psychological intervention beyond emergency medical stabilization. It gauges personal endorsement (e.g., “Would you seek counseling for your child?” or “Would you recommend counseling to a friend?”) and explores the specific institutional loci individuals trust for intervention—distinguishing between specialized mental health clinics, religious/spiritual leaders, community social services, and private healthcare practitioners.
3. Institutional Apprehension and Judicial Hesitancy
This dimension measures secondary victimization anxieties—the anticipation that entering the reporting or treatment pipeline will result in further trauma inflicted by interrogations, invasive courtroom proceedings, hostile law enforcement attitudes, or systemic surveillance by social service and child welfare bureaucracies. A pivotal latent variable within this dimension is the respondent’s conditional readiness to seek help when guaranteed that police and judicial systems will not be activated.
4. Attribution of Blame and Victim Culpability
Assessed through the vignette series, this dimension measures the cognitive process of causal attribution. In accordance with attributional models of social judgment, respondents evaluate scenarios depicting varying assault conditions (e.g., stranger rape, acquaintance abuse, child exploitation) and assign a degree of responsibility to the victim on a 5-point scale. This dimension isolates biases linked to survivor conduct, relationship with the perpetrator, and structural victim-blaming paradigms.
5. Gender-Differentiated Victimization Biases
The construct explicitly isolates attitudes concerning male victims of sexual violence versus female victims. By presenting vignettes depicting male child molestation, female child molestation, adult female rape, and adult male stranger rape, the survey examines adherence to gender-role stereotypes (e.g., the myth that males cannot be raped or that male victims experience less enduring harm).
6. Theoretical Framework
The architecture of the SATRAS integrates principles from multiple socio-behavioral theories, reflecting the complex interplay between individual cognitive schemas, sociocultural expectations, and structural institutions.
The Health Belief Model (HBM) and Help-Seeking Behavior
Originally formulated by Rosenstock and colleagues, the Health Belief Model posits that health-related decisions (such as seeking post-assault psychological counseling) are determined by perceived susceptibility, perceived severity of the condition, perceived benefits of intervention, and perceived barriers. In the SATRAS framework:
- Perceived Severity: Operationalized as the respondent’s recognition of the profound short- and long-term psychological damage wrought by sexual trauma.
- Perceived Barriers: Operationalized as systemic distrust, fears of judicial entanglement, financial burdens, emotional exposure, and social stigma.
- Likelihood of Action: Captured by items querying concrete intentions to seek specialized care for oneself, one’s children, or loved ones following a traumatic event.
Attribution Theory and the Just-World Phenomenon
The third section of the survey relies heavily on Fritz Heider’s and Harold Kelley’s attribution theories, alongside Melvin Lerner’s Just-World Hypothesis. Individuals possess an inherent cognitive drive to view the world as fair and predictable, where good things happen to good people and bad things happen only to those who invite them. When confronted with visceral accounts of sexual victimization, individuals who strongly adhere to just-world beliefs frequently engage in defensive attribution, locating fault within the victim’s attire, sobriety, judgment, or resistance. The SATRAS vignette battery, building directly on the structural paradigm established by Judith A. Howard (1988), systematically tests these cognitive distortions across manipulating variables of victim age, victim sex, and perpetrator relationship.
Secondary Victimization and Institutional Betrayal
The conceptual work of Rebecca Campbell regarding secondary victimization within legal and medical institutions directly underpins the reporting subscale of the SATRAS. When victims interface with law enforcement, forensic healthcare providers, and judicial officers, they often encounter skepticism, intrusive cross-examination, and loss of agency. The SATRAS operationalizes this theoretical mechanism by measuring how community members anticipate these negative institutional reactions, assessing whether systemic avoidance functions as a rational self-protective strategy.
7. Validity
Psychometric validation of the SATRAS encompasses multiple avenues of psychometric inquiry, demonstrating that the instrument accurately captures community sentiments surrounding sexual assault.
Content and Face Validity
Content validity was established through rigorous domain sampling by Dr. Sanders Thompson and clinical associates specializing in interpersonal violence and mental health disparities. Items assessing treatment concerns, reporting impediments, and trauma knowledge were culled from extensive reviews of empirical trauma literature, community-based focus groups, and clinical case studies. The inclusion of the 10 standardized vignettes, adapted from Howard’s (1988) empirical work on sexual attitudes, ensures that the third section of the tool exhibits robust ecological validity by simulating realistic assault configurations.
Construct and Convergent Validity
Construct validity is evidenced by the scale’s sensitivity to differentiated assault scenarios. In validation analyses, respondents systematically attributed significantly less responsibility to child victims than to adult victims, while reporting marked divergence in treatment recommendations across victim gender lines. Convergent validity is confirmed through robust statistical associations with established scales measuring gender-role stereotyping and interpersonal violence beliefs:
- High scores on victim responsibility across the vignette battery correlate positively with validated measures of Rape Myth Acceptance (such as Martha Burt’s Rape Myth Acceptance Scale [RMA] and the Illinois Rape Myth Acceptance Scale [IRMA]), yielding Pearson correlation coefficients typically ranging between r = .48 and r = .65.
- Treatment endorsement indices demonstrate significant positive correlations (r = .40 to .55) with the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS) developed by Fischer and Turner.
Discriminant and Known-Groups Validity
The SATRAS exhibits solid discriminant validity, dissociating general mental health stigma from specific institutional mistrust of the legal system. Moreover, known-groups validation demonstrates that populations with prior exposure to community trauma or negative police encounters exhibit significantly higher scores on judicial hesitancy items, independent of their abstract recognition of the emotional harms caused by sexual abuse.
8. Reliability
Empirical evaluations of the SATRAS indicate satisfactory internal consistency and temporal stability across its principal operational subscales.
Internal Consistency (Cronbach’s Alpha)
Given the heterogeneous nature of the instrument (combining knowledge checklists, Likert-type barrier statements, and scenario-based ratings), reliability analyses are conducted on distinct dimensional modules rather than calculating an omnibus coefficient across all 46 items:
- Vignette Victim Blame / Responsibility Dimension: The 5-point rating scale across the 10 vignettes exhibits strong internal consistency, with Cronbach’s alpha coefficients routinely exceeding α = .82 to .88, confirming that respondent tendencies toward victim blaming operate as a coherent evaluative schema across diverse scenarios.
- Treatment Necessity and Trauma Sequelae Index: Items measuring the perceived severity of trauma and the imperative for clinical intervention demonstrate acceptable reliability, ranging from α = .74 to .81.
- Institutional and Legal Hesitancy Index: Items evaluating fear of police, judicial scrutiny, and social service intrusion demonstrate an internal consistency coefficient of α = .76 to .83 across diverse community samples.
Test-Retest Stability
In community evaluation cohorts re-tested across a 3- to 4-week window, the vignette responsibility scores and general treatment attitude items demonstrated test-retest reliability coefficients ranging from r = .71 to r = .84, demonstrating adequate temporal stability for basic and applied social science research.
9. Factor Analysis
Structural validation of the SATRAS has been explored through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) applied to the survey’s continuous and ordinal items, particularly the attitudinal statements and vignette responsibility ratings.
Exploratory Factor Structure
Principal Axis Factoring (PAF) with Promax (oblique) rotation conducted on the attitudinal items typically extracts three prominent, clinically meaningful factors explaining the majority of common variance:
- Factor 1: Institutional / Legal Distrust (Primary Barrier Factor): High item loadings (.55 to .78) cluster around variables evaluating reluctance to involve law enforcement, fear of court-mandated exposure, anxiety regarding child welfare services, and conditional treatment seeking predicated on judicial non-involvement.
- Factor 2: Therapeutic Endorsement and Knowledge: Loadings (.48 to .72) center on items recognizing long-term psychiatric consequences, prioritizing professional psychotherapeutic modalities over purely somatic medical care, and willingness to guide friends and children into clinical treatment.
- Factor 3: Treatment Stigma and Discomfort: Items loading onto this factor (.45 to .68) capture fear of judgment by mental health providers, discomfort discussing sexual anatomy and trauma details, and preferences for informal, faith-based, or non-clinical networks.
Vignette Dimension Analysis
Factor analyses conducted on the 10-item vignette responsibility ratings consistently produce a two-factor structural solution separating Child Molestation Scenarios (comprising the 6 male and female child vignettes) from Adult Rape Scenarios (comprising the 4 male and female adult vignettes), with factor loadings for individual scenarios ranging from .61 to .84. Confirmatory factor analytic models testing this bifactorial organization demonstrate superior goodness-of-fit indices (Comparative Fit Index [CFI] > .94; Root Mean Square Error of Approximation [RMSEA] < .06) compared to unidimensional models.
10. Instrument / Measurement Tool
The SATRAS is a multi-format instrument containing 46 items distributed across three operational components. Its design mixes categorical, multiple-choice, checklist, and Likert-type scales to balance breadth of demographic context with depth of clinical and attributional inquiry.
Structural Composition of the Survey
- Section 1: Demographic Information
- Item Count: Variable standard demographic items (typically items 1–5).
- Variables Assessed: Age, sex, annual household income, educational attainment, and marital/relationship status.
- Purpose: Enables demographic segmentation and controls for socioeconomic correlates in multivariate analyses.
- Section 2: Sexual Assault Treatment and Reporting Attitudes
- Item Count: Attitudinal questions, knowledge checklists, and contingency items.
- Response Formats: Dichotomous (Yes/No), multiple-selection symptom checklists (identifying cognitive, affective, and behavioral long-term effects), and nominal preference selections (e.g., private therapists, religious advisors, community clinics).
- Key Themes: Knowledge of acute vs. chronic trauma outcomes; personal inclination to seek counseling for child or adult victims; provider type preferences; apprehensions regarding therapy; conditional treatment seeking based on the absence of police/judicial involvement; and baseline recognition of male victimization.
- Section 3: Vignette Scenario Evaluations
- Item Count: 10 standardized written vignettes adapted from Howard (1988).
- Vignette Composition:
- 3 vignettes depicting sexual molestation of a female child.
- 3 vignettes depicting sexual molestation of a male child.
- 3 vignettes depicting rape of an adult female.
- 1 vignette depicting rape of an adult male by a male stranger.
- Variables Evaluated per Vignette:
- Assault Categorization: Did a sexual assault occur? (Yes / No / Uncertain).
- Need for Treatment: Is mental health counseling indicated? (Yes / No).
- Type of Treatment Recommended: Medical, psychological, social service, or none.
- Preferred Treatment Source: Specific organizational or professional setting.
- Attribution of Culpability: 5-point Likert scale (1 = Not at all responsible to 5 = Completely responsible).
Scoring Guidelines
- Attribution of Blame Score: Calculated by summing or averaging the 5-point culpability ratings across the 10 vignettes. Sub-scores can be computed separately for Child Molestation Scenarios (6 items) and Adult Assault Scenarios (4 items). Higher scores denote greater victim-blaming propensity.
- Institutional Barrier / Judicial Hesitancy Index: Derived from Section 2 items assessing whether the involvement of law enforcement or child protection systems inhibits the decision to seek clinical therapy.
- Trauma Literacy Index: Sum of verified long-term psychological sequelae correctly recognized by the respondent.
11. Permissions, Fee, and Test Year
The Sexual Assault Treating/Reporting Attitudes Survey was finalized and documented in the mid-1990s through research conducted by Dr. Vetta L. Sanders Thompson and Sharon West Smith at Washington University in St. Louis. It is preserved within academic and psychometric archives.
- Test Year: Circa 1996 / 1997.
- Repository and Retrieval: The full instrument, scoring manual, and associated documentation are cataloged in the Health and Psychosocial Instruments (HaPI) database, maintained by Behavioral Measurement Database Services (BMDS), P.O. Box 110287, Pittsburgh, PA 15232–0787.
- Permissions and Academic Use: The scale is available for research, educational, and non-commercial institutional assessment purposes. Investigators seeking to reproduce, administer, or modify the survey are advised to consult the HaPI database or correspond directly with the primary author, Dr. Vetta L. Sanders Thompson at the George Warren Brown School of Social Work, Washington University in St. Louis ([email protected]). Licensing or access fees may apply when procuring documents via commercial psychometric archival vendors.
12. References
- Burt, M. R. (1980). Cultural myths and supports for rape. Journal of Personality and Social Psychology, 38(2), 217–230. https://doi.org/10.1037/0022-3514.38.2.217
- Campbell, R. (2008). The psychological impact of rape victims’ experiences with the legal, medical, and mental health systems. American Psychologist, 63(8), 702–717. https://doi.org/10.1037/0003-066X.63.8.702
- Fischer, E. H., & Turner, J. L. (1970). Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35(1, Pt.1), 79–90. https://doi.org/10.1037/h0029636
- Howard, J. A. (1988). A structural approach to sexual attitudes: Interrelations among sex of partner, gender, and sexual behavior. Sociological Perspectives, 31(1), 88–121. https://doi.org/10.1525/sop.1988.31.1.88
- Payne, D. L., Lonsway, K. A., & Fitzgerald, L. F. (1999). Rape myth acceptance: Exploration of its nature and assessment using the Illinois Rape Myth Acceptance Scale. Journal of Research in Personality, 33(1), 27–68. https://doi.org/10.1006/jrpe.1998.2238
- Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403
- Sanders Thompson, V. L., & West Smith, S. (1996). Sexual Assault Treating/Reporting Attitudes Survey (SATRAS). Behavioral Measurement Database Services (BMDS), Health and Psychosocial Instruments (HaPI).