Epstein Secrets

d in the review examined women's experi- ences of delayed disclosure to a range of health-care providers. Health-care providers included physicians (Ahrens, Campbell, Terrier-Thames, Vasco, & Sefi, 2007; Diaz et al., 2004; Fili- pas & Ullman, 2001; Golding et al., 1989; Mazza, Dennerstein, & Ryan, 1996

2006; Filipas & Ullman, 2001; Lessing, 2005; Muganyizi et al., 2009; Plumbo, 1995; Popiel & Sus- skind, 1985; Ullman, 1996b; Ullman & Siegel, 1995). Ahrens, Cabral, and Abeling (2009) found that "emotional support from medical staff was almost always considered healing" for survivors (p. 87). Emotion

; Diaz et al., 2004; Fili- pas & Ullman, 2001; Golding et al., 1989; Mazza, Dennerstein, & Ryan, 1996; Popiel & Susskind, 1985; Starzynski, Ullman, Filipas, & Townsend, 2005; Sturza & Campbell, 2005; Ullman, 3502-017 Page 3 of 15 EFIA_00001478 EFTA00156819 Table I. Description of Included Articles.

ders including health-care providers require train- ing focused on minimizing negative and increasing positive social reactions. Starzynski, Ullman, Filipas, and Townsend (2005) recommended that becoming aware of rape myths will help formal support providers including health-care providers move beyond

). An ecological model of the impact of sexual assault on women's mental health. Trauma. Violence. & Abuse. 10.225-246. Campbell. R.. Wasco. S. M.. Ahrens. C. E.. Sefl, T.. & Barnes. H. E (2001). Preventing the "second rape": Rape survivors' experiences with community service providers. Journal of int

in victim charac- teristics (e.g., age, income level, education level, race). and the contextual characteristics of the crimes. Starzynski. Ullman. Filipas, and Townsend (2005) emphasized that deciding whom to tell about sexual assault is an important and potentially consequential decision for sexual a

(2001). blamed for the AS£BA school•age forms & profiles. Burlington. VP University of Vermont. Research Centre for Children. Youth, and Families. Ahrens. C. E.. Sunset]. 1. & Jennings. A. (2010). To tell or not to tell: The impact of disclosure on sexual assault survivors' nicety. Violence and Victi

and avoidance coping. It is con- ceivable that they delay their disclosure as a result of rape-induced psychological distress (Starzynski. Ullman, Filipas. & Townsend, 2005), not necessarily the severity of the assault. Although the final model showed acceptable goodness of fit, the percentage of exp

losure of a subsequent assault than those without prior victimization (Smith et al., 2000; Ullman, 1996). This is in contrast with the findings of Ahrens et al. (2010), who report no dif- ference in rates of prior sexual trauma between early and delayed disclosers. In addition, the victim's age appear

ervices and report to the police than early disclosers is in line with previous studies in adult women (Ahrens et al., 2010; Ullman, 1996; Ullman & Filipas, 2001). It suggests that disclosure latency is important for public health and safety, as delayed disclosure may not only impede reception of prop