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Case 1:20-cr-00330-PAE lva A. E. Bicanic et al. In addition, adolescents who disclose their rape experience at least | month after the incident took place are found to be at higher risk for major depressive disorder and delinquency (Broman-Fulks et al., 2007) compared to those who disclosed within | month. Victim—assailant relationship is crucial in disclosure latency, with victims being at higher risk for delayed dis- closure if there is a close relation with the assailant (Kogan, 2004; Koss, 1988; Rickert, Wiemann, & Vaughan, 2005). In contrast, delayed disclosure is less common in victims of a stereotypical rape, 1.e., rape by a stranger including a weapon and injury (Smith et al., 2000). Victims of prior sexual trauma are more likely to postpone disclosure 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 appears to be an important variable in predicting disclosure. Evidence suggests that young children are at higher risk for delayed disclosure than adolescents (Kogan, 2004; Schénbucher, Maier, Mohler-Kuo, Schnyder, & Landolt, 2012). Thus, various rape and victim-related character- istics have been found to be associated with timing of disclosure. The majority of the aforementioned studies included college and adult female rape victims. It is important to examine rape disclosure latency in an age and sex group that is most at risk for rape victimization. There is only one prior quantitative study in adolescents (those aged 12-17 years) that identified factors that might influence disclosure latency (Kogan, 2004). He found that identity of the assailant, a familial relationship with the assailant, and a history of drug abuse in the household were related to the timing of disclosure. The results suggested that a familial relationship with the assailant will postpone disclosure, whereas a history of drug abuse in the house- hold, albeit this seems counterintuitive, makes prompt disclosure more likely. This study had some limitations, including the fact that the interviews were conducted by telephone and that the description of the relationship with the assailant was limited. Therefore, in the present study, we investigated a sample of female adolescent and young adult victims of rape who were admitted to a specialized mental health centre for victims of sexual assault. The first aim of this study was to compare demographics, post-rape characteristics, and psychological functioning between early and delayed disclosers in this group. The second aim, based on the exploratory findings of Kogan (2004), was to determine the predictors for delayed disclosure in adoles- cents and young adults, including age, prior trauma, and victim—assailant relationship using logistic regression analyses. Insight into the predictors for delayed disclosure for adolescents and young adults may reveal not only potential causal mechanisms but also possible targets for Document 397-2 Filed 10/29/21 Page 38 of 45 interventions that increase victims’ opportunities to receive timely post-rape services. Methods Subjects and data collection Rape was defined as “an event that occurred without the victim’s consent that involved the use or threat of force in vaginal, anal, or oral intercourse” (Tjaden & Thoennes, 2006). The definition includes both attempted and com- pleted rape; the term “completed” referring to vaginal, oral, anal, or multiple penetrations. Victims who disclosed within | week were defined as “early disclosers,” whereas those who disclosed at least after 1 week were defined as “delayed disclosers.” This dichotomization of the variable “disclosure latency” was based on the study of Ahrens et al. (2010) and the national standard criteria for admis- sion to a Rape Centre in the Netherlands, 1.e., a maximum of 7 days post-rape. The study was conducted in the Dutch National Psychotrauma Centre, which provides psychological ser- vices for rape victims aged 12—25 years and their parents. Between May 2005 and December 2011, the centre re- ceived 621 phone calls concerning alleged rape victims from police authorities, mental health services, and self- referrals. In 178 cases, the phone call did not result in admission at the centre because of age limitations, or motivational reasons. In 108 cases, referrals were made to other institutions because the index trauma was chronic childhood sexual abuse rather than rape in adolescence/ young adulthood. Of the 335 cases admitted to the centre, 12 were not included in this study because of male gender, resulting in a final sample of 323 females with the index trauma being single rape. Referral sources for this final sample included the police (33.7%), mental health services (40.7%), and self-referrals, i.c., victims or parents (25.6%). Procedure During admission, all patients underwent a psychological assessment, consisting of 1) a structured interview for obtaining demographic and post-rape characteristics and 2) self-report questionnaires to obtain information about mental health functioning. Information from the inter- view was transcribed onto a form designed for this purpose. The following variables were obtained and dichotomized or categorized for the purpose of the study: Demographic and victim characteristics We asked patients about their current age, educational level (lower, middle, or higher), and whether they were of Dutch origin (1.e., in case of having parents born in the Netherlands). Those between 12 and 17 years of age were defined as adolescents and those between 18 and 25 years of age as young adults. We also asked whether the patient was living with their parent(s) (yes/no), and whether the 2 Citation: European Journal of Psychotraumatology 2015, 6: 25883 _ http://dx.doi.org/10.3402/ejpt.v6.25883 (page number not for citation purpose) DOJ-OGR-00005948