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Four nested, theoretically specified, increasingly complex models were tested representing cognitive mediation of rape's effects on mental, physical, and social health. Data were cross-sectional (N = 253 rape survivors). Outcomes were standardized assessments of social maladjustment, physical, and psychological symptoms, including posttraumatic stress disorder (PTSD). The best-fitting model was not fully cognitively mediated. Personological and rape characteristics influenced the level of self-blame experienced and the intensity of maladaptive beliefs about self and others. Self-blame and maladaptive beliefs predicted psychological distress, which strongly influenced all health outcomes. Self-ratings of rape memory characteristics contributed little to predicting postrape distress. The model accounted for 56% of the variance in general distress, including 91% of psychological symptom severity; 54% of PTSD symptoms; 65% of social maladjustment; and 17% of physical symptoms. Longitudinal replication is planned.

A previously published cross-sectional model of cognitive mediation of rape's impact on health (M. P. Koss, A. J. Figueredo, & R. J. Prince, 2002) was replicated longitudinally. Rape survivors (n = 59) were assessed 4 times at 3-24 months postrape. Growth curve analysis demonstrated significant change in all mediators and outcomes. Previously reported effects of Characterological Self-Blame, Behavioral Self- Blame, and Maladaptive Beliefs on Psychosocial Distress were partially cross-validated in intercept and slope data. The results suggest that Characterological Self-Blame sets the initial level of Psychosocial Distress and that reduction in Behavioral Self-Blame drives recovery. These effects on distress were wholly mediated through self-blame's association with alterations in beliefs about self and others.