Sexual assault is hard to talk about. Many victims keep quiet on the outside, but on the inside they are screaming for help. According to a new study, more psychological damage is dealt in repetitive sexual assault victims than previously believed.

Researchers at the University of Missouri are taking strides to reduce the prevalence of sexual assault among adolescents by better understanding the patterns of sexual victimization and the associated consequences. They found out that people with a history of multiple sexual assault incidences were experiencing excessive psycho-behavioral effects.

"Our findings are important because we are able to identify some of the weaknesses and potential fallacies in classifying survivors based on the violence encountered during the assault," said Bryana French, assistant professor of counseling psychology in the Department of Educational, School, and Counseling Psychology at the university's College of Education, in a press release.

Most studies involving sexual assault tend to focus on the severity of the attacks, but French embarked on a new quest to investigate the individual patterns of victimization, instead of focusing solely on people who were raped.

For the study, French used a scale of sexual coercion that included verbal coercion, substance-facilitated assault, and forcible rape. The results revealed that victims who are repeatedly assaulted physically or verbally, or given unwanted illegal drugs or alcohol to pressure them to have sex, showed more psycho-behavioral effects, affecting their self-esteem and causing them to take sexual risks later in life, along with other forms of psychological damage

"Most sexual victimization research tends to focus on forcible, violent rape while the subtler forms of sexual assault, like manipulation and coercion, are less studied," French said. "Unfortunately, we know that people who are victimized often experience re-victimization by the same or different individual. Our research focuses on those individuals who receive multiple forms of unwanted sexual advances and the psychological toll those experiences take on the victims."

Two out of five women and one out of five men report experiencing sexual violence, which includes repeated unwanted sexual intercourse. Studies show alarming statistics: One out of five adult women is raped and one out of 100 adult men is raped. The Centers for Disease Control and Prevention's data sheet on sexual assault says sexual violence can lead to long-term physical and psychological issues. Physical consequences include chronic pain, headaches, and sexually transmitted diseases. They also report that victims have fear of trusting others and can develop eating disorders and depression.

With millions of men and women being sexually assaulted, this study hopes to open up conversations with parents and children to help prevent the ongoing cycle of violence.

Source: French B, Bi Y, Latimore T, Klemp H, Butler E. Sexual Victimization Using Latent Class Analysis: Exploring Patterns and Psycho-Behavioral Correlates. Journal of Interpersonal Violence. 2014.