It's a vicious cycle. Child and adolescent victims of sexual assault are anywhere from two to 11 times more likely to be raped or otherwise sexually assaulted as an adult.

While researchers have uncovered helpful information in recent years on the phenomenon known as revictimization, it remains unclear what the most potent predictor of revictimization is and whether there is some sort of common denominator — perhaps an inability to manage emotions — that makes young victims vulnerable to being victimized again, said David DiLillo, associate professor of psychology at the University of Nebraska-Lincoln.

Those questions will guide DiLillo's latest research project: a five-year, multi-site study funded by a $3.1 million grant from the National Institutes of Health and the National Institute of Child Health and Human Development.

Getting to the core of why revictimization occurs is the key to stopping the cycle of victimization, he said.

"If we can identify this common, underlying risk factor, then we might be able to help survivors of early victimization and then more efficiently reduce the chances of later life revictimization," he said.

DiLillo, who directs the Clinical Psychology Training Program and the Family Violence and Injury Lab at UNL, has undertaken extensive research on childhood sexual assault and its long-term impacts. Collaborating with him is Kim Gratz, a nationally recognized expert in emotion dysregulation based at the University of Mississippi Medical Center in Jackson; and Terri Messman-Moore, an associate professor of psychology at Miami University in Oxford, Ohio. Messman-Moore is a well-known expert on revictimization who has previously teamed with DiLillo on related research.

The issue's complexity has prevented researchers so far from doing what his team proposes, DiLillo said. Past research has usually relied on cross-sectional studies, which involve many participants and a single assessment. Researchers are then left to draw correlations, he said.

"But it's hard to test theories about how things play out or unfold over time without actually following participants over time," he said. "You can't draw definitive conclusions about developmental patterns by asking people to come in and report on a single occasion about their prior experiences."

The three researchers will recruit women ages 18-25 to participate in a series of in-depth assessments over a three-year period. DiLillo also has arranged for a fourth research site in Omaha. All total, the study will involve 450 women.

"Although we're looking at risk factors that might increase vulnerability for women, this is no way implies that women are responsible for their victimization," he said. "Perpetrators always are responsible, but if we can reduce risk by intervening with women, we'd like to do that as well."

Such interventions not only could reduce the chances of revictimization, but also could stop problems tied to the initial victimization before they develop, DiLillo said. Previous studies have strongly linked young sexual assault victims to problems later in life like post-traumatic stress disorder, substance abuse and risky sexual behavior. Those, in turn, become risk factors for being victimized again.

The effects of revictimization are even more detrimental, DiLillo said. Revictimization is associated with greater problems with mental health functioning and the ability to establish close, intimate relationships that are long lasting and fulfilling, he said.

"It's bad enough that someone endures the experience multiple times, but when that happens, the associated problems are compounded," he said. "That's one of the reasons that this is such a significant problem."