Rape trauma syndrome

Rape trauma syndrome (RTS) is a form of psychological trauma experienced by a rape victim that consist of disruptions to normal physical, emotional, cognitive, behavioral, and interpersonal characteristics. The theory was first described by psychiatrist Ann Wolbert Burgess and sociologist Lynda Lytle Holmstrom in 1974.[1]

RTS describes a cluster of psychological and physical signs, symptoms and reactions common to most rape victims, during, immediately following, and for months or years after a rape.[2] While most research into RTS has focused on female victims, males who are sexually abused (whether by male or female perpetrators) have also exhibited RTS symptoms.[3][4] RTS also paved the way for consideration of Complex Post Traumatic Stress Disorder, which can more accurately describe the consequences of serious, protracted trauma than Post Traumatic Stress Disorder alone.[5] The symptoms of RTS and Post-Traumatic Stress Syndrome overlap; however, individually each syndrome can have long devastating effects on rape victims.

Contents

Common stages of RTS

RTS identifies three stages of psychological trauma a rape survivor goes through: the acute stage, the outer adjustment stage, and the renormalization stage.

Acute stage

The acute stage occurs in the days or weeks after a rape. Durations vary as to the amount of time a survivor may remain in the acute stage. The immediate symptoms may last a few days to a few weeks and may overlap with the outward adjustment stage.

According to Scarse[6] there is no "typical" response amongst rape victims. However, the U.S. Rape Abuse and Incest National Network[7] (RAINN) asserts that, in most cases, a rape survivor's acute stage can be classified as one of three responses: expressed ("He or she may appear agitated or hysterical, [and] may suffer from crying spells or anxiety attacks"); controlled ("the survivor appears to be without emotion and acts as if 'nothing happened' and 'everything is fine'"); or shock/disbelief ("the survivor reacts with a strong sense of disorientation. They may have difficulty concentrating, making decisions, or doing everyday tasks. They may also have poor recall of the assault"). Not all rape survivors show their emotions outwardly. Some may appear calm and unaffected by the assault.[2]

Behaviors present in the acute stage can include:

The outward adjustment stage

Survivors in this stage seem to have resumed their normal lifestyle. However, they simultaneously suffer profound internal turmoil, which may manifest in a variety of ways as the survivor copes with the long-term trauma of a rape. In a 1976 paper, Burgess and Holmstrom[9] note that all but 1 of their 92 subjects exhibited maladaptive coping mechanisms after a rape. The outward adjustment stage may last from several months to many years after a rape.

RAINN[7] identifies five main coping strategies during the outward adjustment phase:

Other coping mechanisms that may appear during the outward adjustment phase include:

Lifestyle

Survivors in this stage can have their lifestyle affected in some of the following ways:

Some rape survivors now see the world as a more threatening place to live after the rape so they will place restrictions on their lives so that normal activities will be interrupted. For example, they may discontinue previously active involvements in societies, groups or clubs, or a mother who was a survivor of rape may place restrictions on the freedom of her children.

Physiological responses

Whether or not they were injured during a sexual assault, rape survivors exhibit higher rates of poor health in the months and years after an assault,[4] including acute somatoform disorders (physical symptoms with no identifiable cause).[1] Physiological reactions such as tension headaches, fatigue, general feelings of soreness or localized pain in the chest, throat, arms or legs. Specific symptoms may occur that relate to the area of the body assaulted. Survivors of oral rape may have a variety of mouth and throat complaints, while survivors of vaginal or anal rape have physical reactions related to these areas.

Nature of the assault

Underground stage

Reorganization stage

Phobias

A common psychological defense that is seen in rape survivors is the development of fears and phobias specific to the circumstances of the rape, for example:

The renormalization stage

In this stage, the survivor begins to recognize their adjustment phase. Particularly important is recognizing the impact of the rape for survivors who were in denial, and recognizing the secondary damage of any counterproductive coping tactics (e.g., recognizing that one's drug abuse began to help cope with the aftermath of a rape). Typical of male victims is a long interval between the sexual assault and the victim's seeking psychotherapy—according to Lacey and Roberts,[18] less than half of male victims sought therapy within six months and the average interval between assault and therapy was 2.5 years; King and Woollett's[19] study of over 100 male rape victims found that the mean interval between assault and therapy was 16.4 years.

During renormalization, the survivor integrates the sexual assault into their life so that the rape is no longer the central focus of their life. During this stage negative feelings such as guilt and shame become resolved and the survivor no longer blames themselves for the attack.

Typical statements of victims experiencing RTS

^[Citations Required]

See also

References

  1. ^ a b Burgess, Ann Wolbert and Lynda Lytle Holmstrom (1974). "Rape Trauma Syndrome". Am J Psychiatry 131 (9): 981–986. doi:10.1176/appi.ajp.131.9.981. PMID 4415470. 
  2. ^ a b Jonathan Sandoval (2002). Handbook of crisis counseling, intervention, and prevention in the schools. Psychology Press. pp. 1–. ISBN 978-0-8058-3615-8. http://books.google.com/books?id=xwycCgCFIQsC&pg=RA1-PA140. Retrieved 1 October 2011. 
  3. ^ Philip M. Sarrel1 and William H. Masters (1982). "Sexual molestation of men by women". Archives of Sexual Behavior 11 (2): 117–31. doi:10.1007/BF01541979. PMID 7125884. 
  4. ^ a b c Tewksbury, Richard (2007). "Effects of Sexual Assaults on Men: Physical, Mental and Sexual Consequences". International Journal of Men's Health 6 (1): 22. doi:10.3149/jmh.0601.22. 
  5. ^ Bessel A. van der Kolk, Susan Roth, David Pelcovitz, Susanne Sunday, and Joseph Spinazzola (2005). "Disorders of Extreme Stress: The Empirical Foundation of a Complex Adaptation to Trauma". Journal of Traumatic Stress 18 (5): 389–399. doi:10.1002/jts.20047. PMID 16281237. http://www.traumacenter.org/products/pdf_files/SpecialIssueComplexTraumaOct2006JTS3.pdf. 
  6. ^ Scarce, M. (1997). Male on male rape: The toll of stigma and Shame. New York: Insight Books.
  7. ^ a b Rape Trauma Syndrome. rainn.org
  8. ^ Desirée Hansson What is Rape Trauma Syndrome?. Occasional Papers Series 1992. Institute of Criminology. University of Cape Town
  9. ^ Burgess, AW; Holmstrom, LL (1976). "Coping behavior of the rape victim". Am J Psychiatry 133 (4): 413–8. PMID 1267040. 
  10. ^ King, M., Coxell, A. and Mezey, G. (2002). "Sexual molestation of males: Associations with psychological disturbance". British Journal of Psychiatry 181: 153–157. PMID 12151287. 
  11. ^ Groth, N., & Burgess, A. W. (1980). Male rape: Offenders and victims (1980). "Male rape: Offenders and victims". American Journal of Psychiatry 137 (7): 806–810. PMID 7386658. 
  12. ^ Choquet, M., Darves-Bornoz, J. M., Ledoux, S., Manfredi, R. and Hassler, C. (1997). "Selfreported health and behavioral problems among adolescent victims of rape in France: Results of a cross-sectional survey". Child Abuse and Neglect 21 (9): 823–832. doi:10.1016/S0145-2134(97)00044-6. PMID 9298260. 
  13. ^ Burnam, M. A. et al. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology. 56. pp. 843–850. 
  14. ^ Choquet, M., Darves-Bornoz, J. M., Ledoux, S., Manfredi, R. and Hassler, C. (1997). "Self-reported health and behavioral problems among adolescent victims of rape in France: Results of a cross-sectional survey". Child Abuse and Neglect 21 (9): 823–832. doi:10.1016/S0145-2134(97)00044-6. PMID 9298260. 
  15. ^ Garnets, L. and Herek, G. (1990). "Violence and victimization of lesbians and gay men: Mental health consequences". Journal of Interpersonal Violence 5 (3): 366–383. doi:10.1177/088626090005003010. 
  16. ^ Struckman-Johnson, C. and Struckman-Johnson, D. (1994). "Men pressured and forced into sexual experience". Archives of Sexual Behavior 23 (1): 93–114. doi:10.1007/BF01541620. PMID 8135654. 
  17. ^ deVisser, R. O., Smith, A. M., Rissel, C. E., Richters, J. and Grulich, A. E. (2003). "Sex in Australia: Experiences of sexual coercion among a representative sample of adults". Australian and New Zealand Journal of Public Health 27 (2): 198–203. doi:10.1111/j.1467-842X.2003.tb00808.x. PMID 14696711. 
  18. ^ Lacey, H. G. and Roberts, R. (1991). "Sexual assault on men". International Journal of STD and AIDS 2 (4): 258–260. PMID 1911957. 
  19. ^ King, M. and Woollett, E. (1997). "Sexually assaulted males: 115 men consulting a counseling service". Archives of Sexual Behavior 26 (6): 579–588. doi:10.1023/A:1024520225196. PMID 9415795. 

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