Monday, May 4, 2009

What are consequences of a rape or violent sexual encounteron the victim, perpetrator, and bystanders?

There are many pyscological consequences on victims according to the Croatian Medical Journal:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2080379

Psychological Consequences of Rape on Women in 1991-1995 War in Croatia and Bosnia and Herzegovina.

To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina.

The Methods used in this study:

The study included 68 women victims of rape and was conducted at the Medical Center for Human Rights, Zagreb, Croatia, from 1992 to 1995. Testimony method and a questionnaire were used to obtain the description of rapes and symptoms women suffered immediately after rape and at the time of the study, ie, 11.9 ± 2.4 months after the trauma. Structured clinical interviews were conducted to diagnose psychiatric disorders that were present at the time of study, according to the third edition of Diagnostic and Statistical Manual of Mental Disorders.

Results of this study:

The raped women were Croatian and Muslim (Bosniak) women, residents of Croatia and Bosnia and Herzegovina. Forty-four of them were raped more than once, 21 were raped every day during their captivity, and 18 were forced to witness rapes. Most of the rapes (n = 65) were accompanied by physical torture. The most frequent psychological symptoms felt immediately after the rape were depressiveness (n = 58), avoidance of thoughts or conversations associated with the trauma (n = 40), and suicidal ideas (n = 25). Although none of the women had a psychiatric history before the rape, at the time of study 52 suffered from depression, 51 from social phobia, 21 from posttraumatic stress disorder (PTSD), and 17 had sexual dysfunctions. These disorders were often comorbid. Out of 29 women who got pregnant after rape, 17 had artificial abortion. The decision to have an abortion was strongly predicted by suicidal thoughts and impulses (odds ratio, 25.8; 95% confidence interval, 2.53-263.2).

Victims are affected in many ways throughout their lives; here are some of the ways in which vitcims are affected and some consequences:


http://www.rvap.org/pages/victim_impact/


-Control
-Identity
-Sexuality
-Guilt & Shame
-Spirituality
-Relationships with others
-Security and Safety
-Self-esteem/Self worth

Possible reactions to sexual assault:

> Nightmares
> Difficulty working
> Difficulty sleeping
> Decreased interest in things previously enjoyed
> Substance abuse
> Decreased concentration
> Mood swings
> Memory loss
> Eating disturbance
> Sex/Sexuality issues
> Difficulty trusting
> Difficulty being along or with people
> Problems with close relationships

Common feelings following a sexual assault:

-Fear
-Anger
-Isolation
-Feeling out of control
-Depression
-Feeling crazy
-Numbness
-Irritability
-Confusion
-Hopelessness
-Self-blame
-Shame

Trauma Theories:

The psychological and sociological literature of the last twenty years is filled with various theories which can help describe some of the effects of sexual violence on victim/survivors. Concepts include sources as varied as the pioneering research defining “Rape Trauma Syndrome” by Ann Burgess and Lynda Holmstrom, the grief process discussed by Elizabeth Kubler-Ross in “On Death and Dying”, “Post-Traumatic Stress Disorder” as defined in the DSM-IV by the American Psychiatric Association, and “Complex Post Traumatic Stress Disorder” defined by Judith Herman, M.D.

Before we begin a discussion of these theories, it is important to emphasize that a person who has been sexually assaulted is not sick, crazy or mentally ill. Rape is not a disease – it is more like an injury. One cannot be “cured” of the effects of sexual violence, but one’s mind and body can and does heal from them. This process is a natural reaction to trauma. Stress reactions can break down pre-existing healthy adjustments and patterns of behavior or they may enable the individual to advance to a healthier level of adaptation.
Successful or unsuccessful reactions to stress are dependent on a variety of factors, including support systems, personality and previous history of vicitmization. In some cases, stress reactions after sexual assault may be severe enough that victims/survivors may benefit from working with a mental health professional. While professional help may be needed in managing some symptoms, the power to heal and reorder a victim's/survivor’s life is always within the victim/survivor.