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Effects of rape and aftermath

Page history last edited by PBworks 13 years, 10 months ago

Effects of rape and aftermath


 

The most common long term effects of sexual assault and rape are the invisible (psychological) ones. In terms of a victim's impact statement there are 3 types of effects: physical/psychological, financial and social. The immediate symptoms of rape trauma include having unpredictable and intense emotions. The victim may have an exaggerated startle response (jumpy), may have memories and intrusive thoughts about the assault, nightmares, difficulty sleeping and difficulty concentrating. The long term psychological effects of rape can include PTSD and rape trauma syndrome (RTS), OCD, DID, eating disturbances, Self Injury, Self blame, Panic attacks, Flashbacks, Body memories and Sleeping disorders. Unfortunately in many cases these effects can be life long if the victim does not get immediate support and care (Medline & RCIP). The way these symptoms are exhibited can be either expressive or subdued.

 

Immediate symptoms usually involve Acute Stress Disorder. Symptoms of this are:

 

  • feeling numb and detached, like being in a daze or a dream, or feeling that the world is strange and unreal
  • difficulty remembering important parts of the assault
  • reliving the assault through repeated thoughts, memories, or nightmares
  • avoidance of things (places, thoughts, feelings) that remind the victim of the assault
  • anxiety or increased arousal (difficulty sleeping, concentrating, etc.)

 

Psychological effects

 

Rape Trauma Syndrome is experienced by rape victims and can be divided into phases.

 

Phases of Rape Trauma Syndrome

 

During the Acute Phase survivors may feel shock, disbelief, or in some way frozen and may attempt to disconnect himself or herself from the person who was raped. Survivors may feel humiliated, confused, dirty, ashamed, or in some way at fault for the assault, particularly if the assailant was an acquaintance. Victims often experience extreme nightmares, heightened anxiety, frequent flashbacks, and a strong attempt to disconnect from one's emotions. They may be in denial, trying to convince themselves that the assault did not actually occur. It is common for a victim of acquaintance rape to try to protect the perpetrator.

 

Victims may respond to the rape in either an expressive or controlled style. The expressive style involves obvious outward emotions such as crying, shaking, rage, tenseness, ironic and uncomfortable laughter (part of their denial), and restlessness. A controlled style occurs when the victim appears to be quite calm and rational about the situation, even if he or she were facing severe internal turmoil. There is no single response to rape; every individual deals with his or her intensely traumatic emotions differently. The survivor may feel unsafe, which can cause a heightened state of anxiety as well as difficulty with intimate relationships (see social effects). Victims may attempt to return to normal social interaction (i.e. go out to social engagements), and consequently find themselves unable to do so. Their attempts to re-establish themselves in relationships may be hindered by a lack of trust.

 

After the acute phase, the Reorganization Phase begins and the survivor attempts to reorganize their life and create the world that they once knew. Despite their best efforts though, this phase is often riddled with feelings of guilt, shame, fear, and anxiety. Emotions such as anger, anxiety, denial, and loss (of security) surface. Development of an inability to trust is frequently caused by sexual assault. This loss of the fundamental need for security wreaks havoc on the survivor’s life, causing the individual to feel completely powerless and without control over his or her own body.

 

Some of the psychological effects suffered are:

PTSD

Dissociation or DID

OCD

Eating disorders

Self Injury

Self blame

Flashbacks

Memory problems

Panic attacks

Body memories

The mask

Sleeping problems

 

Sexual assault can change an individual forever by altering their outlook. The end result can be an individual in a constant state of turmoil and in extreme cases, suicide.

 

Physical effects - Medical emergency information

see also:

Medical emergency information

 

 

According to the American College of Emergency Physicians (ACEP) in the United States, rape is a medical emergency 1. Medical and law enforcement professionals have strongly recommended that a victim call for help and report it. A victim who seeks immediate medical attention, will not only allow prompt treatment for possibly life-threatening injuries and diseases, but will also preserve evidence. Many recommend that victims should not bathe or clean themselves before the examination, not only to prevent the loss of physical evidence, but also to not delay medical attention.

 

Physical injuries such as gynecologic, rectal or internal hemorrhage may have resulted. Additionally, emergency contraception and preventative treatment against sexually transmitted diseases may be required, in particular prophylactic treatments to prevent HIV infection. In many locations, emergency medical technicians, emergency room nurses and doctors are trained to help rape victims. Some emergency rooms have rape kits which are used to collect evidence.

According to the World Health Organization The other somatic symptoms may include:

  • Chronic pelvic pain
  • Premenstrual syndrome
  • Gastrointestinal disorders
  • Gynecological and pregnancy complications
  • Migraines and other frequent headaches
  • Back pain
  • Facial pain
  • Disability preventing work (Jewkes, Sen, and Garcia-Moreno 2002)

 

 

AIDS prophylaxis is possible within 48 hours, but is not always deemed appropriate, given:

 

  • the extremely small chance of transmission in many cases (0.1 - 0.3%, or between 1 in 333 and 1 in 1000);
  • the lack of certainty of any effective results (it reduces, rather than removes the risk); and
  • the often severe side effects of drugs required.

 

This would usually be a clinical decision based upon circumstances.

 

RAINN

See also:

RAINN

 

Some groups also operate hotlines to offer advice and psychological first aid.

 

In the United States, one of the most prominent hotlines for rape victims is --HOPE; provided by the organisation RAINN, it is confidential, 24-hour and toll-free.

 

 

Social effects

 

Rape is especially stigmitizing in societies with strong sexual customs and taboos. For example, a woman (and especially a virgin) who is raped may be deemed by society to be "damaged": she may suffer isolation, be prohibited to marry, be divorced if she was married, or even killed (known as secondary victimization).

 

Survivors often isolate themselves from their support network either physically or emotionally. The survivor may feel disconnected from peers as a result of the perceived personal experience. The shattering of trust can adversely affect intimate relationships, as survivors may have a heightened suspicion of other’s motives and feelings.

 

She may also suffer from self blame and feel "dirty", as if the crime was her fault. (Dearing et. al., 2005) A proportion of violent sexual assaults end with the death or serious injury of the victim. Other consequences can include pregnancy or sexually transmitted diseases. Because of the sexual nature of rape crimes, the most common effect is psychological.

In the past, survivors of rape and sexual assault were often diagnosed with Rape Trauma Syndrome (RTS), then considered to be a psychological disorder. RTS is no longer considered a diagnosis, but rather a set of normal psychological and physiological reactions that a victim is likely to experience. The reactions are very similar to those that would be experienced by a survivor of any other traumatizing experience, and sometimes result in a diagnosis of Post-Traumatic Stress Disorder PTSD. These traumatic responses are often cited as one of the reasons why rape goes unreported. (NCPTSD)

 

The process to denounce and eventually convict an offender is often hindered by similar psychological effects. Victims frequently feel shame when describing what has happened (especially if the victim is male, or if a female victim must report the incident to a male law officer). Also, the intimate questions and medical examinations required for prosecution can make the victim uncomfortable. In societies that do not accord equal civil rights to women and men, this process is even more difficult for female victims. In societies where denial, sexual stereotyping and pervasive double standards exist, victims of male-male, female-male and female-female rape often suffer double victimization when they seek support from legal, medical, and psychological professionals.

 

Sexual assault of children can lead to the following: life-long depression, D.I.D. (formerly M.P.D.), cutting (self injury), other forms of self-mutilation, Borderline Personality Disorder (BPD), Anti-Social Personality Disorder, Post Traumatic Stress Syndrome (PTSS), flashbacks, psychotic breaks with reality, alcoholism, substance abuse, promiscuity, celibacy, prostitution, an inability to form intimate relationships, self-hate, guilt, anger (which is often directed inwards as well as outwards), general mental deterioration including loss of IQ, emotional hypersensitivity, defensiveness, a lifelong inability to trust others, emotional numbness, an attraction to partners who are dominant and/or abusive. Children with PTSD have been found to have a reduced corpus callosum passage in the brain. Adult survivors often have control issues which can lead to eating disordered behavior. Adult survivors are at great risk of further victimization due to elevated PTSD levels. They find themselves reinacting the abusive situation in relationships in order to overcome it. They also have a tendency to get involved in toxic, co-dependant relationships. Adults previously assaulted as a child are twice as likely to be assaulted as an adult. (MNCASA) Learning about the health and psychological conditions effecting survivors of assault has been cited by researchers as a positive coping skill associated with faster healing. (Matsushita-Arao, 1997),(Ball, 1982)

 

Secondary victimization

 

Secondary victimization is the re-traumatization of the sexual assault, abuse or rape victim. It is an indirect result of assault which occurs through the responses of individuals and institutions to the victim. The types of secondary victimization include victim blaming, inappropriate behavior or language by medical personnel and by other organizations with access to the victim post assault. (Campbell et. al., 1999)

 

Secondary victimization is especially rampant in cases of drug facilitated, acquaintance and statutory rape.

 

 

Victim blaming

see also:

Victim blaming

or

Just World Hypothesis

 

The term Victim blaming refers to holding the victim of a crime to be, in whole or in part, responsible for what has happened to them. In the context of rape, this concept refers to popular attitudes that certain victim behaviours (such as flirting, or wearing sexually-provocative clothing) may encourage rape. In extreme cases, victims are said to have "asked for it", simply by not behaving demurely. In most Western countries, the defense of provocation is not accepted as a mitigation for rape, although in Sweden this happens almost routinely, and questions about the victim's clothing and behaviour is present in almost all rape trials. This has raised a lot of attention among the Swedish public and the press. Despite several changes in legislation, little has changed. This may be due to the impact of the courts' personal opinions and views, which have a large effect on the verdict in the Swedish judicial system.

 

It has been proposed that one cause of victim-blaming is the just world hypothesis. People who believe that the world has to be fair may find it difficult or impossible to accept a situation in which a person is badly hurt for no cause or reason. This leads to a sense that, somehow, the victim must have surely done 'something' to deserve their fate. Another theory entails the need to protect one's own sense of invulnerability. This inspires people to believe that rape only happens to those who deserve or provoke the assault (Schneider et. al., 1994). This is a way of feeling safer. If the potential victim avoids the behaviours of the past victims then they reason they will remain safe and thus feel less vulnerable. A global survey of attitudes toward sexual violence by the Global Forum for Health Research 3 shows that victim-blaming concepts are at least partially accepted in many countries. In some countries, victim-blaming is more common, and women or men who have been raped are sometimes deemed to have behaved improperly. Often, these are countries where there is a significant social divide between the freedoms and status afforded to men and women.

 

A more mainstream view is that everybody has the theoretical right to feel safe at all times, but that the responsibility of preventing and minimising the risk of being in a dangerous situation is largely up to the individual. On this basis, the question is not whether the victim "deserved" to be raped, because nobody "deserves" to be the victim of crime, but rather whether the individual did choose to prevent or minimize the risk of being in a dangerous situation and/or the risk of harm in a dangerous situation.

 

Under cases of alleged date rape, however, the situation is different. In these situations, the question at hand is whether or not the incident was consensual, the alleged victim encouraged the accused, or the alleged victim gave implied consent. These questions become the critical consideration. As such, arguments about the victim's conduct are an accepted element of an affirmative defense.

 

In the United States, rape is unique in that it is the only crime in which there are statutory protections designed in favor of the victim (commonly known as rape shield laws). These were enacted in response to the common defense tactic of "putting the victim on trial". Typical rape shield laws prohibit cross-examination of the victim with respect to issues such as his or her prior sexual history or the manner in which he or she was dressed at the time of the rape. Most state law and the federal law, however, provide exceptions to the rape shield law where evidence of prior sexual history is used to provide an alternative explanation for physical evidence. These exceptions would commonly apply where the defendant and the victim had a prior consensual sexual relationship or where exclusion of evidence would violate the defendant's constitutional rights.

 

 

Self blame

see also: Self blame

 

There are two main types of self blame: undeserved blame based on character and undeserved blame based on actions. These are called characterological self blame and behavioral self blame, respectively.

 

1/ Behavioral self blame refers to victims' feelings that they should have done something differently, and therefore feel at fault.

 

2/ Characterological self blame is when victims feel there is something inherently wrong with them, causing them to deserve to be assaulted. This type of blame is associated with an increased amount of negative psychological effects on the victim.

 

Self blame is an avoidance coping skill which inhibits the healing process. The type of thought involved in self blame of victims is illogical thinking (known as counterfactual thinking) which can be remedied by a therapeutic technique known as cognitive restructuring. The main problem for victims is that feeling shame (stigma with the self) produces more psychological problems than feeling guilt (actions). It is easier to change an action than the self. Guilt promotes resolving action and shame promotes pulling away or wanting to be invisible. Withdrawing prevents the victim from seeking help and reporting. Feeling that you had control during the assault (past control or behavioral self blame) is associated with more psychological distress while believing you have more control now (present control or control over the recovery process) is associated with less distress, less withdrawal and more cognitive reprocessing. (Frazier et. al., 2005)

 

Tagney, considered to be a leading researcher on shame, lists five ways shame can be destructive: lack of motivation to seek care, lack of empathy, cutting themselves off from other people, anger, and aggression. Tangney says shame has a special link to anger. "In day-to-day life, when people are shamed and angry they tend to be motivated to get back at a person and get revenge." In addition shame is connected to psychological problems including but not limited to eating disorders, substance abuse, anxiety, and depression, as well as problematic moral behavior. In one study over several years shame-prone children were prone to substance abuse, earlier sexual activity, less-safe sexual activity, and involvement with the criminal justice system. (Tangney, 2002)

 

Counseling responses found to be helpful in reducing self blame are supportive responses, psychoeducational responses (learning about rape trauma syndrome), and those responses addressing the issue of blame. (Matsushita-Arao, 1997 ) A helpful type of therapy for self blame is cognitive restructuring or cognitive-behavioral therapy. Cognitive reprocessing is the process of taking the facts and forming a logical conclusion from them that is less influenced by shame or guilt. (Branscombe et. al., 2003) See also: !!!! Secondary victimization

 

See also:

Multiple re-victimization of rape victims

 

Financial Effects

Loss of work due to physical or psychological health problems can lead to loss of income. Some assault survivors must depend in disability to survive. According to the National Crime Victimization Survey the cost of care for crime victims is significant. The Medical Examination and Treatment for Victims of Sexual Assault: Report to Congress states that costs for visits to providers, missed work, and treatment for trauma are a burden for the victim. It also states that total costs per incident of non-fatal sexual assault are estimated to be $87,000, broken down into $2,200 in productivity losses, $500 for medical care expenses, $2,200 for mental health care, and $81,400 associated with reduced quality of life. ( US Dept. of Health and Human Services Agency for Health Care Research and Quality )

 

Hotlines

 

 

 

References

* Cost of Mental Health Care for Victims of Crime in the United States, Criminal Justice Response to Victim Harm in the United States, National Crime Victimization Survey,

* Tangney, June Price and Dearing, Ronda L., Shame and Guilt, The Guilford Press, 2002

* Matsushita-Arao, Yoshiko. (1997). Self-blame and depression among forcible rape survivors. Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(9-B). pp. 5925.

* Branscombe, Nyla R.; Wohl, Michael J. A.; Owen, Susan; Allison, Julie A.; N'gbala, Ahogni. (2003). Counterfactual Thinking, Blame Assignment, and Well-Being in Rape Victims. Basic & Applied Social Psychology, 25 (4). p265, 9p.

* Frazier, Patricia A.; Mortensen, Heather; Steward, Jason. (2005). Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors. Journal of Counseling Psychology, Jul2005, Vol. 52 Issue 3, p267-278

* Jewkes, R., Sen P., Garcia-Moreno, C. Sexual Violence. In: Krug E., Dahlberg, L., Mercy, J.A., Zwi, A.B., Lozano, R. World Report of Violence and Health. Geneva, Switzerland: The World Health Organization. 2002: 147-181. (Available on the Internet: http://www.who.int/violence_injury_prevention/ violence/global_campaign/en/chap6.pdf)

* Lamb, Sharon, The Trouble with Blame: Victims, Perpetrators and Responsibility, Harvard Univ Press, 1999.

* Madigan, L. and Gamble, N. (1991). The Second Rape: Society's Continued Betrayal of the Victim. New York: Lexington Books.

* Murray JD, Spadafore JA, McIntosh WD. (2005) Belief in a just world and social perception: evidence for automatic activation. J Soc Psychol. Feb;145(1):35-47.

* Frese, B., Moya, M., & Megius, J. L. (2004). Social Perception of Rape: How Rape Myth Acceptance Modulates the Influence of Situational Factors. Journal-of-Interpersonal-Violence, 19(2), 143-161.

* Pauwels, B. (2002). Blaming the victim of rape: The culpable control model perspective. Dissertation-Abstracts-International:-Section-B:-The-Sciences-and-Engineering, 63(5-B)

* Blumberg, M. & Lester, D. (1991). High school and college students' attitudes toward rape. Adolescence, 26(103), 727-729.

* Shaver, . (2002). Attribution of rape blame as a function of victim gender and sexuality, and perceived similarity to the victim. Journal of Homosexuality, 43(2)

* Anderson , K. J. & Accomando, C. (1999). Madcap Misogyny and Romanticized Victim-Blaming: Discourses of Stalking in There's Something About Mary. Women & Language, 1, 24-28.

* The effect of participant sex, victim dress, and traditional attitudes on causal judgments for marital rape victims. (Author Abstract). Mark A. Whatley. Journal of Family Violence 20.3 (June 2005): p191(10).

* Kay, Aaron C., Jost, John T. & Young, Sean (2005) Victim Derogation and Victim Enhancement as Alternate Routes to System Justification. Psychological Science 16 (3), 240-246.

 

 

 

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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "rape".

 

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