Traumatic events such as rape cause both short-term and long-term stress reactions. Many people who experience long-term stress reactions continue to function at optimal levels. Those who are unable to function at a normal range or have difficulties in one or more areas may have Posttraumatic Stress Disorder (PTSD). This bulletin discusses Rape-related Posttraumatic Stress Disorder (RR-PTSD), a form of PTSD suffered by sexual assault and rape victims. For more information on PTSD, please refer to the bulletin “Posttraumatic Stress Disorder.”
The four major symptoms of Rape-related Posttraumatic Stress Disorder are:
Re-experiencing the trauma
Rape victims may experience uncontrollable intrusive thoughts about the rape, essentially unable to stop remembering the incident. Many rape victims have realistic nightmares and dreams about the actual rape. In addition, victims may relive the event through flashbacks, during which victims experience the traumatic event as if it was happening now. Additionally, victims are distressed by any event that symbolizes the trauma of rape. Victims avoid talking about the
event and will avoid any stimuli or situations which remind them of the rape.
The second major RR-PTSD symptom for rape survivors is social withdrawal. It has been described as psychic numbing, denial and a feeling of being emotionally dead. They do not experience feelings of any kind. One way it shows up in the lives of survivors is a diminished interest in living. It is not that they are suicidal, but they have no interest in their children, in their jobs, and what feelings they do experience have a very narrow range. Victims experiencing RR-PTSD may not feel joy, pain, or really much of anything; many experience a kind of amnesia. In addition, victims with RR-PTSD may not remember the details of what happened to them.
Avoidance behaviors and actions
The third set of symptoms of RR-PTSD are avoidance behaviors and actions. Victims may experience a general tendency to avoid any thoughts, feelings, or cues which could bring up the catastrophic and most traumatizing elements of the rape. This may be characterized by refusing to drive near the spot where the rape occurred.
Increased physiological arousal characteristics
There may be an exaggerated startle response — hyper-alertness and hyper-vigilance — which requires that the victim pay attention to every sound and sight in their environment. Many experience sleep disorders which result in poor sleep patterns for chronic RR-PTSD victims, such as trouble falling or staying asleep. In addition, memory may be impaired, and many victims have difficulties concentrating, which affects tasks that must be completed in their daily lives. Victims may exhibit a kind of irritability, hostility, rage and anger that produce further isolation.
Some disturbing new research indicates that certain physiological changes in the brain may be permanent conditions. Some survivors with RR-PTSD are unable to accurately gauge the passage of time. Consequently, they are likely to show up for appointments late, early, or not at all. Another possible permanent side effect is a kind of tunnel vision. Victims may be unable to see the “big picture” which results in difficulty distinguishing between a little crisis and a big crisis. Therefore, all events in their lives are viewed as crises.
In Rape in America: A Report to the Nation, a widely-cited study by the National Center for Victims of Crime and the Crime Victims Research and Treatment Center, 13 percent of American women surveyed had been raped and 31 percent of theses rape victims developed RR-PTSD. The study showed that with 683,000 women raped each year in this country, approximately 211,000 will develop RR-PTSD each year. In their attempts to cope with RR-PTSD symptoms, many victims may develop major depression. Rape victims are three times more likely than non-victims of crime to have a major depression episode. Rape victims are 4.1 times more likely than non-crime victims to contemplate suicide. In fact, 13 percent of all rape victims actually attempt suicide, which confirms the devastating and potentially life threatening mental health impact of rape.
In attempting to cope with the above symptoms, drug and alcohol consumption are likely to be companions in the victim’s attempt to gain relief from these symptoms. RIA found that, compared to non-victims of crime, rape victims are:
- 13.4 times more likely to have two or more major alcohol problems; and
- Twenty-six times more likely to have two or more major serious drug abuse problems.
With a growing body of knowledge about RR-PTSD, help is available through most rape crisis and trauma centers. Support groups have been established where survivors can meet regularly to share experiences to help relieve the symptoms of RR-PTSD. For some survivors, medication prescribed along with therapy is the best combination to relieve the pain. Just as in the treatment of any other illness, at the first opportunity, the individual should be encouraged to talk about the traumatic experience. This ventilating provides a chance to receive needed support and comforting as well as an opportunity to begin to make sense of the experience (Allen). “To diminish symptoms of PTSD, you must work on two fronts- coming to terms with the past and alleviating stress in the present (Allen).” In addition, violence-related trauma affects not only direct victims, but those who care deeply about them.
National Center for Victims of Crime & Crime Victims Research and Treatment Center. (1992). Rape in American: A Report to the Nation. Arlington, VA: National Center for Victims of Crime.
Ringel, Cheryl. (1997). Criminal Victimization…Washington, DC: Bureau of Justice Statistics, US Department of Justice.
Allen, Jon. (1995). Coping with Trauma: A Guide to Self-Understanding. Washington, DC: American Psychiatric Press.
Figley, Charles R. (1992). “Post-traumatic Stress Disorder, Part 1.” Violence Update, 2(7): 1, p.8-9.
Harvey, Mary & Judith Herman. (1992). “The Trauma of Sexual Victimization: Feminist Contributions to Theory, Research, and Practice.” PTSD Research Quarterly, 3(3): 1-3.
For additional information, please contact:
National Crime Victims Research and Treatment Center
Department of Psychiatry & Behavioral Sciences
Medical University of South Carolina
165 Cannon Street, MSC852
Charleston, SC 29425-0742
Administrative Phone: (843) 792-2945
Clinic Phone: (843) 792-8209
Center for Women’s Policy Studies
1776 Massachusetts Avenue, NW, #450
Washington, D.C. 20036
Phone: (202) 872-1770
Rape Abuse & Incest National Network
24 Hour hotline: 1-800-656-HOPE
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Copyright 2009 by the National Center for Victims of Crime. This information may be freely distributed, provided that it is distributed free of charge, in its entirety and includes this copyright notice.