A Study of the Correlation Between Sexual Assault and Post Traumatic Stress Disorder

During the most recent presidential campaign, one candidate was constantly accused of allegations of sexual assault, rape, and derogatory treatment against women. After the first piece came out with proven evidence of its accuracy, many believed that this candidate was finished and would drop out of the race in shame. He did not, so those who called for his resignation now called for an apology. Instead they were given a hasty excuse of “boys will be boys.” The fact that this person can find success in our nation after showing blatant disrespect to half of the population shows that our society is not gender equal and does not give justice to those it allows to become victims of “boys will be boys.” The awareness of sexual assault and the acceptance that many assault victims suffer from Post Traumatic Stress Disorder is growing, and because of this funding has been given to the research of support and treatment that is different from previous treatments created specifically for war veterans.

From the first recognition as a disorder, PTSD has often been associated with war veterans and first responders. These brave men and women must live with their experiences for the rest of their lives, and society has respected their service and have accepted their newfound disability connected to it. It has been fairly recent that survivors of sexual assault and rape have been given the same courtesy to openly struggle with their mental scars. Veterans and survivors have much in common, both trying to navigate through invisible obstacles that make daily life often impossible. Many assaults are committed by those previously close to the victim, and being hurt be those one trusts is much like not knowing who the enemy in the field is, worrying about shooting at friend or foe. There is strong and compelling evidence that a majority of rape survivors suffer largely immediately following the rape, and now there is research proving that many also suffer from chronic psychological problems for years after. The severity of these problems differ due to many different variables including social support, their relationship with the perpetrator, and physical damage caused initially. This is proven in Ullman’s study, “both preassault ratings of social support in general and postassault support responses should affect recovery from traumatic events like rape.  In general, persons with better social support have better mental and physical health and general social support is an important buffer of life stress.” Statistics gathered by Holmes in the study in 1998 shows that more than 12 million women in the United States have been sexually victimized, and more than 680,000 adult women are sexually assaulted each year. When initially seeking help after an assault, these women report of disturbances in sleep patterns, sexual function, appetite, and spoke of assault-related fears. Even with these severe and often life-altering symptoms, only a total of 31% of victims returned to a follow-up visit, most never seeking psychological help again afterwards. One reason for lack of social support and seeking out professional mental healthcare is in correlation with the role of the perpetrator in the victim’s life.

Women sexually assaulted by a stranger are more likely to contact police and define the event as an assault. Many believe this to be true because attacks like this are seen as “black and white” rather than “grey”. Rape within the confines of a relationship is more questionable in our society and would often be considered “grey”. Defining the attack as an assault allows the victim to receive more medical and mental health care compared to those who delay disclosure do to fear of a close relationship with the criminal. Those who cover or hide their assault often avoid dealing with the reality of the event by drinking, withdrawing from social circles, and dropping out of school or work. Women also face societal stigma after reporting claims of sexual assault. This is described as a “second injury” (Zoellner) which refers to a lack of support after a traumatic event caused by disbelief of its verification and lack of support coming from one’s community, society, family, and friends. Many victims begin to show symptoms of PTSD after losing important societal connections and ties that are severed after an incident. Individuals blame themselves for the assault due to making choices that allowed the incident though legally they cannot be faulted for. This type of self-blame often comes up in dialogue as “I should have left the party earlier,” or “I could have parked somewhere else.” It is completely irrational, as no one could possibly know the future. These thoughts are illogical, but often put much weight on a victim as they try to discover what could have possible prevented their assault. No one is at fault except the person who decided to prey on another. In Miller’s paper, Self-Blame Among Sexual Assault Victims, ‘‘The locus of violence rests squarely in the middle of what our culture defines as ‘normal’ interaction between men and women.’’ (2007) She found that in her study, 73% of rape victims directly denied that they had been raped. One theory to explain this curiosity is that because violent and crass behavior is expected of young males, female victims do not believe their experience was anything out of the norm nor anything worth reporting. The tendency to blame women for their victimization is internalized by victims, leading to statistics reporting of hiding victimization rather than reporting it.

PTSD is often thought to only happen after a sudden, well defined incident. This societal view can be harmful to others whose PTSD was onset due to a long term involvement with an abusive partner or other building trauma. In Kolk’s article, it has been found that for most traumas involving women and children occur in the context of intimate relationships rather than after meeting a stranger on the street. “Researchers consistently report that in approximately 2 to 3 months, many of these early reactions have lessened and although levels of various symptoms have not returned to normal they have improved in most rape survivors. (Neville 1999)” Yet in a follow-up study, many survivors reported that they had not fully healed after 5 years had passed. Neville’s survey data has also suggested a link between sexual assault history and eating disorders in survivors. Those who hold in their initial anger due to not being able to talk about what had happened or other reasons, experience more severe PTSD symptoms as time progresses away from the incident.

The response to trauma from assault and rape survivors is also often different from veterans with PTSD. In her research, Kolk found that victims rarely suffer from flashbacks like war veterans and instead their symptoms mainly include being unable to be present and calm, being “out of it,” being overwhelmed by rage, and lacking meaningful involvement with their current lives. A large majority of rape survivors suffer from intense psychological reactions directly after the attack, and often lasts for up to three months. Severe symptoms lasting longer than this acute phase is what most diagnose as PTSD. The definition of PTSD has newly changed, the greatest difference is the shift from an anxiety disorder to a new category of trauma. The diagnosis has remained mainly stagnant with symptoms including recurrent, involuntary and intrusive distress memories, avoidance of distressing memories and thoughts, as well as hypervigilance. The change has also redefined what constitutes a traumatic event and has added four new symptoms.

The change in definition has not only allowed more people to be assisted with their struggles, but also has spurred the research community to look deeper into PTSD. It has also made a distinct difference between anxiety disorders that show up after a trauma from those who suffer with flashbacks and physical responses to triggers. To be diagnosed with PTSD, there must be a “gatekeeper”, or initial event that one can trace symptoms back to. If a gatekeeper cannot be found, a patient is often diagnosed with another mental disorder like Clinical Depression or General Anxiety Disorder. One of the goals having to do with reframing the prognosis of PTSD was to spur additional research of the disorder. One difficulty researchers are discovering is due to the vastness of symptoms related to the disorder. One example of this is the modulation of arousal states that vary from individual to individual. Some space out, disappear and feel nothing, suffering from hypoarousal while others suffer from hyperarousal and behave as though their life is in danger. In Kolk’s reflection of her research, she adds, “I have been surprised that something that is so obvious to me is not central in our pursuit of effective treatments: learning to regulate your autonomic arousal system is maybe the single most important prerequisite to dealing with PTSD… How people develop treatment techniques that are based on the premise that you can bypass this issue, and ignore what is going on in the basement, beats me”. In a study done by Bisson and Andrew, they looked at different types of treatments that could possibly shorten the length one suffers from the disorder. They found that without treatment, over a third of individuals reported having PTSD six years after developing it. There was also a 50% chance of remission at two years. Most researched and tested interventions have been trauma-focused behavioral therapy that occurs over 4-12 sessions. This technique was found more helpful than a single-event debriefing, which was actually found to have a negative impact on an individual’s coping of trauma. Much more research is needed before a breakthrough in healing those with PTSD can be obtained.

Society has come a far from victim shaming and stoning women who were raped in the confines of a city, yet it still has a long way to go before it can be titled “just”. Taking assault seriously and researching the effects it has on its victims is a start, but there are many problems left. Some of these problems include the need for a witness to identify a criminal in a lineup, the absurd cost of rape kits and the disordered way they are handled during an investigation. It is due to the patriarchal society that we live in that rape and assault is a commonplace in our learning institutions and impacts more than a majority of the women in said facilities. It must become a norm that sexual violence against anyone, especially young women, is disgusting and unacceptable. Those who commit these violent acts should be seen as pariah, not raised to become prominent figures of our nation. As co-existing members of a dangerous world, we must ask, “how can we change this?”

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