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PubMed2000

Prevention of pregnancy resulting from rape: a neglected preventive health measure.

Abstract: Pregnancy following rape is a continuing and significant public health issue. We estimate that the 333,000 sexual assaults and rapes reported in 1998, along with many more unreported, were responsible for 25,000 pregnancies. Potentially, as many as 22,000 such pregnancies could be prevented if all women who were raped received prompt medical services, and if not already protected against pregnancy, were provided with emergency contraceptive treatment.

Adolescent↗

PubMed2003

Rape and HIV post-exposure prophylaxis: addressing the dual epidemics in South Africa.

In South Africa, a country notable for both a rapidly escalating AIDS epidemic and high levels of sexual violence, the issue of HIV post-exposure prophylaxis (PEP) following rape has recently come to the fore, and a policy supporting provision of PEP has been approved by the national government. This paper compares the conditions for providing PEP in Europe and North America with the conditions faced by two initiatives in South Africa, one serving a primarily rural base, and one urban. It is based on a review of the literature on sexual violence in South Africa and use of PEP following occupational and non-occupational exposure. It incorporates perspectives from in-depth interviews in 2000 with 18 key informants, including survivors of sexual violence, gender and HIV activists, domestic violence NGOs, rape crisis centres, physicians, lawyers, researchers and HIV/AIDS advisors in the Department of Health. The paper argues that given the scientific evidence for PEP, and the nature of the dual epidemics of HIV and sexual violence in South Africa, the public health and social justice rationale for implementing PEP equals and indeed exceeds that put forward in industrialised countries. However, delays in accessing PEP caused by the public justice system and lack of training for service providers constitute significant obstacles to effective implementation. In this respect, provision of PEP presents an opportunity to reform and strengthen existing services for post-rape care and to link attention to the epidemic of sexual violence to HIV/AIDS prevention.

Anti-HIV Agents↗

PubMed2001

Posttraumatic stress disorder in rape victims: autonomic habituation to auditory stimuli.

Impaired capacity for physiological habituation may contribute to the persistence of PTSD. Habituation of autonomic responses to auditory tones was examined in 43 women in three groups: 14 adult female rape survivors with chronic PTSD, 11 without PTSD, and a comparison group of 18 who had not been raped. There were no significant differences among the groups in baseline cardiac or electrodermal activity. The PTSD group showed significantly slower electrodermal habituation, as measured by trials to extinction and percentage of nonhabituators, than did the comparison groups. The present study found slower habituation of electrodermal responses for PTSD rape victims to neutral stimuli than for non-PTSD victims and nonvictims.

Acoustic Stimulation↗

PubMed2002

A multiple case study of rape victim advocates' self-care routines: the influence of organizational context.

This study assumes that rape victim advocates who provide community outreach services to victimized women must adjust to a heightened awareness of sexual violence to do their jobs. Using qualitative methodology, this multiple case study explored rape victim advocates' strategies for incorporating repeated exposure to sexual assault into their daily lives as well as ways that organizations can support such endeavors. Findings suggest that advocates' self-care routines draw upon various personal resources (i.e., cognitive, physical, social, spiritual, verbal), and serve 2 roles for coping with rape-related pain: (a) cathartic releasing of traumatic material, and (b) improving capacity to integrate the traumatic material into one's life. Additionally, over 20 organizational characteristics that workers perceive to be supportive (e.g., weekly meetings, flexible hours) were identified. Nonparametric and categorical statistical analyses were used to analyze the relationship between organizational support and self-care routines, finding that advocates working in organizations with higher levels of support utilize more strategies that are integrative in nature. Implications of these findings are discussed.

Adaptation, Psychological↗

PubMed1996

Unacknowledged versus acknowledged rape victims: situational factors and posttraumatic stress.

Investigators of sexual assault have found that a substantial number of women who have been raped do not conceptualize their experiences as such. The present investigation examined differences between 40 unacknowledged rape victims and 20 women who acknowledged their experience as rape in a sample of college women, as well as a control group of 23 nonvictims. Groups were compared in terms of situational factors, postassault symptomatology, defense mechanisms, dissociative disorders, and sexual revictimization. In comparison to unacknowledged victims, acknowledged victims reported more forceful assaults and indicated more resistance and clearer refusal. Acknowledged victims exhibited more posttraumatic stress disorder symptoms than unacknowledged victims, who exhibited more symptoms than nonvictims, as measured by clinical interview. Implications of these findings are discussed.

Adolescent↗

PubMed1996

Traumatic memory characteristics: a cross-validated mediational model of response to rape among employed women.

In a cross-validated mediational model, the authors examined characteristics of memories formed in response to rape and other intense unpleasant and pleasant experiences. Data were responses to a mailed survey of women medical center and university employees. Measurement models of memory and symptom factors and a structural model with pathways among cognitive appraisal, emotional valence, memory characteristics, and health outcomes were developed in Sample 1 (N = 1,307) and confirmed in Sample 2 (N = 2,142). Rape had substantial direct effects on 2 memory factors (Clarity and Affect) and indirect effects through the construal of victimization. Rape was associated with memories described as more emotionally intense but less clear and coherent and less often thought of or talked about. Most effects on physical symptoms were nonsignificant. Implications of findings for neurohormonal and multiple representation models of emotional memory and to cognitive avoidance are discussed.

Adolescent↗

PubMed1999

Sexually aggressive and nonaggressive men: sexual arousal and judgments in response to acquaintance rape and consensual analogues.

Self-identified sexually aggressive (SA) and nonaggressive (NA) college men listened to audiotape analogues of consensual sexual intercourse and acquaintance rape. Phallometric and decision-latency methodology was used to examine sexual arousal and decisions to stop sexual advances in each scenario. Both groups showed increases in penile response to the consensual scenario. Consistent with the inhibition model of sexual aggression, the SA group showed greater sexual arousal and failed to inhibit responding when force was introduced in the rape, whereas the NA group exhibited less arousal and greater inhibition to force. The SA group allowed the rape to continue significantly longer than the NA group. These effects were greatly magnified in SA men who endorsed high calloused sexual beliefs, implying that a cognitive set that justifies sexual aggression and lacks victim empathy may disinhibit sexual arousal and potentiate coercive decision making.

Adult↗

PubMed1979

Characterological versus behavioral self-blame: inquiries into depression and rape.

Two types of self-blame--behavioral and characterological--are distinguished. Behavioral self-blame is control related, involves attributions to a modifiable source (one's behavior), and is associated with a belief in the future avoidability of a negative outcome. Characterological self-blame is esteem related, involves attributions to a relatively nonmodifiable source (one's character), and is associated with a belief in personal deservingness for past negative outcomes. Two studies are reported that bear on this self-blame distinction. In the first study, it was found that depressed female college students engaged in more characterologial self-blame than nondepressed female college students, whereas behavioral self-blame did not differ between the two groups; the depressed population was also characterized by greater attributions to chance and decreased beliefs in personal control. Characterological self-blame is proposed as a possible solution to the "paradox in depression." In a second study, rape crisis centers were surveyed. Behavioral self-blame, and not characterological self-blame, emerged as the most common response of rape victims to their victimization, suggesting the victim's desire to maintain a belief in control, particularly the belief in the future avoidability of rape. Implications of this self-blame distinction and potential directions for future research are discussed.

Depression↗

PubMed1985

Postcoital detection of a male-specific semen protein. Application to the investigation of rape.

Identification of semen in vaginal fluid may provide documentation of sexual contact in alleged victims of rape. We describe an enzyme-linked immunosorbent assay for a semen glycoprotein of prostatic origin, designated p30. This test detects as little as 3 ng of the p30 antigen per milliliter in various body fluids. Semen from normal and vasectomized men contains high levels of p30 (mean, 1.55 mg per milliliter of seminal plasma), and urine from men contains low levels (mean, 260 ng per milliliter). However, the antigen cannot be detected in body fluids from women, including vaginal fluid and urine, suggesting that p30 may be a male-specific antigen. The p30 antigen was detectable in vaginal fluid for a mean period of 27 hours after coitus, as compared with 14 hours for prostatic acid phosphatase. Of 27 vaginal fluid samples from women who were allegedly raped in which the acid phosphatase test was negative, 7 (26 per cent) were unequivocally positive for p30 by our assay. We conclude that the assay for p30 offers a more sensitive and specific method of semen detection in rape investigation than the enzyme assay for prostatic acid phosphatase.

Acid Phosphatase↗

PubMed2000

Attentional dysfunction associated with posttraumatic stress disorder among rape survivors.

Posttraumatic stress disorder (PTSD) is characterized by subjective reports of decreased concentration and an inability to sustain attention. Some empirical validation of these symptoms has been demonstrated via reduced performance on attentional tests among war veterans with PTSD. However, the significance of such findings is unclear given high co-morbidity with other psychiatric, neurologic, and substance abuse disorders among veterans. The present study examined neuropsychological functioning among rape survivors with PTSD, a patient population with comparatively low rates of psychiatric co-morbidity. Rape survivors with PTSD (PTSD+; n = 15) were compared to rape survivors without PTSD (PTSD-; n = 16) and age- and education-matched nontraumatized controls (CTRL; n = 16) on tests of attention. Performance of the PTSD+ group was significantly worse than the other groups on measures of sustained and divided attention, but not on shifting of visuospatial selective attention. Performance differences were not attributable to co-morbid psychiatric disorders or substance abuse. The implications of these findings regarding the effects of trauma on attentional functions are discussed.

Adult↗

PubMed1990

Brief simultaneous couple hypnotherapy with a rape victim and her spouse: a brief communication.

This paper presents a case involving a rape victim and her emotionally affected spouse. Although the assault occurred before the couple met, the husband was too upset to concentrate when the victim wanted to share her rape-related feelings, nor could he provide the much needed empathy and support. This, apparently, was due to his difficulties in handling his own rage. Simultaneous couple hypnotherapy was used to allow the victim to share her experience under conditions safe for both her and her spouse. As he imagined in trance the rape account described by his age-regressed wife, he learned to identify his emotions and experience them in a controlled manner. During subsequent sessions, the husband was encouraged to include himself in his wife's abreaction and reshape the traumatic scene for both of them. The husband's rescuing behavior and the expressions of violent anger towards the perpetrator had several positive consequences. Not only did they change the abandonment component of the victim's traumatic memory, but they also helped the husband deal in better ways with his own feelings of anger. It also provided the couple with a helpful coping mechanism they later effectively applied under different circumstances.

Abreaction↗

PubMed1994

Blame of victim and perpetrator in rape versus theft.

Variables that may affect attribution of responsibility and blame were explored to assess whether societal stereotypes about rape victims still exist among students in Alaska. In ambiguous crime situations, more blame was attributed to victims and less responsibility to perpetrators if the subjects had traditional views about women's roles. The victims were rated as being more responsible for a theft than for a rape, but the perpetrators were rated as being more responsible for a rape than for a theft. Overall, type of crime affected social judgments. Attitudes toward women affected the attribution of blame, but not fault, in ambiguous crime situations.

Adolescent↗

PubMedDate not supplied

Narrative constructions of sexual violence as told by female rape survivors in three populations of the southwestern United States: scripts of coercion, scripts of consent.

There is a growing literature on the narrative construction of rape as sexual violence. This is puzzling, since, in certain contexts, violence may stifle narrative production. Researchers of atrocities, for example, propose that the experience of recurring terror disrupts narrative cohesion in reporting lived trauma. Genocidal horror occurs in the context of communities and ethnic groups. Our rape survival data from women of three populations in the southwestern United States reflect traumas of sexual violence against women, experienced within everyday lives. From interviews with 62 female rape survivors, we (1) identify narrative conventions and linguistic devices to show how these women structure accounts of sexual assault that reflect their cultural background; (2) contrast scripts of coercion and consent; (3) examine how the way in which these women describe the coercive actions of the perpetrator(s) contradicts the assumptions of legal discourse; and (4) discuss the narrative production of several women in abusive relationships and compare it to the narrative production (or lack thereof) of persons who experience state-engineered terror.

Adolescent↗

PubMed2006

Ecstasy (MDMA), methamphetamine, and date rape (drug-facilitated sexual assault): a consideration of the issues.

The term "date rape drug" has traditionally been applied by the media to powerful sedatives, such as gamma hydroxybutyrate (GHB) and flunitrazepam (Rohypnol), which can render a person unconscious and hence unable to resist and/or recall an assault. However, some law enforcement agents and others have recently obtained convictions by arguing that the empathy-generating and sensual effects of MDMA, and an occasional increase in disinhibition and sexual desire linked with methamphetamine use, remove a person's ability to give a reasoned consent, turning the person into "a helpless slave" to their own sexual desires and those of the alleged perpetrator. The argument holds that the victim becomes part of the assault because they may appear to be cooperating and colluding with activity which they would not have consented to without taking these drugs. This interpretation of the term "date rape" has been fed by data that sometimes finds MDMA and amphetamines in samples taken from sexual assault victims, and hence these prosecutions sometimes rely on expert testimony from toxicologists, pathologists and police officers rather than psychologists and psychiatrists who are expert in the human effects of these drugs. Some of those in the latter group have dismissed claims that MDMA is an aphrodisiac or a date rape drug as myths propagated by the media. In this article, these arguments and their respective strengths and weaknesses will be examined to assist professionals and others who may become involved in these cases.

Coma↗

PubMed1991

Acquaintance rape and alcohol consumption on college campuses: how are they linked?

This article explores the links between acquaintance rape and alcohol consumption among college students. Both heavy drinking and acquaintance rape are serious problems on college campuses, and they frequently co-occur. Seven explanations for the relationship between alcohol consumption and acquaintance rape are provided: three of these explanations focus on alcohol consumption by the perpetrator and four focus on alcohol consumption by the victim. The need to conduct studies and develop prevention programs that address these issues is discussed.

Adolescent↗

PubMed1992

College men as perpetrators of acquaintance rape and sexual assault: a review of recent research.

This article reviews literature since 1980 on college men as perpetrators of acquaintance rape and other forms of sexual assault. Topics include (1) the definition and incidence of acquaintance rape and sexual assault; (2) perpetrator characteristics; (3) situations associated with sexual assault; and (4) men's misperception of women's sexual intent. An integrated theory of sexual assault is proposed, along with implications for the development of effective rape-prevention programs for men.

Adult↗

PubMed1999

What date/acquaintance rape victims tell others: a study of college student recipients of disclosure.

The authors surveyed 828 college students and found that approximately one third (n = 282) of the respondents reported that one or more women had told them that they had been raped by their dates or acquaintances. The 282 respondents who knew 1 or more victims of date/acquaintance rape reported on a total of 396 victims. The number of victims identified by respondents ranged from 1 to 3 or more (1 = 73%; 2 = 19%, 3 = 5%, > or = 4 = 3%). Reactions to disclosure offered by these respondents were generally supportive of the victim. The respondents' reactions suggested that there is a continuing need to educate students about the incidence and risks associated with date/acquaintance rape and the possibility of disclosure, particularly by friends or dating partners, and brought out some possible helpful and some counterproductive reactions to such disclosures.

Adolescent↗

PubMed1999

Sexually transmitted infections in female rape victims.

Sexual assault is a common occurrence that carries significant physical and mental health morbidity. Some of the most common concerns expressed by sexual assault victims can be allayed by addressing the risks of rape-related sexually transmitted infections. Although exact risks cannot be accurately quantified, it is important that health-care professionals provide counseling as well as prophylaxis and/or treatment as indicated. Screening and treatments should follow established guidelines, and follow-up care is indicated to confirm successful prevention or treatment. Continued support, surveillance, and medical attention should be offered as needed. This article will address important clinical issues regarding the prevalence and consequences of sexual assault, and will summarize current recommendations for the prophylaxis and treatment of sexually transmitted infections in adolescent and adult rape victims. Some of the logistical issues surrounding HIV testing, counseling, and prevention for rape victims will also be addressed.

Adolescent↗