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PubMed1976

Rape: the gynecologist's role.

The rape victim is a product of both a sexual and violent crime; the patient, in becoming the gynecologist's responsibility, must be received in a manner uniquely adapted to fit this situation. The physician must maintain his or her role as a healer and has no place acting as a lawyer or law enforcement officer. However, by obtaining the necessary, basic knowledge of the community's law, the physician can enable the patient to avoid unnecessary personnel, who tend to interview her at the most traumatic moment. It is best to do the minimum needed so that the patient realizes she is being treated as a troubled individual and not as a part of a future medicolegal case. In addition, the physician can practice good preventive medicine by alerting patients to clues about how to avoid rapists' attacks and yet do all they can to prevent the injuries which, although not primary, are part of many rapes. Our patients need a friend, a physician and a counselor all in one. The gynecologist should be all three.

Female↗
PubMed1988

Rape crisis program helps restore dignity and control.

A rape victim often finds herself in a hospital emergency room before she even has a chance to think about what happened, how she feels, or what she needs. Emergency rooms are not equipped to help restore the victim's feelings of safety, dignity, and control over her life. To remedy that situation, St. Vincent's Hospital and Medical Center of New York instituted the Rape Crisis Program in 1977. The program, staffed by two professional social workers, an administrative assistant, and a student doing field work, offers counseling as an enabling, healing process in which the client actively participates. Two aspects of the counseling are particularly important: providing a perspective on the recovery process and helping the survivor discuss details of the assault that she would not want to tell anyone else. Volunteers assist victims in the emergency room at night and on weekends after completing eight training sessions of 2 1/2 hours each. Readings, discussion, and role playing help trainees understand the fear, anger, and shame that sexual assault victims experience. Sometimes victims return to help others by becoming volunteers.

Counseling↗
PubMed1999

Post-traumatic stress disorder in female survivors of rape attending a genitourinary medicine clinic: a pilot study.

This study describes psychological symptomatology including post-traumatic stress disorder (PTSD) in 19 women attending a specialist sexual assault service within a genitourinary medicine (GUM) clinic. Women were interviewed within one year post-rape (mean = 12 weeks) using standardized questionnaires for PTSD and other psychological symptomatology. Seventeen (89.5%) of 19 women met full criteria for a diagnosis of PTSD. Anxiety predominated amongst other psychological symptomatology. Suicidal ideation was reported by 8 women and one made a suicide attempt following the rape. Although it is acknowledged this is a small, select sample, the high level of psychological trauma found suggests that genitourinary medicine clinics providing for sexual assault require access to mental health professionals.

Adolescent↗
PubMed2000

Drug-facilitated sexual assault ('date rape').

In the past few years, drug-facilitated sexual assaults have received widespread media coverage. In addition to alcohol, the most frequently used date-rape drug, flunitrazepam (Rohypnol), a fast-acting benzodiazepine, and gamma-hydroxybutyrate (GHB) and its congeners are among the most popular drugs used for this purpose. The latter drug is easily procured at some gymnasiums, popular bars, discos, and rave clubs, as well as over the Internet. Perpetrators choose these drugs because they act rapidly, produce disinhibition and relaxation of voluntary muscles, and cause the victim to have lasting anterograde amnesia for events that occur under the influence of the drug. Alcoholic beverages potentiate the drug effects. We review several date-rape drugs, provide information on laboratory testing for them, and offer guidelines for preventing drug-facilitated sexual assault.

4-Butyrolactone↗
PubMed2000

Rape in war: the humanitarian response.

Women and children are vulnerable to sexual violence in times of conflict, and the risk persists even after they have escaped the conflict area. The impact of rape goes far beyond the immediate effects of the physical attack and has long-lasting consequences. We describe the humanitarian community's response to sexual violence and rape in times of war and civil unrest by drawing on the experiences of Médecins Sans Frontières/Doctors Without Borders and other humanitarian agencies. Health care workers must have a keen awareness of the problem and be prepared to respond appropriately. This requires a comprehensive intervention protocol, including antibiotic prophylaxis, emergency contraception, referral for psychological support, and proper documentation and reporting procedures. Preventing widespread sexual violence requires increasing the security in refugee camps. It also requires speaking out and holding states accountable when violations of international law occur. The challenge is to remain alert to these often hidden, but extremely destructive, crimes in the midst of a chaotic emergency relief setting.

Adolescent↗
PubMed2001

Impact of childhood rape and aggravated assault on adult mental health.

Associations among childhood assault (rape, aggravated assault, or both) and indices of adult mental health (posttraumatic stress disorder, major depressive episode) were examined in a national probability sample of 4,008 (weighted) women. Relationships among assault characteristics and these adult mental health indices were also investigated. Findings suggested particularly deleterious effects for childhood aggravated assault and rapes that caused additional physical injury.

Adolescent↗
PubMed2001

[Application of pcr in paternity determination in pregnancy preceded by rape].

Authors present a case of PCR (Polymerase Chain Reaction) technique application for the paternity determination in pregnancy preceded by the rape. Diagnostic material was obtained in the 10th week of pregnancy by the use of transabdominal Chorionic Villous Sampling under the echo-guidance and its DNA feature was compared against the DNA material obtained from the vagina after the rape and the material from mother and her husband. The PCR technique revealed in chorionic villi the presence of allele that were present in material deriving from mother and her husband as well as no even single allele from the material of violator. Exclusion of violator as a father of the foetus effected in decision of continuing the pregnancy.

DNA Fingerprinting↗
PubMed2001

The influence of victim gender and sexual orientation on judgments of the victim in a depicted stranger rape.

This study investigated the impact of respondent gender, victim gender, and victim sexual orientation on judgments toward the victim of a depicted stranger rape. Respondents were required to read a scenario in which victim gender and sexual orientation varied between subjects, and to complete measures of behavioral blame, responsibility, and severity of the attack. Results revealed that male respondents made more anti-victim judgments than female respondents did. Male respondents judged gay male victims more negatively than they did other victims. Female respondents' judgments were pro-victim regardless of victim gender and victim sexual orientation. Results are discussed in relation to the feminist analysis of victim blame, and blame toward male rape victims. Implications for support services, particularly of male victims, are also considered.

Adolescent↗
PubMedDate not supplied

[Analysis of forensic-medical expert conclusions on rap and concealed rape (data from anonymous questionnaires)].

Specific features of modern cases of raping are analyzed on the basis of the data of forensic medical obstetrical and gynecological expert evaluations carried out in the Primorye territory. Age and risk groups are defined, health status of victims is characterized, and specific injuries of the body and genitals are described. Specific features of concealed sexual violations in Vladivostok are defined and the need in creation of rehabilitation centers for victims of raping is discussed.

Female↗
PubMed2003

Rape-law reform circa June 2002: has the pendulum swung too far?

This paper reviews court decisions determining the scope of liability for rape over the period 1998-2002. It finds many troubling signs that some courts, under some circumstances, are still wedded to the traditional (very strict) view of the kind of force necessary to support a charge of rape. There are, however, signs of encouraging progress: convictions in circumstances where even a decision to prosecute would have been unthinkable 20 years ago, and holdings that accept power, authority, or indirect intimidation as sufficient "force." Is it possible to go too far in this direction? And is there any reason to worry that this could actually happen in reality? The research identifies several areas in which this surprising possibility may be about to materialize, for example on the normatively and practically difficult question of the degree of intoxication or alcohol-induced willingness sufficient to invalidate consent.

Alcohol Drinking↗
PubMed2005

What really happened? A validation study of rape survivors' help-seeking experiences with the legal and medical systems.

Much of what is known about rape survivors' experiences with the legal and medical systems has come from victims' accounts; rarely have researchers collected "the other side of the story" to find out what system personnel say did or did not happen in these interactions. In the current study, rape survivors who sought emergency medical care were interviewed before their hospital discharge about what services they received and how they were treated by social system personnel. Corresponding accounts were then collected from doctors, nurses, and police officers. There was significant interrater reliability between the survivors and legal and medical system personnel regarding what services were or were not provided ("service delivery") and if system personnel engaged in "secondary victimization" behaviors (i.e., statements/actions that could be distressing to victims). However, police officers and doctors significantly underestimated the impact they were having on survivors. Victims reported significantly more post-system-contact distress than service providers thought they were experiencing.

Adult↗
PubMedDate not supplied

Accountability: a right of the rape victim.

Accountability by the professional is especially important in a crisis situation. Rape is experienced by victims as a life threatening situation and it thus triggers an acute stress reaction which requires them to go through a long-term reorganization process. As a crisis situation, it makes them hypersensitive to the attitudes of those people to whom they turn for help and assistance. Clients--in this case rape victims--benefit when professionals are careful to be accountable to them. The victim counselors defined and redefined their role to the victims through their work with the victim as well as explaninig the services they could provide. In reviewing the reactions of 146 victims to treatment by police, hospital, and counselors, one theme emerged again and again: clients want explanation from professionals about role expectations and about procedures that are to be done.

Adaptation, Psychological↗
PubMed1991

Victim blame and the disinhibition of sexual arousal to rape vignettes.

The present study examined the effects of differing levels of victim blame on the sexual arousal of males to rape vignettes. In the first experiment, a between-subjects experimental design was used to compare four groups of eight university males for their erectile responses to vignettes rated as low, medium, and high along a victim blame continuum. All groups found a consenting vignette more arousing than a nonconsenting vignette, however, this difference was significantly smaller for subjects in the high blame condition compared to the low and medium blame conditions. A second experiment supported the disinhibiting effect of the high victim blame manipulation using 12 university males in a within-subjects experimental design. The disinhibiting influence of victim blame on male sexual arousal to rape cues was discussed in relation to our broader understanding of sexual assault.

Adult↗
PubMed1991

Emergency management of the adult female rape victim.

Estimates are that one in every six women is raped during her lifetime. The family physician must be able to evaluate and treat the rape victim in the emergency setting. A detailed history, careful physical examination, collection of medical specimens for legal purposes, assessment of the patient's psychologic state, prophylaxis of venereal disease and pregnancy counseling are required.

Ambulatory Care↗
PubMed1990

Medicolegal findings among rape victims.

A survey was done of 249 female victims of alleged sexual offences (mostly rapes) examined at the Department of Forensic Medicine, University of Helsinki in 1978-1984. The judicial outcome of 150 cases of the same material examined in 1978-1981 (annual prevalence 7.8 in Helsinki) was related to the pattern of injuries and to the presence of spermatozoa. Review of medicolegal reports indicated that victims were often quite young, workers and students, who mostly had consumed alcohol and were taken by force by strange offenders often in a remote place, at night and at the weekend. In most cases the offender had used physical violence causing minor injuries to the victim. Apparently, physical injury is not an inevitable consequence of being raped. A vaginal intercourse had mostly occurred. However, spermatozoa were found in just under half the cases. An unconditional imprisonment (usually 0.5-2.5 years) and the withdrawal of the charge was the consequence in one-third of the cases, respectively. There was little correlation between judicial outcome and the severity of injuries and/or the presence of spermatozoa in vaginal samples. Results suggest that the offence should be reported to the authorities as soon as possible so that more medicolegal evidence can be obtained.

Adolescent↗
PubMed1977

The use and abuse of the rape treatment center.

The author acknowledges the fact that the new system of managing alleged rape victims via the RTC is superior to the former method. The RTC has performed very well, giving aid and succor to rape victims. However, it appears that the unit has attracted some individuals who are not completely truthful and have given fraudulent accounts to investigators. Methods have been suggested to screen out these persons.

Community Health Services↗