Skip to main navigation menu Skip to main content Skip to site footer

Research Article

Vol. 9 No. 2 (2006)

Sexual assault and posttraumatic stress disorder: A review of the biological, psychological and sociological factors and treatments

  • Kaitlin A. Chivers-Wilson
DOI
https://doi.org/10.26443/mjm.v9i2.663
Submitted
November 8, 2020
Published
2020-12-01

Abstract

Sexual assault occurs with alarming frequency in Canada. The prevalence of Posttraumatic Stress Disorder (PTSD) in assault survivors is drastically higher than the national prevalence of the disorder, which is a strong indication that the current therapies for sexual- assault-related PTSD are in need of improvement. Increasing knowledge and understanding of the pathologies associated with rape trauma in biological, psychological and sociological domains will help to develop more effective treatments for survivors. A dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis is observed in survivors of sexual assault and this may be a fundamental cause of the structural and functional abnormalities contributing to PTSD symptoms. Pharmacotherapies are available to treat PTSD; however, they are often inadequate or unwanted by the survivor. Psychological health is compromised following interpersonal trauma and many psychological therapies are available, but with varying efficacy. A person's cognitions have a dramatic effect on the onset, severity, and progress of PTSD following sexual assault. Sociological impacts of assault influence the development of PTSD through victim-blaming attitudes and the perpetuation of rape myths. Perceived positive regard and early social support is shown to be important to successful recovery. Education is vital in rape prevention and to foster a supportive environment for survivors. The biological, psychological and sociological impacts and treatments should not remain mutually exclusive. A better appreciation of the biopsychosocial repercussions of sexual assault will aid in developing a more holistic and individualized therapy to help alleviate the physical and emotional pain following the trauma of rape.

References

  1. Canadian Federation of Students. No Means No - Facts about Date Rape/Drug Rape. Canadian Federation of Students 1999 Fact Sheet, 6(2) Retrieved March 26, 2005, from http://www.cfs-fcee.ca/html/english/research/factsheets/fs-6(2)-nmn.pdf; 1999.
  2. Rose, DS. Worse than Death: Psychodynamics of Rape Victims and the Need for Psychotherapy. The American Journal of Psychiatry 1986; 43(7): 817-824.
  3. LoVerso, T. Survey of Unwanted Sexual Experience among University of Alberta Students. Retrieved March 26, 2005 from http://www.uofaweb.ualberta.ca/sac/nav01.cfm?nav01=27459; 2001.
  4. Matsakis, A. I Can't Get Over It: Handbook for Trauma Aurvivors. Oakland, California: New Harbinger Publications; 1996.
  5. Dunmore E, Clark DM, Ehlers A. Cognitive Factors Involved in the Onset and Maintenance of Post Traumatic Stress Disorder (PTSD) after Physical or Sexual Assault. Behaviour Research and Therapy 1999; 37: 809-829.
  6. Brunello N, Davidson JRT, Deahl M, Kessler RC, Mendlewicz J, Racagni G et al. Posttraumatic Stress Disorder: Diagnosis and Epidemiology, Comorbidity and Social Consequences, Biology and Treatment. Neuropsychobiology 2001; 43: 150-162.
  7. Butcher JN, Mineka S, Hooley JM. Abnormal Psychology 12th Edition. Boston, MA: Allyn and Bacon; 2004.
  8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.). Washington, DC: American Psychiatric Association; 2000.
  9. National Center for Post Traumatic Stress Disorder. Epidemiological Facts About PTSD - A National Center for PTSD Fact Sheet. Retrieved April 1, 2005 from http://www.ncptsd.va.gov/facts/general/fs_epidemiological.html; 2005.
  10. Creamer M, Burgess P, McFarlane AC. Post-traumatic stressdisorder: Findings from the Australian National Survey of Mental Health and Well-being. Psychol. Med 2001; 31(7): 1237-1247.
  11. Nutt JD. The Psychobiology of Post Traumatic Stress Disorder. J Clin Psychiatry 2000; 61(5): 24-29.
  12. Gold PW, Goodwin FK, Chrousos GP. Clinical and Biochemical Manifestations of Depression: Relation to the Neurobiology of Stress, Part II. N Engl J Med 319: 412-420; 1988.
  13. Tizabi Y, Aguilera G, Gilad GM. Age Related Reduction in Pituitary Corticotrophin Releasing Hormone Receptors in Two Rat Strains. Neurobiol Aging 1992; 13: 227-230.
  14. Perry BD, Pollard RA, Blakley TL, Baker WL, Vigilante D. Development of the Brain: How States Become Traits. Infant Mental Health Journal, July 25. Retrieved December 8, 2005 from http://www.trauma-pages.com/perry96.htm; 1995.
  15. Davidson J, Glover V, Clow A, Kudler H, Meador K, & Sandler M. Tribulin in Posttraumatic Stress Disorder. Psychol Med 1988; 18(4): 833-836.
  16. VanVoorhees E, Scarpa A. The Effects of Child Maltreatment on the Hypothalamic-Pituitary-Adrenal Axis. Trauma, Violence and Abuse 2004; 5(4): 333-352.
  17. Maren S. LTP in the Amygdala: a Mechanism for Emotional Learning & Memory. Trends in Neurosciences 1999; 22: 561-567.
  18. Bremner JD, Vermetten E. Neuroanatomical Changes Associated with Pharmacotherapy in Posttraumatic Stress Disorder. Ann NY Acad Sci 2004; 1032: 154-157.
  19. Harmon RJ, Riggs PD. Clonidine for Posttraumatic Stress Disorder in Preschool Children. J Am Acad Child Adolesc Psychiatry 1996; 35: 1247-1249.
  20. Boscarino, JA. Posttraumatic Stress Disorder and Physical Illness: Results from Clinical and Epidemiological Studies. Ann NY Acad Sci 2004; 1032: 141-153.
  21. Tucker P, Ruwe WD, Masters B, Parker DE, Hossain A, Trautman RP, Wyatt DB. Neuroimmune and Cortisol Changes in Selective Serotonin Reuptake Inhibitor and Placebo Treatment of Chronic Posttraumatic Stress Disorder. Biol Psychiatry 2004; 56: 121-128.
  22. Rinne T, de Kloet ER, Wouters L, Geokoop JG, de Rijk RH, van den Brink W. Fluvoxamine Reduces Responsiveness of HPA Axis in Adult Female BPD Patients with a History of Sustained Childhood Abuse. Neuropsychopharmacology 2003; 28: 126-132.
  23. Davidson JRT. Pharmacotherapy of Posttraumatic Stress Disorder: Treatment Options, Long-Term follow-Up, and Predictors of Outcome. J Clin Psychiatry 2002; 61(5): 52-56.
  24. Solomon SD, Gerrity ET, Muff AM. Efficacy of Treatments for Posttraumatic Stress Disorder. JAMA 1992; 268: 633-638.
  25. Rivier C, Rivier J, Vale W. Stress Induced Inhibition of Reproductive Functions: Role of Endogenous Corticotrophin Releasing Factor. Science 1986; 231: 607-609.
  26. Berga SL, Daniels TL, Gules DE. Women with Functional Hypothalamic Amenorrhea but not Other Forms of Anovulation Display Amplified Cortisol Concentrations. Fertil Steril 1997; 67: 1024-1030.
  27. Volunteer Training Manual. Sexual Assault Centre of Edmonton. Edmonton, AB; 1999.
  28. Koss MP, Figuerdo AJ. Change in Cognitive Mediators of Rape's Impact on Psychosocial Health Across 2 Years of Recovery. Journal of Consulting and Clinical Psychology 2004; 72(6): 1063-1072.
  29. Brewin CR, Dalgleish T, Joseph S. A Dual Representation Theory of Posttraumatic Stress Disorder. Psychological Review 1996; 103: 670-686.
  30. Frazier PA. Perceived Control and Distress Following Sexual Assault: A Longitudinal Test of a New Model. Journal of Personality and Social Psychology 2003; 84(6): 1257-1269.
  31. Girelli SA, Resick PA, Marhoefer-Dvorak S, Hutter CK. Subjective Distress and Violence During Rape: Their Effects on Long-Term Fear. Violence and Victims 1986; 1: 35-45.
  32. Resnick H, Acierno R, Holmes M, Kilpatrick DG, Jager N. Prevention of Post-Rape Psychopathology: Preliminary Findings of a Controlled Acute Rape Treatment Study. Journal of Anxiety Disorders 1999; 13(4): 359-370.
  33. Capital Health. Sexual Assault Response Team. Community Sector Pamphlet, March 2004; 2004.
  34. Shapiro F. EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books; 2002.
  35. Foe EB, Steketee G, and Rothbaum B. Behavioural/Cognitive Conceptualizations of Posttraumatic Stress Disorder. Behaviour Therapy 1989; 20:155-176.
  36. Rothbaum BO. A Controlled Study of Eye Movement Desensitization and Reprocessing in the Treatment of Posttraumatic Stress Disordered Sexual Assault Victims. Bulletin of the Menninger Clinic 1997; 61(3): 317-334.
  37. British Crime Survey. Rape and Sexual Assault of Women: Findings from the British Crime Survey. Home Office Research Study 159:1-6 Retreived April 3 2005 from http://www.homeoffice.gov.uk/rds/pdfs2/r159.pdf; 2002.
  38. Cuijpers P, Van Straten A, Smit, F. Preventing the Incidence of New Cases of Mental Disorders: a Meta-Analytic Review. J Nerv Ment Dis 2005; 193: 119-125.
  39. Zoellner LA, Feeny NC, Cochran B, Pruitt L. Treatment Choice for PTSD. Behaviour Research and Therapy 41:879-886; 2003.
  40. Burt MR. Cultural Myths and Supports for Rape. Journal of Personality and Social Psychology 1980; 38: 217-230.
  41. Breitenbecher KH, Scarce M. An Evaluation of the Effectiveness of a Sexual Assault Education Program Focusing on Psychological Barriers to Resistance. Journal of Interpersonal Violence 2001; 16(5): 387-407.
  42. Campbell R, Barnes HE, Ahrens CE, Wasco SM, Zaragoza-Diesfeld Y, and Sefl T. Community Services for Rape Survivors Enhancing Psychological Well-Being or Increasing Trauma? Journal of Consulting and Clinical Psychology 1999; 67(6):847-858.
  43. Campbell R, Wasco SM, Ahrens CE, Sefl T, Barnes HE. Preventing the "Second Rape": Rape Survivors' Experiences with Community Services Providers. Journal of interpersonal violence 2001; 16(12): 1239-1259.

Downloads

Download data is not yet available.