Rape Trauma Syndrome

Researchers Burgess and Holmstrom (1974) coined the term rape trauma syndrome (RTS), which describes the effects of rape. RTS is a two-stage stress response pattern characterized by physical, psychological, behavioral, and/or sexual problems, and it oc­curs after forced, nonconsenting sexual activity. Although not all victims respond to rape in the same manner, what follows is a description of what typically occurs.

During the first stage of RTS, the acute phase, most victims fear being alone, strangers, or even their bedroom or their car if that is where the rape took place. Other emotional reactions to rape include anger (at the assailant, the rape, healthcare work­ers, family, one’s self, court), anxiety, depression, confusion, shock, disbelief, incoher­ence, guilt, humiliation, shame, and self-blame (Frazier, 2000). A victim may also expe­rience wide mood fluctuations. Difficulties with sleeping, including recurrent nightmares, are common. This phase begins immediately following the assault, may last from days to weeks, and involves several stress-related symptoms. A man or woman who has been raped may also experience post-traumatic stress disorder (PTSD).

The majority of victims eventually talk to someone about the rape (B. S. Fisher et al., 2003). However, in one study, half of the women who were raped waited years be­fore telling anyone (Monroe et al., 2005). Most of the time a victim will talk to friends

or family members rather than to the police. Younger victims are more likely to tell someone than older victims, perhaps because older victims blame them­selves more for the rape and may fear that others, too, will blame them. Some victims initially tell someone right after the rape and then, because of negative reactions from support persons, halt their disclosure and never mention it again (Ahrens, 2002).

Depression often follows a rape, and some victims report still feeling de­pressed 8 to 12 months postrape. Women who have been raped are more likely to experience depression than women who never experience sexual abuse (Cheasty et al., 2002). Several factors have been found to be related to the de­velopment of a significant depression after a rape, including having a history of prior psychological problems or prior victimization and a tendency to self-blame (Frazier, 2000).

Sometimes depressive feelings are so severe that victims’ thoughts turn to suicide. In fact, research has found an association between rape and attempted suicide (Bridgeland et al., 2001). Poverty, prior depression, and prior sexual as­saults also increase feelings of depression, anxiety, and overall problems associ­ated with the rape (Cheasty et al., 2002).

Emotional reactions also vary depending on whether or not the victim knew his or her assailant. Women who report being raped by strangers experience more anxiety, fear, and startle responses, whereas those raped by acquaintances usually report more depression and guilt and a decrease in self-confidence (Sorenson & Brown, 1990). A woman who knew her assailant may have initially trusted him and agreed to be with him, and so after the rape she may wonder how she could have had such bad judgment, why she did not see it coming, and she may feel a sense of betrayal (see the accompanying Personal Voices, “Acquaintance Rape”).

There are also many physical symptoms experienced by men and women who have been raped. Some of these include general body soreness, bruises, difficulties with swallowing and throat soreness if there was forced oral sex (in women), genital itching or burning, rectal bleeding and/or pain, STI symptoms, and eating dis­orders. In women, the emotional stress of the rape may also cause menstrual irregulari­ties. However, some of these symptoms (nausea and menstrual irregularities) are also signs of pregnancy, which is why a pregnancy test is of utmost importance after a vic­tim has been raped.

Recent research reveals that there is a higher incidence of pregnancy in women who have been raped than in women who engage in consensual unprotected sexual inter­course (Gottschall & Gottschall, 2003). We do know that women who are in prime fer­tile ages are overrepresented in rape victim statistics. This, in conjunction with the fact that women who are ovulating may be more physically attractive to rapists, may con­tribute to the higher pregnancy rates (Gottschall & Gottschall, 2003; the hormones in­volved in ovulation, which we discussed in Chapter 4, often make a woman appear more attractive). A young, healthy woman will have a higher chance of pregnancy than an older woman. Many rape victims are also concerned about the risk of acquiring HIV from their assailants (Salholz et al., 1990).

Long-term reorganization, stage two of RTS, involves restoring order in the victim’s lifestyle and reestablishing control. Many victims report that changing some aspect of their lives, such as changing their address or phone number, helped them to gain con­trol. Symptoms from both stages can persist for 1 to 2 years after the rape (Nadelson et al., 1982), although Burgess and Holmstrom (1979) found that 74% of rape victims re­covered within 5 years. Recovery is affected by the amount and quality of care that the victim received after the rape. Positive crisis intervention and the support of others de­crease the symptoms of the trauma.

In the past, many researchers have argued that rape is a violent crime, not a sex­ual one. “Desexualizing” rape, or taking the sexual aspect out of it, has deemphasized postrape sexual concerns (Wakelin, 2003). Rape is indeed both a violent and a sex­ual crime, and the majority of victims report experiencing sexual problems postrape, even though these problems may not be lifelong (Becker et al., 1986; Holmstrom & Burgess, 1978).