Women’s Health: Treating Survivors of Sexual Assault

2019 ◽  
Author(s):  
Elizabeth Schindler ◽  
Allison Cowan

Almost half of all women and almost a quarter of all men in the United States have experienced sexual violence in their lifetime. Treating individuals who have survived sexual assault can pose challenges for psychiatric and medical treatment. The rates of posttraumatic stress disorder (PTSD) are higher with sexual assault, and people with sexual trauma often feel stigmatized and have difficulty presenting for care. This chapter reviews epidemiology and neurobiology of sexual assault as well as the physical and psychological sequelae of sexual assault. Here, the authors review and propose practical treatment recommendations to assist in the treatment of individuals with a history of sexual assault. This review 5 figures, 5 tables, and 53 references. Key Words: posttraumatic stress disorder, rape recovery, sexual assault, treatment recommendations, women’s mental health, rape survivor treatment, rape

Partner Abuse ◽  
2016 ◽  
Vol 7 (1) ◽  
pp. 26-43 ◽  
Author(s):  
Amanda R. Levine ◽  
Patti A. Timmons Fritz

Intimate relationships involving psychological abuse, particularly those characterized by coercive control (CC), a pattern of behaviors aimed at gaining control over one’s romantic partner, have been associated with poorer mental health for victims than among victims of physical partner abuse alone (Johnson & Leone, 2005). This study investigated whether CC predicted posttraumatic stress disorder (PTSD) and depression above and beyond the effects of childhood maltreatment and frequency and severity of physical partner abuse among a sample of homeless women. This is the first known study to date to investigate the role of CC in the partner abuse experiences of homeless women. Fifty-one ethnically diverse women with a history of partner abuse victimization residing in a homeless shelter in Southwest Ontario, Canada, completed questionnaires assessing partner abuse, CC, depression, and PTSD. As predicted, CC was found to predict PTSD but not depression, after controlling for childhood maltreatment and frequency and severity of physical partner abuse. In addition, women exhibited very high rates of both PTSD and depression. The relation between CC and mental health of victims, particularly the development of PTSD, should be considered in partner abuse prevention programs and interventions. Furthermore, the high rates of psychopathology reported by the women indicate a great need for psychological aid among women residing in homeless shelters.


2018 ◽  
Vol 8 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Tanja Laukkala ◽  
Robert Bor ◽  
Bruce Budowle ◽  
Pooshan Navathe ◽  
Antti Sajantila ◽  
...  

Abstract. The National Transportation Safety Board (NTSB) database was searched to identify fatal accidents in aviation related to trauma and stressor-related disorders in the United States and the medical requirements of aviation authorities were assessed. Between 2000 and 2015, eight pilots with a diagnosis of posttraumatic stress disorder (PTSD; of which two were aviation-related PTSDs) died in aviation accidents. These results indicate a minimum frequency of history of diagnosed PTSD in aviation fatalities to be 8 out of 4,862 fatal accidents (0.16%) in the United States. The guidance from aviation regulatory authorities is to medically assess pilots with a prior history of PTSD based on individual functional impairment and treatment response. The assessment of individual impairment would be significantly improved by the systematic data collection following aviation- and work-related traumatic events. It is also important for investigators to recognize the traumatization that occurs in aviation accident and incident investigations.


2019 ◽  
Vol 149 (8) ◽  
pp. 1393-1403 ◽  
Author(s):  
Henry J Whittle ◽  
Lila A Sheira ◽  
William R Wolfe ◽  
Edward A Frongillo ◽  
Kartika Palar ◽  
...  

ABSTRACT Background Food insecurity, which disproportionately affects marginalized women in the United States, is associated with depressive symptoms. Few studies have examined relations of food insecurity with other mental health outcomes. Objective The aim of this study was to investigate the associations of food insecurity with symptoms of generalized anxiety disorder (GAD), stress, and posttraumatic stress disorder (PTSD) in the Women's Interagency HIV Study (WIHS), a prospective cohort study of women with or at risk of HIV in the United States. Methods Participants were 2553 women with or at risk of HIV, predominantly African American/black (71.6%). Structured questionnaires were conducted during April 2013–March 2016 every 6 mo. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. We measured longitudinal outcomes for GAD (GAD-7 score and a binary GAD-7 screener for moderate-to-severe GAD). Only cross-sectional data were available for outcomes measuring perceived stress (PSS-10 score) and PTSD (PCL-C score and a binary PCL-C screener for PTSD). We examined associations of FS with the outcomes through use of multivariable linear and logistic regression, including lagged associations with GAD outcomes. Results After adjusting for sociodemographic and health-related factors including HIV serostatus, current marginal, low, and very low FS were associated with increasingly higher GAD-7 scores, and with 1.41 (95% CI: 1.10, 1.80; P < 0.01), 2.03 (95% CI: 1.59, 2.61; P < 0.001), and 3.23 (95% CI: 2.43, 4.29; P < 0.001) times higher odds of screening positive for moderate-to-severe GAD, respectively. Low and very low FS at the previous visit (6 mo earlier) were independently associated with GAD outcomes at current visit. Associations of FS with PSS-10 and PCL-C scores exhibited similar dose-response relations. Very low FS was associated with 1.93 (95% CI: 1.15, 3.24; P < 0.05) times higher odds of screening positive for PTSD. Conclusions Food insecurity may be associated with a range of poor mental health outcomes among women in the United States with or at risk of HIV.


2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Viltė Daugirdaitė ◽  
Olga van den Akker ◽  
Satvinder Purewal

Objective. The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF).Methods. Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines.Results. Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss.Conclusions. This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.


2021 ◽  
pp. 002216782110236
Author(s):  
Julie B. Wang ◽  
Jessica Lin ◽  
Leah Bedrosian ◽  
Allison Coker ◽  
Ilsa Jerome ◽  
...  

Background: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition associated with serious adverse health outcomes and functional impairment. Previous MDMA–assisted therapy (MDMA-AT) studies have shown promising results in single site studies. Two open-label studies tested this modality in multisite clinical trials to assess the feasibility of scaling this manualized therapy across 14 North American sites. Method: Cotherapist dyads were trained in the manualized MDMA-AT protocol and administered three experimental sessions 3 to 5 weeks apart among participants with severe PTSD. Cotherapist dyads were provided clinical supervision and evaluated for protocol adherence by centralized raters. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) assessed change in symptoms severity. Results: Adherence rating scores were high across cotherapist dyads ( M = 95.08%, SD = 3.70%) and sites ( M = 95.23%, SD = 2.20%). CAPS-5 scores decreased following 3 MDMA-AT sessions at 18 weeks post baseline (Δ M = −29.99, Δ SD = 13.45, p < .0001, n = 37, Cohen’s d = 2.2, confidence interval [1.97, 2.47]). MDMA was well tolerated. Conclusions: These findings corroborate previous results that MDMA-AT can achieve significant improvements in PTSD symptom severity and demonstrate scalability of manualized therapy across clinic sites in the United States and Canada.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaru Chen ◽  
Xin Huang ◽  
Chengyuan Zhang ◽  
Yuanyuan An ◽  
Yiming Liang ◽  
...  

Abstract Background Coronavirus disease 2019 (COVID-19) has affected more than 5 million people around the world and killed more than 300,000 people; thus, it has become a global public health emergency. Our objective was to investigate the mental health of hospitalized patients diagnosed with COVID-19. Methods The PTSD checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Trauma Exposure Scale, abbreviated version of the Connor–Davidson Resilience Scale (CD-RISC-10), Perceived Social Support Scale (PSSS) and Demographic Questionnaire were used to examine posttraumatic stress disorder (PTSD), depression, anxiety, trauma exposure, resilience and perceived social support among 898 patients who were hospitalized after being diagnosed with COVID-19 in China. The data were analyzed with t tests, one-way ANOVA and multivariable logistic regression analysis. Results The results showed that the prevalence of PTSD, depression and anxiety was 13.2, 21.0 and 16.4%, respectively. Hospitalized patients who were more impacted by negative news reports, had greater exposure to traumatic experiences, and had lower levels of perceived social support reported higher PTSD, depression and anxiety. Conclusions Effective professional mental health services should be designed to support the psychological wellbeing of hospitalized patients, especially those who have severe disease, are strongly affected by negative news and have high levels of exposure to trauma.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joviana Quintes Avanci ◽  
Fernanda Serpeloni ◽  
Thiago Pires de Oliveira ◽  
Simone Gonçalves de Assis

Abstract Background The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated. Methods Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. The data were grouped in blocks regarding sociodemographic, individual, family, and community variables. For statistical analysis, chi-square, Fisher’s exact test, and logistic regression were performed. Results The PTSD prevalence was 7.8% among adolescents. Boys were exposed to significantly higher number of events of community violence, while girls to family violence. The adjusted odds ratio (OR) for PTSD were statistically significant for age (OR, 1.45, [95% CI, 1.043–2.007]), social functional impairment (OR, 4.82, [95% CI, 1.77–13.10]), severe maternal physical violence (OR, 2.79, [95% CI, 0.79–9.93]), psychological violence by significant people (OR, 3.96, [95% CI, 1.89–8.31]) and a high number of episodes of community violence (OR, 3.52, [95% CI, 1.47–8.40). Conclusions There was a high prevalence of PTSD within this population associated with exposure to violence. Not only physical, but also psychological violence contributed to PTSD. The results also raise awareness to the differences in life trajectories between boys and girls regarding violence. These differences need to be better understood in order to enable the development of effective preventative interventions. Treating and preventing mental health disorders presents a challenge for countries, especially those with a lower degree of social and economic development and high community violence.


2019 ◽  
pp. 088626051986008
Author(s):  
Janice Du Mont ◽  
Holly Johnson ◽  
Cassandra Hill

There is a dearth of information about the association of victim-related and assailant-related characteristics and posttraumatic stress disorder (PTSD) among sexually assaulted women. Recently, Statistics Canada included items measuring the possible presence of PTSD symptoms in their 2014 nationally representative General Social Survey on Victimization (GSS-V), for the purpose of improving the understanding of mental health impacts associated with sexual victimization. The present study used the GSS-V to examine the association of sociodemographic, health, and assailant characteristics and prior traumatic experiences in the form of physical or sexual dating violence, physical assault, stalking, childhood abuse, and witnessing of violence between parents with PTSD symptomology among sexually assaulted women. Among 319 women who reported experiencing at least one incident of sexual assault in the 12 months prior to the survey, 68.6% had experienced at least one negative emotional impact as a result, among whom, 43.6% reported past-month PTSD symptoms. Logistic regression modeling revealed that prior traumatic events in the form of physical or sexual dating violence, stalking, and having witnessed violence between parents were associated with higher odds of experiencing PTSD symptoms, as was having been sexually assaulted by a known assailant. In contrast, the odds of experiencing PTSD symptoms was lower for Aboriginal or visible minority women. The results suggest that PTSD symptoms in the near aftermath of sexual victimization are common, and there are a range of factors that contribute to the likelihood of developing these symptoms. Implications for future research are discussed.


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