Introduction
Sexual can be defined as physical force or coerced penetration of genital or anal openings or any part of the victim’s body with any object, such as a bottle, a sexual organ, or any other body part. There are different types of rape, including attempted rape, where the offender attempts to rape the victim, and gang rape, where more than one offenders rape a victim. There is also marital rape, where sexual activities or intercourse is forced knowingly against a woman’s will by her husband. The invasion is usually done by force or threat of coercion or intimidation, including that caused by duress, detention, fear of violence, abuse of power, and psychological oppression against another person. It can also be against an individual unable to offer genuine consent and happen by taking advantage of the coercive environment.
There are different legislations between and within counties concerning events or activities that qualify as sexual assault. In the United Kingdom, for instance, sexual assault is based on touching without permission. Also, in Canada, the Supreme Court considered sexual assault as an act that does not solely rely on contact with any particular human anatomy part but is somewhat a sexual nature act that abuses the sexual integrity of an individual. According to NCVS, there are about 463,634 rape and sexual assault victims aged 12 years and above every year in the United States on average. The National Crime Victimization Survey (NCVS) reported 298,410 rape victims at a rate of 0.20 per 1,000 individuals 12 years and above in 2016, 393,980 victims at a rate of 1.4 in 2017, and 734 630 victims at a rate of 2.7 in 2018 (U.S. Department of Justice, 2021). In 2019 and 2020, NCVS reported 459,310 at a rate of 1.7 and 319,950 at a rate of 1.2 per 1,000 individuals, respectively (U.S. Department of Justice, 2021).
The Psychological and Emotional Impacts of Sexual Violence
Snipes et al. (2015) investigated the theoretical framework of explicit power-sex beliefs on Post-traumatic stress disorder (PTSD) symptoms. From their results, 19.7 % of women and 9.7% of men reported having a history of rape. They found a record of rape victimization to be positively related to Post-traumatic stress disorder (PTSD) symptoms. Compared to women, men had relatively higher explicit power-sex beliefs, and women had greater re-experiencing of PTSD disorders compared to men. However, they did not observe any gender differences in PTSD-associated arousal and avoidance as composite PTSD scores were marginally higher in women than in men. Their findings suggested that conscious beliconsensual sex fundamentally involves power partly accounted for the gravity of Post-traumatic stress disorder symptoms after rape. However, they also had limitations towards their study where they could not determine if explicit power-sex beliefs existed before trauma or if they grew or advanced because of the trauma due to the cross-sectional nature of their data. They were also not able to determine if PTSD symptoms impact power-sex beliefs in a person’s life.
Snipes et al. (2015) suggested two theoretical pathways to the relations between explicit power-sex beliefs, rape and PTSD might exist. First, some victims likely relate sex with power since they were sexually assaulted. A victim might internalize that sex is overtly related with a power differential where their responses to the Explicit Power-Sex Measure may mirror distorted sex thoughts (Guerra et al., 2018). In contrast, some rape victims may have espoused high explicit power-sex beliefs before victimization. These people may have had the proclivity for participating in risky sexual behaviors, which can lead to the possibility of sexual victimization. Additionally, their results suggested that explicit power-sex beliefs are one aspect of the cognitive process that necessitates exploration in association with the victim’s PTSD symptoms irrespective of how clear power-sex beliefs develop.
Chaudhury (2017) reviewed the psychological rape aspects and its impacts or consequences such as depression, sleep disorders, posttraumatic stress disorder, rape trauma syndrome, and anxiety. The primary finding was that women who experienced violent or coercive behaviors or reproductive control without experiencing sexual assault as well had significantly higher PTSD and anxiety scores compared to those that experienced no sexual violence. The mean anxiety scores were very similar to women that had been sexually assaulted, and the mean posttraumatic stress disorder score was over the suggested diagnostic threshold for a sample of primary care (Chaudhury, 2017). Reaching statistical significance recommends that the relationship between poor mental health and these behaviors is strong given the small number of women in every group. Health professionals and general practitioners responding to women ought to explore past experiences of reproductive control in addition to sexual assault and rape as a likely factor in unexplained health symptoms such as anxiety and PTSD. The study also enlightened on the relationship between the identity of the offender and mental health of women.
Chaudhury (2017) and Rahill et al. (2015) found that women assaulted by their spouses assaulted had higher mean PTSD compared to ones assaulted by a stranger and higher mean depressions compared to ones assaulted by a known member such as a relative or friend. This agrees with the theory that sexual violence done by a spouse has specifically severe impacts on mental health. This is because of the increased fear level for personal safety that the majority of women go through while living with the offender or breach of trust and sense of humiliation they undergo. Sexual violence by a spouse is mostly assumed to be less serious compared to one done by a stranger. They also encountered limitations in their study where they were not able to capture data relating to the frequency of experiences of sexual violence and other non-sexual traumas in an attempt to make the survey brief. Therefore, instead of reporting a casual association between women’s mental health and sexual violence, they only reported associations.
Sexual assault in women is rarely discussed despite being a reality. In most cases, sexual violence is not reported because of the close relationships between victims and the perpetrators (Rai & Rai, 2020). For instance, if a girl had been sexually assaulted by relatives such as an uncle or a brother-in-law beyond any suspicion, the family opts not to expose the incidents since it would destroy the family honor and victim’s image (Nikulina et al., 2016; Kline et al., 2018). As a result, this leads to a significant impact on developing mental health disorders later in life. Rai and Rai (2020) also found society inactive towards the sexual violence offenders and very lenient on mental disorder patients. This was primarily because society was not aware of the relation of sexual violence with mental health disorders and its role. Some women were already depressed prior to marriage because of a past traumatic event hence are scared to have sexual intercourse resulting in being sexually violated by their spouses or husbands (Brown et al., 2014). Mentally disordered women experiencing sexual violence suffer more due to inadequate mental health services.
Mbalo et al. (2017) conducted a study to determine the relationship of characteristics of rape, socio-demographic factors, and social support to the development of PTSD and depression among females six months post-rape. Generally, their study supported the view that rape victims experienced an increased chance of developing depression and PTSD symptoms. Their results indicated that the development of PTSD and depression was strongly related to unemployment and socio-demographic context of marital status as hypothesized. Married female rape survivors have a considerably lower mean score of symptoms of depression and PTSD than unmarried ones (Guerra et al., 2018). This shows that support and empathy from intimate partners of rape victims significantly decrease symptoms of depression and PTSD. Mbalo et al. (2017) second finding was associated with employment status where unemployed female rape victims showed symptoms of depression after rape. They indicated that it is likely that sexual assault may mirror a cumulative impact in increasing the chance of developing depression symptoms among unemployed female victims. Also, the psychological response to rape victimization was differentiated across the regions in their study as they thought. This is because compared to other areas, they observed regional differences in depression symptoms and PTSD, with female rape survivors in KwaZulu –Natal province reporting more depression symptoms and PTSD. This could be because more female rape victims in the province reported a history of child sexual abuse (Simon et al., 2016). Mbalo et al. (2017) findings also suggests that an increased level of depression and PTSD could be due to exposure to several traumatic events in the neighboring environments. Additionally, female rape survivors reported being unemployed and having the lowest levels of education, suggesting that increased susceptibility to stress and depression after rape can be due to exposure to poverty. Their findings further highlighted the significance of where the rape happened as a potential predictor of depression symptoms.
Potential Interventions
Artime and Buchholz (2016) conducted a study to determine the nature of sexual assault services at University Counseling Centers (UCCs) in response to the national pressure to improve campus responses to sexual assault survivors. They found out that all participants reported that their University Counseling Center offers some form of service to sexual assault survivors. Still, a fifth of University Counseling Centers refers victims to off-campus counseling services. In accordance with the responses received by respondents, a majority of UCCs offer acute ongoing services due to the occurrence of rape.
Their results also indicated that UCCs implement a wide range of medical and mental health professionals for sexual violence services. As a result, such interdisciplinary services are possibly associated with many challenges and benefits exceptional to the campus setting (Stepleton et al., 2019). Providers considered supportive counseling as the most efficient treatment for sexual assault victims. Other treatments such as Eye Movement Desensitization and Reprocessing Therapy, trauma-focused cognitive-behavioral interventions, and Cognitive Processing Therapy were rated to be moderately efficient on average in spite of being the recommended interventions (Hancock et al., 2014). Majority of UCC clinicians provide to victims of sexual assault that do not meet the PTSD criteria or may perceive supportive counseling as applicable for early instead of more structured conventions. Psychological First Aid had the second-highest ratings, which may have been unique due to the small sample of respondents in their study. Furthermore, participants had high ratings on group treatments interventions for sexually assaulted survivors. There are several types of group treatments where some of which use evidence-based approaches such as Cognitive Processing Therapy in group setup that can be used in UCCs with solid group programs. They may also empower UCCs to overcome resource limitations since one or more mental health professionals can give services to multiple clients.
Miller et al. (2015) conducted a study to determine the efficiency of a brief video-based intervention that provides modeling and psychoeducation of coping approaches to victims at the time of a sexual assault. Their results indicated positive results associated with a brief instructional Video Intervention (VI) and psychoeducation immediately after medical examination to victims of recent sexual violence. As State-Trait Anxiety Inventory (STAI) reduced with time in both groups, women allocated to Video Intervention reported fewer state symptoms of anxiety two weeks and two months past their sexual assault irrespective of history of assault. Additionally, women that were allocated to the video intervention and reported no history of sexual assault reported considerably fewer PTSD symptoms at the two-week follow-up than the other groups. Differences may associate with utilizing only the psychoeducational video component (Miller et al., 2015). They also indicated that some of the examination preparation content may have been considered validating to women with an assault history. As a result, those women may have had a negative experience or care for a particular assault or increased anxiety surrounding health care. Therefore, examination preparation modeling and information, as well as supportive messages incorporated as part of the initial component of the video, may be specifically beneficial for and unlikely to enhance anxiety in women who have experienced sexual assault already.
Conclusion
From the U.S. Department of Justice statistics, rape is a significant issue that affects most people. It leads to various psychological and emotional problems for its victims. Various researchers have focused on understanding the psychological and emotional effects of sexual violence, while others have focused on understanding suitable interventions. One of the significant psychological effects of rape is PTSD. This Psychological defect has been identified to be highly associated with females as they are the ones that are mostly affected by the cases of rape. The level of PTSD also varies with the victim, as individuals who were raped by people close to them have a higher level of PTSD than those assaulted by strangers. These individuals experience these high levels because they experience increased fear as the person who violated them maybe their family member or spouse. There are situations where the family plays a significant role in promoting the emotional problem. This occurs when the family is involved in covering the sexual asset of their family member in the name of honor. The level of psychological effects on the rape victim is also dependent on the economic outline of a person.
Individuals who are unemployed have a higher chance of being impacted by depression and stress after being sexually assaulted. However, various interventions are significant in helping victims of sexual violence. Counselling centres have a significant impact on lowering PTSD. This is because the victims can interact with the counsellor and speak about the issue that affects them as they get counselled, promoting emotional strength. Instructional video intervention is crucial in helping sexual violence victims. The instructional video places the victim into an environment that reduces stress and those who get triggered by the healthcare surrounding. Other significant interventions include trauma-focused cognitive-behavioral intervention, cognitive processing intervention, and reprocessing therapy.
References
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