Community services for rape survivors: Enhancing psychological well-being or increasing trauma?

Abstract

This research examined how contact with the legal, medical, and mental health systems affects rape survivors' psychological well-being. Although community services may be beneficial for some victims, there is increasing evidence that they can add trauma, rather than alleviate distress (termed secondary victimization). This study examined how secondary victimization affects rape survivors' posttraumatic stress (PTS) symptoms. Adaptive and snowball sampling were used to recruit a sample of 102 rape survivors. Victims of nonstranger rape who received minimal assistance from either the legal or medical system, and encountered victim-blaming behaviors from system personnel, had significantly elevated levels of PTS. This high-risk group of rape survivors had PTS levels significantly higher than all other victims in this study, including those who did not seek community assistance postrape. However, for these high-risk rape survivors, receiving sustained mental health services after these negative experiences was associated with a significant decrease in PTS. "They were raking me over the coals, making me feel like a slug, making me feel guilty for doing all the actions I did that day, and treating me like I was the one who raped, the offender, not the victim."-A rape survivor on filing a police report "Worst experience ever. And it was because of the doctor. He was very rough. And he was saying, 'Open your legs. Stay still. Open them further.' I'm saying, 'Excuse me?' I feel like saying, 'I have just been raped!' He was just so crass, so rude about it. Really cold.. .. And then when he scraped [taking the vaginal swabs], I jumped, and he says, 'You gotta stay still!'"-A rape survivor on the medical rape exam "My therapist kept talking about my need for attention. How I made bad choices in life because of my need for attention. How I got myself raped for attention. Those words hurt as much as the rape itself."-A rape survivor on mental health counseling These rape survivors' narratives speak to the detrimental effect community services may have on women's psychological wellbeing. 1 To date, the rape victimology literature has focused primarily on assessing the prevalence of rape and its impact (

Predictors of PTSD symptom severity and social reactions in sexual assault victims

“…Layman, Gidycz, and Lynn's study of college women showed that acknowledged rape victims experienced more forceful assaults, resisted more, demonstrated clearer refusal to the attacker, and reported more PTSD symptoms (Layman et al, 1996). In a convenience sample of 102 communityresiding rape survivors (Campbell et al, 1999), neither victim demographics nor rape characteristics were associated with posttraumatic stress symptoms, but victims of known attackers who received few community services and experienced high secondary victimization postassault had more symptoms.Although the studies just reviewed have analyzed correlates of PTSD sequelae, few focused solely on adult female rape victims. Furthermore, none focused on characteristics of the recovery environment (e.g., support system responses), using a validated instrument, which also may be consequential for recovery (Ullman, 1999).…”

“…Reactions from others may either reinforce and compound the culture's victim-blaming attitudes toward rape victims (e.g., rape myths) or contradict this ideology by believing and supporting victims, and defining rape as a violent crime. Symonds (1980) has argued that "secondary victimization," which refers to the blame, disbelief, and stigmatizing responses that others make to victims, is commonly experienced by rape (Campbell et al, 1999;Davis, Brickman, & Baker, 1991;McAuslan & Abbey, 1998;Ullman, 1996a). Furthermore, some data suggest that social reactions may affect victim coping and subsequent recovery from sexual assault (Ullman, 1996a).…”

“…Symonds (1980) has argued that "secondary victimization," which refers to the blame, disbelief, and stigmatizing responses that others make to victims, is commonly experienced by rape victims. Although little research has focused on the survivor's recovery environment in relation to PTSD, several studies have shown that negative social reactions are related to more psychological symptoms and poorer self-rated recovery in sexual assault victims (Campbell et al, 1999;Davis, Brickman, & Baker, 1991;McAuslan & Abbey, 1998;Ullman, 1996a). Furthermore, some data suggest that social reactions may affect victim coping and subsequent recovery from sexual assault (Ullman, 1996a).…”

Should a Physician Comply with a Parent's Demands for a Forensic Exam on a 16-Year-Old Trauma Patient?

“…Responses to trauma survivors in the literature reveal that their experiences are relatively negative, both within the legal and medical systems [13][14][15]. Survivors often find that the criminal justice system has outcomes quite unfavorable to them; most sexual assault cases are never prosecuted, and, on average, in 12 percent of reported cases the offender is convicted [16].…”

Full Issue

“…The types of secondary victimisation are victim blaming, inappropriate language or conduct by the police, medical professionals and by other organisations that have access to the victim after their experience of crime. This conception of secondary victimisation is also evident in cases of female rape; it was found that many female rape victims feel as if the experience of seeking help from mental, medical, and legal health systems only exacerbates the trauma (Campbell et al, 1999). This study explored the link between posttraumatic stress symptoms (PTSS) and secondary victimisation.…”