Long-Term Effects of Conflict-Related Sexual Violence Compared with Non-Sexual War Trauma in Female World War II Survivors: A Matched Pairs Study

Abstract

The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.

Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women

“…(40) reported that sexual violence was associated with increased risk for lifetime PTSD and exposure to other traumas. Kuwert and colleagues (41) also reported that women exposed to conflict related sexual violence often exhibit more severe symptoms of PTSD than survivors of non-conflict sexual violence. Results of our univariate models showed an association between PTSD/CESD and sexual risk taking.…”

“…Previous studies have established an association between sexual violence, posttraumatic stress disorder and sexual risk taking (6–8, 37–41). Walsh et.…”

“…This is perhaps due to the effect of time since exposure and/or measurement error on the score including that genocidal rape survivors who now have low PTSD/CESD score in the past had more severe PTSD/CESD than other women who now have high PTSD/CESD scores. Kuwert and colleagues (41) have reported how different traumas are associated with posttraumatic sequelae in sexual assault victims. While this result may warrant further investigation, it also highlights the need to better understand and treat the effects of conflict-related sexual violence.…”

A Dual-Model of Posttraumatic Stress and Posttraumatic Growth in a Community Sample of Female Conflict-Related Sexual Violence Survivors from Bosnia & Herzegovina

“…On the basis of the literature outlined above (Brooks et al, 2018;Elderton et al, 2017;Kuwert et al, 2014), and the findings of our previous study (Anderson et al, 2019) a model of PTG was defined. The 6 core assumption is that the relationship between CRSV and PTG is mediated by psychosocial factors such as coping.…”

A Dual-Model of Posttraumatic Stress and Posttraumatic Growth in a Community Sample of Female Conflict-Related Sexual Violence Survivors from Bosnia & Herzegovina

“…This occurs particularly as a result of the difficulty in obtaining retrospective data in certain populations and a reliance on cross-sectional studies, and therefore an inability to make causal inferences (Cole & Lynn, 2010). Given the evidence, the most likely interaction is that events themselves do not result directly in PTG (Brooks et al, 2018), but individuals will respond to stress with a mixture of resiliencepromoting resources and vulnerability to mental illness (Kuwert et al, 2014; Shakespeare-Finch & Lurie-Beck, 2014)-a dual mechanism-rather than PTG falling on the 'adaptive' end of a single spectrum of post-trauma adjustment (Tedeschi & Calhoun,1996). This results in multiple indirect relationships between trauma, PTG and PTSD that may be impacted by psychosocial factors such as coping.…”