Neurobiology of Sexual Assault and Osteopathic Considerations for Trauma-Informed Care and Practice

Abstract

Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and emotional health. Sexual assault is associated with gastrointestinal, neurologic, and reproductive symptoms, as well as obesity, diabetes, and chronic pain. With 1 in 3 women and 1 in 6 men experiencing some form of unwanted sexual violence in their lifetime, sexual assault is a significant public health problem that necessitates attention in the medical community. This review discusses relevant literature on the neurobiologic changes that occur as a consequence of sexual assault, such as how the brain responds during a traumatic experience and the impact of trauma on memory. Osteopathic considerations for trauma-informed care and practice and how all physicians can better serve patients with a history of sexual assault are also discussed.

Sexual Violence, Mental Health, and Prescription Opioid Use and Misuse

“…Importantly, these efforts need to be carefully balanced against the risk of unfairly stigmatizing medically necessary prescription opioid use. The results also highlight the need for a trauma-informed approach to care and treatment 40 among those prescribed opioids or receiving opioid use disorder treatment and emphasize the importance of primary prevention efforts to reduce the occurrence of sexual violence and opioid-related harms. 37 Limitations Several limitations are worth noting.…”

A Trauma-Informed Approach to Sexual Violence Research Ethics and Open Science

“…This issue highlights potential tensions between trauma research and trauma-informed practices. Trauma affects multiple brain–body systems, and neuroendocrine and limbic system dysregulation immediately postassault can make it challenging for victims to process complex information and make decisions (Arnsten, 2009; Baldwin, 2013; Cuevas, Balbo, Duval, & Beverly, 2018; Diamond, Campbell, Park, Halonen, & Zoladz, 2007; Kozlowska, Walker, McLean, & Carrive, 2015; Southwick, Rasmusson, Barron, & Arnsten, 2005). In addition, some postassault services, such as medical forensic exams, require that victims answer an immense number of questions, so is asking victims even more questions in that moment for the sake of research consistent with trauma-informed practice?…”

Health care utilization by women sexual assault survivors after emergency care: Results of a multisite prospective study

“…The frequent lack of reporting of recent sexual assault to providers due to shame, embarrassment, or fear of being judged is an important issue, as the majority of office health care visits in the US are at primary care clinics rather and specialty mental health visits are rare (Rui & Kang, 2020). These findings highlight the urgent need for further work to identify and implement universal screening practices and practices that make the clinic a safe and supportive space for disclosure (Cuevas et al, 2018), such as including embedded mental health professionals (Fedynich et al, 2019).…”