Prevalence and risk of psychiatric disorders as a function of variant rape histories: results from a national survey of women

Abstract

Purpose Rape is an established risk factor for mental health disorders, such as posttraumatic stress disorder (PTSD), major depressive episodes (MDE), and substance use disorders. The majority of studies have not differentiated substance-involved rape or examined comorbid diagnoses among victims. Therefore, the aim of the present study was to estimate the prevalence of common trauma-related psychiatric disorders (and their comorbidity) in a national sample of women, with an emphasis on distinguishing between rape tactics. A secondary objective was to estimate the risk for psychiatric disorders among victims of variant rape tactics, in comparison to non-victims. Methods A nationally representative population-based sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18–86 years) participated in a structured telephone interview assessing rape history and DSM-IV criteria for PTSD, MDE, alcohol abuse (AA), and drug abuse (DA). Descriptive statistics and multivariate logistic regression analyses were employed. Results Women with rape histories involving both substance facilitation and forcible tactics reported the highest current prevalence of PTSD (36%), MDE (36%), and AA (20%). Multivariate models demonstrated that this victim group was also at highest risk for psychiatric disorders, after controlling for demographics and childhood and multiple victimization history. Women with substance-facilitated rapes reported higher prevalence of substance abuse in comparison to women with forcible rape histories. Comorbidity between PTSD and other psychiatric disorders was higher among rape victims in comparison to non-rape victims. Conclusions Researchers and clinicians should assess substance-facilitated rape tactics and attend to comorbidity among rape victims. Empirically supported treatments are needed to address the complex presentations observed among women with variant rape histories.

Predicting Risky Sexual Behavior in Emerging Adulthood: Examination of a Moderated Mediation Model Among Child Sexual Abuse and Adult Sexual Assault Victims

“…In contrast, women who had not been sexually victimized and CSA victims reported similarly low levels of this risk behavior. Among college students, heavy and hazardous drinking are associated with elevated risk of experiencing ASA, and most college ASA victims report drinking or being incapacitated because of substance use during the victimization (Littleton, Grills-Taquechel, & Axsom, 2009;Messman-Moore, Coates, Gaffey, & Johnson, 2008;Testa et al, 2007;Zinzow et al, 2012). Thus, one possible explanation for this finding is that college women who are victims of ASA are more likely than non-victimized women to engage in problematic alcohol use in general.…”

“…Childhood sexual abuse (CSA), most often defined as unwanted sexual contact or intercourse that occurs between a child and an older individual (often a family member or individual in a caretaking role such as a physician, babysitter, or teacher; Bulik, Prescott, & Kendler, 2001;van Roode, Dickson, Herbison, & Paul, 2009), and adolescent/adult sexual assault (ASA), most often defined as sexual acts obtained by threat, force, or against someone who is not capable of consenting (such as because of incapacitation following substance use; Zinzow et al, 2012), have repeatedly been associated with negative mental health outcomes. Outcomes that consistently have been found to be associated with sexual victimization include depression, anxiety, posttraumatic stress disorder (PTSD), and substance use disorders (Bulik et al, 2001;Danielson et al, 2010;Walsh, Galea, & Koenen, 2012;Zinzow et al, 2012).…”

Post Traumatic Stress Disorder in Women: A Case Report

“…Yine olgu bildiriminde hastanın özgeçmişi incelendiğinde erken yaşta babanın kaybı, annenin ikinci kez evliliği sonrası anneden ayrı büyüme, çok istediği halde eğitim olanaklarından yararlanmasının engellenmesi gibi çocukluk çağı travmatik yaşantılarının olması da olguyu TSSB açısından daha riskli bir hale getirmektedir. Çünkü travmatik yaşantıların kadın sağlığı üzerinde kısa ve uzun vadede olumsuz etkileri vardır (17)(18)(19)(20). Çocukluk ve ergenlik dönemin-den beri çoklu travmalara maruz kalan bireylerde (özellikle kadın cinsiyette) uygunsuz bağlanma şemaları ile kişilerarası ilişki-lerde sıkça sorunlar yaşadıkları, yakın ilişkide oldukları kişile-rin şiddet içeren davranışlarına daha fazla maruz kaldıkları bildirilmektedir (21).…”

Kadınlarda çoklu ruhsal travma: Bir olgu sunumu / Multiple psychiatric trauma in women: a case report

“…Anneannenin ise, torununu 'yıllar önce kaybettiği kızının' yerine koyarak, 'onu yanından hiç ayırmayarak', kendi kızı ile kuramadığı, özlediği ilişkiyi torunu ile kurabildiği söylenebilir. Çalışmamızda belirtilen olgu örneğinde olduğu gibi, çoğul ve uzun süreli travma deneyimi olan kadınlar TSSB açısından risk taşırlar; sağaltımları konusunda uygun yöntemlerin seçilmesi, koruyucu ruh sağlığı uygulamaları açısından önemlidir (11,12). Bu nedenle, farklı yaşam biçimleri ile bölgelere özgü sosyoekonomik -kültürel değişkenlerin iyi tanınması ve bu değişkenlerin ruhsal belirtiler ile iliş-kisinin sorgulanmasının ulusal sağlık programlarımıza ışık tutacağı inancındayız.…”