To add insult to injury: Stigmatization reinforces the trauma of rape survivors – Findings from the DR Congo

Abstract

Background: Survivors of sexual violence are frequently condemned and socially excluded. Myths about rape may translate into stigmatization, diminish disclosure, prevent help-seeking from support structures and worsen mental health. Areas of conflict or organized violence remain the evident hotspots of sexual victimization. However, little is known about prevalence and predictors of rape myths in these settings or their association with survivors’ disclosure, stigmatization and psychopathology. Method: Between September 2018 and May 2019, we assessed in a representative sample of 1066 individuals from six communities in Eastern DRC traumatic exposure, sexual perpetration, threats to social integrity, perceived stigmatization (perceived lack of social acknowledgement, shame), stigmatizing attitudes towards survivors (negative attitudes and willingness to provide support, rape myths acceptance), and mental illness (PTSD, depression). Results: Survivors of sexual violence (33%, n = 184 of women, 16%, n = 84 of men) reported more traumatic exposure, threats to social integrity, shame, perceived lack of social acknowledgement, PTSD symptoms and depression. Their social environment affirmed various stigmatizing attitudes (5-89% affirmations). Beliefs in rape myths were predicted by its average acceptance in the community, education, and witness of others’ sexual victimization. The rates of cases whose history of sexual victimization was socially disclosed were higher in communities and among survivors with low rape myths acceptance and disclosure showed associations with perceived stigmatization. Rape myths acceptance among individuals without a history of sexual victimization was associated with survivors’ recently experienced threats to social integrity which predicted their stigma perceptions and mental illness. Conclusion: Rape myths acceptance in the community is associated with stigma and trauma-related mental illness of sexual violence survivors. This adds up to the psychic burden of trauma.

Invited commentary on “Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study” by Clare and colleagues

“…However, as they indicate, the risk for physical and mental illnesses, and impaired social outcomes in the form of revictimization, homelessness, and impaired educational and occupational functioning remains high. As in other studies, external stigma and internalized shame, as well as the subjective meaning of sexual assault, often mediate the relationship between assault and prospective health/functioning [4,5].…”

Sexual Assault Is the Biggest Risk Factor for Violence against Women in Taiwan—A Nationwide Population Cohort Study from 2000 to 2015

“…The World Health Organization (WHO) defines partner and non-partner sexual violence separately, with partner sexual violence being defined as the self-reported forced engagement in sexual activity by a current or ex-partner from age 15 despite their unwillingness due to fear that their partner might act unfavorably during sexual intercourse or being forced to do something that is humiliating or degrading; non-partner sexual violence is defined as being 15 years of age or older when someone other than a person’s husband/partner is forced to perform any unwanted sexual act [ 1 ]. The revelation of sexual violence often creates shame and stigmatization of the victim; the perpetrator shames and blames the victim to reduce their responsibility, and a climate of stigma in sociocultural perceptions develops; in this case, most victims opt not to report their experiences or may not describe what happened to them as sexual violence [ 2 ]. WHO defines sexual abuse during childhood and adolescence (child sexual abuse (CSA)) as, “the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society; CSA is evidenced by this activity between a child and an adult or another child who by age or development is in a relationship of responsibility, trust, or power, the activity being intended to gratify or satisfy the needs of the other person” [ 3 ].…”

“…An important issue of sexual violence is the relationship between the victim and the perpetrator, and recent research has focused on the sexual violence between intimate partners, whether committed by a partner or a non-partner to the victim. Often traumatic, the pattern, extent, and effects of violence may vary by perpetrator [ 1 , 2 , 3 ]. The occurrence of spousal violence depends on determinants at the individual and environmental levels, with unemployment, poverty, and literacy having a significant impact on spousal violence against women [ 4 ].…”

NETfacts: An integrated intervention at the individual and collective level to treat communities affected by organized violence

“…The responses of others (in the family and in the community) can also influence the mental health sequelae of trauma and perpetration of violence. Social attitudes, including stigma and marginalization of survivors (including perpetrators), exacerbate the mental health problems caused by the events themselves ( 7 , 24 , 25 ), with negative impacts on individual and collective functioning.…”