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Effects and aftermath of rape can include both physical trauma and psychological trauma. However, physical force is not necessarily used in rape, and physical injuries are not always a consequence. Deaths associated with rape are known to occur, though the prevalence of fatalities varies considerably across the world. For rape victims the more common consequences of sexual violence are those related to reproductive health, mental health, and social wellbeing.
Physical and psychological response to rapeEdit
- Vaginal or Anal bleeding or infection
- Hypoactive sexual desire disorder
- Dyspareunia, Vaginismus
- chronic Pelvic pain
- Urinary infections
- Main article: Pregnancy from rape
Pregnancy may result from rape. The rate varies between settings and depends particularly on the extent to which non-barrier contraceptives are being used.
In 1982, Fertility and Sterility, the journal of the American Society for Reproductive Medicine, reported that the risk of pregnancy from a rape is the same as the risk of pregnancy from a consensual sexual encounter, 2-4%.
A 1996 longitudinal study in the United States of over 4000 women followed for three years found that the national rape related pregnancy rate was 5.0% per rape among victims aged 12–45 years, producing over 32,000 pregnancies nationally among women from rape each year.
In 1991, a study in a maternity hospital in Lima found that 90% of new mothers aged 12-16 had become pregnant from being raped, the majority by their father, stepfather or other close relative. An organization for teenage mothers in Costa Rica reported that 95% of its clients under the age of 15 had been victims of incest.
A study of adolescents in Ethiopia found that among those who reported being raped, 17% became pregnant after the rape, a figure which is similar to the 15–18% reported by rape crisis centres in Mexico.
Experience of coerced sex at an early age reduces a woman’s ability to see her sexuality as something over which she has control. As a result, it is less likely that an adolescent girl who has been forced into sex will use condoms or other forms of contraception, decreasing the likelihood of her not becoming pregnant.
A study of factors associated with teenage pregnancy in Cape Town, South Africa, found that forced sexual initiation was the third most strongly related factor, after frequency of intercourse and use of modern contraceptives. Forced sex can also result in unintended pregnancy among adult women. In India, a study of married men revealed that men who admitted forcing sex on their wives were 2.6 times more likely to have caused an unintended pregnancy than those who did not admit to such behavior.
Any pregnancy resulting from an encounter with a stranger carries a higher risk of pre-eclampsia, the condition in which hypertension arises in pregnancy in association with significant amounts of protein in the urine. Conversely, repeated exposure to the same partner's semen reduces the risk, through induction of paternal tolerance.
Sexually transmitted diseasesEdit
- Main article: Sexually transmitted disease
Violent or forced sex can increase the risk of transmitting HIV. In forced vaginal penetration, abrasions and cuts commonly occur, thus facilitating the entry of the virus through the vaginal mucosa. Adolescent girls are particularly susceptible to HIV infection through forced sex, and even through unforced sex, because their vaginal mucous membranes have not yet acquired cellular density sufficient to provide an effective barrier that develops in the later teenage years.
Being a victim of sexual violence and being susceptible to HIV share a number of risk behaviors. Forced sex in childhood or adolescence, for instance, increases the likelihood of engaging in unprotected sex, having multiple partners, participating in sex work, and substance abuse. People who experience forced sex in intimate relationships often find it difficult to negotiate condom use either because using a condom could be interpreted as mistrust of their partners or as an admission of promiscuity, or else because they fear experiencing violence from their partners. Sexual coercion among adolescents and adults is also associated with low self-esteem and depression factors that are associated with many of the risk behaviors for HIV infection.
Research on women in shelters has shown that women who experience both sexual and physical abuse from intimate partners are significantly more likely to have had sexually transmitted diseases.
Psychological response to rapeEdit
- Main article: Rape trauma syndrome
- Main article: Blame#Self-blame
Self-blame is among the most common of both short- and long-term effects and functions as an avoidance coping skill that inhibits the healing process and can often be remedied by a cognitive therapy technique known as cognitive restructuring.
There are two main types of self blame: behavioral self blame (undeserved blame based on actions) and characterological self blame (undeserved blame based on character). Victims who experience behavioral self blame feel that they should have done something differently, and therefore feel at fault. Victims who experience characterological self blame feel there is something inherently wrong with them which has caused them to deserve to be assaulted.
Unfortunately, the victim's support system is not always the best place for the victim to seek consolation. Sometimes in an effort to shield oneself from believing such a thing could happen to their loved one, a supporter will make excuses for why the event occurred. Some support will decide that the victim put themselves in a bad situation, even though they didn't deserve to be raped- which does not help the victim in his or her recovery to hear. The victim will often already internally blame themselves, especially because the violation of boundaries, broken trust, and the feeling of personal danger occurs with rape. If the support system they look to for support is a partner or spouse, some may be unwilling to accept reality and leave or blame the victim. In that situation, it is even more important to be able to find support in others.
Most victims cannot be reassured enough that what happened to them is "not their fault." This helps them fight through shame and feel safe, secure, and grieve in a healthy way. In most cases, a length of time, and often therapy, are necessary to allow the victim and people close to the victim to process and heal.
- lack of motivation to seek care;
- lack of empathy;
- cutting themselves off from other people;
Tangney says shame has a special link to anger. "In day-to-day life, when people are shamed and angry they tend to be motivated to get back at a person and get revenge."
In addition, shame is connected to psychological problems – such as eating disorders, substance abuse, anxiety, depression, and other mental disorders as well as problematic moral behavior. In one study over several years shame-prone kids were prone to substance abuse, earlier sexual activity, less safe sexual activity, and involvement with the criminal justice system.
Behavioral self blame is associated with feelings of guilt within the victim. While the belief that one had control during the assault (past control) is associated with greater psychological distress, the belief that one has more control during the recovery process (present control) is associated with less distress, less withdrawal, and more cognitive reprocessing.
Counseling responses found helpful in reducing self blame are supportive responses, psychoeducational responses (learning about rape trauma syndrome) and those responses addressing the issue of blame. A helpful type of therapy for self blame is cognitive restructuring or cognitive-behavioral therapy. Cognitive reprocessing is the process of taking the facts and forming a logical conclusion from them that is less influenced by shame or guilt.
Childhood and adulthood victims of rape are more likely to attempt or commit suicide. The association remains, even after controlling for sex, age, education, symptoms of post-traumatic stress disorder and the presence of psychiatric disorders. The experience of being raped can lead to suicidal behavior as early as adolescence. In Ethiopia, 6% of raped schoolgirls reported having attempted suicide. They also feel embarrassed to talk about what had happened to them. A study of adolescents in Brazil found prior sexual abuse to be a leading factor predicting several health risk behaviours, including suicidal thoughts and attempts.
Effects of sexual assault on childrenEdit
- Main article: Child sexual abuse
Rape and other forms of sexual assault on a child can result in both short-term and long-term harm, including psychopathology in later life. Psychological, emotional, physical, and social effects include depression, post-traumatic stress disorder, anxiety, eating disorders, poor self-esteem, dissociative and anxiety disorders; general psychological distress and disorders such as somatization, neurosis, chronic pain, sexualized behavior, school/learning problems; and behavior problems including substance abuse, destructive behavior, criminality in adulthood and suicide.
The risk of lasting psychological harm is greater if the perpetrator of the sexual assault on the child is a relative (i.e., incest), or if threats or force are used. Incestual rape has been shown to be one of the most extreme forms of childhood trauma, a trauma that often does serious and long-term psychological damage, especially in the case of parental incest.
Rape is especially stigmatizing in cultures with strong customs and taboos regarding sex and sexuality. For example, a rape victim (especially one who was previously a virgin) may be viewed by society as being "damaged." Victims in these cultures may suffer isolation, be disowned by friends and family, be prohibited from marrying, be divorced if already married, or even killed. This phenomenon is known as secondary victimization.
Secondary victimization is the re-traumatization of the sexual assault, abuse, or rape victim through the responses of individuals and institutions. Types of secondary victimization include victim blaming and inappropriate post-assault behavior or language by medical personnel or other organizations with which the victim has contact. Secondary victimization is especially common in cases of drug-facilitated, acquaintance, and statutory rape.
- Main article: Victim blaming
The term victim blaming refers to holding the victim of a crime to be responsible for that crime, either in whole or in part. In the context of rape, it refers to the attitude that certain victim behaviors (such as flirting or wearing sexually provocative clothing) may have encouraged the assault. In extreme cases, victims are said to have "asked for it" simply by not behaving demurely.
It has been proposed that one cause of victim blaming is the just world hypothesis. People who believe that the world is intrinsically fair may find it difficult or impossible to accept a situation in which a person is badly hurt for no reason. This leads to a sense that victims must have done something to deserve their fate. Another theory entails the psychological need to protect one's own sense of invulnerability, which can inspire people to believe that rape only happens to those who provoke the assault. Believers use this as a way to feel safer: If one avoids the behaviours of the past victims, one will be less vulnerable. A global survey of attitudes toward sexual violence by the Global Forum for Health Research shows that victim-blaming concepts are at least partially accepted in many countries.
It has also been proposed by Dr Roxanne Agnew- Davies, a clinical psychologist and an expert on the effects of sexual violence, that victim-blaming correlates with fear. "It is not surprising when so many rape victims blame themselves. Female jurors can look at the woman in the witness stand and decide she has done something 'wrong' such as flirting or having a drink with the defendant. She can therefore reassure herself that rape won't happen to her as long as she does nothing similar."
Many of the countries in which victim blaming is more common are those in which there is a significant social divide between the freedoms and status afforded to men and women.
In Islamic countriesEdit
Rape is forbidden under Islamic law. Some female rape victims are accused and punished for having sex outside of marriage.
- "Local Sharia courts in some third world countries regularly punish raped minor girls and women by flogging and beating them with shoes."
- "In 1979, the government of Pakistan adopted the Zina Ordinance to bring the Penal Code into accord with Islamic principles. Under this ordinance, women who report having been raped must prove that the intercourse was without consent. If unable to prove this lack of consent, they can be charged with fornication. As a result, women are less likely to report rape ..."
Mainstream Sunni Islamic scholars, like Imam Malik, clearly state that no punishment is applied on the raped women. "The hadd (punishment) in such cases is applied to the rapist, and there is no punishment applied to the raped woman" Imam Malik, Muatta, Book36 (Judgements):Section 16 Judgment about raped women.
- ↑ (1995). Health effects of experiences of sexual violence for women with abusive partners. Health Care for Women International 16 (6): 563–576.
- ↑ (1998). A comparative study of women with chronic pelvic pain, chronic nonpelvic pain and those with no history of pain attending general practitioners. British Journal of Obstetrics and Gynaecology 105 (1): 87–92.
- ↑ Yuzpe, A. Albert, Smith, R. Percival and Rademaker, Alfred W. (April 1982). A Multicenter Clinical Investigation Employing ethinyl estradiol combined with dl-norgestrel as a Postcoital Contraceptive agent. Fertility and Sterility 37 (4).
- ↑ (1996). Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women. American Journal of Obstetrics and Gynecology 175 (2): 320–324.
- ↑ (1997) Gender violence : interdisciplinary perspectives, New York [u.a.]: New York Univ. Press.
- ↑ 6.0 6.1 (1998). Prevalence and outcomes of sexual violence among high school students. Ethiopian Medical Journal 36 (3): 167–174.
- ↑ Evaluacio´n de proyecto para educacio´n, capacitacio´n y atencio´n a mujeres y menores de edad en materia de violencia sexual, enero a diciembre 1990. [An evaluation of a project to provide education, training and care for women and minors affected by sexual violence, January–December 1990.] Mexico City, Asociacio´n Mexicana contra la Violencia a las Mujeres, 1990.
- ↑ Carpeta de informacio´n ba´sica para la atencio´n solidaria y feminista a mujeres violadas. [Basic information file for mutually supportive feminist care for women rape victims.] Mexico City, Centro do Apoyo a Mujeres Violadas, 1985.
- ↑ 9.0 9.1 (2001). Relationship dynamics and teenage pregnancy in South Africa.. Social Science and Medicine 5 (5): 733–744.
- ↑ (1992). Sexual abuse as a factor in adolescent pregnancy. Family Planning Perspectives 24 (1): 4–11.
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- ↑ (1997). Adolescent pregnancy and sexual risk taking among sexually abused girls. Family Planning Perspectives 29 (5): 200–227.
- ↑ (1999). Sexual behaviour and reproductive health outcomes: associations with wife abuse in India. Journal of the American Medical Association 282 (20): 1967–1972.
- ↑ Preeclampsia: Risk Factors. Mayo Clinic. Retrieved on 2012-08-22.
- ↑ (1990). Sexually transmitted diseases in victims of rape. New England Journal of Medicine 322 (11): 713–716.
- ↑ (2000). Adverse consequences of intimate partner abuse among women in non-urban domestic violence shelters. American Journal of Preventive Medicine 19 (4): 270–275.
- ↑ 17.0 17.1 Tangney, June Price and Dearing, Ronda L., Shame and Guilt, The Guilford Press, 2002 ISBN 1-57230-987-3
- ↑ (2005). Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors. Journal of Counseling Psychology 52 (3): 267–278.
- ↑ Matsushita-Arao, Yoshiko. (1997). Self-blame and depression among forcible rape survivors. Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(9-B). pp. 5925.
- ↑ (2003). Counterfactual Thinking, Blame Assignment, and Well-Being in Rape Victims. Basic & Applied Social Psychology 25 (4): 265–273.
- ↑ Davidson JR et al. (June 1996). The association of sexual assault and attempted suicide within the community. Archives of General Psychiatry 53 (6): 550–555.
- ↑ Luster T and Small SA (1997). Sexual abuse history and problems in adolescence: exploring the effects of moderating variables. Journal of Marriage and the Family 59 (1): 131–142.
- ↑ McCauley J et al.. Clinical characteristics of women with a history of childhood abuse: unhealed wounds. Journal of the American Medical Association 277 (17): 1362–1368.
- ↑ Nagy S et al. (1994). A comparison of risky health behaviors of sexually active, sexually abused, and abstaining adolescents. Pediatrics 93 (4): 570–575.
- ↑ Romans SE et al. (September 1995). Sexual abuse in childhood and deliberate self-harm. American Journal of Psychiatry 152 (9): 1336–1342.
- ↑ (1998). History of trauma and attempted suicide among women in a primary care setting. Violence and Victims 13 (1): 3–9.
- ↑ Anteghini M et al.. Health risk behaviors and associated risk and protective factors among Brazilian adolescents in Santos, Brazil. Journal of Adolescent Health 28 (4): 295–302.
- ↑ Dinwiddie S et al.. Early sexual abuse and lifetime psychopathology: a co-twin-control study. Psychological Medicine 30 (1): 41–52.
- ↑ Nelson EC et al.. Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study. Archives of General Psychiatry 59 (2): 139–145.
- ↑ (1999). The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups. Journal of Abnormal Child Psychology 27 (1): 65–76.
- ↑ Widom, S., Dumont K., Czaja, S. (2007). A Prospective Investigation of Major Depressive Disorder and Comorbidity in Abused and Neglected Children Grown Up. Archives of General Psychiatry 64 (1).; lay summary
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- ↑ Joan Arehart-Treichel (2005-08-05). Dissociation Often Precedes PTSD In Sexually Abused Childre. Psychiatric News 40 (15).
- ↑ Levitan R. D. et al.. Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: Issues of co-morbidity and specificity. Depression and Anxiety 17 (1): 34–42.
- ↑ Faller, Kathleen C. (1993). Child Sexual Abuse: Intervention and Treatment Issues, Diane Publishing.
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- ↑ (April 2002). Childhood Sex Abuse Increases Risk for Drug Dependence in Adult Women. National Institute of Drug Abuse 17 (1).
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- ↑ Dozier, M., Stovall, K.C., & Albus, K. (1999) Attachment and Psychopathology in Adulthood. In J. Cassidy & P. Shaver (Eds.). Handbook of Attachment (pp. 497–519). NY: Guilford Press, ISBN 1-57230-826-5
- ↑ Kendall-Tacket, K. A., Williams, L. M., & Finkelhor. D. (1993). Impact of Sexual Abuse on Children: A Review and Synthesis of Recent Empirical Studies. Psychological Bulletin 113 (1): 164–180. – also published in Hertzig, Margaret E. and Farber, Ellen A. (1994). Annual progress in child psychiatry and child development 1994, 321–356, Psychology Press.
- ↑ Gauthier L et al. (1996). Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse and Neglect 20 (7): 549–559.
- ↑ Julia Whealin, Ph.D.. Child Sexual Abuse. National Center for Posttraumatic Stress Disorder, US Department of Veterans Affairs.
- ↑ (1992). Methodological issues in the study of sexual abuse effects. Journal of Consulting and Clinical Psychology 60 (2): 196–203.
- ↑ (2001). Features of childhood sexual abuse and the development of psychiatric and substance use disorders. British Journal of Psychiatry 179 (5): 444–449.
- ↑ Courtois, Christine A. (1988). Healing the Incest Wound: Adult Survivors in Therapy, W. W. Norton & Company.
- ↑ Alliance: Factsheets: Trauma of Victimization. Nycagainstrape.org. Retrieved on 2011-10-01.
- ↑ Campbell R, Raja S. (1999). Secondary victimization of rape victims: insights from mental health professionals who treat survivors of violence. Violence Vict. 14 (3): 261–75.
- ↑ EMMA - Most Londoners Believe Rape Victims are to Blame. Emmainteractive.com. URL accessed on 2012-08-24.
- ↑ Uzma Mazhar (2002) Rape & Incest: Islamic Perspective
- ↑ How Sharia Law Punishes Raped Women. Aina.org. Retrieved on 2011-10-01.
- ↑ Polk, Michael F. (1998). Women Persecuted under Islamic Law: The Zina Ordinance in Pakistan as a Basis for Asylum Claims in the United States. Georgetown Immigration Law Journal 12.
- ↑ Will Pakistan ease harsh Sharia rape laws?. Jihad Watch. July 2006
- ↑ http://www.sultan.org/books/Muatta.pdf
- ↑ Malik, Imam Al-Muwatta' of Imam Malik - Judgements - SunniPath Library - Hadith. Sunnipath.com. URL accessed on 2012-08-24.
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- Effects of Rape
- World Health Organization WHO report on sexual violence
- Stigma, Inc A support group for individuals conceived by rape or incest
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