Sexual Violence and PTSD
Sexual Violence and PTSD
Table of Contents
What is Sexual Violence?
Sexual violence refers to obtaining sexual activities by violent measures. The act of sexual assault is going against a person’s sexual choices regardless of what relationship there may be between the assaulter and the victim. If it involves any sexual act without the victim’s consent, it is sexual violence. Anyone can experience sexual violence, including teenagers, adults, or elders, and the perpetrator may be a friend, family member, acquaintance, trusted individual, or stranger.
The term sexual violence is an umbrella term referring to crimes such as sexual abuse, sexual assault, rape, intimate partner abuse, and unwanted sexual touching.
Rape is a sexual act obtained by coercion or physical force. Perpetrators rape victims by violence, physical intimidation, or abuse of power. The act often goes against the will of a person who cannot give consent, such as an intoxicated, unconscious, drugged, or mentally incapacitated person.1 While women are mostly affected by rape,2 men can be rape victims as well. In general, 35% of women have experienced rape, with South Africa having the highest rate of rape.3
Intimate Partner Violence
Intimate partner violence (IPV) is an act carried out by one current or former partner in a personal relationship against the other partner. The World Health Organization (WHO) describes intimate partner violence as behavior by a current partner or ex-partner causing physical, sexual, or psychological harm against the other. Harmful acts can include physical aggression, sexual coercion, psychological abuse, and controlling behaviors.4 Intimate partner violence affects the well-being of millions of people globally. The partners involved may be a current or former partner, boyfriend, girlfriend, and sexual partner.
When researching the prevalence of IPV between 2000-2018 across 161 countries and areas, WHO found that approximately 30% of women have been subjected to physical and sexual violence by an intimate partner, a non-partner, or both. In the same vein, 38% of murders of women are carried out by intimate partners.4
Unwanted Sexual Touching
Unwanted sexual touching involves any sexual touching against a person’s will. Touching without consent can occur anywhere, such as at home, school, a place of work, or in public places such as bus stops or subways. It is often seen in relationships between an employer and employee, employee and employee, parents and children, and more.
How is PTSD Related to Sexual Violence?
Post-traumatic stress disorder (PTSD) occurs when one has experienced one or more traumatic incidents in their lives such as a natural disaster, a death of a loved one, a serious accident, war, threats to life, robbery, and sexual violence.
PTSD and sexual violence have a close relation. Sexual assault happens without consent, which is a violation of the victim’s rights and values as a human being. It indicates that the victim has no right to his/her body or what happens to it during an assault, making victims think they have no value as a person. There is a higher chance that someone will have depressive or suicidal thoughts after experiencing sexual violence.5
About 94% of women experience post-traumatic stress disorder symptoms (PTSD) in the two weeks following the rape, while 30% continue to show signs after nine months.5 In total, 70% of rape or sexual violence victims experience moderate to severe distress, accounting for a higher percentage than any other violent crime.6
Why PTSD is Common with Sexual Violence
There are many rape myths throughout society. Examples include that individuals lie about being assaulted, perpetrators are easily identifiable, or that men cannot be sexually assaulted.7 Many who have reported rape cases or sexual assault do not receive the necessary support for it. Often, victims are accused of lying or over-dramatizing the situation. These lies affect victims and often result in continuously depressive thoughts. To avoid these false accusations, some victims do not speak out about their situation, which further heightens PTSD symptoms.
Effects of PTSD after Sexual Violence
Victims’ reactions to sexual violence will vary. While some survivors experience severe psychological symptoms, others experience little to no effects. At the initial stage, victims often experience consistent nightmares and flashbacks to the incident. Other symptoms may include depression, anxiety, and substance abuse in an effort to cope.
The effect of sexual violence can have a long-term impact on a person’s physical health. A recent study indicated that sexual harassment and violence increase the risk of high blood pressure, poor sleep quality, contracting STDs and STIs, and unwanted pregnancy.
Victims of sexual and domestic abuse, including children, often display a range of reactions or sudden changes in behavior. Some of these include angry outbursts, depression, not feeling safe, startled responses, withdrawal, inappropriate sexual behavior, and substance abuse.
Sexual assault can affect a victim’s sexual health and overall sexual freedom. Victims do not often report their assault due to the stigmatization surrounding sexual assault. This choice limits their chances of receiving the required medical help to curb diseases like STDs, HIV/AIDs, reproductive tract infections (RTIs), infertility, and sexual dysfunction.
Conditions Associated with PTSD
Substance Use Disorder
Substance use disorder (SUD) is a condition where one used a substance unrestrained or at dangerous levels. Victims of sexual and domestic violence sometimes use substances such as tobacco, alcohol, and illegal drugs to the point where it affects an individual’s ability to function.
Anxiety is a significant effect of sexual abuse. Anxiety is a feeling of unease, worry, or fear about a situation or its outcome. Victims of sexual violence sometimes feel they are always in danger, and they often distrust other people.
Depression is the state of feeling constantly unhappy or down. The stigma that comes with sexual assault may cause some victims to feel embarrassed, ashamed, or unworthy. Many victims of sexual abuse suffer through prolong depressive feelings.
OCD stands for obsessive-compulsive disorder. It is a disorder that makes people have repeated and intrusive thoughts, ideas, or obsessions.
An eating disorder may be used by victims as an escape or coping mechanism to mitigate the pain of sexual assault. Some victims feel they don’t deserve to eat due to the trauma they experience.
Treating PTSD with Substance Use Disorder
How is PTSD Treated?
The primary ways to deal with post-traumatic disorder (PTSD) are psychological therapies and medication. The first step in treating PTSD is a detailed assessment of the victim’s symptoms and creating a suitable treatment plan. After that, the mental health specialist (a psychologist or psychiatrist) recommends a treatment plan. The treatment plans include watchful waiting (monitoring), psychological therapy, and in the case of severe PTSD, medication.
How are SUDs Treated?
The treatment of SUDs depends on the severity of the substance use problem, the patient’s motivation to stop using drugs, and the patient’s mental history.8 Treatment will also be based on observation of the patient and interaction with family members.
The standard treatment for SUDs, according to various research, is positive reinforcement over punishment. Other treatment plans include residential treatment, psychological and behavioral treatment such as guided self-change (GSC), and motivational enhancement therapy (MEP).8
How are PTSD and SUDs Treated in a Dual Diagnosis?
PTSD and SUD often occur together in patients. According to epidemiological data, PTSD co-occurs with SUD among roughly 40% of civilians and veterans.9 These disorders often strain the health system, leading to elongated use of substances and treatments.10
Some of the treatments of co-occurring post-traumatic stress disorder and substance use disorders include:
Non-exposure-based psychosocial treatment: These approaches include seeking safety (SS), transcendent, and integrated CBT. All are types of sessions with the therapist.
Exposure-based psychosocial treatment: These include relaxation techniques and skills in interactions between the therapist and the patient, including psycho-education, breath retention, in-vivo exposure, and imaginal exposure.
Medication-based treatment: These approaches are based on using medications to taper an addiction, including medicines such as naltrexone and disulfiram.
The prevalence of sexual violence rises rapidly every day. Sexual assault takes different forms, such as rape, intimate partner violence, and unwanted touch. Victims are distraught, frustrated, scared, and traumatized after such incidents. Some do not report sexual violence due to stigmatization and lack of trust. This can lead to PTSD, anxiety, eating disorders, depression, and OCD. With proper measures, both PTSD and sexual violence can be treated to lead to a better life.