Rape Crisis Syndrome

Basics

  • Known also as rape trauma syndrome
  • Refers to trauma following sexual assault
  • May be experienced by all sexual and gender identities

Description

  • Definitions (vary by jurisdiction on local, state, and national levels):
    • Rape (a legal term), sexual assault (a medical term), or sexual violence (a general term): any form of sexual activity that occurs without consent between a victim and perpetrator(s)/suspect(s)
    • Rape/sexual assault/sexual violence: may be associated with the use of force and/or threats, alcohol, and/or illicit and/or prescription drugs
    • Rape crisis syndrome is a historical term that has previously been used to define what is now known as the following, differentiated by time lapsed since the inciting event:
      • Acute stress reaction (ASR)—up to 3 days following event (no longer recognized in DSM)
      • Acute stress disorder (ASD)—3 days to 1 month following event (DSM-5)
      • Posttraumatic stress disorder (PTSD)—greater than 1 month following event (DSM-5)
  • Psychological responses to sexual violence range from transient to chronic and debilitating.

Epidemiology

  • In the United States, 33% of women and 25% of men have reported experiencing sexual violence during their lifetime.
  • The following populations are especially vulnerable:
    • Adolescents and young children
    • Persons with disabilities
    • Elderly adults
    • Those with a low socioeconomic status and/or that are homeless
    • Sex workers and persons being trafficked
    • People living in institutions/areas of conflict/training environments
  • 33% of female victims first experienced sexual violence before age 18; 13% first experienced it before age 10
  • 25% of male victims first experienced sexual violence before age 18; 25% first experienced it before age 10
  • Only 16–38% of victims report to law enforcement, and only 17–43% of victims obtain a medical evaluation.

Risk Factors

  • History of sexual violence, psychological aggression, physical violence, trafficking, and/or stalking
  • Early initiation of sexual activity
  • Engagement in high-risk sexual behavior
  • Exposure to familial and/or environmental violence
  • Consumption of alcohol/use of illicit drugs
  • Belief in traditional gender roles

General Prevention

  • Primary prevention: Promoting gender equality, teaching skills to prevent sexual violence, empowering and supporting females, and creating protective environments decrease the occurrence of sexual violence perpetration.
  • Secondary prevention: HARK screening tool, which includes questions that assess if a patient has felt humiliated (H) and/or afraid (A), and been raped (R) and/or kicked (K) within the past year, is 81% sensitive and 95% specific for intimate partner violence as well as clinically useful (1).

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