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Rape Crisis Syndrome

Rape Crisis Syndrome is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Definitions (legal definitions vary from state to state)
    • Sexual contact: intentional touching of a person’s intimate parts (including thighs) or the clothing covering such areas, if it is construed as being for the purpose of sexual gratification
    • Sexual conduct: vaginal intercourse between a male and female, or anal intercourse, fellatio, or cunnilingus between persons, regardless of sex
    • Rape (which is a legal term, physician should use the phrase “alleged sexual assault”): any sexual penetration, however slight, using force or coercion against the person’s will
    • Sexual imposition: similar to rape but without penetration or the use of force (i.e., nonconsensual sexual contact, stalking)
    • Gross sexual imposition: nonconsensual sexual contact with the use of force
    • Corruption of a minor: sexual conduct by an individual age ≥18 years with an individual <16 years of age
  • Most states have expanded rape statutes to include marital rape, date rape, and shield laws.
  • System(s) affected: nervous; reproductive; GI

Epidemiology

  • In the United States, 25% of women and 7.6% of men report being target of the definition of rape crisis syndrome listed above. The cost of this is estimated to exceed $5.8 billion annually.
  • Anyone can be sexually assaulted, but some populations are especially vulnerable.
    • Adolescents and young children
    • People with disabilities
    • Elderly
    • Low socioeconomic status and homeless people
    • Sex workers
    • Those living in institutions/areas of conflict
  • Predominant age
    • The incidence of sexual assault peaks in those 16 to 19 years of age, with the mean occurring at 20 years of age.
      • Adolescent sexual assault has a greater frequency of anogenital injuries.
  • Predominant sex: female > male
    • For males
      • 69% of male victims were first raped before age 18 years.
      • 41% of male victims were raped before age 12 years.

Incidence
  • In the United States, approximately 1.5 million women and 834,700 men are sexually assaulted annually.
  • Estimated that only a fraction of sexual assaults are reported to law enforcement.
  • Almost 1 in 5 women (18%) in the United States have experienced rape or attempted rape.
    • 20–25% of undergraduate women indicated that they’ve been a victim of sexual violence since starting college.
  • 2–3% of American men will be sexually assaulted during their lifetime.
  • Most rape victims either know or have some acquaintance with their attacker.

Risk Factors

  • Children living in household of sexual assault are in increased risk of maltreatment and lifelong poor health.
  • Early sexual initiation
  • Sexual risk-taking behavior
  • Exposure to parental violence
  • Alcohol consumption is estimated to be involved in 1/2 of sexual assault.
  • Illicit drug may also contribute to sexual assault.

General Prevention

  • Primary prevention: Evidence suggests that promotion of gender equality decreases sexual violence perpetration—strategies include mobilizing men and boys as allies and empowering/supporting girls and women through economic supports and increasing leadership opportunities.
  • Secondary prevention: The USPSTF recommends screening women of childbearing age for intimate partner violence and refer women who screen positive to intervention services; HARK screening tool is 81% sensitive and 95% specific (1)[B].
  • Tertiary prevention: Support survivors through victim-centered services (refer to patient education section) and medical treatment.

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Citation

Stephens, Mark B., et al., editors. "Rape Crisis Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116511/all/Rape_Crisis_Syndrome.
Rape Crisis Syndrome. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116511/all/Rape_Crisis_Syndrome. Accessed April 20, 2019.
Rape Crisis Syndrome. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116511/all/Rape_Crisis_Syndrome
Rape Crisis Syndrome [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 20]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116511/all/Rape_Crisis_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Rape Crisis Syndrome ID - 116511 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116511/all/Rape_Crisis_Syndrome PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -