Effects of Sexual Assault on Mental Health

 

Sexual assault is defined as an infringement of a person’s sexual space by sexual touch without consent by coercion or physical force to engage in a sexual act against the person’s will. It ranges from verbal sexual insults to the physical acts such as groping, rape, and sodomy and child molestation. The attempt of such an act is also termed as sexual assault. Sexual assault has both physical and emotional effects. Physical effects are the bodily harms caused in the course of the violation for example beatings endured during rape, bruises in the struggle to resist the violation, damaged organs in the event of the act and pregnancy in a woman who has been raped. Physical effects can be treated in a hospital with maximum or near-maximum effective treatment. Emotional effects of these acts include post-traumatic stress disorder (PTSD), depression, suicide, low self-esteem, feelings of shame and guilt and self-blame and unworthiness. These emotional scars may last a lifetime and often the survivor has to deal with the effects by going for counseling and talking out the ordeal. PTSD is a psychiatric disorder that arises after a traumatic encounter. PTSD manifests as reliving the experience through nightmares and flashbacks, having trouble sleeping and feelings of isolation and detachment from the society. PTSD may begin right after the traumatic experience or sometimes after. However, to be diagnosed with the disorder the individual must have the symptoms (reliving the experience, avoidance or numbing symptoms and arousal symptoms) lasting for a month after the experience. Sexual-assault-related PTSD is correlated to a great extent to self-blame. It has been reported that survivors who languish in self-blame tend to have prolonged bouts of PTSD. Reductions in self-blame result in reductions in the symptoms of PTSD and at times there is eventual recovery from the traumatic incidence where the memories no longer elicit anxiety, depression or violence in the survivor. It becomes a far-off memory that is only triggered by an incident but does not pop up in the short-term cognitive memory of the survivor.

There are various psychological concepts identified in survivors with PTSD resulting from sexual assault. In an article featured in Toronto Star on April 27, 2018 “Friends to the end: How the suicide of seven Indigenous girls revealed a community undone” the concepts identified were; stress and coping, attachment and operant conditioning. Operant conditioning refers to behavior modification through positive or negative reinforcements. It is a behavior controlled by consequences (Staddon ” Cerutti, 2003 ). This theory has been used to teach certain behaviors in organisms through positive and negative reinforcements. In the Toronto Star article, the girls were removed from their homes and put in centers after experiencing some form of traumatic experience and therefore were having mental health disorders. In particular, Amy Owen suffered PTSD after a being raped. The negative reinforcement of removing her from her home may have contributed further to the worsening of the mental disorder that eventually resulted in her committing suicide.

The other theory identified stress and coping can be explained by the theory of psychological stress theory by Lazarus. It has two concepts; appraisal i.e. identifying that there is an encounter that is affecting one’s well-being and

coping i.e. the individual’s efforts in dealing with what is happening (Krohne, 2002). There are two strategies for coping with stress trait-oriented and state-oriented strategies. Trait-oriented deals with an individual who has the capability to handle stress while state-oriented is based on a generalized approach to dealing with stress. In the Toronto Star article, the girls had psychological stress caused by the traumatic experiences of sexual abuse. They identified this as the cause of their not well-being. The First Nations community members had children marred with terrible encounters of sexual abuse and most of them had mental health disorders. As a result, their trait-oriented strategy of coping with stress was a negative strategy of committing suicide.

Attachment theory seeks to explain the relationship between humans. Humans will respond when relationships hurt them. The theory was first based on infant-caregiver relationships but was extended to adult-romantic relationships. It can also be used as a model to explain friendships and the emotional attachments. The nature of the First Nations community is to have children put in centers that are kilometers away from home. They do not have any attachment to their parents and extendedly to their foster parents. Consequently, the relationships which they later establish with their friends are shaky and there is a lot of emotional vulnerability when it comes to their relations. They are Alayna Moose, struggling with PTSD took her own life and this greatly affected her friend Kanina who followed in the same footsteps and took her life two weeks after her friend.

A study conducted in the United States of America correlates self-blame and PTSD following sexual assault. The study sought to establish dynamic temporal pathways between behavioral self-blame and PTSD symptom severity. The study was conducted among sexual assault survivors over a period of 4 assessments. The study sought to establish one of the three possible aspects (i) behavioral self-blame prospectively predicted PTSD symptom severity, (ii) PTSD symptom severity prospectively predicted behavioral self-blame, or (iii) behavioral self-blame and PTSD symptom severity were associated reciprocally.

The severity of the PTSD symptoms was assessed using a PTSD checklist that listed the descriptors of PTSD symptoms. The highest score was an indicator of the high severity of the symptoms. Behavioral self-blame was assessed using the Rape Attribution Questionnaire which had statements that assessed whether the sexual assault survivor felt whether they were to blame for the incident.

The findings were that the severity of the PTSD symptoms decreased over time with the decrease in self-blame. Self-blame was at the highest peak shortly after the ordeal or at the beginning of the administration of the questionnaire. Upon treating self-blame, there was a decreased score in the PTSD symptoms severity rate. For those who had behavioral self-blame, the PTSD severity still remained at an all-time high throughout the study i.e. in all the four assessments. This asserts the point that PTSD symptoms become heightened as a survivor tries to reconcile the cause of the rape to their own behaviors. Survivors who have severe PTSD symptoms also exhibit high levels of self-blame. Sometimes the survivors think that if they can change their behaviors then they can avoid the event occurring in the future. Self-blame can, therefore, be a predictor of the severity of PTSD symptoms or can also serve as an outcome of PTSD symptoms (Kline, Berke, Rhodes, Steenkammp, ” Litz, 2018).

The findings in the study correlate to the real-world occurrences. Sexual assault survivors live with the shame and guilt that maybe their actions perpetrated the sexual assault happening. For example, the survivor may question whether their dressing may have attracted the defiler to do the act. Sometimes they ask if their timing may have been wrong therefore placing them in the pathway of the defiler; wrong place, wrong time. The survivor may also struggle with the question of whether if they had learned self-defense classes they would have been in a position to resist and fight the defiler. These self-blame questions further intensify the PTSD symptoms. On the other hand, due to PTSD symptoms, self-blame arises as a consequence. Self-blame may not occur immediately after the sexual assault but as the survivor relives the memories through nightmare and flashbacks of the ordeal or trying avoidance or numb the effects of the ordeal then the feelings of self-blame may arise. The survivor tries to look for a mechanism to deal with the issue. They may resort to the negative stages similar to those of grief i.e. denial and anger which may them result in violence or anxiety and depression especially in the company of the gender that defiled the survivor. PTSD symptoms are also significantly high in males compared to their female counterparts. For a long time, sexual assault was associated with females and it was very unlikely for a male to come out in the open as a sexual assault survivor. For this reason, out of fear of discrimination and stigmatization males will tend to suffer silently without seeking any medical and psychiatric help after the ordeal (Kennedy ” Lefler, 2018). The PTSD symptoms will, therefore, tend to be more severe in them. Among males, self-blame will likely occur as a consequence of the PTSD symptoms rather than a dissipating factor for PTSD symptoms severity.