Examining the Scientific Validity of Rape Trauma Syndrome

Rape trauma syndrome (RTS) was first described by Burgess and Holmstrom (1974 Burgess, A.W., &; Holmstrom, L.L. (1974). Rape trauma syndrome. American Journal of Psychiatry, 131, 980–986. [Google Scholar]) who argued that there was little information that described the physical and psychological effects of rape, associated therapy and provisions for protection of the victim from further psychological harm. Since then, there have been several critiques of RTS and empirical evidence exists that RTS is not generally accepted by the relevant scientific community. Despite this, RTS is still used in courts. As such, in this article, we comprehensively evaluated RTS and determined that it is vague and imprecise, its evidential status is questionable, it is inconsistent with the most common sequelae of trauma, it ignores important mediating variables and it may not be culturally sensitive. In light of these critiques, we recommend no further use of this model in courts or in clinical practice.     

Treatment of military-related post-traumatic stress disorder: challenges,innovations, and the way forward

Abstract

Post-traumatic stress disorder (PTSD) is one of the common mental disorders in military and veteran populations. Considerable research and clinical opinion has been focused on understanding the relationship between PTSD and military service and the implications for prevention, treatment, and management. This paper examines factors associated with the development of PTSD in this population, considers issues relating to engagement in treatment, and discusses the empirical support for best practice evidence-based treatment. The paper goes on to explore the challenges in those areas, with particular reference to treatment engagement and barriers to care, as well as treatment non-response. The final section addresses innovative solutions to these challenges through improvements in agreed terminology and definitions, strategies to increase engagement, early identification approaches, understanding predictors of treatment outcome, and innovations in treatment. Treatment innovations include enhancing existing treatments, emerging non-trauma-focused interventions, novel pharmacotherapy, personalized medicine approaches, advancing functional outcomes, family intervention and support, and attention to physical health.     

Sexual revictimization in a clinical sample of women reporting childhood sexual abuse

Background: Child and adolescent sexual abuse (CSA) increases the risk for adult sexual assault (ASA), and psychological vulnerability as well as aspects of CSA and upbringing might influence the risk. Aims: The aims of this study were to investigate whether women who reported both CSA and ASA: 1) have been exposed to more severe CSA and 2) have greater psychological distress and vulnerability than women who were not revictimized. Methods: The study was a cross-sectional study of 161 adult women with a reported history of intrafamilial CSA. Thirty-six per cent of the women stated they had been exposed to ASA. The severity of CSA, psychological distress (Symptoms Checklist-90-R) and Cognitive Distortion were assessed. Five factors of Cognitive Distortion (fearful, scared, shy, mistrust and vulnerable) were identified by factor analysis of Symptoms Checklist-90-R sub-scale. Results: The CSA was significantly more severe (penetration: 77%/60%; multiple offenders: 67%/25%) in women exposed to ASA compared with their counterparts, as was the rate of suicide attempts (47%/30%). Also, the psychological distress and the factors: fearful, scared, shy and mistrust were significant higher. Conclusion: The results showed an increased psychological vulnerability among women with ASA, but whether the results are cause or effect of sexual revictimization or can be generalized to other clinical samples are not clear. Interventions targeting the increased risk of ASA should be developed, implemented and tested in prevention as well treatment programmes.     

Forever Changed: Posttraumatic Stress Disorder in Female Military Veterans, A Case Report

PURPOSE.  This paper examines the experience of posttraumatic stress disorder (PTSD) in a female veteran of Operation Iraqi Freedom, including the barriers to treatment she encountered in an outpatient psychiatry clinic.
DESIGN AND METHODS.  Case report data were obtained through review of records and interviews with a veteran combat nurse diagnosed with chronic PTSD.
CONCLUSIONS.  Sex differences in PTSD are controversial, but PTSD in female military veterans is a significant problem. Gender may complicate diagnosis and treatment. This case report discusses these issues and invites further research.
PRACTICE IMPLICATIONS.  Advanced practice psychiatric nurses increasingly will see female veterans with PTSD in their practices.     

Male Sexual Assault of Women: Origins,Motivations, and Treatment

Abstract

For more than 20 years I have evaluated recidivist sexual offenders’ risk of reoffending after they complete their prison terms. In written reports and court testimony I provide an expert opinion on whether these men should be released into the community or remain in a secure treatment facility. In this article, I explore the reasons men sexually assault women and discuss the changes they need to make—and capacities they need to develop—to reduce their risk of reoffending. I use a case example to illustrate these points.     

Sexual Trauma,the Dopamine D4 Receptor,and Suicidal Ideation Among Hospitalized Adolescents: A Preliminary Investigation

Though an association exists between sexual trauma and adolescent suicidal thoughts and behaviors (STBs), not all adolescents with a sexual assault history develop STBs. The present study examined whether carrier status of the DRD4 VNTR polymorphism (DRD4 L vs. DRD4S) moderated the relationship between sexual trauma and STBs in a sample of psychiatrically hospitalized adolescents. A total of 76 psychiatrically hospitalized adolescents provided saliva samples for genotyping procedures and completed assessment measures. Using hierarchical regression analyses, results indicated that DRD4 L carriers with a sexual trauma history reported significantly more severe suicidal ideation than DRD4S homozygotes. There was no interaction evident for the prediction of suicide attempts. To our knowledge, this is the first study to provide preliminary support for synergistic effects of sexual trauma, DRD4, and severity of SI in adolescents. Further studies of the relationship between sexual trauma, DRD4, and STBs utilizing larger samples are needed.