Violence and victimization exam 3

sexual assault myths

• no doesnt mean no

• victim blaming

• stranger danger (SA is more frequent when rapist is a stranger)

• perpetrator is always male and victim is always female

male sexual assault survivors

often tie cognitions to physical strength and power, stigma, unsure people will believe them

sexual orientation and SA

similar rates of SA in gay and straight people, some research shows higher victimization in LGB people, bi females have the highest rate of victimization and reporting in LGB community

transgender survivors

almost half of trans individuals experience at least one SA, lack of support, unique challenges relating to gender identity tied to assault, risk for PTSD is higher in LGBTQ community

role of race and ethnicity

highest victimization rates is in indigenous americann - more likely to be victimized by a stranger, mixed research on reporting rates across races, lower rates of reporting for black female victims, increased fear and stigma, may be less trustful of law enforcement, stereotypes

drug related sexual assault

• when drugs are either given to an individual without their knowledge to facilitate the assault or when a person becomes intoxicated and is assaulted, or a combo of the two

• survivor may have limited memory, increased self blame, increased victim blaming, decreased help seeking behavior, and fear they will get in trouble

• inability to remember the assault may increase risk for PTSD

aftereffects of trauma

about 50% of cisfemales who are assaulted will eventually meet PTSD diagnosis, over 90% will experience symptoms of PTSD following the assault, 80% show signs of depression, not everyone shows MH symptoms

trajectory of PTSD

a large number of individuals who meet PTSD criteria will experience a decline in severity of symptoms and no longer meet criteria, some still meet criteria for PTSD years after trauma, majority show symptom decline, 13% of a sample of female survivors met diagnosis after 15 years

chronic PTSD

individual isnt responding to treatment, symptoms last years, flashbacks make it harder to treat

Informal disclosures

most survivors will disclose to at least one family/friend, on average people disclose to about 3 people, most survivors have at least one positive and one negative response

Common responses to informal disclosure

• helplessness (survivor met with silence or a short response, challenges with intimacy, partner pulls away)

• anger and frustration (can be reinforcing/delegitimizing to a certain extent,victim blaming, anger may be directed at victim)

• desire for revenge (jealousy from partner, mild statements can be reaffirming but it may escalate and cause more stress)

Formal disclosures: seeking medical attention

• majority of victims dont seek medical attention, abt 60% who do seek attention report pain during the exam, only 13% receive pain medication, half still report pain after exam

• risk of STDs pregnancy and complications from assault, barriers include cost/access to medical care, fear of others finding out, fear of physical exam

Formal disclosures: mental health treatment

19-40% seek mental health treatment, most dont seek treatment, some may see no reason for mental health treatment (no symptoms)

prolonged exposure therapy

• based on the idea that PTSD is driven by avoidance of the trauma/reminders and negative views of self, world, and reaction to traumatic event

• often education and relaxation strategies before

• amount of time increases over sessions

• 60-120 minutes

• journaling/homework used as well

• reduction in symptoms and severity of PTSD over time

cognitive processing therapy

• takes about 12 weeks

• education on link between thoughts and emotions

• exposure mainly through writing about the event

• cognitive component: therapist looks for themes harmful to mental health and challenges/reframes them to reduce negative impact

• address: thoughts about assault and secondary consequences

• decrease in PTSD symptoms

• some argue cognitive component may make treatment less effective/not a good fit

EMDR

• administered twice a week for 6-12 sessions (may vary)

• clients visualize the memory while focusing on the negative emotions/thoughts while visually tracking a finger, wand, or light

• rationale: mental health symptoms result from a person never properly storing a memory so reminders trigger distress and can produce mental health symptoms