Rape Trauma Syndrome

Impact of Rape Victimization

In one of the first studies of the effects of rape, conducted in 1972 to 1973, Ann Wolbert Burgess and Lynda Lytle Holmstrom interviewed victims brought into an emergency room in a large urban hospital with a complaint of rape. Three types of sexual trauma were observed, and RTS was conceptualized using data from the 92 reported adult rape cases. The researchers also conceptualized two styles of attack using victims' accounts: a sudden surprise attack (blitz rape) and an attack involving betrayal with qualities of a confidence game (confidence rape). Either way, the rapist gained carnal knowledge of the victim by force and without the victim's consent. The victims showed two, equally common, emotional styles at the hospital: (1) an expressed style with fear, anger, and anxiety exhibited through crying, sobbing, and tenseness, and (2) a controlled style—often perplexing to outsiders—with feelings masked or hidden.

Rape trauma syndrome has two stages: the immediate or acute phase, in which the victim's lifestyle is completely disrupted by the rape crisis, and the long-term process, in which the victim has to reorganize this disrupted life style. The syndrome included physical, emotional, and behavioral stress reactions, which resulted from the person being faced with a life-threatening event. The cluster of symptoms that developed after the rape was conceptualized as RTS. [Page 530]In formulating RTS, the social context is important. The prevailing blame-the-victim attitude, for example, encouraged silence. Clinicians were advised to be alert for a syndrome called silent reaction to rape in which the victim does not tell anyone of the rape and suffers from the resulting unsettled feelings. Also, the history of the individual victim was important. Those with a preexisting medical, psychiatric, or social problem had a more complex response—a compound reaction— to rape.

The study also made clear that rape does not end with the assailant's departure; rather, the profound suffering of the victim can be diminished or heightened by the post-rape response of people in their networks and by police, hospital staff, and court personnel.

Posttraumatic Stress Disorder (PTSD)

Rape thrives on silence and cover-ups. The women's movement, especially vocal in the 1970s, helped heighten public and academic awareness. “Rape trauma syndrome” appeared in the American Journal of Psychiatry in 1974. In 1980, the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) included rape as one of the stressors in the category of posttraumatic stress disorder. Although the criteria differ somewhat in the various editions of the DSM, the basic elements of the PTSD diagnosis are (a) experiencing a traumatic event, (b) reexperiencing the trauma (e.g., intrusive recollections, nightmares), (c) avoidance and numbing (e.g., avoiding thoughts or feelings about the trauma, feelings of detachment from others), (d) increased arousal (e.g., difficulty concentrating, hypervigilance, exaggerated startle response), and (e) functional impairment (e.g., impairment in social or occupational functioning).

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