Rape Trauma Syndrome

The term rape refers to illicit sexual intercourse without consent. In this violent assault, sexual intercourse is used as a weapon. Rape inflicts varying degrees of physical and psychological trauma. Rape-trauma syndrome occurs after the rape or attempted rape; it refers to the victim's early-stage (short-term) and later-stage (long-term) reactions and to the methods the victim uses to cope with this trauma.

In the United States, the justice department estimates that 8% of American women are victims of rape or attempted rape in their lifetime. Known victims of rape range in age from 2 months to 97 years. (This covers all types of rape, including incest, child sexual abuse, and date rape.) Women ages 16 to 19 are 84 times more likely to be raped than women age 50 or older.

Causes

Rape-trauma syndrome results from rape or attempted rape.

Symptoms

• Pregnancy
• Crying more than usual.
• Nausea and/or vomiting.
• Immediately after a rape, survivors often experience shock: they are likely to feel cold, faint, become mentally confused (disoriented), tremble, feel nauseous and sometimes vomit.
• Not wanting to be left alone.
• Sexual problems like a fear of sex, a loss of interest in sex or a loss of sexual pleasure.
• A loss of memory for all or part of the rape, which is called psychogenic amnesia.
• Feelings of helplessness and powerlessness.
• Feeling irritable and angry.

Diagnostic tests

The victim should be examined as soon as possible after the rape. Evidence for deoxyribonucleic acid testing should be collected within 48 hours. Recent advances in laboratory evaluation include acid phosphatase detection in vaginal washings; the male­specific semen protein p30; and MHS-5, a sperm­coating antigen from human seminal vesicles. As appropriate, specimens are obtained from the cervical canal, throat, or rectum.

Routine laboratory tests include an STD screen and a rapid plasma reagin test. A pregnancy test, a drug screen, and an alcohol level determination also may be performed. Other tests are determined by patient injuries (for example, X-rays are performed if fractures are suspected).

Treatment

Abrasions, lacerations, and other physical injuries receive standardized care, as appropriate. Tetanus prophylaxis is given when indicated. In addition, all sexual assault victims receive STD prophylaxis, according to guidelines established by the Centers for Disease Control and Prevention. Women should receive information on pregnancy prevention.

Long-term treatment includes crisis intervention and counseling. Also, female patients should schedule a follow-up gynecologic examination after 7 to 14 days to ensure adequate pregnancy and STD prophylaxis; male patients should have a follow-up urologic examination.

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