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Appendix 5

Appendix 5. Victim Impact. ACQUAINTANCE RAPE: THE VICTIM Gail Abarbanel Director Rape Treatment Center Santa Monica-UCLA Medical Center. Issues in Acquaintance Rapes. Not common perception of rape Not “real rape” Context/social situation Relationship Attributions of blame

JasminFlorian
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Appendix 5

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  1. Appendix 5 Victim Impact

  2. ACQUAINTANCE RAPE:THE VICTIM Gail Abarbanel Director Rape Treatment Center Santa Monica-UCLA Medical Center

  3. Issues in Acquaintance Rapes • Not common perception of rape • Not “real rape” • Context/social situation • Relationship • Attributions of blame • Assignment of responsibility

  4. Acquaintance Rape: Questions About the Victim • Lifestyle • Behavior • Judgment • Motivation

  5. Victim/Offender RelationshipSource: Bureau of Justice Statistics • 82% acquaintances • 18% strangers

  6. Number of Rapes ReportedSource: FBI Uniform Crime Report • Once every 5 minutes • 12 cases/hour • 100,000 cases/year

  7. Number of Rapes CommittedSource: Rape In America • More than once every minute • 78 cases/hour • 683,000 cases/year

  8. Age of VictimsSource: Rape In America • 29% < 11 years old • 32% 11-17 years old • 23% 18-24 years old • 7 % 25-29 years old • 6% > 29 years old • 3% unknown

  9. Male Victims • 5% of reported rapes • Underreported •  physical violence •  acquaintance rapes

  10. In the Rape in America study, only 16% of the victims reported their rapes to the police.

  11. Reporting Patterns • Stranger rape  reporting • Acquaintance rape  reporting

  12. Reasons for Late/No Reporting • Fear of retaliation • Being blamed/disbelieved • Loss of privacy • Distrust of legal system • Shame and embarrassment • Not defining experience as rape • Denial and suppression of feelings • Psychogenic or drug-induced amnesia

  13. Common Victim Behaviors • Non-resistance • Passive behavior • Failure to attempt to escape • Friendly behavior towards assailant • Delayed reporting • Calm, non-emotional appearance • Gaps in memory

  14. Differences Between Stranger and Acquaintance Rape • Stranger Rape • “Blitz Attack” • Acquaintance Rape • “Confidence Rape”

  15. Types of Coercion • Weapons • Threats to harm victim • Threats to harm significant others • Restraints • Physical Violence • Incapacitating drugs

  16. Acquaintance Rape:Gaining Access to the Victim • Offers assistance to victim • Requests victim’s help • Invites social relationship • Promises possibility of employment/career opportunity • Requests company while completing a task

  17. Strategies for Self-Defense • Cognitive assessment • Verbal tactics • Screaming • Attempting to escape • Stalling for time • Physical resistance

  18. Victim Responses During a Rape • Non-resistance • Frozen fright • Dissociation

  19. Dissociation During a Traumatic Event • Altered time sense • Feelings of unreality that event is occurring • Derealization (altered perception of external world) • Depersonalization (altered sense of self) • Out-of-body experience • Confusion, disorientation • Feeling disconnected from one’s body

  20. Impact of Sexual Assault on the Victim • Rape Trauma • Sexual Trauma • Acute Stress Disorder • Posttraumatic Stress Disorder

  21. Post-Assault Behaviors • Responses contrary to expectations • Oscillation

  22. Acute Stress Disorder (ASD) Development of anxiety, dissociative, and other symptoms within one month after exposure to an extreme traumatic stressor

  23. ASD Criteria: Witness/Experience Traumatic Event in House • Response includes: • Fear • Helplessness • Horror

  24. ASD Symptoms • Dissociative • Reexperiencing • Avoidance and numbing • Anxiety/increased arousal

  25. ASD: Dissociative Symptoms • During or after the trauma: • Numbness • Detachment • Absence of emotional responsiveness • Reduced awareness of surroundings • Derealization • Depersonalization • Dissociative amnesia

  26. ASD: Reexperiencing Symptoms • Persistent reexperiencing of the trauma: • Images • Thoughts • Dreams • Flashbacks • Sense of reliving the trauma • Distress when exposed to reminders of trauma

  27. ASD: Avoidance Symptoms • Avoidance of stimuli that arouse recollections of the trauma: • Thoughts • Feelings • Conversations • Activities • Places • People

  28. ASD: Anxiety Symptoms • Marked symptoms of anxiety or increased arousal: • Difficulty Sleeping • Irritability • Problems with concentration • Hypervigilance • Startle response • Motor restlessness

  29. ASD: TIMING OF SYMPTOMS • Onset: within 4 weeks of trauma • Duration: 2 days to 4 weeks • Persistence: may indicate PTSD

  30. ASD: Diagnosis • Symptoms cause: • Significant distress • Functional impairment • Impairment in ability to pursue necessary tasks

  31. Posttraumatic Stress Disorder(PTSD): Criteria • Exposure to traumatic event which involves: • Actual or threatened death or serious injury • Threat to victim’s physical integrity or safety of a significant other

  32. PTSD Criteria: Exposure/Response • Response to traumatic event involves intense: • Fear • Helplessness • Horror

  33. PTSD Symptoms • Intrusive re-experiencing • Avoidance • Arousal

  34. PTSD Criteria: Diagnosis • Duration of symptoms > one month • Significant distress • Functional impairment

  35. PTSD Criteria: Reexperiencing • Persistent reexperiencing of the trauma: • Recurrent thoughts • Distressing dreams • Acting or feeling as if trauma re-occurring • Extreme distress when exposed to things that resemble or symbolize the trauma.

  36. PTSD Criteria: Avoidance and Numbing • Avoidance of people/situations associated with trauma • AND • Numbing or reduced responsiveness: • Diminished interest or participation in significant activities; • Inability to recall important aspect of the trauma; • Feeling detached or estranged from others; • Restricted range of affect; and or • Sense of a foreshortened future.

  37. PTSD Criteria: Increased Arousal • Sleep disturbances • Irritability • Difficulty with concentration • Hypervigilance • Exaggerated startle response

  38. Other Symptoms of Rape Trauma • Self-blame • Guilt • Shame • Depressed mood • Sexual dysfunction • Somatic complaints • Loss or self-confidence and self-esteem • Changes in assumption about self, others, and world

  39. Health Impact of Rape:Immediate Aftermath • Acute physical injuries • Psychological trauma • Risk of STDs • Risk of unwanted pregnancy

  40. Health Impact of Rape:Psychological Sequelae • ASD/PTSD • Anxiety • Depression • Suicidality • Substance use/abuse • Sexual problems

  41. Health Impact of Rape:Physical Sequelae • Utilization of medical services • Poorer health perceptions • Negative health behaviors • Somatic symptoms • Chronic medical conditions

  42. Health Impact of Rape:Physical Symptoms • Somatic complaints • Stomach aches/nausea • Headaches • Back pain • Chronic medical conditions • GI symptoms • Pelvic pain • Menstrual symptoms

  43. Factors That May Affect Responseto Trauma • Cultural differences • Life-stage and developmental issues • Mental or physical disabilities • Previous victimization experiences • Response of service providers • Social supports

  44. Educating the Jury • Resistance • Reporting • Affect and demeanor • Recall of details • Medical findings

  45. The Prosecutor’s Task • Victim’s lifestyle • Victim’s behavior • Victim’s judgment • Societal beliefs • Defendant’s behaviors

  46. Is It Consent? • Going to certain locations • Engaging in certain activities • Giving sexual consent on one occasion • Allowing man to pay for date • Dressing in revealing clothing

  47. Going to Court:Common Victim Concerns • Loss of privacy • “Being raped again” • Confronting rapist • Delays/continuances • Unknown/unfamiliar • High-profile cases • Outcome/results

  48. Interviewing Victims • Goals of initial interview • Setting/structure • Principles/techniques • Preparing victim for process • Ongoing support

  49. Goals of Initial Interview • Establish rapport/relationship • Gather reliable information • Assess strengths/weaknesses of case • Involve victim in process • Prepare victim for process

  50. Interview Setting/Structure • Privacy • No interruptions • Non-verbal language • Presence of support person(s) • Time allocation

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