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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 • Assignment of responsibility Acquaintance Rape: Questions About the Victim • Lifestyle • Behavior • Judgment • Motivation Victim/Offender Relationship Source: Bureau of Justice Statistics • 82% acquaintances • 18% strangers Number of Rapes Reported Source: FBI Uniform Crime Report • Once every 5 minutes • 12 cases/hour • 100,000 cases/year Number of Rapes Committed Source: Rape In America • More than once every minute • 78 cases/hour • 683,000 cases/year Age of Victims Source: 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 Male Victims • 5% of reported rapes • Underreported • physical violence • acquaintance rapes In the Rape in America study, only 16% of the victims reported their rapes to the police. Reporting Patterns • Stranger rape reporting • Acquaintance rape reporting 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 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 Differences Between Stranger and Acquaintance Rape • Stranger Rape “Blitz Attack” • Acquaintance Rape “Confidence Rape” Types of Coercion • • • • • • Weapons Threats to harm victim Threats to harm significant others Restraints Physical Violence Incapacitating drugs 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 Strategies for Self-Defense • Cognitive assessment • Verbal tactics • Screaming • Attempting to escape • Stalling for time • Physical resistance Victim Responses During a Rape • Non-resistance • Frozen fright • Dissociation 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 Impact of Sexual Assault on the Victim • Rape Trauma • Sexual Trauma • Acute Stress Disorder • Posttraumatic Stress Disorder Post-Assault Behaviors • Responses contrary to expectations • Oscillation Acute Stress Disorder (ASD) Development of anxiety, dissociative, and other symptoms within one month after exposure to an extreme traumatic stressor ASD Criteria: Witness/Experience Traumatic Event in House Response includes: • Fear • Helplessness • Horror ASD Symptoms • Dissociative • Reexperiencing • Avoidance and numbing • Anxiety/increased arousal ASD: Dissociative Symptoms During or after the trauma: • Numbness • Detachment • Absence of emotional responsiveness • Reduced awareness of surroundings • Derealization • Depersonalization • Dissociative amnesia ASD: Reexperiencing Symptoms Persistent reexperiencing of the trauma: • Images • • • • • Thoughts Dreams Flashbacks Sense of reliving the trauma Distress when exposed to reminders of trauma ASD: Avoidance Symptoms Avoidance of stimuli that arouse recollections of the trauma: • Thoughts • Feelings • Conversations • Activities • Places • People ASD: Anxiety Symptoms Marked symptoms of anxiety or increased arousal: • Difficulty Sleeping • Irritability • Problems with concentration • Hypervigilance • Startle response • Motor restlessness ASD: TIMING OF SYMPTOMS • Onset: within 4 weeks of trauma • Duration: 2 days to 4 weeks • Persistence: may indicate PTSD ASD: Diagnosis Symptoms cause: • Significant distress • Functional impairment • Impairment in ability to pursue necessary tasks 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 PTSD Criteria: Exposure/Response Response to traumatic event involves intense: • Fear • Helplessness • Horror PTSD Symptoms • Intrusive re-experiencing • Avoidance • Arousal PTSD Criteria: Diagnosis • Duration of symptoms > one month • Significant distress • Functional impairment PTSD Criteria: Reexperiencing Persistent reexperiencing of the trauma: • Recurrent thoughts • Distressing dreams • Acting or feeling as if trauma reoccurring • Extreme distress when exposed to things that resemble or symbolize the trauma. 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. PTSD Criteria: Increased Arousal • Sleep disturbances • Irritability • Difficulty with concentration • Hypervigilance • Exaggerated startle response 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 Health Impact of Rape: Immediate Aftermath • Acute physical injuries • Psychological trauma • Risk of STDs • Risk of unwanted pregnancy Health Impact of Rape: Psychological Sequelae • ASD/PTSD • Anxiety • Depression • Suicidality • Substance use/abuse • Sexual problems Health Impact of Rape: Physical Sequelae • Utilization of medical services • Poorer health perceptions • Negative health behaviors • Somatic symptoms • Chronic medical conditions Health Impact of Rape: Physical Symptoms • Somatic complaints – Stomach aches/nausea – Headaches – Back pain • Chronic medical conditions – GI symptoms – Pelvic pain – Menstrual symptoms Factors That May Affect Response to Trauma • Cultural differences • Life-stage and developmental issues • Mental or physical disabilities • Previous victimization experiences • Response of service providers • Social supports Educating the Jury • Resistance • Reporting • Affect and demeanor • Recall of details • Medical findings The Prosecutor’s Task • Victim’s lifestyle • Victim’s behavior • Victim’s judgment • Societal beliefs • Defendant’s behaviors 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 Going to Court: Common Victim Concerns • • • • • • • Loss of privacy “Being raped again” Confronting rapist Delays/continuances Unknown/unfamiliar High-profile cases Outcome/results Interviewing Victims • Goals of initial interview • Setting/structure • Principles/techniques • Preparing victim for process • Ongoing support Goals of Initial Interview • Establish rapport/relationship • Gather reliable information • Assess strengths/weaknesses of case • Involve victim in process • Prepare victim for process Interview Setting/Structure • Privacy • No interruptions • Non-verbal language • Presence of support person(s) • Time allocation Interview Principles/Techniques • • • • • • • Explain purpose Clarify victim’s role Encourage victim to tell you everything Ask open-ended questions Elicit sensory/peripheral detail Acknowledge feelings Give realistic assessment of case Interview Principles/Techniques (continued) • Follow gut instincts • Maintain eye contact • Assess previous interview experiences Prepare Victim for Process • Explain legal process • Specify roles and responsibilities • Encourage questions • Never promise specific outcomes • Maintain contact with victim • Assess support systems • Encourage counseling/therapy Supporting Victims Through the Process • • • • • Give information Explain procedures Include in decisions Support coping and survival Empower by identifying areas where have control