PTSD AFTER A SEXUAL TRAUMA

Post-traumatic stress disorder, or PTSD, is most well-known for its prevalence in the veteran population, but about 30 percent of all PTSD cases in the United States can be attributed to sexual violence*.

The levels of trauma that result from sexual assaults are a little more difficult to define and conceptualize. “Trauma is really self-defined,” said Nancy Downing, PhD, RN, SANE-A, CP-SANE associate professor in the Forensic Nursing Program at the Texas A&M College of Nursing. “What is traumatic to one person may not necessarily be traumatic to another person.”

Beyond physical injuries that can be inflicted during an assault, psychological injuries can result. This type of “injury” can have long-term negative impacts on survivors’ functioning and quality of life. According to the NSVRC, an estimated 94% of women experienced symptoms of PTSD after an assault.

“It is normal to have a very strong reaction to a traumatic episode. And it’s normal to have disruption to your day-to-day activities, especially within the first few days,” Downing said. “You may have trouble concentrating, eating, sleeping, but you need to give yourself time and permission to let yourself feel that way.”

These reactions dissolve in each person’s own time, and are very normal, especially when they occur in the weeks following. However, if they persist, it could be determined to be PTSD. Health care providers cannot diagnose PTSD until four weeks after the trauma, but it is important to seek help when a survivor recognizes they are having trouble, as early intervention could potentially reduce the severity of symptoms.

The severity and type of symptoms can vary greatly among survivors of sexual assault and abuse, but there are a few common symptoms:

• Depression
• Anxiety
• Flashbacks or hyper-reactivity to stimulus like sounds or colors that reminds them of the trauma
• Intrusive symptoms like random thoughts which will drastically change their demeanor
• Avoidance of thoughts or things that remind the person of the trauma
• Hyper-sensitivity and easily triggered feelings
• Detrimental impact on their ability to function day-to-day

Those in a survivor’s inner circle may notice increased irritability, feelings of anger, feelings of numbness or substance abuse. Fights or angry outbursts with friends and family may be an external sign. Other signs are decreased social activity and an unwillingness to leave home. If these symptoms are noted, it’s important to be available to the survivor and guide them to seek help from an advocate or professional.

“Most people who develop PTSD will have a spontaneous recovery, but about 10 percent will keep getting worse,” Downing said. “We do not know why this happens, but hormonal or genetic differences between people and the presence of past trauma, especially during childhood, tends to make people more likely to develop PTSD than others.”

Downing is currently researching why some are effected more than others and to identify who might be at greater risk for PTSD development following sexual assault and potential interventions sexual assault nurse examiners (SANEs) can integrate into their care to prevent or reduce symptoms of PTSD.

The American Psychological Association reports that woman are twice as likely to develop PTSD, experience a longer duration of posttraumatic symptoms and display more sensitivity to stimuli that reminds them of the trauma.

Men and women who have experienced long term sexual abuse, like domestic violence or human trafficking, are also at high risk for PTSD.

“Most women that endure domestic partner violence often also endure sexual assault at some point,” said Nora Montalvo-Liendo, RN, PhD, FAAN, an assistant professor at the Texas A&M College of Nursing, who specializes in interpersonal and sexual violence among minority populations.

“Studies have shown women of color are more likely to experience abuse. These women frequently speak about PTSD symptoms like feelings of numbness, poor sleep patterns and hyper-arousal in regards to their environment,” said Montalvo-Liendo. “One of the biggest challenges for some women with PTSD symptomology is the ability to show maternal warmth to their children. It is important for people who experience sexual trauma to get the help they need, so it does not impact those around them.”

After a sexual trauma, people have a natural tendency to try to ignore what happened and move on with their lives, but seeking help can potentially reduce long-term impacts. Whether or not a survivor reports the assault to law enforcement or believes they will develop PTSD, it’s a good step to seek mental health services after sexual assault. Crisis centers throughout Louisiana are available to counsel survivors with the utmost confidentiality and care. If you’re having trouble after being sexually assaulted, we encourage you to find the center in your parish and speak with an advocate. An initial conversation can lead to a path of wellness and healing.

*US National Center for PTSD