Sexual assault has far reaching effects including the potential for sexually transmitted diseases, pregnancy, major depression, alcohol and drug abuse, chronic pelvic pain, chronic headaches, eating disorders, irritable bowel syndrome, and even suicide (Frampton, 1998). Regardless of physical injuries, wounds inflicted by an assault are much more invasive with long lasting effects (Draucker, 1999). A large number of women who have been raped do not have physical evidence of genitourinary trauma however, this is not generally a relative indicator of overall trauma incurred by the offender on the victim (Slaughter, 1998). The emotional and psychological trauma resulting from an assault is often the deepest and the last to heal.
Rape Trauma Syndrome consists of behavioral, somatic, and psychological reactions to the acute stress of rape and involves two phases: an acute phase of disorganization, and a long term phase of reorganization(Tyra, 1998). According to Frampton (1998) the acute phase of rape trauma lasts up to 3 months after a sexual assault has occurred. Following the acute stage, the reorganization stage occurs and lasts between three months and years after an assault (Frampton, 1998).
Acute Phase
In the acute phase , rape victims tend to be in shock, reacting with expressions of denial and disbelief (Tyra, 1998). Victims in this stage usually respond in either expressed or controlled ways (Tyra, 1998). An expressive victim will show a great deal of emotion where as a controlled victim will appear calm and collected. Psychological symptoms of the acute phase include: flashbacks, numbing of feelings, fear and hyper vigilance (Frampton, 1998). Emotional reactions may include fear, guilt, and self blame; anxiety, insecurity, embarrassment, humiliation, anger, a desire for revenge, and a wish to maintain secrecy (Tyra, 1998). Victims often feel dirty and are self blaming (Hennebry, 1998). Physiological symptoms include: nausea and vomiting, changes in appetite, sleep disturbances , headaches , abdominal pain, mood swings, inability top concentrate, extreme fatigue, irritability, sexually transmitted diseases, pregnancy, and physical injuries. The clients most immediate concerns are often the possibility of infection or pregnancy (Hennebry, 1998). Other symptoms may include: general body soreness, fatigue and muscle tension, nausea, gastrointestinal irritability, and urogenital disturbances(Tyra, 1998). Behavioral responses include making an attempt to regain control, change of phone number, address, or daily routine, seeking anonymity, and failing to keep professional appointments (Frampton, 1998). br>
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Reorganization Phase
The reorganizational period begins weeks to months after an assault, and can last for years. Psychological symptoms of the reorganization phase include: anger, hopelessness, powerlessness, shame, despair, isolation, poor self esteem, loss of control or the feeling that they are going mad, and feelings of abandonment. Physiological symptoms include, chronic pelvic and abdominal pain, premenstrual symptoms, painful intercourse, chronic GI problems, sexual dysfunction, increased risk for STD/HIV, and irritable bowel syndrome. Behavioral responses include: major depression, substance abuse, phobias and panic disorders, obsessive-compulsive disorders, termination of relationships, dangerous sexual behaviors, emotional distancing , posttraumatic stress disorder, and thought of suicide. Victims may suppress and deny feelings of anxiety at this time(Frampton, 1998; Hennebry, 1998; Tyra, 1998).
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