Why Is Post-Traumatic Stress Disorder Common In Sexual Assault Survivors?

A full third of all female rape survivors suffer from post-traumatic stress disorder sometime in the aftermath, research tells us. Ninety-four percent of sexual assault survivors have symptoms within the first two weeks after, while 47 percent are mentally plagued, to the point of PTSD, in the first three months post-assault. In comparison, 3.6 percent of the adult US population will have PTSD in any given year, while 6.8 percent will develop this trauma-related anxiety disorder at some point in their lives. 

Post-traumatic stress disorder is, other words, really very common in sexual assault survivors. Why?

To be diagnosed with PTSD, you have to meet a whole host of diagnostic criteria. You'll be dealing with things like intrusive and distressing memories, flashbacks, and bad dreams. You'll be doing stuff, consciously or otherwise, to avoid reminders of bad things that happened. You may suffer from survivor's guilt, self-blame, and feelings of worthlessness. You may find yourself unable to trust anyone — or feel any positive emotions. You may be overcome by fits of rage, always be on guard for more danger, and feel detached from the world. 

Before you even get to that part, however, you have to have experienced one or more traumatic events, witnessed them in person, learned that something terrible happened to someone you care about, or repeatedly have been exposed to others' traumatic experiences (as a first responder, for instance). 

A closer look: Just why is sexual assault traumatic?

Sexual assault comes in all sorts of forms. While we won't disturb you with graphic details, it can be perpetrated by a total stranger, someone the victim knows extremely well, and everyone in between. There can be one perp, or many. It can happen once, or over the course of many years. Perps can use physical violence or other forms of coercion. Sexual assault can take place anywhere, behind a trash container or in the place where you're meant to feel safest — your own home. Anyone, of any age, gender, and background can become a victim. 

Every victim's story is different — but we also have a lot in common. My own background should more than qualify me to explain just why sexual assault is traumatic. I was, you see, raped by my mother's boyfriend for years, starting at age 11. My life was never in danger during the assaults, and the perpetrator left no lasting physical damage.

Here's what did happen. The rapist took control of the one thing that's supposed to be truly "ours" — my body. He turned it into a weapon for his own self-gratification. He poked around in it as he pleased, and there was nothing I could do about it. My first sexual experience was that of rape, and something many people consider beautiful and connecting and even spritual forever became linked to trauma. He took control over my soul, too. He convinced the people who were meant to keep me safe, my family, that I was lying after I disclosed. He robbed me of my social support network, bonds that forever remained broken.  He ransacked my trust in humanity and my sense of identity. 

I was only diagnosed with PTSD many years — and a few more traumatic experiences — later, and this means that I spent my entire adult life plagued by guilt, feelings of self-loathing, nightmares, unable to enjoy healthy intimate relationships, and, frankly, believing I owed sex to anyone who wanted it. It took me until well after I started therapy to begin experiencing positive feelings. Before that, my emotional life was dominated by fear and anger. 

What factors increase someone's risk of developing PTSD after sexual assault?

Researchers have sought to answer this question, and concluded that sexual assault survivors have higher odds of winding up with post-traumatic stress disorder if:

• The sexual assault was a rape (forced penetration). 
• They were physically injured or feared for their life, among other reasons because the perpetrator threatened them with weapons such as guns or knives. 
• They became victims when they were children.
• They were assaulted by strangers. 
• They were assaulted in places where they were meant to be safe, such as their homes. 

None of these factors can be changed after an assault — but some of the things that happen in the aftermath also contribute to a sexual assault victim's risk of developing post-traumatic stress disorder. That is, ultimately, why this question matters.

Sexual assault victims are, you see, less likely to suffer from PTSD if:

• They are armed with healthy coping mechansism — something therapy can really help with. 
• They have supportive people in their lives who believe them, listen to them, and take them seriously. Secondary victimization in the form of not being believed, being told to just get over it, being shunned and stigmatized because you're a victim, getting the message that the assault was your fault, and other insiduous things people often do to those who survived sexual assault, increase the risk of PTSD. 

This is ultimately good news. We can't change the past, after all, but we can, as a society, change the way we respond to sexual assault victims. The psychological mark sexual assault leaves may never quite go away, but we can reduce the risk that an assault becomes a never-ending nightmare. We can treat sexual assault survivors with dignity and respect, being there for them rather than grilling them about what they were wearing or whether they tried to fight the perp off.