Transcript Appendix 1 - MINCAVA Electronic Clearinghouse

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
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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
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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
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Weapons
Threats to harm victim
Threats to harm significant others
Restraints
Physical Violence
Incapacitating drugs
Acquaintance Rape:
Gaining Access to the Victim
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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
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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
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• 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
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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
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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
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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
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Give information
Explain procedures
Include in decisions
Support coping and survival
Empower by identifying areas where have
control