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% years old 23% years old 7 % 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 re- occurring 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