rape-trauma syndrome
Like other posttraumatic stress disorders, this condition initially causes an acute phase of disorganization and involves a long-term reorganization of lifestyle. Sequelae may include marked changes in lifestyle and a variety of phobias.
SEE: rape.
Acute phase: Profound emotional responses mark the acute phase, i.e., fear, shame, and feelings of humiliation; self-blame and self-degradation; and anger and desire for revenge. Most commonly, rape victims exhibit crying, trembling, talkativeness, statements of disbelief, and emotional shock. Some may exhibit overt signs of hostility, which reflect their anger and feelings of powerlessness. Later, patient complaints of sleep pattern disturbances, gastrointestinal irritability, and genitourinary discomforts reflect physical responses to emotional trauma. Some victims may appear quiet, dispassionate, and smiling; however, these behaviors should not be misinterpreted as indicating a lack of concern; rather, they may represent an avoidance reaction.
Long-term phase: Many rape victims experience one or more of the following: nightmares; chronic suspicion, inability to trust, and altered interpersonal relationships; anxiety, aversion to men, and avoidance of sex; depression; and phobias. Paradoxically, patients express feelings of guilt and shame because they feel that either they invited the attack, should have prevented the episode, or that they deserved being punished.
Patient Care: The nurse exhibits empathy and understand ing and ensures privacy and a quiet supportive environment. The patient is encouraged to verbalize feelings, fears, and concerns. Positive self-perception and self-esteem are promoted and supported. The nurse emphasizes that rape usually is an expression of the rapist's overwhelming feelings of psychosocial impotence and anger and that the act conveys a sense of power over others; the woman was a victim of the rapist's inability to contain a violent personal rage that is not related to her or to sex. The patient is referred to community resources (support groups) and for psychological counseling. Most patients prefer to have a counselor of the same sex.