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For details, please refer to http: Sexual assault occurs with alarming frequency in Canada. The prevalence of Posttraumatic Stress Disorder PTSD in assault survivors is drastically higher than the national prevalence of the disorder, which is a strong indication that the current Sexual post traumatic stress disorder for sexual-assault-related PTSD are in need of improvement.
Sexual post traumatic stress disorder understanding of the pathologies associated with rape trauma in biological, psychological and sociological domains will help to develop more effective treatments for survivors. A dysregulation of the Hypothalamic-Pituitary-Adrenal HPA axis is observed in survivors of sexual assault and this may be a fundamental cause of the structural and functional abnormalities contributing to PTSD symptoms.
Pharmacotherapies are available to treat PTSD; however, they are often Sexual post traumatic stress disorder or unwanted by the survivor. Psychological health is compromised following interpersonal trauma and many psychological therapies are available, but with varying efficacy.
A person's cognitions have a dramatic effect on the onset, severity, and progress of PTSD following sexual assault. Sociological impacts of assault influence the development of PTSD through victim-blaming attitudes and the perpetuation of rape myths.
Perceived positive regard and early social support is shown to be important to successful recovery. Education is vital in rape prevention and to foster a supportive environment for survivors. The biological, psychological and sociological impacts and treatments should not remain mutually exclusive.
A better appreciation of the biopsychosocial repercussions of sexual assault will aid in developing a more holistic and individualized therapy to help alleviate the physical and emotional pain following the Sexual post traumatic stress disorder of rape.
One woman is sexually assaulted in Canada every minute 1. Sexual assault is any form of sexual contact without voluntary consent andthat violates a person's sense of autonomy, control and mastery over their body 2. Sexual assault is widespread and occurs with alarming frequency.
Healing from this trauma does not mean that the survivor will forget the experience or never again experience any symptoms. Rather, successful recovery is subjective and measured by whether the survivor increases his or her involvement in the present, Sexual post traumatic stress disorder skills and attitudes to regain control of his of her life, forgive him or herself for guilt, shame and other negative cognitions, and gain stress reduction skills for overall better functioning 4.
There are many factors involved in successful recovery, including the degree of support received, previous self-concept, personal strength, and professional treatment provided by the medical and justice systems 5. PTSD is one of the problems that may result from of the recovery process.
PTSD is caused by exposure to Sexual post traumatic stress disorder traumatic event and intense
Sexual post traumatic stress disorder distress occurs as a result of re-experiencing the event 6. PTSD is diagnosed when symptoms last longer than one month 7. To prevent the distressing reactions, survivors will avoid stimuli that provoke these feelings and this avoidance behaviour can be severe enough to significantly impair daily life 8.
The consequences of a sexual assault may be manifested biologically, psychologically, and sociologically. By gaining a better appreciation of the repercussions of sexual assault, a holistic and individualized therapy can be developed to ameliorate the physical and emotional pain following the trauma.
The issues facing individuals who have experienced sexual assault will be discussed and improvements in current treatments will be suggested, with hopes to develop more effective and holistic therapies in the future. The alarmingly high rate Sexual post traumatic stress disorder PTSD in survivors of sexual assault is a strong indication that the current therapies for rape victims are inadequate and in need of improvement. There is no 'cookie cutter' treatment for every victim suffering with PTSD, as the disorder can manifest itself in many ways 8.
It is important to consider the biological, psychological, and sociological impacts when developing effective treatment and intervention methods for sexual-assault-related PTSD. The dysregulation seen in individuals with PTSD can be observed and measured on all major systems of the body including the endocrine and immune systems 6.
The Hypothalamic-Pituitary-Adrenal HPA axis plays a key regulatory function in the body, controlling all three systems through negative feedback inhibition. Cortisol is a major hormone of the HPA axis and is the primary stress hormone in the body. It is released when stimulated by Corticotropin Releasing Hormone CRH and inhibited via negative feedback acting at the hypothalamic and pituitary levels.
Intense psychological trauma such as sexual abuse can cause changes in the body's response to stress Sexual post traumatic stress disorder increasing levels of CRH and dysregulating the HPA axis 11 This results in a decreased number of CRH receptors in the anterior pituitary, decreased pituitary responsiveness to CRH, and disturbed negative feedback inhibition Cortisol has widespread action and its dysregulation affects other neural systems including the mesocorticolimbic dopaminergic system, leading to inappropriate fear reactions and persistent mild depression The HPA axis is dysregulated in survivors of sexual assault.
A reduced responsiveness to CRH is observed and the negative feedback by cortisol on the hypothalamus and pituitary is disturbed. Knowledge of the biological changes with PTSD has led to the development of new treatments that offer more Sexual post traumatic stress disorder management of PTSD and enable patients to enjoy an improved quality of life For example, various drug treatments have been developed to treat PTSD.
There are five main goals for treating PTSD with medications, including a reduction of the core symptoms such as anxiety and flashbacks, an improvement in stress resilience, an improvement in the quality of life, and a reduction in disability and comorbidity As Brunello et al.
Concurrent with HPA axis dysfunction, disruption of glutamatergic, serotonergic, and adrenergic systems is a fundamental cause of the structural and functional abnormalities which contribute to the symptoms of PTSD. Such symptoms include hyperarousal and re-experiencing feelings associated with the trauma through flashbacks or nightmares The persistent re-experiencing of traumatic events may cause an increase in CRH levels, which damages the hippocampus, an important region of the brain associated with learning and memory 16 With psychological trauma, a decrease in hippocampal volume has been observed 6.
This volume decrease, when coupled with hypersensitivity of the HPA axis, is associated with a reduction of cognitive functioning drastically affecting the performance of affected individuals Selective Serotonin Reuptake Inhibitors SSRIs have been successfully used to treat these hyperarousal symptoms purported to
Sexual post traumatic stress disorder caused by a decrease in hippocampal volume.
SSRIs are commonly used to treat depression and there is some evidence that they may promote neurogenesis, which might be the therapeutic mechanism by which these medications effect changes in behaviour For example, Bremner and Vermetten demonstrated a 4.
Many hormones and receptors in the glutamatergic, serotonergic, and adrenergic systems have been identified as key factors in memory and perception, one of which is the gamma-aminobutyric acid receptor GABA-R The multifaceted interactions between these systems may explain the connections of Sexual post traumatic stress disorder with factual memory.
It has been proposed that while a traumatic memory is re-lived during a flashback, there is an increase in the stimulation of GABA-R caused by an increase in the release of endogenous benzodiazepines To control the overstimulation of GABA-R and thereby control anxiety and flashbacks, benzodiazepine inhibitors such as flumazenil have been used successfully This has also been achieved with clonidine to stop nightmares by decreasing the release of catecholamines, a key component of the anxiety-provoking 'fight or flight' response of the autonomic nervous system The immune system is reciprocally regulated by the neural and endocrine systems and can also be affected by PTSD PTSD often co-occurs with various inflammatory diseases, likely due to HPA axis dysregulation affecting the immune system Immunomodulation is therefore important to avoid this subsequent dysregulation of the immune system and this can be achieved with SSRIs such as Fluvoxamine.
Fluvoxamine has been shown to
Sexual post traumatic stress disorder effective in decreasing the hyperresponsiveness of the HPA axis, thereby increasing levels of interleukins and other essential immune factors Interestingly, there is a sexual dimorphism in immune functioning, as men with PTSD were found to have an inhibited cell-mediated immunity, while women showed enhanced cell-mediated immunity A better understanding of this is necessary and it is important to consider sexual dimorphism for immunomodulation.
Although there are some promising studies for medications, reviews of pharmacotherapies for PTSD have revealed that most treatments are inadequate, aside from some supportive evidence of SSRI effectiveness Therefore it is useful to Sexual post traumatic stress disorder towards other disciplines for additional treatment.
Although the pathology associated with PTSD Sexual post traumatic stress disorder a biological basis, the treatment need not be restricted to drugs. For example, a serious consequence of HPA axis dysregulation is the effect on the steroid hormones, namely estrogen and testosterone, which are also modulated through this axis As a result, some survivors of sexual assault can become infertile due to sex steroid dysregulation.
Interestingly, research indicates that fertility may be restored with Sexual post traumatic stress disorder behavioural therapy CBTjust one example of many where psychological intervention was used to treat a biologically based malady After an assault, survivors experience The Rape Trauma Syndrome RTSwhich affects not only victims of rape, but also victims of all types of sexual violence and would perhaps be better labelled as Sexual Assault Trauma Syndrome. RTS is characterized by three phases The Acute Phase occurs immediately following the assault when the survivor is in crisis and experiences a wide range Sexual post traumatic stress disorder emotional reactions.
These reactions may be categorized as Expressive, such as shaking, crying or yelling; or Controlled such as flattened affect, appearing outwardly calm and subdued. The second phase is Outward Adjustment, when the survivor focuses less on the assault, often with Sexual post traumatic stress disorder high level of denial, and involves themselves in normal daily activities.
The final phase is Long Term Reorganization, in which the survivor integrates the assault into their view of themselves and resolves their feelings about the assailant. There are many psychological effects to consider following a sexual assault such as feelings of shame, guilt, anxiety or depression 9.
These feelings may be even stronger and more harmful if Sexual post traumatic stress disorder survivor does not receive support from their family, friends or authorities 9. Cognitive factors play a large role in the onset, severity, and outcome of PTSD after sexual assault These factors include mental defeat and confusion, negative appraisal of emotions and symptoms, avoidance and perceived negative responses from others 5.
If the survivor of sexual assault believes that others have failed to react in a positive and supportive manner, there is a greater risk of PTSD 9. It has been suggested that trauma recovery is characterized by a reprogramming, integration, and habituation to the traumatic images, leading to a restoration of
Sexual post traumatic stress disorder sense of safety Over time, PTSD symptoms will decrease, the survivor will be less preoccupied with blame towards self and others, and a will achieve a regained sense of control Events perceived as uncontrollable are much more distressing than controllable events, therefore with uncontrollable events such as sexual assault, survivors will attempt to attribute blame to behavioural, dispositional or vicarious causes Behavioural self-blame has the potential to be adaptive as it promotes the belief that negative outcomes can be avoided in the future; whereas dispositional self-blame attributes the traumatic event to one's personality and this thinking does not give
Sexual post traumatic stress disorder sense of future control Vicarious control refers to the perception that some other person or entity had control over the occurrence of that event Attributing blame in any of these ways focuses on the past and is associated with poorer outcomes in PTSD.
To improve PTSD, treatment outcomes emphasis should be on controlling the present situation and what can be done about the impact of the event, rather than how it could have been avoided or can be avoided in the future In view Sexual post traumatic stress disorder the fact that over the recovery process results in lowered distress levels, fostering this form of control could be important component of interventions for sexual assault survivors Early intervention is critical for sexual assault victims because the level of distress immediately following the assault is strongly correlated to future pathologies and PTSD In a study collecting self-reports from survivors of assault that assessed their degree of support and psychological
Sexual post traumatic stress disorder during and immediately following
Sexual post traumatic stress disorder rape, it was found that high Sexual post traumatic stress disorder levels significantly predicted increased levels of fear and anxiety in the
Sexual post traumatic stress disorder following the assault As the level of distress is strongly correlated to PTSD symptoms, an attempt to decrease levels of distress immediately following sexual assault may result in a more positive treatment outcome.
Sexual post traumatic stress disorder medical assistance, the forensic rape exam can be very traumatizing This form of intervention has been very effective in lowering levels of distress in the hospital setting. SARTE consists of a team of nurses who are sensitized to the particular needs of survivors, and Sexual post traumatic stress disorder in dealing with victims of sexual assault.
When working with survivors, the Sexual post traumatic stress disorder explain in detail the procedures they will perform, assist patients in reporting to the police, and maintaining an open environment where the survivor is able to make as many decisions on their own as possible In addition to promising social programs, there are many therapies focussing on the psychological aspect of PTSD. CBT focuses on changing thought patterns and cognitions to decrease negative emotions, develop skills to cope with anxiety and negative thoughts, restore effective social skills, and develop ways to manage anger and future trauma symptoms 9.
During EMDR, the client thinks of past or present traumatic experiences while concurrently focusing on a stimulus such as auditory tones, tactile stimulation, or visual cues This leads to dual attention, changing the processing of the traumatic memories and decreasing anxiety when thinking about the traumatic experience.
Group therapy can be very effective to help survivors focus on the present and share experiences with others in a safe and empathetic environment.
OBJECTIVE: Difficulties with sex often develop following sexual trauma, yet are rarely targeted within treatment of post-traumatic stress disorder. Objective: The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally.
A review article published in the Journal of Sexual Medicine finds that PTSD- related biological and cognitive processes may contribute to the.