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About The Research Article “Risk Factors for PTSD and Depression in Female Survivors of Rape”

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The research article “Risk Factors for PTSD and Depression in Female Survivors of Rape” was published in the Psychological Trauma: Theory, Research, Practice, and Policy journal in May 2017. The authors of this article are Nolwandle Mgoqi-Mbalo and Sam Ntuti at the University of Limpopo in South Africa, and Muyu Zhang at the University of California, Los Angeles. These authors performed a study of the factors that surround rape to analyze how it affects the development of posttraumatic stress disorder and depression in female victims. The three factors identified were sociodemographic factors, assault circumstances, and post-assault events. Sociodemographic factors are characteristics unique to the rape victim like their marital and employment status, and level of education, etc.

Assault characteristics included how severe the rape was, where it occurred, weapons involved, etc. How the rape victim handled the assault and the social support they received are defined as the post-assault factors. The purpose of this study was to assess these factors that occur before, during and after the rape and how they affect the victim in order to better understand them. The authors hypothesized that the greater the severity of violence during the rape and lack of support will put the victim at greater risk of developing depression and PTSD. They also hypothesized that certain sociodemographic factors, such as marital and employment status, would cause different psychological changes in the survivors.

An abundance of research has been done on the different factors that influence whether or not female rape victims develop psychological disorders. Previous research shows that victims of sexual assault are likely to develop PTSD and depression (Abrahams, Jewkes, & Mathews, 2013; Foa, Cashman, Jaycox, & Perry,1997). Despite this, not all victims do develop PTSD and depression, this suggests that other factors play a role in the likelihood of developing these disorders (Brewin, Andrews, & Valentine, 2000). Sociodemographic factors or pre-assault factors include economic class, ethnicity, marital status, and education level.

A correlation was found between unemployment and victims having symptoms of depression after rape (Abrahams et al., 2013). Factors during rape pertain to how severe the assault was, physically and verbally, as well as the relationship the victim had with the perpetrator. A study found that injury or life-threatening situation lead to a greater risk of PTSD and/or depression (Möller, Bäckstrom, Söndergaard, & Helström, 2014 ). The course of action taken after the assault, post-assault factors, include the degree of social support received. A study on factors found that a lack of support meant a greater risk of PTSD (Brewin et al., 2000). While increasing support leads to a decrease in PTSD overtime (Abrahams et al., 2013). Pre-assault, during assault,and post-assault factors influence the degree of the development of PTSD and depression in victims of rape in many different ways. These studies all set the pathway for the hypotheses and the approach to the study done by Nolwandle Mgoqi-Mbalo, Muyu Zhang and Sam Ntuli.

This study was conducted in hospitals and affiliate sexual assault victim empowerment centers in Limpopo, the Western Cape, and KwaZulu-Natal. The participants were black females, 53% from Limpopo, 25% from the Western Cape, and 22% provinces of South Africa. They were selected from the hospitals and the centers for voluntary participation. The participants had varying sociodemographic factors and assault experiences. 84% had an education level equal or less than grade 12, while the others had a higher educational level. 70% were assaulted outside their home, 28% in their home. 79% experienced it during the night. The authors chose to do a cross-sectional survey of 100 women. They were asked to participate in an in-person 45 minutes interview and then complete various different questionnaire surveys.

The interview and surveys were used to obtain the demographic background of the women, the characteristics of their assault, support received after the event, and then their level of PTSD and depression. The participants were asked to identify the factors that were involved in their case of victimization. Social support was measured through a 10-item Social Support Questionnaire (Van Tilburg, Van Sonderen, & Ormel, 1991). The development of PTSD and depression were measured on two scales. PTSD was measured on the Post-Traumatic Stress Disorder Symptom Scale—Self Report (Foa et al., 1997). Depression was measured with a multiple choice self-rating scale called Beck Depression Inventory II (BDI-II). The higher the score the participate got on the PTSD and depression scales the more severe their symptoms were. The authors then took all the data to evaluate and find a correlation between factors of rape and high level of PTSD and symptoms of depression.

The results showed that majority of the women (87%) had high levels of PTSD and around half (51%) had moderate to severe symptoms of depression. More severe symptoms of depression were found in unmarried and/or unemployed women. The study also revealed a correlation between region and level of the psychological disorders. The research found that in the region of KwaZulu-Natal, victims had a higher history of child abuse and occurrences of rapes in their own homes. This region had a higher proportion of victims experiencing PTSD as well as depression. In regards to the characteristics of the assault, when a weapon was involved, symptoms of depression increased. The results also showed that social support increased symptoms of depression and did not alter levels of PTSD, contrary to prior research that found it decreased PTSD in victims. These results both supported and refuted the author’s hypothesis.

The findings of the study supported most of the previous research on the topic as well as the majority of what the authors anticipated. The authors hypothesized that certain sociodemographic factors, marital status, employment status, and region, would increase the risk of symptoms of depression and PTSD. Those who were unmarried and unemployed where at much greater risk of developing PTSD and symptoms of depression. This may be explained by the idea that married women have an intimate system of support, and that unemployment is already linked to a greater risk of depression on its own. The specific region also affected the development of these psychological disorders, specifically KwaZulu-Natal. KwaZulu-Natal differed from the other provinces because there was a greater report of rape during childhood, higher levels of poverty, and lower education levels. It was also revealed that a more severe assault would increase the development of these disorders.

Those who were assaulted with a weapon involved had a greater score for depression as was predicted. Not all the hypotheses were supported by the findings of the study. The authors predicted that those who lacked social support would be at greater risk for PTSD and symptoms of depression. However, the result showed that the risk of PTSD was not affected either a lack or abundance of support, while symptoms of depression increased along with social support. This may be because social support may make a victim “weaker”, making it more difficult for them to recover.

One strength was the approach to the study, the analysis of a broad range of factors that may or may not impact the severity of PTSD and depression in victims of rape. The authors chose a wide variety of different factors and compared them to the sample of victims in order to find the factors that have a stronger correlation to psychological disorders. The sample size was large, and from three different provinces in South Africa. The can be seen as a strength as an analysis of this specific group of women, who are mainly from the black community. However, this is also a weakness because the sample size is not representative of women of different ethnic background and community.

Another weakness is in the procedure, where rape victims were all those who reported their rape or were in the empowerment centers. This may have created an imbalance in the representation of the severity of the assaults because of the idea that those who go to these centers experienced a more severe assault. Another deficiency being, it is difficult to differentiate whether the factor itself played the main role in the individual’s depression prior to the assault or if the assault along with the factors was more influential.

This study contributed to a greater understanding of the impact of factors that surround the victimization of women. This understanding allows for a better treatment for depression and PTSD. The study revealed how being married impacted victims of rape by lessening their severity of disorders. This brought about the idea that marriage creates a type of support system that positively effects a victimized women. Contrary, the study found that social support correlated with an increase of likeness to have the symptom of depression and did not alter PTSD, rather than decreasing them as hypothesized. These results can be used to create a better more effective treatment that is formulated to reduce and avoid the psychological disorders in victims.

There are a number of different approaches one can take to further the understanding of this topic. One can choose to specifically study symptoms of depression or PTSD alone since they were impacted differently by the same factors. A study can be done with a larger sample size and more diverse group. Another follow-up study could be done on the negative effect of social support to victims of sexual assault. The authors hypothesized that there would be a decrease in both PTSD and depression in those who had social support, but the findings showed otherwise. This particular study is necessary because the findings were surprising and could reveal important information on how victims of assault should be treated. For this particular study, focusing on the topic of social support can reveal influential changes to the treatment of these disorders in the case of rape.

It seems no matter how advanced a society is, sexual assault still commonly occurs, despite being at a lower rate. Though there are things that societies implement such as harsher punishments and technological advances in rape kits, that reduce the likelihood of sexual assault, it still prevails in certain areas. Due to the fact that there is no simple way to stop sexual assault from occurring altogether, it’s important to strengthen the knowledge of PTSD and depression and how to can be treated in these victims. Sexual assault and rape is a huge violation of someone’s body and can be very negative to the victim’s mental health. Having a deep understanding of all the surround factors that can contribute to the development of mental disorder is crucial to creating an effective treatment for a victim.

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