The Psychological Impact of Sexual Assault
Corroborated or not, cases of sexual assault have monopolized the news, focusing a spotlight on a topic that has been ignored for too long. Now, a study shows that sexual harassment and assault are a public health problem. The subsequent consequences, both mental and physical, continue to affect women for many years.
According to a study published in JAMA Internal Medicine, sexual assault survivors are three times more likely to be depressed than people with no history of sexual trauma. They were also two times more likely to have high anxiety and sleep issues, including insomnia.
Sexual harassment at work also left an indelible mark. Women who suffered through such a situation had higher blood pressure, which put them at risk for several serious conditions, including heart disease, stroke, aneurysms, and kidney disease.
“For a long time these cases were minimized,” explains Dr. Nicole Ann Mavrides, a psychiatrist with the University of Miami Health System, “but now there’s proof that women are carrying these effects for life.”
The study, she adds, is particularly important not only because it comes at a seminal time but also because so many women have faced these uncomfortable and often dangerous situations. While the rate of sexual assault and rape has fallen since 1993, according to the Rape, Abuse & Incest National Network (RAINN), the organization that operates the National Sexual Assault Hotline, incidents remain a problem, with hundreds of Americans affected by sexual violence every day.
Every 98 seconds, an American is sexually assaulted. And every 8 minutes, that victim is a child.
Victim numbers are likely higher
The CDC puts the number of victims in the millions, estimating that one in three women and one in six men have experienced sexual violence involving physical contact at some point in their lives. “Statistics,” the CDC further adds, “underestimate the problem because many victims do not tell the police, family, or friends about the violence.”
In the JAMA study, which looked at more than 300 healthy, middle-aged women in Pittsburgh, one in five had been sexually harassed at work, and about 22 percent said they’d been sexually assaulted. About 20 percent said they had been the victim of both. Though the JAMA study was focused on examining the link between hot flashes in menopause and atherosclerosis, a trauma interview and questionnaire revealed these numbers.
Dr. Mavrides says she wouldn’t be surprised if those figures inch up in the future, as women (and men) feel more comfortable talking about experiences that older victims may have sought to suppress.
“I don’t think it’s necessarily happening more, but I do think people are talking about it more now,” she says. “In my practice, I see young adult patients who are more comfortable bringing it up. They’re more confident.”
The JAMA study, while providing “a great start” for further research into the link between sexual assault and health issues, does not prove a cause and effect, she cautions. It does, however, show that sexual harassment and assault appear to compromise health. This is true of other negative social situations. For example, studies have shown that racial discrimination is associated with high blood pressure, obesity, depression, low self-esteem, and heart conditions.
Internalized feelings lead to poor health
This, she adds, may be attributed to the fact that sexual assault, like racial discrimination, is “a very polarizing topic that is not easy to talk about. Some deal with it, report it or tell HR [human resources], but many don’t do anything about it. They internalize their feelings.”
This internalization does not help in the long term. Conflicting emotions will eventually manifest themselves in unhealthy ways. Dr. Mavrides believes that looking at sexual assault and harassment as a public health risk may draw much-needed attention and funding to the topic. “We need more studies, bigger multi-site studies that focus on this subject.”
She also hopes that this research will prove useful in developing a risk-assessment screening for sexual assault and harassment. A screening could be used by primary care physicians and gynecologists, much in the same way doctors already screen patients for other conditions. Doctors should approach the subject when they ask if a patient is sexually active. A simple inquiry about whether a patient has ever been in a situation where she was touched inappropriately, or without her consent, may open the door to further discussion.
“The doctor may have to ask multiple times and in different ways,” Dr. Mavrides says, “but it can spark more interest. It’s a way of getting these people the help they need.”
Ana Veciana-Suarez, Guest Contributor
Ana is a regular contributor to the University of Miami Health System. She is a renowned journalist and author, who has worked at The Miami Herald, The Miami News, and The Palm Beach Post. Visit her website at anavecianasuarez.com or follow @AnaVeciana on Twitter.
Tags: anxiety, depression, mental health, sexual assault, sexual harassment, women's mental health