Impacts of Sexual Violence on Mental Health

Sexual violence (SV) is globally prevalent among women. Approximately one in five women have experienced some form of SV since the age of 15 years old [1]. Researches consistently show strong associations between SV victimization and poor mental health, including anxiety, depression, and post-traumatic stress disorder (PTSD), regardless of the women’s demographics, socioeconomic status, medication use, and medical history [1, 2].

However, there is inconsistency around what behaviors are included in the definition of sexual violence. The majority of literature focuses only on rape or physically violent sexual assault, yet SV also encompasses other behaviors such as harassment, indecent assault, reproductive control, and forced consumption of pornography [1]. It is important to note that force does not just mean physical force, but includes manipulation, coercion, threats, and situations where a person is unable to give consent [3]. A study by Tarzia L et al in Australia shows women most commonly reported experiencing public harassment or flashing, unwanted groping, and being coerced into having sex [1].

People who were victims of rape or sexual assault are at an increased risk for developing [3];

• Depression

• PTSD

• Substance use disorders

• Eating disorders

• Anxiety

According to the Rape, Abuse, & Incest national network (RAIN), sexual assault includes [3];

• Attempted rape

• Fondling or unwanted sexual touching

• Forcing a victim to perform sexual acts, such as oral sex or penetrating the perpetrator's body and

• Penetration of the victims’ body (rape)

A study by Thurston R et al found that assaulted women were almost three times more likely to have symptoms consistent with major depression and were more than two times more likely to have elevated anxiety [2]. Sexual harassment was associated with a two-fold higher likelihood of poor sleep consistent with clinical insomnia [2]. The associations held true even when demographics, socioeconomic status, medication use, and medical history were taken into account [2].

Sexual harassment in the workplace has also long been a fact of life for working women. Women who are sexually harassed in their workplace often struggle with psychological problems caused by their workplace ordeal, which can lead to issues affecting physical health, according to the experts [4]. Bouts of depression, anxiety, and stress are the least of the psychological problems caused by sexual harassment, said Ann McFadyen, an associate professor of strategic management at the University of Texas at Arlington [4].

In more severe cases, victims can suffer flashbacks and panic attacks that occur as part of post-traumatic stress disorder [4]. They also may be more inclined to develop a substance abuse problem or attempt suicide. When the anxiety becomes pretty intense and regular, women can go to dread work [4]. It affects their concentration. They can become depressed and feel helpless and that can cause anger with self-doubt [4]. Said Debra Borys, a Los Angeles psychologist who specializes in the causes and impact of sexual harassment.

Victims also can develop physical symptoms such as stomach problems, headaches, and other stress-related ailments, Borys said [4]. These health problems can crop up even if a person isn't a victim of outright sexual assault, McFadyen said. Sexist behavior and unwanted sexual attention can be detrimental to a person's health if it occurs as a matter of course in the workplace [4]. "If it's frequent but not intense, that still can kind of wear you down over the long term," McFadyen said [4].

Studies also consistently suggest that women are most likely to be sexually assaulted by a known perpetrator in their own home, yet community understandings of sexual violence typically focus on stranger rapes in dark alleyways. This is highly problematic since compared to SV perpetrated by a stranger, SV at the hands of an intimate partner is associated with [1];

• a higher risk of death or serious injury,

• exposure to multiple and repeated attacks,

• greater risk of sexually transmitted infection and

• Increased feelings of shame.

All of which are likely to contribute to poor mental health outcomes.

Many survivors of sexual violence report flashbacks of their assault and feelings of shame, isolation, shock, confusion and guilt [3]. As well as diminished self-esteem, self-confidence and psychological well-being [5].

These health issues of sexual violence are threatening and need to be addressed, however, there are no accurate statistics in health facilities to answer why and how. Government, hospitals, and other organizations must still enforce sexual harassment policies with emphasis on prevention and not just upon correction and punishment after the incident is reported. Sexual violence questionnaires should be introduced in hospitals and workplaces in order to stay informed of the issue. More awareness and emphasis on gender equality are equally important.

Also having a previous history of being a victim and negative reactions from family, friends, and professionals worsen the impact of sexual violence trauma and can have such a serious impact on mental health [3]. Hence, it is very important that services and supports consider and address the trauma that many individuals have experienced and create an environment that encourages the victims to speak freely and be safe when they encountered any form of sexual violence.

Reference:

1. Exploring the relationships between sexual violence, mental health and perpetrator identity: a cross-sectional Australian primary care study | BMC Public Health | Full Text. Available at https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-6303-y. Accessed on 16th June 2021

2. Sexual Harassment and Sexual Assault Associated with Poorer Physical and Mental Health among Midlife Women | University of Pittsburgh Department of Psychiatry. Available at https://psychiatry.pitt.edu/news/sexual-harassment-and-sexual-assault-associated-poorer-physical-and-mental-health-among. Accessed on 16th June 2021

3. Sexual Assault and Mental Health | Mental Health America. Available at https://www.mhanational.org/sexual-assault-and-mental-health. Accessed on 16th June 2021

4. Sexual Harassment Toxic to Mental, Physical Health. Available at https://www.webmd.com/women/news/20171204/sexual-harassment-toxic-to-mental-physical-health. Accessed on 16th June 2021

5. The Impact of Sexual Harassment on Depressive Symptoms during the Early Occupational Career. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227029/. Accessed on 16th June 2021.