Department of Psychology, Clemson University, 418 Brackett Hall, Clemson, SC 29634, USA.
Soc Psychiatry Psychiatr Epidemiol. 2012 Jun;47(6):893-902. doi: 10.1007/s00127-011-0397-1. Epub 2011 May 21.
Rape is an established risk factor for mental health disorders, such as posttraumatic stress disorder (PTSD), major depressive episodes (MDE), and substance use disorders. The majority of studies have not differentiated substance-involved rape or examined comorbid diagnoses among victims. Therefore, the aim of the present study was to estimate the prevalence of common trauma-related psychiatric disorders (and their comorbidity) in a national sample of women, with an emphasis on distinguishing between rape tactics. A secondary objective was to estimate the risk for psychiatric disorders among victims of variant rape tactics, in comparison to non-victims.
A nationally representative population-based sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18-86 years) participated in a structured telephone interview assessing rape history and DSM-IV criteria for PTSD, MDE, alcohol abuse (AA), and drug abuse (DA). Descriptive statistics and multivariate logistic regression analyses were employed.
Women with rape histories involving both substance facilitation and forcible tactics reported the highest current prevalence of PTSD (36%), MDE (36%), and AA (20%). Multivariate models demonstrated that this victim group was also at highest risk for psychiatric disorders, after controlling for demographics and childhood and multiple victimization history. Women with substance-facilitated rapes reported higher prevalence of substance abuse in comparison to women with forcible rape histories. Comorbidity between PTSD and other psychiatric disorders was higher among rape victims in comparison to non-rape victims.
Researchers and clinicians should assess substance-facilitated rape tactics and attend to comorbidity among rape victims. Empirically supported treatments are needed to address the complex presentations observed among women with variant rape histories.
强奸是心理健康障碍的既定风险因素，例如创伤后应激障碍（PTSD）、重度抑郁发作（MDE）和物质使用障碍。大多数研究并未区分涉及物质的强奸或检查受害者中的共病诊断。因此，本研究的目的是估计在全国女性样本中常见与创伤相关的精神障碍（及其共病）的患病率，重点区分强奸策略。次要目的是估计与非受害者相比，各种强奸策略受害者中精神障碍的风险。
一项基于全国代表性的、基于人群的样本，包括 3001 名非机构化、平民、讲英语或西班牙语的女性（年龄在 18-86 岁之间），她们参加了一项结构电话访谈，评估强奸史和 DSM-IV 创伤后应激障碍、MDE、酒精滥用 (AA) 和药物滥用 (DA) 的标准。采用描述性统计和多变量逻辑回归分析。
涉及物质促进和强制策略的强奸史女性报告当前 PTSD（36%）、MDE（36%）和 AA（20%）的患病率最高。多变量模型表明，在控制人口统计学、儿童期和多次受害史后，这个受害群体的精神障碍风险最高。与有强迫性强奸史的女性相比，有物质促进的强奸史的女性报告了更高的物质滥用患病率。与非强奸受害者相比，强奸受害者的 PTSD 与其他精神障碍之间的共病率更高。
研究人员和临床医生应评估物质促进的强奸策略，并关注强奸受害者的共病。需要有经验支持的治疗方法来解决有不同强奸史的女性中观察到的复杂表现。
