Möller Anna, Söndergaard Hans Peter, Helström Lotti
Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2017 Aug;96(8):932-938. doi: 10.1111/aogs.13174. Epub 2017 Jun 22.
Active resistance is considered to be the 'normal' reaction during rape. However, studies have indicated that similar to animals, humans exposed to extreme threat may react with a state of involuntary, temporary motor inhibition known as tonic immobility. The aim of the present study was to assess the occurrence of tonic immobility during rape and subsequent post-traumatic stress disorder and severe depression.
Tonic immobility at the time of the assault was assessed using the Tonic Immobility Scale in 298 women who had visited the Emergency clinic for raped women within 1 month of a sexual assault. Information about the assault and the victim characteristics were taken from the structured clinical data files. After 6 months, 189 women were assessed regarding the development of post-traumatic stress disorder and depression.
Of the 298 women, 70% reported significant tonic immobility and 48% reported extreme tonic immobility during the assault. Tonic immobility was associated with the development of post-traumatic stress disorder (OR 2.75; 95% CI 1.50-5.03, p = 0.001) and severe depression (OR 3.42; 95% CI 1.51-7.72, p = 0.003) at 6 months. Further, previous trauma history (OR 2.36; 95% CI 1.48-3.77, p < 0.001) and psychiatric treatment history (OR 2.00; 95% CI 1.26-3.19, p = 0.003) were associated with the tonic immobility response.
Tonic immobility during rape is a common reaction associated with subsequent post-traumatic stress disorder and severe depression. Knowledge of this reaction in sexual assault victims is important in legal matters and for healthcare follow up.
主动抵抗被认为是强奸过程中的“正常”反应。然而，研究表明，与动物类似，遭受极端威胁的人类可能会出现一种非自愿的、暂时的运动抑制状态，即紧张性不动。本研究的目的是评估强奸过程中紧张性不动的发生率以及随后的创伤后应激障碍和重度抑郁症。
使用紧张性不动量表对298名在性侵犯发生后1个月内前往强奸女性急诊诊所就诊的女性在袭击发生时的紧张性不动情况进行评估。有关袭击和受害者特征的信息取自结构化临床数据文件。6个月后，对189名女性的创伤后应激障碍和抑郁症发展情况进行评估。
在298名女性中，70%报告在袭击过程中出现明显的紧张性不动，48%报告出现极端紧张性不动。紧张性不动与6个月时创伤后应激障碍的发生（比值比2.75；95%置信区间1.50 - 5.03，p = 0.001）和重度抑郁症的发生（比值比3.42；95%置信区间1.51 - 7.72，p = 0.003）相关。此外，既往创伤史（比值比2.36；95%置信区间1.48 - 3.77，p < 0.001）和精神科治疗史（比值比2.00；95%置信区间1.26 - 3.19，p = 0.003）与紧张性不动反应相关。
强奸过程中的紧张性不动是一种常见反应，与随后的创伤后应激障碍和重度抑郁症相关。了解性侵犯受害者的这种反应在法律事务和医疗随访中很重要。
