The Physical Health Consequences of Rape: Assessing Survivors' Somatic Symptoms in a Racially Diverse Population

By Campbell, Rebecca; Seft, Tracy et al. | Women's Studies Quarterly, Spring 2003 | Go to article overview

The Physical Health Consequences of Rape: Assessing Survivors' Somatic Symptoms in a Racially Diverse Population


Campbell, Rebecca, Seft, Tracy, Ahrens, Courtney E., Women's Studies Quarterly


Sexual assault is a devastating problem for women's health. In national studies of women's perceptions of their health, rape victims' assessments of their physical well-being are considerably poorer than national norms (National Center for Health Statistics, 1999). Rape survivors have significantly lower self-ratings of their current health status than do non-victimized women (Golding, 1994; Koss, Woodruff, & Koss, 1990; Koss, Koss, & Woodruff, 1991; Waigandt, Wallace, Phelps, & Miller, 1990; Wenzel, Leake, & Gelberg, 2000). In comparison to victims of other types of crimes, survivors of sexual assault also appear to have more health problems (Koss et al., 1990, 1991). These decrements in women's health appear as early as one month post-assault (Kimerling & Calhoun, 1994) and may remain detectable years after the assault (Golding, 1994; Koss et al., 1990).

Although there is compelling evidence that sexual violence is a serious threat to women's health, historically the medical system has characterized abused women's health symptoms as hysteria or psychosomatic in nature (Golding, 1994; Warshaw, 1994). While some of the health symptoms described by victims of sexual assault do overlap with markers of depression, anxiety, and posttraumatic stress disorder, many health issues are indeed physical in nature. In her study of the relationship between sexual assault and medically explained and unexplained somatic symptoms, Golding (1994) found that 29% of women with a history of sexual assault reported at least six medically explained somatic symptoms and 11% reported at least six symptoms that were not explained by medical conditions. Rape victims were twice as likely to report medically explained symptoms and four times as likely to report medically unexplained symptoms (Golding, 1994). These results suggest that while some of the physical health symptoms experienced by rape victims may reflect psychological distress, far more of these symptoms result from medically explained conditions.

Current research indicates that the physical health distress that rape victims experience throughout their recoveries are "real" health problems and are extremely common. Specifically, these health symptoms include both chronic diseases and recurring health problems. Rape victims are more likely than nonvictims to have chronic illnesses such as diabetes, arthritis, and asthma (Felitti, 1991; Golding, 1994). They are also more likely to report gastrointestinal symptoms (e.g., nausea, diarrhea, indigestion, constipation, abdominal pain), muscular/skeletal problems (e.g., back pain, headaches, and muscle soreness), cardiopulmonary symptoms (e.g., rapid heart rate, pain in heart or chest, shortness of breath), neurological symptoms (e.g., fainting, dizziness, sleep problems, numbness/tingling in the body), and gynecological problems (e.g., pelvic pain, pain during intercourse, menstrual symptoms) than are nonvictims (Eby, Campbell, Sullivan, & Davidson, 1995; Felitti, 1991; Golding, 1994, 1996; Kimerling & Calhoun, 1994; Koss & Heslet, 1992; Wenzel et al., 2000). The number and frequency of these symptoms are considerably higher than the national averages for women (National Center for Health Statistics, 1999) and are not related to differences in previous chronic diseases, injuries, or differences in family history of disease (Waigandt et al., 1990).

The reasons why rape victims have more health problems are not well understood. Koss and her colleagues have suggested that a number of factors may explain the victimization-health relationship (Koss, 1994; Koss & Heslet, 1992; Koss et al., 1990). For example, the stress associated with the assault may lower immune system functioning, the assault causes secondary damage that is initially undetected, or both. It is also possible that victims' attempts to cope with the assault result in increased health risk behaviors. In addition to these biobehavioral factors, victims' demographic characteristics and assault experiences (i. …

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