Whether a person is raped by a stranger, an acquaintance, or a partner, the experience can be traumatic and can have long-term repercussions. Given the characteristics of rape—the physical violation and psychological trauma that it inflicts and our societal attitudes about it—it is understandable that many rape survivors suffer long-lasting emotional effects. Rape perpetrated by multiple offenders is often more violent and involves more severe forms of violation than does rape committed by a lone rapist (Woodhams et al., 2012).

Feelings of shame, anger, fear, guilt, depression, and powerlessness are common (Koss et al., 2002; Vandeusen & Carr, 2003). One reason that some women feel guilt and shame is that they are often seen, and see themselves, as being responsible—no matter what the circumstances—for not preventing unwanted sexual activity from taking place. Rape survivors may also exhibit a tendency toward subsequent victimization by further sexual assaults (Littleton et al., 2009; Reese-Weber & Smith, 2011). A recent study of several hundred college women found that some of these women were at greater risk for rape due to their use of substances (alcohol, marijuana, etc.) to reduce distress associated with previous trauma (sexual, physical, emotional abuse) (Messman-Moore et al., 2009).

In addition to the psychological impact of rape, physical symptoms such as nausea, headaches, gastrointestinal problems, genital injuries, and sleep disorders frequently occur (Hilden et al., 2005; Ullman & Brecklin, 2003). Approximately 32% of women and 16% of men who were raped after age 18 reported being physically injured during the assault (Tjaden & Thoennes, 1998). Rape survivors may associate sexual activity with the trauma of their assault. As a result, sexual activity may induce anxiety rather than desire or arousal (Koss et al., 2002, 2003).

When the emotional and physical reactions women experience following rape or attempted rape are severe, victims may be classified as suffering from posttrau­matic stress disorder (PTSD). PTSD, an official diagnostic category of the Ameri­can Psychiatric Association (2000), refers to the long-term psychological distress that can develop after a person is subjected to a physically or psychologically traumatic event (or events). People who experience a profoundly disturbing incident, such as sexual assault, wartime combat, or a horrendous accident, often exhibit a range of

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distressing symptoms as an aftermath of the occurrence. These reactions include dis­turbing dreams, nightmares, depression, anxiety, and feelings of extreme vulnerability. In addition, just as combat veterans may have flashbacks of traumatic war experiences, so too might a rape survivor have vivid flashbacks of the attack in which she reexperi­ences all the terror of the assault. Research indicates that rape produces one of the highest rates of PTSD among nonwartime traumatic events (Koss et al., 2002; Ullman et al., 2007).

Victims often find that supportive counseling, either individually or in groups, can help ease the trauma caused by rape (Romeo, 2004; Vandeusen & Carr, 2003). Research has shown that women who receive help soon after an assault experience less severe emotional repercussions than women whose treatment is delayed (Campbell, 2006). Most rape survivors find that it helps to talk about their assault and the emotional upheaval they are experiencing. Often the process of reviewing the event allows them to gain control over their painful feelings and to begin the process of healing. The Let’s Talk About It box, "Helping a Partner or Friend Recover From Rape," suggests ways to communicate and interact with a rape victim.