Abstract
Rape is the most common trauma leading to post-traumatic stress disorder (PTSD) among women, with a conditioned prevalence of up to 50%. PTSD is considered to be a lethal condition associated with increased risk of suicide, drug- and alcohol dependence, neurological- and vascular problems, as well as sick leave. Given the scope of this problem, novel and swiftly delivered interventions for this large vulnerable population are clearly warranted. One previous trial conducted in the United States (N = 137) showed that an adapted brief version of prolonged exposure (PE) to the fearful memory of the event and situations, provided in the immediate aftermath after trauma (<72 h after a traumatic event), was effective in reducing early PTSD symptoms in rape victims. The aims of the present study were to adapt the brief PE protocol to a Swedish context and investigate its feasibility and delivery in 10 executive patients recruited at the Emergency Clinic for Rape Victims in Stockholm. Ten participants were provided with three sessions of early PE with overall successful results in terms of session attendance, home-work compliance, and also symptom reduction of PTSD and depressive symptoms. However, only a fraction of the screened patients at the Emergency Clinic (5.2%) were eligible to be included in the study, where the majority (40%) were excluded due to the time criteria of 72 h. In this article, we will present detailed results of the intervention and elaborate on how to increase feasibility of preventive interventions for rape victims. In the current form, providing PE with the strict time criteria was not feasible in the clinical setting that constitutes the Emergency Department for rape.
Highlights
Sexual assault, including sexual abuse, rape, intimate partner, and sexual violence, is a global public health concern affecting an estimated 12% of women around the world (Scott et al, 2018)
A total of 191 patients underwent the pre-selection screening for eligibility of which 118 (61.7%) were immediately excluded due to the following reasons: >72 h had passed since the rape (36 patients; 18.8% of the screened sample), not fluent in Swedish (18 patients, 9.4% of the screened sample),
We hypothesized that a brief prolonged exposure (PE) intervention provided in the early aftermath of rape would be a feasible and acceptable early psychological treatment for post-traumatic stress disorder (PTSD) in regular Swedish care
Summary
Sexual assault, including sexual abuse, rape, intimate partner, and sexual violence, is a global public health concern affecting an estimated 12% of women around the world (Scott et al, 2018). Sexual assault can lead to a variety of problems including lifetime diagnosis of anxiety disorders, depression, post-traumatic stress disorder (PTSD), eating- and sleep. A recent large-scale epidemiological study from Iceland showed an increased risk for negative effects on both maternal health as well as fetal development among women with a history of sexual assault (Gisladottir et al, 2014). This is an important finding given that as much as one out of 12 pregnant women has experienced a sexual assault during her lifetime (Stenson et al, 2003)
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