Skip to main content

Advertisement

Log in

Long-Term Effects of Conflict-Related Sexual Violence Compared with Non-Sexual War Trauma in Female World War II Survivors: A Matched Pairs Study

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • Campbell, R., & Wasco, S. M. (2005). Understanding rape and sexual assault: 20 Years of progress and future directions. Journal of Interpersonal Violence, 20, 127–131.

    Article  PubMed  Google Scholar 

  • Cann, A., Calhoun, L. G., Tedeschi, R. G., Taku, K., Vishnevsky, T., Triplett, K. N., et al. (2010). A short form of the Posttraumatic Growth Inventory. Anxiety, Stress and Coping, 23, 127–137.

    Article  Google Scholar 

  • Casanas, G. (2010). UN: Wartime rape no more inevitable, acceptable than mass murder. CNN World News. Retrieved November 23, 2011 from http://edition.cnn.com/WORLD/.

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Press.

    Google Scholar 

  • Derogatis, L. R. (2000). BSI-18: Brief Symptom Inventory 18: Administration, scoring, and procedures manual. Minneapolis, MN: NCS Pearson.

    Google Scholar 

  • Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavioral Research Methods, 39, 175–191.

    Article  Google Scholar 

  • Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychological Assessment, 9, 445–451.

    Article  Google Scholar 

  • Forstmeier, S., Kuwert, P., Spitzer, C., Freyberger, H. J., & Maercker, A. (2009). Posttraumatic growth, social acknowledgment as survivors, and sense of coherence in former German child soldiers of World War II. American Journal of Geriatric Psychiatry, 17, 1030–1039.

    Article  PubMed  Google Scholar 

  • Frazier, P., Conlon, A., & Glaser, T. (2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology, 69, 1048–1055.

    Article  PubMed  Google Scholar 

  • Glaesmer, H., Kaiser, M., Braehler, E., Freyberger, H. J., & Kuwert, P. (2012). Posttraumatic stress disorder and its comorbidity with depression and somatisation in the elderly: A German community-based study. Aging and Mental Health, 16, 403–412.

    Article  PubMed  Google Scholar 

  • Gola, H., Engler, H., Schauer, M., Adenauer, H., Riether, C., Kolassa, S., et al. (2011). Victims of rape show increased cortisol responses to trauma reminders: A study in individuals with war- and torture-related PTSD. Psychoneuroendocrinology, 37, 213–220.

    Article  PubMed  Google Scholar 

  • Gottschall, J. (2004). Explaining wartime rape. Journal of Sex Research, 41, 129–136.

    Article  PubMed  Google Scholar 

  • Hargreaves, S. (2001). Rape as a war crime: Putting policy into practice. Lancet, 357, 737.

    Article  PubMed  Google Scholar 

  • Henigsberg, N., Folnegovic-Smalc, V., & Moro, L. (2001). Stressor characteristics and post-traumatic stress disorder symptom dimensions in war victims. Croatian Medical Journal, 42, 543–550.

    PubMed  Google Scholar 

  • Johnson, K., Scott, J., Rughita, B., Kisielewski, M., Asher, J., Ong, R., et al. (2010). Association of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo. Journal of the American Medical Association, 304, 553–562.

    Article  PubMed  Google Scholar 

  • Kuwert, P., & Freyberger, H. J. (2007). The unspoken secret: Sexual violence in World War II. International Psychogeriatrics, 19, 782–784.

    Article  PubMed  Google Scholar 

  • Kuwert, P., Klauer, T., Eichhorn, S., Grundke, E., Dudeck, M., Schomerus, G., et al. (2010). Trauma and current posttraumatic stress symptoms in elderly German women who experienced wartime rapes in 1945. Journal of Nervous and Mental Disease, 198, 450–451.

    Article  PubMed  Google Scholar 

  • Laufer, A., & Solomon, Z. (2006). Posttraumatic symptoms and posttraumatic growth among Israeli youth exposed to terror incidents. Journal of Social and Clinical Psychology, 25, 429–447.

    Article  Google Scholar 

  • Leiner, A. S., Kearns, M. C., Jackson, J. L., Astin, M. C., & Rothbaum, B. O. (2012). Avoidant coping and treatment outcome in rape-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 80, 317–321.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lev-Wiesel, R., & Amir, M. (2003). Posttraumatic growth among Holocaust child survivors. Journal of Loss and Trauma, 8, 229–237.

    Article  Google Scholar 

  • Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17, 11–21.

    Article  PubMed  Google Scholar 

  • Loncar, M., Medved, V., Jovanovic, N., & Hotujac, L. (2006). Psychological consequences of rape on women in 1991–1995 war in Croatia and Bosnia and Herzegovina. Croatian Medical Journal, 47, 67–75.

    PubMed Central  PubMed  Google Scholar 

  • Maercker, A., & Müller, J. (2004). Social acknowledgement as a victim or survivor: A scale to measure a recovery factor of PTSD. Journal of Traumatic Stress, 17, 345–351.

    Article  PubMed  Google Scholar 

  • McMillen, J. C., Smith, E. M., & Fisher, R. H. (1997). Perceived benefit and mental health after three types of disaster. Journal of Consulting and Clinical Psychology, 65, 733–739.

    Article  PubMed  Google Scholar 

  • Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992). The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease, 180, 111–116.

    Article  PubMed  Google Scholar 

  • Newman, E., & Kaloupek, D. G. (2004). The risks and benefits of participating in trauma-focused research studies. Journal of Traumatic Stress, 17, 383–394.

    Article  PubMed  Google Scholar 

  • Powell, S., Rosner, R., Butollo, W., Tedeschi, R. G., & Calhoun, L. G. (2003). Posttraumatic growth after war: A study with former refugees and displaced people in Sarajevo. Journal of Clinical Psychology, 59, 71–83.

    Article  PubMed  Google Scholar 

  • Roelofs, K., van Peer, J., Berretty, E., Jong, P., Spinhoven, P., & Elzinga, B. M. (2009). Hypothalamus–pituitary–adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia. Biological Psychiatry, 65, 336–343.

    Article  PubMed  Google Scholar 

  • Swiss, S., Jennings, P. J., Aryee, G. V., Brown, G. H., Jappah-Samukai, R. M., Kamara, M. S., et al. (1998). Violence against women during the Liberian civil conflict. Journal of the American Medical Association, 279, 625–629.

    Article  PubMed  Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–472.

    Article  PubMed  Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–18.

    Article  Google Scholar 

  • van Berlo, W., & Ensink, B. (2000). Problems with sexuality after sexual assault. Annual Review of Sex Research, 11, 235–257.

    PubMed  Google Scholar 

  • Weaver, T. L. (2009). Impact of rape on female sexuality: Review of selected literature. Clinical Obstetrics and Gynecology, 52, 702–711.

    Article  PubMed  Google Scholar 

  • Witteveen, A. B., Huizink, A. C., Slottje, P., Bramsen, I., Smid, T., & van der Ploeg, H. M. (2010). Associations of cortisol with posttraumatic stress symptoms and negative life events: A study of police officers and firefighters. Psychoneuroendocrinology, 35, 1113–1118.

    Article  PubMed  Google Scholar 

  • Zawati, H. M. (2007). Impunity or immunity: Wartime male rape and sexual torture as a crime against humanity. Torture, 17, 27–47.

    PubMed  Google Scholar 

  • Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology—A critical review and introduction of a two component model. Clinical Psychology Review, 26, 626–653.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philipp Kuwert.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kuwert, P., Glaesmer, H., Eichhorn, S. et al. Long-Term Effects of Conflict-Related Sexual Violence Compared with Non-Sexual War Trauma in Female World War II Survivors: A Matched Pairs Study. Arch Sex Behav 43, 1059–1064 (2014). https://doi.org/10.1007/s10508-014-0272-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-014-0272-8

Keywords

Navigation