Examining the Scientific Validity of Rape Trauma Syndrome

In 1974, the team of Burgess and Holstrom conducted research as to the symptoms and behaviors that survivors of sexual violence exhibited after their assaults. This groundbreaking study led to the description of these behaviors to what is now referred to as Rape Trauma Syndrome. They studied groups of women who presented to hospitals and law enforcement agencies following their attacks and carefully tracked the evolving of their behaviors over the course of many months, whether those women chose to prosecute and/or seek further treatment for their assaults. Rape Trauma Syndrome (RTS) quickly became the "go-to" diagnosis for anyone who had been raped or sexually assaulted. Although this study proved, in a way, that those of us who have survived sexual violence often display myriad, and sometimes baffling, behaviors that can range from anywhere between generalized depression to outright aggression, this blanket term actually left more questions than answers to describe these different behaviors, especially during expert testimony where RTS is used as an explanation to assist the jury in understanding the victim. RTS may have actually created much more havoc for the prosecutors during trial where RTS is explained, thereby causing some of the defendants basic rights during trial to be violated. A recent article featured in the academic journal Psychiatry, Psychology and Law in 2014 called Examining the Scientific Validity of Rape Trauma Syndrome (https://www.infotextmanuscripts.org/falserape/false-rape-720.pdf) did an excellent job of explaining why RTS may actually hurt the victim more during trial and why using the term during expert testimony should be halted and replaced with the more scientifically well-known and respected diagnosis of Post Traumatic Stress Disorder.

The article and its research was conducted by four psychologists from the University of Nevada, Reno and does an excellent job explaining why RTS may not be as scientifically valid as once believed and why the "disorder" should not continue to be used in expert testimony during trial. I was diagnosed with Post Traumatic Stress Disorder and Rape Trauma Syndrome in 2006 after an overdose, so it stands to reason that my first reaction to the article's position was angry disagreement; however, after reading through the research, my opinion has changed quite a bit and I believe I may have been misdiagnosed.

In order to understand the research, the authors take us through a mini time-warp into 1974, when the term Rape Trauma Syndrome was first introduced by the research team of Burgess and Holstrom. At that point in time, Burgess and Holstrom had it right when they stated there really was no diagnosis or term to use to describe the myriad behaviors that survivors of sexual violence experience. Their research was groundbreaking, and although the research certainly assisted the law enforcement, psychological, judicial, and medical communities to understand what we go through as victims, there were many empirical, logistical, and fundamental issues with their research. For example, when attempting to research any theories, a control group must be used to measure the results of any testing done during said research; unfortunately, Burgess and Holstrom did not use one. Furthermore, they only studied women who reported to the ER after rape and continued to follow them both pre and post judicial process to see if their behaviors changed. Sexual violence is an extremely complicated issue and its effects are almost too much to research with any accuracy and/or adequacy. Men who experienced sexual violence, child survivors, and those who were raped and/or assaulted but chose not to report were all not included in the initial RTS study.

The article outlines in great detail what the major problems surrounding RTS are, with a large issue being its vagueness. According to the article, a "syndrome" is defined as "a group of symptoms, signs, laboratory findings, and physiological history" (Taber's Cyclopedic Medial Dictionary, 21st eds, n.d.). The syndrome has to be pathological and for something to be pathological, it needs to have a history. RTS does not define anything pertaining to a victim's history and if the victim ever experienced any other type of sexual violence. Even an attempted rape or assault can have lone-lasting psychological effects similar to those outlined in RTS. This "syndrome" is also not mentioned in the DSM, which is the "Bible" of psychiatric disorders and psychological issues. The terms used by Burgess and Holstrom to describe RTS ("disorganized" "traumaphobia") are not accepted in the psychological science spectrum anymore, and tested and acceptable scientific methods happen to be a large part of allowing expert testimony into court proceedings.

Compounding on the scientific aspect of determining the validity of RTS, the article makes quite a valid argument for a more well-known and both clinically scientific and psychologically valid diagnosis of Post Traumatic Stress Disorder be used when diagnosing the various behaviors of survivors of sexual violence. PTSD is a widely used diagnosis for those who have suffered some type of trauma in their lives and is not exclusive to acts of rape or sexual assault, but is linked to a number of traumatic events including childhood molestation and abuse. Its diagnosis can be clearly found in the DSM-V, where RTS is not, and has psychological testing to measure the level of the disorder, namely the Clinician Administered PTSD Sale (CAPS) and Post Traumatic Stress Disorder Checklist (PCL), where RTS has no such testing. These tests help determine the correct method of treatment for those suffering its effects, like certain cognitive behavioral therapy treatments, while RTS has no known form of psychological treatment.

Lastly, the article makes an argument for something I myself never thought of, which is the risk a prosecutor may take in losing a rape trial if they use expert testimony surrounding RTS. If an expert states something along the lines of "the victim's behavior is consistent with a diagnosis of Rape Trauma Syndrome," they are actually risking a mistrial or acquittal because of the prejudicial nature of the disorder's title. Stating a victim has "Rape Trauma Syndrome" is outwardly implying that the victim could not have become that way by any other means than rape, which without further evidence risks the defendant's due process rights being violated, and quite frankly no prosecutor would want to risk that. The goal is to get justice for the victim and not to have a mistrial or worse, an acquittal, based on a technicality. Instead, an expert testifying to a victim's behavior being consistent with PTSD casts a much wider net and produces less of a chance for the defendant's counsel to object on the grounds of the testimony being unduly prejudicial.

Based on the information contained within the article, I firmly agree with the researchers that the use of RTS in expert testimony, or even when diagnosing a survivor, should be phased out and altogether stopped. The article breaks down the fundamental issues behind RTS as a diagnosis excellently and suggests other more scientifically valid and accepted ways to diagnose, treat, and assist victims of sexual violence, which in turn would also assist the judicial system in successful prosecution of defendants charged with an act of sexual violence.

O'Donohue, W., Carlson, G., Benuto, L., Bennett, N. (2014). Examining the Scientific Validity of Rape Trauma Syndrome. Psychiatry, Psychology and Law. Vol. 21, No. 6,

858-876, http://dx.doi.org/10.1080/13218719.2014.918067