title: Long-term effects of conflict-related sexual violence compared with non-sexual war trauma in female World War II survivors: a matched pairs study.
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.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medicine Greifswald at the HELIOS Hansehospital Stralsund, Rostocker Chaussee 70, 18437, Stralsund, Germany, kuwert@uni-greifswald.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kuwert
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
authors.forename: Svenja
authors.initials: S
authors.lastname: Eichhorn
authors.forename: Elena
authors.initials: E
authors.lastname: Grundke
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Freyberger
authors.forename: Thomas
authors.initials: T
authors.lastname: Klauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D011902:Rape / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014858:War Crimes / Q000523:psychology*; D047789:World War II