Mücahit ORUÇ, Ahmet Sedat DÜNDAR, İsmail ALTIN, Özlem ÖZEL ÖZCAN, Osman CELBİŞ

To what extent does sexual assault affect mental health?

This study aimed to examine the effects of the assault on mental health with the time since the event of sexual assault, the characteristics of the perpetrator and the victim, and psychiatric diagnoses. A retrospective examination was made of the records of 105 cases of sexual assault of all age groups, who were referred for forensic psychiatric examination by the forensic authorities between 1 January 2012 and 30 December 2017 to the Inonu University Medical Faculty Health Committee for the Determination of Sexual Abuse/Assault Crimes. In the examination, the characteristics of the abuse, the type of sexual assault and effects on mental health, psychiatric diagnoses of the victim after the event, and psychiatric diagnoses made after examination by the committee were evaluated retrospectively. The 105 cases examined comprised 83 (79%) females and 22 (21%) males with a mean age of 14.3±7.4 years, and 22 (21%) cases aged ≥18 years. The types of sexual assault were non-penetrative assault in 56 (53.3%) cases and penetrative assault in 49 (46.7%). Mental health impairment at a level that impaired functionality was determined in 52 (49.5%) cases and at a level that did not impair functionality in 53 (50.5%) cases. It seems to be inevitable that mental health is affected following sexual assault. Moreover, a mental disorder at a level that will impair the functionality of the victim may emerge with the passage of time since the sexual assault and the degree of this impairment may only be revealed with examinations made after a certain time.

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Lehman D. Sexual assault in Pernell, MI. current obstetrics and gynecologic diagnosis and treatment, Seventh Ed. Prentice-Hall International, Lebanon; 1991:1144-5.

Soysal Z, Eke M. Forensic science: Soysal Z, Cakalir C. (Eds): Adli Tip Cilt III, Istanbul Universitesi Cerrahpasa Tip Fakultesi Yayinlari, Rektorluk No: 4165, Fakulte No:224, Istanbul Universitesi Basimevi ve Film Merkezi, Istanbul; 1999:1167-1244.

Glover K, Olfson M, Gameroff MJ et al. Assault and mental disorders: a cross-sectional study of urban adult primary care patients. Psychiatr Serv. 2010;61:1018-23.

Symes L. Abuse across the lifespan: prevalence, risk, and protective factors. Nurs Clin North Am. 2011;46:391-411.

Yates A. Sexual abuse of children. In: JM Wiener ed.textbook of child adolescent psychiatry, 2nd edition. Washington: American Psychiatric Press; 1999:699-709.

Iseri E. FC Cetin, B Pehlivanturk, et al. Basic book on child and adolescent psychiatry. 1. Baskı. Ankara: Hekimler Yayın Birliği; 2008:470-7.

World Health Organization https://www.who.int/reproductivehealth/topics/ violence/clinical-response-csa/en/ access date 11.12.2019

Danielson CK, Holmes MM. Adolescent sexual assault: an update of the literature. Curr Opin Obstet Gynecol. 2004;16:383-8.

Gokdogan MR. Need for forensic nurse working on sexual assault. Adli Tip Bulteni. 2008;13:69-77.

Resnick H. Prevalence of civilian trauma and post-traumatic stress disorder in a representative national sample of women. J Consult Clin Psychol. 1993;61:984-99.

Gise L, Paddison PR. Sexual abuse and its victims. Psychiatr Clin North Am. 1988;11:629-48.

La Flair LN, Franko DL, Herzog DB. Sexual assault and disordered eating in Asian women. Harv Rev Psychiatry. 2008;16:248-57.

Kendall-Tackett K. The Long-term health effects of child sexual abuse. In: Goodyear-Brown P, ed. Handbook of Child Sexual Abuse. Identification, Assessment and Treatment icinde, New Jersey: John Wiley & Sons. 2012:49-70.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington: American Psychiatric Association, (Text Revision).

Yalvac G. Turkish Penal Code. Confrontational TCK, CMK, CGTİK and Related Laws and Regulations Book. G Yalvac (Ed), Ankara. Adalet Yayinevi. 2005:218-24.

Finkelhor D. Epidemiological factors in the clinical identification of child sexual abuse. Child Abuse Negl. 1993:17-67.

Robin RW, Chester B, Rasmussen JK, et al. Characteristics, and impact of childhood sexual abuse in a southwestern American Indian tribe. Child Abuse and Neglect. 1997;21:769-87.

Back S, Lips HM. Child sexual abuse: victim age, victim gender, and observer gender as factors contributing to attributions of responsibility. Child Abuse&Neglect. 1988;22:1239-52.

Mitra M, Mouradian VE, Fox MH, et al. Prevalence and characteristics of sexual violence against men with disabilities Am J Prev Med. 2016;50:311- 7.

Putnam FW. Ten-year research update review: Child sexual abuse. J Am Acad Child Adolesc Psychiatry. 2003;42:269-78.

Golge ZB, Yavuz MF, Yuksel S. Sexual Aggressor Profile. Adli Tip Dergisi, 2006;20:1-17.

Karbeyaz K, Gunduz T, Balci Y, et al. Sexual crime cases evaluated after the new Turkish Penal Code; Eskişehir experience. Turkiye Klinikleri J Forensic Med. 2009;6:1-8.

Murray LK, Nguyen A, Cohen JA. Child sexual abuse. Child Adolesc Psychiatr Clin N Am. 2014;23:321-37.

Briere J, Elliott DM. Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women. Child Abuse Negl. 2003;27:1205-22.

Ullman SE. Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survivors. J Child Sex Abus. 2007;16:19-36.

Celbis O, Altin I, Ayaz N, et al. Evaluation of ıncest cases: 4-years retrospective study. J Child Sex Abus. 2019:1-11.

Boroughs MS, Valentine SE, Ironson GH, et al. Complexity of childhood sexual abuse: Predictors of current post-traumatic stress disorder, mood disorders, substance use and sexual risk behaviour among adult men who have sex with men. Arch Sex Behav. 2015;44:1891-902.

Erdogan A, Tufan E, Karaman MG, et al. Characteristics of people who sexually abuse children and adolescents in four different regions of Turkey. Anadolu Psikiyatr Derg. 2011;12:55-61.

Aydin B, Akbas S, Turla A, et al. Child sexual abuse in Turkey: An analysis of 1002 cases. J Forensic Sci. 2015;60:61-5.

Kloppen K., Haugland S., Svedin C. G., et al. Prevalence of child sexual abuse in the Nordic countries: A literature review. J Child Sex Abus. 2016;25:37-55.

Mossige S, Abrahamsen S. National reports: Sexual abuse in Norway. In S. Mossige, M. Ainsaar, & (Eds.), The Baltic Sea regional study on adolescents’ sexuality. 2007:93-111. Oslo, Norway: Norwegian Social Research (NOVA).

Uytun MC, Oztop DB. Evaluation of the continuation of psychiatric diagnoses and treatments applied to children and adolescents who are victims of sexual abuse. Yeni Sempozyum Dergisi. 2016;54:18-24.