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Monday, February 26, 2024

How PTSD affects sexual assault survivors

Those who experience an emotional trauma are at a greater risk for revictimization due in part to an onset of post traumatic stress disorder. But, a stronger understanding of the human brain’s processes may help reduce the risk and severity of these symptoms, thereby reducing the risk for revictimization, researchers say.

The general model of PTSD would predict hypervigilance in individuals who have already undergone a trauma, but that is not always the case, explained Josh Cisler, the principal investigator of the Neurocircuitry of Trauma and PTSD lab.

This is the phenomenon of revictimization, which refers to the notion that those who experience abuse once in their past are likely to experience it again. A survivor’s social behaviors change, putting them at a greater risk for experiencing another attack; they may be less self-assertive or judge situations differently, often perceiving them as less dangerous.

Cisler’s research takes a twist on the more holistic approach to PTSD by focusing on neurocircuitry responses after undergoing sexual assault and how that psychopathology may place someone at a greater risk for revictimization.

“Most people don’t talk about this problem … the ultimate goal would be that the work that we do informs some kind of treatment,” Cisler said.

Ninety-four percent of sexual assault survivors develop symptoms of PTSD after an attack and 30 percent sustain those symptoms on some spectrum of severity up to nine months later.

Cisler emphasized that those who feel they have a solid support system often heal faster.

“One of the best protectors against PTSD is social support,” Cisler said, explaining that a survivor should feel they have people they can open up to. “The act of disclosing is certainly helpful but it’s more so …. making sure that [they’ve] got a group of friends to turn.”

Cisler’s study coordinator, Karyn Esbensen, added that the more self-blame a woman has for her assault, the more severe the symptoms may be.

“Avoiding victim-blaming is really important so women who have been victimized by sexual assault don’t internalize that,” Esbensen said.

If a person is conscious during a sexual assault, regardless of intoxication, their fear circuitry kicks in and immediately dominates brain functioning. Instantly, the prefrontal cortex is impaired due to a rush of stress chemicals, affecting the individual’s ability to think rationally.

The person’s reflex responses take control; in other words fight, flight or freeze. During the fear circuitry response, freeze often dominates.

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The freezing response occurs when the amygdala first detects an attack, signalling the brainstem to stop all movement. It acts as a primer for the fight or flight, but neither necessarily follow.

In most traumatic situations, like for members of the military mid-battle, responses are well-trained, nearly conditioned responses. While still susceptible to PTSD, soldiers have formed effective habit responses which help lift themselves out of the freeze stage more quickly.

During the fear circuitry, a survivor must rely only on their innate responses, which are primarily social. This process, since not well-trained, often ignores fight or flight responses and allows extreme survival reflexes to dominate. Survivors may describe a dissociation from oneself—a feeling of autopilot control—or other forms of immobility that hinder their ability to speak or cause them to pass out.

What the fear circuitry focused on during the assault may influence central details in the memory of a survivor. These memories, although often recalls of seemingly miniscule details like the pattern of wallpaper, are more likely to be accurate and consistent and often become highly valued during investigations.

Fear acts most commonly on the hippocampus’ ability to encode and store contextual information and time sequencing. Some studies suggest that the hippocampus temporarily enters a super-encoding stage right when the fear kicks in, leading to a nearly perfect recall of events just before and after the attack. However, memories of the attack, encoded when the brain ended its super-encoding mode, tend to be fragmented and incomplete.

In order to gain a stronger understanding of these phenomenon, Cisler’s lab is currently recruiting study participants. Women who have experienced physical or sexual abuse and are between the ages of 21 and 50 are encouraged to reach out to the NeuroTaP Lab.

“The more bad things happen to you, the more likely you are to have [other] bad things happen to you,” Cisler said, explaining abuse is a risk factor for mental disorders in addition to cancers and other diseases. “So if we can stop that cycle of violence, or victimization, then we can decrease that risk.”

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