Acknowledging complexity in the impacts of sexual victimisation trauma
Traumatic events are those that overwhelm the "ordinary human adaptations to life" (Herman, 1992a, p. 33). However, one particular type of trauma is increasingly being recognised as a driver of many complex social and mental health problems in those affected by it. The repeated trauma caused by ongoing sexual abuse that is prolonged, occurs in the developmental stages of a person's life, and is often perpetrated by an authority figure is now being more readily perceived as a causal feature of multiple social and mental health issues and the consequent need for human services. Although not officially recognised in diagnostic classification, the term "complex trauma" or "complex post-traumatic stress disorder" describes a broad-ranging set of disorders, symptoms and social problems that are not captured by a limited diagnostic category of post-traumatic stress disorder (PTSD). People suffering complex trauma need treatments that are multifaceted and varied to accommodate their particular range of symptoms. Isolated treatment of particular symptoms may only impact on one aspect of their needs and will not resolve the underlying issues that have created the problem.
The mental health impacts of sexual victimisation are frequently acknowledged but there are specific and additional impacts where victims have suffered a particular type of abuse that is: interpersonal, commences at an age where emotional development is affected, is ongoing, chronic or features multiple types of abuse.
Many researchers and practitioners in the fields of psychiatry, psychology and social work do not see the mental health diagnosis of post-traumatic stress disorder (PTSD) as sufficient to capture these specific effects of multiple types of abuse and chronic victimisation. There have been calls for an additional category called "complex PTSD" or "complex trauma".
The impacts of complex trauma symptomatology on victim/survivors can be a driver of need for many human services, including mental health, medical and substance abuse services as well as social services like housing and relationship services.
Acknowledging an underlying basis of trauma could enhance service delivery to the victim/survivor that may have multiple needs across services.
It is important to acknowledge the link between ongoing sexual victimisation and complex trauma in order to facilitate a cultural shift towards the connectedness of services and a person-centred approach to service use.
Authors and Acknowledgements
Liz Wall is a Research Officer and Antonia Quadara is the Manager of the Australian Centre for the Study of Sexual Assault.
The authors thank Dr Pam O'Connor, Clinical Psychologist and Associate Professor at the University of Canberra; Jackie Burke, Clinical Director of the Rape and Domestic Violence Services Australia (Formerly NSW Rape Crisis Centre); and Daryl Higgins, Deputy Director - Research at AIFS, for their valuable input.
Wall, L., & Quadara, A. (2014). Acknowledging complexity in the impacts of sexual victimisation trauma (ACSSA Issues No. 16). Melbourne: Australian Centre for the Study of Sexual Assault, Australian Institute of Family Studies.
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