Data from our National Women's Study of 4008 female Americans (Kilpatrick et al., 1992; Resnick et al., 1993) indicate that approximately 12,100,000 (12.7%) adult women aged 18 years or older have been victims of complete rape. Moreover, it is estimated that more than 683,000 adult women are raped each year. Findings from our pilot study and studies of other rape victim cohorts indicate very clearly that sequelae of sexual assault include PTSD. However, this pilot study also demonstrated that rape victims are at greatly increased risk of depression, substance abuse, and panic. In addition, our data indicate that those women who may be most in need of follow-up medical care are significantly less likely to obtain it. Unfortunately, resource limitations and difficulty maintaining ongoing contact may preclude offering comprehensive treatments that address each of the psychological and health outcome risk areas to all rape victims who report the crime to police and receive emergency medical care. Thus, attention is justifiably turned toward preventive interventions. To date, no economically feasible preventive emergency room-based interventions have been developed and empirically evaluated for rape victims to reduce risk of developing PTSD, depression, substance use, or panic symptomatology and to increase likelihood that victims make use of adaptive health care/medical follow-up facilities. The present proposal, therefore, is to evaluate, in a controlled experimental design, the efficacy of a brief video-based programmatic preventive intervention that is potentially available to all rape victims immediately during their first emergency room contact, and: (1) contains components that serve to reduce anxiety and distress immediately in the emergency room (2) includes information about and introduction to procedures included in a medical follow-up clinic designed specifically for rape victims, (3) addresses risk of PTSD, depression, substance abuse, and panic, (4) does not over-tax financial or time resources of rape victims or hospitals, (5) is brief and easily administered, (6) considers relevant cultural characteristics of rape victims, and (7) is offered in a format that is easily standardized, but also engaging and non-threatening for the majority of victims.
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