CARACTERÍSTICAS DE FLUJO

Criterion A1 (perceiving life in danger and phvsical iniurv): Relationship to PTSD: Ten participants (34.5%) failed to meet criterion A1 for PTSD. O f the 19 who met criterion A l, 16 reported physical injury; and only 10 reported thinking that their life was in danger. Those who met criterion A l were significantly more likely to have experienced intense fear (Chi-Square fl^ = 13.997, p < 0.001). There was no significant difference in PTSD severity between those who thought their life was in danger at the time and those who did not, t (27) = -1.48, p = 0.15.

Twenty participants recalled ‘some thoughts’ and nine reported recalling ‘no thoughts’ from the time o f the assault. Participants rated level o f distress associated with peri­ traumatic thoughts on a 5-point scale where 0 = No distress and 5 = extreme distress. Thirteen participants (44.8%) reported little or no distress due to feeling ‘emotionally num b’. Level o f distress associated with peritraumatic cognitions was not significantly correlated with PTSD severity (r = -0.12, p = 0.53).

Peritraumatic Consciousness:

Participants were asked to rate how much o f the assault they were conscious for: None, a little, half, most or all. Twenty-six participants reported some degree o f conscious awareness during the assault and only 3 reported being totally unconscious. Consciousness during assault was not significantly correlated with PTSD severity, r = 0.21, p = 0.27.

Peritraumatic and posttraumatic emotional processing

To further explore the findings above, a more detailed analysis o f emotional processing and its impact on PTSD severity was undertaken. Participants rated the emotions they experienced at the time o f the trauma (peritraumatic), in the month after and in the last month. Participants rated each emotion on a five-point scale where O=not experienced and 4=experienced very intensely. Five participants reported feeling totally ‘emotionally numb’ or were unconscious, at the time o f the assault, and therefore rated zero for all peritraumatic emotions. Twenty-four participants reported feeling emotions at some point during the assault, though in many cases this was not intense.

DSM-IV Criterion A2: Fean helplessness and horror Cprimary emotions’):

The intensity o f ‘primary’ emotions reported at the time o f the trauma (peritraumatically) and after the trauma are both illustrated in figure 6.

Figure 6: Criterion A Emotions: Retrospective reports for time of assault, in the month after the assault, and in the last month

3.5 3.0 M ean in tensity 2.5 2.0 1.5 Emotion — “ Helplessness 1.0 Fear .5 i —

Peritraumatic Month after Last month

Peritraumatic fear: As hypothesised, mean intensity rating for peritraumatic fear was low (1.21) and 14 participants reported feeling no fear at the time o f the assault. Ten participants (34.5%) reported ‘extremely intense’ peritraumatic fear. Intensity o f peritraumatic fear was significantly negatively correlated with PTSD severity (r = -0.40, p = 0.03). Further comparison revealed PTSD was higher for those who reported no fear (N = 14, mean = 29.50, SD = 10.39), compared with those who reported ‘very intense’ fear (mean = 19.20, SD = 10.06), t (17) = 2.043, p = 0.05). Furthermore, those who reported low fear during the rape described significantly higher distress associated with intrusive memories post-assault (r = -0.487, p = 0.007).

Post-traumatic fear: There was a significant effect o f time since assault on mean intensity rating for fear (W ilks’ Lambda = 0.31, F (2, 27) = 29.66, p < 0.001). Post-hoc pairwise comparisons with Bonferroni adjustment for multiple comparisons revealed that fear intensity increased significantly in the month after the assault (p < 0.001) and was significantly positively correlated with PTSD severity, r = 0.55, p = 0.002. This

supports the hypothesis that post-traumatic fear would be experienced as an evaluative emotion, but not as a primary emotion during the trauma.

Peritraumatic helplessness: As hypothesised, helplessness was the most commonly and intensely experienced criterion A2 emotion. Although 22 participants experienced peritraumatic helplessness o f at least moderate intensity, and consequently met criterion A2 for PTSD, helplessness was not significantly correlated with PTSD severity, r = 0.16, p = 0.42. This could have been partially due to lack o f variance in scores. However, even when participants who scored ‘not at all’ and ‘very intensely’ were compared, there was still no significant difference in PTSD severity (t (17) = 0.959, p = 0.349).

Post-traumatic helplessness: There was a significant effect o f time since assault on intensity o f helplessness (W ilks’ Lambda = 0.35, F (2, 27) = 25.43, p < 0.001). Post-hoc pairwise comparisons with Bonferroni adjustment for multiple comparisons revealed no significant difference in intensity o f helplessness at the time o f trauma and in association with intrusive memories in the month after the assault (p = 1.000). Helplessness reduced significantly in the last month (p < 0.001) and was not significantly correlated with PTSD severity (r = 0.282, p = 0.138).

Horror: Mean intensity rating for peritraumatic horror was low (1.24, SD = 1.62) and was not significantly correlated with PTSD severity (r = -0.198, p = 0.304). Posttraumatic horror ratings remained low in intensity.

The frequency and mean intensity o f ‘primary’ (criterion A) emotions reported by participants are described in table 8.

Table 8: Primary emotions experienced at the time of trauma and post-traumatic emotions associated with intrusive memories (N = 29)

Emotion Time-point Frequency (N/29)

Mean (SD) Intensity

Median Intensity

Fear Peritraum atic 15 1.21 (1.50) 1

M onth after assault 28 3 .1 0 (1 .2 0 ) 4

Last month 24 1 .6 4 (1 .2 2 ) 2

Helplessness Peritraum atic 22 2 .8 3 (1 .6 1 ) 4

M onth after assault 27 3 .1 0 (1 .2 3 ) 4

Last m onth 14 1.03 (1.43) 0

Horror Peritraum atic 13 1.24(1.62) 0

M onth after assault 12 1.52 (1.88) 0

Last m onth 5 2 .8 6 (1 .0 9 ) 0

These results suggest that, as hypothesised, drug-rape survivors’ PTSD severity was not reduced by the absence o f criterion A1 or criterion A2 emotions. Furthermore, they suggest that lower intensity o f peritraumatic fear (emotional numbing) was associated with high PTSD severity and post-traumatic fear.

Secondary (evaluative) emotions: Guilt, shame and anger

It was hypothesised that drug-rape survivors would experience low levels o f evaluative emotions at the time o f the assault, but would experience high frequency and intensity evaluative emotions, particularly guilt and shame post-trauma. In concordance with recent literature (e.g. Grey et al, 2000), participants also identified a range o f evaluative peri-traumatic emotions, including shame, guilt and anger. However, intensity and frequency were low. None were significantly correlated with PTSD severity, or negative cognitive appraisals (p>0.05 in all cases).

The intensity o f peri and post-traumatic evaluative emotions are illustrated in figure 7, and the means and standard deviations shown in appendix 7.

Figure 7: Secondary, ‘evaluative’ (VAM) peri and posttraumatic emotions reported by participants 3 .5 M ean in ten sity rating Emotion

y

Month after Last month

As hypothesised, significant increases in intensity o f evaluative emotions were reported in the month after the assault, with a significant effect o f time on guilt (W ilks’ Lambda = 0.76, F (2, 27) = 4.24, p = 0.025), anger (W ilks’ Lambda - 0.22, F (2, 27) = 48.91, p < 0.001) and shame (W ilks’ Lambda = 0.57, F (2, 27) = 10.13, p = 0.001).

However, although anger and shame were experienced at considerable intensity, no evaluative emotions were significantly correlated with PTSD severity {anger r = 0.26, p = 0.18, shame r = 0.15, p = 0.44, guilt r = 0.11, p = 0.56).