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Study looks at preventing post-traumatic stress in sexual assault victims

Dr. Gary Bawtinhimer hopes medicine can stop the onset of post-traumatic stress disorder in sexual assault victims.
GREENVILLE, N.C.   (Mar. 11, 2004)   —   Post-traumatic stress disorder is a term commonly associated with troops returning from major combat, but a psychiatrist at East Carolina University says victims of sexual assault can also suffer from the debilitating disorder, and he’s studying a way to prevent the disorder.

Dr. Gary Bawtinhimer, director of residency training and associate clinical professor in the ECU Department of Psychiatric Medicine, wants to find out if prescribing Paxil, a common antidepressant and anti-anxiety drug, to women soon after they’ve been assaulted can prevent post-traumatic stress disorder from setting in.

“Victims of sexual assault have an extremely high rate of PTSD, as high as 90 percent,” Bawtinhimer said. PTSD can cause people to avoid things that remind them of the traumatic event, such a car-crash victim who avoids getting back into a car. PTSD sufferers can also experience vivid, frightening flashbacks, painful memories, a hyperawareness of their surroundings and increased anxiety, Bawtinhimer said.

“A significant number of people will resolve over time, but not all,” he said.

For the study, Bawtinhimer seeks women at least 18 years old who have been a victim of sexual assault within the past week. Even with assistance from the Pitt County Memorial Hospital emergency department physicians and the REAL Crisis Center, the local safe place for sexual assault victims, recruiting participants hasn’t been easy. So far, the study has no enrollees.

“Understandably, sexual assault victims have a lot going on and they may not be willing to get involved in a study,” Bawtinhimer said.

Those who do will receive up to $100 plus a free prescription for Paxil. Drug manufacturer GlaxoSmithKline, maker of Paxil, is helping fund the study. Researchers will check in with study participants every week or two in person or by telephone to monitor their progress. Victims may receive counseling, but that is not part of the study. According to the National Institute of Mental Health, PTSD is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat. PTSD can be extremely disabling.

About 3.6 percent of U.S. adults ages 18 to 54 – 5.2 million people – have PTSD during the course of a given year. About 30 percent of the men and women who have spent time in war zones experience PTSD, which was once referred to as “shellshock.” One million war veterans developed PTSD after serving in Vietnam. PTSD has also been detected among veterans of the 1991 Persian Gulf War, with some estimates running as high as 8 percent, NIMH said.

Bawtinhimer said a spike in PTSD occurred locally after Hurricane Floyd and the flood it brought. Afterward, rain, storms and water caused anxiety for many people, he said.

“Anyone can develop PTSD secondary to trauma,” Bawtinhimer said. “It has nothing to do with personal weakness or strength. We’re not sure why some individuals develop it and some don’t.”

Recent studies into PTSD suggest the part of the brain involved in short-term memory – the hippocampus – may be involved with PTSD, as may the body’s production of abnormal levels of key hormones after a traumatic event.

The Centers for Disease Control and Prevention define sexual violence as sex acts completed or attempted against victims’ will or when victims are unable to consent due to age, illness, disability or the influence of alcohol or other drugs. It may involve actual or threatened physical force, use of guns or other weapons, coercion, intimidation or pressure.

Sexual violence also includes intentional touching of the genitals, anus, groin or breast against a victim’s will or when a victim is unable