RAPE

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Epidemiology
Russell’s (1984) wide research in random samples of San Francisco women is regarded by now the most thorough research in relation to the measuring of undesired sexual experiences. The percentage of 24% which is extracted by this survey keeps up with the 27.5% of Koss et al (1987) which resulted after a sample survey on American female students who reported rape or attempt of rape from the age of 14. Gavey’s (1991) research in New Zealand resulted to a similar percentage (25.3%) of women who reported rape or attempt of rape. As Koss (1992) marks, women have four times more chances to be raped by a familiar person rather than a stranger. This remark agrees with Gavey’s (1991) results, which indicate that two thirds of reported undesired sexual experiences were committed within a type of heterosexual relationship, while the percentage rises up to 80% if familiar persons, ex-husbands, ex-friends and lovers are included. According to the International Statistics on rape from the UN, one in six women has been raped. Nearly one in eight of Black women has suffered racist sexual assault. Two women a week are murdered by their partner or ex-partner, while 98% of domestic violence is not reported to the police.

Theories on sexual aggressiveness and rape

Psychodynamic Theory
Psychodynamic researchers always included in their theories the notions of castration stress and oedipodean opposition. These theories support that various emotions of fear and sexual or personal inadequacy, sexual and personal, along with the possible existence of unrecognized homosexual tendencies, interact with aggressiveness and are directed towards the victim as a substitute for mother, resulting in sexual abuse (Freud, 1905/1953, Fenichel, 1945, Rada, 1978, Groth et al, 1977).

Behaviorist Theory
The behaviorist model of “emotional state augmentation” suggests that non sexual emotional situations act complicatedly with sexual stimulation, in order to induce sexual response. This is a possible mechanism which is implicated in the positive (love) and the negative (hate) interactions of a relationship. The model of “state disinhibition of arousal” suggests that the non consensus pain and suffocation on behalf of the victim, as well as the emotions of fear, cause the inhibition of rape stimulation in most men. The mechanism in question is regulated by the ability of a person to empathize (Malamuth & Check, 1983). Indications of such a case come from phallometry, which shows that the proportion of stimulation during scenes of rape, in opposition to scenes of sexual intercourse by consent, is higher to rapists and is related to the number of the victims and the extend of violence (Abel et al, 1977). The inhibition of stimulation during scenes of rape is for some reason absent in rapists. The cause or the circumstances, under which this is due to happen, relate to the general behavior of the environment. Such examples include situations where the victim is attributed with provocative outfit or situations that evoke anger to the rapist.

Socio-cognitive Theory
The bibliography on sexual offenders describes the prejudiced way of processing the information in almost every step of the chain of perpetration (Marshall & Barberee, 1989). The expectations or the beliefs of the sexual offenders affect the process of the information related to sexuality (Stermac & Segal, 1989). For example, rapists regard the way their victims dress as a “challenge” and they have difficulty in realizing the situation on behalf of their victims. Similarly, during perpetration the rapist conceives the passivity or the terrified consent of women as desire and pleasure of the rape. The more confused the behavior of the victim is, the easier is for the rapist to misinterpret it. Mallamuth & Brown (1994) defined the following dysfunctional mechanisms concerning the insights or the beliefs of the sexually aggressive men: 1) Hyper-perception of hostility/seductiveness, meaning that aggressive men have difficulty in discriminating between friendliness and provocativeness and between claim and animosity. 2) Negative blindness, meaning that sexually aggressive men are incompetent to realize the negative female signs. 3) Suspicious attitude, meaning that the sexual aggressive men regard the female sexual behavior and its relations as unreliable. Such a prejudiced information process creates high levels of distrustfulness and animosity towards women, and eventually sexual violence.

Feminist Theory
One of the main feminist theories was that of S. Brownmiller, who in 1975, with her book “Against Our Will”, laid the foundations for the feminist view of rape. Also, Burts’ feminist theory (1980) for rape described the way social beliefs reinforce sexual aggressiveness. They suggested that the standard views for the role of the sex, the contradictory sexual beliefs, as well as the acceptance of interpersonal violence, are important factors which stand between the culture of society and sexual aggressiveness. Feminist theory regard rape as a pseudo-sexual act induced by the sociopolitical domination of men. It was cited that not only rape but also the fear of a potential rape serves a mechanism of social control (Brownmiller 1975, Riger & Gordon 1981). During the ‘70s rape was a major issue for the feminist movement, a fact which at least partially was attributed to the belief that this form of violence was due to the change of roles which women gradually experienced (Donat & D’ Emilio, 1992).

Socio-biological views
In the socio-biological theory of Ellis (1989, 1991), the biological variables have evolutionary meaning. According to this theory, men in contradiction with women, tend to maximize their capacity to mate by the sexual intercourse with many different partners. Ellis’ theory clearly suggests an almost sexual incitement in rape, a fact which contradicts the feminist views and those on social learning. He also suggests that the non sexual dimensions of the rapists’ behavior, such as the aggressive and dominative behavior, should be regarded as a strategy rather than a target. In addition, Ellis attributed testosterone with the leading role that, according to his estimations, affects not only the tension of the sexual urge, but also the sensitivity towards the thread of punishment and the ability to understand the pain of others (empathy).

Biological Theories
Many parameters of a normal adult man’s sexual behavior seem to depend on androgens. The low levels of testosterone are related to an important decrease of sexual fantasies, sexual stimulation and desire, automatic night erection, ejaculations and sexual activity. In addition, certain sexual activities such as masturbation and orgasm, temporarily increases testosterone levels, while in contrast, the stressful incidents of life decrease testosterone levels (Christiansen, 1998). Studies show that in both men and women, aggressive behavior is related to the circulated androgens, and this fact seems to apply mostly in adolescents and children than adult men. Studies in prisoners also showed that prisoners with a record of violent crimes had higher testosterone levels, in relation to those with no such record, while research on the relation between androgens and sexual aggressiveness showed controversial results (Dabbs et al, 1987, Olweus et al, 1988, Giotakos et al 2003, 2004). Several researches have described the more or less successful confrontation of sexual aggressiveness using the anti-androgens acetic methoxyprogesterone και acetic cyproterone. The first, effecting directly to the testosterone, inhibits the excretion of gonadotropines, and the second competes directly with the effect of testosterone into the receptor of the target organ, resulting to the reduction of the testosterone levels. In addition, the suppression of the hypothalamic-pituitary-gonadal axis by a GnRH (Gonadotropine Releasing Hormone) agonist seemed to reduce at a great extend both the testosterone levels and the sexually aggressive behaviors (Rosler & Witztum 1998).

Psycho-social features of sexual offenders

Family history
A number of family factors which intervene significantly in the development of the sexual aggressiveness have been identified. Interrelating factors, such as bad and distant relationships with the parents, unstable or neglectful care, loss of a parent due to death, separation or divorce and high frequency of physical and sexual abuse, are the factors that characterize the early childhood experiences of many sexual offenders (Prentky et al., 1989, Ryan &Lane, 1991, Seghorn et al., 1987).

Education record
Even though their educational development varies, rapists tend to leave school. Obviously, cognitive capacities affect the course of the treatment. For that reason, the estimation should include the educational record, the general cognitive level and the existence of learning difficulties. The achievement of educational goals and good behavior in school give useful information concerning the cognitive and psychological abilities. For example, difficulties in attending the lessons, impulsiveness, lack of goals, low self esteem and persistence can be detected. These factors have obvious effect on the development of the therapeutic procedure of the offender’s sexual behavior and can suggest the need for additional educational intervention (Bard et al, 1987).

Work record
The existence of a stable work record tends to protect from the development of criminal behavior. Indeed, rapists tend to have unstable work record in unskilled professions. It is thus useful that the work record is evaluated focusing in stability, type of work, level of capacity and responsibility and the overall attitude towards the work. These factors might relate to psychological characteristics such as persistence, capacity of tolerating defeat and the ability to plan and achieve goals. The information provided by the work record could also indicate the need for special interventions aiming in raising the future ability for work (Bartol, 1991, Bard et al., 1987).

Social record
People who have a record of deranged attachment with those who have raised them are more likely to present dysfunctional relationships in other sectors as well (Hazan & Shaver, 1994). Baring in mind the aforementioned deranged family relationships the fact that rapists have a problematic social record is not surprising. For example, low levels of emotional interference with their colleagues has been reported (Blaske et al., 1989), while a 85% had few, if no friends at all during adolescence (Tingle et al. 1986). Thus, recognizing the significance of the early childhood experiences in the future development of social stress, the thorough investigation of the social record is regarded necessary. The evaluation should include quality, stability and duration of friendly relationships, nature and extend of social isolation, the form of interpersonal relationships, the difficulties that might existed during early relationships and the way a person deals with sexual relationships. The detection of potential deficiencies in a rapists’ social life is crucial for the planning of the treatment. Knight & Prentky (1987) emphasizing on the study of social relationship development factors and type of offence, concluded that rapists who present sadistic tends, compared with other types of rapists, have more often been assaulted themselves and had poorer social life, low levels of heterosexual dependability and more unstable interpersonal relationships.

Sexual record
A series of common features in the sexual record of rapists has been identified. Men who present high levels of sexual aggressiveness seem to have had early and often sexual experiences (Koss, 1989) more loose beliefs on sexuality in general (Marshall, 1989), and also presented indications of increased morbidity related to paraphilia (Freund, 1990, Marshall et al, 1991), as well as increased occupation with pornography (Carter et al, 1987). It is commonly accepted that a significant number of rapists have been sexually assaulted during their childhood or have witnessed deviating sexual activity (Dhawan & Marshall, 1996). But not all the assaulted during childhood present sexual aggressiveness. This fact indicates the existence of other factors which intervene in the course of development of sexual activity, such as the desire to humiliate the victim and the lack of empathy (Finkelhor, 1984).

Sexual relationships
Several researchers observed that sexual offenders are socially isolated and had only a few intimate sexual relationships (Fagan & Wexler, 1988, Marshall 1989, Tingle et al., 1986). In addition, the sexual offenders who had many relationships describe them as superficial (Marshall, 1989). The common element among sexual offenders is the failure to contract an intimate sexual relationship, which leads them to isolation (Tingle et al., 1986). After comparing separately non sexual offenders and the general population, sexual offenders presented greater difficulties in developing a sexual relationship, as well as significantly higher levels of feeling isolated. Similar were the results among prisoners convicted for sexual offenses, while especially the prisoners charged with incest, compared separately with rapists and non sexual offenders, present higher levels of fear for developing an intimate sexual relationship, while rapists compared with pedophiles present low desire for an intimate relationship with other men and members of their family (Bumby & Marshall, 1994).

Psychiatric record
The existence of mental disorders is often in rapists. According to a research, one third of a sample of rapists was diagnosed with depression, while two thirds were diagnosed with overuse or dependability from alcohol (Hilbrand et al., 1990). Another research found high frequency of stress disorders (Dewhurst et al., 1992), while another one (Seghorn et al., 1987) found 7% schizophrenia, 2% schizo-emotional disorder, 3% major depression and 6% organic psycho syndrome. Examining the disorders of Axis II (Personality Disorders), Seghorn et al (1987) observed that almost one third of the sample presented personality disorder, while other researchers found higher levels, even up to 90% (Berner et al., 1992, Serin et al, 1994, Stermac & Quinsey, 1986). The recent models of sexual aggressiveness focus mostly on the antisocial personality characteristics and less on other features (Marshall & Barbaree, 1990). Additionally, drug abuse is usual in rapists. Particularly, alcohol use seems to very often precede a rape. Alcohol use or abuse increases significantly violence levels, as well as the possibility of an occasional rather than a planned rape .At least half of the prisoners for rape were found to have consumed excessive quantity of alcohol just before the rape (Seto & Barbaree, 1995), while according to the results the use of alcohol was related to sexual aggressiveness (Abbey, 1991, Richardson & Hammock 1991).

Commorbidity with paraphilias
Exhibitionism was always related to rape (Paitich et al., 1977). Gebhard et al (1965) suggested that 1 in 10 exhibitionists has seriously thought or attempted rape. Abel’ s et al (1986) research found that out of 126 rapists who were examined, 44% had sexually assaulted girls outside the family circle, while 14% had additionally assaulted boys outside the family circle. However, several significant differences between rapists and pedophiles, related to the characteristics of the adult and the former development phase have been found. Rapists, compared with pedophiles, tend to be younger, have graduated from high school, impose themselves (aggressive) rather than being imposed to (passive), have been married or connected with a woman for a satisfactory period, and tend to rarely present mental deficiency or some organic brain syndrome. During the development stages, rapists compared to pedophiles, tend to come from non divorced parents, do not have relatives with psychiatric record, have half possibilities to have experienced sexual assault, have not presented significant health problems, but have abused animals and have demonstrated problematic behavior in school (Bard et al., 1987).

Commorbidity with non-sexual aggressivity
People who had been convicted for rape had often been convicted for non sexual crimes as well, and this fact seems to apply also for adolescent rapists (Epps, 1991). It was also found that half of the rapists had been convicted at the same time for other non sexual crimes, while almost all of them had committed at least one non sexual attack. However, it has not been defined whether these facts characterize all rapists, including the occasional ones (Stermac & Quinsey, 1986).

Phallometry
The discrimination between rapists and non rapists by the method of phallometry has changed a lot during the last years. At the end of the 70’s and the beginning of the 80’s, bibliography clearly stated that the models of the rapists’ sexual stimulation were different than those of the non rapists (Abel et al., 1977, Barbaree et al, 1979, Quinsey et al., 1984). It was also observed that rapists react similarly in case of non sexual violence towards women and it was assumed that the criteria of violence are the connective link. However, more recent research showed several similarities between rapists and non rapists since both groups demonstrate low levels of sexual stimulation in scenes of rape, compared to the stimulants which include consensus sexual intercourse (Blader & Marshall, 1989, Murphy et al,. 1986).

Sexual offenders’ treatment
Treatment programs
Examples of integrated programs on sexual offenders come from USA, Canada, Australia and England (Marshall et al, 1998). In general, the treatment interventions of sexual offenders are distinguished in those performed in prisons and those performed within the community, in other words on persons who are under surveillance or probation or have just been released from prison. The therapeutic programs for confronting sexual crime prisoners are usually held in the form of group therapy. The primary goals are: 1) Settlement of minimization issues and resumption of responsibility, 2) definition of the circle or the procedure which results to crime, 3) definition and supervision of individual therapeutic goals, 4) learning the prevention methods and 5) help to embody therapeutic material from other groups. The group also acquires training in basic social skills, such as communication skills, empathy towards the victim, anger management, stress management, sexual hygiene etc. Each member of the group also acquires interpersonal therapy, mainly occupied with behavior, fears or individual procedure of depended sexual stimulation. In the end of the therapy it is expected that the person under cure will have acknowledged the factors which contribute to the procedure of the sexual crime, will be capable of detecting the situations which might increase the danger of relapse and will have acquired skills allowing the avoidance of high risk situations. It is recommended that his therapeutic intervention will be continued even after the release from prison. It is believed that in order to achieve satisfactory results the programs should last at least 2 years. In the community programs, which are run by the Probation Services, participate sexual offenders under surveillance or probation. These programs, as the aforementioned ones, use as basic therapeutic hubs the reduction of denial and the enforcement of the ability to resume responsibility, the increase of self-criticism ability and the enforcement of empathy towards the victim. Equivalent cognitive and behavioral techniques are also applied. According to the results, almost half of the participants after 54 hours of therapy showed a decrease in the parameters of cognitive perversion, empathy towards the victim and the sexual compulsivity on levels equivalent to those of non sexual offences (Marshall, 1998). Alongside the psychotherapeutic forms of approach, other therapeutic methods have been tested and aim mainly to the reduction of sexual aggressiveness. Surgical confrontation, neuroleptics, and estrogens have been dispensed with, due to side effects. The antidepressants, especially the specific serotonin reuptake inhibitors (SSRIs), had satisfactory effects. Hormone therapies with anti-androgens and Gonadotropine Releasing Hormone (GnRH) agonists also had a satisfactory outcome in the reduction of sexual aggressiveness (Rosler & Witztum, 1998, Kafka, 1997).

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