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Recalde-Esnoz I, Prego-Meleiro P, Montalvo G, Del Castillo H. Drug-Facilitated Sexual Assault: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1814-1825. [PMID: 37650508 DOI: 10.1177/15248380231195877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Since the last two decades, the scientific community has made an effort to analyze drug-facilitated sexual assault (DFSA). However, a lack of understanding remains about the DFSA problem, particularly concerning the opportunistic variant. Facing this situation, a systematic review of the term DFSA is carried out from its first appearance in the scientific databases consulted (Web of Science, Scopus, and PubMed) to the current day. The search resulted in 773 publications, reduced to a final study sample composed of 19 articles. Eligible studies for this review had to meet certain inclusion criteria, in addition to providing information on DFSA prevalence, DFSA victim profile, DFSA offender profile, involved drugs, or contextual information about the assault. The results demonstrated that the assailants are men, who mostly know victims before the assault. The victims are young women under 30 years old. Alcohol is the drug involved in most DFSA cases, prevailing a voluntary use. Most assaults occur in private spaces, particularly the aggressors' own homes. Furthermore, there is a detected need for a standard definition of DFSA to allow the different actors involved in dealing with sexual violence to work effectively together, and, at the same time, it is detected that the available studies overrepresent proactive DFSA and underestimate opportunism, the most common modus operandi involved in DFSA cases.
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Affiliation(s)
| | - Pablo Prego-Meleiro
- Universidad Complutense de Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Spain
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Colbert S. The Impact On Eye Movement And Desensitization Reprocessing Of Incomplete Memory In A Drug-Facilitated Rape: A Single Case Study. J Trauma Dissociation 2024; 25:218-231. [PMID: 38031432 DOI: 10.1080/15299732.2023.2289193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/15/2023] [Indexed: 12/01/2023]
Abstract
In a drug-facilitated sexual assault (DFSA), the person's level of intoxication may result in incomplete memory. This paper describes eye movement and desensitization reprocessing (EMDR) with client-centered adaptations to address an incomplete trauma memory in a 26-year-old woman. The client was experiencing PTSD, characterized by nightmares and derealization. Therapy followed standard EMDR procedures with three minor modifications to help the client maintain current awareness. Although the memory remained incomplete, the client-centered adaptations promoted working through of the clients' trauma responses (e.g. disorientation, physical sensations) and a sense of competence and self-confidence were restored. At the end of reprocessing, and at follow-up, the client was no longer experiencing nightmares or derealization and her wellbeing had improved.
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Affiliation(s)
- Susannah Colbert
- Speedwell, South London and Maudsley Mental Health NHS Trust, London, UK of Great Britain and Northern Ireland
- Salomons Institute for Applied Psychology, Tunbridge Wells, Kent, UK of Great Britain and Northern Ireland
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Edwards CN, Tilley DS, Ayala F. Drug-Facilitated Sexual Assault With Tetrahydrozoline (Visine): A Case Report. JOURNAL OF FORENSIC NURSING 2023; 19:271-275. [PMID: 37278617 DOI: 10.1097/jfn.0000000000000445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
ABSTRACT This is a case presentation of an 18-year-old male victim who experienced a drug-facilitated sexual assault (DFSA). The drug used to incapacitate him was tetrahydrozoline (Visine) given rectally. Tetrahydrozoline, intended for ophthalmic administration, is in the class of drugs known as imidazoline receptor agonists and has been used as an agent for DFSA since the 1940s. DFSA is increasing, particularly among young men. Care of victims of DFSA is discussed with particular attention to mental health sequelae in this patient population.
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Affiliation(s)
- Carrie Nelms Edwards
- Author Affiliations: School of Nursing, Texas Tech University Health Sciences Center
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Park J, Hong S, Min S, Lee NY, Chung H, Han E. Awareness survey on drug crime scene investigation and drug detection kits among drug-related police officers. J Forensic Leg Med 2023; 94:102470. [PMID: 36610107 DOI: 10.1016/j.jflm.2022.102470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/11/2022] [Accepted: 12/18/2022] [Indexed: 01/04/2023]
Abstract
This questionnaire-based study aimed to investigate the drug crime scene experienced by drug-related police officers and the perceptions of drug test kits by them before initiating the development of drug test kits to detect 16 types of drugs. The subjects were 57 drug-related police officers. Most of the respondents (96.5%) had <10 years of experience in drug-related work. Respondents were questioned about the drug scene investigation and perceptions of drug test kits. The questionnaire about drug test kits included the question on 'simple/rapid drug test kit' and 'electronic portable drug analyzer' regarding the disadvantages of existing kits and expecting features when a new kit is developed. First, in the on-site survey, the drug-related crime occurred at the suspect's house (47.8%), and methamphetamine (35.0%) and γ-hydroxybutyric acid (19.5%) were mainly found. In the awareness survey on drug test kits, most respondents (67.2%) had an experience of using 'simple/rapid drug test kits', whereas 17.5% for the 'electronic portable drug analyzer'. In the case of 'simple/rapid drug test kit', the false-positive rate reached 53.8% by a misinterpretation due to ambiguous color change (47.6%). The inaccuracy of the result (33.3%) was the most concern in 'electronic portable drug analyzer'. Respondents most favored pipette type for sample collector when a new kit is developed. In addition, they preferred the smaller kit with short detection times in both kit types. This survey could be applied to the development of efficient and practical kits for police officers working in drug-related fields.
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Affiliation(s)
- Jungmin Park
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea
| | - Songhee Hong
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea; Innovation Drug Center, Duksung Women's University, Seoul, Republic of Korea.
| | - Sunyoung Min
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea
| | - Na Yeon Lee
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea
| | - Heesun Chung
- Department of Forensic Science, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Eunyoung Han
- College of Pharmacy, Duksung Women's University, Seoul, Republic of Korea; Innovation Drug Center, Duksung Women's University, Seoul, Republic of Korea.
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Guo M, Do B, Wong K, Lee TH, Talagi D, Lum B, Rahberg N, Ha E, Fan VY. Sexual Violence and Substance Use Diagnosed in Emergency Department Discharges in Hawaii, 2005-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16220. [PMID: 36498293 PMCID: PMC9740929 DOI: 10.3390/ijerph192316220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/10/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Substance use (SU) and sexual violence (SV) present unique challenges when contextualizing their relationship due to underreporting of SU and SV. Both are significant public health concerns with a large magnitude and expense to the overall U.S. and to the state of Hawaii, which is identified as a high-intensity drug-trafficking area. Since substance users have a higher risk for sexual violence than the general public, this study aims to analyze the proportion and demographics of emergency department (ED) visit individuals reporting sexual violence with or without substance use disorder and examine how the number of ED visits of individuals diagnosed with SV and SU disorder compare to all individuals. METHODS Data from the Healthcare Cost and Utilization Project was used to examine the relationship between SV and SU. The database contained 3.5 million observations for 24 Hawaii hospitals from 2005-2014. The data was summarized in descriptive statistics and Chi-square tests were run to assess statistical significance for variables of interest. RESULTS A greater proportion of individuals reporting sexual violence also reported substance use disorders compared to the general population of individuals. While 8% of all ED visits were related to SU, 17% of ED visits involving SV were also related to SU, demonstrating a statistically significant association between SV and SU. CONCLUSIONS There is a greater need to further understand the complexity of the relationship between substance use and sexual violence. Sexual violence and substance use disorders share a complex relationship; survivors of sexual abuse may develop a substance use disorder, and those who use drugs and alcohol may be at an increased risk for sexual violence. Results from this study demonstrate visits for individuals reporting sexual violence have a greater proportion of substance use disorder than visits for the general population.
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Affiliation(s)
- Mary Guo
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Bobby Do
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Korben Wong
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Thomas H. Lee
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Deveraux Talagi
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Brandon Lum
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Nichole Rahberg
- Office of Planning, Policy and Program Development, Department of Health, Honolulu, HI 96813, USA
| | - Edra Ha
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Victoria Y. Fan
- Pacific Health Analytics Collaborative, Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
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Luong R, Parkin JA, Cunningham N. Acute concomitant injury and intoxication in complainants of recent sexual assault: A review. J Forensic Leg Med 2022; 92:102448. [DOI: 10.1016/j.jflm.2022.102448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
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Fields L, Young DA, Patel AR, Munroe C, Shumway M, Bell S, Richer LA. Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment. Eur J Psychotraumatol 2022; 13:2057165. [PMID: 35558683 PMCID: PMC9090424 DOI: 10.1080/20008198.2022.2057165] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Sexual assault (SA) is a highly prevalent global public health problem and a robust predictor of posttraumatic stress disorder (PTSD), substance use disorder (SUD), and suicidality. A large percentage are drug or alcohol facilitated (DFSA), impairing trauma memory and affecting the application of evidence-based treatments. Despite these problems, few have investigated DFSA-specific mental health (MH) needs. OBJECTIVE Goals of this study were (1) to identify psychological sequelae characterizing DFSA towards explaining why symptoms have been treatment-refractory, comparing survivors with involuntary substance ingestion (forced, covert: DFSA-I), voluntary ingestion (DFSA-V), and non-DFSA; and (2) to determine how impaired trauma memory relates to the development of PTSD and depression symptoms. METHOD Data from a retrospective chart review of 74 adults receiving SA MH services at an outpatient trauma center are presented. The sample includes a 2-year cohort seen acutely at an urban rape treatment center. The study is one of the first to examine therapy records beyond case studies for DFSA. Logistic, Poisson, and negative binomial regression analyses of quantitative data and qualitative thematic analysis of trauma cognitions and treatment foci were conducted. RESULTS DFSA-V had five times greater odds of SUD, and notable substance-related self-blame compared to DFSA-I. DFSA-I had prominent relationship distress and self-blame for missing danger of perpetrator drugging. Survivors with impaired trauma memory had significantly fewer hyper-arousal and overall PTSD symptoms, and specifically less hypervigilance. No differences were found in re-experiencing symptoms. CONCLUSION Impaired trauma memory is common in DFSA and is associated with fewer baseline hyper-arousal and overall PTS. Despite this, DFSA issues including re-experiencing symptoms that are particularly distressing without the ability to cognitively connect the intrusions contribute to increased treatment needs. Impaired memory limits the application of evidence-based treatments, and collectively these findings call for the development of trauma-specific treatment protocols to enhance recovery for DFSA survivors. HIGHLIGHTS Survivors of drug-facilitated sexual assault have prominent PTSD including reexperiencing, though trauma memory may not be encoded. • Those absent trauma memory have less hyperarousal, but DFSA complications explain why it is treatment refractory and inform treatment development.
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Affiliation(s)
- Laurie Fields
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Dmitri A Young
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Anushka R Patel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.,T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Cat Munroe
- School of Public Health, University of California, Berkeley, CA, USA.,Alcohol Research Group, Public Health Institute, Berkeley, CA, USA
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Shannon Bell
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | - Laurie A Richer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
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Thompson KM. Beyond roofies: Drug- and alcohol-facilitated sexual assault. JAAPA 2021; 34:45-49. [PMID: 33332834 DOI: 10.1097/01.jaa.0000723940.92815.0b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Substance use in victims of sexual assault, whether voluntary or involuntary, changes the aftermath and recovery process significantly, affecting the way memories are processed and recalled, the chances of developing significant mental health complications, and the disclosure reactions that the survivor receives. Clinicians must understand these differences in order to provide the best possible care to survivors. This article provides an overview of these topics, detailing some of the nuances of interviewing, testing, and the physiology of memory formation and how that affects the outcomes of prosecution in these crimes.
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Affiliation(s)
- Katherine M Thompson
- Katherine M. Thompson practices in urgent care and is the medical director for interpersonal violence services in Bellevue, Wash., and is chief executive officer and founder of IPV Educators LLC, which educates healthcare providers about interpersonal violence. The author has disclosed no potential conflicts of interest, financial or otherwise
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