Program Goals/Target population
The Post-Rape Video Intervention (PRVI) is a two-part video intervention that was developed for use in acute post-rape time frames. The intervention has two goals: (1) to help reduce the distress and anxiety associated with a forensic rape examination, thereby reducing the risk of future emotional problems, and (2) to prevent the post-assault increased risk of later developing substance use and abuse issues. PRVI is delivered to rape victims who are receiving a standard forensic rape examination. These exams are usually conducted within 72 hours of the sexual assault.
The trauma of rape is associated with extreme acute distress and anxiety that can lead to increased risk of developing psychopathology and substance use or abuse problems post-rape. Often the degree of initial distress experienced by rape victims can predict future problems, such as drug or alcohol use. Unfortunately, the experience of undergoing an invasive post-rape forensic evidence collection procedure may exacerbate the anxiety and anguish of rape victims, which may in turn increase their risk of resorting to substance use to ameliorate distress. The PRVI was designed as a preventive technique to reduce the initial anxiety and distress associated with post-rape forensic procedures and to provide coping strategies following the procedure.
The intervention features a 17-minute video that is shown immediately preceding the forensic medical examination. The video consists of two components. The first component is designed to reduce distress during the rape examination by explaining what happens in the exam and strategies for coping successfully. The second component contains information that can be used by victims to prevent future emotional problems and substance abuse. Among the reactions described are symptoms of physiological arousal that might be experienced following a rape. Information and strategies are presented that could help a victim limit future avoidance and inappropriate coping mechanisms (such as substance use). The video provides guidance on how to avoid high-risk cues.
Victims also receive standard services, which include attendance at the examination by a rape crisis counselor and completion of the forensic rape examination itself.
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Although the studies that examined the effectiveness of the Post-Rape Video Intervention (PRVI) found some significant and positive findings, the preponderance of evidence revealed null effects. There were significant intervention effects on marijuana use, but only among those women who reported using marijuana prior to the sexual assault. There were no significant differences in alcohol or hard drug use between the treatment and nontreatment groups. In addition, there were significant intervention effects that reduced posttraumatic stress disorder (PTSD) and depression symptoms, but only among women who had a prior history of rape. Women who received the PVRI intervention and had no prior history of rape actually reported a higher frequency of PTSD and anxiety symptoms in the short-term and no effect on depression symptoms.
Resnick, Acierno, Amstadter, and colleagues (2007) found the PVRI was not significantly associated with alcohol abuse. There were no statistical differences between the treatment group (full video intervention) and nontreatment group (nonvideo intervention), after controlling for other predictor variables.
Hard Drug Use
There was also no significant association between treatment condition and hard drug abuse, after controlling for pre-assault use of hard drugs and other predictor variables at any time point.
There were some statistically significant differences found in marijuana use between the groups. Compared to women in the nontreatment condition, being in the treatment condition was significantly associated with reduced frequency of marijuana use, but only among those treatment women who were using marijuana prior to the recent sexual assault.
However, after controlling for other predictor variables at any of the time points, there were no significant differences found between the groups.
Posttraumatic Stress Disorder (PTSD) Symptoms
Resnick and colleagues (2007) found that average Post-Traumatic Symptom Scale – Self-Report (PSS-SR) scores were moderated by prior history of rape, such that the effects were greater for women with a prior rape history. Specifically, at Time 1 (6 weeks post-assault), women in the PVRI treatment group with a prior history of rape had a significantly reduced frequency of reporting PTSD symptoms compared to women in the nontreatment group with a prior rape history (the average PSS-SR score was 19.59 for treatment women compared to 28.47 for nontreatment women). At Time 2 (6 months post-assault), there was a smaller effect associated with the intervention (15.85 compared to 17.59).
In contrast, for women without a prior rape history, the average PSS-SR scores of the treatment group were slightly higher than the average scores of the nontreatment group (23.48 vs. 20.13), meaning treatment women reported a slightly higher frequency of PTSD symptoms in the short-term follow-up compared to nontreatment women.
There were no significant differences between treatment and nontreatment women (with or without a prior rape history) in PTSD symptoms at Time 2.
Among treatment women with a prior rape history, the PVRI intervention appeared to be associated with lower average Beck Depression Inventory (BDI) scores at Time 1 (16.48 vs. 24.74) and Time 2 (11.34 vs. 14.97) compared to nontreatment women with a prior rape history.
However, there were no significant differences in BDI scores between treatment and nontreatment women without a prior rape history at the short-term and longer-term follow-up periods.
Among treatment women with a prior rape history, there was no intervention effect and no significant differences in Beck Anxiety Inventory (BAI) scores at Time 1 and Time 2.
Among treatment women without a prior rape history at Time 1, the intervention was associated with a modest effect that resulted in higher BAI scores compared to nontreatment women without a prior rape history (24.6 vs. 19.5, respectively), meaning treatment women reported more anxiety in the short-term follow-up. At Time 2, however, there were no significant differences. The results raise a question as to whether or not this treatment should be offered to women without a prior history of rape in the acute phase.