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Published in: BMC Women's Health 1/2014

Open Access 01-12-2014 | Research article

Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling

Authors: An Verelst, Maarten De Schryver, Eric Broekaert, Ilse Derluyn

Published in: BMC Women's Health | Issue 1/2014

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Abstract

Background

The conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the ‘weapons of war’. Currently, sexual violence continues, with a considerable increase in civilian perpetrators. However, little is known regarding the particular impact of different experiences of sexual violence on adolescents’ mental health. This study therefore investigates the impact of sexual violence on eastern Congolese adolescents’ mental health and its differing associations with daily stressors, stigma, and the labeling of sexual violence (as ‘rape’ or ‘non-consensual sexual experience’).

Methods

A cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, eastern Congo, a region extensively affected by war. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, war-related traumatic events, experiences of sexual violence, daily stressors, and stigmatization were administered. Differences in sociodemographic characteristics, traumatic experiences and daily and social stressors between types of sexual violence (rape, non-consensual sexual violence, no sexual violence) were explored through statistical analysis. ANCOVA analyses investigated associations between those risk factors and adolescents’ mental health.

Results

More than one third of eastern Congolese adolescent girls reported experiences of sexual violence. Elevated levels of daily stressors, experiences of stigmatization, and stressful war-related events were found amongst girl victims of sexual violence, with the highest levels for girls who labeled the sexual violence as rape. Daily stressors, stigmatization, and war-related events showed a large impact on the girls’ mental health. Last, girls who labeled the sexual violence as non-consensual sexual experiences reported more post-traumatic hyper-arousal and intrusion symptoms compared to those labeling the sexual violence as rape.

Conclusions

These findings point to the important association between how war-affected adolescent girls label sexual violence (rape or non-consensual sexual experiences) and their mental health. This study also documents the large impact of sexual violence on other stressors (daily stressors, stigmatization, and stressful war events) and the impact of these stressors on girl victims’ mental health. It discusses important implications for addressing sexual violence and its consequences in war-affected contexts.
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Literature
1.
go back to reference Coghlan B, Brennan R, Ngoy P, Dofara D, Otto B, Clements M, Stewart T: Mortality in the Democratic Republic of the Congo: a nationwide survey. Lancet. 2006, 367 (9504): 44-51. 10.1016/S0140-6736(06)67923-3.CrossRefPubMed Coghlan B, Brennan R, Ngoy P, Dofara D, Otto B, Clements M, Stewart T: Mortality in the Democratic Republic of the Congo: a nationwide survey. Lancet. 2006, 367 (9504): 44-51. 10.1016/S0140-6736(06)67923-3.CrossRefPubMed
3.
go back to reference Pottier J: Displacement and ethnic reintegration in Ituri, DRCongo: challenges ahead. J Mod Afr Stud. 2008, 46 (3): 427-450.CrossRef Pottier J: Displacement and ethnic reintegration in Ituri, DRCongo: challenges ahead. J Mod Afr Stud. 2008, 46 (3): 427-450.CrossRef
4.
go back to reference Vlassenroot K, Raeymaekers T: The politics of rebellion and intervention in Ituri: the emergence of a new political complex?. Afr Aff. 2004, 103 (412): 385-412. 10.1093/afraf/adh066.CrossRef Vlassenroot K, Raeymaekers T: The politics of rebellion and intervention in Ituri: the emergence of a new political complex?. Afr Aff. 2004, 103 (412): 385-412. 10.1093/afraf/adh066.CrossRef
6.
go back to reference Eriksson-Baaz M, Stern M: Sexual Violence As A Weapon Of War? Perceptions, Prescriptions, Problems In The Congo And Beyond. 2013, London: AfricaNow Eriksson-Baaz M, Stern M: Sexual Violence As A Weapon Of War? Perceptions, Prescriptions, Problems In The Congo And Beyond. 2013, London: AfricaNow
7.
go back to reference Human Rights Watch: Kosovo: Rape as a Weapon of “Ethnic Cleansing”. 2000, New York; NY: Human Rights Watch Human Rights Watch: Kosovo: Rape as a Weapon of “Ethnic Cleansing”. 2000, New York; NY: Human Rights Watch
8.
go back to reference Leatherman J: Sexual Violence And Armed Conflict. 2011, Cambridge: Polity Press Leatherman J: Sexual Violence And Armed Conflict. 2011, Cambridge: Polity Press
9.
go back to reference Wood EJ: Variation in sexual violence during war. Polit Soc. 2006, 34 (3): 307-41. 10.1177/0032329206290426.CrossRef Wood EJ: Variation in sexual violence during war. Polit Soc. 2006, 34 (3): 307-41. 10.1177/0032329206290426.CrossRef
11.
go back to reference Peterman A, Palermo T, Bredenkamp C: Estimates and determinants of sexual violence in the democratic Republic of the Congo. Am J Public Health. 2011, 101 (6): 1060-1067. 10.2105/AJPH.2010.300070.CrossRefPubMedPubMedCentral Peterman A, Palermo T, Bredenkamp C: Estimates and determinants of sexual violence in the democratic Republic of the Congo. Am J Public Health. 2011, 101 (6): 1060-1067. 10.2105/AJPH.2010.300070.CrossRefPubMedPubMedCentral
12.
go back to reference Thomas DQ, Ralph RE: Rape In War: The Case Of Bosnia. Gender Politics in the Western Balkans. Women and Society in Yugoslavia and the Yugoslav Successor States. Edited by: Ramet SP. 1999, University Park, PA: Pennsylvania University Press, 203-218. Thomas DQ, Ralph RE: Rape In War: The Case Of Bosnia. Gender Politics in the Western Balkans. Women and Society in Yugoslavia and the Yugoslav Successor States. Edited by: Ramet SP. 1999, University Park, PA: Pennsylvania University Press, 203-218.
13.
go back to reference Human Rights Watch: Soldiers Who Rape, Commanders Who Condone: Sexual Violence And Military Reform in the Democratic Republic of Congo. 2009, New York: Human Rights Watch Human Rights Watch: Soldiers Who Rape, Commanders Who Condone: Sexual Violence And Military Reform in the Democratic Republic of Congo. 2009, New York: Human Rights Watch
14.
go back to reference Mukwege DM, Nangini C: Rape with extreme violence: the wew pathology in South Kivu, Democratic Republic of Congo. PLoS Med. 2009, 6: e1000204-10.1371/journal.pmed.1000204.CrossRefPubMed Mukwege DM, Nangini C: Rape with extreme violence: the wew pathology in South Kivu, Democratic Republic of Congo. PLoS Med. 2009, 6: e1000204-10.1371/journal.pmed.1000204.CrossRefPubMed
15.
go back to reference Maedl A: Rape as weapon of War in the Eastern DRC? The Victims’ perspective. Human Rights Q. 2011, 33: 128-147. 10.1353/hrq.2011.0005.CrossRef Maedl A: Rape as weapon of War in the Eastern DRC? The Victims’ perspective. Human Rights Q. 2011, 33: 128-147. 10.1353/hrq.2011.0005.CrossRef
16.
go back to reference Kalisya LM, Justin PL, Kimona C, Nyavandu K, Eugenie KM, Jonathan KML, Claude KM, Hawkes M: Sexual violence toward children and youth in war-torn Eastern Democratic Republic of Congo. PLoS One. 2011, 6 (1): e15911-10.1371/journal.pone.0015911.CrossRef Kalisya LM, Justin PL, Kimona C, Nyavandu K, Eugenie KM, Jonathan KML, Claude KM, Hawkes M: Sexual violence toward children and youth in war-torn Eastern Democratic Republic of Congo. PLoS One. 2011, 6 (1): e15911-10.1371/journal.pone.0015911.CrossRef
17.
go back to reference Nelson BD, Collins L, VanRooyen MJ, Joyce N, Mukwege D, Bartels S: Impact of sexual violence on children in the Eastern Democratic Republic of Congo. Med Confl Surviv. 2011, 27 (4): 211-225. 10.1080/13623699.2011.645148.CrossRefPubMed Nelson BD, Collins L, VanRooyen MJ, Joyce N, Mukwege D, Bartels S: Impact of sexual violence on children in the Eastern Democratic Republic of Congo. Med Confl Surviv. 2011, 27 (4): 211-225. 10.1080/13623699.2011.645148.CrossRefPubMed
18.
go back to reference Douma N, Hilhorst D: Fond De Commerce? Sexual Violence Assistance In The Democratic Republic Of Congo. Occasional Paper no. 2. 2012, Wageningen, The Netherlands: Wageningen University, Disaster Studies Douma N, Hilhorst D: Fond De Commerce? Sexual Violence Assistance In The Democratic Republic Of Congo. Occasional Paper no. 2. 2012, Wageningen, The Netherlands: Wageningen University, Disaster Studies
19.
go back to reference Bartels S, Scott J, Leaning J, Mukwege D, Lipton R, Van Rooyen M: Surviving sexual violence in Eastern Democratic Republic of Congo. J Int Women’s Stud. 2010, 11 (4 4): 37-49. Bartels S, Scott J, Leaning J, Mukwege D, Lipton R, Van Rooyen M: Surviving sexual violence in Eastern Democratic Republic of Congo. J Int Women’s Stud. 2010, 11 (4 4): 37-49.
20.
go back to reference Johnson K, Scott J, Rughita B, Kisielewski M, Asher J, Ong R, Lawry L: Association of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo. JAMA. 2010, 304 (5): 553-562. 10.1001/jama.2010.1086. doi:10.1001/jama.2010.1086CrossRefPubMed Johnson K, Scott J, Rughita B, Kisielewski M, Asher J, Ong R, Lawry L: Association of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo. JAMA. 2010, 304 (5): 553-562. 10.1001/jama.2010.1086. doi:10.1001/jama.2010.1086CrossRefPubMed
21.
go back to reference Resick PA: The psychological impact of rape. J Interpers Violence. 1993, 8: 223-255. 10.1177/088626093008002005.CrossRef Resick PA: The psychological impact of rape. J Interpers Violence. 1993, 8: 223-255. 10.1177/088626093008002005.CrossRef
22.
go back to reference Bal S, Crombez G, Van Oost P, Deboudeaudhuij I: The role of social support in well-being and coping with self-reported stressful events in adolescents. Child Abuse Negl. 2003, 27 (12): 1377-1395. 10.1016/j.chiabu.2003.06.002.CrossRefPubMed Bal S, Crombez G, Van Oost P, Deboudeaudhuij I: The role of social support in well-being and coping with self-reported stressful events in adolescents. Child Abuse Negl. 2003, 27 (12): 1377-1395. 10.1016/j.chiabu.2003.06.002.CrossRefPubMed
23.
go back to reference Allwood MA, Bell-Dolan D, Husain SA: Children’s trauma and adjustment reactions to violent and nonviolent war experiences. J Am Acad Child Adolesc Psychiatry. 2002, 41 (4): 450-457. 10.1097/00004583-200204000-00018.CrossRefPubMed Allwood MA, Bell-Dolan D, Husain SA: Children’s trauma and adjustment reactions to violent and nonviolent war experiences. J Am Acad Child Adolesc Psychiatry. 2002, 41 (4): 450-457. 10.1097/00004583-200204000-00018.CrossRefPubMed
24.
go back to reference Campbell R, Dworkin E, Cabral G: An ecological model of the impact of sexual assault on women’s mental health. Trauma Violence Abuse. 2009, 10: 225-246. 10.1177/1524838009334456.CrossRefPubMed Campbell R, Dworkin E, Cabral G: An ecological model of the impact of sexual assault on women’s mental health. Trauma Violence Abuse. 2009, 10: 225-246. 10.1177/1524838009334456.CrossRefPubMed
25.
go back to reference Ellis H, MacDonald H, Lincoln A, Cabral H: Mental health of Somali adolescent refugees: the role of trauma, stress and perceived discrimination. J Consult Clin Psychol. 2008, 76 (2): 184-193.CrossRefPubMed Ellis H, MacDonald H, Lincoln A, Cabral H: Mental health of Somali adolescent refugees: the role of trauma, stress and perceived discrimination. J Consult Clin Psychol. 2008, 76 (2): 184-193.CrossRefPubMed
26.
go back to reference Miller KE, Omidian P, Rasmussen A, Yaqubi A, Daudzai H: Daily stressors, war experiences, and mental health in Afghanistan. Transcult Psychiatry. 2008, 45 (4): 611-638. 10.1177/1363461508100785.CrossRefPubMed Miller KE, Omidian P, Rasmussen A, Yaqubi A, Daudzai H: Daily stressors, war experiences, and mental health in Afghanistan. Transcult Psychiatry. 2008, 45 (4): 611-638. 10.1177/1363461508100785.CrossRefPubMed
27.
go back to reference Miller KE, Rasmussen A: War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med. 2010, 70: 7-16. 10.1016/j.socscimed.2009.09.029.CrossRefPubMed Miller KE, Rasmussen A: War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med. 2010, 70: 7-16. 10.1016/j.socscimed.2009.09.029.CrossRefPubMed
28.
go back to reference Johnson K, Asher J, Rosborough S, Raja A, Panjabi R, Beadling C, Lawry L: Association of combatant status and sexual violence with health and mental health outcomes in postconflict Liberia. JAMA. 2008, 300 (6): 676-690. 10.1001/jama.300.6.676.CrossRefPubMed Johnson K, Asher J, Rosborough S, Raja A, Panjabi R, Beadling C, Lawry L: Association of combatant status and sexual violence with health and mental health outcomes in postconflict Liberia. JAMA. 2008, 300 (6): 676-690. 10.1001/jama.300.6.676.CrossRefPubMed
29.
go back to reference Kelly J, Kabanga J, Cragin W, Alcayna-Stevens L, Haider S, Vanrooyen MJ: ‘If your husband doesn’t humiliate you, other people won’t’: gendered attitudes towards sexual violence in eastern Democratic Republic of Congo. Glob Public Health. 2012, 7 (3): 285-298. 10.1080/17441692.2011.585344.CrossRefPubMed Kelly J, Kabanga J, Cragin W, Alcayna-Stevens L, Haider S, Vanrooyen MJ: ‘If your husband doesn’t humiliate you, other people won’t’: gendered attitudes towards sexual violence in eastern Democratic Republic of Congo. Glob Public Health. 2012, 7 (3): 285-298. 10.1080/17441692.2011.585344.CrossRefPubMed
31.
go back to reference Bohner G, Pina A, Viki Tendayi G, Siebler F: Using social norms to reduce men’s rape proclivity: perceived rape myth acceptance of out-groups may be more influential than that of in-groups. Psychol Crime Law. 2010, 16 (8): 671-693. 10.1080/1068316X.2010.492349.CrossRef Bohner G, Pina A, Viki Tendayi G, Siebler F: Using social norms to reduce men’s rape proclivity: perceived rape myth acceptance of out-groups may be more influential than that of in-groups. Psychol Crime Law. 2010, 16 (8): 671-693. 10.1080/1068316X.2010.492349.CrossRef
32.
go back to reference Betancourt TS, Agnew-Blais J, Gilman SE, Ellis BH: Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010, 70 (1): 17-26. 10.1016/j.socscimed.2009.09.038.CrossRefPubMed Betancourt TS, Agnew-Blais J, Gilman SE, Ellis BH: Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010, 70 (1): 17-26. 10.1016/j.socscimed.2009.09.038.CrossRefPubMed
33.
go back to reference Campbell R, Ahrens C, Sefl T, Wasco SM, Barnes HE: Social reactions to rape victims: healing and hurtful effects on psychological and physical health outcomes. Violence Vict. 2001, 16: 287-302.PubMed Campbell R, Ahrens C, Sefl T, Wasco SM, Barnes HE: Social reactions to rape victims: healing and hurtful effects on psychological and physical health outcomes. Violence Vict. 2001, 16: 287-302.PubMed
34.
go back to reference Ullman SE, Starzynski LL, Long S, Mason G, Long LM: Sexual assault disclosure, social reactions, and problem drinking in women. J Interpers Violence. 2008, 23: 1235-1257. 10.1177/0886260508314298.CrossRefPubMed Ullman SE, Starzynski LL, Long S, Mason G, Long LM: Sexual assault disclosure, social reactions, and problem drinking in women. J Interpers Violence. 2008, 23: 1235-1257. 10.1177/0886260508314298.CrossRefPubMed
35.
go back to reference Pankhurst D: Introduction: Gendered War And Peace. Gendered War And Peace. Edited by: Pankhurst D. 2008, New York: Routledge, 1-30. Pankhurst D: Introduction: Gendered War And Peace. Gendered War And Peace. Edited by: Pankhurst D. 2008, New York: Routledge, 1-30.
36.
go back to reference Puechgirbal N: Women and war in the Democratic Republic of Congo. Signs J Women Cult Soc. 2003, 28 (4): 1271-1281. 10.1086/368319.CrossRef Puechgirbal N: Women and war in the Democratic Republic of Congo. Signs J Women Cult Soc. 2003, 28 (4): 1271-1281. 10.1086/368319.CrossRef
38.
go back to reference Jejeebhoy SJ, Bott S: Non-Consensual Sexual Experiences Of Young People In Developing Countries. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 3-46. Jejeebhoy SJ, Bott S: Non-Consensual Sexual Experiences Of Young People In Developing Countries. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 3-46.
40.
go back to reference Arata CM: Coping with rape: the roles of prior sexual abuse and attributions of blame. J Interpers Violence. 1999, 14: 62-78. 10.1177/088626099014001004.CrossRef Arata CM: Coping with rape: the roles of prior sexual abuse and attributions of blame. J Interpers Violence. 1999, 14: 62-78. 10.1177/088626099014001004.CrossRef
41.
go back to reference Braun-Lewensohn O, Celestin-Westreich S, Celesing LP, Verleye G, Verté D, Ponjaert-Kristoffersen I: Coping styles as moderating the relationships between terrorist attacks and well-being outcomes. J Adolesc. 2009, 32: 585-599. 10.1016/j.adolescence.2008.06.003.CrossRefPubMed Braun-Lewensohn O, Celestin-Westreich S, Celesing LP, Verleye G, Verté D, Ponjaert-Kristoffersen I: Coping styles as moderating the relationships between terrorist attacks and well-being outcomes. J Adolesc. 2009, 32: 585-599. 10.1016/j.adolescence.2008.06.003.CrossRefPubMed
42.
go back to reference Kahn AS, Mathie VA, Torgler C: Rape scripts and rape acknowledgment. Psychol Women Q. 1994, 18: 53-66. 10.1111/j.1471-6402.1994.tb00296.x. doi:10.1111/j.1471-6402.1994.tb00296.xCrossRef Kahn AS, Mathie VA, Torgler C: Rape scripts and rape acknowledgment. Psychol Women Q. 1994, 18: 53-66. 10.1111/j.1471-6402.1994.tb00296.x. doi:10.1111/j.1471-6402.1994.tb00296.xCrossRef
43.
go back to reference Bondurant B: University women’s acknowledgment of rape: individual, situational, and social factors. Violence Against Women. 2001, 7: 294-314. 10.1177/1077801201007003004.CrossRef Bondurant B: University women’s acknowledgment of rape: individual, situational, and social factors. Violence Against Women. 2001, 7: 294-314. 10.1177/1077801201007003004.CrossRef
44.
go back to reference McGee H, O’Higgins M, Garavan R, Conroy R: Rape and child sexual abuse: what beliefs persist about motives, perpetrators, and survivors?. J Interpers Violence. 2011, 26 (17): 3580-3593. 10.1177/0886260511403762.CrossRefPubMed McGee H, O’Higgins M, Garavan R, Conroy R: Rape and child sexual abuse: what beliefs persist about motives, perpetrators, and survivors?. J Interpers Violence. 2011, 26 (17): 3580-3593. 10.1177/0886260511403762.CrossRefPubMed
45.
go back to reference Peterson ZD, Muehlenhard CL: Was it rape? The function of women’s rape myth acceptance and definitions of sex in labeling their own experiences. Sex Roles. 2004, 51: 129-144.CrossRef Peterson ZD, Muehlenhard CL: Was it rape? The function of women’s rape myth acceptance and definitions of sex in labeling their own experiences. Sex Roles. 2004, 51: 129-144.CrossRef
46.
go back to reference Ryan KM: The relationship between rape myths and sexual scripts: the social construction of rape. Sex Roles. 2011, 65: 774-782. 10.1007/s11199-011-0033-2. DOI 10.1007/s11199-011-0033-2CrossRef Ryan KM: The relationship between rape myths and sexual scripts: the social construction of rape. Sex Roles. 2011, 65: 774-782. 10.1007/s11199-011-0033-2. DOI 10.1007/s11199-011-0033-2CrossRef
47.
go back to reference Erulkar AS: The experience of sexual coercion among young people in Kenya. International family planning perspectives. Gend Based Violence Reprod Health. 2004, 30 (4): 182-189. Erulkar AS: The experience of sexual coercion among young people in Kenya. International family planning perspectives. Gend Based Violence Reprod Health. 2004, 30 (4): 182-189.
48.
go back to reference Jewkes R: Non-Consensual Sex Among South African Youth: Presence of Coerced Sex and Discourse of Control and Desire. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 86-95. Jewkes R: Non-Consensual Sex Among South African Youth: Presence of Coerced Sex and Discourse of Control and Desire. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 86-95.
49.
go back to reference Kahn AS, Jackson J, Kully C, Badger K, Halvorsen J: Calling it rape: differences in experiences of women who do or do not label their sexual assault as rape. Psychol Women Q. 2003, 27: 233-242. 10.1111/1471-6402.00103.CrossRef Kahn AS, Jackson J, Kully C, Badger K, Halvorsen J: Calling it rape: differences in experiences of women who do or do not label their sexual assault as rape. Psychol Women Q. 2003, 27: 233-242. 10.1111/1471-6402.00103.CrossRef
50.
go back to reference Jejeebhoy SJ, Shah I, Thapa S: Sex Without Consent: Young People in Developing Countries. 2005, New York: Macmillan Jejeebhoy SJ, Shah I, Thapa S: Sex Without Consent: Young People in Developing Countries. 2005, New York: Macmillan
51.
go back to reference Krug E, Dahlberg L, Mercy JA, Zwi AB, Lozano R: World Report on Violence and Health. 2002, Geneva Switzerland: WHO Krug E, Dahlberg L, Mercy JA, Zwi AB, Lozano R: World Report on Violence and Health. 2002, Geneva Switzerland: WHO
52.
go back to reference Clements CM, Ogle RL: Does acknowledgment as an assault victim impact postassault psychological symptoms and coping?. J Interpers Violence. 2009, 24: 1595-1614. 10.1177/0886260509331486. doi:10.1177/0886260509331486CrossRefPubMed Clements CM, Ogle RL: Does acknowledgment as an assault victim impact postassault psychological symptoms and coping?. J Interpers Violence. 2009, 24: 1595-1614. 10.1177/0886260509331486. doi:10.1177/0886260509331486CrossRefPubMed
53.
go back to reference Gidycz CA, Koss MP: Predictors of long-term sexual assault trauma among a national sample of victimized college women. Violence Vict. 1991, 6: 175-190.PubMed Gidycz CA, Koss MP: Predictors of long-term sexual assault trauma among a national sample of victimized college women. Violence Vict. 1991, 6: 175-190.PubMed
54.
go back to reference Botta RA, Pingree S: Interpersonal communication and rape: women acknowledge their assaults. J Health Commun. 1997, 2: 197-212. 10.1080/108107397127752.CrossRefPubMed Botta RA, Pingree S: Interpersonal communication and rape: women acknowledge their assaults. J Health Commun. 1997, 2: 197-212. 10.1080/108107397127752.CrossRefPubMed
55.
go back to reference Littleton HL, Axsom D, Breitkopf CR, Berenson A: Rape acknowledgment and postassault experiences: how acknowledgment status relates to disclosure, coping, worldview, and teactions received from others. Violence Vict. 2006, 21 (6): 761-778. 10.1891/0886-6708.21.6.761.CrossRefPubMed Littleton HL, Axsom D, Breitkopf CR, Berenson A: Rape acknowledgment and postassault experiences: how acknowledgment status relates to disclosure, coping, worldview, and teactions received from others. Violence Vict. 2006, 21 (6): 761-778. 10.1891/0886-6708.21.6.761.CrossRefPubMed
56.
go back to reference Harned MS: Understanding women’s labeling of unwanted sexual experiences with dating partners. Violence Against Women. 2005, 11: 374-413. 10.1177/1077801204272240.CrossRefPubMed Harned MS: Understanding women’s labeling of unwanted sexual experiences with dating partners. Violence Against Women. 2005, 11: 374-413. 10.1177/1077801204272240.CrossRefPubMed
57.
go back to reference Layman MJ, Gidycz CA, Lynn SJ: Unacknowledged versus acknowledged rape victims: situational factors and posttraumatic stress. J Abnorm Psychol. 1996, 105 (1): 124-131.CrossRefPubMed Layman MJ, Gidycz CA, Lynn SJ: Unacknowledged versus acknowledged rape victims: situational factors and posttraumatic stress. J Abnorm Psychol. 1996, 105 (1): 124-131.CrossRefPubMed
58.
go back to reference Punier G: From Genocide to Continental War: The Congolese Conflict and the Crisis of Contemporary Africa: The Congo Conflict and the Crisis of Contemporary Africa. 2009, London: C Hurst & Co Publishers Ltd Punier G: From Genocide to Continental War: The Congolese Conflict and the Crisis of Contemporary Africa: The Congo Conflict and the Crisis of Contemporary Africa. 2009, London: C Hurst & Co Publishers Ltd
59.
go back to reference Human Rights Watch: Ituri: “Covered in Blood”: Ethnically Targeted Violence in Northeastern DR Congo’. 2003, Washington, DC: HRW Human Rights Watch: Ituri: “Covered in Blood”: Ethnically Targeted Violence in Northeastern DR Congo’. 2003, Washington, DC: HRW
60.
go back to reference Mels C, Derluyn I, Broekaert E: A community-based procedure for the cross-cultural adaptation of mental health self-report measures in emergency settings: validation of the IES-R and HSCL-37A for use in Eastern Democratic Republic of Congo. Soc Psychiatry Psychiatr Epidemiol. 2010, 45: 899-910. 10.1007/s00127-009-0128-z.CrossRefPubMed Mels C, Derluyn I, Broekaert E: A community-based procedure for the cross-cultural adaptation of mental health self-report measures in emergency settings: validation of the IES-R and HSCL-37A for use in Eastern Democratic Republic of Congo. Soc Psychiatry Psychiatr Epidemiol. 2010, 45: 899-910. 10.1007/s00127-009-0128-z.CrossRefPubMed
61.
go back to reference DRC government: La Loi Sur Les Violences Sexuelles. 2006, Kinshasa: DRC government DRC government: La Loi Sur Les Violences Sexuelles. 2006, Kinshasa: DRC government
62.
go back to reference Williams DR, Yan Yu JS, Anderson NB: Racial differences in physical and mental health: socioeconomic status, stress and discrimination. J Health Psychol. 1997, 2: 335-351. 10.1177/135910539700200305.CrossRefPubMed Williams DR, Yan Yu JS, Anderson NB: Racial differences in physical and mental health: socioeconomic status, stress and discrimination. J Health Psychol. 1997, 2: 335-351. 10.1177/135910539700200305.CrossRefPubMed
63.
go back to reference Weiss D: The Impact of Event Scale-Revised. Assessing Psychological Trauma and PTSD. Edited by: Keane T. 2004, New York: Guilford, 168-189. Weiss D: The Impact of Event Scale-Revised. Assessing Psychological Trauma and PTSD. Edited by: Keane T. 2004, New York: Guilford, 168-189.
64.
go back to reference Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P: Validation of the multiple language versions of the Hopkins symptom checklist-37 for refugee adolescents. Adolescence. 2007, 42 (165): 51-71.PubMed Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P: Validation of the multiple language versions of the Hopkins symptom checklist-37 for refugee adolescents. Adolescence. 2007, 42 (165): 51-71.PubMed
65.
66.
go back to reference McMullin D, White JW: Long-term effects of labeling a rape experience. Psychol Women Q. 2006, 30: 96-105. 10.1111/j.1471-6402.2006.00266.x.CrossRef McMullin D, White JW: Long-term effects of labeling a rape experience. Psychol Women Q. 2006, 30: 96-105. 10.1111/j.1471-6402.2006.00266.x.CrossRef
67.
go back to reference Koss MP: Hidden Rape: Sexual Aggression And Victimization In A National Sample Of Students In Higher Education. Violence In Dating Relationships: Emerging Social Issues. Edited by: Pirog-Good MA, Stets JE. 1989, New York: Praeger, 145-184. Koss MP: Hidden Rape: Sexual Aggression And Victimization In A National Sample Of Students In Higher Education. Violence In Dating Relationships: Emerging Social Issues. Edited by: Pirog-Good MA, Stets JE. 1989, New York: Praeger, 145-184.
68.
go back to reference Koss MP, Harvey MR: The Rape Victim: Clinical and Community Interventions. 1991, Thousand Oaks, CA: Sage Koss MP, Harvey MR: The Rape Victim: Clinical and Community Interventions. 1991, Thousand Oaks, CA: Sage
69.
go back to reference Paardekooper B, de Jong J, Hermanns J: The psychological impact of war and the refugee situation on South Sudanese children in refugee camps in Northern Uganda: an exploratory study. J Child Psychol Psychiatry. 1999, 40: 529-536. 10.1111/1469-7610.00471.CrossRefPubMed Paardekooper B, de Jong J, Hermanns J: The psychological impact of war and the refugee situation on South Sudanese children in refugee camps in Northern Uganda: an exploratory study. J Child Psychol Psychiatry. 1999, 40: 529-536. 10.1111/1469-7610.00471.CrossRefPubMed
71.
go back to reference Flisher AJ: Non-Consensual Adolescent Sexual Experiences: Policy Implications. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 269-285. Flisher AJ: Non-Consensual Adolescent Sexual Experiences: Policy Implications. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 269-285.
72.
go back to reference Jejeebhoy SY, Thapa S: Non-Consensual Sex And Young People: Looking Ahead. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 3-46. Jejeebhoy SY, Thapa S: Non-Consensual Sex And Young People: Looking Ahead. Sex Without Consent: Young people in Developing Countries. Edited by: Jejeebhoy SY, Shah I, Thapa S. 2005, New York: Macmillan, 3-46.
Metadata
Title
Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling
Authors
An Verelst
Maarten De Schryver
Eric Broekaert
Ilse Derluyn
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2014
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-14-106

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