Evaluation of Physical, Genital and Psychiatric Examination Findings in Female Sexual Assault and Sexual Abuse Victims

Abstract

Objective:It was aimed to reveal the limitations of different structural features of hymen in determining whether there is a sexual intercourse or vaginal sexualassault/abuse and the importance of the other physical examination findings of the genital region, general physical examination and psychological examination findings on creating idea about whether the incident has happened or not, while evaluating this issue.Methods:Between January 1, 2016 and December 31, 2018, 121 cases of sexual abuse and sexual assaul twhich were genitally examined in the Forensic Medicine Department of Süleyman Demirel University Faculty of Medicine were analyzed retrospectively. For statistical analysis, the SPSS version 22.0 program was used.Results:In the first examination, the rate of detecting physical findings in the genital area, physical findings other than genital areas were determined as 8.3%, 28.9%, respectively, and also a psychiatric finding was observed in 47.1% of thecases. In regressional analysis; the risk of developing psychiatric symptoms is 3.8 times higher in the group with the claim compared to the group without penetration claim, and according to the results of the genital examination, it was found 8.2 times higher in the group with acute rupture (p<0.05). According to the degree of victim-perpetratorcloseness, taking into account the group where the victim does not know the perpetrator, the risk of developing psychiatric symptoms is 2 times higher in cases of incest, 2.5 times higher in cases where the attack occurs against the partner, alcohol, drugs-narcotic substances under the influence of alcohol, 1.7 times higher than not to increase the development of psychiatric symptoms. A statistically significant correlation was found between being exposed to physical violence/threat/forced and the development of psychiatric symptoms (p<0.05). A significant correlation was found between the claim of penetration and the development of psychiatric symptoms (p<0.05). A statistically significant correlation was found between revealing evidence of penetration by detecting signs of acute penetration in genital examination and the development of psychiatric symptoms (p<0.05).Conclusion:In most of the victims of sexual crimes, noobvious physical traumatic changes occur. Therefore, detailed psychiatric evaluations should be made in each case, and the psychological evidence of sexual assault/abuse should be investigated and this evidence should be included as a result of the report.

Keywords

• sexual abuse
• sexual assault
• hymen
• psychiatric evaluation