The Surprising #1 Trigger of PTSD

Sexual assault

Post-traumatic stress disorder (PTSD) has earned a place in the social consciousness due to increased media coverage about the condition. If you’re like most people, you probably think PTSD predominantly affects military veterans. Wrong! Surprisingly, the #1 trigger of PTSD in the U.S. is rape. Statistics from the Anxiety and Depression Association of America shows that 46% of women and 65% of men who are raped will develop the disorder, which affects 7.7 million adult Americans. Other forms of sexual assault—including attempted rape, unwanted physical contact, and childhood sexual abuse—can also increase the risk of developing PTSD.

If you’re like most people, you probably think post-traumatic stress disorder (PTSD) predominantly affects military veterans. Wrong! Surprisingly, the #1 trigger of PTSD is rape. Click To Tweet


Sexual assault is alarmingly common. Every 68 seconds, someone in America is sexually assaulted, according to RAINN, the nation’s largest anti-sexual violence organization. And CDC statistics show that over 1 in 3 women and 1 in 4 men experience sexual violence in their lifetime. Experts agree that the incidence of sexual assault is likely much higher as many cases go unreported.

The lack of reporting is due, in part, to the stigma attached to being a rape survivor. Victims often feel guilt and shame about the experience, so they keep it to themselves. In some cases, an abuser threatens the victim or their loved ones with physical violence if they tell anyone. In other instances, victims feel hopeless and think that telling someone will do no good. Still, others may fear that speaking up will invite unwarranted scrutiny and victim-blaming.

Sadly, this means that millions of Americans keep rape and other forms of sexual assault a secret and don’t seek help for the distressing psychological consequences they bring.


Following sexual trauma, it’s common to experience feelings of stress, anger, fear, anxiousness, guilt, and sadness. For most survivors, these feelings subside over time, but in others, they fester into PTSD. The researchers behind the 2020 meta-analysis mentioned earlier suggest that the trauma associated with sexual assault can result in the dysregulation of the body’s stress response system, leading to chronic stress or PTSD.

Sexual assault survivors are more likely to develop PTSD than people who experience other forms of trauma. An epidemiological study of over 4,000 women found that 32% of rape survivors and 31% of sexual assault survivors will have PTSD at some point during their lifetime. Compare that to just 9% of survivors of traumatic events, such as a car accident or natural disaster, that aren’t crime-related.

Brain SPECT imaging, which measures cerebellar blood flow and activity, shows that PTSD is associated with overactivity in the emotional centers of the brain. This overactivity seen on SPECT scans typically looks like a diamond pattern that is also associated with an increased risk of other mental health issues.


PTSD isn’t the only psychological fallout associated with rape and other forms of sexual assault. Being the victim of this form of trauma is also linked to a heightened risk of a range of psychiatric issues, including:

Depression and anxiety.

Take a look at the findings of a 2019 study involving over 300 middle-aged women in JAMA Internal Medicine, for example. In this study, 22% of the participants said they had been sexually assaulted, and the survivors were 3 times as likely to experience symptoms of major depression and twice as likely to have anxiety.

Suicidal thoughts and behaviors.

For some victims, the psychological impact of the incident is so powerful that they begin having suicidal thoughts. A 2020 meta-analysis of dozens of studies with over 88,000 participants found a significantly greater prevalence of suicidal thoughts and behaviors among people with a history of sexual assault compared with those who had no such experiences. Specifically, over 27% of sexual assault survivors experienced suicidality compared to just 9% of people with no history of assault.

This analysis confirms earlier research indicating a rise in suicidality following sexual assault. For example, a study in the Archives of General Psychiatry indicates an increased risk of suicide attempts in women with a history of sexual assault. When the sexual trauma occurred before the age of 16, the rate of attempted suicide was 3-4 times higher.

Increased suicide risk also affects teens. Troubling findings in JAMA Pediatrics point to an increased rate of suicide attempts among teenage females who have experienced recent dating violence and males who have been subjected to sexual assault.


A wealth of research indicates that sexual assault and rape increase the risk of developing substance abuse. Experts suggest that sexual assault victims may turn to alcohol or drugs to cope with the psychological distress that typically follows an attack.

Dementia and other brain disorders.

New brain imaging research from the University of Pittsburgh shows that not only does sexual assault impact mental health, but it can also harm brain health. This 2021 study in Brain Imaging and Behavior found that experiencing trauma, and especially sexual assault is associated with greater volumes of white matter hyperintensities (WMH), which are considered neuroimaging markers of dementia, cognitive decline, stroke, and other brain disorders.


If you’ve endured the trauma of a sexual assault and developed PTSD, it is possible to heal. In order to overcome PTSD related to rape—even if it occurred decades earlier—it’s critical to get a comprehensive assessment. SPECT can help you see if there are changes in blood flow or activity in the brain, such as the diamond pattern, that are typically associated with trauma and PTSD. Determining if you’re also suffering from other mental health issues—such as anxiety, depression, or substance abuse—is another critical part of the process to ensure you get the most targeted and effective treatment plan.

PTSD, anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Testing

    Comment by Andrew Nguyen — December 2, 2021 @ 1:37 PM

  2. Thank you. At 54 I thought I was crazy but a friend began to talk about a missing teen that I knew, and immediately started crying and having a panic attack. I knew it bought out the rape that happened to me from age 12 to 19. I got pregnant at 13 because of it and eventually told my mother, but said that it was someone other than the rapist. She immediately took me to get an abortion. Also I am just beginning to realize that when my mother got married to my stepfather she prostituted out myself and my brother in subtle ways, using us, and allowing him to take control. She still does it to enrich herself and him. Taking. I could really never figure out why I never wanted my children around them because her methods are very insidious and creepy. So she thinks it’s unseen and feels entitled to myself and my children. And her method of abusing me is to continue to treat me as a child, dismissing me and disrespecting me. And if I speak against she immediately cries victim to her husband to which he used to play along because he was befitting from the degradation of us. My sister became a schizophrenic, they locked her away. Threw her out at 16 and never let her come back home. She has now dead at 55. My brother became a severe diabetic is now newly on dialysis waiting for a kidney in the future at 52. He looks like he is dying, but he needs them because he is also legally blind as well. He told me recently that he is a hoarder and has to step over things in his apartment. God bless him. My brother needs them because that is the only family that we have. I moved to another state but still struggle with whether or not to visit them on holidays because of course they feel entitled to our presence. I know the game now, so I am able to an extent to work around them, leave when I feel I am starting to be used. They creep me out so I can’t sleep near their room. They make me feel like I am being raped. I try to keep latest information/discoveries limited or not at all that I so want to share with my parents. Because I was exploited for that among other things. I am a Registered Nurse have gone to every psychiatrist blaming my anxiety (now I know PTSD) on work or other things until a male friend from elementary school during a conversation as I stated made me spontaneously cry uncontrollably and go into a panic attack. and he was talking about a missing child that he knew as I said. Today I am taking klonopin, gabapentin, adderall. I only started that in my late forties after using naturopathic methods to try to heal after feeling “sick” all the time.

    Comment by Denah Feigenbaum — December 3, 2021 @ 3:52 AM

  3. I do think food addictions should be included in the list.

    Comment by Eve Avery — December 3, 2021 @ 4:43 AM

  4. I did the scan have the triangle of over activity in the emotional center. I also was diagnosed with adhd, PTSD, anxiety and depression. My medication I thought was working by my life circumstances due to job conditions and my husband’shealth my anxiety is still through the roof. I take my dog for walks, breathe pray, visualize a better Tim and place eat healthy but nothing helps. I’m exhausted. I’m actually sleeping pretty good just not feeling rested. Burnt out. Any suggestions?

    Comment by Heather Witherow — December 3, 2021 @ 4:54 AM

  5. My son was incarcerated due to clerical error at the age of 17yrs. He was sent to a MEDIUM PRISON, where he was raped, beat, traumatized in so many inhumane ways. He has been diagnosed with a plethora of mental disorders now. He lives with his father and his father is not mentally strong enough to get him the help he needs. My son does not trust doctors, etc.. he feels he does not have any mental issues. HE DOES. when he was released, he went to a mental health hospital. He spoke like an alien, dissassociated himself with humans, it was A NIGHTMARE!! No one wants to help!!! Our justice system IS HORRIBLE.

    Comment by Lisa Limoge — December 3, 2021 @ 5:28 AM

  6. I was raped when I was 15, was molested at 7. I am 78 and do have PTSD. Interesting article.

    Comment by CATHERINE GRUNER — December 3, 2021 @ 5:41 AM

  7. Really good article. Thank you.

    Comment by Timothy Lee — December 3, 2021 @ 6:07 AM

  8. As an incest survivor I completely agree. I was subject to incest and emotional and physical abuse as a child and even though I am in my late 70’s, I carry a lot of anxiety and probably depression as a result.

    Comment by rachela lea solomon — December 3, 2021 @ 6:28 AM

  9. What non drug and non supplement supports can you provide for PTSD and PANs in a 15 year old girl?

    Comment by Judi Yost — December 3, 2021 @ 6:33 AM

  10. I have only recently begun receiving your informative emails. I elected to add my name to a request for the emails after listening to you speak on a PBS program. Today I find myself almost in tears when reading your article on PTSD. Several years ago I was diagnosed with PTSD for the first time. I had been in outpatient treatment for depression several times since I was 18 years old. Even though I knew of my diagnosis my depression persisted, even after medication. With the onset of the Covid-29 pandemic I was advised to return to pschotherapy once again. I am now 85 years old and continue with my therapist once weekly and have finally been able to speak about the gang rape at 13 years of age and rape by a 21 years old man at age 14. It has been a lifetime of treatment. I am finally able to speak about the trauma I suffered. Reading your article on PTSD was such a gift to me. It added affirmation to my diagnosis which I believed might just be a one-off ! Thank you Dr. Amen.

    Comment by Doris S. Wilk — December 3, 2021 @ 7:03 AM

  11. Sad but true, spot on . It was my guess without reading.

    Comment by Been there — December 3, 2021 @ 7:10 AM

  12. Would “sexual assault” include childhood sexual abuse? Or does this category have different characteristics?

    Comment by Bruce W — December 3, 2021 @ 8:02 AM

  13. L Sexual assault is one of many traumas I suffered. So it doesn’t have to be the sole cause, right? Complex PTSD is raging in the USA yet it is Not recognized in the DSM and finding a trained therapist in this is impossible. These things must change!

    Comment by Sue — December 3, 2021 @ 9:33 AM

  14. Interesting to learn more.

    Comment by Suyapa Martinez — December 3, 2021 @ 9:51 AM

  15. If one is unable to afford SPECT scan with history of sexual assault, would Brain Type assessment even be helpful? Your online evaluation revealed Brain Type 8 for me. I ordered Neurolink which was suggested in my report. Would this help with anxious, negative thoughts, depression? I am curious is Happy Saffron would be helpful.
    Given the difficulties of some with history of sexual assault, has Amen Clinics considered finding donors for scholarship funding for SPECT scans and treatment?
    I am so grateful for your information.

    Comment by Lani M — December 3, 2021 @ 6:53 PM

  16. Bullying is another epidemic that is costing us so many lives, jobs, relationships…one way to deal with it is to understand that it is not about you but it is all about the bullies dysfunction…same with the rapists…However a good brain health program like doctor Amen’s is needed to restore the brain.

    Comment by Liam Briones MD, MBA — December 4, 2021 @ 5:53 AM

  17. I just recently started seeing a psychologist who identified that I have PTSD from trauma as a young adult. I have been in counseling off and on for most of my life but only diagnosed as depression. I have an eating disorder and feel it is from my trauma as I have not been able to control it; it controls me.This information is very beneficial but still need more information on how to get treatment.

    Comment by Gayle Sorg — December 4, 2021 @ 8:08 AM

  18. There are very compelling studies showing MDMA can successfully treat PTSD. Do you all have any SPECT data following MDMA “cures”?

    Comment by Tara — December 4, 2021 @ 10:35 AM

  19. I would add disordered eating and self harm to the list.

    Comment by M Horn — December 5, 2021 @ 9:56 PM

  20. This article was spot on. I recently had been working on my inner child or shadow work, and I “recovered” my “forgotten” memories. I have been journaling and I’m going to publish the journey as a novel, not as a memoir.

    As I had some triggers pushing my buttons, all of the past sexual assaults came to surface. I’ve been a victim of child abuse: sexual, physical, emotional, and neglect. My own father molested me from age 3 until 12, and other male members of the family sexually assaulted me: unwanted physical contact. In addition, I had experienced attempted rape at the age of 16, at 21 and at 27. Then I was actually raped at 22.

    Because I’ve been suffering from panic attacks since I was 23 almost on a monthly basis, I searched for help. But I didn’t find someone I feel I could trust, so I continued on with my life not knowing how all the sexual traumas had been affecting me.. Recently, an acquaintance who is a professional therapist told me that it all sounded like I was experiencing PTSD. I didn’t know. When I recognized that I’ve been in constant anxiety, I discovered that I’m experiencing all of them: Catastrophic Fears (Glossophobia and Separation Anxiety), Fear of Evaluation (Social Anxiety including fear of being watch and criticized, and eye contact anxiety) Fear of Losing control (Panic disorder), and Fear of Uncertainty (general anxiety).

    Lately I’ve been feeling that I don’t want to continue to live. I just recently started treatment with a psychotherapist. Maybe I should get a comprehensive assessment. I’ll find the nearest one to my hometown. Now that we recognized what’s ailing us, now we can do something about it. Blessings to all. May we find considerable help to heal these deepest wounds.

    Comment by Judith Willemsen — December 7, 2021 @ 4:43 PM

  21. I have PTSD from incest as a small child through the age of 20. It
    is debilitating. I also suffer from treatment resistant depression and anxiety. I wish I could afford your treatments. Just to feel normal for once would be life changing.

    Comment by Jill Pfaff — December 13, 2021 @ 4:43 PM

  22. I was sexually assaulted by my biological father my entire childhood I will not disclose exactly the age because sexual assault on a child is traumatic. Some people can call it what they want i will call it rape. I have had Grand mail seizures in the past that my mind could not cope with the horrific trauma. I will say that when the stressor is no longer in your life it impacts your life in a positive way. I believe in Christian based counseling to help deal with the stress that rape causes an individual . I have PTSD and I am not scared to say it is nothing to be ashamed of because it is not your fault it is the abusers twisted mind or what I call a psychopaths twisted mind. Do not let the abuse get you depressed because you are important and find activities that make you happy and content. What bothers me are sometimes the sleepless nights because you are scared of the nightmares you may have of the abuse . I encourage journaling about how you feel even if it is late a night or early in the morning.

    In conclusion if you are having thoughts that you are not worth anything remember this you are not alone. Stay strong and remember this you are important .

    Comment by Katharine — June 4, 2022 @ 2:08 AM

  23. wonderful article!

    Comment by Doug Morris — October 31, 2023 @ 2:33 PM

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