Rape Trauma Syndrome in the Military Courts

Stephen A. Young, MD

The military courts have developed a rich case law tradition in the area of trauma syndrome testimony. These cases are particularly important in the context of a military that is both increasingly female and increasingly sensitive to mixed gender relationships. This article reviews the military court's approach to rape trauma testimony over the past 15 years. The author notes that military courts have been accepting of this testimony within certain well defined limits. The author analyzes the approach to testimony at one military medical center and offers a testimony model for the forensic psychiatrist who testifies in a military setting.

Background icant percentage of women on active duty Women in the Military The military (Table 1). has increasingly become a two-gender or- The growing number of women in the ganization over the past 20 years, with active duty force has created a number of greater and more varied opportunities for logistical and social changes. The mili- female soldiers. From 1980 to 1990 the tary, like any other large organization, has percentage of women in the Army in- had to deal with the many issues that arise creased from 6.6 to 11.2 percent of the when men and women are working force.' At the end of October 1994, they closely together. Sexual relationships and comprised 12.9 percent of active duty roles have been a source of complex dif- Army soldiers.* More than 26,000 ficulties for the military law enforcement women were deployed to Southwest Asia and legal e~tablishrnent.~.~Recent U.S. during Operation Desert Storm (8.6% of Court of Appeals for the Armed Forces all deployed Army forces), and of these 4 (USCAAF) opinions576have addressed were killed in action, 21 wounded in ac- issues of sexuality to include rape trauma tion, and 2 were taken prisoner.' The syndrome (RTS)~and .' In a other military services also show a signif- dissenting opinion in a decision involving the importance of rehearing a case that involved an (US v. Dr. Young was formerly affiliated with Walter Reed Pierce), the court noted particular con- Army Medical Center, Washington, DC. Address corre- spondence to: Stephen A. Young, MD, Psychiatric As- cern about the necessity of force to prove sociates, 235 Carrnel Dr., Ft. Walton Beach, FL 32548. a rape and stated:

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Table 1 consent required, however, is more than mere Women Serving in the Armed Forces, by lack of acquiescence. If a woman in possession Servicea of her mental and physical faculties fails to make her lack of consent reasonably manifest Branch of Service Actual Number % of Force by taking such measures of resistance as are Army 69,284 12.9 called for by the circumstances, the inference Air Force 65,755 15.6 may be drawn that she did consent. Consent, Navy 52,317 11.3 however, may not be inferred if resistance Marine Corps 3,671 4.4 would have been futile, where resistance is aData provided by the Defense Manpower Data overcome by threats of death or great bodily Center, Monterey, CA.2 harm, or where the female is unable to resist because of the lack of mental or physical fac- ulties.' In the absence of executive or legislative clar- Rape in the Military In 1992 the ification, the burden historically falls to the Orange County (California) Register ob- judiciary to confront important legal issues. . .in a manner which provides clear and meaningful tained data on in the U.S. Army via guidance. Viewed in this light, the facts of the Freedom of Information Act. Num- every military rape case, particularly "acquain- bers widely reported at the time9 stated tance rape" cases, whose central issue is suffi- that women serving in the military were ciency of the evidence, become exceptionally important. They help define the permissible 50 percent more likely to be raped than a limits of relationships between male and female civilian (e.g., the military rate of reported soldiers. rapes was l29/lOO,OOO compared with This article addresses the issue of RTS in 8 111 00,000 for civilian women). Unpub- the context of a military in which female lished data collected from the Clerk of the soldiers are now commonplace and in Court, U.S. Army Judiciary, reveal that which the judiciary is examining the ad- the number of rape charges brought for equacy of statutes concerning sexual be- adjudication in fiscal years 1992, 1993, havior among soldiers. and 1994 were 120, 1 16, and 99, respec- Statutes and Rules Regarding Rape tively. The conviction rate for all three Article 120 of the Uniform Code of Mil- years was around 40 percent. Notably, the itary Justice (UCMJ) defines rape as fol- percentage of victims who were active- lows: duty female soldiers was nearly 37 per- (a) Any person subject to this chapter who cent. commits an act of sexual intercourse, by force and without consent, is guilty of rape and shall be punished by death or such other punishment Rape Trauma Syndrome as a court-martial may direct.' RTS has been defined as "a type of The Manual for Courts-Martial de- posttraumatic stress disorder (PTSD) or scribes the role of physical force and the reaction that concerns typical reactions a issue of lack of consent in some detail, rape victim could exhibit due to the trau- stating that: matizing impact of rape."I0 First de- scribed in 1974 by Burgess and Holm- (c)(l)(b) . . . Force and lack of consent are nec- essary to the offense. Thus, if the female con- strom," RTS consists of "behavioral, sents to the act, it is not rape. The lack of somatic, and psychological reactions to

564 Bull Am Acad Psychiatry Law, Vol. 23, No. 4, 1995 Rape Trauma Syndrome in Military Courts the attack."12 The syndrome is generally when discussing the usefulness of RTS described as a series of phases, beginning testimony in the courtroom. with an acute response to the trauma fol- The research has continued to develop lowed by stage(s) leading to eventual re- over the last 20 years. Research is diffi- covery and integration. Victims are de- cult in part because, although the original scribed as initially experiencing a period description implies an illness character- of disorganization, characterized by so- ized by phases, much of the research has matic complaints (muscle tension, head- equated RTS to PTSD. This is a difficult aches) and ." Burgess and Holm- comparison, because PTSD is not gener- strom later published data that also ally described in a phase model, but described sleep pattern disturbances (ini- rather the diagnosis is made by the pres- tial and middle ), eating pattern ence or absence of a complex of symp- disturbances (decreased appetite), and so- toms. matic symptoms focused on the area of In addition, other studies have focused the body that was attacked.13 This initial on other important symptoms that may be phase can last from a few days to weeks. missing from both models, such as the The reorganization phase generally oc- impact of marital status15 or specific vic- curs over the next several months to years tim vulnerability factors.16 Studies have and is characterized by victims frequently been consistent with the concept of a spe- moving away from home, nightmares, cific set of symptoms in the aftermath of various (particularly of things assaults in general17 and specifically after reminiscent of the rape. e.g., being in- a rape.I6 Other studies have shown that doors and especially being alone), and these symptoms appear independent of sexual difficulties. The nightmares can be premorbid psychiatric diagnoses. 16. l9 of both the attack itself and less specific More recent studies have supported the dreams in which the victim is being idea that the most significant factor in the chased by an unspecified assailant or is in development of PTSD symptoms after a a situation where she feels unable to act in crime is the trauma itselfI6 and that PTSD the face of a threat. Rogers has described symptoms are highly prevalent in rape this quality (e.g., the varied nature of the victims.20 Frazier and ~orgida,~'in their dreams of trauma victims) as one way to review on this subject, succinctly state: distinguish between true PTSD sufferers "It seems most appropriate, however, to and malingerers.I4 Sexual difficulties base assessments on scientific reliability consist of of sexual activity itself, or on the entire, evolving body of research feelings of isolation and in the vic- on rape." tim's ongoing significant relationships. One-half of the women described in the Rape Trauma Syndrome in original article demonstrated a "con- the Courts trolled" reaction to the rape, characterized RTS testimony is primarily used to es- by a "calm, composed, or subdued af- tablish the lack of consent to a sexual act. fect."' These descriptors become critical The use of this testimony sprang from a

Bull Am Acad Psychiatry Law, Vol. 23, No. 4, 1995 565 Young

number of concerns about rape trials that to the presentation of expert testimony. traditionally required "corroboration of The U.S. Supreme Court, in the recent the charge, utmost resistance by the vic- landmark decision Daubert v. Merrell tim, a prompt complaint, cautionary jury Dow ~harrnaceuticals,~~supported this instructions, and a 'chaste' victim."22 The relevancy or helpfulness standard in lieu central issue that surrounds RTS testi- of the Frye test. mony in the courts is admissibility. Con- Two early RTS cases, State v. ~arks'~ cerns have been expressed about both the and State v. ~aldana,~~came to differing scientific basis of the testimony as well as opinions on the admissibility of expert whether or not it is too prejudicial to the testimony. In Marks, the Kansas Supreme accused. Court accepted the testimony based on Civilian Courts The debate over ad- the general acceptance standard, whereas missibility of RTS testimony has oc- in Saldana the Minnesota Supreme Court curred over the same period of time that found just the opposite. The development the courts (both civilian and military) of the civilian courts approach to RTS has have redefined the admissibility standard been well described elsewherelZ7227 27; for expert testimony in general. Prior to however, 16 of 20 state supreme courts the changes in the Federal Rules of Evi- have ruled the testimony admissible, usu- dence adopted in 1975 (and subsequently ally with limitations on how it may be adopted in military courts in 1980), the used.27 standard for expert testimony was the Central to the RTS debate in all courts Frye test, which stated that the basis of has been the argument over whether the expert testimony "must be sufficiently es- testimony is more probative or predjudi- tablished to have gained general accep- cial. Ideally, RTS testimony would be tance in the particular field in which it useful in determining whether or not the belong^."'^ accuser has, in fact, suffered a sexual Since that time the "general accep- assault. Viewed in this light, the testi- tance" standard (Frye v. U.S.) has been mony is highly probative of the question replaced by the "helpfulness" or "rele- at issue. However, other courts have vancy" standard as directed in Federal feared that such testimony comes too (and Military) Rule of Evidence 702, close to establishing the of the de- which states: "If scientific, technical, or fendant and is thus too predjudicial. The other specialized knowledge will assist Saldana court was concerned that the the trier of fact to understand the evidence "aura of special reliability and trustwor- or to determine a fact in issue, a witness thiness" of the expert would be prejudi- qualified as an expert by knowledge, ciaLZ6 skill, experience, training, or education, Military Case Law Like their civilian may testify thereto in the form of an opin- counterparts, military courts have strug- ion or otherwise." This relevancy stan- gled with the psychological consequences dard allows the trier of fact to weigh the of rape, as well as the changing rules of evidence and generally lowers the barrier evidence.

566 Bull Am Acad Psychiatry Law, Vol. 23, No. 4, 1995 Rape Trauma Syndrome in Military Courts

In U.S. v. ~oore,~'published one year case (Henderson) to support the idea that after Marks and Saldana, USCAAF re- the mental state of the victim did have viewed admissibility of psychological relevance in a rape trial. The third expert testimony concerning the victim of a sex- accepted by the Moore court did not ex- ual assault. In Moore, the victim had a amine the victim, but rather was accepted long history of previous sexual . At as an expert on the "psychology of rape" the time of the offense, she was engaged and testified about a theory of rape clas- to one soldier, but living in a car parked sifications and patterns of rape victim re- on post. The court allowed three experts, sponses. all of whom opined that the victim had a A vigorous dissenting opinion criti- tendency to appear seductive and place cized the acceptance of the testimony on herself in positions where a the grounds that it did not meet the Frye might occur. Two of the three, however, test and that a comparison between the stated that it was unlikely that she would victims in Henderson and Moore was in- engage voluntarily in sex and "later cry appropriate. Chief Judge Everett wrote: rape." The court found the testimony rel- this evidence invited the members-in the evant to the central question of consent. name of science-to speculate, disregard the They did not specifically mention RTS, evidence about what actually had occurred, ig- but gave much credence to a psycholo- nore their own experience and common sense, gist's opinion about the victim's mental and decide on the basis of sympathy for the prosecutrix.28 state at the time of the offense as proba- tive in the question of consent: He also points out in a later footnote that [Dr Randall] stated that, in his opinion, it would "[tlhis is one of several reasons why 'rape be consistent with Sandra's 'fear of retaliation' trauma syndrome' has been rejected by that, if she were struck one or more times by a some courts." male who was 'respond[ing] on a sexual basis Other military co~rts~~,~~during the to her' conduct, and the male 'threaten[ed] to kill her,' she would likely consent to the inter- early to mid 1980s offered different opin- course. This statement of opinion was compa- ions. In U.S. v. Tomlinson, the U.S. Army rable to the medical testimony the Court ap- Court of Criminal Appeals (USACCA) proved in United States v. ~enderson.~' (the highest Army court, but one tier be- Notably, the testimony in ~erzderson~~low USCAAF) rejected rape trauma syn- concerned the mental state of a victim drome testimony stating that the prejudi- who suffered from schizophrenia. In that cial value outweighed the probative case the court found the victim's "mental value. Citing Saldana, the court felt that condition was such as to cause her to be the testimony had little probative value overawed more easily by a demonstration because the (jury) members were fully of force than would be usual in a woman competent to determine the credibility of her age." Although there is little similar- the victim and that "the danger of unfair ity between schizophrenia and RTS as prejudice created by such testimony is presently conceptualized, the Moore obvious."30 The Tomlinson court left the court went back nearly 30 years to find a door partially open, however, when they

Bull Am Acad Psychiatry Law, Vol. 23, No. 4, 1995 567 Young stated that the testimony may have been in the judgement of others. This unique allowed had it been limited to show that method of jury selection ensures that the the "inconsistencies in [the victim's] 'asserted vagaries of juries' found in statements were the product of emotional other criminal justice systems are mini- trauma." The implication was that limited mized in the military."33 RTS testimony might have been accept- In U.S. v. ~e~lzolds~~USCAAF again able. affirmed a conviction of a defendant in Similarly, the U.S. Air Force Court of which the admissibility of RTS was Criminal Appeals ruled in U.S. v. East- raised on appeal. They relied on Carter man3' that RTS testimony was inadmis- but also reemphasized the role of the ex- sible. but noted that "our decision in this pert by citing U.S. v. ~rruza~'for the case turns on the question of the witness' proposition that "the expert cannot 'opine qualifications and not on the admissibility as to the credibility or believability of the or inadmissibility of evidence of Rape victim." Other military cases from that Trauma Syndrome." period confirmed the court's position36-38 In 1988 a lower court decision on RTS and allowed testimony from an expert was accepted for review by USCAAF in who had not evaluated the victim39 and U.S. v. In Carter, a military specifically discussed the admissibility of psychiatrist specifically discussed RTS testimony about failure to immediately and correlated published information report.36 One case was overturned be- about the syndrome with the case at bar. cause the expert used a testing instrument The expert did not specifically give an that had not been widely accepted and opinion as to whether or not a rape had in testified as to the credibility of the wit- fact occurred, and the military judge gave nes40 an instruction placing the testimony "in The most recent decision involving proper perspective." The USACCA up- military case law and RTS is U.S. v. held the conviction as did USCAAF. ~ouser.~In Houser, USCAAF upheld the The reasoning by the higher court in- conviction of a soldier who had raped a cluded six parts: (I) there is sufficient 15-year-old, live-in babysitter while his data to support the existence of a rape wife was absent. In his opening statement trauma syndrome; (2) the evidence will the defense counsel raised questions con- assist the trier of fact; (3) the relevance of cerning the victim's failure to report (she the testimony is "unquestionable"; (4) the told the wife about the incident the next matter is within the discretion of the mil- day) and resist. He followed this lead itary judge; and (5) the importance of a with a "vigorous" cross-examination of proper limiting instruction is "para- the victim in these perceived areas of mount." The sixth reason is unique to the inconsistency. In rebuttal, the Govern- military and has to do with the character- ment offered an expert in RTS. The ex- istics of military jurors, whose selection pert was a counseling psychologist who is governed "by a list of criteria that re- had worked extensively with rape vic- quires that only the best qualified will sit tims. Notably, she had not evaluated the

568 Bull Am Acad Psychiatry Law, Vol. 23, No. 4, 1995 Rape Trauma Syndrome in Military Courts victim, but rather spoke about typical been the growing knowledge and under- RTS symptoms in a multistage model. standing of rape trauma syndrome. The USCAAF opinion records a great The military environment is a partic- deal of her actual testimony, making this ularly difficult place to address the is- a model case for what the court feels is sue of rape, given the historically pre- appropriate testimony in this area. dominant male membership, the In Houser the court specifically noted growing role of women, and the emo- that RTS testimony need not be limited to tional and complex interpersonal issues rebuttal, was "logically relevant," and that arise in combat. Public concern and more probative than prejudicial. They publicity about a military unconcerned also restated that the testimony was lim- with female members has also been ex- ited in that the expert could not opine as tremely prominent in the past several to whether or not a rape had occurred or years.4 A recent article examined rape on the credibility of the witness. by soldiers during wartime as a "delib- The opinion also revisited an issue ad- erate strategy to undermine community dressed in Carter, the use of testimony bonds and weaken resistance to aggres- from experts who have treated the victim ~ion."~'Of course, a rape in the context versus testimony from experts in RTS in of a plundering army is vastly different general. In both cases the court stated the from rape at a stateside military post preferred method would be to use both during peacetime. However, both situa- kinds of experts. Quoting Carter, in a tions, and the many that fall along the concurring opinion, Judge Wiss writes: spectrum between these two poles, must be addressed by military law. We believe the better practice would be to have To a large extent, the military courts the treating medical personnel testify as to the have accepted RTS testimony. Indeed, victim's emotional, physical, and mental state and have another individual, properly qualified they have shown a great concern about as an expert, testify as to the various aspects of women and men in the military environ- rape trauma syndrome and whether the victim's ment in the above opinions on RTS as symptoms are consistent with rape trauma syn- well as in other areas. Two recent cases, drome. Such an expert, appropriately distanced from U.S. v. Pierce (quoted above) and US. v. the alleged victim, is in a position to offer truly Webster, reveal that the court is particu- objective assistance for the factfinders, with a larly sensitive to these issues. In both substantially reduced risk of a subconscious cases the court raised the complex issues suggestion creeping into the testimony that the expert believes the ~ictim.~ of date and acquaintance rape in an effort to clarify military law. ~ebster~~in par- ticular contains a detailed and thoughtful Discussion analysis of these difficult areas. In that The entire area of expert testimony has case the court analyzed the definition of been the subject of interest in both mili- resistance, noting that: "Such evidence of tary and civilian courts in the past 10 unwavering and repeated verbal protest in years. Concurrent with these changes has the context of a surprise immobilization

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surely could be considered reasonable re- one of the major criticisms of RTS is that sistance . . ." The court reaffirmed the it is too nonspecific, and therefore un- idea that "lack of consent, as well as the helpful. The properly trained expert can appropriate level or measure of resistance integrate the specific response of a vic- by the victim, is determined by the 'total- tim, incorporate it into the published ity of the circumstances.' " knowledge about the syndrome, and ex- Despite this acceptance, problems with plain how it is or is not manifested in that RTS testimony still exist. While the sci- victim. Simply reading the medical entific basis for certain symptoms has record or responding to hypothetical continued to develop, there remains much questions is not adequate. Also, this to be done. Much of this work, like the model would not apply in a situation original research, is being done to further where the victim had not sought treat- clinical rather than forensic goals (e.g., ment. how better to treat, not how better to At the Walter Reed Army Medical correctly identify). Center, the victim is always interviewed A complete review of the RTS litera- by the consulting expert. In addition, in- ture is beyond the scope of this discus- vestigative reports, medical records, and sion. However, the use of experts in rape pertinent background information is re- cases in the military setting will be ad- viewed. Neurologic and psychometric dressed briefly. consultants are available to the evaluating As noted above, the courts in Carter psychiatrist if indicated. This is a model and Houser suggested a two-witness ap- of an RTS expert who, while not treating proach to RTS (e.g., the treating profes- the victim, has personally assessed her. sional to testify as to the actual clinical course of the victim and a separate expert The subsequent testimony integrates the to testify about RTS in general). This victim's experience in the context of the leaves the fact finder in the position of present state of knowledge about how integrating the specific symptoms of an victims respond to rape. individual victim with the "neutral" testi- Despite the natural desire to want to mony of the RTS expert. This approach assist victims of a sexual assault, the mil- theoretically reduces the "risk of a sub- itary psychiatrist must keep in mind that conscious suggestion creeping into the false rapes are reported43 and that the testimony that the expert believes the vic- issue of RTS remains in di~pute.~'The tim."6 courts have been clear about the limits of While this model appears logical on testimony in this area; the expert must not initial review, it is difficult to follow in address whether or not they believe a rape practice. The risk of using two experts is actually occurred or comment on the that the jury will be unable to perform the credibility or believability of the victim. necessary analysis of the clinical and re- Our clinical experience in four recently search data. It is precisely this analysis litigated cases has been that RTS testi- that requires the expert's input. Indeed. mony can be of great assistance to the

570 Bull Am Acad Psychiatry Law, Vol. 23, No. 4, 1995 Rape Trauma Syndrome in Military Courts military trier of fact in situations that are in rape victims: past history and current symp- tomatology. Compr Psychiatry 28:77-82, commonly confusing and emotional. 1987 20. Rothbaum BO, Foa EB, Riggs DS, Murdock References T, Walsh W: A prospective examination of posttraumatic stress disorder in rape victims. J 1. Defense Advisory Committee on Women in Traumatic Stress 5:455-75, 1992 the Services: Fact Sheet. Washington, DC: 21. Frazier PA, Borgida E: Rape trauma syn- DACOWITS, February 1994 drome: a review of case law and psychologi- 2. Dawson H, personal communication, Decem- cal research. Law Hum Behav l6:293-3 11, ber 1994 1992 3. Jonas DS: Fraternization: time for a rational 22. Note, checking the allure of increased convic- Department of Defense Standard. Mil L Rev tion rates: the admissibility of expert testi- l35:37-135, 1992 mony on rape trauma syndrome in criminal 4. Chema JR: Arresting 'Tailhook': the prosecu- proceedings. Va L Rev 70: 1657-1 705, 1984 tion of in the military. Mil 23. Frye v. US., 293 F 1013, 1014 (DC Cir 1923) L Rev 140: 1-64. 1993 24. Daubert v. Merrell Dow Pharmaceuticals, Inc, 5. U.S. v. Pierce, 40 MJ 584 (ACMR 1994) 113 S Ct 2786 (1993) 6. U.S. v. Houser, 36 MJ 392, 401 (CMA), cert 25. State v. Marks, 647 P2d 1292 (Kan 1982) denied, 1 14 S Ct 182 (1993) 26. State v. Saldana, 324 NW2d 227, 230 (Minn 7. Unified Code Military Justice Art 120(a), cod- 1982) ified as 10 USCA § 920 (West Supp 1995) 27. Stefan S: The protection racket: rape trauma 8. Manual for Courts-Martial United States 1984 syndrome, psychiatric labeling, and law. Nw (1994 ed), Pt IV, ¶ 45(c)(1)(6) U L Rev 88:1271-1345, 1994 9. Army Rape Rate Tops Civilian. Chicago Tri- 28. U.S. v. Moore, 15 MJ 354, 374-375 (CMA bune. December 3 1, 1992, p 3 1983) 10. Tetrault PA: acceptance: a case for 29. U.S. v. Henderson, 15 CMR 268, 272 (CMA providing educational expert testimony in 1954) rape jury trials. Behav Sci Law 7:243-57, 30. U.S. v. Tomlinson, 20 MJ 897, 901, 903 1989 (ACMR 1985) 11. Burgess AW, Holmstrom LL: Rape trauma 31. U.S. v. Eastman, 20 MJ 948, 952 (AFCMR syndrome. Am J Psychiatry 131:980-6. 1974 1985) 12. Block AP: Rape trauma syndrome as scien- 32. US. v. Carter, 22 MJ 771 (ACMR 1986), tific expert testimony. Arch Sex Behav 19(4): aff'd, 26 MJ 428 (CMA 1988) 309-23, 1990 33. Unified Code Military Justice Art 25(d)(2), 13. Burgess AW, Holmstrom LL: Rape: Victims codified as 10 USCA 5 825(d)(2) (West Supp of Crisis. Bowie, MD: Robert J Brady, 1974, 1995) pp 38-40 34. U.S. v. Reynolds, 29 MJ 105 (CMA 1989) 14. Rogers R: Clinical Assessment of Malinger- 35. U.S. v. Amza, 26 MJ 234 (CMA 1988), cert ing and Deception. New York: Guilford Press, denied, 489 US 101 1 (1989) 1988, p 96 36. US. v. Peel, 29 MJ 235 (CMA 1989), cert 15. Moss M, Frank E, Anderson B: The effects of denied, 493 US 1025 (1990) marital status and partner support on rape 37. U.S. v. Savage, 30 MJ 863 (NMCMR 1990) trauma. Am J Orthopsychiatry 60:379-91, 38. U.S. v. Moss, CMR 89-1 152 (USNMCCCA 1990 1990) 16. Resnick HS, Kilpatrick DG, Best CL, Kramer 39. U.S. v. Leger, CMR 91 -0412 (USNMCCCA TL: Vulnerability stress factors in develop- 1992) ment of posttraumatic stress disorder. J Nerv 40. U.S. ". Bostick, 33 MJ 849 (ACMR 1991) Ment Dis 180:424-30, 1992 41. Swiss S, Giller JE: Rape as a crime of war: a 17. Modlin HC: Is there an assault syndrome? medical perspective. JAMA 270:612-15, Bull Am Acad Psychiatry Law 13:139-45, 1993 1985 42. U.S. v. Webster, 40 MJ 384, 386-387 (CMA 18. Ellis E: A review of empirical rape research: 1994) victim reactions and response to treatment. 43. Feldman MD, Ford CV, Stone T: Deceiving Clin Psychol Rev 3:473-90, 1981 othersldeceiving oneself: four cases of facti- 19. Frank E, Anderson BP: Psychiatric disorders tious rape. South Med J 87:736-8, July 1994

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