Final Research Paper

Running Head: SEX TRAFFICKING AND PTSD

Sex Trafficking and PTSD in Adolescent Girls in the United States Jasmine Parker University of North Florida

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Human sex trafficking is a major public health concern that creates a myriad of problems that affect many people and communities. Roughly 2.5 million people become victims of human trafficking, with over 900,000 being minors (International Labour Organization, 2012). As the number of individuals who purchase sex increases, the demand for workers increases, leading to the coercion of most to be exploited (Gerassi, 2015). There are components to sex trafficking, such as the recruitment process. In one study, 47% of trafficked victims reported that they were brought in by friends who were forced into recruiting by their own trafficker (Curtis et al., 2008). Deception and exploitation are the underlying concepts of human trafficking that lead to the development of issues that forever impact an individual’s life. Declining mental health is a big problem considering the increased chance of acquiring disorders such as post-traumatic stress disorder. PTSD can be said to be debilitating because it is characterized by failing to recover from a traumatic time. For the general population, the chance of developing the disorder after a traumatic event is between 5% and 24% (Breslau, 2001). Adolescents seem to fall towards the lower end of that scale due to misdiagnosis. Most are diagnosed with illnesses such as ADHD or ODD, but the true cause is PTSD (Cook et al., 2003). A significant portion who are accurately diagnosed attributed the disorder to sexual abuse trauma. Being a victim of human sex trafficking can be a major determinant of developing PTSD. Because there is no uniform way of collecting data on a topic no one wants to discuss, the statistics are inaccurate and insufficient (Macy & Graham, 2012). As a result, researchers fail to get the most accurate data while studying the link. The purpose of this review is to discover if there is an association between human sex trafficking and PTSD in adolescent girls aged 13-18

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in the United States. If adolescent girls are exposed to sex trafficking, then the chance of developing PTSD is increased. Human sex trafficking deprives its victims of their freedom and the right to make decisions. When girls are placed into these situations, they have a limited ability to foresee and control factors that can negatively impact their health. Research shows that of 204 sex trafficked victims interviewed, 68 being adolescent girls, 77% presented possible symptoms of PTSD (Hossain, Zimmerman, Abas, Light, & Watts, 2010). The unsettling feeling of not knowing the circumstances surrounding the next meal, sleeping patterns, client list, and condom use leads to more severe mental responses. Furthermore, being a victim of sex trafficking can be detrimental to one’s self esteem, giving rise to PTSD symptoms before and after the diagnosis. Feelings of worthlessness can lead to isolation and emotional numbness. One study included 5 women who were all forced into sex trafficking as teenagers. All 5 victims developed one or more mental health disorders, with 3 being diagnosed with PTSD (Farley, 2003). One victim stated that she only felt useful as a place for someone to empty themselves into and tried to escape her emotions to protect herself (Farley, 2003). When thoughts like such as those begin to set in, the positive self-confidence a victim once had of themselves is lost and difficult to regain. Additionally, human sex trafficking has adverse effects on gynecology including early pregnancy and pregnancy complications, which literature has associated with PTSD. Exams to the pelvic and abdominal areas are used to identify medical conditions in adolescent girls that can arise from forced sexual activity such as dysmenorrhea and dyspareunia. Studies have shown that PTSD can lead to changes in the brain that increase reactivity and pain sensitivity (Ashby & Kaul, 2016). Although this is true, adolescents with this type of sexual trauma tend to be more likely to participate in high-risk sexual activity for reasons that have yet to be studied.

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Sex trafficking seen and unseen is becoming all too ordinary in the United States, illegitimately grossing millions of dollars per year. As researchers link this sexual trauma to PTSD, the next challenge becomes finding ways to treat the victims. Researchers have tested different treatments options, but have struggled to determine their effectiveness. Narrative exposure therapy, is a psychologist-guided autobiography of the sex trafficking experience in chronological order. Although unpleasant, talking about the experience can aid the recovery process by remembering the events so that they can be put into context and distinguish the past and present. Recent research shows that the completion of at least 10 narrative exposure therapy sessions helped decrease the PTSD severity scores in 10 women (Robjant, Roberts, & Katona, 2017). Moreover, finding effective treatments should come with gaining a better understanding of PTSD and how it manifests. When this type of trauma is left unaddressed and untreated, the chances of an individual to be revictimized or reenact the trauma themselves is increased. Prevention can be complicated to accomplish when it comes to a traumatic event such as sex trafficking, which turns the focus towards early intervention. Studies show that having knowledge of the early signs of PTSD is crucial during early treatment and that adolescents stand a better of chance of recovering and re-establishing themselves (Beals & Scott, 2012). Knowing about PTSD has its advantages. An adolescent who has been victimized will not always selfidentify for reasons such as self-blame and is not always easy to recognize without proper knowledge. Early intervention can prevent adolescents from growing up with chronic PTSD and help suppress symptoms. The exploration of using more than one type of therapy within a single intervention could be helpful due to the complexity that each case can bring about. Understanding the psychological and physical injury that is the result of sex trafficking can be beneficial when it comes to preparing care and support resources.

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The purpose of this review was to determine if there is an association human sex trafficking and PTSD in adolescent girls aged 13-18 in the United States. With the minimal studies that have been done, most researchers would support the statement that if adolescent girls are exposed to sex trafficking, their chances of developing PTSD will increase. The studies show the association with statistics from case series, case controls, and reviews including published literature. Even though adolescent girls are being sexually exploited in the United States, most Americans are turning a blind eye based on the belief that sex trafficking only occurs in other countries. Due to lack of education, the difference between a prostitute and a sex trafficked victim is unclear. Girls exposed to this type of environment are at a higher risk of getting PTSD, along with multiple other mental health disorders than girls who do not become victims. Public health practitioners can use the results of my review to start considering conducting more research to see what types of treatment programs are the most effective and efficient. In the past, the conversation has been about law enforcement issues, often leaving out the journey to recovery of the survivor. Media, as an integral part of society, can be utilized to bring the necessary attention to the health needs of victims and survivors. Resources can be used to implement distinctive health services that are readily available. More funding can be put towards not only developing health services, but designing them to be long-term and effective.

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The purpose of this review was to determine if there is an association human sex trafficking and PTSD in adolescent girls aged 13-18 in the United States. With the minimal studies that have been done, most researchers would support the statement that if adolescent girls are exposed to sex trafficking, their chances of developing PTSD will increase. The studies show the association with statistics from case series, case controls, and reviews including published literature. Even though adolescent girls are being sexually exploited in the United States, most Americans are turning a blind eye based on the belief that sex trafficking only occurs in other countries. Due to lack of education, the difference between a prostitute and a sex trafficked victim is unclear. Girls exposed to this type of environment are at a higher risk of getting PTSD, along with multiple other mental health disorders than girls who do not become victims. Public health practitioners can use the results of my review to start considering conducting more research to see what types of treatment programs are the most effective and efficient. In the past, the conversation has been about law enforcement issues, often leaving out the journey to recovery of the survivor. Media, as an integral part of society, can be utilized to bring the necessary attention to the health needs of victims and survivors. Resources can be used to implement distinctive health services that are readily available. More funding can be put towards not only developing health services, but designing them to be long-term and effective.

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1.

Johnson, K. (2017). The DSM-5 Definition of PTSD. Journal of Legal Nurse Consulting, 28(3), 25-29.

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Gerassi, L. (2015). From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls. Journal of Human Behavior in The Social Environment, 25(6), 591-605

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Miller-Perrin, C., & Wurtele, S. K. (2017). Sex Trafficking and the Commercial Sexual Exploitation of Children. Women & Therapy, 40(1/2), 123. doi:10.1080/02703149.2016.1210963

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Beals, K. R., & Scott, D. A. (2012). Neglect, Physical and Sexual Abuse: A Look at Posttraumatic Stress Disorder in Children and Adolescents. Michigan Journal of Counseling: Research, Theory, And Practice, 39(1), 31-38.

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Ashby, B. D., & Kaul, P. (2016). Mini-Review: Post-traumatic Stress Disorder After Sexual Abuse in Adolescent Girls. Journal of Pediatric and Adolescent Gynecology, 29531-536. doi: 10.1016/j.jpag.2016.01.127

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Hossain, M., Zimmerman, C., Abas, M., Light, M., & Watts, C. (2010). The Relationship of Trauma to Mental Disorders Among Trafficked and Sexually Exploited Girls and Women. American Journal of Public Health,100(12), 2442-2449. doi:10.2105/ajph.2009.173229

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Farley, M. (2003). Prostitution, trafficking, and traumatic stress. New York: Routledge.

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Robjant, K., Roberts, J., & Katona, C. (2017). Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit. Frontiers in Psychiatry, 8, 63.

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Macy, R. J., & Graham, L. M. (2012). Identifying domestic and international sex-trafficking victims during human service provision. Trauma, Violence, & Abuse, 13(2), 59–76. doi:10.1177/1524838012440340

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Breslau, N. (2001). The epidemiology of posttraumatic stress disorder: What is the extent of the problem? Journal of Clinical Psychiatry, 2001; 62, Suppl 17:16-22

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Simon, P., Krugman, R. D., Clayton, E. W., National Research Council, (U.S.), & Institute of Medicine, (U.S.). (2013). Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States. Washington, D.C.: National Academies Press .

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