These rapists are more likely to be diagnosed as psychotic. Extensive violent injury and death are characteristic. The Assessment Victims may not present immediately following a rape, especially if no apparent or serious physical injury has resulted. Among women who do admit to the emergency department, many will not offer rape as the initial complaint. Rather they will claim assault from robbery or voice concerns about sexually transmitted disease.
Rape produces feelings of helplessness and worthlessness in addition to fear.
Providers must carefully examine the complaint with respect and concern for her overall well being using a nonjudgmental approach. In some cases, women will present with psychiatric symptoms including anxiety or depression and some may be brought in secondary to a suicide attempt. In most states, there is a well-defined series of steps or protocols that should be followed in examining the patient insuring that evidence is appropriately collected and the chain of evidence is not broken. Emergency departments may have state issued collection kits identifying how and in what order samples should be collected as well as documenting guidelines. Clinics or private offices may keep one or two kits on hand in the event they are needed.