Yes. And the doctor says beaten is a possibility as well.
GRUESOME ALERT - MORE DIRECT THAN PREVIOUS POST:
I think he's the type - just like his lawyer buddy KW was with his own wife - to rape her. Hence, the zip ties, which were apparently around HER, to restrain her. They were apparently not around the outside of the bag, where one would use them after killing someone - even then, their use would not be likely.
If he wanted to just kill her, he would not restrain her first - it would increase the chance of her getting away.
Sorry, I know that's upsetting to read, but I think that's what he did before killing her, and he did have the time.
I do think he's that sick, and it's the ultimate control move, to hurt her emotionally as much as he possibly could.
Why else remove her clothing, and why "cut" underwear, as stated in the AW?
I've tried to think of "better" scenarios, but this one makes the most sense after reading the last AW.