Sexual Assault Disclosure and Sexual Functioning: The Role of Trauma Symptomatology

Latent Profiles of Co-occurring Sexual Problems and Posttraumatic Stress Symptoms Among Young Women Exposed to Sexual Violence

Sexual dysfunctions (SDs) have been noted to occur following exposure to sexual violence although how these conditions covary with other mental health conditions, particularly posttraumatic stress disorder symptoms (PTSS), is relatively understudied. The current study examined patterns of co-occurring SDs and PTSS in a sample of 328 college-aged, female-identified survivors of adolescent/early adulthood sexual assault (ASA). Latent profile analysis was used to examine patterns of symptom endorsement of various types of SDs and PTSS at the symptom cluster level. Four profiles were identified: asymptomatic (41.2% of sample), sexually distressed + intrusions (24.7%), co-occurring (21%), and PTSS (13.1%). Profiles were compared to one another on various characteristics of sexual assault and social reactions from others following assault disclosure. Results indicated that those in the co-occurring symptom and PTSS profiles reported more severe ASA and more unsupportive social responses relative to the sexually distressed + intrusions and asymptomatic profiles. The asymptomatic profile was significantly less likely to have experienced rape relative to the other three profiles and was less likely to report instances where a close other treated them in a negative manner following assault disclosure. Results are discussed in light of mental health needs for young women who have experienced ASA, with implications discussed for future research and clinical services for university students.

A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories

Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.

"Coming out of the closet about sexual assault": Intersectional sexual assault stigma and (non) disclosure to formal support providers among survivors using Reddit

Sexual assault is a pervasive, violent and often gendered crime that can result in significant negative consequences. Many sexual assault survivors consider disclosing to health and social care providers, therapists, and others who collectively fall under the banner of formal support, in order to access information, referrals, treatment and/or emotional support, however barriers to disclosure remain. This qualitative study is unique in its application of an intersectional sexual assault stigmatization framework to understand (non)disclosure to formal support providers among diverse sexual assault survivors. Through anonymous online narratives posted to the platform Reddit, survivors documented experiences of intersectional sexual assault stigma (perceived, internalized, anticipated, experienced) showing that they were not only stigmatized through negative gender stereotyping, but they were also marginalized through other structural inequities. The experience of multiple marginalization that arose from intersectional sexual assault stigma often impeded survivors in accessing and/or utilizing the formal support they wished for. The findings suggest that formal support providers could benefit from stigma reduction training related specifically to sexual assault survivors and that current models of stigma and discrimination training need to be expanded to include intersectional stigma. Further, the findings suggest that beyond training at an organizational level, a broader intervention aimed at reducing structural stigma and discrimination toward sexual assault survivors at a societal level appears warranted. Implications for future research related to the unique disclosure, health, and social care needs of diverse sexual assault survivors and support-seeking online alongside or in lieu of formal support are discussed.

Gynecological Health Complaints Among College Women With Sexual Victimization Histories: Examination of Depression and Anxiety as Potential Mediators

PURPOSE

The study's purpose was to examine the relation between sexual victimization history and gynecological health complaints among college women. A further aim was to explore whether anxiety and depression are mediators of this relation, as well as to examine the size of these indirect relations among individuals with different types of victimization histories (childhood sexual abuse, adolescent/adult sexual assault, combined childhood sexual abuse/adolescent/adult sexual assault).

METHODS

A sample of 1,759 undergraduate cisgender women attending a large Southeastern U.S. university completed online measures of lifetime sexual victimization history, current anxiety and depression, and current gynecological health complaints (dysmenorrhea, dyspareunia, vaginal discharge, pain during urination, and pelvic pain). Mediation analyses with bootstrapping were conducted to explore the relations among study variables.

RESULTS

College women with a history of sexual victimization were significantly more likely to report experiencing the gynecological health complaints in the past month than women with no sexual victimization history (all ps < .05). There was a significant indirect path from sexual victimization to gynecological health complaints through both anxiety and depression for all three victimization types (βs = 0.12-0.26). The indirect paths were stronger for women with combined childhood sexual abuse/adolescent/adult sexual assault histories as compared with the other two types of victimization history.

CONCLUSIONS

Health care providers working with college women should implement a trauma-informed approach to addressing gynecological health complaints that recognizes that sexual victimization survivors are at an increased risk for these issues. Further, anxiety and depression represent possible mechanisms of risk for gynecological health complaints among survivors.

Social Reactions to Disclosure of Sexual Violence in Adulthood and Women's Sexuality: The Mediating Role of Shame and Guilt

This study examined the mediating role of emotions related to sexual violence in adulthood in the associations between social reactions to sexual violence disclosure and sexual outcomes. Self-reported data were collected from 324 women reporting sexual violence and path analyses were conducted among the 264 women (81.5%) who disclosed their most recent sexual violence experience. Results showed that emotional support was associated with higher sexual satisfaction. Victim blame was associated with greater guilt related to the sexual violence, which, in turn, was associated with higher sexual compulsivity. Stigmatization was associated with greater shame related to the sexual violence, which, in turn, was associated with higher sexual distress and avoidance, and lower sexual satisfaction and function. Our findings highlight the importance of social reactions to sexual violence disclosure in women's sexuality.

Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study

The present study aims to evaluate the relationship in women between a history of physical/sexual abuse and the preferences regarding the choice of a partner for a short/long-term relationship in terms of male facial dimorphism, and to assess their sexual functioning. We enrolled 48 abused women and 60 non-abused women. Facial preferences were evaluated with the Morphing test. Sexual functioning was measured with the Female Sexual Function Index (FSFI). Regarding the choice for a short-term partner, abused and non-abused women did not show any differences, and both groups chose a less masculine male face. On the other hand, regarding the choice for a long-term partner, abused women showed a preference for an average male face, whilst non-abused women preferred a less masculine face. The sexual functioning of abused women was found significantly dysfunctional in all domains of the FSFI. These data, generated from a small but highly selected cohort, demonstrated that physical/sexual abuse may be associated with a more rational and conscious choice of a male partner for a long-term relationship, but not with an instinctive one, as the choice of an occasional partner. In addition, the sexual functioning of abused women appears to be compromised by the traumatic experience.

State of the Art Treatment Options for Actual and Potential Sexual Offenders and New Prevention Strategies

Sexual violence is a significant and devastating issue for men and women throughout the world. Its consequences are not only disastrous for victims of sexual violence but are also extremely costly (estimated cost of $41,000 per rape) for society. Successful treatment of sexual offenders is therefore an important goal for society as well as for victims and offenders themselves. Over the years, multiple treatment approaches for sex offenders have been developed. Treatment programs range from the risk-need-responsivity (RNR) model, which focuses on providing tailored treatment for high-risk and low-risk offenders, to psychodynamic models. This article presents an overview for clinicians of state-of-the-art offender treatment, describing the most common treatment approaches, in particular the RNR model, cognitive-behavioral programs (relapse prevention programs, sexual offender treatment programs), psychodynamic approaches (transference-focused psychotherapy, mentalization-based therapy), the Good Lives Model, as well as pharmacological options. In addition, it provides an evaluation of the various treatment programs. However, given the fact that most acts of sexual violence will never be reported to the police, the question arises if treating convicted perpetrators is enough. Do we need rather-in terms of preventive work-a program for potential sexual offenders and men with delinquent sexual fantasies? Given the prevalence of sexual violence and its impact on victims, society, and the medical community, it would be remiss not to try to reach potential/unconvicted perpetrators. This article offers novel ideas and a project the goal of which is to prevent sexual offenses against women by introducing the "I CAN CHANGE" program from Hannover Medical School.