The relationship between childhood sexual abuse and adult male sexual dysfunction

The Relationship Between Child Sexual Abuse and Sexual Dysfunction in Adults: A Meta-Analysis

Child sexual abuse (CSA) has been recognized as a risk factor for sexual dysfunction and has attracted increasing attention. However, controversies remain regarding related research. The aim is to calculate the pooled effect size estimate for the correlation between CSA and sexual dysfunction in adults by meta-analysis. Five bibliographic databases (PubMed, Cochrane Library, Web of Science, Embase, and PsycINFO) were comprehensively searched to clarify the association between CSA and sexual dysfunction in adults. We used a fixed-effects model to determine the total pooled effect size estimate and reported odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Subgroup analysis, publication bias analysis, and sensitivity analysis were conducted. Adults who had a history of CSA experienced a higher proportion of sexual dysfunction than adults with no history of CSA (OR = 1.68, 95% CI [1.49, 1.87]). Subgroup analysis showed that women with a history of CSA reported a higher proportion of sexual dysfunction than men with a history of CSA (men: OR = 1.45, 95% CI [1.05, 1.84]; women: OR = 1.62, 95% CI [1.42, 1.83]). The estimates of the effect sizes differed substantially depending on the CSA and sexual dysfunction instruments that were used in each study and the region of each sample. This meta-analysis provides conclusive evidence of an association between CSA and sexual dysfunction in adults. Currently known interventions for the treatment of sexual dysfunction after CSA have only been evaluated in women, so specific interventions should be designed for men CSA survivors who experience sexual impairment.

The Impact of Child Sexual Abuse on Men's Sexual Function: A Systematic Review

Child sexual abuse (CSA) is strongly associated with sexual dysfunction. However, research about male survivors' sexual functioning after CSA is lacking. The current systematic review searched for all studies that reported on CSA and sexual function among male survivors to answer the following questions: Do male survivors of CSA experience sexual dysfunctions, and if so, to what extent? Does CSA increase the risk of developing sexual dysfunctions in adulthood among men? Studies were identified by searching seven databases and sources of gray literature. The selection criteria included empirical studies involving a population of adult men who experienced CSA before the age of 18. Studies focused on sexual functioning and sexual development after the abuse. Twelve studies met the selection criteria. While some studies confirmed that CSA is a risk factor for sexual dysfunction in adult male survivors, including low sexual drive, problems with arousal, and difficulties with orgasm and pain, other studies failed to find a correlation between sexual dysfunction and CSA. The wide range in quality, methodology, and definitions of CSA and sexual function presented challenges to consistent analysis of the studies and to determine the impact of CSA. Further research is required to fully understand the effect of CSA on adult men's sexual function.

[Childhood sexual abuse: how important is the diagnosis to understand and manage sexual, anorectal and lower urinary tract symptoms]

OBJECTIVE

To understand and manage the sequels of childhood sexual abuse on sexual, anorectal and lower urinary tract functions.

MATERIAL AND METHODS

Review of articles published in the Medline database, selected according to their scientific relevance and published guidelines on this subject together with our own experience.

RESULTS

A history of sexual abuse is frequently found when assessing dysfunction or symptoms of the lower urinary tract. In this context, urinary stress incontinence is rarely involved but it can be linked by epidemiological factors. Dysuria with urgency is the most frequent expressed symptom. When associated with anorectal disorders and pelvic pain or a sexual disorder in particular dyspareunia, a sexual abuse should be evoked and specific questions asked to the patient. Although these symptoms are frequently encountered in 12 to 33% of women, and 8 to 16% of men, few practitioners, whatever their speciality ask about them as routine. It is important that the physician diagnose the existence of sexual abuse, in particular when the symptoms mentioned by the patient are not conclusive, in spite of thorough urological assessment. Patients finding the initial examination difficult and painful and the failure of the initial treatment should lead to questions concerning abuse, if neglected by the initial medical inquiry.

CONCLUSIONS

Clinicians involved in perineal functional pathology are able to acquire standardized modalities of inquiry about child sexual abuse for a better time management and efficacy in the therapeutic approach. The interest of a multidisciplinary diagnostic and therapeutic approach is primordial, associating psychological therapy and if necessary perineal re-education. This can avoid unnecessary tests and out-patient visits. Directing patients towards a multidisciplinary approach is highly advisable.

History of sexual abuse among bariatric surgery candidates

BACKGROUND

A history of sexual abuse is associated with a range of psychosocial difficulties and health risk behaviors in the general population. Sexual abuse also appears to be a risk factor for the development of obesity. Little is known, however, about the prevalence and psychosocial correlates of sexual abuse among persons with extreme obesity who seek bariatric surgery.

METHODS

Questionnaire data were collected from 567 individuals with extreme obesity who presented for bariatric surgery. Those with and without a self-reported history of sexual abuse were compared on several psychosocial variables.

RESULTS

Sixteen percent of the surgery candidates (17.0% of women and 11.5% of men) reported a history of sexual abuse. Those who reported a history of sexual abuse were more likely to report previous emotional difficulties, as well as a personal and family history of substance abuse. They also were significantly more likely to meet the criteria for binge eating disorder, as determined from self-report responses to the Questionnaire on Eating and Weight Patterns, compared with those without a self-reported history of sexual abuse. In addition, those who reported a history of sexual abuse were more likely to report both current and previous psychiatric treatment than were those who denied a history of abuse.

CONCLUSION

A significant minority of bariatric surgery candidates reported a history of sexual abuse. Among these individuals, a history of sexual abuse was associated with both current and past psychiatric problems and treatment. The relationship of these variables to postoperative outcomes, however, is unknown.

Childhood sexual abuse and obesity

The causes of the current obesity epidemic are multifactorial and include genetic, environmental, and individual factors. One potential risk factor may be the experience of childhood sexual abuse. Childhood sexual abuse is remarkably common and is thought to affect up to one-third of women and one-eighth of men. A history of childhood sexual abuse is associated with numerous psychological sequelae including depression, anxiety, substance abuse, somatization, and eating disorders. Relatively few studies have examined the relationship between childhood sexual abuse and adult obesity. These studies suggest at least a modest relationship between the two. Potential explanations for the relationship have focused on the role of disordered eating, particularly binge eating, as well as the possible "adaptive function" of obesity in childhood sexual abuse survivors. Nevertheless, additional research on the relationship between childhood sexual abuse and obesity is clearly needed, not only to address the outstanding empirical issues but also to guide clinical care.

Childhood sexual abuse: a gender perspective on context and consequences

Literature on gender and child sexual abuse (CSA) has highlighted patterns of similarity and difference among survivors and the need for further research. This study relied on gender analysis of 128 women and 69 men, obtained through an examination of childhood hospital records, to further examine gender differences in mental health outcomes among abuse survivors and correlates of mental health outcomes including professional help seeking, family environment, and other trauma exposure. Overall, men and women were similar in the context and consequences of CSA. The role of the characteristics of CSA and contextual variables in explaining variance in mental health for 106 male victims and nonvictims was also examined. Among male participants, number of incidents of sexual abuse, injury at the hands of a caregiver, and exposure to other traumas significantly explained higher levels of an array of mental health symptoms. Implications for future research are discussed.