The association between childhood sexual abuse and adult female sexual difficulties

Traumatized Sexuality: Understanding and Predicting Profiles of Sexual Behaviors Using Childhood Abuse and Trauma Measures

In the current study we sought to identify sexual behavior profiles and examine the levels of childhood abuse history and trauma measures in each profile. The study was conducted among a large non-clinical sample of men and women (n = 806). Latent profile analysis was employed to identify distinct profiles of sexual behaviors and then childhood abuse, posttraumatic stress disorder (PTSD), depression, and anxiety, and motives for engaging in sex were assessed in each profile. Four distinct profiles of sexual behavior were identified: hyposexual individuals, hypersexual porn users, porn users, and within usual ranges (WURs). Hypersexual porn users had significantly more childhood trauma (emotional, physical, and sexual) than WURs, significantly greater PTSD symptom than WURs and hyposexual individuals, and significantly greater anxiety and depression as compared with all other groups. The hyposexual individuals had significantly lower scores on all motives for engaging in sex than did porn users or hypersexual porn users. Hypersexual porn users and porn users reported coping and peer-pressure as motives for engaging in sex more than did WURs or hyposexual individuals. Clinicians working with survivors of childhood abuse should consider directly targeting these different maladaptive sexual behaviors by addressing PTSD symptoms, affective disorders, and motives for engaging in sex.

Child Maltreatment and Couples' Sexual Health: A Systematic Review

INTRODUCTION

Childhood maltreatment (CM) is an interpersonal trauma reported by 35% to 40% of individuals in population-based studies in North America. It refers to physical, sexual, and emotional abuse, as well as physical and emotional neglect. Although there is a growing body of cross-sectional work focusing on associations between CM and sexual health, most studies have ignored the broader relationship context in which sexuality is experienced.

OBJECTIVES

The current review sought to systematically and critically appraise all studies that reported on the association between CM and couples' sexual health, to inform clinical care and recommendations for research.

METHODS

The electronic literature search was conducted using PubMed, PsycNET (PsycINFO, PsychArticles), Medline, CINAHL, and Eric for peer-reviewed journal articles published before September 2021. Eligible studies had to report on the association between any form of CM and any dimension of sexual health in couples or individuals in a romantic relationship.

RESULTS

In total, 13 studies (18 articles) were included in this systematic review: 4 studies pertained to clinical couples and 9, to community couples; 2 studies used a longitudinal design and 11, a cross-sectional design; 3 studies examined CM as a whole, 2 studies examined multiple subtypes of CM separately, 1 study examined both CM as a whole and its subtypes separately, whereas the other 7 studies focused on childhood sexual abuse. Results indicated that studies using valid measures of sexual health outcomes found significant associations between CM and worse outcomes - including declines over time - in both clinical and community samples. Mediators and moderators of these associations were also identified.

CONCLUSIONS

Findings provide preliminary support for the role of CM in couples' sexual health. There is a need for future longitudinal studies involving both members of the couple, valid and multidimensional measures of sexual health, and potential mediators and moderators. Bergeron S, Bigras N, Vaillancourt-Morel M-P. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022;XX:XXX-XXX.

Treating Sexual Dysfunctions Among Survivors of Child Sexual Abuse: An Overview of Empirical Research

Sexual problems are very prevalent among survivors of child sexual abuse (CSA). Yet, various approaches to therapy do not seem to address this issue when treating these individuals. Traditional sex therapy may also not suit the experiences of CSA survivors, as CSA was not considered when the most well-known and frequently used techniques were developed. The present review sought to identify (1) theory-based therapeutic approaches that address sexual problems among CSA survivors and offer treatment protocols (including an outline of specific therapy stages, sessions, or techniques) to treat these sexual problems and (2) identify therapeutic approaches that include a protocol for treating sexual problems among CSA survivors that was empirically tested and validated. In total, six approaches for treating sexual dysfunctions among CSA survivors that provide detailed guidelines for implementing the approach within sex therapy for CSA survivors were identified in the literature. Only two of the studies conducted a randomized controlled trial to test the intervention. This overview concludes with important issues to address when treating sexual problems among CSA survivors and a call for additional evidence-based practices for treating sexual problems among survivors of CSA.

Childhood Maltreatment and Mid-Life Adult Sexuality: A 10-Year Longitudinal Study

One important long-term outcome of childhood maltreatment is thought to be impairments in intimate relationships. However, the specific nature of these impairments is not well understood. To address this gap, we examined the long-term relation of sexual, emotional, and physical abuse/neglect to four key aspects of sexuality in women and men: importance of sex, intimacy in sex, pain during sex, and pleasure during sex. As part of the U.S. longitudinal National Survey of Midlife Development, 807 participants in their mid-life (410 women, 397 men) completed measures of recollected childhood maltreatment and current aspects of adult sexuality. These measures were obtained at baseline (at which time the mean age was 53.28 years (SD = 10.97) and again 10 years later. For women at baseline, emotional abuse was positively associated with pleasure, emotional neglect was negatively associated with intimacy and with pleasure, physical abuse was positively associated with pain, and physical neglect was associated with importance of sex. For men, no significant associations were found. Prospectively, for women, sexual abuse predicted increases in pleasure during sex, and physical abuse significantly predicted increases in pain during sex. For men, physical neglect significantly predicted increases in pain. We discuss these sex differences and the role these results may play in the detrimental long-term effects of childhood maltreatment.

Suicidal ideation among Chinese survivors of childhood sexual abuse: Associations with rumination and perceived social support

BACKGROUND

Although previous studies have shown that childhood sexual abuse (CSA) experiences might be related to suicidal ideation in later life, its associations with rumination and perceived social support (PSS) remain unclear.

OBJECTIVE

The present study aimed to expand prior findings among Chinese survivors of CSA to investigate rumination's effect on the association between CSA and suicidal ideation, and the potential moderating role of PSS in this relationship.

METHODS

The Childhood Sexual Abuse Questionnaire, the Ruminative Response Scale, the Multi-dimensional Scale of Perceived Social Support, and the Symptom Checklist were completed by 6834 college students (56.61% females).

RESULTS

In all, 1400 (20.76%) students reported experiences of CSA. The rate of CSA in males was higher than that in females (24.23% vs. 18.10%). Students with CSA experiences reported a higher level of suicidal ideation than those without such experiences. CSA and rumination were positively related to suicidal ideation, and PSS were negatively related to CSA, rumination and suicidal ideation. CSA predicted suicidal ideation both directly and indirectly through rumination. PSS moderated the effect of rumination on suicidal ideation.

CONCLUSIONS

This study provides evidence for the effects of rumination on the association between CSA and suicidal ideation, and the buffering role of PSS on the relationship between rumination and suicidal ideation in Chinese survivors with CSA experiences. These findings suggest that developing adaptive emotional regulation strategies and enhancing the level of PSS might contribute to the alleviation of negative influences from CSA.

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.

The impact of childhood sexual trauma on intimacy and sexuality needs among people with non-affective psychosis

BACKGROUND

Childhood trauma, in particular childhood sexual abuse (CSA), and unmet sexuality and intimacy needs are prevalent among people with psychosis spectrum disorders. The association between CSA and sexuality and intimacy needs over time in adults with psychosis spectrum disorders were examined.

METHOD

Patients (n = 1119) were recruited as part of the Genetic Risk and OUtcome of Psychosis (GROUP) study, a representative cohort of patients with non-affective psychotic disorder. At baseline, three-year and six-year follow-up, sexuality and intimacy needs were assessed with the Camberwell Assessment of Needs. CSA was assessed with the Childhood Trauma Questionnaire.

RESULTS

At baseline, sexuality (26%) and intimacy (40%) needs were prevalent; 90% of these needs remained unmet. Cross-sectionally, CSA was associated with sexuality needs (OR = 1.68, 95% CI: 1.13-2.04) and intimacy needs (OR = 1.75, 95% CI: 1.04- 1.77). Childhood emotional abuse (CEA) was also cross-sectionally associated with sexuality and intimacy needs. Others forms of trauma were not. Prospectively, CSA predicted incidence of a sexuality need (HR = 2.1, 95% CI: 1.23-3.74) as well as an intimacy need (HR = 1.7, 95% CI: 1.11-2.66), as did CEA (sexuality: HR = 1.8, 95% CI: 1.11-2.89; intimacy: HR = 1.4, 95% CI: 1.03-1.96). CSA and CEA were not associated with persistence of sexuality or intimacy.

CONCLUSION

CSA and CEA are associated with a higher prevalence and incidence of sexuality and intimacy needs in patients with psychotic disorders. High rates of unmet sexuality and intimacy needs may indicate an underlying need for trauma-related treatment as well as a need for novel interventions targeting these needs.

Associations between Childhood Sexual Abuse and Sexual Well-being in Adulthood: A Systematic Literature Review

Child sexual abuse (CSA) tends to occur in close relationships and involves sexual acts and betrayal. Thus, it is thought to affect sexual well-being in adulthood more so than any other form of childhood trauma. Research conducted over the last decade resulted in an impressive diversity of evidence reporting that CSA may be related to greater sexual dysfunction and lower sexual satisfaction as an adult, but also to higher levels of sexual compulsivity and sexual risk behaviors. Some studies also found no significant association between CSA and adult sexual well-being. Faced with these mixed results, understanding how CSA may affect sexual well-being in adulthood remains challenging for clinicians and researchers. The aim of this comprehensive literature review was to synthesize the empirical studies published in the last five years documenting the associations between CSA and several indicators of sexual well-being in adults excluding risky sexual behaviors. The literature search yielded 18 eligible studies which mainly examined five domains of sexual outcomes of CSA: sexual function, sexual satisfaction, sex-related cognitions, sexual behaviors and affective components of sexuality. Findings suggest that CSA is not unanimously related to all domains of sexual well-being, but rather, that associations are largely a function of the presence of other comorbidities or nature of the sample. Moreover, men are still significantly underrepresented in reviewed studies. Implications of the findings will be discussed in light of their relevance for clinicians and for researchers about gaps in current literature need to be filled.

The effects of alexithymia, experiential avoidance, and childhood sexual abuse on non-suicidal self-injury and suicidal ideation among Chinese college students with a history of childhood sexual abuse

BACKGROUND

Although previous studies have shown that childhood sexual abuse (CSA) experiences might be related to suicide-related thoughts and behaviours in later life, the effects of alexithymia and experiential avoidance (EA) on this relationship have remained unclear. The present study aimed to expand prior findings among Chinese college students with a history of CSA in order to further test the effects of alexithymia on the relationship between CSA and non-suicidal self-injury (NSSI) and suicidal ideation (SI), and its indirect effects on NSSI and SI through EA.

METHODS

The Childhood Sexual Abuse Questionnaire, the Toronto Alexithymia Scale-20, the Acceptance and Action Questionnaire-II, the Non-Suicidal Self-Injury Questionnaire, and the Symptom Checklist were completed by 6,834 college students (3,829 female).

RESULTS

Overall, 1404 (20.76%) Chinese college students reported experiences of CSA; students with CSA experiences reported higher rates of SI and NSSI than those without CSA (12.82% vs. 4.50%, 35.11% vs. 20.82%). CSA, alexithymia, and EA were positively related to NSSI and SI. The effect of alexithymia on the relationship between CSA and NSSI and SI were significant. The effects of EA on the relationship between alexithymia and NSSI and SI were significant, too.

LIMITATIONS

The major limitations of this study are its cross-sectional design and the use of self-report scales, especially retrospective self-reports (e.g., the Childhood Sexual Abuse Questionnaire).

CONCLUSIONS

This study cast light on the effects of alexithymia, EA, and CSA on NSSI and SI in Chinese college students with a history of CSA. These findings can contribute to the prevention and treatment of suicide-related thoughts and behaviours.

Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality

BACKGROUND

Individuals with histories of sexual abuse may be more likely to experience sexual-related problems including hypersexuality, but gender-related differences remain unclear.

AIM

This online study examined sexual abuse history and hypersexuality by gender among 16,823 Hungarian adults, adjusting for age, sexual orientation, relationship status, education, employment status, and residence.

METHODS

An online questionnaire on one of the largest Hungarian news portals advertised this study examining sexual activities in January 2017. 3 categorizations of age-related sexual abuse were examined: child sexual abuse (CSA) occurring at age 13 and earlier (compared to no abuse), adolescent/adult sexual abuse (AASA; compared to no abuse), and CSA and AASA (CSA/AASA; compared to one age-related category of abuse or the other).

OUTCOMES

The outcome variable, hypersexuality, was examined as a continuous variable due to the low prevalence of clinical hypersexuality in this sample. 3 multivariate linear regression analyses adjusting for covariates aimed to predict hypersexuality from each category of abuse, along with gender and its interaction with each category.

RESULTS

In all models, younger age, non-heterosexual sexual orientation, male gender, single relationship status, less than full-time work, and living in a capital city were associated with hypersexuality, and education was not a significant predictor. CSA, AASA, and CSA/AASA predicted hypersexuality in both men and women. There was a significant interaction between CSA/AASA and gender, such that the relationship between CSA/AASA and hypersexuality was stronger in men than in women.

CLINICAL TRANSLATION

Sexual abuse at each developmental time-point may influence hypersexuality among men and women, although the cumulative impact of CSA and AASA on hypersexuality may be particularly relevant among men.

STRENGTHS & LIMITATIONS

This is one of the largest studies to examine gender-related differences in the relationship between sexual abuse and hypersexuality. Nevertheless, our study is cross-sectional, and longitudinal work is needed to determine how sexual abuse affects children, adolescents, and adults throughout their lives.

CONCLUSION

Developmental impacts of sexual abuse may be considered in a gender-informed fashion in order to develop and optimize effective prevention and treatment strategies for hypersexuality. Slavin MN, Blycker GR, Potenza MN, et al. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020;17:2029-2038.

Childhood Sexual Abuse and Suicidal Ideation Among Bipolar Patients: Existential But Not Religious Well-Being as a Protective Factor

Individuals diagnosed with bipolar disorder (BD) are at an increased risk of Suicidal ideation, attempts, and death. Moreover, a strong association exists between childhood sexual abuse (CSA) and suicidal ideation among individuals with BD. Yet growing evidence suggests that existential well-being (EWB) may be a protective factor against suicidality. In this study, adult BD patients (N = 112) provided data on CSA, religious well-being (RWB; spiritual life in relation to God), EWB (purpose/meaning in life), and suicidal ideation. Participants were between 19 and 65 years of age. The majority was female and described their race/ethnicity as African American. Results indicated that CSA was negatively associated with EWB and was not related to RWB. Further, EWB mediated the association between CSA and suicidal ideation, whereas RWB did not. Having meaning/purpose in life may serve as a protective factor against suicidal ideation among individuals with BD who experienced CSA, whereas having a relationship/belief in God may not serve the same function.

Sexual Dysfunctions are Predicted by Childhood Sexual Abuse in Women with Opioid Use Disorder

BACKGROUND

Studies on sexual functioning of populations with substance use disorders (SUDs) are mostly conducted with male substance users. We have very limited information about the sexuality and related factors in women with opioid use disorder (OUD).

OBJECTIVES

We aimed to evaluate the relationship between childhood traumatic experiences (CTEs) and sexual dysfunctions (SDs) of women with OUD and to compare it with a sample of women who do not have SUD.

METHODS

Participants included 51 outpatient women with OUD who were on opioid maintenance treatment (OMT) with Buprenorphine/Naloxone and 48 women without SUD. Participants were evaluated by a semi-structured sociodemographic form, the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI).

RESULTS

In women with OUD; CTQ-28, BDI, STAI, and GRISS scores were significantly higher. In the partial correlation analysis, sexual abuse was found to be significantly correlated with nonsensuality, avoidance and total GRISS score. In stepwise regression model, sexual abuse was found to predict SDs together with depression.

CONCLUSIONS

CTE, SD, depression, and anxiety rates were higher in the women with OUD. Especially childhood sexual abuse was associated with SDs in this group. Sexual abuse was predicting SDs together with depression. Further investigation of different characteristics of women with SUD may give an opportunity to clinicians to have a better understanding for adaptable treatment strategies.

Herbal medicine for low sexual desire in menopausal women: A clinical review

Many women typically experience a significant reduction in sexual desire during the late perimenopausal and early postmenopausal stages, with the biggest decline in sexual desire occurring from three years prior to two years after the final menstrual period. Despite being a prevalent female complaint, currently no standard treatment for low sexual desire exists. Herbal medicines have been used therapeutically all around the world, and are an important component of Traditional and Complementary Medicine. There have been numerous trials and pharmacological studies of specific herbal preparations related to the treatment of low sexual desire. This article serves to provide a clinical review of the evidence relating to the herbal treatment options for this common condition.

Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review

OBJECTIVE

Review literature focused on neurological associations in brain structure among individuals with a history of childhood sexual abuse (CSA).

METHODOLOGY

A review of literature examining physiological irregularities in brain structures of individuals with a history of CSA was conducted.

RESULTS

Results revealed that a history of CSA was associated with irregularities in the cortical and subcortical regions of the brain. These irregularities have been recognized to contribute to various cognitive, behavioral, and psychological health outcomes later in life. Age of CSA onset was associated with differential neurological brain structures.

CONCLUSION

Mental and behavioral health problems such as anxiety, depression, substance abuse, dissociative disorders, and sexual dysfunction are associated with CSA and may persist into adulthood. Research depicting the associations of CSA on neurological outcomes emphasizes the need to examine the biological and subsequent psychological outcomes associated with CSA. Early intervention is imperative for CSA survivors.

Prevalence and correlates of childhood sexual abuse in adults consulting for sexual problems

The main objectives of the study were to assess the prevalence of childhood sexual abuse in individuals consulting for sexual therapy and to explore the association between a history of childhood sexual abuse and psychological and couple functioning. A sample of 218 adults receiving sex therapy completed questionnaires assessing depressive and anxious symptomatology, as well as dyadic adjustment. Prevalence of childhood sexual abuse was high in women (56%) and men (37%), and clients with a history of childhood sexual abuse were more likely to report psychological and relationship problems. Findings should aware clinicians of the need to assess sexual trauma and related outcomes.

Sexual health in women reporting a history of child sexual abuse

OBJECTIVE

The present study examined the association between child sexual abuse (CSA) and sexual health outcomes in young adult women. Maladaptive coping strategies and optimism were investigated as possible mediators and moderators of this relationship.

METHOD

Data regarding sexual abuse, coping, optimism and various sexual health outcomes were collected using self-report and computerized questionnaires with a sample of 889 young adult women from the province of Quebec aged 20-23 years old.

RESULTS

A total of 31% of adult women reported a history of CSA. Women reporting a severe CSA were more likely to report more adverse sexual health outcomes including suffering from sexual problems and engaging in more high-risk sexual behaviors. CSA survivors involving touching only were at greater risk of reporting more negative sexual self-concept such as experiencing negative feelings during sex than were non-abused participants. Results indicated that emotion-oriented coping mediated outcomes related to negative sexual self-concept while optimism mediated outcomes related to both, negative sexual self-concept and high-risk sexual behaviors. No support was found for any of the proposed moderation models.

CONCLUSIONS

Survivors of more severe CSA are more likely to engage in high-risk sexual behaviors that are potentially harmful to their health as well as to experience more sexual problems than women without a history of sexual victimization. Personal factors, namely emotion-oriented coping and optimism, mediated some sexual health outcomes in sexually abused women. The results suggest that maladaptive coping strategies and optimism regarding the future may be important targets for interventions optimizing sexual health and sexual well-being in CSA survivors.

Child sexual abuse and women's sexual health: the contribution of CSA severity and exposure to multiple forms of childhood victimization

Research studies have provided increasing evidence for the potential adverse impact of child sexual abuse on women's sexual health. The present study examined the association between child sexual abuse and sexual health while controlling for various forms of childhood victimization. Self-report questionnaires were administered to 889 young women from the province of Quebec. Results suggest that child sexual abuse survivors were more likely to report having experienced other forms of childhood victimization than were women without child sexual abuse. Women with a history of both child sexual abuse and multiple forms of victimization were at greater risk of experiencing more adverse outcomes, including risky sexual behaviors, sexual problems, and negative sexual self-concept. Regression analyses revealed that child sexual abuse was significantly related to indicators of sexual health outcomes even when controlling for the effect of single forms of victimization. Clinically, interventions optimizing sexual health may be particularly helpful for a subgroup of child sexual abuse survivors.