Sexual Self-Concept After Child Maltreatment: The Role of Resilient Coping and Sexual Experience Among U.S. Young Adults

Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18-25) wherein 44.5% (n = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.

Health Outcomes of Sexual Minority Women Who Have Experienced Adverse Childhood Experiences: A Scoping Review

Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.

Predictors of Online Child Sexual Abuse in a U.S. National Sample

As technology has become increasingly integrated into the everyday lives of young people and social interactions have moved online, so too have the opportunities for child sexual abuse. However, the risk factors for online sexual abuse, and their similarities or differences with those of offline sexual abuse have not been clarified, making it difficult to design prevention strategies. Using a nationally representative online survey panel of young adults ages 18 to 28, the current study sought to identify risk factors for online childhood sexual abuse and compare their relevance and strength in predicting offline sexual abuse. The 2,639 participants, ages 18 to 28, were sampled from the Ipsos KnowledgePanel and were asked questions about 11 different kinds of technology-facilitated online sexual abuse that occurred in childhood, follow-up questions about their dynamics and offenders, and a variety of potential risk factors. Results indicated that: (1) being cisgender female, nonheterosexual, and having parents with less than a high school education emerged as important demographic predictors of online child sexual abuse (OCSA); and (2) early offline sexual abuse was the strongest predictor of OCSA, when considering both its direct and indirect effects through online risky behavior. Findings suggest that prevention programs directed at reducing risk of sexual abuse, in general, are likely to be effective against online sexual abuse, provided they also incorporate efforts to educate youth on the need to avoid risky online behaviors.

"It was wrapped in a kind of normalcy": The lived experience and consequences in adulthood of survivors of female child sexual abuse

BACKGROUND

Survivors' surveys on the frequency of sexual offenses committed by women indicated a prevalence rate of 9.9 % to 11.6 %. Nevertheless, only a few studies have explored the long-term consequences of abuse on survivors.

OBJECTIVES

Examine the lived experiences and the long-term consequences of child sexual abuse committed by women.

PARTICIPANTS

Fifteen adult participants who experienced child sexual abuse conducted by female offenders participated in the study.

METHODS

The Interpretive Phenomenological Approach was applied to semi-structured interviews.

RESULTS

Three central themes emerged: types of abuse, characteristics of the perpetrator, and consequences of abuse. Most survivors experienced direct or indirect forms of sexual abuse committed by their mothers. In most cases, the offenders masked their abuse in caregiving, disciplinary or playful behavior. The survivors perceived their mothers as narcissistic, controlling, hostile, and having tremendous difficulties with separation. The survivors reported the need to engage in extensive negative long-lasting psychopathologies, which they attributed partly to having been invalidated and silenced by society. Many participants expressed fears of re-enacting the survivor or perpetrator role, which has led to difficulties in various relationships. They described an altered perception of their bodies as shameful and repulsive, manifesting in self-harm, eating disorders, and the elimination of signs of femininity.

CONCLUSION

This complex form of sexual abuse hampers the internalization and the construction of positive feminine, masculine, and parental identities.

Who am I as a Sexual Being? The Role of Sexual Self-Concept Between Dispositional Mindfulness and Sexual Satisfaction among Child Sexual Abuse Survivors

Childhood sexual abuse (CSA) is associated with long-lasting and pervasive impacts on survivors' sexual health, particularly on their sexual satisfaction. Dispositional mindfulness has been found to be associated with greater sexual satisfaction among adult CSA survivors. However, the mechanisms involved in this association remain understudied. The present study examined the role of sexual self-concept (i.e., sexual esteem, sexual preoccupation, and sexual depression) in the relationship between dispositional mindfulness and sexual satisfaction among CSA survivors. A total of 176 adult CSA survivors (60.6% women, 39.4% men) completed an online survey assessing dispositional mindfulness, sexual self-concept, and sexual satisfaction. Path analyses revealed that dispositional mindfulness was positively related to sexual satisfaction through a significant indirect effect of higher sexual esteem and lower sexual depression. The integrative model explained 66.5% of the variance in sexual satisfaction. These findings highlight the key roles that dispositional mindfulness and sexual self-concept play in CSA survivors' sexual satisfaction. Implications for interventions based on trauma-sensitive mindfulness targeting the sexual self-concept are discussed, as they may promote sexual satisfaction in adult CSA survivors.

Sex in the Shadow of Child Sexual Abuse: The Development and Psychometric Evaluation of the Post-Traumatic Sexuality (PT-SEX) Scale

Sexual-related post-traumatic stress symptoms (sexual-related PTSS) refers to the traumatic reactions that are replicated during sexual activity among survivors of child sexual abuse (CSA). However, the construct of sexual-related PTSS have been adapted from clinical work with survivors, and research with limited examination of the scales themselves. Given this gap, the current study offers the development of a new measure (PT-SEX) that examines sexual-related PTSS. The study was conducted online, among two convenience samples of women survivors of CSA (study 1 included 451 women and study 2 included 330 women). Six reliable PT-SEX factors emerged from Study 1: Dissociation during sex, intrusiveness during sex, shame and guilt in regard to sexual aspects, pleasing the other during sex, interpersonal distress, and hypervigilance during sex. Study 2 revealed survivors of CSA had significantly higher sexual-related PTSS levels as compared to participants without such a history. Also, post-traumatic stress disorder and sexual-related PTSS made unique and unshared contributions to the observed data, including sexual self-esteem, sexual motives, relationship satisfaction, compulsive sexual behavior, and mental health. CSA significantly moderated the associations between sexual-related PTSS and sexual self-esteem, sexual motivations of self-affirmation and coping, and depression and anxiety. Findings from the current study show that over time, the trauma of CSA seems to be implicated in survivors' sexual experience. As sexual difficulties are accompanied by sexual-related PTSS, these symptoms are unlikely to resolve by trauma-focused therapy and must be actively targeted in therapy.

Positive mental health in Canadian adults who have experienced childhood sexual abuse: exploring the role of social support

PURPOSE

Childhood sexual abuse (CSA) is predictive of poorer mental health, greater psychiatric disorder risk, and lower positive mental health (PMH) during adulthood, outcomes potentially moderated by social support. The current study aimed to explore whether Canadian adults who have experienced CSA differ from those who have not in terms of PMH and social support. Within the CSA sample, it was further investigated whether gender differences exist with respect to PMH and social support, and if particular social support subscales predict PMH.

METHOD

Using data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), 1,328 adults between 20 and 64 years reporting CSA were profiled and compared in terms of sociodemographic and socioeconomic factors, using an age, sex, and frequency matched sample of non-CSA adults. Social Provisions Scale (SPS), and the Mental Health Continuum - Short Form (MHC-SF) means were subsequently compared between the CSA and non-CSA samples, and Hierarchical regressions were conducted for CSA males and females separately to examine whether SPS subscales predicted PMH after controlling for age and income.

RESULTS

Canadian adults reporting CSA had significantly lower PMH and social support (overall and for particular subscales). For adult CSA females, guidance, social integration, and reassurance of worth predicted higher PMH, while attachment and reassurance of worth predicted higher PMH scores for CSA males.

CONCLUSION

Adults who have experienced CSA are at risk for lower PMH and social support. Gender differences are also evident in social support subtypes that predict PMH which have important clinical implications.

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.

Sexual Dysfunction Among Childhood Sexual Abuse Survivors: The "Functional" Dysfunction?

Various studies have established the association between child sexual abuse and sexual dysfunction. Although sexual dysfunction can be a distressing and undesirable condition for survivors of child sexual abuse, the current article suggests viewing sexual dysfunction not solely as a negative outcome but as a condition with a potent psychological function in regulating various psychological and relational needs among survivors. The main question addressed in the current paper is: What are the functional aspects of sexual dysfunction among child sexual abuse survivors? Four main protective purposes for sexual dysfunction among survivors of child sexual abuse are proposed: avoiding re-traumatization, regulating closeness within the relationship, gaining a sense of power and control and avoiding vulnerability, and restoring a positive sense of self. Although healthy sexual functioning is a desirable long-term goal for survivors, therapists need to view sexual dysfunction within the context of trauma, and to understand the protective functions of dysfunctions, before attempting to restore sexual function.

Women Get Worse Sex: A Confound in the Explanation of Gender Differences in Sexuality

Gender differences in sexuality have gained considerable attention both within and outside of the scientific community. We argue that one of the main unacknowledged reasons for these differences is simply that women experience substantially worse sex than men do. Thus, in examinations of the etiology of gender differences in sexuality, a confound has largely been unacknowledged: Women and men are treated to different experiences of what is called "sexuality" and "having sex." We discuss four arenas in which women's experience of sexuality may often be worse than men's: (a) anatomical differences, (b) sexual violence, (c) stigma, and (d) masculine cultures of sexuality. Then we consider how each disparity might explain well-known gender differences in sexuality.

Sexual Self-Concept and Psychological Functioning of Women With a History of Childhood Sexual Abuse in Hong Kong

Sexual self-concept (SSC) is an important component of health that is closely associated with the well-being of survivors of child sexual abuse (CSA). Compared with non-CSA respondents, SSC of CSA survivors was deleteriously affected, resulting in ineffective psychological functioning (negative self-evaluation, psychological ill-health, and difficulties in interpersonal relationships). Negative SSC (sexual anxiety, sexual depression, and sexual fear) played a significant role in mediating the adverse effects of CSA on psychological functioning. Future studies may recruit a sample with greater variation in CSA characteristics and use externalizing problems as outcome measures to cross-validate findings of this study.

Trauma-Informed Sex Positive Approaches to Sexual Pleasure

This paper develops a trauma-informed sex-positive framework as a public health, clinical, and research approach to sexual experience over the life course. The framework centers trauma-informed sex positivity as the linkage for sexual pleasure (along with sexual wellbeing and sexual health) to the social, cultural, and legal concepts of sexual justice. By providing a conceptual distinction of sexual pleasure from sexual wellbeing and sexual health, the framework improves clarity about how these constructs are related as well as provides possibilities for detailed operationalization in public health surveillance and in the new research.

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.

A Dyadic Longitudinal Study of Child Maltreatment and Sexual Well-Being in Adult Couples: The Buffering Effect of a Satisfying Relationship

This study examined the contribution of child maltreatment (CM) to trajectories of couples' sexual well-being, and whether relationship satisfaction moderates these associations. Using a sample of 269 mixed-sex couples followed over one year, dyadic latent growth curve models showed both actor and partner effects. In terms of actor effects, women's emotional neglect was associated with lower initial levels of sexual satisfaction, and most types of women's CM were related to a sharper decrease over time in sexual satisfaction. Men and women's emotional abuse and neglect, and women's sexual abuse, were associated with lower initial levels of sexual function. Men and women's emotional neglect and women's emotional abuse were related to higher initial levels of sexual distress. Women's sexual abuse was associated with a steeper increase in sexual distress. In terms of partner effects, women's emotional neglect was associated with lower initial levels of partner sexual satisfaction, and women's emotional abuse and neglect, with lower initial levels of partner sexual function. Greater relationship satisfaction buffered some of these negative effects. Given that sexual well-being requires a context in which the individual feels safe, all forms of CM may affect sexual well-being, although a satisfying relationship may buffer some of these effects.

At risk and in love: A mixed methodexamination of the link between childhood maltreatment and youth relationships

INTRODUCTION

Research indicates that sexual and romantic relationships play an important role in youth well-being and development. This strengths-based perspective sits in tension with the documented risks that youth with histories of maltreatment face in sexual/romantic relationships. We conducted a U.S.-based mixed-method study to examine the connection between childhood maltreatment and youth relationships.

METHOD

We collected retrospective ratings of relationship quality and open-ended comments about those relationships using an online sexual life history calendar. Quantitative analyses drew on data from 98 participants (51 cisgender women, 47 cisgender men) between the ages of 18-25 (M_age = 22.51). Qualitative analyses compared demographically matched subsamples of 19 participants who reported multiple forms of child maltreatment and 20 who reported none.

RESULTS

Quantitative analyses indicated that ratings of relationship stability, intimacy, and pleasure were unrelated to prior abuse or neglect. Qualitative analyses showed the relationships of those with multiple maltreatment histories, compared to those without any maltreatment, to be more often intertwined with and complicated by other hardships (e.g., homelessness).

CONCLUSIONS

Quantitatively, childhood maltreatment appeared unrelated to youth sexual/romantic relationship quality, though we regard those findings with due caution. Complementing this was qualitative evidence of differences between participants based on trauma histories, with those who had experienced childhood maltreatment referring more often to surrounding circumstances and hardships in descriptions of their youth sexual/romantic relationships. These mixed method findings reinforce the importance of youth sexuality research, policy, and practice that takes the broader conditions of young people's lives into consideration.

Unwanted Sex Due to Intoxication among Australians Aged 16-69 Years

Intoxication can be a factor in unwanted sex, but research on the extent of the issue in both women and men is limited. We assessed the prevalence, correlates, and 10-year time-trends of unwanted sex due to intoxication among a representative sample of 4,279 women and 3,875 men aged 16-69 years in Australia and considered how these vary by gender. In 2012-13, 16% of women and 10% of men reported ever having had a sexual experience when they "did not want to because they were too drunk or high at the time." For both women and men, this was associated with younger age, bisexual activity, and reports of lifetime injection drug use, sexually transmitted infections, and forced sex. Among women only, it was associated with drinking above guideline levels and ever having terminated a pregnancy. Among men only, it was associated with current tobacco smoking, elevated psychosocial distress, and poor general health. Compared with 2001-02 data, fewer men reported unwanted intoxicated sex, while there were no changes for women as a whole. Interpreting these findings through an intersectional assemblage framework supports stronger understanding of the multiple factors influencing sexuality and substance use with implications for promoting equity, safety, and sexual health.

It's Good to Have You: The Moderator Role of Relationship Satisfaction in the Link Between Child Sexual Abuse and Sexual Difficulties

Research has revealed a significant prevalence of sexual problems in adulthood among child sexual abuse (CSA) survivors, yet many survivors do not report such difficulties. This study examined the moderator role of relationship satisfaction in the association between CSA and sexual difficulties in adulthood. Questionnaires assessing history of CSA, sexual difficulties, and relationship satisfaction were completed by 320 adults in intimate relationships. Analyses indicated that CSA survivors who were highly dissatisfied with their relationships reported more sexual difficulties than those who were satisfied with their relationships. Results highlight the importance of positive intimate relationships when working with CSA survivors.

Self-Reported Sexual Behavioral Similarities and Differences Among Young Men Who Have Sex With Men With Childhood Sexual Abuse Histories: A Qualitative Exploratory Study

Young men who have sex with men (YMSM) have the highest burden of sexually transmitted infections (STIs), including HIV. Childhood sexual abuse (CSA) is a risk factor for high-risk sexual behavior and STI acquisition. Studies that have explored sexual behavior based on the type of reported sexual abuse are limited. This study aimed to further understand current sexual behaviors and perceptions among YMSM that have experienced different types of CSA. Sixteen YMSM who were survivors of CSA were interviewed utilizing a phenomenological conceptual framework and methodology. Thematic findings were divided into two parts. Part I gave an overview of the entire sample, and themes were as follows: unprotected oral sex used to evaluate penile abnormalities, trust promoting unprotected sex, and alcohol and other drugs not cited as the reason for casual sex. Part II demonstrated the differences among those with a history of CSA involving non-penile-anal intercourse and those with a history of CSA involving penile-anal intercourse. The major themes in Part II were that victims of CSA involving penile-anal intercourse reported the following: a hypersexual self-definition, an STI diagnosis and noncondom use history, and a third sexual partner during sexual activity. Based on the findings, early life experiences such as CSA should be considered when developing preventative sexual health strategies and individuals who experienced penetrative sexual abuse may have different needs which should be further explored.

Sexual self-concept among men and women child sexual abuse survivors: Emergence of differentiated profiles

BACKGROUND

Child sexual abuse (CSA) can impact survivor's sexuality, notably regarding sexual self-concept, a key component of sexual well-being. Yet, sexual self-concept has been understudied among CSA survivors and gender differences have been sparsely investigated.

OBJECTIVE

The current study aimed to identify CSA survivors' distinct profiles according to their sexual self-concept, and compare these profiles based on factors such as CSA characteristics, gender, current age, sexual functioning and adult sexual assault (ASA).

PARTICIPANTS AND SETTING

A total of 176 CSA survivors (60 % women, 40 % men), recruited through community organizations for CSA victims and social media publications, completed an online survey.

METHODS

Hierarchical cluster analysis was performed using the Sexuality Scale (Snell & Papini, 1989). Chi-square and ANOVA tests were used to compare the groups on external variables.

RESULTS

Cluster analysis revealed the best overall fit for a three-group model. The Confident and non-preoccupied profile (48 %) is characterized by a moderate score on sexual esteem and the lowest scores of sexual preoccupation and depression. The Demeaning and depressive (37 %) profile is characterized by the lowest scores on sexual esteem and the highest scores on sexual depression. The Hyperconfident and preoccupied profile (15 %) shows the highest scores on sexual esteem and sexual preoccupation.

CONCLUSION

Sexual self-concept is an important component of sexuality that needs to be addressed by practitioners working with CSA survivors. Given heterogeneity and gender differences among survivors, identification of profiles is relevant for adapting interventions and clinical care.

Child Maltreatment and Adult Sexual Assault Victimization: Genetic and Environmental Associations

Despite the pervasiveness of adult sexual assault (ASA), evidence-based knowledge on the risk factors for sexual victimization is insufficient. Here, we investigated the etiology of ASA in a population-based Finnish twin sample. Specifically, we estimated the extent of the genetic and environmental influences on the risk of ASA, and we examined its phenotypic and genetic associations with five types of child maltreatment (CM). We found large unique environmental, but also small genetic influences on the risk of ASA, motivating further research on situational and behavioral conditions potentially exploited by sexually motivated perpetrators. The prevalence of ASA was highest among victims of severe child sexual abuse. However, when accounting for the co-occurrence of multiple types of CM, emotional abuse was the strongest predictor of ASA. We further examined, and could not entirely rule out, the possibility of common genetic and environmental pathways underlying CM and ASA. Lastly, we focused on sex differences. Emotional and physical abuse were the strongest predictors of ASA in women and men, respectively, and genetic influences on the risk of ASA were larger in women than men. However, such higher heritability did not reflect sex-limited genetic effects, but, rather, women's systematic exposure to environmental risk of ASA.

Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women

Introduction

A person's sexual satisfaction reflects their judgment and analysis of their own sexual behavior. Factors that affect sexual satisfaction vary in different societies and cultures.

Aim

This study investigated the determinants of sexual satisfaction in women referred to health centers in Sari, north of Iran, in 2016.

Methods

This cross-sectional study investigated 490 women who had been referred to health centers in 2016 and who were qualified for the study; the population was selected using convenient sampling method.

Main Outcome Measure

The main outcome of this study was sexual satisfaction that assessed by the Larson's sexual satisfaction questionnaire. Other Data were 2 questionnaires: the general health questionnaire–28 and a researcher-made questionnaire developed on factors related to sexual satisfaction. Data were analyzed with IBM SPSS software using the one-way analysis of variance, Pearson correlation coefficient, and t-test. To determine the predictors of sexual satisfaction, all the significant independent variables were incorporated into a linear regression model.

Results

The average age of the women in this study was 33.6 years, and average sexual satisfaction score was 99.26. The results of the linear regression model showed that the spouse's job as a laborer (P = .003), a low income (P < .002), insufficient income of the spouse (P < .001), and dissatisfaction with being a woman (P < .001) were the main social determinants of sexual satisfaction (r² = 0.54).

Conclusion

It can be concluded from the findings of this study that several factors influence women's sexual satisfaction. The main social determinants of women's sexual satisfaction were dissatisfaction with their gender, the spouse's job as a laborer, low income, and insufficient income. Sexual healthcare providers can play a prominent role in increasing women's sexual satisfaction, thereby, improving the quality of their sexual life by identifying and discussing ways to control them.

Afzali M, Khani S, Hamzehgardeshi Z, et al. Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women. Sex Med 2020;8:290–296.

Pathways from childhood sexual abuse to trait anxiety

BACKGROUND

Children exposed to sexual abuse are at risk for developing several psychological and behavioral difficulties during adulthood. Here, direct and indirect effects of family conflict, insecurity within the family system (manifested as disengagement and/or preoccupation), and negative feelings provoked by childhood sexual abuse (CSA) on trait anxiety scores were analyzed with structural equation modeling. Both Finkelhor and Browne's traumagenic dynamics model and Davies and Cummings Emotional Security Theory were applied.

METHODS

A total of 168 female college student survivors of CSA participated in this study. Information regarding each participant's abuse was obtained from a self-reported questionnaires. Emotional security was assessed with the Security in the Family System scale. To assess negative feelings regarding abuse and trait anxiety, Children's Impact of Traumatic Events Scale-Revised and State-Trait Anxiety Inventory were applied, respectively.

RESULTS

Level of family conflict was found to directly relate to emotional insecurity and trait anxiety. In addition, preoccupation strategies were found to be directly related to trait anxiety. Conversely, disengagement strategies were indirectly related to anxiety through the negative feelings provoked by abuse. Experience with other types of abuse and/or neglect was also related to emotional insecurity and feelings provoked by CSA. Meanwhile, continuity of abuse only correlated with feelings provoked by abuse.

CONCLUSIONS

Strong relationships between family conflict, emotional insecurity, negative feelings provoked by CSA and trait anxiety were observed. These results suggest that treatment of CSA survivors should focus on improving security within the survivors' family system and reducing negative feelings provoked by abuse.

Predictors of Sexual Aggression Perpetration Among Male and Female College Students: Cross-Cultural Evidence From Chile and Turkey

This two-wave longitudinal study examined risky sexual scripts and sexual behavior regarding consensual sexual interactions, sexual self-esteem, initiation assertiveness, and religiosity as predictors of sexual aggression perpetration in a cross-cultural comparison of college students in Chile and Turkey. As predicted, risky sexual scripts were linked to higher odds of perpetration through more risky sexual behavior cross-sectionally in both the Chilean and the Turkish sample and indirectly predicted perpetration 12 months later. High sexual self-esteem increased the likelihood of perpetration via higher initiation assertiveness in the Turkish sample only. High religiosity reduced the odds of perpetration through less risky sexual scripts and less risky sexual behavior in both samples. In addition, high religiosity increased the probability of perpetration through lower sexual self-esteem in the Turkish sample. Implications of these findings and the role of cultural factors contributing to the differential functioning of religiosity and sexual self-esteem are discussed.

Self esteem levels vs global scores on the Rosenberg self-esteem scale

Background

The Rosenberg Self-esteem Scale (RSS) is the most widely used instrument to measure this trait. Although the test offers results by levels (low, medium & high), the mean of global scores it is the indicator mostly used in scientific studies. The purpose of this study is to compare self-esteem levels with the global scores as criteria for contrasting self-esteem in subjects with and without a History of Childhood Sexual Abuse (HCSA).

Method

RSS was administered to 74 subjects between 17 and 60 years, half of them with a HCSA, 20 men and 54 women; subjects without a HCSA were used as a comparison group.

Results

Using the mean of the global scores as a criterion to compare the two groups, no significant differences were observed. However, when using self-esteem levels as a criterion, the findings indicate significant differences between subjects with and without HCSA.

Conclusions

The study shows that self-esteem levels are more accurate than global scores to describe this trait and to make comparisons between groups of subjects.

Sexual Victimization and Sex-Related Drinking Motives: How Protective is Emotion Regulation?

One in five college women experience sexual victimization (SV), and SV severity is associated with subsequent psychological distress, including sex-related distress. SV severity may also be associated with drinking motives to cope with sex-related distress and to enhance sex (sex-related drinking motives [SRDMs]), particularly if individuals suffer from emotion regulation (ER) difficulties. College women (N = 151) completed a survey assessment of ER, SV history, childhood sexual abuse (CSA), and SRDMs. Twelve regression models assessed six facets of ER as moderators between SV severity and SRDMs. Among women with no or low levels of prior SV severity, women with greater access to ER strategies were less likely to endorse drinking to cope SRDMs. At higher levels of SV severity, women at all levels of access to ER strategies were equally likely to endorse drinking to cope SRDMs, suggesting that access to ER strategies did not mitigate motivations to drink to cope with sex-related distress for these women. Women with severe SV histories may benefit from interventions that build on existing ER strengths or address other factors. However, greater access to ER strategies may serve as a protective factor against SRDMs when SV severity is low.

Perceptions of Physical Sexual Health Among Young Men Who Have Sex with Men with a Previous History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) has been reported to be disproportionately higher among young men who have sex with men (YMSM) than among heterosexual men. Most research and public health programs among YMSM CSA survivors have been mainly infectious disease-based, and research on the physical sexual health among this group is limited. This study sought to further understand components of physical sexual health among YMSM with CSA histories. Sixteen participants were recruited, and through a phenomenological approach, semi-structured interviews were conducted. Four themes were found, participants (1) reported a one-dimensional definition of sexual health; (2) had limitations in health insurance hindering preventative care; (3) described reoccurring anal pain during sexual intercourse; and (4) conveyed a positive perception of sexual satisfaction. These findings indicate a need for healthcare providers, health educators, and researchers to increase awareness about the comprehensive needs of YMSM with CSA histories.

A resilience framework: Sexual health trajectories of youth with maltreatment histories

There is a wealth of knowledge regarding negative sexual outcomes experienced by youth with childhood maltreatment (CM) histories, yet a dearth of research examines healthy sexual development among these youth. This gap exists despite evidence of resilience highlighting alternative and healthy physical, social, and psychological futures for youth who were abused. This study tested whether trajectories of resilience identified in studies of psychological functioning were applicable to sexual health. Using data from the first four waves of the National Longitudinal Study of Adolescent to Adult Health, latent class growth analysis was conducted among individuals with histories of CM (N = 1,437). On average, participants were 15, 16, 21, and 28 years old, respectively, by waves of data collection. About half of the sample was female (55%), the majority were White (66%), and a sizeable portion had experienced multiple forms of CM prior to Wave I (38%). Controlling for CM severity, three distinct sexual health trajectory classes were identified: resilient, survival, and improving, which were differentiated by age and biological sex. Older participants' sexual health was more likely to diminish over time, girls were more likely to show gains in sexual health over time, and significant differences in levels of sexual behaviors between the classes were only present during adolescence. Findings support the need for increased attention on the potential for sexual health despite experiences of CM, and highlight the applicability of resilience theory to youth sexuality.

Adult Profiles of Child Sexual Abuse Survivors: Attachment Insecurity, Sexual Compulsivity, and Sexual Avoidance

The present study examined the possibility of different groups of child sexual abuse (CSA) survivors based on their different patterns of attachment and sexual problems. A sample of 324 CSA survivors and 484 participants who did not report any child maltreatment experiences completed online questionnaires. A cluster analysis on attachment and sexual outcomes revealed that CSA survivors formed two distinct profiles. The first profile included CSA survivors with elevated attachment anxiety and low to moderate scores on attachment avoidance, sexual compulsion, and sexual avoidance. The second profile comprised CSA survivors with high scores on attachment anxiety, attachment avoidance, sexual compulsion, and sexual avoidance. These groups were then compared on CSA severity, gender differences, and other child maltreatment experiences. As compared to CSA survivors of the first profile, survivors from the second profile reported more intrusive and extrafamilial CSA, higher rates of psychological maltreatment and witnessed parental violence, and experienced more personal and couple distress. These results suggest that CSA survivors form a heterogeneous population and that sexual abuse is differentially associated with the complex unfolding of the attachment and sexual systems within two distinct subgroups.

Sexual well-being of sexual minority women in dating relationships who have experienced childhood sexual abuse and/or adolescent and adult sexual victimization

Few studies have examined the sexual sequelae of child sexual abuse (CSA) for sexual minority women (SMW), particularly SMW in dating relationships. We examined the impact of CSA on several aspects of sexual well-being. Participants were 299 SMW in a non-cohabiting dating relationship who completed an online survey that assessed CSA, adolescent and adult sexual victimization (AASV) and their behavioural, motivational, and cognitive-affective sexual responses. Four groups were formed based on sexual abuse experiences before the age of 14: No lifetime sexual abuse (NSA Group); AASV only (AASV Group); CSA limited to fondling (CSAfon Group); and, CSA involving attempted/completed vaginal, oral and/or anal penetration (CSApen Group). Women in the CSAfon and CSApen groups were significantly more likely to report having experienced AASV (77% and 56%, respectively) than were women in the AASV and NSA groups (32%). Women in the CSApen Group reported significantly lower sexual desire and sexual satisfaction, and more frequent negative automatic sexual thoughts than women in the other groups but no differences in their frequency of sexual behaviours, sexual duration, sexual esteem, or sexual anxiety. The AASV Group did not differ from the NSA Group on any of the sexual well-being variables. Overall, women in all four groups generally reported positive sexual well-being. These results suggest CSA involving attempted/completed penetration with or without subsequent AASV negatively affects only some aspects of SMW's sexual well-being. They also suggest SMW who have experienced sexual abuse can and do enjoy healthy sexual well-being within the context of a dating relationship.

Cumulative Childhood Trauma and Adult Sexual Satisfaction: Mediation by Affect Dysregulation and Sexual Anxiety in Men and Women

Childhood cumulative trauma (CCT) refers to an amalgam of childhood maltreatment experiences that can lead to a range of symptoms and problems in adulthood. The current study examined an integrative model of CCT for its relevance to psychosexual adjustment in adult survivors. A total of 620 participants aged 18 years and over completed a questionnaire assessing early life experiences, affect dysregulation, sexual anxiety, and sexual satisfaction. Path analyses confirmed the hypothesis that CCT is associated with affect dysregulation and sexual anxiety that, in turn, predict lower levels of sexual satisfaction. The validity of this mediational model was demonstrated for different operationalizations of CCT. The results suggested that sex therapists, who are likely to encounter CCT survivors in their practice, should consider targeting affect dysregulation in their efforts to decrease sexual anxiety and increase sexual satisfaction.

Positive Sexual Self-Schemas of Women Survivors of Childhood Sexual Abuse

The purpose of this qualitative study was to examine the experiences of eight women survivors of childhood sexual abuse who view themselves as having a positive sexual self-schema, including their experiences of sexual satisfaction. Through thematic analysis, we developed the following themes: The Context for Sexual Development, Sexual Exploration, Coping Strategies, and Embracing the Sexual Self as Whole. The findings highlight the importance of relational, interpersonal, and community healing. Integral to women’s healing were experiences of sexual risk that allowed them to gain a sense of agency and empowerment. The themes that emerged provide additional support for Relational Cultural Theory as well as post-traumatic growth. We discuss the implications of these results in relation to counseling practice, training, and research.

Validation of the Interpersonal Exchange Model of Sexual Satisfaction With Women in a Same-Sex Relationship

We examined the validity of the interpersonal exchange model of sexual satisfaction for sexual-minority women (SMW) with a range of sexual identities (lesbian, bisexual, queer, unlabeled, questioning). Participants, 898 (192 who were dating, 439 who were cohabitating) SMW in a romantic relationship of at least 3 months, completed an online survey that included the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire. The results provide support for the validity of the model for SMW in that all the model components (relationship satisfaction, balance of sexual rewards and costs, balance of relative sexual rewards and costs, equality of rewards, equality of costs) were significantly associated with sexual satisfaction. All of the components, except equality of sexual costs, contributed uniquely to the prediction of sexual satisfaction. Neither relationship stage (dating vs. cohabiting) nor sexual identity (lesbian vs. other sexual-minority identity) moderated these associations. Women daters reported a significantly higher level of sexual rewards, sexual costs, and sexual satisfaction than did women cohabiters. The interpersonal exchange model may be used by clinicians as a framework for exploring experiences of low sexual satisfaction with a couple. The results also add to an emerging positive picture of the sexual relationships of SMW at both stages; this information can be used to counter negative stereotypes. Online supplemental files are available at http://journals.sagepub.com/doi/suppl/10.1177/0361684316679655 .

Adaptation and Validation of the Brief Sexual Opinion Survey (SOS) in a Colombian Sample and Factorial Equivalence with the Spanish Version

Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias.

Sexual Contact in Childhood, Revictimization, and Lifetime Sexual and Psychological Outcomes

Using data from the 2010 to 2011 wave of the National Social Life, Health, and Aging Project-a nationally representative probability sample of older U.S. adults-this study queried distinctive linkages of mild and of severe childhood sexual contact with lifetime sexual and psychological outcomes among women and men aged 60-99 years (N = 3283). In addition, we examined stratification of these associations by sexual revictimization (forced sex and/or harassment). Among women, sequelae of childhood contact seemed consistently negative for the mild rather than severe variant-but only in the co-presence of revictimization-a pattern that may have remained obscured in previous analysis of event effects. Men's results suggested lifelong eroticizing but not psychological effects of this early experience-with the co-presence of revictimization potentially enhancing rather than lowering their mental health. Overall, findings appeared to reflect gendered patterns of risk-with mild childhood contact potentially channeling women but not men into revictimization and finally to elevated sexuality and poor mental health in late life. Early sexual experiences should thus be conceptualized not as singular events, but as part of a lifelong career with regularities and rhythms that may influence their pathogenic potential.

Predictors of the Sexual Well-being of Individuals Diagnosed with Herpes and Human Papillomavirus

Research suggests that having a sexually transmitted infection (STI) such as genital herpes and human papillomavirus (HPV) can negatively affect sexual well-being. However, there is little research examining factors associated with poorer sexual well-being among individuals with a STI. This study investigated the extent to which stigma experiences, individual characteristics, and STI characteristics were associated with multiple aspects of sexual well-being among individuals diagnosed with herpes and/or HPV. Participants were an average of 36 years old (SD = 11.58) and included 188 individuals with herpes and/or HPV who completed measures of sexual activity, sexual problems, and sexual cognitive-affective factors. The results showed that experiences of stigmatization were the most important predictors of sexual well-being. Participants who perceived were stigmatized by others as well as those who internalized negative social attitudes to a greater extent reported poorer sexual well-being across all dimensions, over and above individual and STI characteristics. The implications of these findings for sexual health professionals are discussed.

Online sexual behaviours among Swedish youth: associations to background factors, behaviours and abuse

Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not perform any of the assessed online sexual behaviours. Young people who reported online sexual behaviour showed a more problematic background, rated their health as poorer, had a more sexualized life and had experienced more sexual or physical abuse. Professionals who work with young people need to help them better evaluate potential risks online and offer support when needed. Youths who sell sex online are especially at risk and need extra attention, as they might be in greater need of protection and therapeutic support.

Child sexual abuse, attachment style, and depression: the role of the characteristics of abuse

The aim of the current study was to examine the effects of secure, avoidant, and anxious attachment styles on depressive symptomatology in child sexual abuse (CSA) among young female adult victims. The role of attachment style was studied by considering possible interactive effects with the type of abuse, the relationship with the perpetrator, and the continuity of abuse. Participants were 168 female victims of CSA. Information about the abuse was obtained from a self-reported questionnaire. Attachment style was assessed with the Attachment Style Measure (ASM), and the Beck Depression Inventory (BDI) was used to assess depressive symptomatology. Secure and anxious attachment styles were correlated with low and high depression scores respectively. The effects of attachment style were stronger in cases where the abuse consisted of oral sex/penetration, a non-family member as perpetrator, and in isolated, compared with continued, abuse. These results confirm that characteristics of CSA (type of abuse, relationship with the perpetrator, and continuity of abuse) can affect the impact of attachment style on depressive symptomatology.