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.

Transdiagnostic factors in the COVID-19 pandemic: Examining the role of childhood abuse and neglect in establishing latent profiles of risk and resilience

BACKGROUND

Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis.

OBJECTIVE

We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach.

PARTICIPANTS AND SETTING

A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19.

METHODS

Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs.

RESULTS

A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: "risk" (5.1 %)-individuals with meaningfully high levels of childhood abuse and neglect and dissociation; "vulnerable" (14.2 %)-individuals high in risk factors and low in protective factors; "moderately resilient" (47.6 %)-those with moderate levels of protective and risk factors; "highly resilient" (33.1 %)-individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress.

CONCLUSIONS

Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed.

Breaking the cycle: Mentalizing moderates and mediates the link between childhood sexual abuse and satisfaction with adult romantic relationships

BACKGROUND

Childhood sexual abuse (CSA) is a significant risk factor with consistently demonstrated negative implications for satisfaction with adult romantic relationships. Yet, research on risk and protective factors in this context is scarce, particularly among well-functioning adults.

OBJECTIVE

Addressing this gap, the present study focused on the potential mediating and moderating roles of mentalizing or reflective functioning, i.e., the capacity to understand oneself and others in terms of intentional mental states. We investigated whether impairments in mentalizing underlie the association between CSA and relationship satisfaction and whether robust mentalizing can buffer the CSA-relationship satisfaction link.

METHOD

A sample of 667 individuals engaged in a meaningful romantic relationship was drawn from a larger sample obtained in an online convenience survey. A mediation and moderation model was examined using PROCESS.

RESULTS

The results confirmed our integrative model-the association between CSA and satisfaction with romantic relationships was mediated by impairments in mentalizing (uncertainty about mental states) and was simultaneously moderated by robust mentalizing (certainty about mental states). These effects were shown even when controlling for age, gender, education, and psychopathological symptoms.

CONCLUSIONS

These findings highlight the importance of mentalizing, a key transdiagnostic factor. Reduced mentalizing is a risk factor for harmful impact of CSA on romantic relationships, while greater mentalizing abilities can be a significant resilience factor protecting CSA survivors. This study supports the potential contribution of mentalization-based interventions with survivors of CSA at risk for dissatisfaction with romantic relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trauma behind the keyboard: Exploring disparities in child sexual abuse materials exposure and mental health factors among investigators and forensic examiners - A network analysis

BACKGROUND

Despite acknowledging the detrimental impact of child sexual abuse material (CSAM) exposure on the mental and physical well-being of investigators and forensic examiners, there is a need for comprehensive exploration into the complex relationship between CSAM exposure, its various dimensions, mental health (i.e., anxiety, depression, and PTSD), and burnout, as well as the presence of positive attitudes towards the job.

OBJECTIVE

To understand how CSAM exposure, mental health and burnout interconnect and cluster within distinct networks of police investigators and forensic examiners.

PARTICIPANTS AND SETTING

Police investigators and forensic examiners from across the United States who were exposed to CSAM as part of their professions (N = 470).

METHODS

Participants, recruited through connections with the National Criminal Justice Training Center, completed an anonymous online survey.

RESULTS

The network analysis revealed differences in centrality between investigators and forensic examiners, particularly in their associations with exposure factors and mental health variables. Edges invariance tests showed differences in the strength of these associations, with some factors being more strongly linked to PTSD avoidance symptoms among investigators and others among forensic examiners. Stability analyses suggested potentially greater heterogeneity among investigators, while both groups displayed high stability in other centrality indices.

CONCLUSIONS

This study contributes to our comprehension of the distinct experiences and challenges faced by CSAM investigators and forensic examiners, and specifically the nuanced disparities between CSAM investigators and forensic examiners in terms of their exposure to CSAM content and the associated mental health factors. These insights highlight the imperative need for tailored support mechanisms and interventions that can effectively address the unique challenges encountered by individuals working tirelessly in this critical field.

The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations

Background

The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups.

Methods

We used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation.

Results

Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001).

Conclusion

The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.

Cross-cultural validation and measurement invariance of anxiety and depression symptoms: A study of the Brief Symptom Inventory (BSI) in 42 countries

BACKGROUND

Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the Brief Symptomatology Index (BSI) in 42 countries.

METHODS

Using data from the International Sex Survey (N = 82,243; Mage = 32.39; SDage = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations.

RESULTS

Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined.

LIMITATIONS

The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations.

CONCLUSIONS

The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety.

Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries

OBJECTIVES

This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use.

STUDY DESIGN

The study design is a cross-sectional self-report study conducted across 42 countries.

METHODS

A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set.

RESULTS

The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior.

CONCLUSIONS

The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.

From trauma to intimacy: Examining the link between childhood maltreatment and adult sexual functioning - The mediating role of self-criticism

BACKGROUND

Childhood maltreatment has been linked to negative sexual functioning, but the underlying mechanisms for this association are poorly understood.

OBJECTIVE

Addressing this gap, this study investigates the mediating role of self-criticism in the association between childhood maltreatment and adult sexual functioning.

PARTICIPANTS AND SETTING

Two independent studies were conducted, each utilizing a distinct dataset to enhance the robustness and generalizability of the findings. The sample in Study 1 included 914 participants, while the sample in Study 2 consisted of 451 women. Both samples completed self-report online questionnaires; however, in Study 2, we purposefully oversampled for child sexual abuse survivors.

METHODS

This study employed a mediation model using PROCESS.

RESULTS

Study 1 confirmed the negative association between childhood maltreatment and sexual functioning, as well as the positive association between childhood maltreatment and self-criticism. Self-criticism was also negatively associated with sexual functioning. The mediation analysis revealed that self-criticism significantly mediated the association between childhood maltreatment and sexual functioning. Study 2 built upon these findings by oversampling childhood sexual abuse survivors and incorporating comprehensive measures of sexual functioning. The results in Study 2 replicated the findings of Study 1, providing a more representative understanding of the link between childhood maltreatment and sexual functioning.

CONCLUSIONS

The findings highlight the importance of self-criticism as a potential mechanism underlying the negative impact of childhood maltreatment on sexual functioning in adulthood. This knowledge can inform interventions and therapeutic approaches aimed at addressing self-criticism and improving sexual well-being in individuals with a history of childhood maltreatment.

War-Time Stress and Sexual Well-Being in Israel

Objective

This study explored the relationship between war-related stressors and sexual well-being among a civilian population during the 2023 Israel-Hamas War, emphasizing a comprehensive assessment of sexual satisfaction, function, and distress. We aimed to investigate how direct exposure, media exposure, and acute stress symptoms during the war contribute to various dimensions of sexual well-being using a quasi-longitudinal online survey method.

Methods

An online survey with a convenience sample of 1033 Israeli adults, utilizing measures of direct and media exposure to war stress, acute stress symptoms, and various aspects of sexual well-being, both pre-war and present was distributed. Data analysis involved Pearson correlations and hierarchical regression.

Results

There were significant associations between stress-related variables and sexual well-being, highlighting the differential contribution of direct exposure, media exposure, and acute stress symptoms. Direct exposure to stress was uniquely associated with sexual dysfunction, while media exposure and acute stress symptoms contributed significantly to predicting various aspects of sexual well-being.

Conclusions

Recognizing the multifaceted impact of stress during wartime on sexual well-being is crucial for developing comprehensive mental health interventions that address individual and societal factors. This study contributes valuable insights into the relationships between stress-related variables and sexual well-being during wartime, emphasizing the need for holistic approaches in addressing the intimate challenges individuals face during times of conflict.

Rights or Obligations: The Extent to Which Sexual Desire and Gender Roles Determine Sexual Intimacy in Romantic Relationships

The present study aims to investigate the relationship between traditional gender roles and the frequency of sexual intimacy within romantic relationships, considering sexual desire and societal norms and expectations. The study was conducted among a convenience sample of men and women in Israel. The survey included measures of sociodemographic information, traditional gender roles, sexual desire, perceived partner's sexual desire, and frequency of engaging in sex. Findings suggest that men who embraced less traditional gender roles exhibit a greater synchronization between their own sexual desire and their perceived partner's sexual desire, whereas women who embraced more traditional gender roles tend to rely more on their partners' sexual desire in their frequency of sex. These results imply that men's sexual desire plays a significant role in determining the frequency of sexual activity in romantic relationships, especially in relationships where traditional gender roles are more strongly embraced. Findings from the current study underscore the idea that the decision to engage in intimate acts may not solely hinge on individual sexual desire; rather, it operates within a broader context influenced by societal and cultural expectations. It is important to challenge societal norms to promote more balanced and equitable sexual dynamics in committed relationships.

I'm sexy and I know it: Exploring the moderating role of sexual motivations in the relationship between sexual self-esteem and sexual functioning in Israeli adults

This study investigated the relationship between sexual self-esteem and sexual functioning while exploring the moderating role of sexual motives, thereby contributing to a deeper comprehension of factors that affect sexual well-being. The study used a convenience sample of 781 Israeli adults with a mean age of 31.2. Participants completed the sexual self-esteem subscale of the Multidimensional Sexuality Questionnaire, Female Sexual Function Index (for women), International Index of Erectile Function (for men), and Sexual Motives Scale, which assesses motives of self-enhancement, intimacy, self-affirmation, coping, partner approval, and peer pressure. A moderation model examined the role of these sexual motives in the association between sexual self-esteem and sexual functioning. The analysis indicated that higher sexual self-esteem and motivation for intimacy and enhancement were associated with better sexual functioning. The study also revealed that participants' motivation for partner approval and peer pressure moderated the association between sexual self-esteem and sexual functioning. Participants with low motivation for partner approval showed an association between higher sexual self-esteem and greater sexual function, while participants with high motivation for partner approval did not show this association. For peer pressure, the association between higher sexual self-esteem and greater sexual function was strongest for participants who experienced high peer pressure as a sexual motive. Higher sexual self-esteem was associated with better sexual functioning, regardless of peer pressure level, but the association was stronger for participants experiencing high peer pressure. The study results shed light on the connection between sexual self-esteem, sexual motivations, and sexual functioning. Clinically, interventions for addressing sexual functioning should consider both self-esteem and sexual motivations.

In Love With a Trauma Survivor: When a History of Childhood Abuse Interferes With Relationship Satisfaction Among Couples

To date, the majority of research examining the effect of childhood abuse on relational aspects in adulthood is almost exclusively based on intraindividual data. The current study explores a moderating-mediating model from a dyadic perspective, examining the mediating effect that perceived intimacy has on the associations between concern couple caregiving and relationship satisfaction. It further investigates whether these mediation paths are moderated by a history of childhood abuse (physical/emotional/sexual). A total of 143 nonclinical couples (n = 286) in enduring relationships were recruited. A moderated mediation actor-partner interdependence model (moderated mediation actor-partner interdependence model (APIM)) comprised of three segments, was conducted. Results indicated that intimacy mediated the link between concern caregiving and relationship satisfaction on the actor's level, with effects applying equally to both husbands and wives. A higher level of intimacy among husbands and wives alike is linked, in turn, with higher relationship satisfaction. The path between actors' concern caregiving and their level of intimacy was moderated by the actors' childhood emotional and physical abuse; specifically, concern caregiving exerts greater effect on intimacy among participants who experienced high levels of emotional abuse, or low levels of physical abuse. Our findings highlight how different types of childhood abuse affect adult romantic relationships differently.

Cross-Cultural Adult ADHD Assessment in 42 Countries Using the Adult ADHD Self-Report Scale Screener

OBJECTIVE

We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener.

METHOD

Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57).

RESULTS

The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed.

CONCLUSIONS

Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.

Dating Apps: A New Emerging Platform for Sexual Harassment? A Scoping Review

Currently, dating apps are one of the most popular platforms for meeting romantic and sexual partners. However, little is known about the potential for sexual harassment on these platforms. In the current scoping review, we sought to examine what is known about sexual harassment facilitated through smartphone dating apps. We searched for studies that reported on sexual harassment via dating apps through PubMed, Web of Science, PsycInfo, Communication Abstracts, Sociological Abstracts, and IEEE Xplore databases. Twelve studies addressed the risk of sexual harassment on dating apps. We found that sexual harassment when using dating apps is prevalent and ranges between 57 and 88.8%, with two populations being at higher risk: women and individuals who identify as a sexual minority. In terms of forms of harassment, sexual harassment via dating apps can take place online (e.g., being sent unsolicited images, or "dick pics") or offline (e.g., a face-to-face meeting that was arranged on a dating app). Experiencing sexual harassment on dating apps is associated with higher levels of depression, anxiety, post-traumatic stress disorder, loneliness, early childhood maltreatment, less perceived self-control, and lower self-esteem. Some studies suggest that experiencing sexual harassment on dating apps reflects social structures and appears differently in different groups (e.g., among sexual minorities). More research is needed to capture the prevalence of adult sexual harassment via the use of dating apps, the different forms of harassment, risk and protective factors, and social and cultural structures that facilitate this kind of sexual harassment.

The mental health of officials who regularly examine child sexual abuse material: strategies for harm mitigation

BACKGROUND

The current study aims to better understand the mental health and subjective well-being of investigators and forensic examiners exposed to child sexual abuse material (CSAM) by examining which components of this work are associated with elevated mental health conditions and decreased well-being, as well as the intra-personal and organizational variables that may mitigate harm and improve well-being.

METHODS

Police investigators, forensic examiners, and others connected with the criminal justice system from across the United States who were exposed to CSAM as part of their professions (N = 500) completed an anonymous online survey. Participants were recruited through connections with the National Criminal Justice Training Center.

RESULTS

Duration, frequency, amount, and content of CSAM exposure was not related to poorer mental health with the exception of exposure to violent CSAM which was related to elevated post-traumatic stress symptoms. Several agency-level practices and policies, such as the availability of an Officer Wellness Program and more frequently knowing the final case resolution, were related to better mental health and well-being. Harm mitigation strategies, such as talking to other officers investigating the case and taking breaks from the material being viewed, were also related to better mental health.

CONCLUSIONS

Findings indicate that police agencies have options for implementing agency-level procedures and practices that have the potential to reduce the negative impact of CSAM investigations. Additionally, many investigators use strategies that are correlated with greater well-being, suggesting opportunities for improving training programs.

"I Know It's Hard to Believe, But the Monster Who Abused Me is My Mother:" Experiences of Being Sexually Abused as a Child by a Female

In the present study we sought to shed light on the experience of adults who were sexually abused by females. Narratives in the current study were chosen from a large set of narratives (n = 505) that were submitted to the Israeli Independent Public Inquiry on CSA. Twenty-eight (n = 28) narratives of adults who experienced CSA committed by females were included in the study and analyzed using inductive thematic analysis. Two main themes were identified: (1) adults who as children experienced CSA committed by females, and (2) personal, interpersonal, and social constructions of the abuse. Most of the narratives included intrafamilial abuse, with half of the participants reporting that their mother was the one who committed the CSA, which often occurred during daily routine activities, with the main abuse scene being the shower/bathroom. Participants described various abuse experiences including the experience of powerlessness, "standing together," and captivity. Finally, participants discussed how social constructions of gender impacted how they understood and experienced the abuse. Child sexual abuse committed by females was described by the participants as having serious consequences for their lives. Participants shared how perceived gender roles and social scripts have an important role in casting doubt on the existence and reliability of CSA experiences committed by females. Findings from the current study help to identify key characteristics of sexual abuse that was conducted by females, and suggests social mechanisms that may help explain why perpetration by females is understood and treated differently than perpetration by males.

Correlates of intimate relationship satisfaction among investigators of child sexual abuse material

Introduction

This study investigates correlates of intimate relationship satisfaction among investigators of child sexual abuse material (CSAM). Previous research has shown that exposure to CSAM content can negatively impact investigators' emotional wellbeing, but little is known about its association with their intimate relationships.

Methods

The study included 500 participants who were police investigators, forensic examiners, and other professionals connected with the criminal justice system in the United States that are exposed to CSAM as part of their profession. The study collected data through an anonymous survey administered via the Qualtrics online survey system.

Results

The findings reveal that higher levels of depressive symptoms and post-traumatic stress disorder are associated with lower relationship satisfaction among CSAM investigators. Additionally, group connectedness is positively related to relationship satisfaction for both men and women. Parent investigators also reported lower relationship satisfaction, suggesting unique challenges faced by this subgroup. Exposure to varying types of CSAM content was not significantly related to lower relationship satisfaction. This study highlights the association between depressive symptoms and PTSD with relationship satisfaction among CSAM investigators, emphasizing the role of group connectedness in promoting positive outcomes for both male and female investigators.

Discussion

Recognizing the association between depressive symptoms and PTSD with relationship satisfaction can guide interventions and support services for investigators, promoting group connectedness and addressing mental health concerns to enhance resilience and effectiveness in combating child exploitation.

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

INTRODUCTION

Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations.

AIMS

The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation.

METHODS

Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses.

RESULTS

A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached.

CONCLUSIONS

In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.

The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is an instrument to screen substance-use-related health risks. However, little is known whether the ASSIST could be further shortened while remaining psychometrically sound across different countries, languages, gender identities, and sexual-orientation-based groups. The study aimed to validate a shortened 11-item ASSIST (ASSIST-11). Using the International Sex Survey data, 82,243 participants (M age = 32.39 years) across 42 countries and 26 languages completed questions from the ASSIST-11 regarding gender identity, sexual orientation, and other information. Confirmatory factor analysis (CFA) and multigroup CFA (MGCFA) evaluated the ASSIST-11's structure and tested measurement invariance across groups. Cronbach's α and McDonald's ω were used to examine the internal consistency. Cohen's d and independent t-tests were used to examine known-group validity. The ASSIST-11 was unidimensional across countries, languages, age groups, gender identities (i.e., men, women, and gender-diverse individuals), and sexual orientations (i.e., heterosexual and sexual minority individuals). Cronbach's α was 0.63 and McDonald's ω was 0.68 for the ASSIST-11. Known-group validity was supported by Cohen's d (range between 0.23 and 0.40) with significant differences (p-values<0.001). The ASSIST-11 is a modified instrument with a unidimensional factor structure across different languages, age groups, countries, gender identities, and sexual orientations. The low internal consistency of the ASSIST-11 might be acceptable as it assesses a broad concept (i.e., use of several different substances). Healthcare providers and researchers may use the ASSIST-11 to quickly assess substance-use information from general populations and evaluate the need to follow up with more detailed questions about substance use.

The relationship between narcissistic traits and attitudes toward infidelity: A dyadic analysis

Previous research suggested that narcissism is associated with infidelity and reduced commitment in relationships. However, the majority of studies supporting this association were conducted among individuals and did not examine dyadic paths and also conceptualized and measured narcissism as a global variable, lacking a nuance perspective of the two traits of narcissism (i.e., grandiose and vulnerable). The present study sought to examine attitudes toward infidelity from a dyadic perspective, using narcissism personality traits (grandiose and vulnerable) as predictors. The effect of narcissism personality traits on attitudes toward infidelity was investigated among 135 couples (N = 270) in enduring relationships. To assess whether attitudes toward infidelity were explained by grandiose narcissism and vulnerable narcissism, we used multivariate multilevel statistical model for matched pairs to evaluate the effect of each partner's characteristics on their own (actor effect) and their partner's (partner effect) attitudes. The results indicate that females' attitudes toward infidelity were positively associated with their own grandiose narcissism and vulnerable narcissism and negatively associated with their partner's grandiose narcissism. Males' attitudes toward infidelity were positively associated with both their own and their partner's vulnerable narcissism but not with their or their partner's grandiose narcissism. The results highlighted the importance of studying different aspects of narcissism in relation to dyadic processes within intimate relationships in general and regarding infidelity in particular. Our findings suggest that more or less favorable attitudes toward infidelity depend not only on the individual's narcissistic traits but on his/her partner's grandiosity and vulnerability as well. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Lo(u)st in Therapy: Development and Psychometric Evaluation of the Therapists' Attitude toward Sexual and Erotic Feelings Scale (TASEF)

This study aimed to develop the Therapists' Attitude toward Sexual and Erotic Feelings (TASEF) scale for assessing therapists' attitudes and responses toward sexual and erotic feelings in therapy. A total of 507 therapists participated in two separate studies. Study 1 focused on finalizing the format of the TASEF and evaluating its construct validity. Through Exploratory Graph Analysis, four factors were identified within the TASEF questionnaire: Gratification, which captures the positive affect experienced by therapists in response to a patient's sexual attraction toward them; Fear, which represents therapists' apprehension or discomfort when encountering sexual feelings from the patient; Threat, which reflects the perception of risk or danger that erotic transference poses to the patient, therapist, and the therapeutic process; and Aversion, which encompasses the therapist's discomfort or aversion toward the patient's sexual feelings. Study 2 aimed to confirm the structure of the TASEF questionnaire and assess its overall validity. The results showed that the TASEF demonstrated adequate overall validity, with higher convergence validity observed for the Fear, Aversion, and Threat clusters compared to the Gratification cluster. The TASEF enables therapists to understand and manage their emotional reactions to sexual feelings in therapy, maintaining standards of care.

Childhood Sexual Abuse and Relationship Satisfaction: The Moderating Role of PTSD and Sexual-Related Posttraumatic Stress Symptoms

Research on childhood sexual abuse (CSA) has consistently demonstrated the long-term effects of such abuse, not only on survivors' development, but also on the nature and quality of their adult relationships, particularly romantic ones. In this study we examined the moderating role of posttraumatic stress disorder (PTSD) and sexual-related posttraumatic stress symptoms (sexual-related PTSS) between CSA and relationship satisfaction. Survey data from 529 individuals who reported being currently in a romantic relationship were analyzed. In the first set of analyses, results demonstrated that participants with CSA reported significantly lower relationship satisfaction and significantly greater severity of PTSD and sexual-related PTSS than participants without CSA. Sexual-related PTSS but not PTSD moderated the association between CSA and participants' relationship satisfaction, with the model of sexual-related PTSS explaining 20.8% of the variance in relationship satisfaction and the model of PTSD explaining 11.3% of this variance. In the second set of analyses conducted among survivors of CSA only, higher sexual-related PTSS severity was linked with ongoing abuse and with abuse by a non-family member. This study points to the potential contribution made by sexual-related PTSS to relationship satisfaction among survivors of CSA.

Between pleasure, guilt, and dissociation: How trauma unfolds in the sexuality of childhood sexual abuse survivors

BACKGROUND

Childhood sexual abuse (CSA) is a significant risk factor for sexual difficulties in adulthood.

OBJECTIVE

In the current study we aimed to expand the understanding of the association between CSA and sexual difficulties by examining the moderating role of traumatic sexuality in the association between CSA and sexual difficulties among a sample of CSA survivors.

PARTICIPANTS AND SETTING

The hypothesized moderation model was examined among a sample of 393 CSA survivors.

METHODS

Significant interactions were probed using simple slopes tests using the interactions R package.

RESULTS

The results indicated main effects of traumatic sexuality on survivors' sexual difficulties: Greater severity of dissociation during sex was linked with greater sexual dysfunction and higher compulsive sexual behavior disorder (CSBD), and greater intrusiveness during sex and pleasing the other during sex were linked with higher CSBD. Experiencing higher sex-related guilt and/or shame and hypervigilance with regard to sex were associated with greater sexual dysfunction. As for the moderations, intrusiveness during sex and pleasing the other during sex moderated the association between CSA and sexual dysfunction. Intrusiveness during sex and sex-related guilt and/or shame moderated the association between CSA and CSBD. Intrusiveness during sex, pleasing the other during sex, and/or hypervigilance with regard to sex moderated the association between CSA and problematic pornography use.

CONCLUSION

This study points to the potential contribution of traumatic sexuality symptoms to sexual difficulties among survivors of CSA and lends support to the idea of offering trauma-focused therapy when treating the sexual difficulties of CSA survivors.

Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools

Background and aims

Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice.

Method

Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD.

Results

A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability.

Discussion and conclusions

This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.

Why Do Women with Disordered Eating Engage in Sex? The Mediating Role of Sexual Motivations in the Association Between Disordered Eating Behaviors and Attitudes and Sexual Dysfunction

Although there is growing evidence of an association between disordered eating and sexual dysfunction, the mechanism underlying this association is still unclear. In the current study, we sought to examine the mediating role of sexual motivation between disordered eating and sexual dysfunction. We used a multi-path mediation model to examine the mediating role of sexual motivation between disordered eating and sexual functioning among a sample of 341 non-clinical women in a steady relationship. Analysis revealed two significant mediation paths associating disordered eating with sexual functioning: (1) a high level of disordered eating was significantly linked with higher motivation for partner approval via sex and sexuality which, in turn, was associated with lower sexual functioning and (2) a high level of disordered eating was significantly linked with lower enhancement sexual motivation which, in turn, was associated with lower sexual functioning. This study extends the existing knowledge by offering an explanation for the relation between disordered eating and sexual dysfunction via sexual motives. Findings from the current study suggest women with disordered eating utilized sex for self-affirmation, for coping with negative emotions, for partner approval, and to increase intimacy. Also, these women were not likely to engage in sex for enhancement reasons.

The Sexual Fantasies of Childhood Sexual Abuse Survivors: A Rapid Review

Although the association between childhood sexual abuse (CSA) and various aspects of sexual difficulties is well established, little is known about the association between CSA and adult sexual fantasies. The current rapid review searched for studies that reported on CSA and sexual fantasies through PubMed, PsycInfo, and Violence & Abuse Abstracts databases. Included in the review were empirical studies involving a population of adults who experienced CSA before the age of 18 and which reported on survivors' sexual fantasies. The impact of CSA on adult sexual fantasies was found across three main dimensions: prevalence of sexual fantasies, content, and appraisal of the fantasies. Overall, 13 studies that addressed the sexual fantasies of survivors of CSA were identified. This review found an association between CSA and adult sexual fantasies, indicating that survivors of CSA are more likely to report: unrestricted sexual fantasies, more atypical sexual fantasies, more sexual fantasies that involve force, and more fantasies that include elements of sadomasochism, submissiveness, and dominance. Survivors of CSA also begin having sexual fantasies at a significantly earlier age and report their sexual fantasies as being significantly more intrusive than do nonabused subjects. When treating CSA survivors, therapists should acknowledge that a history of CSA can impact the survivors' sexual fantasies. Further studies with adult survivors of CSA are needed to determine how these sexual fantasies develop subsequent to the abuse, how they are perceived by survivors, and what their effect is on survivors' and their partners' sexual health, function, and satisfaction.

The association between problematic pornography use and eating disorder symptoms among heterosexual and sexual minority men

In this study, we investigated the link between problematic pornography use and eating disorder symptoms in men, with body comparison and body image as mediators, and perceived realism and anxiety and depression as moderators. We also analyzed the model for both heterosexual and sexual minority men to detect any differences. The current study included 705 Israeli men, 479 of whom identified as heterosexual and 226 as sexual minority. The majority of the sample (90.6%) identified as Jewish with a mean age of 32.5. Results showed that problematic pornography use was linked to more upward body comparison, which in turn was related to negative body image, and ultimately, increased severity of eating disorder symptoms. Anxiety and depression moderated the association between male body image and eating disorder symptoms. However, perceived realism did not moderate the link between problematic pornography use and upward body comparison. Whereas there were significant differences in the mean rank values between heterosexual and sexual minority men in all measures, the processes linking these measures were virtually the same. To reduce the risk of developing or worsening eating disorder symptoms, clinicians working with male clients should assess for problematic pornography use and body image concerns during therapy.

The role of self-compassion and relation satisfaction in the association between child sexual abuse and sexual functioning

BACKGROUND

The current study is based on the established association between child sexual abuse (CSA) and self-compassion, and CSA and sexual functioning, with an overall goal to better understand how self-compassion explains the association between CSA and sexual functioning.

AIM

The current study examined the role of self-compassion as a potential mediator, and relationship satisfaction as a potential moderator, in the association between CSA and sexual functioning among a nonclinical sample of men and women.

METHODS

Participants completed an online survey assessing CSA, self-compassion, sexual functioning, and relationship satisfaction. The sample consisted of 914 individuals, of whom 582 reported currently being in a romantic relationship and were included in the current analysis. The majority of the sample was female (n = 534, 91.8%), with a mean age of 31.85 years (SD, 9.76).

OUTCOMES

Self-compassion mediated the link between CSA and sexual dysfunction, and relationship satisfaction moderated this same link.

RESULTS

Results indicate that self-compassion mediated the association between CSA and sexual functioning. In addition, there was a significant 2-way interaction between CSA and intimate relationship satisfaction predicting sexual functioning. Specifically, CSA was negatively associated with sexual functioning only when there were low levels of relationship satisfaction, whereas in the presence of average and high intimate relationship satisfaction, the association between CSA and sexual functioning was nonsignificant.

CLINICAL IMPLICATIONS

Findings from the current study suggest that clinicians working with CSA survivors should take into account survivors' self-compassion and relational functioning when engaging in therapeutic work around their sexual dysfunction.

STRENGTHS AND LIMITATIONS

The study included a nonclinical sample of individuals and used self-report measures, which are highly subjective and increase the possibility of social desirability biases. Additional research should be conducted among clinical samples and among couples to explore this model from a dyadic perspective.

CONCLUSION

Our results highlight the importance of self-compassion and relationship satisfaction when considering sexual dysfunction following CSA.

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.

Sex and Love Among Older Adults in the Digital World: A Scoping Review

BACKGROUND AND OBJECTIVES

The digital world offers opportunities for sex and love and also reflects societal stereotypes regarding sex and love among older adults. The aim of the current review is to look at the ways older adults use digital media for sex and love and also at digital media's representations of older adults.

RESEARCH DESIGN AND METHODS

We searched for studies published in English that used qualitative and/or quantitative methods, with findings based on empirical data from individuals 55 years of age or older. The following data sets were searched: PubMed, Web of Science, PsycINFO, Cochrane Database of Systematic Reviews, and CINAHL. Bibliographies of all relevant studies were searched. Titles and abstracts were reviewed, and selected articles were extracted independently by 2 reviewers.

RESULTS

A total of 1,819 records were retrieved. After removing duplicates, 1,488 records remained. Of these, 70 records remained for full-text screening, and a final count of 15 records was included for synthesis.

DISCUSSION AND IMPLICATIONS

The present review highlights major research gaps in the field. Although studies have indeed focused on the online dating scene among this cohort, they have ignored older adults' sexuality in favor of other aspects (e.g., love and companionship). Representations of this cohort in terms of love and sex are also lacking, and diversity is hardly addressed. Additional research is needed to examine how older adults use digital media for reasons related to love and sex, and how the media mirrors societal stereotypes regarding sex and love among older adults.

Self-Compassion Moderates the Mediating Effect of Self-Criticism in the Link Between Childhood Maltreatment and Psychopathology

Childhood maltreatment (CM) has been associated with psychological symptoms (i.e., psychopathology) among clinical and nonclinical samples. The mechanisms underlying this link have been understudied, especially among well-functioning adults. Arguably, exposure to CM may be translated into negative and critical self-appraisals and self-blame, reflected in high self-criticism. CM may also result in difficulty in extending kindness towards oneself, that is, low self-compassion. These characteristics are linked with elevated psychopathology. Nevertheless, no study has yet tested the extent to which self-criticism and self-compassion may serve as independent mechanisms linking CM and psychopathology and whether in this context self-compassion buffers the link between self-criticism and psychopathology. Here, we tested an integrative model in which the relation between CM and psychopathology was mediated by self-compassion and self-criticism, and the path between self-criticism and psychopathology was moderated by self-compassion. A convenience sample of 914 individuals completed online self-report questionnaires. Results indicated that CM was related to psychopathology through the mediation of self-compassion and self-criticism, with a significant interaction between self-criticism and self-compassion. Showing a moderated-mediational effect, the link between self-criticism and psychopathology was weaker under high than under low levels of self-compassion. Our findings highlight the importance of self-compassion, a robust resilience factor related to reduced psychopathology and moderating the link between self-criticism, a potent transdiagnostic risk factor, and psychopathology in the context of CM. These results thus provide empirical evidence for the relevance of compassion and mindfulness in counseling settings, particularly with CM survivors, who are at greater risk for psychopathology.

Discomfort in Discussing Sexual Issues: Developing a New Scale for Staff at Long-Term Care Facilities for Older Adults

Interviews reveal that many health professionals working with older adults are uncomfortable discussing sexual issues with those under their care. Nevertheless, to date, discomfort in discussing sexual issues with older adults has not been empirically investigated. To facilitate exploration of this subject, the current study evaluated the psychometric properties of a new measure: The Discomfort in Discussing Sexual Issues (DDSI) with Older Adults scale. The study was conducted via online survey among 127 long-term care staff (e.g., nurses, physicians, physical therapists, social workers, speech therapists, occupational therapists) serving older adults. A confirmatory factor analysis confirmed the DDSI scale's structure as a single, four-item construct. More conservative attitudes regarding sexuality in later life were associated with higher DDSI scores. In addition, DDSI scale scores were negatively correlated with knowledge about sexuality in later life and educational level. Findings indicate that the DDSI has good psychometric properties, as reflected by its high reliability and adequate validity, making it a useful assessment tool for future research. [Journal of Gerontological Nursing, 48(9), 27-37.].

A profile analysis of COVID-19 stress-related reactions: The importance of early childhood abuse, psychopathology, and interpersonal relationships

BACKGROUND

There is little argument that COVID-19 is potentially highly stressful for many people, however, little research has broken down COVID-19-related distress into different aspects clustering together, and how these clusters differ in terms of the vulnerability of the individuals.

OBJECTIVE

The primary aim of the present study was to identify distinct profiles of individuals' reactions to COVID-19-related stress, and analyze potential differences and risk and protective factors associated with these profiles in relation to childhood abuse, psychopathology, and interpersonal relationships.

PARTICIPANTS AND SETTING

Data was collected online among a convenience sample of 914 men and women in Israel.

METHODS

A Latent Profile Analysis (LPA) for estimating distinct profiles in people's COVID-19-related distress was applied. Next, profiles were compared in childhood abuse, psychopathology, perceived social support and relationship satisfaction.

RESULTS

Five distinct profiles were identified: The distressed (23.75%), the worried (38.96%), the financially and socially distressed (15.20%), the caregivers (13.65%), and the untroubled (8.44Profiles in which individuals had more COVID-19 related distress are characterized by more childhood abuse, psychopathology, and less social support and relationship satisfaction.

CONCLUSION

An assessment of the psychological implications of COVID-19 (when screening the population and creating prevention/intervention programs) should take into account the different responses individuals have when facing COVID-19, and their vulnerability, including their history of abuse, psychopathology, social support and relationship satisfaction, so that these programs will be better tailored to each type of distress experienced.

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.

Reasons people refrain from sex in later life

There has been an increase in research on sexual activity in later life, yet far less is known about the actual perceptions and experiences of older adults who refrain from sexual activity. In the current study, a thematic analysis was conducted to identify patterns in semi-structured interviews with 47 older adults, aged 60-91. The analysis yielded seven themes that describe why older adults refrain from sex: 1) avoiding confronting sexual dysfunctions, 2) avoiding confronting the aging body, 3) avoiding performance anxiety, 4) being uninterested in sexual activity, 5) taking time to grieve the loss of a partner, 6) avoiding judgment, and 7) seeing sexuality as evolving and changing. Themes were organized according to the bio-psycho-social perspective and based on the axis of personal (self-focused) and interpersonal (partner-focused) motives. It is perfectly acceptable for people to refrain from sexual activity for their own reasons. However, if older adults want to remain sexually active, they should receive complete information about the many possibilities of treating different sexual problems in later life and about the many ways, beyond sexual penetration, one can enjoy sexual activity even in old age.

Behavioral activation for live-in migrant home care workers and care recipients in Israel: a pilot study

In a growing global trend, individuals are migrating to other countries to live with and care for older adults with dementia. Although this trend addresses the geriatric workforce shortage, workers and older adults often experience distress. In a pilot study in Israel, six migrant care workers participated in a six-week group intervention in which they learned to increase valued, enjoyable activities for themselves and the older adult with whom they lived (behavioral activation). After the intervention, workers reported that they increased activities for themselves and the older adult and were satisfied, and quality of life and sense of achievement showed medium and large effect sizes, respectively. Participants suggested adapting the intervention to an online format for greater access. Although findings are tentative, the study points to promising strategies for migrant home care workers: focusing on the worker and older adult and offering online interventions.

Public perceptions and the willingness to get vaccinated against COVID-19: Lessons from Israel

Objectives

To explore the associations between vaccine hesitancy and demographic and socio-economic characteristics, as well as perspective towards the COVID-19 and its vaccines.

Methods

Data were collected through four online surveys on Israel's representative sample in March (3/2 to 3/7, n = 1517), August (8/10–8/11, n = 925; 8/18–8/22, n = 1054), and September (9/22-9/24; n=1406), 2021. We employ a set of logistic regression models to explore the association between the vaccination action and intentions and the individual-level attributes.

Results

We find that individual characteristics, such as age, ethnicity/religiosity, and income, were associated with the vaccination action and intention during the early stage of vaccine distribution. However, most of the discrepancies across demographic groups have disappeared as time passed, and once we limit to those who had not been infected. Lastly, individuals' perspectives toward COVID-19 and its vaccines have prediction power as high as 39% of the vaccination action and intention, higher than their demographic and socio-economic characteristics.

Implications

Our findings have the potential to facilitate efforts to increase vaccine uptake by targeting populations, which are the most likely to express hesitancy, and address reported barriers to receipt.

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.

COVID-19 Among Youth in Israel: Correlates of Decisions to Vaccinate and Reasons for Refusal

PURPOSE

The primary aim of the present study is to examine the reasons for adolescents' refusal to get vaccinated with the COVID-19 vaccine, and examine correlates of vaccination among adolescents aged 12-18 years in Israel.

METHODS

A total of 150 youth aged 12-18 years participated in the study. Following parental consent (30% response rate) from an online internet Israeli participants' pool, 150 youth completed the survey (50.5% response rate). Data were collected from May to June 2021.

RESULTS

Over half (64.0%) of youth in this study had received the COVID-19 vaccine (25.5% received one dose and 38.9% two doses). Of the youth who were not vaccinated the most common reasons cited for refusing the vaccine was not knowing enough about the harms that a vaccine has in the long run, not trusting the drug companies that the vaccine will be safe, believing the virus is not dangerous, and doubting the safety of the vaccine in the short term. Bivariate odds ratios indicate that age (older) and having both parents vaccinated was related to increase the odds of the youth getting vaccinated. Higher distress over the effects of the vaccine was significantly related to lower odds of receiving the vaccine. Social media use was also related to a higher likelihood of being vaccinated at the bivariate level.

DISCUSSION

Study findings provide specific ways in which peer-designed and peer-led public health programs may encourage youth to receive the COVID-19 vaccine in a manner that recognizes concerns of Israeli youth.

Eating Disorders and Sexual Satisfaction: The Mediating Role of Body Image Self-consciousness during Physical Intimacy and Dissociation

Women with eating disorders experience difficulties related to sexual activity, yet little is known about the indirect association between eating disorders and sexual satisfaction. This study examined the indirect association between eating disorders and sexual satisfaction using body image self-consciousness during physical intimacy and dissociation as mediators. Online questionnaires were answered by 985 Israeli women. Of them, 98 were identified as likely to have eating disorders (study group). A matching control group (n = 98) was selected from the remaining respondents. Participants in the study group had significantly higher body image self-consciousness and dissociation than the matched controls, as well as significantly lower sexual satisfaction. The research model revealed that body image self-consciousness during physical intimacy mediates the link between eating disorders and sexual satisfaction, while dissociation does not. Women with eating disorders have higher levels of self-consciousness about their body during sexual activity, which may distract them from their own sexual needs and desires and those of their partners, and this, in turn, is associated with sexual dissatisfaction. Findings highlight the need for improved evidenced-based assessment and management of the sexual satisfaction of women with eating disorders.Abbreviations: ED: eating disorders; AN: anorexia nervosa; BN: bulimia nervosa; BED: binge eating disorder.

Practices and Policies Around Wellness: Insights From the Internet Crimes Against Children Task Force Network

This article aims to understand what practices and training Internet Crimes Against Children (ICAC) Task Forces and affiliated agencies are currently using to help mitigate distress and promote wellbeing among investigators of child sexual abuse material (CSAM). Data were collected via telephone interviews with Commanders of 54 ICAC Task Forces as well as an online survey of 155 investigators at ICAC-affiliated agencies. Sixty-two percent of respondents said their agency had an Officer Wellness Program. Findings highlighted considerable gaps in protective practices with 46.1% of respondents mentioning the need for more wellness resources in their agency for personnel who have viewed CSAM as a high priority. Stigma created by help-seeking was the most widely acknowledged barrier discussed in relation to police wellness. A large and salient problem was the persistent lack of wellness practices in the affiliated agencies in comparison to the Task Forces themselves. Exposure to CSAM can be a source of stress for personnel and the results indicate concern about the problem and a diffusion of proactive initiatives, but barriers and inconsistent adoption remain.

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.

Children under fire: The role of maternal caregiving, reflection functioning, and posttraumatic stress disorder

OBJECTIVE

The study seeks to examine the psychological maladjustment of children who are exposed to continuous terror attacks. It is hypothesized that maternal posttraumatic stress disorder (PTSD) may hinder mothers' sensitive and responsive caregiving, reflective functioning, and viewing of her child (as "difficult"), which can subsequently negatively impact their children's psychological adjustment.

METHOD

A cohort of 235 mother-child dyads participated in the study. The children's (aged 7-11; 43% boys) psychological maladjustment was assessed by the PAQ. The mothers completed the DSM-5 checklist for PTSD, Caregiving System Functioning scale, Rumination-Reflection Questionnaire, and Difficult Child scale.

RESULTS

High levels of maternal PTSD, high scores of avoidant caregiving, and low reflective functioning of the mother predicted the child's psychological maladjustment. Maternal levels of PTSD moderated the associations between maternal avoidant caregiving and reflection, and child's maladjustment, whereas perceiving the child as difficult moderated the association between maternal reflection and child maladjustment.

CONCLUSION

The findings suggest that, to enhance the psychological adjustment of children confronted with stressful life situations, their mothers must be able to process their traumatizing experiences, or else they may struggle to provide their children with emotional regulation and support. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood Sexual Abuse and Sexual Motivations - The Role of Dissociation

The present study sought to examine the relations between a history of childhood sexual abuse (CSA) and sexual motivations and to explore the moderating role of dissociation within these relations. The study was conducted among 889 men and women (ages 18-70). Results indicated a history of CSA was significantly related to higher scores on self-affirmation, coping, partner approval and peer pressure sexual motivations. Interactions between CSA and gender in explaining sexual motivations, were not significant. Among participants with a history of CSA (n = 365), dissociation was significantly related to sexual motivations, so that participants who had dissociation scores above the cutoff (reporting high levels of dissociation) scored higher on intimacy, self-affirmation, coping, and partner approval than did those with a history of CSA who reported low levels of dissociation. Analyzes revealed significant moderating effects for dissociation within the relations between CSA and intimacy, coping, and partner approval sexual motivations. The present study suggests CSA survivors and those who report high levels of dissociation in particular, utilize sex for intimacy, for coping with negative emotions, and for partner approval. Therapists working with CSA survivors should be aware of the potential effects the abuse has on the survivor's reasons to engage in sex.

#Me2PT: A qualitative analysis of a social media network campaign to raise awareness of the consequences of childhood sexual abuse

BACKGROUND

Childhood sexual abuse (CSA) is a highly prevalent and serious stressor, linked to short- and long-term psychopathology and to posttraumatic stress disorder (PTSD) specifically. The hashtag #Me2PT, which stands for "me-too-post-trauma," was created in order to raise awareness of the longitudinal consequences of sexual abuse, as specifically manifested in symptoms of PTSD or complex PTSD. It was disseminated on social media networks during 2019 and offered a platform for CSA survivors to share their own personal experience of living with CSA-related posttraumatic symptoms.

OBJECTIVE

The current study was designed in order to examine the way survivors conveyed their experiences and perceptions with response to the invitation of the hashtag #Me2PT. All the posts were written in the Hebrew-language, and thematic analysis was carried on all the written narratives.

PARTICIPANTS AND SETTING

40 Posts that were written in the Hebrew language under the hashtag campaign of #Me2PT.

METHODS

Thematic analysis was carried on the 40 posts by two of the authors. Shenton four criterions for qualitative study trustworthiness were employed with peer discussion on main results were discussed with the leaders of the campaign, survivors of CSA.

RESULTS

The authors identified four main themes within the written narratives of the survivors: (1) why am I writing, (2) my personal PTSD, (3) between life and death, and (4) post-trauma as 'a bleeding wound'.

CONCLUSIONS

These findings exemplify the constant mental pain and struggle that survivors deal with, but at the same time demonstrate the importance of hope, the comfort found in being understood, and the wish to live a meaningful life despite the pain. This paper may contribute to the understanding of survivors' experiences of living with CSA-related posttraumatic symptoms, as conveyed by them spontaneously and authentically, potentially informing best practice for professionals working with this population.

Communicating with older adults about sexual issues: How are these issues handled by physicians with and without training in human sexuality?

Although sexuality is an important part of health and emotional well-being throughout the entire life cycle, including during old age, little is known about how physicians discuss or approach the topic of sexuality during later life. The present study examined the perspectives of two groups of physicians toward discussing sexuality with older patients: 17 physicians who did not have any training in human sexuality and 21 physicians who were certified as sex therapists. The interviews underwent thematic content analysis to identify and code major themes and patterns. Qualitative analysis of the interviews yielded three main themes: (a) discourse between physicians and older adults regarding sexuality, (b) diagnosing sexual dysfunction among older adults, and (c) treating sexual dysfunction among older adults. Physicians who were not trained in sex therapy did not regularly ask their older patients about sexual functioning and/or problems with sex, tended to diagnose sexual problems from a medical perspective, and offered medication as the main treatment for sexual problems. Physicians trained as sex therapists felt more comfortable discussing sex-related issues with their older patients and diagnosed sexual problems from a medical, social, dyadic and psychological perspective. Although they offered their older patients a greater variety of medication-oriented interventions than those without training in sexuality, they did not rush into such interventions and instead emphasised the importance of the psychological and relational aspects of sex. The present study highlights the importance of human sexuality training for physicians and points out the effects of such training on the discourse, diagnosis and treatment of sexual concerns in later life.

Profiles of Sexual Disorders and Eating Disorder Symptoms: Associations With Body Image

BACKGROUND

Although the empirical evidence supporting the co-occurrence of sexual disorders and eating disorders is growing, it is not yet known how often these 2 conditions co-occur, and whether the comorbidities of sexual disorders and eating disorders differ in any specific ways.

AIM

To examine the co-occurrence of sexual disorders and eating disorders.

METHODS

In the current study, we used latent profile analysis to identify distinct profiles of sexual disorders and eating disorder symptoms among a large non-clinical sample of women (n = 985). We also examined how these profiles differed in terms of body image self-consciousness. The study was conducted as an online survey among a convenience sample of Israeli women.

MAIN OUTCOME MEASURES

For sexual disorders we used the Arizona Sexual Experience Scale, and for eating disorders we used the Eating Disorders Inventory 2.

RESULTS

Latent profile analysis revealed 4 profiles: no disorder (low levels of sexual disorders and eating disorder symptoms), eating disorder symptoms (low levels of sexual disorders and high levels of eating disorder symptoms), sexual disorders (high levels of sexual disorders and low levels of eating disorder symptoms), and comorbidity (high levels of both sexual disorders and eating disorder symptoms). Women in the comorbidity group had significantly more body image self-consciousness during sexual activity than did women in the other groups.

CONCLUSION

The 4 profiles identified in the study support the co-occurrence of sexual disorders and eating disorder symptoms, yet also raise many clinical considerations. Limitations of the study, directions for future research, and clinical implications are discussed. Gewirtz-Meydan A, Spivak-Lavi Z. Profiles of Sexual Disorders and Eating Disorder Symptoms: Associations With Body Image. J Sex Med 2021;18:1364-1373.

Men Who Pay for Sex Once, More than Once, or Not at All: The Associations between Attitudes toward Paying for Sex, Socio-Demographic Characteristics, and Frequency of Sex Payment

In an attempt to characterize men who pay women for sex (MPWS), theory and research generally divides men into two groups: men who pay for sex and those who never paid for sex. However, this dichotomy may lack sufficient detail to understand sex payment accurately, and with regard to attitudes toward paying for sex and frequency of sex payment. The present study set out to explore the associations between views toward MPWS; socio-demographic characteristics and frequency of paying for sex. A sample of 632 Israeli men, ages 18-75, were recruited via Facebook ads. Participants completed an anonymous, online questionnaire on their attitudes toward MPWS. Men who paid for sex once were more similar in their attitudes to men who did not pay for sex than to those who paid more than once. In addition, favorable views on MPWS predicted paying for sex only among men who paid for sex more than once, but not among men who paid for sex once. These findings may require new programmatic attention in public policy considerations and therapeutic strategies, taking into consideration both attitudes of men who pay for sex toward, and frequency of, this behavior.

Attachment and Sexual Functioning: Understanding the Mediating Role of Body Image Among LGB and Non-LGB Women

INTRODUCTION

Despite studies showing that individuals with insecure attachment suffer from poor body image, and that poor body image is a main risk factor for sexual dysfunction, the mediating role of body image between attachment insecurities and sexual functioning has not been assessed. Moreover, differences in body self-consciousness among sexual minority women have not been examined, even though LGB individuals have been found to be more conscious of stigma and the disapproval of others.

AIM

To fill this gap, the current study examines the mediating role of body image self-consciousness between insecure attachment and sexual functioning among LGB and non-LGB women.

METHODS

The study sample consisted of 1,001 women; of them, 808 defined themselves as heterosexual (80.7%), and 193 (19.3%) identified as LGB. The sample was a convenience sample of women who responded to ads on social media. Participants completed an online questionnaire (via Qualtrics) about their attachment orientation, body-image self-consciousness, and sexual functioning.

MAIN OUTCOME

Body image self-consciousness mediated the relationship between insecure attachment and sexual dysfunction among women in general and LGB women in particular.

RESULTS

Results indicated that among LGB women, the relationship between attachment and sexual functioning was fully mediated by body image self-consciousness. For non-LGB women, a full model with statistically significant direct and indirect effects was revealed. Both avoidant attachment and anxious attachment were related to body image self-consciousness which was, in turn, related to sexual functioning. A statistically significant direct path from avoidant attachment to sexual functioning was also revealed.

CONCLUSION

The study findings contribute to the literature by revealing the mediating role that body image self-consciousness plays between insecure attachment and sexual dysfunction among women in general and LGB women in particular.

CLINICAL IMPLICATIONS

This study provides support for the negative relationship between body image self-consciousness and sexual functioning of women regardless of sexual orientation, and suggests that women affected by body image concerns might be prone to more sexual dysfunction. Therefore, body image self-consciousness should be brought up in sex therapy sessions and future interventions. Clinicians should also be cognizant of differences between LGB and non-LGB women in terms of this effect, taking into account the history of stigma that LGB women may have endured and how this history affects their body image. Gewirtz-Meydan A, Mitchell KJ, Spivak-Lavi Z. Attachment and Sexual Functioning: Understanding the Mediating Role of Body Image Among LGB and Non-LGB Women. J Sex Med 2021;18:1245-1257.