Sexual functioning in women reporting a history of child sexual abuse: review of the empirical literature and clinical implications.

Researchers have frequently linked childhood sexual abuse (CSA) with some form of adult sexual disturbance. Unfortunately, research on how to treat sexual dysfunctions in women with a history of childhood sexual abuse has lagged behind. In this article, we review the literature concerning childhood sexual abuse and sexual dysfunction. In addition, we look at two theories that help explain the relationship between CSA and sexual dysfunction. Both of these theories highlight the importance of emotional experience. The contextual behavioral model described by Polusny and Follette (1995) is derived from the work of Hayes and colleagues (Hayes, Strosahl, & Wilson, 1999) and focuses on the role of experiential avoidance in understanding the problems experienced by CSA survivors. Greenberg and colleagues' emotion theory (Greenberg & Pavio, 1998; Greenberg, Rice, & Elliott, 1993; Greenberg & Savin, 1987) is useful in highlighting the way in which early abuse experiences can impair emotional development and result in maladaptive emotional schemes contributing to sexual problems. Treatments for CSA survivors' sexual problems based on the two above theories are outlined. The question concerning the applicability of traditional sex therapy for CSA survivors versus a modified treatment is discussed and recent developments in the field of sexual functioning as well as future directions for the field are also highlighted.