Postma Riemke, Bicanic Iva, van der Vaart Huub, Laan Ellen
National Psychotrauma Centre for Children and Youth, University Medical Centre, Utrecht, The Netherlands.
J Sex Med. 2013 Aug;10(8):1978-87. doi: 10.1111/jsm.12196. Epub 2013 May 16.
Prior studies have addressed sexual abuse and sexual function in adult women. No studies have focused on the effect of adolescence rape on sexual functioning.
To investigate the effect of rape on sexual problems and on pelvic floor problems, as well as the mediating role of pelvic floor problems on sexual problems, in a homogenous group of victims of adolescence rape without a history of childhood sexual, physical, and/or emotional abuse.
Sexual functioning and pelvic floor functioning were assessed using self-report questionnaires.
In this cross-sectional study, a group of 89 young women aged 18-25 years who were victimized by rape in adolescence was compared with a group of 114 nonvictimized controls. The rape victims were treated for posttraumatic stress disorder (PTSD) 3 years prior to participation in the study.
Three years posttreatment, rape victims were 2.4 times more likely to have a sexual dysfunction (lubrication problems and pain) and 2.7 times more likely to have pelvic floor dysfunction (symptoms of provoked vulvodynia, general stress, lower urinary tract, and irritable bowel syndrome) than nonvictimized controls. The relationship between rape and sexual problems was partially mediated by the presence of pelvic floor problems. Rape victims and controls did not differ with regard to sexual activities.
Rape victims suffer significantly more from sexual dysfunction and pelvic floor dysfunction when compared with nontraumatized controls, despite the provision of treatment for PTSD. Possibly, physical manifestations of PTSD have been left unaddressed in treatment. Future treatment protocols should consider incorporating (physical or psychological) treatment strategies for sexual dysfunction and/or pelvic floor dysfunction into trauma exposure treatments.
先前的研究探讨了成年女性的性虐待与性功能问题。但尚无研究聚焦于青春期强奸对性功能的影响。
在一组无童年性、身体和/或情感虐待史的青春期强奸受害者同质群体中，调查强奸对性问题和盆底问题的影响，以及盆底问题在性问题中的中介作用。
使用自我报告问卷评估性功能和盆底功能。
在这项横断面研究中，将一组89名年龄在18 - 25岁、青春期遭受强奸的年轻女性与一组114名未受侵害的对照者进行比较。强奸受害者在参与本研究前3年接受过创伤后应激障碍（PTSD）治疗。
治疗3年后，强奸受害者出现性功能障碍（润滑问题和疼痛）的可能性是非受害对照者的2.4倍，出现盆底功能障碍（激发性外阴痛、一般应激、下尿路和肠易激综合征症状）的可能性是非受害对照者的2.7倍。强奸与性问题之间的关系部分由盆底问题介导。强奸受害者和对照者在性活动方面没有差异。
与未受创伤的对照者相比，尽管接受了PTSD治疗，但强奸受害者仍明显更多地遭受性功能障碍和盆底功能障碍。可能在治疗中未解决PTSD的身体表现问题。未来的治疗方案应考虑将（身体或心理）性功能障碍和/或盆底功能障碍的治疗策略纳入创伤暴露治疗中。
