Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University, Frankfurt Main, Germany.
Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University, Frankfurt Main, Germany.
J Sex Med. 2018 Apr;15(4):529-538. doi: 10.1016/j.jsxm.2018.02.016. Epub 2018 Mar 14.
Impairments in sexual functioning and sexual satisfaction are very common in women who have experienced childhood sexual abuse (CSA). A growing body of literature suggests a high prevalence of sexual distress in patients with post-traumatic stress disorder (PTSD). However, the influence of sexual trauma exposure per se and the influence of PTSD symptoms on impairments in sexual functioning remain unclear.
The aim of this study was to investigate the influence of sexual trauma exposure and PTSD on sexual functioning and sexual satisfaction by comparing 3 groups of women.
Women with PTSD after CSA (N = 32), women with a history of CSA and/or physical abuse but without PTSD (trauma controls [TC]; N = 32), and healthy women (N = 32) were compared with regards to self-reported sexual functioning and sexual satisfaction. Trauma exposure was assessed with the Childhood Trauma Questionnaire, and PTSD was assessed with the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Sexual functioning was assessed with the Sexual Experience and Behavior Questionnaire, and sexual satisfaction was assessed with the questionnaire Resources in Sexuality and Relationship.
PTSD patients had significantly lower sexual functioning in some aspects of sexual experience (sexual aversion, sexual pain, and sexual satisfaction) but did not significantly differ in sexual arousal and orgasm from the other 2 groups. TC and healthy women did not significantly differ from each other on the measures of sexual functioning or sexual satisfaction.
Results suggest that the development of PTSD has a greater impact on sexual functioning than does the experience of a traumatic event. This emphasizes the importance to address possible sexual distress and sexual satisfaction in women with PTSD by administering specific diagnostic instruments and by integrating specific interventions targeting sexual problems into a trauma-specific treatment.
The study is the first comparing PTSD patients and TC with healthy women with regards to sexual functioning. Limitations are selection and size of the samples, the assessment of sexual functioning by self-report measures only, and lack of consideration of other potentially relevant factors influencing sexuality. The findings suggest that the experience of sexual abuse does not necessarily lead to sexual impairment, whereas comparably low levels of sexual functioning seem to be prominent in PTSD patients after CSA. Further research is needed on how to improve treatment for this patient group. Bornefeld-Ettmann P, Steil R, Lieberz KA, et al. Sexual Functioning After Childhood Abuse: The Influence of Post-Traumatic Stress Disorder and Trauma Exposure. J Sex Med 2018;15:529-538.
经历过儿童期性虐待（CSA）的女性中，性功能和性满意度受损非常常见。越来越多的文献表明，创伤后应激障碍（PTSD）患者中存在较高的性困扰发生率。然而，性创伤暴露本身以及 PTSD 症状对性功能障碍的影响仍不清楚。
本研究旨在通过比较 3 组女性，调查性创伤暴露和 PTSD 对性功能和性满意度的影响。
比较了 32 名经历过 CSA 后患有 PTSD 的女性（CSA PTSD 组）、32 名有 CSA 和/或身体虐待但无 PTSD 的女性（创伤对照组[TC]）和 32 名健康女性，评估其性报告性功能和性满意度。创伤暴露用儿童期创伤问卷评估，PTSD 用精神障碍诊断与统计手册第五版的临床医生管理 PTSD 量表评估。
性功能用性体验和行为问卷评估，性满意度用性资源和关系问卷评估。
PTSD 患者在某些性体验方面（性厌恶、性疼痛和性满意度）的性功能明显较低，但在性唤起和性高潮方面与其他 2 组无显著差异。TC 和健康女性在性功能或性满意度方面无显著差异。
结果表明，PTSD 的发展对性功能的影响大于创伤事件的经历。这强调了在 PTSD 女性中通过使用特定的诊断工具和将针对性问题的特定干预措施纳入特定的创伤治疗中，来解决可能的性困扰和性满意度的重要性。
本研究是首次比较 PTSD 患者和 TC 与健康女性的性功能。限制因素包括样本的选择和大小、仅通过自我报告措施评估性功能，以及缺乏考虑其他可能影响性的相关因素。研究结果表明，性虐待的经历不一定导致性功能障碍，而 CSA 后 PTSD 患者的性功能障碍似乎相对较低。需要进一步研究如何改善该患者群体的治疗。
