San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California; San Diego VA Healthcare System, San Diego, California.
Center of Excellence for Stress and Mental Health, San Diego VA Healthcare System, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California.
Womens Health Issues. 2019 Jan-Feb;29(1):72-79. doi: 10.1016/j.whi.2018.10.003. Epub 2018 Nov 16.
Posttraumatic stress disorder (PTSD) and sexual dysfunction commonly co-occur. Although sexual dysfunction is more prevalent among women and the negative impact of sexual dysfunction on quality of life is stronger in women compared with men, few studies examine the impact of evidence-based PTSD treatments on sexual functioning outcomes in women with PTSD. The current study examined the relationship between PTSD and sexual functioning among women trauma survivors to examine if sexual functioning improves after cognitive processing therapy (CPT).
A total of 126 civilian and veteran women were randomly assigned to receive CPT delivered via either office-based videoconferencing or traditional office-based care. PTSD outcomes were examined from before treatment to after treatment and sexual functioning outcomes were examined from before treatment to the 3-month follow-up. Multigroup structural equation modeling was used to compare changes in sexual functioning and PTSD scores over time. We also compared how sexual functioning changed after treatment among women who identified a sexual trauma as their index trauma compared with those with nonsexual index traumas.
Greater baseline PTSD symptoms predicted poorer sexual satisfaction at baseline. Sexual satisfaction, arousal, and desire improved after CPT; veteran status and index trauma type (i.e., sexual vs. nonsexual) did not attenuate this relationship. Women who had greater decreases in PTSD symptoms experienced greater improvements in sexual satisfaction, arousal, and desire.
The current study provides preliminary support that CPT treatment may improve sexual functioning in women trauma survivors. Clinicians should assess sexual functioning to promote disclosure and develop a treatment plan.
创伤后应激障碍（PTSD）和性功能障碍通常同时发生。尽管性功能障碍在女性中更为普遍，且性功能障碍对女性生活质量的负面影响强于男性，但很少有研究探讨基于证据的 PTSD 治疗对 PTSD 女性性功能结果的影响。本研究检查了创伤后应激障碍女性幸存者的 PTSD 与性功能之间的关系，以检验认知处理疗法（CPT）后是否会改善性功能。
共有 126 名平民和退伍军人女性被随机分配接受通过办公室视频会议或传统办公室方式提供的 CPT。从治疗前到治疗后检查 PTSD 结果，从治疗前到 3 个月随访检查性功能结果。多组结构方程模型用于比较随时间推移性功能和 PTSD 评分的变化。我们还比较了在治疗后，将性创伤作为索引创伤的女性与非性索引创伤的女性相比，性功能变化如何。
基线 PTSD 症状越严重，基线时的性满意度越低。CPT 后性满意度、唤起和欲望改善；退伍军人身份和索引创伤类型（即性创伤与非性创伤）并未减弱这种关系。PTSD 症状减轻程度越大的女性，性满意度、唤起和欲望的改善程度越大。
本研究初步支持 CPT 治疗可能改善创伤后应激障碍女性幸存者的性功能。临床医生应评估性功能以促进披露并制定治疗计划。
