Interaction effects of emotional status and sexual abuse on adult sexuality

Prenatal care in adult women exposed to childhood sexual abuse

AIMS

Several case reports show a negative impact of childhood sexual abuse (CSA) on prenatal care. The study aimed to systematically investigate this association in a larger study group.

METHODS

CSA was investigated by face-to-face interviews and by a modified questionnaire developed by Wyatt. All study participants completed a self-administered questionnaire designed to investigate the consequences of CSA on prenatal care during adulthood. Data from 85 women after CSA were compared to those of 170 matched women without such experiences.

RESULTS

Women exposed to CSA had fewer than five prenatal consultations more often than unexposed women (26%/7%; P<0.0001). Of the 85 women with a positive history for CSA, 9.4% had been asked for such antecedents, 36.5% had intense memories on original abuse situations during pregnancy, 56.6% mentioned specific consequences of CSA on prenatal care and 61.2% were satisfied with obstetrical support. Exposed women (62.4%) felt significantly less prepared for labor than unexposed women (75.9%) (P<0.0001).

CONCLUSIONS

CSA experiences are associated with impaired prenatal care. These results underscore the compelling need to improve prenatal care in women exposed to CSA through better education of obstetricians regarding the effects of CSA and in their ability to provide empathetic professional support.

Drinking motives for self and others predict alcohol use and consequences among college women: the moderating effects of PTSD

Although drinking motives have been shown to influence drinking behavior among women with trauma histories and PTSD, no known research has examined the influence of drinking motives on alcohol use and alcohol-related consequences for women with PTSD as compared to women with a trauma history but no PTSD and women with no trauma history. Therefore, the present study sought to examine the associations between drinking motives women held for themselves as well as their perception of the drinking motives of others and their own alcohol use and consequences, and whether this was moderated by a history of trauma and/or PTSD. College women (N=827) were categorized as either having no trauma exposure (n=105), trauma exposure but no PTSD (n=580), or PTSD (n=142). Results of regression analyses revealed that women with trauma exposure and PTSD consume more alcohol and are at greatest risk of experiencing alcohol-related consequences. A diagnosis of PTSD moderated the association between one's own depression and anxiety coping and conformity drinking motives and alcohol-related consequences. PTSD also moderated the association between the perception of others' depression coping motives and one's own consequences. These findings highlight the importance of providing alternative coping strategies to women with PTSD to help reduce their alcohol use and consequences, and also suggest a possible role for the perceptions regarding the reasons other women drink alcohol and one's own drinking behavior that may have important clinical implications.

A population-based study of childhood sexual contact in China: prevalence and long-term consequences

OBJECTIVES

This study provides national estimates of the prevalence of childhood sexual contact and its association with sexual well-being and psychological distress among adults in China.

METHOD

A national stratified probability sample of 1,519 women and 1,475 men aged 20-64 years in urban China completed a computer-administered survey in 1999-2000. The data from this survey on both adult-to-child and peer-to-peer sexual contact before age 14 were subjected to descriptive and multivariate analyses that were adjusted for both sampling weights and sampling design.

RESULTS

The overall prevalence of reported childhood sexual contact was 4.2%, with prevalence higher among men (5.1%) than among women (3.3%) and higher among those aged 20-29 years (8.3%). Childhood sexual contact was associated with multiplex consequences, including hyper-sexuality (high levels of masturbation, thoughts about sex, varieties of sexual practices, partner turnover), adult sexual victimization (unwanted sex, unwanted sexual acts, sexual harassment), sexual difficulties (genitor-urinary symptoms, sexually transmitted infections, sexual dysfunctions), and psychological distress. Psychological distress was largely mediated by adult sexual victimization, sexual difficulties, and hyper-sexuality.

CONCLUSIONS

Despite the relatively modest prevalence of childhood sexual contact among Chinese adults, the association with multiplex adult outcomes suggests that much as in the West early sexual contact is a significant issue.

PRACTICE IMPLICATIONS

The findings underscore the importance of public education about childhood sexual contact and abuse in China. The findings suggest a need for public health campaigns that tackle the stigma associated with being abused and encourage victims to report abusive behavior to proper sources. The findings are also consistent with new efforts to alleviate the negative long-term impact of childhood sexual abuse.

The relationship between childhood sexual abuse and adult mental health among undergraduates: victim gender doesn't matter

A large body of research has documented the harmful effects of childhood sexual abuse (CSA) on adult mental health among females, but less work has examined this issue among males. This study examined whether gender moderated the relationship between CSA and adult mental health among a mixed-gender sample of 406 undergraduates. A Pearson chi-square test indicated that a significantly greater proportion of females (41.6%) than males (30.7%) reported a history of CSA. ANCOVAs tested whether gender, CSA status, and their interaction were related to adult mental health symptomatology as measured by Brief Symptom Inventory gender-normed t scores. Participants with a history of CSA reported significantly higher levels of global mental health problems, hostility, paranoid ideation, and psychoticism. The gender by CSA status interaction was not significant for any scale, indicating that the harmful effects of CSA on adult mental health did not vary by gender.

Sexual functioning in women with chronic pelvic pain: the impact of depression, support, and abuse

Many studies have documented associations between sexual functioning, depression, experiences of childhood sexual abuse, relationship support, and chronic pelvic pain, but none have addressed the interrelationships among all of these variables in a unified model. The aim of this preliminary study was to construct an integrative model predicting sexual functioning for women with chronic pelvic pain. Sixty-three women with chronic pelvic pain completed measures of sexual functioning for use as the criterion variable, and measures of the impact of chronic pain, depression, experiences of sexual abuse, and relationship support as predictors. The primary finding was that depression mediated the effects of child sexual abuse and partially mediated the effects of relationship support on sexual behavior and satisfaction with the sexual relationship. In addition to its indirect relationship through depression, relationship support also independently predicted sexual function. Thus, in this nonclinical sample, the effects of child sexual abuse on sexual function depended on the extent of depressive symptoms, while the influence of relationship support depended in part on depression.

Psychophysiological sexual arousal in women with a history of child sexual abuse

On the basis of literature that suggests that child sexual abuse (CSA) survivors with post traumatic stress disorder (PTSD) have higher baseline sympathetic nervous system (SNS) activity than healthy controls and research that suggests that the SNS plays a critical role in female physiological sexual arousal, we examined the impact of SNS activation through intense exercise on sexual arousal in women with CSA and PTSD. We measured physiological and subjective sexual arousal in women with CSA (n = 8), women with CSA and PTSD (n = 10), and healthy controls (n = 10) during exposure to nonerotic and erotic videos. After exercise, women with CSA and women with CSA and PTSD showed no significant differences in the physiological sexual response compared with no exercise, which was different from the increased physiological sexual response after exercise observed in control women.