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Villeneuve É, Paradis A, Brassard A, Vaillancourt-Morel MP, Fernet M, Gewirtz-Meydan A, Godbout N. Dissociation and Sexual Concerns in Male Survivors of Childhood Sexual Abuse: The Role of Identity Cohesion. J Trauma Dissociation 2024; 25:500-515. [PMID: 38766998 DOI: 10.1080/15299732.2024.2356597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/09/2024] [Indexed: 05/22/2024]
Abstract
Research on male survivors of childhood sexual abuse is notably deficient when it comes to addressing their sexual concerns, such as experiences of sexual distress, negative thoughts, and feelings related to their sexuality. Dissociation, a known consequence of childhood sexual abuse, could be associated with higher sexual concerns through identity cohesion. Precisely, dissociation can potentially be related to lower identity cohesion (e.g., not knowing what you want or need). In return, lower identity cohesion may be related to higher sexual concerns by impeding the capacity to know and accept oneself, which tends to promote a positive and healthy sexuality. This study aimed to examine the role of identity cohesion in the link between dissociation and sexual concerns in 105 men consulting for their history of childhood sexual abuse. Men completed questionnaires assessing dissociation, sexual concerns, and identity cohesion at admission in a community setting. Results of a path analysis revealed an indirect association between dissociation and higher sexual concerns through lower identity cohesion. The model explained 27.6% of the variance in sexual concerns. This study highlights the relevance of interventions targeting dissociative symptoms to improve identity cohesion and sexual health in male survivors of childhood sexual abuse.
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Affiliation(s)
- Élise Villeneuve
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Alison Paradis
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Mylène Fernet
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Natacha Godbout
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
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Jones HR, Lorenz TK. Higher sexual excitation is associated with an increase in sex-linked substance use in women with a history of unwanted sexual contact. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022; 31:432-442. [PMID: 37274840 PMCID: PMC10237101 DOI: 10.3138/cjhs.2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex histories primarily engage in SLSU to increase sexual excitation or decrease inhibitions. We conducted exploratory analyses of an online survey in a convenience sample of 516 undergraduate women including data on their history of unwanted sex, SLSU, and sexual excitation/inhibition. Sexual excitation mediated the association between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sexual histories reported higher levels of sexual excitation, which in turn was associated with a higher likelihood of using substances to increase pleasure during sexual activity. Specifically, arousability, partner characteristics, and power dynamics subfactors were significant mediators. Sexual inhibition did not mediate the relationship between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sex histories may have been less likely to use substances to reduce sexual inhibitions. If replicated, these findings suggest that sexual excitation may be a useful target of intervention surrounding SLSU, particularly in women with histories of unwanted sexual contact. Specifically, treatments targeting cognitive and affective tendencies associated with sexual excitation may help women who engage in SLSU to have safe, pleasurable sexual activity, without increasing the risk of intoxication-related harms.
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Affiliation(s)
- Harper R. Jones
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
- Center for Brain Biology and Behavior, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
| | - Tierney K. Lorenz
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
- Center for Brain Biology and Behavior, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
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Spivak-Lavi Z, Gewirtz-Meydan A. Eating Disorders and Sexual Satisfaction: The Mediating Role of Body Image Self-consciousness during Physical Intimacy and Dissociation. JOURNAL OF SEX RESEARCH 2022; 59:344-353. [PMID: 34269636 DOI: 10.1080/00224499.2021.1948491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Women with eating disorders experience difficulties related to sexual activity, yet little is known about the indirect association between eating disorders and sexual satisfaction. This study examined the indirect association between eating disorders and sexual satisfaction using body image self-consciousness during physical intimacy and dissociation as mediators. Online questionnaires were answered by 985 Israeli women. Of them, 98 were identified as likely to have eating disorders (study group). A matching control group (n = 98) was selected from the remaining respondents. Participants in the study group had significantly higher body image self-consciousness and dissociation than the matched controls, as well as significantly lower sexual satisfaction. The research model revealed that body image self-consciousness during physical intimacy mediates the link between eating disorders and sexual satisfaction, while dissociation does not. Women with eating disorders have higher levels of self-consciousness about their body during sexual activity, which may distract them from their own sexual needs and desires and those of their partners, and this, in turn, is associated with sexual dissatisfaction. Findings highlight the need for improved evidenced-based assessment and management of the sexual satisfaction of women with eating disorders.Abbreviations: ED: eating disorders; AN: anorexia nervosa; BN: bulimia nervosa; BED: binge eating disorder.
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Affiliation(s)
- Zohar Spivak-Lavi
- Faculty of Social Work & Faculty of Education, Max Stern Yezreel Valley College
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Rojas-Jara C, Polanco-Carrasco R, Caycho-Rodríguez T, Acuña-Espinoza R, González-Serrano C, Roa-Méndez P, Rojas-Román A, Sepúlveda-López MA. Experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez: un análisis de la evidencia. UNIVERSITAS PSYCHOLOGICA 2021. [DOI: 10.11144/javeriana.upsy20.eaiu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
El objetivo de este estudio es la revisión de la evidencia actual sobre la relación entre la vivencia de experiencias adversas en la infancia y el posterior uso de drogas en la adolescencia y adultez, y sus características. La metodología utilizada fue una revisión sistemática de publicaciones científicas, entre el periodo 2013-2017, disponibles en la base de datos Scopus sobre experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez que arrojó un total de 69 publicaciones incluidas en el estudio. Las experiencias adversas en la infancia presentan una elevada relación con el uso y/o abuso de drogas en la adolescencia y adultez. El consumo de drogas en adolescentes y adultos expuestos a experiencias traumáticas en la infancia se da principalmente en hombres. Las drogas mayormente usadas son alcohol, tabaco, cannabis y fármacos no recetados y, en menor medida, opioides, cocaína y anfetaminas. Las drogas, en este sentido, cumplen el rol de barrera química para distanciar el dolor emocional que deriva del recuerdo de las experiencias traumáticas y su intensa carga psíquica. Se requieren acciones de promoción del buen trato en la infancia, así como el abordaje terapéutico temprano de niños expuestos a experiencias traumáticas.
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Gewirtz-Meydan A, Lahav Y. Childhood Sexual Abuse and Sexual Motivations - The Role of Dissociation. JOURNAL OF SEX RESEARCH 2021; 58:1151-1160. [PMID: 32897738 DOI: 10.1080/00224499.2020.1808564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study sought to examine the relations between a history of childhood sexual abuse (CSA) and sexual motivations and to explore the moderating role of dissociation within these relations. The study was conducted among 889 men and women (ages 18-70). Results indicated a history of CSA was significantly related to higher scores on self-affirmation, coping, partner approval and peer pressure sexual motivations. Interactions between CSA and gender in explaining sexual motivations, were not significant. Among participants with a history of CSA (n = 365), dissociation was significantly related to sexual motivations, so that participants who had dissociation scores above the cutoff (reporting high levels of dissociation) scored higher on intimacy, self-affirmation, coping, and partner approval than did those with a history of CSA who reported low levels of dissociation. Analyzes revealed significant moderating effects for dissociation within the relations between CSA and intimacy, coping, and partner approval sexual motivations. The present study suggests CSA survivors and those who report high levels of dissociation in particular, utilize sex for intimacy, for coping with negative emotions, and for partner approval. Therapists working with CSA survivors should be aware of the potential effects the abuse has on the survivor's reasons to engage in sex.
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Affiliation(s)
| | - Yael Lahav
- Department of Occupational Therapy, the Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University
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Fuentes-Pumarola C, Reyes-Amargant Z, Berenguer-Simon A, Ballester-Ferrando D, Burjalés-Martí MD, Rigol-Cuadra A, Maestre-González E, Rascón-Hernán C, Galbany-Estragués P, Rodríguez-Martín D. Alcohol Use and Sexual Violence among Nursing Students in Catalonia, Spain: A Multicentre Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116036. [PMID: 34199702 PMCID: PMC8200010 DOI: 10.3390/ijerph18116036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 12/02/2022]
Abstract
(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related (p < 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770; CI 95%: 1.229–6.242; p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839; 95% CI: 1.551–5.197; p = 0.001) and individuals pressured to consume alcohol (OR: 2.091; 95% CI: 1.332–3.281; p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people.
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Affiliation(s)
- Concepció Fuentes-Pumarola
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain; (C.F.-P.); (A.B.-S.); (C.R.-H.)
| | | | - Alba Berenguer-Simon
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain; (C.F.-P.); (A.B.-S.); (C.R.-H.)
| | - David Ballester-Ferrando
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain; (C.F.-P.); (A.B.-S.); (C.R.-H.)
- Correspondence: ; Tel.: +34-972-418771
| | - Maria Dolors Burjalés-Martí
- Nursing Department, Faculty of Nursing, Rovira and Virgili University, Avinguda Catalunya, 35, 43002 Tarragona, Spain;
| | - Assumpta Rigol-Cuadra
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine, University of Barcelona, Feixa Llarga, s/n, 08907 L’Hospitalet del Llobregat, Spain; (A.R.-C.); (D.R.-M.)
| | - Elena Maestre-González
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group on Gender, Identity and Diversity (2017-SGR-1091), University of Barcelona, 08036 Barcelona, Spain;
| | - Carolina Rascón-Hernán
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain; (C.F.-P.); (A.B.-S.); (C.R.-H.)
| | - Paola Galbany-Estragués
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500 Vic, Spain;
| | - Dolors Rodríguez-Martín
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine, University of Barcelona, Feixa Llarga, s/n, 08907 L’Hospitalet del Llobregat, Spain; (A.R.-C.); (D.R.-M.)
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Cavanaugh C, Kapij A. A Brief Report on the Association between Dissociation During Sex and Condom Use Self-Efficacy Among Women Residing in Domestic Violence Shelters. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2020; 32:171-176. [PMID: 32788947 PMCID: PMC7416723 DOI: 10.1080/19317611.2020.1749209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Female survivors of intimate partner violence have greater risk for contracting HIV/STI's and experiencing dissociation. However, no studies have examined the association between dissociation and condom use self-efficacy in this population. This study explored whether dissociation during sex was negatively associated with condom use self-efficacy. METHODS Thirty-five women (88% African American) who were residing in domestic violence shelters in the United States completed questionnaires. RESULTS There was a negative correlation between dissociative experiences during sex and condom use self-efficacy, r = -.62, n=35, p< .01. CONCLUSIONS Findings suggest that dissociation during sex interferes with abused women's condom use self-efficacy.
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George WH. Alcohol and Sexual Health Behavior: "What We Know and How We Know It". JOURNAL OF SEX RESEARCH 2019; 56:409-424. [PMID: 30958036 DOI: 10.1080/00224499.2019.1588213] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women's sexual victimization history and men's condom use resistance. Limitations and implications associated with this body of research are also discussed.
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