Sexual Concerns

Individuals who have experienced sexual assault or CSA frequently report problems with sexual functioning and sexual satisfaction (e.g., see Browne & Finkelhor, 1986; Leonard & Follette, 2002; Resick, 1993, for reviews). Many individuals experience a relationship between childhood sexual abuse and later sexual problems, which has been supported by numerous empirical studies and case reports. CSA survivors are reported to have significantly more sexual problems (Becker, Skinner, Abel, Axelrod, & Cichon, 1984; Sarwer & Durlak, 1996; Wenninger & Heiman, 1998), more negative sexual symptoms (Gold, 1986), to be less satisfied with their sexual functioning (Jackson, Calhoun, Amick, Maddever, & Habif, 1990), and to be less satisfied with their present sexual relationship (Gold, 1986) than nonabused women in the control group.

Researchers have investigated the various types of sexual problems experienced by CSA and sexual assault survivors. According to the DSM-IV, there are four types of sexual dysfunctions related to desire, arousal, orgasm, and pain (American Psychiatric Association, 1994). In addition to these areas, a lack of sexual satisfaction is also considered a frequently experienced problem by survivors. Within these parameters, researchers have consistently found that CSA survivors are likely to experience problems with sexual desire and/or sexual arousal (Becker et al., 1984; Jackson et al., 1990; Kirschner, Kirschner, & Rappaport, 1993; Westerlund, 1992). Fear of sexual contact (sexual aversion) is a dysfunction of desire and is also frequently reported by CSA survivors. Clinical experience suggests that women presenting with sexual aversion disorder have almost always been victims of a sexual trauma in childhood and/or as an adult (Wincze & Carey, 1991). Women who were victims of adult sexual assault frequently report decreased sexual satisfaction (Ellis, Calhoun, & Atkeson, 1980), as do CSA survivors (Gold, 1986; Jehu, 1988).

It is difficult to imagine a more open and vulnerable experience than to allow oneself to be close, emotionally and physically, to a spouse or partner. To embrace this degree of vulnerability can be a challenge for anyone. It is a natural tendency to guard oneself from such vulnerability because this is precisely when one can be rejected or hurt the most. The inherent vulnerability associated with sexual intimacy presents individuals with situations that require trust and acceptance of emotional uncertainty. Experiences such as these can be emotionally overwhelming for many trauma survivors.

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