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The Impact of Childhood Sexual Abuse on Women’s Sexuality

Explore the impact of Childhood Sexual Abuse (CSA) on women's sexual lives, function, and therapy needs. Essential for health professionals and survivors seeking support and treatment.

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The Impact of Childhood Sexual Abuse on Women’s Sexuality

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  1. The Impact of Childhood Sexual Abuse on Women’s Sexuality

  2. CAPSTONE • The purpose of this capstone is to provide a further understanding of the impact of Childhood Sexual Abuse (CSA) on women’s sexual lives, sexual schemas, sexual functioning and satisfaction, as well as gynecological problems and psychological treatment of sexual problems.

  3. RATIONALE • 20 percent of adult women experienced CSA (Perada, Guilera, Forns & Gomez-Benito, 2009) • With such a high percentage of women having experienced childhood sexual abuse, it is likely that many women seeking therapy will have histories that include sexual abuse. • Health care professionals need to be aware of symptoms, consequences and retraumatization in order to provide support, appropriate care and treatment for the survivor. • For health care professionals to gain a better understanding of what is needed in therapy for CSA survivors. • There is a need to create treatment programs that empower survivors to avoid this re-victimization.

  4. METHODOLOGY • Access via: • EBSCO, PsycArticles, PsycInfo, Social Sciences Full Text, Google, Google Scholar, PubMed, TRIP database. • Keywords used: • Adulthood sexual victimization (ASV), adult sexual assault (ASA), childhood sexual abuse (CSA), complex PTSD, sexuality, sexual function, sexual risk, sexual schema, sexual avoidance, sexual compulsivity, sexually transmitted disease (STD), sex therapy, sexual schemas, intimacy, revictimization, sexual risk-taking, prostitution, porn industry, human trafficking, women military veterans, gynecological issues, therapeutic implications, inter-partner violence (IPV), CBT therapy, marriage and cohabitation, sex therapy for couples.

  5. Current Research • More vulnerable to mental health problems, but especially so to sexual difficulties and STIs, including HIV/AIDS, (Doll, Koenig & Purcell, 2003) • Increased risk of engaging in subsequent high-risk sexual behaviors at a younger age • Having a higher number of sexual partners, a higher frequency of unprotected sex • Less sexual satisfaction • Experiencing greater gynecological problems Coker (2007) and Lemieux & Byers (2008)

  6. Current Research • Use of drugs or alcohol during sexual activities Coker (2007) and Lemieux & Byers (2008) . • Lifetime diagnosis of nonspecific chronic pain, functional gastrointestinal disorders, psychogenic seizures, and chronic pelvic pain (Paras et al. 2009). • Exposure to more severe forms associated with earlier abuse - more frequent cohabitation, higher rates of perpetrated inter-partner violence (IPV), early parenthood, lower relational satisfaction and investment (Friesen, Woodward, Horwood and Fergusson 2010).

  7. Current Research • Being older at the time of the abuse increased the likelihood of being afraid of sex and feeling guilty during sex and being dissatisfied with sex during adulthood (Easton, Coohey, O’Leary, Zhang, Hua 2011). • Single survivors are more likely to evidence sexual compulsivity, whereas cohabiting survivors report a mixture of sexual avoidance and compulsivity (Vaillancourt-Morel et al. 2016). • A significant interaction between CSA and avoidance tendencies was found for orgasm function, with the combination of sexual abuse and avoidance tendencies explaining lower orgasm function Staples, Rellini and Roberts (2012). • Sexual self-schemas predicted negative affect prior to exposure to sexual stimulation, which, in turn, partially explained the lower sexual arousal function and sexual satisfaction (Rellini and Meston 2011).

  8. Current Research • CSA abuse severity was associated with higher sexual compulsivity in single individuals, both higher sexual avoidance and compulsivity in cohabitating individuals and higher sexual avoidance in married individual (Vaillancort-Morel et al. 2016). • CSA was associated with greater risk of reporting other forms of childhood victimization, including exposure to multiple victimization (Lacelle, Hebert, Lavoie, Vitaro and Tremblay 2012).

  9. Current Research • Women involved in street prostitution reported sexual health problems, co-occurring health issues and addiction compared to the international group of human trafficked women. A greater percentage of domestic trafficking victims reported having experienced physical and/or sexual abuse as a child compared to the international group of trafficked women (Muftic and Finn 2013). • Abused women had a 50 to 70 percent increase in gynecological problems such as sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections. Abused women also had more chronic stress-related, central nervous system (back pains, headaches etc.), and total health problems (Campbell et al. 2002)

  10. TREATMENT • Evidence-based therapy - cognitive behavioral therapy (CBT) for women show significant promise (Resick, Nishith, Griffin, 2010). • Combination of education, CBT, sexual/relationship therapy, mindfulness in group settings or in individual treatment has demonstrated significantly better outcomes (Brotto, Basson,Luria 2008). • Expresive writing treatment may help survivors process their abuse, and explore the importance of sexual self-schema themes (Pulverman, Boyd, Stanton, Meston 2016).

  11. Implication of Findings • For clinicians in particular, the need for assessment of both partner’s sexual abuse history and severity through face-to-face interviews and detailed questionnaires is paramount (Vaillancourt-Morel et al.(2016). • Practitioners who treat adults with CSA histories for sexual functioning problems should assess all three dimensions of psychosexual functioning (emotional, behavioral and evaluative) (Easton, Coohey, O’Leary, Zhang, Hua 2011) . • For couples who are both survivors of CSA, there is a probability that in conflict resolution or problem-solving both may be triggered by their own trauma (Walker, Sheffield, Larson and Holman 2011).

  12. Implication of Findings • Assessment and treatment of CSA should include both members of a romantic couple for communication problems (Walker, Sheffield, Larson and Holman 2011). • Preventative efforts should also be addressed such as emotional issues, awareness of risky situations, and impact of substance abuse (Schultz, Bell, Naugle and Polousny 2006). • To decrease problems with touch and arousal and to increase satisfaction with sex, practitioners may need to address the underlying emotional aspects such as fear of sex and guilt during sex (Easton, Coohey, O’Leary, Zhang, Hua 2011). • When treating female veterans or active military duty military personnel, CSA and ASV history should be assessed, and include emotional functioning for revicimitization(Schultz, Bell, Naugle and Polousny 2006).

  13. Future Research •Repressed memories and CSA • Comparison of sexuality and relationships in Twelve-Step and non-Twelve-Step recovery programs • Differences in healing of CSA histories with somatic versus talk therapy • Differences in outcomes for women who were abused at home compared with those abused outside of the home • Potential differential treatment effects for men as compared with women • CDA as a predictor of later-life sexual offending • CSA and its impact on women’s spirituality • CSA and its effects among incarcerated women • CSA in women military veterans

  14. Future Research • Effects of CSA in women with chronic health issues • Role of CSA in relationships and revictimization • Pornography actresses and CSA • Effects of sexual abuse on sexual cognition/fantasy • Gender differences with regards to sexual outcomes of survivors • Personality issues, disorders and attachment issues

  15. References Anderson, S.R., Miller, R.B. (2006) The effectiveness of therapy with couples reporting a history of childhood sexual abuse: an exploratory study. Contemp. Fam. Therapy. 28:353-366. Bird, E.R., Seehauus, M., Clifton, C., Rellini, A.H. (2014). Dissociation during sex and sexual arousal in women with and without a history of childhood sexual abuse. Arch. Sex Behav. 43:953-964. Barnes, E., Noll, J.G., Putnam, F.W., Trickett, P.K., (2010). Sexual and physical revictimization among victims of severe childhood sexual abuse. Child Abuse Neglect Jul: 33(7); 414-420. Berthelot, N., Godbout, N., Hebert, M., Goulet. M., Bergeron. S., (2014). Prevalence and Correlates of Childhood Sexual Abuse in Adults Consulting for Sexual Problems. Journal of Sex & Marital Therapy, 40(5), 434-443. Brotto, L.A., Basson R., Luria, M. (2008) A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J. Sex. Med. 5:1646-1659.

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