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Sexual symptoms in post-traumatic stress disorder following childhood sexual abuse: a network analysis

Published online by Cambridge University Press:  10 June 2020

Leonhard Kratzer Open the ORCID record for Leonhard Kratzer [Opens in a new window] ,
Peter Heinz ,
Rebecca Schennach ,
Matthias Knefel ,
Günter Schiepek ,
Sarah V. Biedermann  and
Melanie Büttner
Leonhard Kratzer*
Affiliation:
Department of Psychotraumatology, Clinic St. Irmingard, Prien am Chiemsee, Germany
Peter Heinz
Affiliation:
Department of Psychotraumatology, Clinic St. Irmingard, Prien am Chiemsee, Germany
Rebecca Schennach
Affiliation:
Schoen Clinic Roseneck, Prien am Chiemsee, Germany Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
Matthias Knefel
Affiliation:
Faculty of Psychology, University of Vienna, Vienna, Austria
Günter Schiepek
Affiliation:
Institute for Synergetics and Psychotherapy Research, Paracelsus Medical University, Salzburg, Austria Department of Psychiatry and Psychotherapy, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
Sarah V. Biedermann
Affiliation:
Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Melanie Büttner
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technische Universität München, Munich, Germany
*
Author for correspondence: Leonhard Kratzer, E-mail: l.kratzer@st-irmingard.de
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Abstract

Background

Even though recent research indicates that sexual symptoms are highly prevalent in post-traumatic stress disorder following childhood sexual abuse and cause severe distress, current treatments neither address them nor are they effective in reducing them. This might be due to a lack of understanding of sexual symptoms' specific role in the often complex and comorbid psychopathology of post-traumatic stress disorder following childhood abuse.

Methods

Post-traumatic, dissociative, depressive, and sexual symptoms were assessed in 445 inpatients with post-traumatic stress disorder following childhood sexual abuse. Comorbidity structure was analyzed using a partial correlation network with regularization.

Results

A total of 360 patients (81%) reported difficulties engaging in sexual activities and 102 patients (23%) reported to suffer from their sexual preferences. Difficulties engaging in sexual activities were linked to depressive and hyperarousal symptoms, whereas sexual preferences causing distress were linked to anger and dissociation. Dissociative amnesia, visual intrusions, and physical reactions to trauma reminders were of central importance for the network. Dissociative amnesia, depressed mood, lack of energy, and difficulties engaging in sexual activities were identified as bridge symptoms. Local clustering analysis indicated the non-redundancy of sexual symptoms.

Conclusions

Sexual symptoms are highly prevalent in survivors of childhood sexual abuse with post-traumatic stress disorder. Further research is needed regarding the link of difficulties engaging in sexual activities, depression, and post-traumatic stress disorder, as well as regarding the association of dissociation and sexual preferences causing distress. Sexual symptoms require consideration in the treatment of post-traumatic stress disorder following childhood sexual abuse.

Keywords

Childhood sexual abusedissociationparaphiliapost-traumatic stress disordersexual dysfunction
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 1 , January 2022 , pp. 90 - 101
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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