Theoretical and epidemiological studies indicate that women with a history of child sexual abuse (CSA) experience more sexual problems during adulthood compared to non-abused women. Despite the abundance of research conducted on prevalence and incidence of sexual difficulties associated with a history of CSA, very little is known on the psychophysiological sexual response of CSA survivors. A study was conducted to examine whether women with and without a history of CSA differed in their physiological and subjective sexual responses when exposed to erotic videos. A second study was conducted to explore potential predictors of the physiological and subjective sexual responses of women with a history of CSA. Overall, the physiological sexual arousal of CSA survivors was not significantly weaker than the response of women with no history of CSA. However, when controlling for levels of sexual distress and sexual function those CSA survivors with higher levels of sexual distress showed lower physiological sexual arousal compared to CSA survivors with less sexual distress. In agreement with prior studies, for women with no history of CSA the relationship between levels of distress and physiological sexual arousal was not significant. Similarly, levels of subjective sexual arousal reported in the laboratory were associated with sexual distress in CSA survivors but not in women with no history of CSA. Women who reported more re-experiencing symptoms and more negative affect before the erotic video showed a significantly lower increase in subjective sexual arousal in the presence of an increase in physiological sexual arousal. Cortisol levels measured before and after exposure to the erotic video indicated that higher dissociation experienced during the sexual interaction with a partner is associated with a cortisol secretion during exposure to sexual stimuli. This finding suggests a potentially learned stress response to erotic stimuli which may negatively affect the physiological sexual arousal for a subgroup of CSA survivors. Findings from the two studies suggest that the psychophysiological assessment of the sexual response of CSA survivors captures some important aspects of the sexual difficulties experienced by these women. A number of potential predictors of the physiological and the subjective sexual responses of CSA survivors were identified. Future studies will need to examine whether interventions that target these predictors can help CSA survivors to increase their physiological and subjective sexual arousal to sexual cues and whether this provides some relief to their sexual distress.

Two-hundred and twenty-four participants who reported a history of child abuse trauma were recruited from the internet, clinical (community outpatient) and prison settings and completed a battery of assessment measures, including Briere's Child Maltreatment Interview Schedule (CMIS) (slightly modified), Detailed Assessment of Traumatic Stress (DAPS), Cognitive Distortion Scale (CDS), and Inventory of Altered Self Capacities (IASC); van der Kolk's Self Inventory of Disorders of Extreme Stress (SIDES-SR); Nijenhuis's Somatoform Dissociation Questionnaire (SDQ-20); and a modification of the CMIS to assess for adult victimization experiences (Adult Victimization Survey or AVS; Dietrich, unpublished instrument). It was hypothesized that Posttraumatic Stress Disorder (PTSD), Affect Dysregulation, and Problems with Interpersonal Relatedness would be associated with later revictimization experiences during adulthood with this sample, and that disturbances in ability to regulate self capacities and other complex posttraumatic sequelae would be associated with perpetration of physical or sexual violence during adulthood. Data were analyzed for 207 individuals who reported childhood maltreatment per the CMIS. Results provide partial support for the hypotheses. Women were significantly more likely to report revictimization, and male inmates were significantly more likely to perpetrate against others. Whereas PTSD and Somatoform Dissociation are the strongest dynamic predictors of any sexual or physical revictimization, Impaired Self Capacities are more often associated with revictimization by intimate partners in particular. Trauma-specific dissociation was associated with a decreased risk of revictimization, whereas peritraumatic and trait dissociation did not enter predictive models. Posttraumatic sequelae were not associated with increased risk of physical perpetration with these samples; however, IASC scores were associated with an increased risk of sexual perpetration and victim-based cognitive distortions were associated with decreased odds of sexual violence. These findings provide partial support for the Complex PTSD (Herman, 1992a) construct. Results are discussed in terms of implications for treatment, further study, and classification. Limitations are noted.

Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 176-193). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 176-193). Also available on the Internet.

Thesis (Ph.D.)--Kent State University, 2007. / Title from PDF t.p. (viewed Apr. 29, 2009). Advisor: Stevan Hobfoll. Includes bibliographical references (p. 49-60).

Thesis (Psy. D.)--Wheaton College, 2007. / Abstract. Includes bibliographical references (leaves 40-47).

Thesis (Ph.D.)--Kent State University, 2005. / Title from PDF t.p. (viewed Sept. 12, 2006). Advisor: Stevan E. Hobfoll. Keywords: child abuse; HIV; sexual risk; high-risk behaviors; PTSD; sexual assault; rape. Includes survey instrument. Includes bibliographical references (p. 37-47).

Two-hundred and twenty-four participants who reported a history of child abuse trauma were recruited from the internet, clinical (community outpatient) and prison settings and completed a battery of assessment measures, including Briere's Child Maltreatment Interview Schedule (CMIS) (slightly modified), Detailed Assessment of Traumatic Stress (DAPS), Cognitive Distortion Scale (CDS), and Inventory of Altered Self Capacities (IASC); van der Kolk's Self Inventory of Disorders of Extreme Stress (SIDES-SR); Nijenhuis's Somatoform Dissociation Questionnaire (SDQ-20); and a modification of the CMIS to assess for adult victimization experiences (Adult Victimization Survey or AVS; Dietrich, unpublished instrument). It was hypothesized that Posttraumatic Stress Disorder (PTSD), Affect Dysregulation, and Problems with Interpersonal Relatedness would be associated with later revictimization experiences during adulthood with this sample, and that disturbances in ability to regulate self capacities and other complex posttraumatic sequelae would be associated with perpetration of physical or sexual violence during adulthood. Data were analyzed for 207 individuals who reported childhood maltreatment per the CMIS. Results provide partial support for the hypotheses. Women were significantly more likely to report revictimization, and male inmates were significantly more likely to perpetrate against others. Whereas PTSD and Somatoform Dissociation are the strongest dynamic predictors of any sexual or physical revictimization, Impaired Self Capacities are more often associated with revictimization by intimate partners in particular. Trauma-specific dissociation was associated with a decreased risk of revictimization, whereas peritraumatic and trait dissociation did not enter predictive models. Posttraumatic sequelae were not associated with increased risk of physical perpetration with these samples; however, IASC scores were associated with an increased risk of sexual perpetration and victim-based cognitive distortions were associated with decreased odds of sexual violence. These findings provide partial support for the Complex PTSD (Herman, 1992a) construct. Results are discussed in terms of implications for treatment, further study, and classification. Limitations are noted. / Arts, Faculty of / Psychology, Department of / Graduate

Structural equation modeling was used to examine how childhood sexual abuse (and other associated variables, such as family functioning and experiencing multiple forms of abuse) relates to revictimization and psychological distress. Participants were women who participated in Project HOW: Health Outcomes of Women interviews, a longitudinal study that spanned six waves of interviews. Only women with a history of childhood sexual abuse were included in the present study (n=178). Experiencing nonsexual child maltreatment in addition to childhood sexual abuse appears directly related to adult sexual and physical revictimization and indirectly related to psychological distress. Childhood sexual abuse alone was not predictive of revictimization or psychological abuse. This suggests that other mediating factors may explain the relation between CSA and revictimization found in other research. Clinical implications based on the results of the present study emphasize the importance of identifying children who have experienced multiple forms of abuse as particularly at risk for future victimization. In addition, providing interventions with a focus on education and empowerment might decrease risk for future violence and subsequent emotional maladjustment. Potential future research could examine the treatment outcomes and efficacy of these interventions as well as identify those mediating factors that increase the risk for adult revictimization for those individuals who experience only childhood sexual abuse.

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