Child sexual abuse, peer sexual abuse, and sexual assault in adulthood: a multi-risk model of revictimization

This study explored the predictors and consequences of sexual assault occurring after the age of 16 years in a nonclinical sample of women. Child sexual abuse occurring before the age of 16 years was the only predictor of later sexual assault among comorbid risk factors. Peer sexual abuse, number of perpetrators, age at time of sexual abuse, and severity of sexual abuse did not increase the risk for later sexual assault. Adult sexual assault victims showed lower levels of mental health functioning than did survivors of child or peer sexual abuse. We discuss a specificity model of revictimization and the differential effects of child, peer, and adult sexual trauma on the developmental trajectory of sexual violence and psychosocial functioning.     

女性性功能障碍的常见病因

女性的性功能障碍是一种常见和多发疾病,给夫妻生活带来显著的不良影响,而明确其病因是合理诊治的基础。本文介绍了女性性功能障碍的常见病因,主要包括心理与社会因素、神经因素、性激素异常、疾病因素、药物因素和产后。     

Cumulative trauma: The impact of child sexual abuse,adult sexual assault,and spouse abuse

The present study investigated the relationship between trauma symptoms and a history of child sexual abuse, adult sexual assault, and physical abuse by a partner as an adult. While there has been some research examining the correlation between individual victimization experiences and traumatic stress, the cumulative impact of multiple victimization experiences has not been addressed. Subjects were recruited from psychological clinics and community advocacy agencies. Additionally, a nonclinical undergraduate student sample was evaluated. The results of this study indicate not only that victimization and revictimization experiences are frequent, but also that the level of trauma specific symptoms are significantly related to the number of different types of reported victimization experiences. The research and clinical implications of these findings are discussed.     

Authenticity of recovered sexual abuse memories: A Rorschach study

Distinguishing authentic abuse from false memory among adults who recover memories of childhood sexual trauma has far-reaching significance. This study initially examined 13 previously reported Rorschach signs of sexual abuse in women not abused, and women sexually abused (and not amnestic). The abuse signs were more prevalent in the abused group. A sexual abuse index composed of 8 signs correctly classified 93% of the abused, and 98% of the nonabused group. The index was then applied to women who recovered memories of abuse; some had analogues of dissociation in their protocols and others did not. Those exhibiting dissociative signs produced more signs of sexual abuse. The index classified 88% of the dissociative group as abused, but only 24% of the nondissociative group. The relevance of these findings for assessing authenticity of recovered memories is explored.     

The effects of short-term oral phytoestrogen supplementation on the hypothalamic-pituitary-testicular axis in prostate cancer patients

BACKGROUND: Here we evaluate the effects of oral phytoestrogen supplementation on hypothalamic-pituitary-testicular (HPT) axis in CaP patients. METHODS: We recruited 40 men about to undergo radical prostatectomy for CaP to receive either 240 mg of clover phytoestrogens or placebo daily for 2 weeks. Serum hormone levels were measured before and after treatment. In addition, recombinant cell bioassay was used to measure serum androgen bioactivity (ABA). RESULTS: Phytoestrogen treatment increased serum LH from mean of 3.4-5.2 IU, P = 0.03. Concomitantly, non-significant trend towards decline in serum T, cfT and ABA values was noted. However, mean serum LH/T ratio was upregulated from 0.20 to 0.48 IU/nM, P = 0.004, suggesting compensated hypogonadism. During the course of treatment, serum concentration of equol correlated strongly with the concomitant decrease in ABA (r = -0.586, P = 0.022). CONCLUSIONS: Phytoestrogen treatment interferes with HPT axis in CaP patients by inducing testicular resistance to LH and compensated hypogonadism.     

Posttraumatic stress associated with delayed recall of sexual abuse: A general population study

This study examined delayed recall of childhood sexual abuse in a stratified random sample of the general population (N=505). Of participants who reported a history of sexual abuse, 42% described some period of time when they had less memory of the abuse than they did at the time of data collection. No demographic differences were found between subjects with continuous recall and those who reported delayed recall. However, delayed recall was associated with the use of threats at the time of the abuse. Subjects who had recently recalled aspects of their abuse reported particularly high levels of posttraumatic symptomatology and self difficulties (as measured by the IES, SCL, and TSI) at the time of data collection compared to other subjects.     

Chiropractic leadership in the eradication of sexual abuse

Health practitioners work under fiduciary constraint, and are obligated to favour patient needs over all others and in particular their own. The principles of professionalism demand that professionals take great care to ensure that boundaries are maintained safely to provide an optimal setting in facilitating patient care. Boundary violations cause serious harm to the patient. Any romantic or sexual activity between parties is the most serious form of boundary violation. The chiropractic profession is included in the list of disciplines which are at an increased risk for boundary violations. The authors propose a four stage protocol which is designed to offer all parties maximal protection beginning with undergraduate professional education and then mandatory continuing education for registrants in professional practice. The protocol would affect all aspects of professional life including training in boundaries and jurisdictional regulation.     

MMPI-2 F scale elevations in adult victims of child sexual abuse

The present study assessed whether the Minnesota Multiphasic Personality Inventory—2 (MMPI-2) F scale elevations may reflect genuine trauma-related distress and/or psychopathology, rather than malingering, in a clinical sample of adult child sexual abuse (CSA) victims. Eighty-eight women seeking outpatient treatment for CSA after-effects participated. Self-report measures of dissociation, posttraumatic stress, depression, and family environment individually correlated significantly with F, and collectively accounted for 40% of its variance. Dissociation was the strongest predictor. Findings suggest that high F elevations may reflect genuine problem areas often found among CSA victims, rather than symptom overreporting.     

Post-traumatic stress disorder in child sexual abuse survivors: A literature review

Research to date has failed to identify a unique syndrome describing the sequelae of child sexual abuse (CSA). Recently, however, some researchers have suggested Post-Traumatic Stress Disorder as the diagnosis which best fits the syndrome commonly seen in CSA survivors. Research examining the consequences of CSA in terms of the applicability of a PTSD diagnosis is reviewed. Additionally, based on findings of significant relationships between PTSD and traumatic exposure in other trauma groups, this review also examines studies which have investigated relationships between exposure and symptom development among CSA survivors. Finally, conclusions regarding the applicability of PTSD to CSA survivors and suggestions for future research are offered.This article was accepted for publication under the Editorship of Charles R. Figley.     

Parental caring as a possible buffer against sexual revictimization in young adult survivors of child sexual abuse

This study examined whether parental caring provided a buffer against the revictimization effect. Nine hundred and seventy-four undergraduate women provided information about child sexual abuse, physical abuse, and whether they witnessed violence between their parents during childhood. They also reported whether they had ever been the victim of sexual assault in adulthood, and offered their perceptions of the degree of care they received as a child from each parent. Results indicated that women who had been sexually abused in childhood were twice as likely to be sexually assaulted in adulthood and that women with 2 or more types of childhood trauma were 3 times as likely to be sexually revictimized. Parental caring was not found to buffer against the revictimization effect.     

Perceptions of sexuality as related to sexual functioning and sexual risk in women with different types of childhood abuse histories

Perceptions of one's sexuality, self-reported sexual functioning, and sexual risk were examined in a community sample of 148 women with histories of either childhood sexual abuse (n = 26), both childhood sexual and physical abuse (n = 44), and neither form of abuse (n = 78). Controlling for depression and anxiety, the groups did not differ on sexual desire, arousal/orgasm, sexual pain, or masturbation. Women with abuse histories reported more negative affect during sexual arousal and reported more lifetime vaginal intercourse partners than nonabused women. In addition, the abuse samples reported more negative perceptions of their sexuality in their worst psychological states using the Structural Analysis of Social Behavior (SASB) method than did women with no abuse history. An interpersonal focus and more precise abuse labeling are recommended, potentially revising our assumptions about symptom clusters and treatment.     

The role of prolactin levels in the sexual activity of married men with erectile dysfunction

OBJECTIVE: To evaluate the effects of risk factors for erectile dysfunction (ED) including anthropometry, hormones, metabolic profiles and lifestyle, on sexual activity in married men with ED. PATIENTS AND METHODS: The study included 261 men (mean age 53.7 years, range 23-80), who were evaluated for anthropometry, hormone levels, metabolic profiles and lifestyle factors. Erectile function was evaluated using the self-administered International Index of Erectile Function. Patients were classified into two groups based on the six-item erectile-function domain, as those with sexual activity and those without. RESULTS: Of all patients, 62.5% (163 of 261) had no sexual activity (erectile-function domain score <6). There was a significant difference in mean (sem) prolactin level between patients with and with no sexual activity, at 4.8 (0.4) vs 6.8 (0.7) (P = 0.013). Of all patients, 73.7% (42 of 57) with diabetes had no sexual activity, while 59.3% (121 of 204) without diabetes had (P = 0.048). In a multivariate model, a higher prolactin level was associated with a greater likelihood of sexual inactivity (odds ratio 1.094; 95% confidence interval, 1.010-1.185; P = 0.028) but diabetes lost its statistical significance. The area under the receiver-operating characteristic curve for prolactin was 60.5% (95% confidence interval, 52.9-68.1%; P = 0.009) for sexual inactivity. No other factors were significant in this regard. CONCLUSION: Our findings suggest that prolactin levels might play a role in sexual activity in men with ED.     

南京市城区女性性功能障碍的调查

目的:女性性功能障碍(FSD)是影响女性生活质量的常见疾病,有关中国女性FSD的报道少见。本研究探讨南京城区女性FSD的发病情况,为制定中国女性FSD的防治策略提供依据。方法:本研究为回顾性调查,调查对象为2008年8月至2009年3月在南京医科大学附属南京市妇幼保健院进行健康体检的20岁以上女性及其女性陪护人。采用女性性功能指数(FSFI)问卷评估性功能,以FSFI评分总分<25分作为FSD的诊断标准。以各单项评分的中位数作为诊断各类型性功能障碍的标准。结果:共发放问卷1 002份,收回有效问卷609份,有效问卷回收率60.8%。本组女性FSFI得分(24.21±4.40)分,随着年龄增长,FSFI评分及各单项评分逐渐下降。本调查各年龄组总的FSD发生率为56.8%,随年龄增长,FSD发生率逐渐增加,<29岁组为47.1%,30~39岁组为57.0%,40~49组为75.0%,50岁以上高达90.3%。最常见的性功能障碍类型为性满意度下降(43.2%),其次为性高潮障碍(41.7%)、性交疼痛(40.2%)、性欲低下(35.1%)、阴道润滑障碍(31.4%)及性唤起困难(29.6%)。结论:FSD是困扰中国城市女性的常见问题,最常见的类型为性满意度下降及性高潮障碍。     

女性性功能障碍的治疗进展

随着社会的进步和性医学的发展,女性性功能障碍的治疗水平不断提高。本文综述了女性性功能障碍的基本治疗方法,包括心理治疗、性行为疗法、机械治疗、生活方式调整和体育锻炼、针灸、药物、手术及基因治疗,提出要客观认识现有治疗手段的局限性,强调以患者为中心的综合治疗原则,以及加强患者认知教育,全面改善女性性功能障碍的治疗现状。     

Diabetes and sexual dysfunction: results from the Olmsted County study of urinary symptoms and health status among men

PURPOSE: We examined the association of diabetes and domains of sexual dysfunction in a population based sample of men residing in Olmsted County, Minnesota. MATERIALS AND METHODS: A cohort of 2,115 white men 40 to 79 years old as of January 1, 1990 was randomly selected from the Olmsted County population. Men who had a history of prostate or bladder surgery, urethral surgery or stricture, or medical or other neurological condition that could affect normal urinary function were excluded from analysis. Diabetes itself was not used as an exclusionary criterion, although those with end stage organ failure as a result of diabetes were excluded. A previously validated male sexual function index was included in the questionnaires administrated to the cohort in 1996, which consisted of 11 questions on the 5 sexual function domains of sexual drive, erectile function, ejaculatory function, sexual problem assessment and sexual satisfaction. The baseline questionnaire also included whether they had ever been diagnosed by a physician as having diabetes. Only men with regular sexual partners were included. RESULTS: Individuals with diabetes at baseline had significantly greater dysfunction in all 5 sexual function domains. In multivariate adjusted analyses diabetes was significantly associated with all sexual dysfunction domains. The associations remained significant after adjusting for numerous predictors of sexual dysfunction. CONCLUSIONS: The presence of diabetes at baseline was significantly associated not only with erectile dysfunction but with all aspects of sexual dysfunction, including sexual drive, ejaculatory function, sexual problems and sexual satisfaction in this population based sample of men residing in Olmsted County.     

Female sexual dysfunction in urological patients: findings from a major metropolitan area in the USA

Study Type – Symptom prevalence (prospective cohort)
Level of Evidence 1b

OBJECTIVE

To determine the prevalence of and risk factors for female sexual dysfunction (FSD) in a practice focused mainly on female urology.

PATIENTS AND METHODS

A modified version of the Female Sexual Function Index (FSFI) was used to assess the prevalence of FSD in 587 patients who completed the questionnaire. Logistic regression was used to identify risk factors.

RESULTS

The prevalence of FSD was 63%; age, menopausal status and usage of selective serotonin reuptake inhibitors were statistically significant risk factors for FSD.

CONCLUSIONS

FSD is highly prevalent in this population of patients and screening female urological patients for FSD should be considered.     

Potential future options in the pharmacotherapy of female sexual dysfunction

Female sexual dysfunction (FSD) is considered a common medical problem estimated to affect millions of women in the westernized countries. FSD has been classified into four different categories including sexual arousal disorder (FSAD), sexual desire disorder (HSDD), orgasmic disorder and sexual pain disorder. The focus of this article is the potential role of pharmacological compounds currently under development, in the treatment of sexual arousal and orgasmic disorders in order to enhance the sexual response in adult females. While a number of potential therapeutic options are available to date, not one of the pharmacological treatment regimens has been yet considered the Gold standard in the management of symptoms of FSD. This article reviews the rationale and potential benefits of using distinct drug formulations in the treatment of FSD.     

Recovered memories of abuse in women with documented child sexual victimization histories

This study provides evidence that some adults who claim to have recovered memories of sexual abuse recall actual events that occurred in childhood. One hundred twenty-nine women with documented histories of sexual victimization in childhood were interviewed and asked about abuse history. Seventeen years following the initial report of the abuse, 80 of the women recalled the victimization. One in 10 women (16% of those who recalled the abuse) reported that at some time in the past they had forgotten about the abuse. Those with a prior period of forgetting—the women with recovered memories—were younger at the time of abuse and were less likely to have received support from their mothers than the women who reported that they had always remembered their victimization. The women who had recovered memories and those who had always remembered had the same number of discrepancies when their accounts of the abuse were compared to the reports from the early 1970s.