Interpersonal Trauma and Sexual Function and Satisfaction: The Mediating Role of Negative Affect Among Survivors of Military Sexual Trauma

Abstract

Healthy sexual function among women service members/veterans (SM/Vs) is associated with higher quality of life, lower incidence and severity of mental health diagnoses, higher relationship satisfaction, and less frequent suicidal ideation. Although trauma exposure has been established as a predictor of poor sexual function and satisfaction in women SM/Vs, no study to date has examined whether specific trauma types, such as military sexual trauma (MST), increase risk for sexual issues. Moreover, the possible mechanisms of this association have not been explored. The current study examined whether posttraumatic stress disorder (PTSD) and depression symptom clusters mediated the association of trauma type and sexual function and satisfaction in 426 trauma-exposed women SM/Vs. Two hundred seventy participants (63.4%) identified MST as their index trauma. Path analyses demonstrated that MST was related to poorer sexual function and lower satisfaction relative to the other traumas ( χ2[28, N = 426] = 43.3, p = 0.03, CFI = 1.00, TLI = 0.99, and RMSEA = 0.04), and this association was mediated by higher non-somatic depressive symptoms and PTSD symptom clusters of anhedonia and negative alterations in cognition and mood (NACM). Causality cannot be inferred due to the cross-sectional nature of the data. However, our findings suggest that interventions aimed at decreasing sexual issues among female SM/Vs with MST should target depressogenic symptoms, whether the origin is depression or PTSD. Longitudinal research exploring the etiological processes that contribute to sexual dysfunction among those with MST is needed.

Military Sexual Trauma As a Risk Factor for Treatment Non-Response from an Online, Self-Management Posttraumatic Stress Disorder Treatment for Women Veterans

“…MST is associated with more severe PTSD and mental health symptoms when compared with other trauma types (Blais et al, 2022;Sexton et al, 2017). While several non-controlled, mixed-gender studies conducted in intensive outpatient or residential PTSD rehabilitation programs found no association between MST and treatment outcome after accounting for pretreatment differences in severity (Christ et al, 2022;Holliday et al, 2020;Rauch et al, 2021;Tiet et al, 2015;Voelkel et al, 2015), some studies have found persistent differences in treatment response as a function of whether MST was the index trauma (Zalta et al, 2018).…”

Posttraumatic Cognitions Differ Between Men and Women after Military Sexual Assault Revictimization in Their Contribution to PTSD Symptoms

“…Prior studies on MSA have either been restricted to women samples (e.g., Blais, 2020; Blais et al, 2020, 2022; Creech & Orchowski, 2016) or had a small sample of men with MSA (e.g., Tannahill et al, 2021). By having a larger sample of men with a history of MSA, the current study was able to test whether the relationships between revictimization experiences, PTC, and PTSS varied by gender.…”

“…PTSD and posttraumatic stress symptoms (PTSS) are associated with lower quality of life (Vogt et al, 2017), sexual dysfunction (Blais et al, 2022), poorer interpersonal functioning (Blais, 2020, 2022; Blais & Zalta, 2023), substance misuse (Schumm & Chard, 2012), and suicidal ideation and attempts (Wisco et al, 2014), highlighting the importance of continuing to study risk factors of PTSS to fine-tune assessments and treatments. Traumas that involve sexual violation are associated with the highest risk for PTSS (Blais et al, 2020; Wisco et al, 2014), with repeated exposure conferring even greater risk (see review, Classen et al, 2005; Tirone, Bagley et al, 2020a). Notably, those with a history of military sexual assault (MSA), or sexual assault that occurred during their military service, are 2 to 4.5 times more likely to have experienced previous sexual assault compared to those without a history of MSA (Schry et al, 2015, 2016), and is significantly associated with greater risk for sexual revictimization (see review, Tirone, Bagley et al, 2020a).…”

Sexual Violence in Military Service Members/Veterans Individual and Interpersonal Outcomes Associated with Single and Multiple Exposures to Civilian and Military Sexual Violence

“…Indeed, experiencing MSV is associated with increased risk for posttraumatic stress disorder (PTSD), depression, substance and alcohol use disorders, as well as suicide (e.g., Blais & Geiser, 2019;Kimerling et al, 2007). Moreover, MSV is positively correlated with greater distress relative to other trauma exposures, including combat (i.e., Blais et al, 2020;Blais & Monteith, 2019). In fact, MSV is associated with more severe distress and impairment relative to sexual violence that occurred before or after military service (Creech & Orchowski, 2016;Himmelfarb et al, 2006), highlighting its complex and lasting nature.…”