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

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.

Co-occurrence of severe PTSD, somatic symptoms and dissociation in a large sample of childhood trauma inpatients: a network analysis

“…For example, researchers found that dysphoria-related symptoms connected PTSD and depression [ 29 ] and identified the feeling of being worthless and avoiding internal reminders of the stressor as central symptoms in a comorbidity network including PTSD, depression, and anxiety symptoms [ 30 ]. Looking beyond nosologically specified symptom sets, Kratzer and colleagues [ 31 ] identified sexual problems as connected to psychiatric symptoms in adult PTSD patients with childhood sexual abuse experiences. Difficulties engaging in sexual activities were linked to depressive and hyperarousal symptoms, whereas sexual preferences causing distress were linked to anger and dissociation [ 31 ].…”

“…Looking beyond nosologically specified symptom sets, Kratzer and colleagues [ 31 ] identified sexual problems as connected to psychiatric symptoms in adult PTSD patients with childhood sexual abuse experiences. Difficulties engaging in sexual activities were linked to depressive and hyperarousal symptoms, whereas sexual preferences causing distress were linked to anger and dissociation [ 31 ]. However, a network perspective on psychiatric disorders does not necessarily preclude a classificatory approach to nosology in clinical practice.…”

Network analysis of COVID-19-related PTSD and depressive symptoms among Chinese general population and comorbidity subgroup.

“…chose bridge strength expected influence (1-step) and bridge expected influence (2-step) due to previous studies (Jones et al, 2021;Kratzer et al, 2022). Bridge strength indicated a node's total connectivity with other disorders.…”

“…Previous studies have examined the structure of comorbid PTSD and depressive symptoms with network analyses (Hardy et al, 2021; J. Cheng et al, 2020; Kratzer et al, 2022), yet reached no consensus regarding the most communicable symptom. J.…”

Associations between PTSD symptoms and other psychiatric symptoms among college students exposed to childhood sexual abuse: a network analysis

“…Another study also found that hypervigilance was a bridge symptom between PTSD and psychotic symptoms (Hardy et al, 2021 ). Dissociative amnesia, visual intrusions, and physical reactions also play key roles in the network among CSA survivors (Kratzer, 2020 ).…”