Dissociation During Sex and Sexual Arousal in Women With and Without a History of Childhood Sexual Abuse

Arch Sex Behav (2014) 43:953964 DOI 10.1007/s10508-013-0191-0

ORIGINAL PAPER

Dissociation During Sex and Sexual Arousal in Women With and Without a History of Childhood Sexual Abuse

Elizabeth R. Bird Martin Seehuus

Jessica Clifton Alessandra H. Rellini

Received: 25 October 2012 / Revised: 26 April 2013 / Accepted: 2 June 2013 / Published online: 3 December 2013 Springer Science+Business Media New York 2013

Abstract Women with a history of childhood sexual abuse (CSA) experience dissociative symptoms and sexual difcul-ties with greater frequency than women without a history of CSA. Current models of sexual dysfunction for sexual abuse survivors suggest that dissociation may mediate the relationship between CSA and sexual arousal difculties. Dissociation, however, is often conceptualized as a single construct in studies of CSA and not as separate domains as in the dissociation literature. In the present study,women with (CSA, N =37) and without (NSA, N = 22) a history of CSA recruited from the community were asked to indicate the frequency and intensity of their experience in two dissociation subgroups, derealization and depersonalization, during sex with a partner and in their daily life. Findings showed that, in the NSA group, more depersonalization during sex with a partner was associated with lower sexual arousal functioning. However, for both the NSA and CSA groups, more derealization during sex was associatedwith higher sexual arousal functioning.No measure of dissociation was signicantly associated with sexual responses in the laboratory. These ndings highlight the importance of distinguishing between different forms of dissociation(i.e., derealization and depersonalization) in the study of sexual arousal functioning. In addition, the ndings challenge the notion that dissociation is a main predictor of sexual arousal problems in survivors of CSA and suggest that a more nuanced relationship may exist.

Keywords Sexual arousal Dissociation Women

Childhood sexual abuse

Introduction

Childhood Sexual Abuse and Sexual Arousal

Childhood sexual abuse (CSA), dened as unwanted or forced sexual experiences during childhood or early adolescence, has beenhighlightedbytheWorldHealthOrganization(2003)asa major public health issue that affects mostly women. Approximately 20 % of women in North America are sexually abused by the time they reach adulthood (Kendall-Tackett, Williams, & Finkelhor, 1993; Stoltenborgh, IJzendoorn, Euser, & Bakermans-Kranenburg, 2011). Survivors of CSA are at high risk fordevelopingvariouspsychologicalandbehavioralproblems inadulthood,suchaspost-traumaticstressdisorder, borderline personality disorder, dissociation, alcohol problems, and suicidal ideation (for a...