Sexual Assault, Post-Traumatic Stress Disorder Symptoms, and Sexual Functioning in Young Adult Women

Individuals with a history of sexual assault (SA) often experience subsequent sexual dysfunction. Theories posit that Post-Traumatic Stress Disorder (PTSD) symptoms mediate this relationship; however, much of the literature is based on military samples. Young women in the years of early adulthood (i.e., 18-25) have higher rates of SA compared to other age groups, yet the implications of SA on their sexual functioning has rarely been evaluated. This project tested associations between SA, PTSD, and sexual functioning in two samples of young adult women: a college sample (230 students) and a community sample (38 low-income women of the same age). Participants reported on SA, PTSD symptoms, and sexual functioning. Sexual functioning was operationalized based on DSM-5 models of sexual dysfunction (desire, arousal, orgasm, pain) and attachment theory models of sexual behavioral systems (sexual system hyperactivation and deactivation). After controlling for past intercourse, young women with a SA history did not report worse sexual functioning in the arousal, orgasm or pain domains. In the university sample, SA history was associated with greater desire and a hyperactive sexual system, with PTSD symptoms potentially mediating this link. PTSD symptoms were also predictive of worse sexual functioning over time. PTSD symptoms were more strongly related to concurrent sexual functioning in the community sample compared to the college sample. Results highlight one mechanism that may contribute to re-victimization in young women with a SA history, and emphasize the need for sexual functioning measures and interventions that are adapted to the sexual difficulties of young women