The impact of child sexual abuse on adult interpersonal functioning: A review and synthesis of the empirical literature

The many studies that have examined the long-term impact of child sexual abuse (CSA) on adult functioning have primarily focused on the personal distress of survivors, largely ignoring the impact of CSA on interpersonal relationships. This article reviews empirical findings concerning the interpersonal distress of survivors as expressed in their intimate and sexual relationships. First, current conceptualizations of the relationship between CSA and interpersonal relationships are reviewed, with a focus on the theoretical models that appear to have implications for the long-term interpersonal sequelae associated with CSA. This is followed by a review of the research conducted on intimacy within the area of social psychology and a summary of the empirical findings related to intimacy functioning in CSA survivors. A hypothesized typology of intimacy functioning for survivors is suggested. The effects of CSA on three components of sexuality—sexual dysfunctions, underlying psychological components of sexuality, and sexual orientation—are discussed. Finally, the interpersonal issues believed to be most salient for CSA survivors in the therapeutic setting are discussed, along with implications for the client–therapist relationship. Methodological, assessment, and conceptual issues are discussed throughout. Recommendations for future research and clinical endeavors are suggested.     

Sexuality and intimacy following radical prostatectomy: patient and partner perspectives.

Most research on adjustment following radical prostatectomy has focused on limited assessments of urinary and erectile functioning. In this study, the authors provided a more comprehensive assessment of sexuality from 134 radical prostatectomy patients and their partners and determined the extent to which various components of sexuality are associated with psychosocial adjustment. Measures of sexuality and intimacy modestly predicted patients' emotional distress and quality of life (QoL), with body image and dyadic adjustment playing the most important roles after controlling for medical variables, general physical functioning, and optimistic outlook. Urinary incontinence and other sexuality variables were not unique predictors. In contrast, partner ratings of sexual satisfaction played a more important role in predicting their QoL.     

Is it all about intimacy? Age,menopausal status,and women’s sexuality

Two studies examined the contribution of aging to various aspects of sexual functioning. Study 1 examined the association between age and sexual response among 289 women. Results showed that aging and relationship length were associated with relatively low sexual desire, excitement, and intimacy, with sexual intimacy mediating the association between relationship length and sexual excitement. Furthermore, the negative association between aging and sexual desire was particularly pronounced among women experiencing lower sexual intimacy. In Study 2, 93 women were classified according to menopausal status. Findings paralleled those of Study 1, indicating that postmenopausal state was negatively associated with sexual desire, mainly among women who experienced low sexual intimacy. Implications for the understanding of sexuality of women at midlife are discussed.     

Sexual Experiences among College Women: The Differential Effects of General versus Contextual Body Images on Sexuality

Women’s bodies are often objectified and evaluated, which may result in body dissatisfaction associated with sexual difficulties. This study of 384 college women confirmed that contextual body image during sex was more associated with a lower self-confidence to refuse sex, poorer sexual functioning, and reduced sexual assertiveness than general body dissatisfaction, and the level of contextual body image mediated the effect of body dissatisfaction. Moreover, greater contextual body image was associated with lower sexual self-efficacy, more ambivalence in sexual decision-making, and more emotional disengagement during sex with a partner, implying that contextual body image is a better predictor of women’s sexuality than general body image. Findings are discussed in relation to needed research and their implications for clinical interventions.     

Is Good Sex Good for You? Rethinking Sexuality and Health

Despite the central importance of sexuality to human well‐being, the study of sexuality remains marginalized within health psychology, which hampers the ability of clinicians and policy‐makers to promote comprehensive health and well‐being. In this review we discuss the evidence that sexual functioning makes critical contributions to human health, focusing specifically on findings linking sexual activity to morbidity and mortality, to the health‐promoting effects of intimate relationships, and to processes of emotion regulation. We argue that researchers studying the psychology of health and well‐being should more substantively integrate sexuality into their research agendas. Health psychologists’ specific expertise in investigating and interpreting complex, reciprocal associations between subjective emotional states, health‐relevant cognitions, and health‐relevant behavior can make a notable contribution to elucidating some of the most intruiging correlations between sexuality and health that have emerged from medical and epidemiological studies. If we want to foster optimum physical and mental health among youths and adults, we must rigorously investigate the multiple mechanisms through which positive sexual functioning plays a unique and fundamental role in human well‐being across the life course.     

The valence of sex:Automatic affective associations in erotophilia and erotophobia

Sexual stimuli may elicit positive and negative emotions that can impact sexual thoughts, responses, and behavior. To date, most research on affect and sexuality has focused on conscious processes and affective states. Less is known about how automatic and trait-level affective processes influence our reactions to sexual stimuli. This study used a priming task with backward masking and a trait measure of erotophobia-erotophilia - the tendency to respond to sex on a negative-to-positive continuum - to improve our understanding of the role of automatic and affective processes in response to sexual stimuli. Erotophilic individuals demonstrated automatic associations between sexual primes and positively-valenced targets, whereas erotophobic individuals classified negatively-valenced targets faster regardless of whether primes were sexual or neutral. The findings suggest that the valence of sexual stimuli can be processed automatically and is associated with trait-level affective responses to sex. Implications for research on risky sexual behavior and sexual dysfunction are discussed.     

Cumulative estrogen exposure and prospective memory in older women

This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to influence estrogen levels across the life span, and performance on prospective and retrospective memory measures in a group of 50 postmenopausal women (mean age=69.3years) who, if they were current or former users of estrogen therapy, had started therapy within 5years of menopause. The ICEE was found to be a significant predictor of performance on the Prospective Memory task (F(1)=4.21, p=.046, η(p)(2)=.084). No significant relationship was noted between the ICEE and performance on measures of retrospective memory. The results suggest that the level of cumulative lifetime exposure to estrogen a woman has influences her prospective memory performance later in life and that the influence of reproductive and biological markers of endogenous estrogen exposure are relevant factors to consider when studying the effect of estrogen therapy on cognitive functioning in postmenopausal women. In addition, the finding that performance on a measure of prospective memory, but not performance on measures of retrospective memory, was associated with the ICEE adds further support to the theory that the frontal cortex may be especially sensitive to estrogen.     

Treating the Sexual Concerns of Adult Incest Survivors and Their Partners

SUMMARY

Negative attitudes about sex and sexuality and many types of sexual dysfunction are common aftereffects of sexual child abuse and incest. The traumatic sexualization and the aversive sexual conditioning resulting from childhood abuse have long gone unrecognized, however. This article presents research findings regarding the impact of incest on sexual attitudes and functioning along with treatment recommendations.     

It's all in your head: Feminist and medical models of menopause (strange bedfellows)

The purpose of this article is twofold. First, it addresses the substantive area of menopause. It argues that there has been and continues to be a paucity of literature on the topic, which may be due largely to the stigma associated with aging females in our society. Though some current women's studies literature has addressed itself to this area, menopause is still relatively ignored or poorly researched as compared to menstruation and other feminine physiological issues. Furthermore, the few studies which have emerged from the recent wave of feminist research have tended to perpetuate aspects of the medical model of menopause found in current gynecological textbooks and popular paperbacks, i.e., It's all in your head. This ironic compatibility between medical establishment and feminist models of menopause is the second focus of this article. How such a stance could be shared by two radically different ideological groups is a subject worthy of further analysis because it raises more general questions about the relationship of political ideology to research into human behavior, an issue which is crucial to contemporary studies on sex-role differences.This article is a revised version of a paper presented at the meetings of the American Anthropology Association in Washington, D.C., November 1976. Many thanks to my colleague and friend Judith Katz for her invaluable editorial assistance.     

PORTRAYAL OF MARRIED SEX IN THE MOVIES

While media research has incidentally addressed the portrayal of sex between married partners, this study specifically analyzed how sexuality between married couples is depicted in popular films, as represented by the top 25 movie video rentals of 1998. Of the occurrences of sexual behavior (N=105), married partners represented 15 percent of the total compared to 85 percent for unmarried couples. The most common sexual behavior among husbands and wives was passionate kissing, which accounted for 63 percent of their sexual activity. By comparison, implied intercourse was the most common sexual behavior among unmarried partners, occurring in 38 percent of their sexual encounters. This and other findings suggest that sexual behavior among married characters is rare and rather mundane compared to those having unmarried sex. These findings and their implications are discussed. The authors wish like to thank kim Vetter and Andrew McIntosh for their assistance in coding the films and to Craig Henderson for assistance with data analysis. In addition, this research was partially funded by Blockbuster Entertaiment and Payless Video.     

The Roman Catholic Pedophilia Crisis and the Call to Erotic Conversion

Abstract

The abuse of children and associated cover-ups have damaged the laity's trust in priests, unsettled the church's finances and exposed a culture of self-deception. Consequently, there is more focus on priest's sexual orientation and a clerical culture that includes hidden sexual behavior. Yet, Rome and the bishops are creating an environment which encourages the suppression of sexuality. In this climate, priests may be more prone to a less healthy and less mature incorporation of sexuality into daily living. Meanwhile, little theological discussion has occurred regarding the contribution of the church's narrow view of sexuality on this crisis. As a response, this article will use Lonergan's methodology to introduce the notion of Erotic Conversion, or, ‘turning with’ our sexual energies in an affirming manner. This concept will be brought into dialogue with the concept of embodiment and those theologies which have arisen from the gay and lesbian liberation movement.     

Facilitating sexual arousal via anger,aggression, or dominance

The hypothesis that either an angry emotional state or the expression of aggressive behavior facilitates sexual arousal has been the subject of considerable speculation but relatively little research. In a series of studies, Barclay found that anger increased sexual arousal as measured by the amount of sexual imagery produced in response to TAT-like stimuli that depicted males and females in dominant and submissive roles. In the present research, a series of experiments was conducted to determine whether such facilitation can be generalized beyond the specific procedures used by Barclay. Subjects (151 males and 136 females) in three experiments were angered by being negatively evaluated by a confederate identified as a fellow subject. Some subjects were subsequently given an opportunity to aggress; additionally, some subjects were exposed to male- and female-dominant pictorial stimuli. Results indicated that neither anger instigation nor the opportunity to engage in aggressive acts influenced self-reported sexual arousal. There was consistent evidence, however, that portrayals of dominance influenced perceptions of the stimulus person's sexuality. Though anger and aggression do not seem to facilitate sexual arousal, dominance cues (which can be confounded with anger manipulation) clearly elicit perceptions of sexuality.     

Infantile sexuality, gender identity, and obstacles to oedipal progression

Contrary to when it was first proposed, infantile sexuality nowadays is accepted as an important part of child development. However, Freud's views on masculine primacy and feminine inferiority are seen to be incomplete and inaccurate not only because they over-emphasize sexuality and sexual anatomy, but also because they neglect aggression, object relations, ego and superego functioning, and the sense of self. Infantile sexuality is therefore reconsidered within the broader perspective of gender identity. Within this broader perspective, normal and aberrant sexual development is discussed, and new ideas are offered about familiar concepts such as castration anxiety and penis envy.     

Sexual Prejudice among Christian College Students, Denominational Teachings, and Personal Religious Beliefs

Although numerous studies have examined the role of religious tradition and religiosity on attitudes toward lesbian, gay, and bisexual people, the role of endorsement of denominational teachings has largely been overlooked, even though such teachings are often cited to explain study findings. To better understand the complex relationship between religion and sexual prejudice, this study explores the unique contributions of religious tradition, religiosity, and individual endorsement of denominational doctrine about same-sex sexuality in shaping these attitudes. Findings indicate that endorsement of denominational doctrine concerning same-sex sexuality is more influential than religiosity, and that endorsement of denominational doctrine is not simply a proxy for believing that same-sex sexuality is a sin. Implications for future research are discussed.     

“Ye Double-Minded”: Black Parishioners’ Attitudes toward Nonaffirming Church Climates

Homophobia in the black community has been largely attributed to the Black Church's conservative views concerning sexual orientation. Prior research demonstrates that black congregations are generally nonaffirming of nonheterosexuality; however, few studies have investigated black congregants’ responses to their churches’ climates regarding sexuality. Using in-depth interviews, this paper examines the extent to which black Christians are content with their congregations’ nonaffirming climates. Findings indicate that although some black parishioners are content with or indifferent to their churches’ climates, most respondents advocate for a change in how their congregations address sexual orientation, specifically calling for open conversations about sexuality. Furthermore, an examination of the language respondents used to evaluate congregational climates suggests discussions of sexuality in churches that humanize and encourage empathy for nonheterosexual identities may help facilitate such conversations. These results challenge assumptions of ideological homogeneity within religious organizations and could inform strategies to promote nonheterosexual inclusion in congregations.     

When Do Motives to Sexually Please a Male Partner Benefit Women’s Own Sexual Agency?

Motivation to please a partner sexually, also known as sexual communal strength (SCS), has been positively associated with sexual and relationship functioning, particularly for partners. We used a critical sexuality studies approach to examine SCS as it relates to women’s own sexual agency. We also examined the potential moderating role of partner sexual coercion, defined as persistent pressure to attain sex. Specifically, we investigated whether frequency of partner sexual coercion moderates the effect of SCS on three different aspects of women’s sexual agency: sexual desire, sexual refusal assertiveness, and relational power. Participants were 172 U.S. women in dating relationships with men who responded to self-report measures. Results showed that SCS was positively related to women’s own sexual desire, regardless of how often women experienced partner sexual coercion. SCS and partner sexual coercion frequency were associated with sexual refusal assertiveness: The least assertive women reported both higher SCS and more frequent partner coercion. Sexual coercion frequency was negatively related to women’s relational power, regardless of their own SCS. These findings support educational and clinical interventions to reduce sexual coercion and suggest the concept of SCS be further refined to better account for the potential roles sexual coercion and heterosexual norms play more broadly.

     

Sexuality education and young people's sexual behavior: a review of studies

Sexuality education for children and young adults is one of the most heavily debated issues facing policy-makers, national AIDS program planners, and educators, provoking arguments over how explicit education materials should be, how much of it there should be, how often it should be given, and at what age instruction should commence. In this context, the World Health Organization's Global Program on AIDS' Office of Intervention Development and Support commissioned a comprehensive literature review to assess the effects of HIV/AIDS and sexuality education upon young people's sexual behavior. 52 reports culled from a search of 12 literature databases were reviewed. The main purpose of the review is to inform policy-makers, program planners, and educators about the impact of HIV and/or sexuality education upon the sexual behavior of youth as described in the published literature. Of 47 studies which evaluated interventions, 25 reported that HIV/AIDS and sexuality education neither increased nor decreased sexual activity and attendant rates of pregnancy and sexually transmitted diseases (STDs). 17 reported that HIV and/or sexuality education delayed the onset of sexual activity, reduced the number of sex partners, or reduced unplanned pregnancy and STD rates Only 3 studies found increases in sexual behavior associated with sexuality education. Inadequacies in study design, analytic techniques, outcome indicators, and the reporting of statistics are discussed.     

The Problematization of Sexuality among Women Living with HIV and a New Feminist Approach for Understanding and Enhancing Women’s Sexual Lives

In the context of HIV, women’s sexual rights and sexual autonomy are important but frequently overlooked and violated. Guided by community voices, feminist theories, and qualitative empirical research, we reviewed two decades of global quantitative research on sexuality among women living with HIV. In the 32 studies we found, conducted in 25 countries and composed mostly of cis-gender heterosexual women, sexuality was narrowly constructed as sexual behaviours involving risk (namely, penetration) and physiological dysfunctions relating to HIV illness, with far less attention given to the fullness of sexual lives in context, including more positive and rewarding experiences such as satisfaction and pleasure. Findings suggest that women experience declines in sexual activity, function, satisfaction, and pleasure following HIV diagnosis, at least for some period. The extent of such declines, however, is varied, with numerous contextual forces shaping women’s sexual well-being. Clinical markers of HIV (e.g., viral load, CD4 cell count) poorly predicted sexual outcomes, interrupting widely held assumptions about sexuality for women with HIV. Instead, the effects of HIV-related stigma intersecting with inequities related to trauma, violence, intimate relations, substance use, poverty, aging, and other social and cultural conditions primarily influenced the ways in which women experienced and enacted their sexuality. However, studies framed through a medical lens tended to pathologize outcomes as individual “problems,” whereas others driven by a public health agenda remained primarily preoccupied with protecting the public from HIV. In light of these findings, we present a new feminist approach for research, policy, and practice toward understanding and enhancing women’s sexual lives—one that affirms sexual diversity; engages deeply with society, politics, and history; and is grounded in women’s sexual rights.     

Romantic relationships and sexuality in adolescence and young adulthood: The role of parents,peers, and partners

The formation of romantic relationships and the engagement in sexual behaviours are considered normative and salient developmental tasks for adolescents and young adults. These developmental tasks are increasingly viewed from an ecological perspective, thus not only as individual processes, but also as strongly embedded in different social contexts, including the proximal social domains of parents, peers, and partners. This special issue brings together seven recent empirical studies on adolescents' and young adults' romantic relationships and sexuality in the context of relationships and interactions with parents, peers, and partners. In this editorial introduction, we describe two important recent changes in the theoretical perspectives on emerging romantic relationships and sexual activity: from risky behaviours to normative tasks, and from individual to contextualized processes. We then discuss recent advances in empirical research on romantic relationships and sexuality of adolescents and young adults. After that, we review the seven studies in this special issue, and discuss the contributions of these studies to the existing literature. Finally, we discuss directions for future research regarding how the interrelational perspective can be further incorporated into empirical research, and how the gap between the research fields on romantic relationships and sexuality may be bridged.     

Altered Sexuality and Body Image after Gynecological Cancer Treatment: How Can Psychologists Help?

Once medical treatment for gynecological cancer is completed, what happens to patients' sexuality and body image? Due to the delicate nature of the cancer site, treating this cancer typically affects sexual functioning and body image adversely, making it critical to identify the concerns of these patients and do so in a manner less restrictive than paper-and-pencil assessment. To gain a deeper understanding of the phenomenological experiences in question, we interviewed nine gynecological cancer patients and seven cancer-free women. After implementing a relaxation protocol, we asked each woman to describe her feelings and thoughts on her sexuality and body image in one-on-one interviews. A variety of themes emerged on patients' attitudes and perspectives concerning sexuality and body image following diagnosis and treatment of the cancer. The themes that were considerably different from those of the cancer-free women included decreased sexual functioning and body image, abrupt shifts in self-identity due to loss of physical integrity, and distancing in intimate relationships. Several implications of these findings for clinical practice are discussed, as well as the need to train medical professionals to properly assess these patients' alterations in sexuality.