Article summary with The Sexual Well-Being of Women Who Have Experienced Sexual Abuse During Childhood by Lemieux & Byers - 2008

Preface

Sexual abuse during childhood is associated with a variety of negative short- and long-term effects such as depression, anxiety, anger, poor self-esteem, drug abuse, eating disorders and experiencing sexual abuse again. However, there have been relatively little studies conducted into the sexual well-being of women who have been abused during childhood. Some women may not experience sexual problems after sexual abuse. However, they may still experience a decrease in positive aspects of their sexual functioning (for example lower sexual satisfaction, sexual rewards, or a negative sexual self-image).

Explanations of long-term effects of sexual abuse during childhood

The conditioning model

The consequences of sexual abuse can be explained with the use of the conditioning model. In this model, it is thought that the coupling (the association) of negative cognitive, emotional and physical responses to sexual abuse are conditioned (so, they are associated together in the mind). So, over time, these negative responses can be triggered by a wide range of stimuli and lead to a series of behaviors aimed at avoiding painful thoughts, feelings, and memories of the sexual abuse.

Traumagenic dynamics model

This model is mainly used to understand how sexual abuse can contribute to later sexual problems. In this model, traumatic sexualization is defined as: "a process in which the sexuality of a child, which contains both sexual feelings and sexual attitudes, is shaped in an inappropriate developmental area and in an interpersonal dysfunctional manner as a result of sexual abuse". More serious sexual abuse will lead to greater traumatic sexualization and will have a greater impact on later sexual functioning.

Sexual abuse during childhood and the sexual well-being of women

Studies have shown that women who used to be sexually abused during their childhood have unhealthy or inappropriate sexual practices, have less sex and experience more sexual problems and dysfunctions compared to women who have not been sexually abused during their childhood. In this study, the association between sexual abuse during childhood and a series of positive and negative aspects of women's sexual functioning was studied. Three types of cognitive and emotional sexual assessments were used for this.

• Various sexual stimuli of women (erotophobia-erotophilia)

• Assessment of sexual self-image

• Assessment of sexual experiences

Erotophobia erotophilia

Childhood sexual abuse leads to greater erotophobia, more negative sexual self-schemas and lower sexual self-esteem. This can cause some women to avoid sex because of negative associations. People with erotophobia often have negative emotional responses and evaluations on a variety of sexual simili and behaviors. These individuals show less erotic behavior, have fewer heterosexual experiences, are less likely to acquire and use contraception and have a more negative attitude towards their sexuality compared to people with eterotophilia.

Assessment of sexual self-image and sexual self-esteem

Sexual self-image is defined as 'cognitive representations (or thoughts) about the sexual aspects of the self'. People with a negative sexual self-schemas tend to view themselves as sexually conservative, inhibited and insecure. A sexual self-image consists of five different dimensions: experiences, evaluation, attractiveness, control, moral judgment and adaptability. In previous research, sexually abused women had a lower sexual self-image on the dimensions of moral judgment and control.

Sexual self-esteem is defined as a woman's emotional responses to her subjective assessment of her sexual thoughts, feelings, and behaviors.

Assessment of sexual experiences

Some studies have shown that lower sexual satisfaction occurs in women who have been sexually abused during their childhood. Higher yields and lower costs in the sexual relationship are associated with greater sexual satisfaction. Little research has been conducted into whether women with a history of sexual abuse experience lower sexual rewards and higher sexual costs.

Hypothesis

The relationship between sexual abuse in childhood and the various aspects of women's sexual well-being has been investigated in this study. First, it was predicted that women who experienced sexual abuse where an attempt was made to penetrate sexually would function worse sexually compared to women who experienced sexual abuse, but were only sexually fondled. Second, it was predicted that non-abused women would function better sexually. Finally, it was predicted that the cognitive and emotional sexual assessments of women would mediate the relationship between sexual abuse and sexual functioning.   

Method

The sample eventually consisted of 224 participants who were obtained through psychology classes at the University of Canada. The participants were between the ages of 17 and 48 and were almost all born in Canada. The average age of the participants when they first started dating was 14.6. On average they were 16.5 years old when they had sex for the first time and had an average number of sex partners of 4.8. The participants received extra credits for their participation in the study. The researchers used a broad range of instruments to capture all the different aspects of sexual well-being in women who were abused during childhood.

Results

Ultimately, the sample was divided into three groups: 'no experience with sexual abuse', 'sexually touched' and 'sexual abuse with penetration'.   

A sexual victim, again

Women who were sexually abused with penetration were significantly more likely to fall victim to sexual abuse again in their adult age compared to women from the other two groups. 

Experiences of sexual violence and the sexual functioning of women

Women who were sexually abused with penetration are significantly more likely to have superficial sex and report a higher value of sexual costs than the other two groups. Also, the group with "sexually touched women" and "sexual abuse with penetration" were more often engaged in unprotected sex. Finally, women from the "sexual abuse with penetration" group deliberately abstained from sexual activities more often and they reported fewer sexual rewards compared to the "no sexual abuse experience" group.

Sexual abuse and the cognitive and emotional sexual assessments of women

Women who were sexually abused with penetration had significantly lower sexual self-esteem than the other two groups. Contrary to expectations, the group of women who were sexually abused with penetration, were more often erotophilic and had a more positive sexual self-schema compared to the two other groups.

The role of childhood abuse in the sexual functioning of women

Women who experienced emotional abuse had a greater risk on experiencing sexual abuse and voluntarily renounced sexual activities. They also reported more sexual problems, lower sexual rewards, higher sexual costs, lower sexual self-esteem and less sexual satisfaction. Women who were physically abused were more likely to engage in superficial sex, unprotected sex, and reported lower sexual confidence.

The mediating role of cognitive and emotional assessments of women

The sexual self-esteem of women who were sexually abused was significantly associated with superficial sex, sexual withdrawal and a higher level of perceived sexual costs.

Discussion

As predicted, the women from the group who were sexually abused with penetration had lower sexual confidence than the other two groups. It has also been found that women who have experienced sexual abuse are less comfortable with their sexual behavior and see themselves as less physically and sexually attractive compared to women who had not been sexually abused experience. However, contrary to the researchers' hypothesis, women who were sexually abused are more erotophilic and report having more positive sexual self-schedules. 

Limitations research

First, the women who had not yet had sexual intercourse were removed from the sample due to a large amount of missing data. Although they were younger, less experienced and were not yet married / cohabiting, that does not mean that their chance of experiencing sexual abuse is less. Second, the majority in the sample were heterosexual students. Thirdly, the women were asked whether they had ever had an STD or had accidentally become pregnant to determine if they were engaged in unprotected sexual activities. This could provide a distorted picture, since there may be other reasons for, for example, getting pregnant unintentionally (for example, the tearing of a condom). Finally, there are women who have experienced multiple types of child abuse in their youth, but these types are not distinguished. However, certain combinations of abuse may have more specific outcomes with regards to sexual functioning.