Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Women with a history of childhood sexual abuse (CSA) experience dissociative symptoms and sexual difficulties 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 difficulties. 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 associated with higher sexual arousal functioning. No measure of dissociation was significantly associated with sexual responses in the laboratory. These findings 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 findings 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Aderibigbe, Y. A., Bloch, R. M., & Walker, W. R. (2001). Prevalence of depersonalization and derealization experiences in a rural population. Social Psychiatry and Psychiatric Epidemiology, 36, 63–69.

    Article  PubMed  Google Scholar 

  • Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks, CA: Sage.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • An, J. S., & Cooney, T. M. (2006). Psychological well-being in mid to late life: The role of generativity development and parent–child relationships across the lifespan. International Journal of Behavioral Development, 30, 410–421.

    Article  Google Scholar 

  • Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54, 140–148.

    Article  PubMed  Google Scholar 

  • Bernstein, D. P., & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. San Antonio, TX: Harcourt Brace & Co.

    Google Scholar 

  • Blake, D. D., Keane, T. M., Wine, P. R., Mora, C., Taylor, K. L., & Lyons, J. A. (1990). Prevalence of PTSD symptoms in combat veterans seeking medical treatment. Journal of Traumatic Stress, 3, 15–27.

    Article  Google Scholar 

  • Both, S., Laan, E., & Everaerd, W. (2011). Focusing “hot” or focusing “cool”: Attentional mechanisms in sexual arousal in men and women. Journal of Sexual Medicine, 8, 167–179.

    Article  PubMed  Google Scholar 

  • Boysan, M., Goldsmith, R. E., Çavuş, H., Kayri, M., & Keskin, S. (2009). Relations among anxiety, depression, and dissociative symptoms: The influence of abuse subtype. Journal of Trauma & Dissociation, 10, 83–101.

    Article  Google Scholar 

  • Bremner, J. D., Krystal, J. H., Putnam, F. W., Southwick, S. M., Marmar, C., Charney, D. S., et al. (1998). Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS). Journal of Traumatic Stress, 11, 125–136.

    Article  PubMed  Google Scholar 

  • Briere, J., Weathers, F. W., & Runtz, M. (2005). Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory. Journal of Traumatic Stress, 18, 221–231.

    Article  PubMed  Google Scholar 

  • Brotto, L. A. (2011). Non-judgmental, present-moment, sex…as if your life depended on it. Sexual and Relationship Therapy, 26, 215–216.

    Article  Google Scholar 

  • Brotto, L. A., Basson, R., & Luria, M. (2008a). A mindfulness based group psychoeducational intervention targeting sexual arousal disorder in women. Journal of Sexual Medicine, 5, 1646–1659.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Krychman, M., & Jacobson, P. (2008b). Eastern approaches for enhancing women’s sexuality: Mindfulness, acupuncture, and yoga. Journal of Sexual Medicine, 5, 2741–2748.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Seal, B. N., & Rellini, A. (2012). Pilot study of a brief cognitive behavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. Journal of Sex and Marital Therapy, 38, 1–27.

    Article  PubMed  Google Scholar 

  • Catania, J. A., McDermott, L. J., & Pollack, L. M. (1986). Questionnaire response bias and face-to-face interview sample bias in sexuality research. Journal of Sex Research, 22, 52–72.

    Article  Google Scholar 

  • Chu, J. A., & Dill, D. L. (1990). Dissociative symptoms in relation to childhood physical and sexual abuse. American Journal of Psychiatry, 147, 887–892.

    Article  PubMed  Google Scholar 

  • Classen, C. C., Palesh, O. G., Cavanaugh, C. E., Koopman, C., Kaupp, J. W., Kraemer, H. C., … Spiegel, D. (2011). A comparison of trauma-focused and present-focused group therapy for survivors of childhood sexual abuse: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 84–93.

  • Cloitre, M., Scarvalone, P., & Difede, J. (1997). Posttraumatic stress disorder, self- and interpersonal dysfunction among sexually retraumatized women. Journal of Traumatic Stress, 10, 437–452.

    PubMed  Google Scholar 

  • Davidson, J. M., & Davidson, R. J. (1980). The psychobiology of consciousness. New York: Plenum Press.

    Book  Google Scholar 

  • DePrince, A. P. (2005). Social cognition and revictimization risk. Journal of Trauma & Dissociation, 6, 125–141.

    Article  Google Scholar 

  • Finkelhor, D., Hotaling, G. T., Lewis, I. A., & Smith, C. (1989). Sexual abuse and its relationship to later sexual satisfaction, marital status, religion, and attitudes. Journal of Interpersonal Violence, 4, 379–399.

    Article  Google Scholar 

  • Fleiss, J. L. (1975). Measuring agreement between two judges on the presence or absence of a trait. Biometrics, 31, 651–659.

    Article  PubMed  Google Scholar 

  • Gilmore, A. K., Schacht, R. L., George, W. H., Otto, J. M., Davis, K. C., Heiman, J. R., … Kajumulo, K. F. (2010). Assessing women’s sexual arousal in the context of sexual assault history and acute alcohol intoxication. Journal of Sexual Medicine, 7, 2112–2119.

  • Hanh, T. N. (1976). The miracle of mindfulness (M. Ho, Trans.). Boston: Beacon Press.

  • Hansen, N. B., Brown, L. J., Tsatkin, E., Zelgowski, B., & Nightingale, V. (2012). Dissociative experiences during sexual behavior among a sample of adults living with HIV infection and a history of childhood sexual abuse. Journal of Trauma & Dissociation, 13, 345–360.

    Article  Google Scholar 

  • Hillberg, T., Hamilton-Giachritsis, C., & Dixon, L. (2011). Review of meta-analyses on the association between child sexual abuse and adult mental health difficulties: A systematic approach. Trauma, Violence, & Abuse, 12, 38–49.

    Article  Google Scholar 

  • Johnson, D. M., Pike, J. L., & Chard, K. M. (2001). Factors predicting PTSD, depression, and dissociative severity in female treatment-seeking childhood sexual abuse survivors. Child Abuse and Neglect, 25, 179–198.

    Article  PubMed  Google Scholar 

  • Keane, T. M., Caddell, J. M., & Taylor, K. L. (1988). Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85–90.

    Article  PubMed  Google Scholar 

  • Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164–180.

    Article  PubMed  Google Scholar 

  • King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the Clinician-Administered PTSD Scale: Evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90–96.

    Article  Google Scholar 

  • Laan, E., Everaerd, W., Van Aanhold, M.-T., & Rebel, M. (1993). Performance demand and sexual arousal in women. Behaviour Research and Therapy, 31, 25–35.

    Article  PubMed  Google Scholar 

  • Laan, E., Everaerd, W., van Bellen, G., & Hanewald, G. F. P. (1994). Women’s sexual and emotional responses to male- and female-produced erotica. Archives of Sexual Behavior, 23, 153–169.

    Article  PubMed  Google Scholar 

  • Laan, E., Everaerd, W., van der Velde, J., & Geer, J. H. (1995). Determinants of subjective experience of sexual arousal in women: Feedback from genital arousal and erotic stimulus content. Psychophysiology, 32, 444–451.

    Article  PubMed  Google Scholar 

  • Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537–544.

    Article  PubMed  Google Scholar 

  • Leiblum, S. R., & Rosen, R. C. (1989). Principles and practice of sex therapy: Update for the 1990s. New York: Guilford Press.

    Google Scholar 

  • Leonard, L. M., & Follette, V. M. (2002). Sexual functioning in women reporting a history of child sexual abuse: Review of the empirical literature and clinical implications. Annual Review of Sex Research, 13, 346–388.

    PubMed  Google Scholar 

  • Lewis, R. W., Fugl-Meyer, K. S., Corona, G., Hayes, R. D., Laumann, E. O., Moreira, E. D., … Segraves, T. (2010). Definitions/epidemiology/risk factors for sexual dysfunction. Journal of Sexual Medicine, 7, 1598–1607.

    Google Scholar 

  • Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • Lyons, J. A., & Keane, T. M. (1992). Keane PTSD scale: MMPI and MMPI-2 update. Journal of Traumatic Stress, 5, 111–117.

    Article  Google Scholar 

  • Maercker, A., Beauducel, A., & Schützwohl, M. (2000). Trauma severity and initial reactions as precipitating factors for posttraumatic stress symptoms and chronic dissociation in former political prisoners. Journal of Traumatic Stress, 13, 651–660.

    Article  PubMed  Google Scholar 

  • Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. London: Churchill.

    Google Scholar 

  • Meston, C. M. (2006). The effects of state and trait self-focused attention on sexual arousal in sexually functional and dysfunctional women. Behaviour Research and Therapy, 44, 515–532.

    Article  PubMed Central  PubMed  Google Scholar 

  • Meston, C. M., Hull, E., Levin, R. J., & Sipski, M. (2004). Disorders of orgasm in women. Journal of Sexual Medicine, 1, 66–68.

    Article  PubMed  Google Scholar 

  • Meston, C. M., & Lorenz, T. A. (2012). Physiological stress responses predict sexual functioning and satisfaction differently in women who have and have not been sexually abused in childhood. Psychological Trauma: Theory, Research, Practice, and Policy, 5(4), 350–358.

    Article  Google Scholar 

  • Mitchell, E. S., Woods, N. F., & Mariella, A. (2000). Three stages of the menopausal transition from the Seattle Midlife Women’s Health Study: Toward a more precise definition. Menopause, 7, 334–349.

    Article  PubMed  Google Scholar 

  • Mulder, R. T., Beautrais, A. L., Joyce, P. R., & Fergusson, D. M. (1998). Relationship between dissociation, childhood sexual abuse, childhood physical abuse, and mental illness in a general population sample. American Journal of Psychiatry, 155, 806–811.

    PubMed  Google Scholar 

  • Noll, J. G., Horowitz, L. A., Bonanno, G. A., Trickett, P. K., & Putnam, F. W. (2003). Revictimization and self-harm in females who experienced childhood sexual abuse: Results from a prospective study. Journal of Interpersonal Violence, 18, 1452–1471.

    Article  PubMed  Google Scholar 

  • O’Brien, R. M. (2007). A caution regarding rules of thumb for variance inflation factors. Quality & Quantity: International Journal of Methodology, 41, 673–690.

    Article  Google Scholar 

  • Plaud, J. J., Gaither, G. A., Hegstad, H. J., Rowan, L., & Devitt, M. K. (1999). Volunteer bias in human psychophysiological sexual arousal research: To whom do our research results apply? Journal of Sex Research, 36, 171–179.

    Article  Google Scholar 

  • Putnam, F. W. (1997). Dissociation in children and adolescents: A developmental perspective. New York: Guilford Press.

    Google Scholar 

  • Putnam, F. W., & Trickett, P. K. (1997). Psychobiological effects of sexual abuse. Annals of the New York Academy of Sciences, 821, 150–159.

    Article  PubMed  Google Scholar 

  • Rellini, A. (2008). Review of the empirical evidence for a theoretical model to understand the sexual problems of women with a history of CSA. Journal of Sexual Medicine, 5, 31–46.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., Elinson, S., Janssen, E., & Meston, C. M. (2012). The effect of pre-existing affect on the sexual responses of women with and without a history of childhood sexual abuse. Archives of Sexual Behavior, 41, 329–339.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., Ing, A. D., & Meston, C. M. (2011). Implicit and explicit cognitive sexual processes in survivors of childhood sexual abuse. Journal of Sexual Medicine, 8, 3098–3107.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., McCall, K. M., Randall, P. K., & Meston, C. M. (2005). The relationship between women’s subjective and physiological sexual arousal. Psychophysiology, 42, 116–124.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., & Meston, C. M. (2006a). Psychophysiological sexual arousal in women with a history of child sexual abuse. Journal of Sex and Marital Therapy, 32, 5–22.

    Article  PubMed  Google Scholar 

  • Rellini, A., & Meston, C. (2006b). The sensitivity of event logs, self-administered questionnaires and photoplethysmography to detect treatment-induced changes in female sexual arousal disorder (FSAD) diagnosis. Journal of Sexual Medicine, 3, 283–291.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rellini, A., & Meston, C. (2007). Sexual function and satisfaction in adults based on the definition of child sexual abuse. Journal of Sexual Medicine, 4, 1312–1321.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rellini, A. H., & Meston, C. M. (2011). Sexual self-schemas, sexual dysfunction, and the sexual responses of women with a history of childhood sexual abuse. Archives of Sexual Behavior, 40, 351–362.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., … D’Agostino, R. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy, 26, 191–208.

  • Sanders, B., & Giolas, M. H. (1991). Dissociation and childhood trauma in psychologically disturbed adolescents. American Journal of Psychiatry, 148, 50–54.

    Article  PubMed  Google Scholar 

  • Schacht, R. L., George, W. H., Heiman, J. R., Davis, K. C., Norris, J., Stoner, S. A., et al. (2007). Effects of alcohol intoxication and instructional set on women’s sexual arousal vary based on sexual abuse history. Archives of Sexual Behavior, 36, 655–665.

    Article  PubMed  Google Scholar 

  • Seal, B. N., & Meston, C. M. (2007). The impact of body awareness on sexual arousal in women with sexual dysfunction. Journal of Sexual Medicine, 4, 990–1000.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sintchak, G., & Geer, J. H. (1975). A vaginal plethysmograph system. Psychophysiology, 12, 113–115.

    Article  PubMed  Google Scholar 

  • Staples, J., Rellini, A. H., & Roberts, S. P. (2012). Avoiding experiences: Sexual dysfunction in women with a sexual abuse history in childhood and adolescence. Archives of Sexual Behavior, 41, 341–350.

    Article  PubMed  Google Scholar 

  • Stephenson, K. R., Hughan, C. P., & Meston, C. M. (2012). Childhood sexual abuse moderates the association between sexual functioning and sexual distress in women. Child Abuse and Neglect, 36, 180–189.

    Article  PubMed Central  PubMed  Google Scholar 

  • Stoltenborgh, M., IJzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16, 79–101.

    Article  PubMed  Google Scholar 

  • Strassberg, D. S., & Lowe, K. (1995). Volunteer bias in sexuality research. Archives of Sexual Behavior, 24, 369–382.

    Article  PubMed  Google Scholar 

  • Van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics of North America, 12, 293–317.

    Article  PubMed  Google Scholar 

  • Van Lankveld, J. J. D. M., van den Hout, M. A., & Schouten, E. G. W. (2004). The effects of self-focused attention, performance demand, and dispositional sexual self-consciousness on sexual arousal of sexually functional and dysfunctional men. Behaviour Research and Therapy, 42, 915–935.

    Article  PubMed  Google Scholar 

  • Weathers, F. W., Keane, T. M., & Davidson, J. R. T. (2001). Clinician-Administered PTSD Scale: A review of the first ten years of research. Depression and Anxiety, 13, 132–156.

    Article  PubMed  Google Scholar 

  • Wincze, J. P., Hoon, P., & Hoon, E. F. (1977). Sexual arousal in women: A comparison of cognitive and physiological responses by continuous measurement. Archives of Sexual Behavior, 6, 121–133.

    Article  PubMed  Google Scholar 

  • Wolchik, S. A., Spencer, S. L., & Lisi, I. S. (1983). Volunteer bias in research employing vaginal measures of sexual arousal. Archives of Sexual Behavior, 12, 399–408.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2003). Guidelines for medico-legal care for victims of sexual violence. Geneva: Author.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Vermont, John Dewey Hall, 2 Colchester Ave., Burlington, VT, 05401, USA

    Elizabeth R. Bird, Martin Seehuus, Jessica Clifton & Alessandra H. Rellini

Authors
  1. Elizabeth R. Bird
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Seehuus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jessica Clifton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alessandra H. Rellini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandra H. Rellini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bird, E.R., Seehuus, M., Clifton, J. et al. Dissociation During Sex and Sexual Arousal in Women With and Without a History of Childhood Sexual Abuse. Arch Sex Behav 43, 953–964 (2014). https://doi.org/10.1007/s10508-013-0191-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-013-0191-0

Keywords

Search

Navigation