Problems with sexuality after sexual assault.

In this article, we review a number of studies on sexual functioning after sexual assault. Among the studies discussed, three different approaches can be distinguished: the descriptive analyses of sexual functioning and sexual problems, the exploration of factors which predict sexual problems, and the study of relationships between sexual problems and other psychological problems. Although the studies vary considerably in methodology, they point to the conclusion that frequency of sexual contact decreases after sexual assault. Satisfaction and pleasure in sexual activities seem to diminish for a considerable group of victims for at least 1 year postassault. In several studies it was revealed that victims develop sexual problems that can persist for years after the assault. These include response inhibiting problems, such as fear and arousal and desire dysfunctions. Most researchers have found that factors such as a young age, a known offender, and penetration during the assault are related to sexual problems. With respect to physical violence used during the assault, the results are inconclusive. Furthermore, emotions felt during and immediately after the assault, such as anger towards self, shame, and guilt, may predict sexual problems. Avoidance of sexual contact also appears to be related to sexual problems. A loving and understanding partner seems to be a protective factor. Finally it can be concluded that sexual problems are related to other psychological problems, including posttraumatic stress symptoms and depression.