Review of the empirical evidence for a theoretical model to understand the sexual problems of women with a history of CSA.

INTRODUCTION: Sexual problems in women with a history of child sexual abuse (CSA) are relatively common but only a few studies have attempted to explain the mechanisms of these problems. Given the potential for a variety of factors associated with sexual problems in CSA survivors, the field needs a theoretical model to explain these difficulties. AIM: The main aim of this article was to illustrate a theoretical model to understand sexual problems in CSA survivors. Sexual problems are here grouped into hyposexual and hypersexual. A review of empirical studies that support this model is presented. A second aim was to discuss the definition of CSA adopted in research projects.
METHODS: Results from studies targeting psychophysiologic, affective, and cognitive sexual responses are discussed. MAIN OUTCOME MEASURES: Vaginal photoplethismography, sexual self-schemas, and implicit sexual associations to sexual stimuli were the focus of the studies reviewed.
RESULTS: These studies showed that during the exposure to sexual stimuli, CSA survivors experienced more inhibitory responses and less excitatory responses than women in the comparison groups. On the other hand, in situations when sexual stimuli were not present, CSA survivors showed a greater excitation of sexual responses than women in the comparison groups. Additionally, CSA survivors showed a potential difficulty inhibiting intrusive sexual thoughts.
CONCLUSIONS: The model shows promising qualities to adequately explain the hypo- and hypersexuality of CSA survivors. The advantages of this model over others include the ability to guide the selection of cognitive and behavioral interventions for patients presenting for treatment.