Manifestations Of Posttraumatic Stress Disorder Research Articles

PECULIARITIES OF ADAPTATION AND COURSE OF POST-TRAUMATIC STRESS DISORDER IN SERVICEMEN DEPLOYED TO INTENSE COMBAT ZONES

In the context of war, post-traumatic stress disorder (PTSD) emerges as one of the most prevalent psychological conditions, particularly among military personnel deployed in combat zones. The primary triggers for PTSD in military personnel often include the loss of comrades or the necessity to use lethal weapons, resulting in significant consequences. For PTSD to manifest, individuals must undergo a traumatic experience that exceeds normal human stress levels and leads to distress. The aim of this study is to investigate the course of PTSD in military personnel who have been exposed to intense combat operations and to explore their maladaptive manifestations. The study comprised 38 patients diagnosed with PTSD (F43.1) according to the ICD-10, who received treatment at the Regional Mental Health Care Institution for the Protection of the Armed Forces. All patients provided informed consent to participate in the study. A structured clinical diagnostic interview known as CAPS-DX was applied in this study. Developed based on the DSM-IV, this interview assesses the symptoms of posttraumatic stress disorder (PTSD), the duration of the disorder, and the degree of impairment of social functioning. The CAPS-DX scale provided insights into the presence of PTSD symptoms both currently and throughout the individual's life following psychotrauma. To diagnose psychosocial maladjustment and its characteristics, we employed the Psychosocial Maladjustment Scale by L. Herasymenko (2018). Clinical and anamnestic examinations revealed that 86% of servicemen had experienced multiple traumatic events, indicating a history of several psychotraumas. The study identified that the primary psychopathological manifestations of PTSD did not differ significantly from the traditional course of the disorder, but they were more intense and pronounced in this group of servicemen. The study has demonstrated that servicemen with combat experience and PTSD exhibited reduced levels of psychosocial adaptation. Their adaptive resources and capabilities, as well as their neuropsychological stability, were significantly diminished, along with a decrease in their communication abilities. Based on the overall level and quality of social and psychological adaptation, three levels of adaptation/maladaptation were distinguished among servicemen with combat-related PTSD: sufficient, partial, or maladaptation. It should be noted that the levels of adaptation were correlated with the severity of anxiety. Servicemen with sufficient adaptation typically exhibited low levels of anxiety, while those with partial adaptation showed an average level, and those with maladaptation displayed high levels of anxiety. The study revealed a spectrum of psychopathological manifestations in servicemen who were in the combat zone, ranging from semiotic complexes resembling panic attacks to psychogenic catalepsy. Furthermore, it was found that servicemen with combat experience and post-traumatic stress disorder had reduced levels of psychosocial adaptation, which correlated with the severity of anxiety.

Neuroanatomical and functional correlates in post-traumatic stress disorder: A narrative review.

Post-traumatic stress disorder (PTSD), currently included by the Diagnostic and Statistical of Mental Disorders, Fifth Edition, Text Revisionin the macro-category "disorders related to traumatic and stressful events",is a severe mental distress that arises acutely as a result of direct or indirect exposure to severely stressful and traumatic events. A large body of literature is available on the psychological and behavioral manifestations of PTSD; however, with regard to the more purely neuropsychological aspects of the disorder, they are still the subject of research and need greater clarity, although the roles of the thalamus, hypothalamus, amygdala, cingulate gyrus, cerebellum, locus coeruleus, and hippocampus in the onset of the disorder's characteristic symptoms have already been elucidated.

Psychological consequences of combat trauma at the hospital stage of rehabilitation

BACKGROUND: Currently, the issues of restoring the somatic and mental health of combatants undergoing treatment and rehabilitation in hospital conditions are becoming particularly relevant.
 AIM: To examine and compare the mental states and psychological consequences of combat trauma at the hospital stage of rehabilitation of combatants.
 MATERIALS AND METHODS: The study involved 97 combatants with various wounds and injuries that were hospitalized in the clinical units of the surgical and therapeutic profile of the Military Medical Academy. Of these, 44 people were examined in 2014 and 53 people in 2022.
 RESULTS: Comparison of independent samples of combatants in 2014 and 2022 at the stage of treatment and rehabilitation showed a statistically significant twofold decrease in asthenic manifestations from 38.6% in 2014 to 20% in 2022 (p 0.05). The relative number of combatants with negative psychological consequences of combat trauma in the form of manifestations of post-traumatic stress disorder in 2014 and 2022 was similar and amounted to 15.9% and 17%, respectively, which is apparently due to the homogeneity of the sample and the similarity of factors causing these stress-reactive changes. Uncompensated negative psychological consequences of combat trauma can be fixed in the form of combatant accentuation and chronic, irreversible personality change. These stress-reactive changes reduce both the professional qualities of the combatants and their quality of life.
 CONCLUSION: The clinical and psychological characteristics of patients indicate the need for psychological assistance, starting from the moment of injury and continuing throughout the wound disease.

Study of manifestations of post-traumatic stress disorder in internally displaced persons and methods of improvement their psychological state

Study of manifestations of post-traumatic stress disorder in internally displaced persons and methods of improvement their psychological state

Kendra Allen’s Learning & Unlearning

Kendra Allen’s Learning & Unlearning Jalen Eutsey (bio) When You Learn the Alphabet, by Kendra Allen (University of Iowa Press, 2019), 160 pp. Kendra Allen’s literary debut, the essay collection When You Learn the Alphabet, is a relatively short but densely packed portrait of a Black life, a raw rendering of familial relationships inflected by race, gender, trauma, and disability. The book explores grown folks’ business in great detail, business that Allen is caught precariously in the middle of as a child. Allen’s parents’ relationship, her childhood in Dallas, Texas, and the fallout of their coming together, burning out, and pulling apart are the central events that the book orbits. The second essay in the collection, titled “About American Marriages,” details her parents’ seven-year separation and eventual divorce: “This is what happened: What I’ve been told: Which is what always happens: Your husband begins having sex with a woman, who isn’t you and he doesn’t even care enough to hide it well.” The essay goes on to describe the separation that allows her mother to keep hope alive and allows her father to come and go as he pleases, often without seeing Allen. Allen painfully draws out the rising tension as her father builds a life with the other woman and her child in Houston, unbeknownst to her mother, and mandates that she participate in the cover-up. It leads to this heartbreaking culmination: “When my mama finally files for divorce, it feels like she not only divorces my daddy, but every once in a while, when the subject is brought up, it feels like she’s divorced me too.” As the book develops, we learn more and more about this triumvirate. We see moments of physical violence and manifestations of post-traumatic stress disorder—both of Allen’s parents have been diagnosed as disabled veterans, although her father’s diagnosis is “100% disabled veteran” while her mother’s is “90% disabled veteran.” It’s clear that even this diagnosis is not free of the influence of race and gender: “She’s been shooting for 100% for a couple of years now, but even after working at the VA for 28 years, and even after all her apparent symptoms of forcefulness, forgetfulness, and injury, they just won’t let her have it. Her wounds ain’t physical enough. She ain’t pale enough. She ain’t male enough.” We’re never quite on settled ground in When You Learn the Alphabet. [End Page 128] Allen makes all the beautiful and painful contradictions of humanity, of the individual, plain in her essays. One of my favorite examples comes in the titular essay, “When You Learn the Alphabet,” which is presented as an abecedarian, with each new vignette beginning with a subsequent letter of the alphabet. H begins this way: “Horror story: Your childhood friend goes to jail for not snitching.” The section continues by detailing the conditioning, from childhood, that puts the highest priority on not snitching. Yet, the most compelling part of the section is how Allen feels about this life- altering decision: “He was just doing what he was told. But part of you blames him he’s still in a small cell years later for a crime he didn’t commit. Part of you blames him for committing to be loyal only.” But even as Allen makes this point, there is this honest admission: “Part of you that follows the impossible expectations of the hood praises him for being some obscured version of a real nigga.” Allen slips in and out of genres in this collection, from the abecedarian essay to a short section, “Boy Is a White Racist Word,” organized as a contrapuntal poem. All the while, she mixes personal narrative with cultural critique, placing her work invariably in conversation with the work of writers like Hanif Abdurraqib and Kiese Laymon. Allen often references pop culture, most notably music and film. True Blood, Moonlight, Monster’s Ball, The Fresh Prince of Bel-Air, Behind the Music, Jay-Z, Boyz n the Hood, and Everybody Hates Chris (among others), all get a mention. This familiarity with popular media allows her to...

Insular activation and functional connectivity in firefighters with post-traumatic stress disorder.

Firefighters are frequently exposed to stressful situations and are at high risk of developing post-traumatic stress disorder (PTSD). Hyperresponsiveness to threatening and emotional stimuli and diminishment of executive control have been suggested as manifestations of PTSD. To examine brain activation in firefighters with PTSD by conducting an executive control-related behavioural task with trauma-related interferences. Twelve firefighters with PTSD and 14 healthy firefighters underwent functional magnetic resonance imaging (fMRI) while performing a Stroop match-to-sample task using trauma-related photographic stimuli. Seed-based functional connectivity analysis was conducted using regions identified in fMRI contrast analysis. Compared with the controls, the participants with PTSD had longer reaction times when the trauma-related interferences were presented. They showed significantly stronger brain activation to interfering trauma-related stimuli in the left insula, and had weaker insular functional connectivity in the supplementary motor area and the anterior cingulate cortex than the controls. They also showed a significant correlation between left insula-supplementary motor area connectivity strength and the hyperarousal subscale of the Clinician-Administered PTSD Scale. Our findings indicate that trauma-related stimuli elicit excessive brain activation in the left insula among firefighters with PTSD. Firefighters with PTSD also appear to have weak left insular functional connectivity with executive control-related brain regions. This aberrant insular activation and functional connectivity could be related to the development and maintenance of PTSD symptoms in firefighters.

Intranasal Neuropeptide Y as a Potential Therapeutic for Depressive Behavior in the Rodent Single Prolonged Stress Model in Females.

The susceptibility to stress-elicited disorders is markedly influenced by sex. Women are twice as likely as men to develop posttraumatic stress disorder (PTSD), depression, anxiety disorders, and social impairments following exposure to traumatic stress. However, most of the studies in animal models examining putative therapeutics for stress-triggered impairments, including single prolonged stress (SPS), were performed predominantly with males. Previous studies in males demonstrated that intranasal neuropeptide Y (NPY) can provide therapeutic relief of many SPS-triggered behaviors, but is ineffective in females at the same dose. Thus, females may need a higher dose of exogenous NPY to attain a therapeutically significant concentration since the overwhelming majority of studies found that NPY levels in females in many brain regions are lower than in male rodents. Here, we examined SPS as an appropriate model to elicit many PTSD-associated symptoms in females and whether intranasal NPY at higher doses than with males is able to alter the development of SPS-triggered behavioral impairments. Sprague-Dawley female rats were exposed to SPS only, or in a separate cohort after SPS stressors were immediately infused intranasally with one of several doses of NPY, starting with 600 μg/rat—four times the dose effective in males. In the third cohort of animals, females were infused intranasally with either 600 μg NPY, omarigliptin [a dipeptidyl peptidase IV (DPP4) inhibitor], or both right after the SPS stressors. After 19 days they were tested on several behavioral tests. SPS elicited significant depressive/despair like behavior on the forced swim test (FST), anxiety behavior on the elevated plus maze (EPM), as well as impaired social interaction. On the FST, there was a dose-response effect of intranasal NPY, with 1,200 μg, but not 600 μg, preventing the development of the SPS-elicited depressive-like behavior. The omarigliptin and 600 μg NPY combined treatment, but neither alone, was also sufficient at preventing depressive-like behavior on the FST. The results demonstrate that: (1) SPS elicits several behavioral manifestations of PTSD in females; (2) early intervention with a high dose of intranasal NPY has therapeutic potential also for females; and (3) NPY cleavage by DPP4 may play a role in the higher dose requirement for females.

Analysis of socio-psychological aspects of PTSD of combatants

In this work, the modern scientific approaches what concerns post-traumatic stress disorder (PTSD), reasons of its formation and characteristics of its manifestation in individuals who participated in military actions were analyzed and considered; the data of experimental investigation of the manifestations of PTSD and widespreading of these disorders in the groups of war and participants of the military actions who didn‘t get injured. Particularities of manifestation of certain characteristics of social-psychological adaptation of combatants in peacetime have been studied and analyzed; practical recommendations of psychological counselling and ways of solving the topical problems of combatants, strategies of overcoming personal and crisis have been suggested.

Vascular And Blood Flow Responses To Upper Limb Exercise In Individuals With Posttraumatic Stress Disorder

The physiological manifestations of posttraumatic stress disorder (PTSD) have been associated with an increase in risk of cardiovascular disease (CVD) independent of negative lifestyle factors. Peripheral vascular dysfunction may be a mechanism by which PTSD increases CVD risk. PURPOSE: This study sought to determine if blood flow regulation and peripheral vascular function are altered during exercise in individuals PTSD when compared to age-matched controls. METHODS: Sixteen individuals with PTSD (10 women, 6 men; age 24 ± 4 years), and twenty-four age, and sex-matched healthy controls (CTRL); 15 women, 9 men, 24 ± 4 years), participated in the study. Upper limb vascular function and blood flow was assessed during rhythmic, progressive handgrip exercise (at rest, 3 and 6 kilograms (kg)) with Doppler ultrasonography. Exercise-induced changes in mean arterial pressure (MAP), brachial artery (BA) flow mediated dilation (normalized for BA shear rate), BA blood flow, and arm vascular conductance (VC) were quantified at each workload. RESULTS: Although no significance was noted in MAP, BA flow mediated dilation, or blood flow between groups, the PTSD group reported significantly lower VC at the highest exercise workload (6 kg - PTSD: 2.04 ± 0.9; CTRL: 2.87 ± 1.0 mL·min−1·mmHg−1; p = 0.008), when compared to the CTRL group. CONCLUSION: This study revealed that individuals with PTSD reported lower vascular conductance during upper limb arm exercise when compared to healthy controls. Further research is needed to determine if this finding translates to larger muscle mass exercise, potentially leading to exercise intolerance, as well as the potential mechanisms may be driving this dysfunction in individuals with PTSD, such augmented sympathetic activity during exercise and/or microvascular dysfunction.

1080 Self-reported Hyperarousal Predicts Lower Parasympathetic Activity During Slow-Wave Sleep In Trauma-exposed Individuals

Abstract Introduction Hyperarousal and abnormal autonomic functioning are among the core manifestations of posttraumatic stress disorder (PTSD). In this study, we examined the association of parasympathetic activity during slow wave sleep (SWS) with self-reported hyperarousal measures in recently traumatized individuals. Methods Individuals exposed to a PTSD Criterion-A trauma within the past 2 years (N=76) aged 18-40 (mean 24.06, SD 4.76), of whom 43% met DSM-5 criteria for PTSD, underwent a night of ambulatory polysomnography (PSG) following an acclimation night. ECG recordings during SWS-sleep periods of at least 5 min were analyzed for 2 parasympathetic indices: Root Mean Square of the Successive Differences (RMSSD) and High Frequency (0.14-0.4Hz) power (HF power) using Kubios software. Hyperarousal indices included the hyperarousal items from the PTSD Checklist for DSM-5 (PCL-5) excluding the sleep item #20 (PCLhyp), those from the Clinician-Administered PTSD Scale (CAPS-5) including sleep items (CAPShyp), as well as a published Hyperarousal Scale (HAS) and Hypervigilance Questionnaire (HVQ). In addition, a Composite Hyperarousal Index (CHI) was computed from combined hyperarousal items on the PCL-5 and the CAPS-5 as well as the HAS total score. Results SWS RMSSD was negatively associated with PCLhyp (R = -.244, p = 0.035), CAPShyp (R = -.250, p = 0.03), CHI (R = -.280, p = 0.014), and HAS (R = -.229, p = 0.049). SWS HF power was negatively associated with CHI (R = -.227, p = 0.049). Conclusion The hyperarousal (Criterion E) symptoms of PTSD are associated with lowered parasympathetic tone during SWS across the spectrum of posttraumatic severity from resilient individuals to those diagnosed with PTSD. Support R01MH109638

Traumatismes psychiques, trouble de stress posttraumatique et syndrome coronarien aigu : une synthèse des données de la littérature

The objective of this article is to present a synthesis of studies on the links between psychological trauma and myocardial infarction. In recent years, many studies have demonstrated a two-way link between manifestations of post-traumatic stress disorder [Post-Traumatic Stress Disorder (PTSD)] and myocardial infarction (MI). In other words, the occurrence of this cardiac event can be traumatic for some people and lead to the development of PTSD. Conversely, suffering from PTSD appears to be a major risk factor for acute coronary artery disease. Further, studies show that potentially traumatic life events experienced in childhood are also associated with a significant increase in the risk of ischemic heart disease in adulthood.

Peripheral Vascular Function in Individuals with Posttraumatic Stress Disorder

THE IMPACT OF POSTTRAUMATIC STRESS DISORDER ON PERIPHERAL VASCULAR FUNCTION J. Weggen, A. Hogwood, B. Imthurn, A. McIntyre, A. Darling, K. Decker and R. Garten. Virginia Commonwealth University, Richmond, VA The physiological manifestations of posttraumatic stress disorder (PTSD) have been associated with an increase in risk of cardiovascular disease (CVD) independent of negative lifestyle factors. Peripheral vascular dysfunction may be a mechanism by which PTSD increases CVD risk via increases in oxidative stress, inflammation, and/or sympathetic nervous system activity. PURPOSE: This study sought to examine peripheral vascular function in those with PTSD compared to age-matched controls. METHODS: Eight individuals with PTSD (5 women, 3 men; age 22 ± 2 years), and sixteen healthy controls (CON; 10 women, 6 men, 23 ± 2 years), participated in the study. Leg vascular function was assessed via passive leg movement (PLM) technique and evaluated with Doppler ultrasonography. PLM-induced increases in leg blood flow were quantified as peak change in blood flow from baseline (ΔPeak LBF) and blood flow area under the curve (LBF AUC). RESULTS: Significant differences in leg vascular function were revealed between groups. The PTSD group reported significantly lower ΔPeak LBF (PTSD: 294.16 ± 54.16; CON: 594.78 ± 73.70 ml∙min-1; p = 0.01) and LBF AUC (PTSD: 57.23 ± 24.37; CON: 169.92 ± 29.84 ml; p = 0.02) when compared to the CON group. CONCLUSION: This study revealed that lower limb vascular function is impaired in individuals with PTSD when compared to healthy counterparts.

Проявление симптомов посттравматического стрессового расстройства у мужчин и женщин, проживающих в условиях конфликта на востоке Украины

The article presents the results of an empirical study of the manifestations of posttraumatic stress disorder in a civilians living in the conditions of an armed conflict. It is revealed that the level of posttraumatic disorder depends on the state of health, the level of human resourcefulness and the degree of depression, as well as the coping behavior that is used in a stressful situation. It has been established that the residents from the areas of intensive shelling (the second group) are more likely to experience poor health, lower vital activity, and worsening of the mood. It is determined that the civilians from the areas of intense shelling characterized by depressive states of different levels, and their personal resourcefulness is decreasing. It was revealed that in the extreme conditions of life under constant stress the respondents of the second group most often use unproductive behavior strategies: emotional coping (more often in women), and avoidance-oriented coping (more evident in men). It is proved that in the second group of respondents (from the areas of intensive shelling) the average and elevated level of posttraumatic disorder prevails.

Molecular indicators of stress-induced neuroinflammation in a mouse model simulating features of post-traumatic stress disorder

A social-stress mouse model was used to simulate features of post-traumatic stress disorder (PTSD). The model involved exposure of an intruder (male C57BL/6) mouse to a resident aggressor (male SJL) mouse for 5 or 10 consecutive days. Transcriptome changes in brain regions (hippocampus, amygdala, medial prefrontal cortex and hemibrain), blood and spleen as well as epigenome changes in the hemibrain were assayed after 1- and 10-day intervals following the 5-day trauma or after 1- and 42-day intervals following the 10-day trauma. Analyses of differentially expressed genes (common among brain, blood and spleen) and differentially methylated promoter regions revealed that neurogenesis and synaptic plasticity pathways were activated during the early responses but were inhibited after the later post-trauma intervals. However, inflammatory pathways were activated throughout the observation periods, except in the amygdala in which they were inhibited only at the later post-trauma intervals. Phenotypically, inhibition of neurogenesis was corroborated by impaired Y-maze behavioral responses. Sustained neuroinflammation appears to drive the development and maintenance of behavioral manifestations of PTSD, potentially via its inhibitory effect on neurogenesis and synaptic plasticity. By contrast, peripheral inflammation seems to be directly responsible for tissue damage underpinning somatic comorbid pathologies. Identification of overlapping, differentially regulated genes and pathways between blood and brain suggests that blood could be a useful and accessible brain surrogate specimen for clinical translation.

PTSD and Bad Paper Discharges: Why the Fairness to Soldiers Act is Too Little, Too Late

PTSD and Bad Paper Discharges: Why the Fairness to Soldiers Act is Too Little, Too Late

Relaxation Techniques for Trauma

Physiological symptoms of posttraumatic stress disorder (PTSD) manifest as increased arousal and reactivity seen as anger outburst, irritability, reckless behavior with no concern for consequences, hypervigilance, sleep disturbance, and problems with focus (American Psychiatric Association, 2013). In seeking the most beneficial treatment for PTSD, consideration must be given to the anxiety response. Relaxation techniques are shown to help address the physiological manifestations of prolonged stress. The techniques addressed by the authors in this article include mindfulness, deep breathing, yoga, and meditation. By utilizing these techniques traditional therapies can be complemented. In addition, those who are averse to the traditional evidence-based practices or for those who have tried traditional therapies without success; these alternative interventions may assist in lessening physiological manifestations of PTSD. Future research studies assessing the benefits of these treatment modalities are warranted to provide empirical evidence to support the efficacy of these treatments.

Mental health consequences of violence against women and girls.

Recent studies on mental health consequences of violence against women and girls were reviewed in a range of situations. Although several studies continued to show cross-sectional associations between child sexual abuse (CSA) and mental health outcomes, a few prospective studies showed a robust association between CSA and depression. Studies on the impact of dating violence are still at a nascent stage and focus on antecedents of violence rather than its consequences. Women at higher risk, such as adolescents, migrants, the homeless, and women in the perinatal period have been studied and specific vulnerabilities identified. Women reporting bidirectional violence had higher rates of depression and post-traumatic stress disorder (PTSD). Cumulative violence, severity of violence, and recent violence are associated with higher morbidity. Studies among women in conflict zones have emphasized the role of different forms of sexual and physical violence on mental health. Newer emerging areas that need more research include mental health consequences of women in conflict zones and among same sex relationships. There are also few studies on the violence experience of both older women and adolescents. The need to better delineate the psychopathology of complex manifestations of PTSD is underscored.

Manifestations of Post-Traumatic Stress Disorder in Different Generations of Meskhetian Turks Families after deportation

In June 1989, in the Fergana region, Uzbek Soviet Socialist Republic, there were mass riots and clashes, known as «Fergana events». In the course of these events have been attacked Meskhetian Turks. Authorities evacuated Turks from Fergana, and then within a year almost all Turkish Uzbek population fled to other Soviet republics. In our study attended Meskhetian Turks who took part in the Fergana's events of 1989 and their children (the younger generation). In the work took part two groups: experimental group (30 patients, who were born before 1989 and were deportees) and control group (20 patients, who were born in the Rostov region in the period after 1989). The purpose of the article – theoretical and empirical investigation of the PTSD manifestations among different generations of Meskhetian Turks families after the Fergana's events of 1989. We evaluated the manifestations of PTSD by Mississippi scale and the profile of lateral organization in participants of study. The tragic events associated with deportation are reflected in post-traumatic stress reactions till now are manifested in persons who were exposed to deportation. Significant relationships between left features in profile of lateral organization and negative changes in beliefs and feelings, such as feelings of guilt and a tendency to suicidal behaviour, was found.

Panser par l’hypnose après un traumatisme périnéal : prise en charge d’une jeune fille en état de stress post-traumatique par l’hypnothérapie

Children and teenagers may face trauma that threatens their life, but also their psychological integrity. These injuries can lead to posttraumatic stress disorder (PTSD), which is the most common psychopathological consequence after a trauma. Age is not a protective factor and this disorder can be severe and may last over a long-term period. Effective therapies on PTSD are scarce and research on this topic is rare in children. We report a case of a 12-year-old girl affected by PTSD after a carousel accident at the age of 4 years. A therapy based on hypnosis and psychological support was rapidly effective. This psychotherapeutic option was chosen on the basis of common features shared by hypnosis and the posttraumatic symptoms. Clinical manifestations of PTSD disappeared after 4 weeks of therapy and the patient remained symptom-free during a 1-year follow-up. Our report suggests that hypnosis could be an effective therapy for children with PTSD. Prospective studies on a larger number of patients are needed to validate this hypothesis.

Pelvic Floor Muscle Problems Mediate Sexual Problems in Young Adult Rape Victims

Prior studies have addressed sexual abuse and sexual function in adult women. No studies have focused on the effect of adolescence rape on sexual functioning. To investigate the effect of rape on sexual problems and on pelvic floor problems, as well as the mediating role of pelvic floor problems on sexual problems, in a homogenous group of victims of adolescence rape without a history of childhood sexual, physical, and/or emotional abuse. Sexual functioning and pelvic floor functioning were assessed using self-report questionnaires. In this cross-sectional study, a group of 89 young women aged 18-25 years who were victimized by rape in adolescence was compared with a group of 114 nonvictimized controls. The rape victims were treated for posttraumatic stress disorder (PTSD) 3 years prior to participation in the study. Three years posttreatment, rape victims were 2.4 times more likely to have a sexual dysfunction (lubrication problems and pain) and 2.7 times more likely to have pelvic floor dysfunction (symptoms of provoked vulvodynia, general stress, lower urinary tract, and irritable bowel syndrome) than nonvictimized controls. The relationship between rape and sexual problems was partially mediated by the presence of pelvic floor problems. Rape victims and controls did not differ with regard to sexual activities. Rape victims suffer significantly more from sexual dysfunction and pelvic floor dysfunction when compared with nontraumatized controls, despite the provision of treatment for PTSD. Possibly, physical manifestations of PTSD have been left unaddressed in treatment. Future treatment protocols should consider incorporating (physical or psychological) treatment strategies for sexual dysfunction and/or pelvic floor dysfunction into trauma exposure treatments.