Understanding the Relationship Between Sexual Abuse and Compulsive Sexual Behavior.

Understanding the Relationship Between Sexual Abuse and Compulsive Sexual Behavior, Frederick J. Muench and Jon Morgenstern, Columbia University 

Several descriptive studies have found that a striking number of persons seeking treatment for sexual compulsivity (SC) have reported childhood sexual abuse (CSA). Consequently, there has been an assumption that CSA is a primary etiological factor in the development of the problem, but there has been little information the nature of this relationship. We tested the association between several forms of childhood abuse and neglect and SC symptomology, the relationship between CSA and PTSD symptoms, and the variance accounted by each in determining the severity of SC symptomology. Participants in this study were 183 gays and bisexuals who self-identified as having difficulty controlling their sexual behavior. Measures included the Compulsive Sexual Behavior Inventory, Childhood Trauma Questionnaire, and Posttraumatic Diagnostic Scale. Results indicated that participants scored significantly above the normative range in the domains of sexual, physical, and emotional abuse, as well as in emotional neglect. When entered into a regression predicting compulsive sexual behavior (CSB) severity, CSA remained the only significant predictor. The PTSD symptom subscales of avoidance, re-experiencing, and arousal were significantly associated with the level of CSB. Finally, we ran a stepwise regression predicting level of CSB by entering CSA score in the first step and the PTSD symptom subscales in the second step. Only severity of CSA and the PTSD avoidance subscale score remained significant predictors, and the avoidance subscale partially mediated the relationship between CSB and CSA. Results confirmed previous assumptions that CSA is a significant predictor of CSB and that this relationship is partially explained by the level of PTSD symptomology, particularly level of avoidance, suggesting that people who act in a sexually compulsive manner may be dissociating from their feelings during sexual encounters.