Sexual Behavior and Concerns in a Sample of Elderly, Former Indentured Swiss Child Laborers

Introduction

Past research suggests a link between post‐traumatic stress disorder (PTSD) and an increased risk for sexual problems. However, there is still no clear picture whether these higher rates are related to trauma exposure or to PTSD itself.

Aim

The aim of the present study was to complement existing knowledge on the relative impact of trauma and PTSD on sexuality in later life, considering different aspects of trauma exposure on both men and women.

Methods

The study was conducted on a unique population sample of former Swiss indentured child laborers (55 men,M _age 78, age range 60–95 years) who have repeatedly experienced a variety of severe childhood traumas.

Main Outcome Measures

Sexual outcomes were measured using two scales from the Trauma Symptom Inventory—Dysfunctional Sexual Behavior (DSB) and Sexual Concerns (SC). PTSD symptoms and trauma were assessed with the Short Screening Scale for PTSD and the Composite International Diagnostic Interview, respectively.

Results

Twenty‐two individuals showed PTSD symptoms, and 53 reported having experienced childhood trauma. Significant differences between men and women were reported for DSB and SC. Men reported a significantly higher prevalence of both SC and DSB compared with women.

Conclusions

This is the very first study investigating DSB and SC in a sample of older adults exposed to similar traumatic experiences and settings. However, some study limitations need to be considered such as the small sample size. Additional studies are needed to further explore the relative role of traumatization and PTSD on sexual behavior and well‐being, especially to improve sexual therapy for patients who experience trauma.

...Although there is an extensive body of literature suggesting the tendency for sexual abuse alone to predict sexual symptoms (e.g., Briere et al. [13, 20]), only physical abuse was significantly associated with sexual concerns in this study. None of the other trauma exposure types (i.e., sexual or emotional abuse) were associated with either SC or DSB. These findings are in line with a recent epidemiologic study, which found a significant relationship between previous experiences of any kind of abuse and sexual impairment of various domains of women's sexual functioning [10]. The study further revealed that the specific form of abuse was irrelevant to the development of sexual problems, suggesting that different types of abuse—whether they are of emotional, sexual, or physical nature—all have similar effects on one's emotional regulation and sexuality. This study also supports our findings concerning the artificial categorization of the various traumas into interpersonal vs. accidental—interpersonal trauma was more significantly associated with SC compared with accidental trauma. Further, no specific effects of cumulative trauma on sexual behavior could be detected in the present study, but additional research including both men and women and assessing different types of trauma events is needed.

Overall, the results of this study support that neither time of the traumatic event nor screening positively for PTSD symptoms is an independent risk factor or predictor for sexual problems...

Full article at:   http://goo.gl/Rqoobi

By:  Karin Rechsteiner, MSc, 1 Andrea Burri, PhD, 1 and Andreas Maercker, PhD, MD 1

¹University of Zurich—Department of Psychology, Zurich, Switzerland

Corresponding author.

^*Corresponding Author: Karin Rechsteiner, MSc, University of Zurich—Psychology, Binzmühlestrasse 14/17, Zürich 8050, Switzerland. Tel: 41‐44‐635‐73‐12; E‐mail: moc.liamg@nirak.renietshcer

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Differences in HPA Axis Reactivity to Intimacy in Women With & Without Histories of Sexual Trauma

BACKGROUND:

Sexual trauma can lead to longstanding effects on individuals' intimacy functioning. The current study aimed to assess hypothalamic pituitary adrenal (HPA) axis functioning (i.e., cortisol reactivity) prior to (-5min), during (+15, +30, +45min), and following (+60min) an experimental manipulation of emotional closeness in a sample of women survivors of sexual trauma with varying levels of posttraumatic stress disorder (PTSD) symptomatology versus controls.

METHODS:

Participants included 50 women, which were divided into 2 groups on the basis of a structured clinical interview: 26 women with a history of sexual trauma with and without PTSD (sexual trauma group), and 24 women without a history of sexual trauma or PTSD (controls). Participants came into the lab and participated in a 45min emotional closeness exercise with a male confederate and completed self-report questionnaires of closeness, state anxiety/depression, and cortisol assays at the aforementioned time points.

RESULTS:

Women with a history of sexual trauma exhibited a blunted cortisol response and greater anxious mood in reaction to the intimacy induction task compared to controls. Results also demonstrated that, unexpectedly, PTSD symptom severity scores among sexual trauma survivors were not associated with differential cortisol responding to the task compared to controls.

CONCLUSIONS:

Adaptive responses to stress are characterized by a relatively rapid cortisol increase followed by a steady decline. The results of this study demonstrated that women with a history of sexual trauma, in contrast, displayed a blunted cortisol response to an intimacy induction task. Both controls and women with a history of sexual trauma reported increased feelings of closeness to the male confederate in response to the intimacy induction task, suggesting that survivors were able to achieve similar adaptive feelings of intimacy when provided with the right conditions.

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By:  Martinson A1, Craner J2, Sigmon S3.

• 1VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, Utah 84108, USA. Electronic address: amber.martinson@va.gov.
• 2Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905, USA.
• 3University of Maine, 301 Little Hall, Orono, Maine 04469, USA. 
• Psychoneuroendocrinology. 2015 Dec 24;65:118-126. doi: 10.1016/j.psyneuen.2015.12.025

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Vicarious Trauma among Sexual Assault Nurse Examiners

ABSTRACT: 

Vicarious trauma (VT), the phenomenon of changes in cognition and worldview that result from empathic response and repeated exposure to narratives of trauma, is a risk for helping professionals. 

This descriptive, correlational study sought to examine levels of VT among sexual assault nurse examiners (SANEs) as compared with other women’s health nurses. It also explored whether levels of VT are different for nurses who have experienced primary trauma alone, VT alone, or both personal trauma and VT. VT was assessed through an anonymous online survey using the nurses’ total scores on the Trauma and Attachment Belief Scale. 

Trauma and Attachment Belief Scale scores were significantly higher for SANEs (M = 178.5, SD = 42.6) than for women’s health nurses (M = 168.1, SD = 41.4; p = 0.025), indicating higher levels of trauma-related cognitive disruption in the SANE group. Scores were also significantly higher for both groups with personal trauma histories at the p < 0.05 level compared with the women’s health nurses with no personal history. 

SANEs who had no personal history of trauma did not differ significantly from either group of nurses who did, suggesting that VT from working as an SANE is associated with levels of cognitive disruption similar to oneself having experienced trauma. 

Nurses should be aware of this phenomenon and its sequelae when choosing to pursue the specialty of sexual assault nursing. Hospitals and other organizations employing SANEs should also be aware of VT and provide a support system with resources in place to mitigate these effects. 

Future research should further explore effects of primary trauma versus VT, clinical manifestations and significance of varying levels of VT, and interventions and strategies for dealing with VT.

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Full PDF article at:  http://goo.gl/7BmLyA

By:   Raunick CB¹, Lindell DF, Morris DL, Backman T.

¹Author Affiliations: 1St. Vincent Carmel Women's Center, Case Western Reserve University; and 2Case Western Reserve University.

  

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Influence of the 5-HT3A Receptor Gene Polymorphism and Childhood Sexual Trauma on Central Serotonin Activity

Background

Gene-environment interactions are important for understanding alterations in human brain function. The loudness dependence of auditory evoked potential (LDAEP) is known to reflect central serotonergic activity. Single nucleotide polymorphisms (SNPs) in the 5-HT3A serotonin receptor gene are associated with psychiatric disorders. This study aimed to investigate the effect between 5-HT3A receptor gene polymorphisms and childhood sexual trauma on the LDAEP as an electrophysiological marker in healthy subjects.

Methods

A total of 206 healthy subjects were recruited and evaluated using the childhood trauma questionnaire (CTQ) and hospital anxiety and depression scale (HADS). Peak-to-peak N1/P2 was measured at five stimulus intensities, and the LDAEP was calculated as the linear-regression slope. In addition, the rs1062613 SNPs of 5-HT3A (CC, CT, and TT) were analyzed in healthy subjects.

Results

There was a significant interaction between scores on the CTQ-sexual abuse subscale and 5-HT3A genotype on the LDAEP. Subjects with the CC polymorphism had a significantly higher LDEAP than T carriers in the sexually abused group. In addition, CC genotype subjects in the sexually abused group showed a significantly higher LDAEP compared with CC genotype subjects in the non-sexually abused group.

Conclusions

Our findings suggest that people with the CC polymorphism of the 5-HT3A gene have a greater risk of developing mental health problems if they have experienced childhood sexual abuse, possibly due to low central serotonin activity. Conversely, the T polymorphism may be protective against any central serotonergic changes following childhood sexual trauma.

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By:   

Kuk-In Jang, Jeong-Ho Chae

Department of Biomedicine & Health Sciences, The Catholic University of Korea, College of Medicine, Seoul, Korea

Seung-Hwan Lee

Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea

Kuk-In Jang, Seung-Hwan Lee

Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea

Hyu Jung Huh, Jeong-Ho Chae

Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea

 

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Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans

Purpose: Transgender (TG) persons are overrepresented in prison settings and in the U.S. veteran population. Health disparities studies of large populations of transgender people involved with the criminal justice system have not been published to date.

Methods: We studied a large cohort of TG veterans who received care in Veterans Health Administration (VHA) facilities during 2007–2013 (n = 4,793) and a 3:1 matched control group of veterans without known TG identification (n = 13,625). Three hundred twenty six (n = 138 TG, 188 non-TG) had received VHA services in programs designed to address the needs of justice involved (JI) veterans. We linked patients in each of the three groups to their medical and administrative data.

Results: TG veterans were more likely to be justice involved than controls (2.88% vs. 1.38%; P < .0001). Compared to non-TG JI veterans, TG JI veterans were more likely to have a history of homelessness (80% vs. 67%; P < .05) and to have reported sexual trauma while serving in the military (23% vs. 12%; P < .01). Significant health disparities were noted for TG JI veterans for depression, hypertension, obesity, posttraumatic stress disorder, serious mental illness, and suicidal ideation/attempts.

Conclusion: These data suggest that TG veterans experience a number of health risks compared to non-TG veterans, including an increased likelihood of justice involvement. TG veterans involved with the criminal justice system are a particularly vulnerable group and services designed to address the health care needs of this population, both while incarcerated and when in the community, should take these findings into account in the development of health screenings and treatment plans.

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By: George R. Brown, MD^1,2 and Kenneth T. Jones, PhD

¹Mountain Home Veterans Affairs Medical Center, Psychiatry Service, Johnson City, Tennessee.

²Department of Psychiatry and Behavioral Sciences, East Tennessee State University, Quillen College of Medicine, Johnson City, Tennessee.

³Office of Health Equity, Veterans Health Administration, Washington, D.C.

Address correspondence to:

George R. Brown, MD

549 Miller Hollow Road

Bluff City, TN 37618

E-mail: george.brown@va.gov

 

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Assessing Sexual Trauma Histories in Homeless Women

Almost one out of every three homeless women, 32%, in the United States, United Kingdom, and Australia, has experienced childhood sexual trauma. We assessed lifetime sexual trauma histories among 29 homeless women from three southern California community sites: one residential safe house and two safe parking areas. 

• More than half of the women (54%) reported a history of sexual trauma. 
• That rate was higher (86%) among women living at the safe home, 
• Versus only 42% among women staying at the safe parking sites. 
• All of the women who had served in the military reported having experienced military sexual trauma. 

The high percentages of sexual trauma found in homeless women highlight the need for effective interventions for sexual trauma.

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By:  Weinrich S1, Hardin S1, Glaser D1, Barger M1, Bormann J1,2, Lizarraga C3, Terry M1, Criscenzo J4, Allard CB5.

• 1 University of San Diego Hahn School of Nursing and Health Science & Betty and Bob Beyster Institute for Nursing Research, Advanced Practice, and Simulation , San Diego , CA.
• 2 Department of Veterans Affairs , Center of Excellence for Stress and Mental Health , San Diego , CA.
• 3 Sharp Grossmont Hospital , La Mesa , CA.
• 4 Amikas , San Diego , CA.
• 5 VA San Diego Healthcare System , University of California at San Diego, Military Sexual Trauma & Interpersonal Trauma Clinic , San Diego , CA.

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Self-Efficacy, Male Rape Myth Acceptance & Devaluation of Emotions in Sexual Trauma Sequelae: Findings from a Sample of Male Veterans

Sexual trauma is an understudied but regrettably significant problem among male Veterans. As in women, sexual trauma often results in serious mental health consequences for men. Therefore, to guide potential future interventions in this important group, we investigated associations among self-efficacy, male rape myth acceptance, devaluation of emotions, and psychiatric symptom severity after male sexual victimization. 

We collected data from 1,872 Gulf War era Veterans who applied for posttraumatic stress disorder (PTSD) disability benefits using standard mailed survey methods. The survey asked about history of childhood sexual abuse, sexual assault during the time of Gulf War I, and past-year sexual assault as well as Veterans' perceived self-efficacy, male rape myth acceptance, devaluation of emotions, PTSD, and depression symptoms. 

Structural equation modeling revealed that self-efficacy partially mediated the association between participants' sexual trauma history and psychiatric symptoms. Greater male rape myth acceptance and greater devaluation of emotions were directly associated with lower self-efficacy, but these beliefs did not moderate associations between sexual trauma and self-efficacy. 

In this population, sexual trauma, male rape myth acceptance, and devaluation of emotions were associated with lowered self-efficacy, which in turn was associated with more severe psychiatric symptoms. Implications for specific, trauma-focused treatment are discussed. 

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By: Voller E1, Polusny MA1, Noorbaloochi S2, Street A3, Grill J2, Murdoch M2.

• 1Department of Psychiatry.
• 2Minneapolis VA Health Care System.
• 3National Center for PTSD.  

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Fracture of the Penis in the Niger Delta Region of Nigeria

Penile fracture is a surgical emergency which often frightens the patient and partner. Varying incident rates, precipitating mechanisms and outcomes of treatment have been reported from different parts of the world.

To determine clinical presentation, aetiological factors and outcome of treatment of penile fracture in Port Harcourt, Niger Delta region of Nigeria.

This was a retrospective study of all patients who presented with penile fracture to our institution from 2007 and 2015. Data on age of patient, events leading to the injury, mode and time of presentation, mode and outcome and complications of treatment were collected and analysed with SPSS 20.0 software

Twenty one patients with a median age of 34.0 years (21-45) were treated within the study period. Nine patients (42.9%) were married. Overenthusiastic/ vigorous sex-related events were responsible for penile fracture in 17 patients (81.0%). Seven injuries were self inflicted while in 14 patients (66.7%), partners were involved. All the patients presented with pain, swelling, sudden detumescence and deviation of the penis. The right side was affected in 61.9% of the cases. The penile mid-shaft was the site of injury in 57.1% of cases. Six patients (28.6%) had associated urethral injuries. Eighteen patients (85.7%) had immediate surgery, 2 patients (9.5%) refused surgery and were treated conservatively. One patient who presented late was also managed conservatively. All but one patient had satisfactory penile erections with no significant complications.

Overenthusiastic and vigorous sexual activities were the most common causes of penile fracture in this study. A third of the patients had associated urethral injuries. Early surgical repair led to satisfactory outcome.

Below:  Causes of penile fracture

Below:  Site of penile fracture

Below:  Penile fracture with bleeding from the urethral meatus

Full article at: http://goo.gl/WnNw6m

By: ON EKEKE and N EKE

Department of Surgery, University of Port Harcourt Teaching Hospital, Alakahia, Port Harcourt

  

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Prevalence & Mental Health Correlates of Insomnia in First-Encounter Veterans With & Without Military Sexual Trauma

There is limited information about prevalence of insomnia in general populations of veterans of recent wars in Iraq and Afghanistan...

53.1% of veterans without military sexual trauma (MST) and 60.8% of veterans with MST had clinically significant insomnia symptoms, with the MST subsample reporting more severe symptoms. Insomnia was more prevalent than depression, hypomania, PTSD, and substance misuse. Veterans with insomnia were more likely to seek care for physical health problems and primary care versus mental health concerns. For the veteran sample without MST, age, combat service, traumatic brain injury, pain, and depression were associated with worse insomnia. For the MST subsample, employment status, pain, and depression were associated with worse insomnia.

Study findings indicate a considerably higher rate of insomnia in veterans compared to what has been found in the general population. Insomnia is more prevalent, and more severe, in veterans with MST. Routine insomnia assessments and referrals to providers who can provide evidence-based treatment are crucial.

Via:  http://ht.ly/ScStb 

By: Jenkins MM, Colvonen PJ, Norman SB, Afari N, Allard CB, Drummond SP.

Effectiveness of Cognitive Processing Therapy for Male & Female US Veterans With & Without Military Sexual Trauma

Military sexual trauma (MST) affects approximately 2% and 36% of male and female veterans, respectively. Although the deleterious consequences of MST have been clearly established, few studies have explored treatment effectiveness for this population. Using archival data from a residential treatment program, the current study explored the effectiveness of cognitive processing therapy (CPT) in treating full or subthreshold posttraumatic stress disorder (PTSD) to compare U.S. veterans reporting an MST index trauma (MST-IT) to those without MST-IT. 

Of the 481 participants, 40.7% endorsed MST-IT. Multiway frequency analyses were utilized to compare men and women with and without MST on baseline demographic variables. Hierarchical linear models were constructed to investigate treatment outcome by MST status and sex. Results showed that 44.8%, 23.8%, and 19.6% of the variation in clinician- and self-reported PTSD and depression symptoms were explained by three models. Scores on all outcome measures significantly decreased over time for both groups. 

Additionally, women demonstrated a sharper decrease in PTSD symptoms over time than men. Lastly, men who reported MST-IT had higher PTSD symptoms than men without MST-IT on average. With no control group or random assignment, preliminary findings suggest residential treatment including CPT may be effective for MST-IT regardless of sex.

Via: http://ht.ly/ScQC3 

By: Voelkel E1, Pukay-Martin ND1, Walter KH2, Chard KM1,3.

• 1Trauma Recovery Center, Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio, USA.
• 2Veterans Medical Research Foundation and VA San Diego Healthcare System, San Diego, California, USA.
• 3Department of Psychiatry, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.

Recent Sexual Trauma & Adverse Health & Occupational Outcomes among U.S. Service Women

Of 13,001 U.S. service women, 1,364 (10.5%) reported recent sexual harassment and 374 (2.9%) recent sexual assault. Women reporting recent sexual harassment or assault were more likely to report poorer mental health. They reported poorer physical health. They reported difficulties in work/activities due to emotional health. They also reported difficulties with physical health after adjustment for demographic, military, health, and prior sexual trauma characteristics. 

Findings demonstrated that sexual trauma represents a potential threat to military operational readiness and draws attention to the importance of prevention strategies and services to reduce the burden of sexual trauma on military victims.

Via: http://ht.ly/SaOTq 

By: Millegan J1, Milburn EK2, LeardMann CA2, Street AE3,4, Williams D5, Trone DW2, Crum-Cianflone NF2.

• 1Directorate of Mental Health, Naval Medical Center, San Diego, California, USA.
• 2Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
• 3National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.
• 4Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
• 5Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA.

Sexual Trauma and Combat During Deployment: Associations with Suicidal Ideation among OEF/OIF/OND Veterans

Compelling evidence has emerged on the association between military sexual trauma and suicide attempt; however, research investigating how sexual trauma during deployment relates to suicidal ideation has received considerably less attention and has yielded mixed findings. Furthermore, such research has not accounted for other types of trauma that may occur during deployment. 

Our objectives were to examine whether sexual trauma during deployment was associated with recent suicidal ideation, adjusting for exposure to combat. Our sample included 199 Operation Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) veterans entering inpatient trauma-focused treatment who completed the Beck Scale for Suicide Ideation (Beck & Steer, ) and the Deployment Risk and Resilience Inventory Sexual Harassment and Combat Experiences Scales (King, King, Vogt, Knight, & Samper, ). 

Deployment-related sexual trauma was significantly associated with recent suicidal ideation, adjusting for age and gender and additionally for combat. 

These findings underscore the importance of assessing for deployment-related sexual trauma when assessing suicide risk in OEF/OIF/OND veterans in inpatient settings.

Via: http://ht.ly/Sa2x8 

By: Monteith LL1,2, Menefee DS3,4, Forster JE1,5, Wanner JL3,4, Bahraini NH1,2,6.

• 1Denver Veterans Affairs Medical Center, Veterans Integrated Service Network (VISN) 19 Mental Illness Research, Education and Clinical Center (MIRECC), Denver, Colorado, USA.
• 2Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
• 3Michael E. DeBakey Veterans Affairs Medical Center, VISN 16 MIRECC, Houston, Texas, USA.
• 4Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.
• 5Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA.
• 6Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Military Sexual Trauma among Recent Veterans: Correlates of Sexual Assault and Sexual Harassment

Military sexual trauma (MST) includes sexual harassment or sexual assault that occurs during military service and is of increasing public health concern. The population prevalence of MST among female and male veterans who served during Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) has not been estimated to our knowledge. The purpose of this study is to assess the population prevalence and identify military correlates of MST, sexual harassment, and sexual assault among OEF/OIF veterans.

MST was assessed in the 2009-2011 National Health Study for a New Generation of U.S. Veterans, a survey of 60,000 veterans who served during the OEF/OIF eras (response rate, 34%, n=20,563). Weighted prevalence estimates and AORs of MST, sexual harassment, and sexual assault among women and men were calculated. Gender-stratified logistic regression models controlled for military and demographic characteristics. Data analyses were conducted in 2013-2014.

Approximately 41% of women and 4% of men reported experiencing MST. Deployed men had lower risk for MST compared with non-deployed men, though no difference was found among women. 

However, veterans reporting combat exposure during deployment had increased risk for MST compared with those without, while controlling for OEF/OIF deployment. 

Among women, Marines and Navy veterans had increased risk for MST compared with Air Force veterans. MST was significantly higher among veterans who reported using Veterans Affairs healthcare services.

These prevalence estimates underscore the importance of public awareness and continued investigation of the public health impact of MST.

Via: http://ht.ly/Sa28i 

By: Barth SK1, Kimerling RE2, Pavao J2, McCutcheon SJ3, Batten SV4, Dursa E5, Peterson MR5, Schneiderman AI5.

• 1Department of Veterans Affairs, Office of Public Health, Post Deployment Health, Epidemiology Program, Washington, District of Columbia. Electronic address: shannon.barth@va.gov.
• 2Department of Veterans Affairs, VHA Mental Health Services and National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, California.
• 3Department of Veterans Affairs, VHA Mental Health Services, Washington, District of Columbia.
• 4Booz Allen Hamilton, Washington, District of Columbia.
• 5Department of Veterans Affairs, Office of Public Health, Post Deployment Health, Epidemiology Program, Washington, District of Columbia.