Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial

Abstract

Introduction: Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood.

Aim: We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA.

Methods: Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus.

Main outcome measures: Validated self-report measures of psychopathology and sexual function were conducted at posttreatment: 2 weeks, 1 month, and 6 months.

Results: Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction.

Conclusions: Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients.

Trial registration: ClinicalTrials.gov NCT01803802.

Keywords: Childhood Sexual Abuse; Depression; Expressive Writing; Sexual Dysfunction; Sexual Function; Sexual Satisfaction.

© 2013 International Society for Sexual Medicine.

Figures

Figure 1

Participant flowchart.

Figure 2

Proportion of participants (by condition) meeting criteria for Hypoactive Sexual Desire Disorder (HSDD) at intake not recovered.

Figure 3

Proportion of participants (by condition) meeting criteria for Female Sexual Arousal Disorder (FSAD) at intake not recovered.

Figure 4

Change in depression symptoms (BDI) and Post-Traumatic Stress Disorder symptoms (CAPS) over time.