The role of sexual assault history and Posttraumatic Stress Disorder (PTSD) symptoms in online treatment for Sexual Interest/Arousal Disorder in women

Abstract

Cognitive-Behavioral Therapy (CBT) and Mindfulness-Based Therapy (MBT) are efficacious treatments for Sexual Interest/Arousal Disorder (SIAD) in women. Many women with SIAD have a history of sexual assault (SA), but the degree to which SA history predicts engagement in treatment of SIAD, or its efficacy, is generally unknown. It is also possible that treatment of SIAD may improve Posttraumatic Stress Disorder (PTSD) symptoms related to SA. We engaged in secondary analysis of a trial assessing an online intervention for SIAD (called eSense) to explore whether SA history predicted treatment engagement or outcomes, and whether PTSD symptoms improved. Women with SIAD were randomized to online CBT (n = 43), online MBT (n = 43), or a waitlist control (n = 43). Participants completed self-report measures of engagement, SIAD symptoms, and PTSD symptoms at baseline, mid-treatment, posttreatment, and 6-month posttreatment. SA history did not predict treatment engagement or changes in SIAD symptoms. Overall PTSD symptoms decreased in MBT over and above waitlist. Exploratory analyses including follow-up assessment suggested that, among SA survivors, PTSD symptoms improved most in CBT whereas, for those without SA history, improvement was greater in MBT. SA survivors can use and benefit from evidence-based online therapies, like eSense, for SIAD.