Background Impairments in sexual functioning and sexual satisfaction are very common in women who have experienced childhood sexual abuse (CSA). A growing body of literature suggests a high prevalence of sexual distress in patients with post-traumatic stress disorder (PTSD). However, the influence of sexual trauma exposure per se and the influence of PTSD symptoms on impairments in sexual functioning remain unclear. Aim The aim of this study was to investigate the influence of sexual trauma exposure and PTSD on sexual functioning and sexual satisfaction by comparing 3 groups of women. Methods Women with PTSD after CSA (N = 32), women with a history of CSA and/or physical abuse but without PTSD (trauma controls [TC]; N = 32), and healthy women (N = 32) were compared with regards to self-reported sexual functioning and sexual satisfaction. Trauma exposure was assessed with the Childhood Trauma Questionnaire, and PTSD was assessed with the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Outcomes Sexual functioning was assessed with the Sexual Experience and Behavior Questionnaire, and sexual satisfaction was assessed with the questionnaire Resources in Sexuality and Relationship. Results PTSD patients had significantly lower sexual functioning in some aspects of sexual experience (sexual aversion, sexual pain, and sexual satisfaction) but did not significantly differ in sexual arousal and orgasm from the other 2 groups. TC and healthy women did not significantly differ from each other on the measures of sexual functioning or sexual satisfaction. Clinical Translation Results suggest that the development of PTSD has a greater impact on sexual functioning than does the experience of a traumatic event. This emphasizes the importance to address possible sexual distress and sexual satisfaction in women with PTSD by administering specific diagnostic instruments and by integrating specific interventions targeting sexual problems into a trauma-specific treatment. Conclusions The study is the first comparing PTSD patients and TC with healthy women with regards to sexual functioning. Limitations are selection and size of the samples, the assessment of sexual functioning by self-report measures only, and lack of consideration of other potentially relevant factors influencing sexuality. The findings suggest that the experience of sexual abuse does not necessarily lead to sexual impairment, whereas comparably low levels of sexual functioning seem to be prominent in PTSD patients after CSA. Further research is needed on how to improve treatment for this patient group.

Facial width-to-height ratio (fWHR) is correlated with a number of aspects of aggressive behavior in men. Observers appear to be able to assess aggressiveness from male fWHR, but implications for interpersonal distance preferences have not yet been determined. This study utilized a novel computerized stop-distance task to examine interpersonal space preferences of female participants who envisioned being approached by a man; men's faces photographed posed in neutral facial expressions were shown in increasing size to mimic approach. We explored the effect of the men's fWHR, their behavioral aggression (measured previously in a computer game), and women's ratings of the men's aggressiveness, attractiveness, and masculinity on the preferred interpersonal distance of 52 German women. Hierarchical linear modelling confirmed the relationship between the fWHR and trait judgements (ratings of aggressiveness, attractiveness, and masculinity). There were effects of fWHR and actual aggression on the preferred interpersonal distance, even when controlling statistically for men's and the participants' age. Ratings of attractiveness, however, was the most influential variable predicting preferred interpersonal distance. Our results extend earlier findings on fWHR as a cue of aggressiveness in men by demonstrating implications for social interaction. In conclusion, women are able to accurately detect aggressiveness in emotionally neutral facial expressions, and adapt their social distance preferences accordingly.

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