Trauma, attachment style, and somatization: a study of women with dyspareunia and women survivors of sexual abuse

Abstract

BackgroundEvidence points toward shared characteristics between female survivors of sexual abuse and women with dyspareunia. This study explored, for the first time, similarities and differences between women who were exposed to sexual abuse to those with dyspareunia, in order to examine whether insecure attachment styles and high somatization level are associated with trauma among women with dyspareunia.MethodsAttachment styles were explored using the Experience in Close Relationships Scale to reflect participants’ levels of anxiety and avoidance. Somatization was assessed using the Brief Symptom Inventory focusing on the frequency of painful and non-painful bodily complaints. Trauma was categorized into three levels: sexual trauma, nonsexual trauma, and no trauma.ResultsSexually abused (SA) women (n = 21) compared to women with dyspareunia (dys) (n = 44) exhibited insecure attachment styles, as expressed by high levels of avoidance (SA 4.10 ± 0.99 vs. dys 3.08 ± 1.04, t(61) = 2.66, p = .01) and anxiety (SA 4.29 ± 1.22 vs. dys 3.49 ± 1.04, t(61) = 3.61, p = .001), and higher somatization (21.00 ± 8.25 vs. 13.07 ± 7.57, t(59) = 3.63, p = .001). Attachment and somatization level did not differ significantly between women with dyspareunia without trauma to those with nonsexual trauma.ConclusionsOur findings emphasized the unique role of sexual trauma as a contributing factor to the augmentation of perceived bodily symptoms and to insecure attachment style. This illuminates the importance of disclosing previous sexual abuse history among women with dyspareunia.

Symptoms within somatization after sexual abuse among women: A scoping review

“…Although the phenomenon of somatization was first described four decades ago, the clinical problem persists. However, new underlying causes, such as sexual abuse, 12 have been discovered along the way.…”

“…As previous research has shown that trauma, particularly sexual trauma, is often an underlying cause of somatization, 12 this issue needs to be raised early in the consultation. For patients seeking medical care for medically unexplained symptoms, especially pain, the patient history should include questions about previous trauma, and different treatment pathways as alternatives to comprehensive somatic investigations should be considered.…”

“…Previous sexual abuse has been associated with multiple somatic diagnoses 11 . In women, a recent study showed that sexual trauma affects somatization level to a greater extent than nonsexual trauma 12 . Several previous studies have reported associations between somatic symptoms and sexual abuse 13‐19 …”

“…11 In women, a recent study showed that sexual trauma affects somatization level to a greater extent than nonsexual trauma. 12 Several previous studies have reported associations between somatic symptoms and sexual abuse. [13][14][15][16][17][18][19] Adult patients with somatization disorder have a higher outpatient consumption, seek more specialist care, and have more emergency visits than nonsomatization patients.…”

Somatic Symptoms in Young Adult Women Who Experienced Sexual Violence Throughout Life Development: A Systematic Review

“…The next study is a study by Granot et al [16] which aims to look at the description of trauma, attachment style, and somatization felt by two groups of participants, which are women with dyspareunia disorder and women with a history of being victims of sexual violence. The results show that the insecure attachment style accompanied by high levels of anxiety in women with a history of sexual violence is a supporting factor for the emergence of somatic symptoms.…”