Past Sexual Assault, Daily Posttraumatic Stress Symptoms, And Sexual Functioning: The Role Of Pre Sex Drinking
Women with a history of adolescent or adult sexual assault (ASA) report difficulties with sexual functioning. One hypothesized contributor is posttraumatic stress (PTS), however, for whom and under what circumstances PTS affects sexual functioning is unclear. While ongoing research has found that some ASA survivors may drink to cope with PTS symptoms, little research has examined the association between PTS, pre-sex drinking, and sexual functioning at the proximal level. This study examines the moderating effects of number of standard drinks prior to sex on the indirect association between ASA and sexual functioning via PTS symptoms. Method: First- and second-year college women (N = 286; M = 18.85, SD = .85) completed an online, longitudinal survey assessing past ASA and reported on the number of standard drinks consumed prior to sex and sexual functioning during their most recent sexual encounter in the last six weeks. PTS symptoms occurring on that day were also assessed. Moderated indirect effects were tested using a path analysis with 10,000 bootstrap resamples and probing interactions at the mean and one standard deviation above and below the moderator. Childhood sexual abuse and number of non-sexual traumatic events were included as covariates. Results: The indirect effect of past ASA severity to sexual functioning via PTS was moderated by number of standard drinks before sex (β = -.45, p < .01; 95% CI [-.54, -.36]). For women who reported a low (0-1.5) and mean (4.08) number of drinks, past ASA severity was negatively associated with sexual functioning (β = -.16, 95% CI [-.29, -.03]; β = -.08, 95% CI [-.13, -.01]) through PTS symptoms. The indirect association of past ASA severity to sexual functioning via PTS symptoms was not significant for those who reported heavier pre-sex drinking (> 6.5 drinks). Conclusion: Daily PTS symptoms were negatively associated with sexual functioning among women who drank low or average number of standard drinks prior to sex. Future research may wish to examine drinking motives to elucidate whether some ASA survivors may drink to ameliorate the association between PTS symptoms and sexual functioning. Alcohol interventions for college students may wish to assess sexual functioning difficulties and PTS as potential treatment targets.