title: Changes in Autonomic Nervous System Activity are Associated with Changes in Sexual Function in Women with a History of Childhood Sexual Abuse.
abstract: BACKGROUND
  Women with histories of childhood sexual abuse (CSA) have higher rates of sexual difficulties, as well as high sympathetic nervous system response to sexual stimuli.
  
  
  OBJECTIVE
  The study aims to examine whether treatment-related changes in autonomic balance, as indexed by heart rate variability (HRV), were associated with changes in sexual arousal and orgasm function.
  
  
  METHODS
  In study 1, we measured HRV while writing a sexual essay in 42 healthy, sexually functional women without any history of sexual trauma. These data, along with demographics, were used to develop HRV norms equations. In study 2, 136 women with a history of CSA were randomized to one of three active expressive writing treatments that focused on their trauma, sexuality, or daily life (control condition). We recorded HRV while writing a sexual essay at pretreatment, posttreatment, and 2-week, and 1- and 6-month follow-ups; we also calculated the expected HRV for each participant based on the norms equations from study 1.
  
  
  METHODS
  The main outcome measures used were HRV, Female Sexual Function Index, Sexual Satisfaction Scale--Women.
  
  
  RESULTS
  The difference between expected and observed HRV decreased over time, indicating that, posttreatment, CSA survivors displayed HRV closer to the expected HRV of a demographics-matched woman with no history of sexual trauma. Also, over time, participants whose HRV became less dysregulated showed the biggest gains in sexual arousal and orgasm function. These effects were consistent across condition.
  
  
  CONCLUSIONS
  Treatments that reduce autonomic imbalance may improve sexual well-being among CSA populations.
authors.affiliation: The Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.
authors.forename: Tierney K
authors.identifier: http://orcid.org/0000-0002-4999-1584
authors.initials: TK
authors.lastname: Lorenz
authors.affiliation: Research Service, VA Boston Healthcare System, Boston, MA, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Harte
authors.affiliation: Department of Psychology, University of Texas at Austin, Austin, TX, USA.
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Meston
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000534:rehabilitation; D003075:Coitus / Q000523:psychology*; D004644:Emotions; D005260:Female; D006339:Heart Rate; D006801:Humans; D009948:Orgasm; D010549:Personal Satisfaction; D011613:Psychotherapy; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D016387:Women's Health; D055815:Young Adult
keywords: Autonomic Nervous System; Childhood Sexual Abuse; Expressive Writing; Heart Rate Variability; Sexual Function