title: In-The-Moment Dissociation, Emotional Numbing, and Sexual Risk: The Influence of Sexual Trauma History, Trauma Symptoms, and Alcohol Intoxication.
abstract: OBJECTIVE
  Prior research on the effects of sexual trauma has examined dissociation but not emotional numbing during sex and has relied exclusively on retrospective surveys. The present experiment examined associations among distal factors of childhood sexual abuse (CSA), adolescent/adult sexual assault (ASA), and trauma symptoms and the proximal factor of acute alcohol intoxication on in-the-moment dissociation, emotional numbing, and sexual risk intentions.
  
  
  METHODS
  Young adult female drinkers (N= 436) at elevated sexual risk were randomized to receive alcohol (target peak breath alcohol concentration = .10%) or no alcohol. They then read an eroticized sexual scenario and reported on their dissociation and emotional numbing experiences, unprotected sex refusal self-efficacy, and unprotected sex intentions.
  
  
  RESULTS
  Path analysis revealed that CSA was indirectly associated with increased unprotected sex intentions through increased ASA severity, increased trauma-related symptoms, increased emotional numbing, and decreased unprotected sex refusal self-efficacy. Further, alcohol intoxication was indirectly associated with increased unprotected sex intentions through increased emotional numbing and decreased unprotected sex refusal self-efficacy.
  
  
  CONCLUSIONS
  Emotional numbing, but not dissociation, was associated with unprotected sex intentions and may be one potential target for interventions aimed at reducing HIV/STI-related risk among women with a history of sexual trauma.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Stappenbeck
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: William H
authors.initials: WH
authors.lastname: George
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Staples
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Hong
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: School of Social Work, University of Washington.
authors.forename: Kelly Cue
authors.initials: KC
authors.lastname: Davis
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington.
authors.forename: Debra
authors.initials: D
authors.lastname: Kaysen
authors.affiliation: Department of Psychological and Brain Sciences, Indiana University.
authors.forename: Julia R
authors.initials: JR
authors.lastname: Heiman
authors.affiliation: School of Social Work, University of Washington.
authors.forename: N Tatiana
authors.initials: NT
authors.lastname: Masters
authors.affiliation: Alcohol and Drug Abuse Institute, University of Washington.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Norris
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington.
authors.forename: Cinnamon L
authors.initials: CL
authors.lastname: Danube
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Gilmore
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Kelly F
authors.initials: KF
authors.lastname: Kajumulo
keywords: Alcohol Intoxication; Childhood Sexual Abuse; Dissociation; Emotional Numbing; HIV/STI Risk; Sexual Assault