Personal and environmental factors contributing to participation in romantic relationships and sexual activity of young adults with cerebral palsy

Abstract

Purpose: To study determinants of romantic relationships and sexual activity of young adults with cerebral palsy (CP), focusing on personal and environmental factors. Method: A cohort study was performed with 74 young adults (46 men; 28 women) aged 20–25 years (SD 1.4) with CP (49% unilateral CP, 76% GMFCS level I, 85% MACS level I). All participants were of normal intelligence. Romantic relationships, sexual activity (outcome measures), personal and environmental factors (associated factors) were assessed. Associations were analyzed using logistic regression analyses. Results: More females than males with CP were in a current romantic relationship. Self-esteem, sexual esteem and feelings of competence regarding self-efficacy contributed positively to having current romantic relationships. A negative parenting style contributed negatively. Age and gross motor functioning explained 20% of the variance in experience with intercourse. In addition, sexual esteem and taking initiative contributed significantly to intercourse experience. Conclusions: For young adults with CP personal factors (20–35% explained variances) seem to contribute more than environmental factors (9–12% explained variances) to current romantic relationships and sexual experiences. We advice parents and professionals to focus on self-efficacy, self-esteem and sexual self-esteem in development of young adults with CP.

Implications for Rehabilitation

• The severity of gross motor functioning contributed somewhat to sexual activities, but not to romantic relationships.

• High self-efficacy, self-esteem and sexual self-esteem can facilitate involvement in romantic and sexual relationships for young adults with CP.

Keywords::

• Cerebral palsy
• sexuality
• romantic relationships
• young adults
• determinants

Acknowledgments

The authors thank all the participating young adults with CP. The following members of the Transition Research Group South West Netherlands contributed to this study: Department of Rehabilitation Medicine, Erasmus MC, University Medical Centre, Rotterdam, (M. Donkervoort, PhD, C. Nieuwenhuijsen, MSc, J. van Meeteren, MD PhD); Rijndam Rehabilitation Center, Rotterdam (M.P. Bergen MD, PhD); Sophia Rehabilitation, The Hague (W. Nieuwstraten MD, A. de Grund, PT)/Delft (M. Terburg, MD, E. Celen, PT); Rijnlands Rehabilitation Center, Leiden (H. vd Heijden-Maessen, MD); Rehabilitation Center “de Waarden”, Dordrecht (H.J.R. Buijs, MD); Foundation of Rehabilitation Medicine Zeeland, Goes (Th Voogt, MSc); Department of Rehabilitation Medicine, Leiden University Medical Center (J.H. Arendzen MD, PhD, M.S. van Wijlen-Hempel, MD, PhD). In addition the Rehabilitation Center De Hoogstraat, Utrecht (J.W. Gorter, MD, PhD) co-operated.

This research has been performed as part of the PERRIN (Pediatric Rehabilitation Research in the Netherlands) research program.

Declaration of Interest: This work is supported by the Johanna Children’s Fund (JKF grant no 07.02.28–2007/0042) and the Fund for Research about Sexuality.