Childhood Sexual Abuse and Relationship Satisfaction: The Moderating Role of PTSD and Sexual-Related Posttraumatic Stress Symptoms

Figures & data

Table 1. The study’s sample characteristics.

Characteristic	NO-CSA*, N = 375^a	CSA, N = 154^a
Age	35.55 (12.45), 18.00–73.00	34.58 (11.13), 19.00–75.00
Unknown	74	40
Gender
Man	86 (23%)	15 (9.7%)
Woman	289 (77%)	137 (89%)
Other	0 (0%)	2 (1.3%)
Family status
Single/not in a relationship	7 (1.9%)	5 (3.2%)
In a relationship (not married)	232 (62%)	101 (66%)
Married	11 (2.9%)	16 (10%)
Separated/divorced	122 (33%)	32 (21%)
Widow/ed	0 (0%)	0 (0%)
Other	3 (0.8%)	0 (0%)
Education
Less than 12 y (not completed high school)	8 (2.1%)	3 (2.0%)
Completed high school	110 (29%)	35 (23%)
Certificate	29 (7.7%)	16 (10%)
Bachelor degree	131 (35%)	54 (35%)
Master degree	88 (23%)	45 (29%)
PhD/MD	9 (2.4%)	0 (0%)
Unknown	0	1
Religion
Jewish	252 (68%)	90 (59%)
Muslim	95 (25%)	51 (33%)
Christian	15 (4.0%)	6 (3.9%)
Other	11 (2.9%)	6 (3.9%)
Unknown	2	1
Religiosity
Non-religious	233 (62%)	92 (60%)
Traditional	99 (26%)	45 (29%)
Religious	35 (9.3%)	14 (9.1%)
Ultra-orthodox	1 (0.3%)	1 (0.6%)
Other	7 (1.9%)	2 (1.3%)
Income
A lot below average income	65 (17%)	33 (21%)
Somewhat below average income	76 (20%)	29 (19%)
Average income	115 (31%)	49 (32%)
Somewhat above average income	94 (25%)	32 (21%)
A lot above average income	24 (6.4%)	11 (7.1%)
Unknown	1	0
Health
Very bad	2 (0.5%)	0 (0%)
Not so good	8 (2.1%)	5 (3.3%)
Average	41 (11%)	21 (14%)
Good	212 (57%)	95 (63%)
Great	112 (30%)	31 (20%)
Unknown	0	2
Abuse characteristics
Age at onset	14.18 (2.72), 7.00–17.00	10.64 (4.16), 3.00–17.00
Unknown	347	70
Was the abuse a single episode?
Yes	21 (72%)	62 (64%)
No	8 (28%)	35 (36%)
Unknown	346	57
Duration of the abuse
Less than a year	25 (89%)	73 (82%)
More than a year	3 (11%)	16 (18%)
Perpetrator’s identity
Acquaintance	19 (66%)	75 (80%)
Stranger	10 (34%)	20 (20%)

^a Mean (SD), minimum-maximum; n (%).

* According to cutoff.

Table 2. Mean and SD of all study variables.

Characteristic	N = 5291
Relationship satisfaction	5.59 (1.05), 1.25–7.00
PTSD	13.11 (16.42), 0.00–78.00
Sexual functioning	−0.42 (0.78), −2.49–2.77
Dissociation during sex	1.64 (0.83), 1.00–4.86
Intrusiveness during sex	1.24 (0.61), 1.00–5.00
Guilt and shame in relation to sex	1.24 (0.61), 1.00–5.00
Pleasing the partner in sex	1.82 (0.98), 1.00–5.00
Interpersonal distress during sex	1.38 (0.69), 1.00–5.00
Hypervigilance during sex	1.40 (0.76), 1.00–5.00
Sexual-related posttraumatic stress symptoms	1.45 (0.58), 1.00–4.26

^a Mean (SD), minimum-maximum.

Figure 1. Differences between participants with and without CSA in relationship satisfaction. Participants with CSA reported significantly lower relationship satisfaction than participants without CSA.

Bar graph depicting differences in relationship satisfaction between participants with and without CSA. The bar representing participants with CSA is noticeably lower, indicating significantly lower levels of relationship satisfaction compared to the bar representing participants without CSA.

Figure 2. Differences between participants with and without CSA in PTSD (A) and sexual-related PTSS (B). Participants with CSA reported significantly higher severity of PTSD and sexual-related PTSS than participants without CSA.

This figure presents a comparison between participants with and without CSA regarding two measures: PTSD and sexual-related PTSS. The graph shows that participants with CSA report significantly higher levels of both PTSD severity and sexual-related PTSS compared to participants without CSA.

Figure 3. Sexual-related PTSS significantly moderated the association between CSA and relationship satisfaction. Simple slopes test indicated that relationship satisfaction was high among those with low severity of sexual-related PTSS regardless of the presence or absence of CSA. Conversely, among those with high severity of sexual-related PTSS, those with CSA had significantly lower relationship satisfaction as compared with those without CSA.

This figure illustrates the moderating effect of sexual-related PTSS on the association between CSA and relationship satisfaction. Results show that individuals with low PTSS severity report high relationship satisfaction regardless of CSA status. However, among individuals with high PTSS severity, those with CSA display significantly lower relationship satisfaction compared to those without CSA, emphasizing the importance of PTSS in shaping the impact of CSA on relationship well-being.

Table 3. Robust regression coefficients for predicting relationship satisfaction by covariates, PTSD, CSA, and their interaction.

	Relationship satisfaction (Step 1)			Relationship satisfaction (Step 2)
Predictors	Estimates	CI	p	Estimates	CI	p
(Intercept)	6.15	5.87–6.44	<0.001	6.43	6.13–6.72	<0.001
Gender (women)	0.12	−0.10–0.34	0.275	0.05	−0.17–0.26	0.674
Age	−0.01	−0.02–−0.01	<0.001	−0.02	−0.03–−0.01	<0.001
Level of education	0.01	−0.06–0.08	0.864	0.02	−0.04–0.09	0.504
PTSD				−0.01	−0.02–−0.00	0.001
CSA (yes)				−0.22	−0.50–0.07	0.133
PTSD x CSA				−0.00	−0.01–0.01	0.707
R2/R2 adjusted	0.030/0.023			0.113/0.100

Estimation was based on MM-estimator with Croux, Dhaene and Hoorelbeke’s (2003) robust standard errors.

Table 4. Robust regression coefficients for predicting relationship satisfaction by covariates, sexual-related PTSS, CSA, and their interaction.

	Relationship satisfaction (Step 1)			Relationship satisfaction (Step 2)
Predictors	Estimates	CI	p	Estimates	CI	p
(Intercept)	6.15	5.87–6.44	<0.001	6.87	6.45–7.29	<0.001
Gender (women)	0.12	−0.10–0.34	0.275	0.09	−0.14–0.32	0.446
Age	−0.01	−0.02–−0.01	<0.001	−0.01	−0.02–−0.00	0.002
Level of education	0.01	−0.06–0.08	0.864	−0.02	−0.10–0.05	0.553
Sexual-related PTSS				−0.41	−0.61–−0.21	<0.001
CSA (yes)				0.36	−0.15–0.87	0.168
Sexual-related PTSS x CSA				−0.40	−0.70–−0.10	0.009
R^2/R^2 adjusted	0.030/0.023			0.208/0.195

Estimation was based on MM-estimator with Croux, Dhaene and Hoorelbeke’s (2003) robust standard errors.

Table 5. Robust regression coefficients for predicting PTSD, sexual-related PTSS, and relationship satisfaction by abuse characteristics.

	PTSD			Sexual-related PTSS
Predictors	Estimates	CI	p	Estimates	CI	p
(Intercept)	20.78	7.99–33.58	0.002	1.13	0.76–1.50	<0.001
Abuse age	0.35	−0.41–1.11	0.365	0.01	−0.01–0.03	0.302
Number of events (ongoing)	4.21	−3.01–11.42	0.251	0.22	0.01–0.43	0.040
Abuse duration (> 1 year)	8.00	−1.32–17.33	0.092	0.20	−0.08–0.47	0.160
Family member? (non-family)	0.42	−7.55–8.38	0.918	0.22	0.01–0.45	0.049
Adult? (adult)	−5.18	−13.46–3.10	0.218	0.11	−0.13–0.34	0.377
Stranger? (stranger)	−6.84	−15.71–2.02	0.129	0.05	−0.21–0.30	0.714
R2/R2 adjusted	0.085/0.048			0.108/0.069
	Relationship satisfaction
Predictors	Estimates	CI	p
(Intercept)	6.32	5.21–7.42	<0.001
Abuse age	−0.04	−0.11–0.02	0.192
Number of events (ongoing)	−0.22	−0.82–0.38	0.466
Abuse duration (> 1 year)	−0.11	−0.86–0.63	0.770
Family member? (non-family)	0.41	−0.24–1.05	0.211
Adult? (adult)	−0.80	−1.50–−0.10	0.026
Stranger? (stranger)	−0.52	−1.28–0.24	0.179
R^2/R^2 adjusted	0.123/0.070

Estimation was based on MM-estimator with Croux, Dhaene and Hoorelbeke’s (2003) robust standard errors.