Sexual Problems Predict PTSD and Depression Symptom Change Among Male OEF/OIF Veterans Completing Exposure Therapy

Abstract

Objective: A growing literature documents frequent sexual problems among Operations Enduring/Iraqi Freedom (OEF/OIF) veterans with post-traumatic stress disorder (PTSD). However, there has been no examination of how (1) sexual problems may be affected by evidenced-based psychotherapy for PTSD or (2) how the presence of sexual problems might impact effectiveness of evidenced-based psychotherapy for PTSD. As such, the present study investigated associations among symptoms of PTSD, depression, and problems with sexual desire and arousal among 45 male OEF/OIF veterans receiving behavioral activation and therapeutic exposure (BA-TE), an evidence-based behavior therapy targeting co-occurring symptoms of PTSD and depression. Method: Participants completed clinical interviews and several questionnaires including measures of sexual arousal, sexual desire, PTSD symptoms, and depression symptoms at baseline and after completion of 8 sessions of BA-TE treatment. A records review was also conducted to assess for relevant medication use. Results: Overall, sexual desire and sexual arousal problems did not improve during the course of treatment. Moreover, veterans with co-occurring sexual problems at baseline evidenced significantly less improvement in symptoms of PTSD and depression across treatment as compared to veterans without sexual problems. Conclusions: These findings suggest that veterans with co-occurring symptoms of PTSD and sexual problems may require additional assessment and treatment considerations in order to improve their treatment outcomes for both primary psychiatric symptoms as well as sexual problems. Future research on combination treatments of medication for sexual problems and psychotherapy for PTSD is needed.

CONFLICTS OF INTEREST

The authors have no conflicts of interest to disclose.

ACKNOWLEDGMENTS

This publication was supported, in part, by grants from the Department of Defense (W81XWH-07-PTSD-IIRA [PI: Acierno]), Department of Veteran Affairs Clinical Sciences Research and Development Career Development Award (CX000845 [PI: Gros]), and the South Carolina Clinical & Translational Research Institute, with an academic home at the Medical University of South Carolina (NIH Grant Number UL1 TR000062 [PI: Brady]). Dr. Badour is supported by a grant from the National Institute of Mental Health (T32 MH018869). Several authors are also core and affiliate members of the Ralph H. Johnson VA Centers of Innovation (PI: Egede), Charleston Health Equity and Rural Outreach Innovation Center. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the National Institutes of Health, or the United States government. There are no conflicts of interest to disclose.

Additional information

Notes on contributors

Christal L. Badour

Christal L. Badour, PhD, is affiliated with the University of Kentucky, Lexington, Kentucky, USA.

Daniel F. Gros

Daniel F. Gros, PhD, Derek D. Szafranski, PhD, and Ron Acierno, PhD, are affiliated with the Medical University of South Carolina, Charleston, South Carolina, USA, and the Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA.

Derek D. Szafranski

Daniel F. Gros, PhD, Derek D. Szafranski, PhD, and Ron Acierno, PhD, are affiliated with the Medical University of South Carolina, Charleston, South Carolina, USA, and the Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA.

Ron Acierno

Daniel F. Gros, PhD, Derek D. Szafranski, PhD, and Ron Acierno, PhD, are affiliated with the Medical University of South Carolina, Charleston, South Carolina, USA, and the Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA.