Change in sexual distress during cognitive processing therapy: Characterization and baseline predictors

Experiences of interpersonal trauma can negatively impact survivors' sexual wellness, including leading to increased sexual distress. Cognitive processing therapy (CPT) has been shown to reduce symptoms of posttraumatic stress disorder (PTSD), but the extent to which treatment gains extend to sexual distress is less known. We examined change in sexual distress and baseline predictors of change in sexual distress in a sample of 161 adult survivors of interpersonal violence receiving CPT for PTSD (86 % female, 47 % Black). Latent difference score models showed sexual distress significantly decreased (d = −0.79 at posttreatment; d = −0.95 at 3-month follow-up). Change in sexual distress covaried significantly with change in PTSD from pretreatment to posttreatment. We examined several potential baseline predictors of change in sexual distress during treatment. Greater pretreatment dissociation predicted poorer improvement in sexual distress during treatment. None of the following uniquely predicted change in sexual distress over time: pretreatment PTSD severity, relationship impairment with the respondent's significant other, gender, index trauma (childhood physical assault, childhood sexual assault, or adult sexual assault vs. adult physical assault), pretreatment depression, or pretreatment posttraumatic cognitions. Findings help characterize change in sexual functioning over the course of CPT and point to dissociation as a potential negative prognostic indicator of sexual distress change during CPT.