{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:42:23Z","timestamp":1794361343259,"version":"4.9.0"},"reference-count":88,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2017,2,12]],"date-time":"2017-02-12T00:00:00Z","timestamp":1486857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,2,12]],"date-time":"2017-02-12T00:00:00Z","timestamp":1486857600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100008240","name":"Fonds de recherche du Qu\u00e9bec-Soci\u00e9t\u00e9 et Culture","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008240","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Joseph-Armand Bombardier Canada Graduate Scholarships Program"},{"name":"Fonds de recherche du Qu\u00e9bec-Sant\u00e9"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Patients consulting for sexual difficulties frequently present additional personal or relational disorders and symptoms. This is especially the case when they have experienced cumulative adverse childhood experiences (CACEs), which are associated with symptom complexity. CACEs refer to the extent to which an individual has experienced an accumulation of different types of adverse childhood experiences including sexual, physical, and psychological abuse; neglect; exposure to inter-parental violence; and bullying. However, past studies have not examined how symptom complexity might relate to CACEs and sexual satisfaction and even less so in samples of adults consulting for sex therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To document the presence of CACEs in a sample of individuals consulting for sexual difficulties and its potential association with sexual satisfaction through the development of symptom complexity operationalized through well-established clinically significant indicators of individual and relationship distress.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Men and women (n\u00a0= 307) aged 18 years and older consulting for sexual difficulties completed a set of questionnaires during their initial assessment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>(i) Global Measure of Sexual Satisfaction Scale, (ii) Dyadic Adjustment Scale\u20134, (iii) Experiences in Close Relationships\u201312, (iv) Beck Depression Inventory\u201313, (v) Trauma Symptom Inventory\u20132, and (vi) Psychiatric Symptom Inventory\u201314.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Results showed that 58.1% of women and 51.9% of men reported at least four forms of childhood adversity. The average number of CACEs was 4.10 (SD = 2.23) in women and 3.71 (SD = 2.08) in men. Structural equation modeling showed that CACEs contribute directly and indirectly to sexual satisfaction in adults consulting for sex therapy through clinically significant individual and relational symptom complexities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The findings underscore the relevance of addressing clinically significant psychological and relational symptoms that can stem from CACEs when treating sexual difficulties in adults seeking sex therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2017.01.013","type":"journal-article","created":{"date-parts":[[2017,2,13]],"date-time":"2017-02-13T15:07:56Z","timestamp":1486998476000},"page":"444-454","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":45,"title":["Cumulative Adverse Childhood Experiences and Sexual Satisfaction in Sex Therapy 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