{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T20:58:20Z","timestamp":1763499500399,"version":"3.41.2"},"reference-count":35,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T00:00:00Z","timestamp":1562112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>There is mixed evidence regarding how posttraumatic stress disorder (PTSD) symptom clusters are associated with sexual dysfunction (SD), and most studies to date have failed to account for potentially confounding variables. Our study sought to explore the unique contribution of PTSD symptom clusters on (a) lack of sexual desire or pleasure, and (b) pain or problems during sexual intercourse, after adjusting for comorbidities and medication usage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Participants included 543 male treatment-seeking veterans and Canadian Armed Forces (CAF) personnel (aged &lt;65 years), referred for treatment between September 2006 and September 2014. Each participant completed self-report measures of demographic variables, depressive symptom severity, chronic pain, alcohol misuse, and psychotropic medication usage as part of a standard clinical intake protocol. Hierarchical ordinal logistic regression analyses were used to determine the incremental contribution of PTSD symptom clusters on sexual dysfunction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nearly three-quarters (71.5%) of participants reported a lack of sexual desire or pleasure and 40.0% reported pain or problems during intercourse. Regression analyses suggested that avoidant\/numbing symptoms were the only symptoms to be independently associated with lacking sexual desire or pleasure (AOR = 1.10; 95% CI 1.05\u20131.15). None of the PTSD symptom clusters were independently associated with pain or problems during intercourse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Sexual dysfunction is prevalent among male treatment-seeking CAF personnel and veterans. Results suggest that PTSD symptoms are differentially associated with sexual desire or pleasure concerns. Assessing sexual function among CAF personnel and veterans seeking treatment for PTSD is critical in order to treat both conditions and improve overall functioning.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usz163","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T13:03:43Z","timestamp":1562159023000},"source":"Crossref","is-referenced-by-count":3,"title":["Sexual Dysfunction in Male Canadian Armed Forces Members and Veterans Seeking Mental Health Treatment"],"prefix":"10.1093","author":[{"given":"J Don","family":"Richardson","sequence":"first","affiliation":[{"name":"Operational Stress Injury Clinic, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"},{"name":"MacDonald\/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"},{"name":"Department of Psychiatry, Western University, 1151 Richmond St, London, ON, Canada"},{"name":"Department of Psychiatry, McMaster University, 1280 Main St W, Hamilton, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia","family":"Ketcheson","sequence":"additional","affiliation":[{"name":"Operational Stress Injury Clinic, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"King","sequence":"additional","affiliation":[{"name":"Operational Stress Injury Clinic, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Callista A","family":"Forchuk","sequence":"additional","affiliation":[{"name":"MacDonald\/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9e","family":"Hunt","sequence":"additional","affiliation":[{"name":"MacDonald\/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"},{"name":"Department of Psychiatry, Western University, 1151 Richmond St, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"St. Cyr","sequence":"additional","affiliation":[{"name":"Operational Stress Injury Clinic, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"},{"name":"MacDonald\/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College St. Rm 500, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Nazarov","sequence":"additional","affiliation":[{"name":"MacDonald\/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, Canada"},{"name":"Department of Psychiatry, Western University, 1151 Richmond St, London, ON, Canada"},{"name":"Department of Psychiatry, McMaster University, 1280 Main St W, Hamilton, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Shnaider","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"McIntyre-Smith","sequence":"additional","affiliation":[{"name":"Private Practice, 25 Morrow Ave, Suite 100, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon D","family":"Elhai","sequence":"additional","affiliation":[{"name":"Department of Psychology, and Department of Psychiatry, University of Toledo, 2801 Bancroft St, Toledo, OH, 43606"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"volume-title":"Canadian Community Health Survey Cycle 1.2 \u2013 Mental Health and Well-being (Canadian Forces Supplement)","year":"2002","author":"Statistics Canada","key":"2019070309024637800_usz163C1"},{"issue":"2","key":"2019070309024637800_usz163C2","first-page":"1","article-title":"Mental health of Canadian Armed Forces Veterans \u2013 review of population studies","volume":"1","author":"Thompson","year":"2015","journal-title":"JMVFH"},{"issue":"9","key":"2019070309024637800_usz163C3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1177\/070674370805300906","article-title":"Posttraumatic Stress Disorder and Health Related Quality Of Life (HRQol) among a Sample of Treatment- and Pension-Seeking deployed Canadian Forces Peacekeeping Veterans","volume":"53","author":"Richardson","year":"2008","journal-title":"Can J Psychiatry"},{"key":"2019070309024637800_usz163C4","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed."},{"key":"2019070309024637800_usz163C5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.comppsych.2014.12.012","article-title":"Problems in sexual functioning among male OEF\/OIF veterans seeking treatment for posttraumatic stress","volume":"58","author":"Badour","year":"2015","journal-title":"Compr Psychiatry"},{"issue":"1","key":"2019070309024637800_usz163C6","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/jsm.12201","article-title":"Sexual dysfunction in male Iraq and Afghanistan war veterans: association with posttraumatic stress disorder and other combat-related mental health disorders: a population-based cohort study","volume":"11","author":"Breyer","year":"2014","journal-title":"J Sex Med"},{"issue":"7","key":"2019070309024637800_usz163C7","doi-asserted-by":"crossref","first-page":"817","DOI":"10.7205\/MILMED-D-14-00125","article-title":"Sexual functioning among a cohort of treatment-seeking canadian military personnel and veterans with psychiatric conditions","volume":"180","author":"McIntyre-Smith","year":"2015","journal-title":"Mil Med"},{"issue":"1","key":"2019070309024637800_usz163C8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1080\/19317611.2011.639441","article-title":"The Impact of Sexual Functioning Problems on Mental Well-Being In U.S. Veterans from the Operation Enduring Freedom and Operation Iraqi Freedom (OEF\/OIF) Conflicts","volume":"24","author":"Nunnink","year":"2012","journal-title":"Int J Sex Health"},{"issue":"10","key":"2019070309024637800_usz163C9","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1111\/jsm.12643","article-title":"Sexual Functioning in Military Personnel: Preliminary Estimates and Predictors","volume":"11","author":"Wilcox","year":"2014","journal-title":"J Sex Med"},{"issue":"4","key":"2019070309024637800_usz163C10","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1111\/jsm.12084","article-title":"Assessment and documentation of sexual health issues of recent combat veterans seeking VHA care","volume":"10","author":"Helmer","year":"2013","journal-title":"J Sex Med"},{"issue":"2","key":"2019070309024637800_usz163C11","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/j.1743-6109.2012.02978.x","article-title":"Sexual dysfunction among male veterans returning from Iraq and Afghanistan: prevalence and correlates","volume":"10","author":"Hosain","year":"2013","journal-title":"J Sex Med"},{"issue":"3","key":"2019070309024637800_usz163C12","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1159\/000056286","article-title":"Sildenafil citrate for the sexual dysfunction in antidepressant-treated male patients with posttraumatic stress disorder. A preliminary pilot open-label study","volume":"71","author":"Reznik","year":"2002","journal-title":"Psychother Psychosom"},{"issue":"1","key":"2019070309024637800_usz163C13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00004714-199902000-00013","article-title":"Effects of SSRIs on sexual function: a critical review","volume":"19","author":"Rosen","year":"1999","journal-title":"J Clin Psychopharmacol"},{"issue":"4","key":"2019070309024637800_usz163C14","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.eurpsy.2005.12.005","article-title":"Effects of atypical and typical antipsychotic treatments on sexual function in patients with schizophrenia: 12-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study","volume":"21","author":"Dossenbach","year":"2006","journal-title":"Eur Psychiatry"},{"issue":"5","key":"2019070309024637800_usz163C15","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1111\/jsm.12856","article-title":"PTSD and sexual dysfunction in men and women","volume":"12","author":"Yehuda","year":"2015","journal-title":"J Sex Med"},{"issue":"3","key":"2019070309024637800_usz163C16","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1080\/00332747.2017.1395313","article-title":"The unique roles of emotional numbing and arousal symptoms in relation to social connectedness among military veterans in residential treatment for PTSD","volume":"81","author":"Sippel","year":"2018","journal-title":"Psychiatry"},{"issue":"1","key":"2019070309024637800_usz163C17","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1037\/0893-3200.18.1.36","article-title":"Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war","volume":"18","author":"Cook","year":"2004","journal-title":"J Fam Psychol"},{"issue":"1","key":"2019070309024637800_usz163C18","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1023\/A:1024409200155","article-title":"The quality of the intimate relationships of male Vietnam veterans: problems associated with posttraumatic stress disorder","volume":"11","author":"Riggs","year":"1998","journal-title":"J Trauma Stress"},{"issue":"6","key":"2019070309024637800_usz163C19","doi-asserted-by":"crossref","first-page":"424","DOI":"10.7205\/MILMED-D-09-00085","article-title":"The role of emotional numbing in sexual functioning among veterans of the Iraq and Afghanistan wars","volume":"175","author":"Nunnink","year":"2010","journal-title":"Mil Med"},{"issue":"10","key":"2019070309024637800_usz163C20","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1089\/jwh.2008.1165","article-title":"Sexual function outcomes in women treated for posttraumatic stress disorder","volume":"18","author":"Schnurr","year":"2009","journal-title":"J Womens Health"},{"issue":"6","key":"2019070309024637800_usz163C21","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1111\/j.1743-6109.2012.02709.x","article-title":"Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis","volume":"9","author":"Atlantis","year":"2012","journal-title":"J Sex Med"},{"issue":"2","key":"2019070309024637800_usz163C22","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/0019-5545.33257","article-title":"Prevalence of sexual dysfunction in male subjects with alcohol dependence","volume":"49","author":"Arackal","year":"2007","journal-title":"Indian J Psychiatry"},{"issue":"1","key":"2019070309024637800_usz163C23","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1743-6109.2004.10106.x","article-title":"Epidemiology\/risk factors of sexual dysfunction","volume":"1","author":"Lewis","year":"2004","journal-title":"J Sex Med"},{"issue":"4","key":"2019070309024637800_usz163C24","doi-asserted-by":"crossref","first-page":"499","DOI":"10.3325\/cmj.2008.4.499","article-title":"Sexual functioning in war veterans with posttraumatic stress disorder","volume":"49","author":"Anticevic","year":"2008","journal-title":"Croat Med J"},{"issue":"5","key":"2019070309024637800_usz163C25","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S0090-4295(02)01899-X","article-title":"Sexual dysfunction in combat veterans with post-traumatic stress disorder","volume":"60","author":"Cosgrove","year":"2002","journal-title":"Urology"},{"year":"1993","author":"Weathers","key":"2019070309024637800_usz163C26"},{"issue":"6","key":"2019070309024637800_usz163C27","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1002\/jts.22059","article-title":"The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation","volume":"28","author":"Blevins","year":"2015","journal-title":"J Trauma Stress"},{"issue":"18","key":"2019070309024637800_usz163C28","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1001\/jama.282.18.1737","article-title":"Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire","volume":"282","author":"Spitzer","year":"1999","journal-title":"JAMA"},{"volume-title":"AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care","year":"2001","author":"Babor","key":"2019070309024637800_usz163C29"},{"volume-title":"SF-36 Health Survey: Manual and lnterpretation Guide","year":"1993","author":"Ware","key":"2019070309024637800_usz163C30"},{"year":"2013","author":"STATA","key":"2019070309024637800_usz163C31"},{"volume-title":"Multivariate Data Analysis.","year":"1995","author":"Hair","key":"2019070309024637800_usz163C32"},{"volume-title":"SF-36 Health Survey: Manual and Interpretation Guide","year":"2000","author":"Ware","key":"2019070309024637800_usz163C33"},{"issue":"4","key":"2019070309024637800_usz163C34","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/jsm.12823","article-title":"Sexual dysfunction in veterans with post-traumatic stress disorder","volume":"12","author":"Tran","year":"2015","journal-title":"J Sex Med"},{"issue":"5","key":"2019070309024637800_usz163C35","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1682\/JRRD.2011.09.0158","article-title":"Review of posttraumatic stress disorder and chronic pain: the path to integrated care","volume":"49","author":"Gibson","year":"2012","journal-title":"J Rehabil Res Dev"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usz163\/28900135\/usz163.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"}],"deposited":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T13:04:31Z","timestamp":1562159071000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usz163\/5527821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,3]]},"references-count":35,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usz163","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published":{"date-parts":[[2019,7,3]]},"article-number":"usz163"}}