{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:17:15Z","timestamp":1788427035096,"version":"build-2803163510"},"posted":{"date-parts":[[2026,9,3]]},"group-title":"Social Sciences","reference-count":0,"publisher":"MDPI AG","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,2]]},"abstract":"<jats:p>Background: Childhood maltreatment, and childhood sexual abuse in particular, is a potent developmental risk factor for disrupted adult sexuality. Survivors show two divergent yet frequently co\u2011occurring outcomes: elevated sexual risk-taking and compulsive sexual behavior on one hand, and sexual avoidance and dysfunction on the other. These patterns arise from trauma\u2011organized alterations in sexual meaning, attachment, emotion regulation, dissociation, and stress\u2011reactivity. The manuscript highlights that survivors may simultaneously exhibit sexual preoccupation and sexual aversion, forming a state of sexual ambivalence. It also notes that sexual\u2011minority and gender\u2011diverse individuals experience compounded risk due to minority stress and sociocultural factors. Objectives: To synthesize four decades of empirical, theoretical, and cross\u2011cultural evidence explaining how childhood sexual abuse produces both hypersexuality and sexual avoidance; to identify central mediating mechanisms; to evaluate the methodological quality of the evidence base; and to outline implications for trauma\u2011informed, culturally responsive clinical practice. Methods: A narrative\u2011integrative review was conducted using peer\u2011reviewed literature from major scientific databases, supplemented by citation tracking. Priority was given to meta\u2011analyses, umbrella reviews, prospective cohort studies, and large cross\u2011national datasets. The review integrates traumagenic dynamics, attachment theory, sexual self\u2011schema models, neurobiological stress\u2011reactivity research, minority\u2011stress frameworks, and cross\u2011cultural findings. Evidence quality was appraised using established umbrella\u2011review grading criteria. Results: Childhood sexual abuse uniquely predicts early sexual initiation, multiple partners, transactional sex, revictimization, and other risk behaviors beyond the effects of other maltreatment types. It also increases the likelihood of adult sexual dysfunction, including low desire, arousal difficulties, orgasmic problems, sexual pain, and avoidance. Prospective studies show early emergence and persistence of sexual preoccupation, aversion, and ambivalence. Cluster\u2011analytic work identifies survivor subtypes combining high compulsivity and high avoidance. Neurobiological findings indicate stress\u2011system sensitization that can manifest as either hyperactivation or hypoactivation of sexual response. Minority stress, gender identity, and cultural context shape the severity and expression of sexual outcomes. Evidence quality for sexual outcomes is variable, with several associations supported by modest rather than high\u2011certainty evidence. Conclusions: Hypersexuality and sexual avoidance represent complementary expressions of a trauma\u2011organized sexual system shaped by dissociation, insecure attachment, emotion dysregulation, and altered stress physiology. These patterns often co\u2011occur within individuals and fluctuate with relational, cultural, and identity\u2011related contexts. A comprehensive understanding of this paradox requires integrating psychological, biological, and sociocultural mechanisms. Clinical Implications: Assessment should routinely evaluate both compulsive and avoidant sexual patterns, dissociation, minority stress, and attachment insecurity. Trauma\u2011informed treatment should address emotion regulation, relational functioning, and sexual concerns within culturally responsive frameworks. Standardized measurement of sexual outcomes is essential for improving evidence quality and guiding intervention.<\/jats:p>","DOI":"10.20944\/preprints202609.0221.v1","type":"posted-content","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T08:45:41Z","timestamp":1788425141000},"source":"Crossref","is-referenced-by-count":0,"title":["Childhood Abuse, Sexual Risk-Taking, and Sexual Dysfunction: The Paradox of Hypersexuality and Sexual Avoidance"],"prefix":"10.20944","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6042-2472","authenticated-orcid":false,"given":"Sushil Kumar","family":"SV","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","container-title":[],"original-title":[],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T08:46:12Z","timestamp":1788425172000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.preprints.org\/manuscript\/202609.0221\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":0,"URL":"https:\/\/doi.org\/10.20944\/preprints202609.0221.v1","relation":{},"subject":[],"published":{"date-parts":[[2026,9,3]]},"subtype":"preprint"}}