{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T23:39:06Z","timestamp":1784936346208,"version":"3.55.0"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Individuals with posttraumatic stress disorder (PTSD) often experience sexual disturbances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether intensive trauma-focused treatment is associated with an improvement in sexual functioning (i.e., sexual satisfaction and sexual desire) in individuals with PTSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In total, 227 patients with PTSD (68.7% women, mean age\u2009=\u200940.97) participated in an intensive eight-day trauma-focused treatment program consisting of prolonged exposure, eye movement and desensitization and reprocessing (EMDR) therapy, physical activity, and psychoeducation. Patients were assessed (i.e., Clinician Administered PTSD Scale and Sexual Functioning Questionnaire) pre- and post-treatment and at 6-months follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sexual satisfaction and sexual desire increased significantly associated with trauma-focused treatment from pre-treatment to 6-months follow-up, albeit the effect sizes were small (Cohen\u2019s <jats:italic>d\u2009=<\/jats:italic> 0.39 and 0.17, respectively). Although men reported greater overall sexual desire than women, sexual functioning improved after treatment in both men and women. Furthermore, those with remission of PTSD reported greater sexual functioning post-treatment and at 6-months follow-up, than those without remission. However, changes in PTSD symptoms associated with treatment were not predictive of the level of sexual satisfaction or sexual desire 6\u2009months after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this uncontrolled study suggest that intensive treatment for PTSD can have beneficial effects on sexual satisfaction and desire in both men and women; however, this may not necessarily be due to a decrease in PTSD symptoms.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2023.1191916","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T12:21:42Z","timestamp":1691497302000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["The impact of intensive trauma-focused treatment on sexual functioning in individuals with PTSD"],"prefix":"10.3389","volume":"14","author":[{"given":"Clair","family":"van Woudenberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline M.","family":"Voorendonk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Tunissen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vince H. F.","family":"van Beek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Rozendael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Van Minnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad","family":"De Jongh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,8]]},"reference":[{"key":"ref1","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1146\/annurev-psych-120710-100422","article-title":"Working memory: theories, models, and controversies","volume":"63","author":"Baddeley","year":"2012","journal-title":"Annu. Rev. Psychol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.1016\/j.jsxm.2021.05.011","article-title":"Relationship between posttraumatic stress disorder and sexual difficulties: a systematic review of veterans and military personnel","volume":"18","author":"Bird","year":"2021","journal-title":"J. Sex. Med."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1080\/00332747.2019.1672439","article-title":"Sexual desire among veterans receiving prolonged exposure therapy for PTSD: does successful PTSD treatment also yield improvements in sexual desire?","volume":"83","author":"Badour","year":"2020","journal-title":"Psychiatry"},{"key":"ref5","doi-asserted-by":"publisher","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"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1002\/smrj.47","article-title":"Systematic review of sexual dysfunction among veterans with post-traumatic stress disorder","volume":"3","author":"Bentsen","year":"2015","journal-title":"Sex. Med. Rev."},{"key":"ref7","volume-title":"Life Events Checklist for DSM-5 \u2013 Nederlandstalige versie. Uitgave: Stichting centrum \u201845, Arq Psychotrauma expert Groep","author":"Boeschoten","year":"2014"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1546085","DOI":"10.1080\/20008198.2018.1546085","article-title":"Development and evaluation of the Dutch clinician-administered PTSD scale for DSM-5 (CAPS-5)","volume":"9","author":"Boeschoten","year":"2018","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.jsxm.2018.02.016","article-title":"Sexual functioning after childhood abuse: the influence of post-traumatic stress disorder and trauma exposure","volume":"15","author":"Bornefeld-Ettmann","year":"2018","journal-title":"J. Sex. Med."},{"key":"ref10","first-page":"22","article-title":"Comorbidity of psychiatric disorders and posttraumatic stress disorder","author":"Brady","year":"2000","journal-title":"J. Clin. Psychiatry"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X21666230428091433","article-title":"Treatment of posttraumatic stress disorder: a state-of-the-art review","volume":"21","author":"Burback","year":"2023","journal-title":"Curr. Neuropharmacol."},{"key":"ref12","first-page":"31","article-title":"Antipsychotics and sexual dysfunction: epidemiology, mechanisms and management","volume":"10","author":"Chiesa","year":"2013","journal-title":"Clin. Neuropsychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1517\/14740338.2014.951324","article-title":"Sexual dysfunction associated with major depressive disorder and antidepressant treatment","volume":"13","author":"Clayton","year":"2014","journal-title":"Expert Opin. Drug Saf."},{"key":"ref14","article-title":"Handboek EMDR: Een geprotocolleerde behandelmethode voor de gevolgen van psychotrauma (handbook EMDR: a protocolled treatment for the consequences of psychotrauma). Amsterdam: Pearson assessment and information B.V. Amsterdam [ISBN 978 90 430 3647 4]","author":"De Jongh","year":"2019"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1002\/da.22469","article-title":"A critical analysis of the current treatment guidelines for complex PTSD in adults","volume":"33","author":"De Jongh","year":"2016","journal-title":"Depress. Anxiety"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1080\/00224499.2011.576351","article-title":"Different perspectives on the sex-attachment link: towards an emotion-motivational account","volume":"49","author":"Dewitte","year":"2012","journal-title":"J. Sex Res."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1080\/15299732.2018.1451975","article-title":"Sexual vs. non-sexual trauma, sexual satisfaction and function, and mental health in female veterans","volume":"19","author":"DiMauro","year":"2018","journal-title":"J. Trauma Dissociation"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1016\/j.jsxm.2016.08.011","article-title":"Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of US adults","volume":"13","author":"Flynn","year":"2016","journal-title":"J. Sex. Med."},{"key":"ref19","doi-asserted-by":"crossref","DOI":"10.1093\/med:psych\/9780195308501.001.0001","volume-title":"Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide (treatments that work)","author":"Foa","year":"2007"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1177\/1073191104269954","article-title":"Psychometric properties of the life events checklist","volume":"11","author":"Gray","year":"2004","journal-title":"Assessment"},{"key":"ref22","doi-asserted-by":"publisher","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."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"204380872090774","DOI":"10.1177\/2043808720907744","article-title":"The effects of eye movements and alternative dual tasks on the vividness and emotionality of negative autobiographical memories: a meta-analysis of laboratory studies","volume":"11","author":"Houben","year":"2020","journal-title":"J. Exp. Psychopathol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1007\/s10508-019-01577-x","article-title":"The association between sexual functioning and suicide risk in US military veteran couples seeking treatment for post-traumatic stress disorder","volume":"49","author":"Khalifian","year":"2020","journal-title":"Arch. Sex. Behav."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1017\/S0033291720001750","article-title":"Sexual symptoms in post-traumatic stress disorder following childhood sexual abuse: a network analysis","volume":"52","author":"Kratzer","year":"2022","journal-title":"Psychol. Med."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.psyneuen.2015.10.015","article-title":"Sexual dysfunction and neuroendocrine correlates of posttraumatic stress disorder in combat veterans: preliminary findings","volume":"63","author":"Lehrner","year":"2016","journal-title":"Psychoneuroendocrinology"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"432","DOI":"10.3390\/jcm8040432","article-title":"Predictors of sexual dysfunction in veterans with post-traumatic stress disorder","volume":"8","author":"Letica-Crepulja","year":"2019","journal-title":"J. Clin. Med."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1891\/1933-3196.8.1.25","article-title":"The \u201cFlashforward procedure\u201d: confronting the catastrophe","volume":"8","author":"Logie","year":"2014","journal-title":"J. EMDR Pract. Res."},{"key":"ref29","volume-title":"Human Sexual Response","author":"Masters","year":"1966"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1956793","DOI":"10.1080\/20008198.2021.1956793","article-title":"The effect of EMDR versus EMDR 2.0 on emotionality and vividness of aversive memories in a non-clinical sample","volume":"12","author":"Matthijssen","year":"2021","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1007\/s10508-005-6277-6","article-title":"Sexual abuse in childhood and sexual dysfunction in adulthood: an Australian population-based study","volume":"34","author":"Najman","year":"2005","journal-title":"Arch. Sex. Behav."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1080\/19317611.2011.639441","article-title":"The impact of sexual functioning problems on mental well-being in US 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"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1111\/papt.12077","article-title":"Sexual problems and post-traumatic stress disorder following sexual trauma: a meta-analytic review","volume":"89","author":"O'Driscoll","year":"2016","journal-title":"Psychol. Psychother. Theory Res. Pract."},{"key":"ref34","volume-title":"MINI: Mini international neuropsychiatric interview, (Dutch version 5.0. 0). (DSM-IV)","author":"Overbeek","year":"1999"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1080\/09638230500066356","article-title":"Evaluation of a PTSD psychoeducational program for psychiatric inpatients","volume":"14","author":"Pratt","year":"2005","journal-title":"J. Ment. Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1017\/S1092852900018605","article-title":"How well does cognitive-behavioral therapy treat symptoms of complex PTSD? An examination of child sexual abuse survivors within a clinical trial","volume":"8","author":"Resick","year":"2003","journal-title":"CNS Spectr."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1080\/009262300278597","article-title":"The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function","volume":"26","author":"Rosen","year":"2000","journal-title":"J. Sex Marital Ther."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1016\/S0090-4295(97)00238-0","article-title":"The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction","volume":"49","author":"Rosen","year":"1997","journal-title":"Urology"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s10591-012-9198-2","article-title":"The impact of depressive symptoms and health on sexual satisfaction for older couples: implications for clinicians","volume":"34","author":"Scott","year":"2012","journal-title":"Contemp. Fam. Ther."},{"key":"ref40","doi-asserted-by":"publisher","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. Women's Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1002\/jts.22556","article-title":"A systematic review of intensive empirically supported treatments for post-traumatic stress disorder","volume":"33","author":"Sciarrino","year":"2020","journal-title":"J. Trauma. Stress."},{"key":"ref42","volume-title":"Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures","author":"Shapiro","year":"2018"},{"key":"ref43","first-page":"22","article-title":"The Mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"J. Clin. Psychiatry"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/jts.22456","article-title":"Barriers and facilitators to help seeking for individuals with posttraumatic stress disorder: a systematic review","volume":"33","author":"Smith","year":"2020","journal-title":"J. Trauma. Stress."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.sxmr.2018.02.004","article-title":"The effects of exercise on sexual function in women","volume":"6","author":"Stanton","year":"2018","journal-title":"Sex. Med. Rev."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.sexol.2011.11.012","article-title":"Early treatment of rape victims: presentation of an emergency EMDR protocol","volume":"21","author":"Tarquinio","year":"2012","journal-title":"Theol. Sex."},{"key":"ref47","doi-asserted-by":"publisher","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."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/20008198.2018.1492836","article-title":"Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder","volume":"9","author":"Van Minnen","year":"2018","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.brat.2009.12.003","article-title":"When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors","volume":"48","author":"Van Minnen","year":"2010","journal-title":"Behav. Res. Ther."},{"key":"ref50","first-page":"393","article-title":"The MINI-international neuropsychiatric interview. A brief structured diagnostic psychiatric interview for DSM-IV and ICD-10 psychiatric disorders","volume":"49","author":"Van Vliet","year":"2007","journal-title":"Tijdschr. Psychiatr."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1487225","DOI":"10.1080\/20008198.2018.1487225","article-title":"Effectiveness of an intensive treatment programme combining prolonged exposure and eye movement desensitization and reprocessing for severe post-traumatic stress disorder","volume":"9","author":"Van Woudenberg","year":"2018","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"2016219","DOI":"10.1080\/20008198.2021.2016219","article-title":"Augmenting PTSD treatment with physical activity: study protocol of the APPART study (augmentation for PTSD with physical activity in a randomized trial)","volume":"13","author":"Voorendonk","year":"2022","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref53","author":"Weathers","year":"2013"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1037\/pas0000486","article-title":"The clinician-administered PTSD scale for DSM\u20135 (CAPS-5): development and initial psychometric evaluation in military veterans","volume":"30","author":"Weathers","year":"2018","journal-title":"Psychol. Assess."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.whi.2018.10.003","article-title":"Examining changes in sexual functioning after cognitive processing therapy in a sample of women trauma survivors","volume":"29","author":"Wells","year":"2019","journal-title":"Womens Health Issues"},{"key":"ref56","doi-asserted-by":"publisher","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."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1111\/j.1743-6109.2010.01784.x","article-title":"Posttraumatic symptoms, marital intimacy, dyadic adjustment, and sexual satisfaction among ex-prisoners of war","volume":"7","author":"Zerach","year":"2010","journal-title":"J. Sex. Med."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1191916\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T12:22:00Z","timestamp":1691497320000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1191916\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,8]]},"references-count":56,"alternative-id":["10.3389\/fpsyg.2023.1191916"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2023.1191916","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,8]]},"article-number":"1191916"}}