Posttraumatic Stress Disorder Symptoms Moderate the Association between Childhood Sexual Abuse and Compulsive Sexual Behavior Among Adults in Residential Substance Use Treatment

Abstract

Compulsive sexual behavior (CSB) is common among people with substance use disorders (SUDs) and these behaviors may mutually reinforce each other. Thus, research into risk factors for CSB in this population could inform interventions that reduce CSB and stifle this reinforcement pattern. People with SUDs report high rates of childhood abuse and posttraumatic stress disorder (PTSD) symptoms, which are also empirically supported risk factors for CSB. We examined the moderating effect of PTSD symptoms on the associations between forms of childhood abuse (i.e., physical, sexual, emotional) and CSB among 707 patients in residential treatment for SUDs (M_age = 40.8 years, SD = 12.1; 73.6% men). PTSD symptoms moderated the association between childhood sexual abuse, but not other forms of childhood abuse, and CSB. Childhood sexual abuse was positively related to CSB at high, but not low or mean levels of PTSD symptoms. Childhood emotional abuse was also related to CSB, whereas childhood physical abuse was not significantly related to CSB. Findings indicate that PTSD symptoms could exacerbate the association between childhood sexual abuse and CSB. Future applied studies might consider exploring whether trauma-focused interventions can reduce CSB in patients with SUDs who are survivors of childhood sexual abuse.