A Dimensional Approach to PTSD After Drug-Facilitated Sexual Assault: Impact on Sexual Functioning

Sexual assault (SA) is linked to both posttraumatic stress disorder (PTSD) symptoms and sexual functioning (SF) difficulties, but the psychological consequences of drug-facilitated SA (DFSA) remain insufficiently characterized. This study primarily compared PTSD symptom profiles between DFSA and non-DFSA survivors, while secondarily examining SF deterioration and exploring associations between PTSD symptom profiles and SF impairment. Thirty-nine women who experienced an isolated SA within the past year (20 non-DFSA, 19 DFSA) and 35 nontraumatized controls were recruited. Participants with prior SA, trauma history, or previous psychiatric disorders were excluded. PTSD symptoms were assessed only in the survivor groups. Although both survivor groups met PTSD criteria at similar rates, DFSA survivors exhibited fewer and less severe symptoms, particularly in reexperiencing, distress, avoidance, and dissociation. Both survivor groups reported SF deterioration after the SA compared with pre-assault functioning. In exploratory linear regression analyses, greater hyperarousal severity, but not negative alterations in cognition and mood, was associated with greater SF deterioration. These findings suggest that DFSA is characterized by a distinct profile of PTSD symptoms despite comparable diagnostic rates, emphasizing the importance of moving beyond categorical PTSD diagnoses toward symptom-informed clinical assessment. Such an approach may facilitate more personalized trauma-informed interventions. The exploratory association between hyperarousal and SF deterioration provides preliminary evidence for a potential therapeutic target that warrants confirmation in larger prospective studies.