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Implicit and Explicit Cognitive Sexual Processes in Survivors of Childhood Sexual Abuse


Alessandra Rellini, MD, Department of Psychology, University of Vermont, John Dewey Hall/2 Colchester, Burlington, VT 05461, USA. Tel: (802) 656-4110; Fax: 802-656-8783; E-mail:


Introduction.  Women with a history of childhood sexual abuse (CSA) exhibit higher rates of sexual dysfunction than nonabused women.

Aim.  Because sexual responses are affected by cognitive processes, this study investigated the implicit and explicit cognitive processing of sexual stimuli in women with a history of CSA.

Methods.  Women with (CSA; N = 34) and without (no history of abuse [NSA]; N = 22) a history of CSA participated in a quasi-experimental study.

Main Outcome Measure.  Implicit processes, described as involuntary or unintentional responses to stimuli, were assessed using the Implicit Association Test (IAT). Explicit processes, described as intentional, voluntary, or effortful processing of sexual stimuli, were assessed through a self-reported questionnaire (Sexual Self-Schema Scale).

Results.  Results showed initial evidence of between group differences in the cognitive processing of sexual stimuli. Regarding the implicit processes, women in the NSA group showed that sexual pictures were more strongly associated with positive valence (pleasure) than nonsexual pictures. For the CSA group, neutral and sexual pictures were similarly associated with pleasure. Conversely, for both groups, romantic pictures were more strongly associated with positive valence than sexual pictures. Moreover, sexual satisfaction was predicted by both implicit and explicit processes, suggesting that the sexuality of women is affected by both processes independently.

Conclusions.  These results fit within the larger body of literature suggesting that implicit and explicit processes independently predict different aspects of behavior. Rellini AH, Ing AD, and Meston CM. Implicit and explicit cognitive sexual processes in survivors of childhood sexual abuse. J Sex Med 2011;8:3098–3107.