Linda R. Mona

Sexuality among wounded veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND): Implications for rehabilitation psychologists.

OBJECTIVE The sexual lives of returning Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans have only been discussed minimally in the psychological literature. Given the nature of military social and cultural contexts, the potential for exposure to combat-related stressors that may lead to posttraumatic stress disorder (PTSD), and the risk of traumatic brain injury secondary to physical injury, the potential for significant psychological and relational ramifications exists. This article focuses on the intimate relationships and sexuality of returning OIF/OEF/OND veterans within the context of their personal cultural variables and the diverse experience of being a part of military life. CONCLUSIONS Culturally competent assessment and evidenced-based treatment approaches are highlighted to offer clinicians initial strategies to begin treatment of sexuality issues within the returning Veteran population. These clinical tools are discussed within a positive psychology approach that emphasizes healthy sexuality as a part of overall satisfactory quality of life.

Sexual self views of women with disabilities: The relationship among age-of-onset, nature of disability and sexual self-esteem

The sexual self-esteen of 43 women with mobility impairments was examined on the basis of age-of-onset and nature (fluctuating versus stable health conditions) of disability. Based on past literature, it was hypothesized that women with earlier age-of-onset disabilities would report lower positive levels of sexual self-esteem compared to women with later age-of-onset disabilities. Subjects were acquired through two computer on-line services, two large urban universities, and nationally based disability-related organizations. A hierarchical multiple regression indicated that as age-of-onset of disability increased (i.e. the disability occurred later in life), positive sexual self-esteem decreased significantly. Future research should acquire participants from residential institutions other than rehabilitation facilities and those who remain at home. The necessity of creating psychological scales and tools applicable to this population is discussed.

Sexual Health and Well-Being After Cancer Applying the Sexual Health Model

Sexual quality of life after cancer is an integral component of well-being for many survivors. However, the experience of cancer presents significant challenges to sexual health and well-being, often requiring survivors to negotiate the many physical, psychological, social/relational, and cultural factors that impact psychosexual functioning. By embracing a sex-positive approach to conceptualization, assessment, and treatment, psychologists can better serve the unique psychosexual needs of survivors and assist in enhancing sexual and intimate expression that promotes adaptation and flexibility. This article will (a) present a positive conceptualization of sexual health and well-being for cancer survivors and (b) discuss culturally competent treatment strategies to promote the sexual health and well-being of cancer survivors.

Posttraumatic Stress Disorder Symptomatology in Men and Women with Spinal Cord Injury

This descriptive study explored posttraumatic stress disorder (PTSD) symptoms in a nonveteran sample (N = 109 men and 86 women) of participants with spinal cord injury (SCI). Participants completed a demographic survey and Foas (1995) Posttraumatic Stress Diagnostic Scale. Results suggested that there were no significant differences between men and women or by level of injury (i.e., paraplegic and tetraplegic) in terms of number of PTSD items endorsed and PTSD severity score. Both men and women reported PTSD symptom severity total scores classified in the mild range of symptom severity. Research and clinical implications are discussed.

The use of computers and on-line services in conducting sexuality research with people who have physical disabilities

The sexuality of individuals with severe physical disabilities is an extremely under-studied topic area. Part of the difficulty in conducting research in this domain involves overcoming many of the obstacles in gaining access to this population in addition to designing the methodology in such a way that it is possible for these individuals to participate. One promising technique that addresses many of these difficulties is the use of “on-line” computer services. Obtaining subjects in this manner has several advantages that are of particular importance with this population.

Personal assistance, disability, and intimate partner violence: A guide for healthcare providers.

PURPOSE/OBJECTIVE Our objective was to provide evidence-based guidance for health care providers to engage in brief and extensive assessment of intimate partner violence (IPV) and to initiate appropriate safety precautions and referrals, all within the context of disability. Research Method/Design: This article is a review of the literature on prevalence and risk factors for IPV in nondisabled couples and in couples where a partner has a disability, on various assessment tools, and on the impact of personal assistance on relationships. RESULTS When an individual has a disability, it is often her or his partner who provides personal assistance. While providing this assistance can produce individual and/or interrelational benefits, it is also associated with a number of mental and physical health problems, including anxiety, depression, anger, drug abuse, and relationship discord and dissatisfaction. In addition, IPV is not uncommon among couples, and risk for partner violence may include depression, drug abuse, and relationship dissatisfaction, among others. CONCLUSIONS/IMPLICATIONS It is likely that health care providers will encounter individuals with disabilities who are both receiving care from their partners and who are also the victims of partner violence. Thus, they will need to be prepared to assess and triage patients who are in or may be at risk for abusive relationships and to ensure patient safety in the context of these relationships. However, it is also critically important that this assessment occurs within a culturally inclusive and disability-affirming context. (PsycINFO Database Record

Sex-Positive Assessment and Treatment Among Female Trauma Survivors: Sex Positive Treatment For Female Trauma Survivors

Sexuality and intimacy difficulties are often a part of the aftermath of sexual trauma. We argue that combining techniques from evidence-based, trauma-focused treatment with sex-positive techniques used in sex therapy can best help survivors reduce trauma-related symptoms and develop or regain comfort with their sexuality. In this article, we illustrate this approach by describing the case of a survivor of sexual assault, who completed 20 sessions of treatment that combined modules of trauma-focused therapies, Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE) with sensate focus therapy, a technique often used in sex therapy. The outcome of this case suggests that clinicians who work with sexual trauma survivors may want to consider a sex-positive approach to conceptualizing and planning the course of treatment, to achieve optimal results.

Disability culturally competent sexual healthcare.

Though cultural competence and inclusion of diverse identities are increasingly emphasized in psychological training and practice, sexual health and well-being among people with disabilities (PWD) continue to be underrecognized areas in which disability cultural competence is needed. The experience of disability is best conceptualized as an interaction between physical, sensory, or cognitive differences and environmental and sociocultural contexts that facilitate or impede adaptive functioning; these complex interactions, coupled with an individual’s age, gender, ethnicity, religious background, and sexual orientation, often inform one’s sexual health and well-being. Disability can be thought of as a minority cultural status—a marginalized and stigmatized identity. Given the imperative that psychologists must be culturally competent and self-aware, as well as the centrality of sexual health and well-being to quality of life including among PWD, assessment of sexuality as a facet of overall well-being among individuals with physical disabilities should be part of routine clinical practice. A discussion of disability cultural competence is offered as a foundation to explore disability sexual health and wellness competence in clinical assessment. The disability and sexuality health care competency model is introduced to address the need for evidence-based sexual health and wellness assessment of PWD. Specific conceptual and behavioral sexuality and disability competencies that correspond to the provision and facilitation of these services are delineated.