Sexual Dysfunction in Male Canadian Armed Forces Members and Veterans Seeking Mental Health Treatment

J Don Richardson; Felicia Ketcheson; Lisa King; Callista A Forchuk; Renée Hunt; Kate St Cyr; Anthony Nazarov; Philippe Shnaider; Alexandra McIntyre-Smith; Jon D Elhai

doi:10.1093/milmed/usz163

Sexual Dysfunction in Male Canadian Armed Forces Members and Veterans Seeking Mental Health Treatment

Mil Med. 2020 Feb 12;185(1-2):68-74. doi: 10.1093/milmed/usz163.

Authors

J Don Richardson^{1

2

3

4}, Felicia Ketcheson¹, Lisa King¹, Callista A Forchuk², Renée Hunt^{2

3}, Kate St Cyr^{1

2

5}, Anthony Nazarov^{2

3

4}, Philippe Shnaider⁶, Alexandra McIntyre-Smith⁷, Jon D Elhai⁸

Affiliations

¹ Operational Stress Injury Clinic, Parkwood Institute, 550 Wellington Rd, London, ON, N6C 5J1 Canada.
² MacDonald/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, N6C 5J1, Canada.
³ Department of Psychiatry, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada.
⁴ Department of Psychiatry, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8 Canada.
⁵ Dalla Lana School of Public Health, University of Toronto, 155 College St. Rm 500, Toronto, ON, M5T 3M7, Canada.
⁶ St. Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A6, Canada.
⁷ Private Practice, 25 Morrow Ave, Suite 100, Toronto, ON, M6R 2H9, Canada.
⁸ Department of Psychology, and Department of Psychiatry, University of Toledo, 2801 Bancroft St, Toledo, OH, 43606.

PMID: 31268528
DOI: 10.1093/milmed/usz163

Abstract

Introduction: There is mixed evidence regarding how posttraumatic stress disorder (PTSD) symptom clusters are associated with sexual dysfunction (SD), and most studies to date have failed to account for potentially confounding variables. Our study sought to explore the unique contribution of PTSD symptom clusters on (a) lack of sexual desire or pleasure, and (b) pain or problems during sexual intercourse, after adjusting for comorbidities and medication usage.

Materials and methods: Participants included 543 male treatment-seeking veterans and Canadian Armed Forces (CAF) personnel (aged <65 years), referred for treatment between September 2006 and September 2014. Each participant completed self-report measures of demographic variables, depressive symptom severity, chronic pain, alcohol misuse, and psychotropic medication usage as part of a standard clinical intake protocol. Hierarchical ordinal logistic regression analyses were used to determine the incremental contribution of PTSD symptom clusters on sexual dysfunction.

Results: Nearly three-quarters (71.5%) of participants reported a lack of sexual desire or pleasure and 40.0% reported pain or problems during intercourse. Regression analyses suggested that avoidant/numbing symptoms were the only symptoms to be independently associated with lacking sexual desire or pleasure (AOR = 1.10; 95% CI 1.05-1.15). None of the PTSD symptom clusters were independently associated with pain or problems during intercourse.

Conclusions: Sexual dysfunction is prevalent among male treatment-seeking CAF personnel and veterans. Results suggest that PTSD symptoms are differentially associated with sexual desire or pleasure concerns. Assessing sexual function among CAF personnel and veterans seeking treatment for PTSD is critical in order to treat both conditions and improve overall functioning.

Keywords: complex PTSD; military; physical health/pain; regression models; sexuality/sexual functioning; war/armed conflict in military role.

MeSH terms

Aged
Canada
Humans
Male
Mental Health*
Military Personnel*
Stress Disorders, Post-Traumatic / complications
Stress Disorders, Post-Traumatic / epidemiology
Veterans*