Studies on Sympathetic Nervous System Activation Among CSA Survivors

One common reaction to CSA is chronic elevated SNS activity or physiologic hyperarousal. Symptoms of increased SNS activity can include increased heart rate, increased respiration, muscle tension, perspiration, exaggerated startle response, and difficulty sleeping. Increased SNS activation has been linked to trauma exposure in general and to certain psychological disorders, especially anxiety disorders and post-traumatic stress disorder (PTSD). Although this physiologic response is common to all major traumas, in childhood trauma the increased SNS activity begins so early in life that it can fundamentally alter the individual’s overall physiologic functioning and put that individual at increased risk for stress-related disorders. Activity of the SNS naturally increases during sexual arousal. Studies on the relation between SNS arousal and sexual arousal in women have identified an optimal level of SNS arousal for facilitating genital sexual arousal (Lorenz, Harte, Hamilton, & Meston, 2012). Research using exercise and ephedrine to increase SNS arousal before viewing an erotic film showed that, in sexually functional women, increases in SNS arousal provided a jumpstart to genital sexual arousal, resulting in enhanced genital sexual arousal to an erotic film (Meston & Gorzalka, 1995; 1996a; Meston & Heiman, 1998). The enhancement to genital sexual arousal provided by exercise also has been demonstrated in (non-abused) sexually dysfunctional women (Meston & Gorzalka,1996b; Lorenz & Meston, 2012). However, in an exercise study comparing women with CSA histories with and without PTSD with non-abused women, the women with abuse histories did not show an increase in genital sexual arousal in the exercise condition, in contrast to their non-abused peers who showed the expected increase (Rellini & Meston, 2006). In fact, we found an inverse relation between PTSD symptoms and genital arousal, such that women with CSA histories and greater symptoms of PTSD showed lower levels of genital sexual arousal after exercise (the opposite of the non-abused women). We concluded that, for women with CSA histories, SNS arousal could already be so elevated that the increase in SNS arousal that occurs naturally during sexual arousal might push their SNS activation beyond the optimal range, leading to impaired sexual function. Using alternate methods of assessing SNS activation including measurement of the stress hormone cortisol we (Rellini, Hamilton, Delville, & Meston,2009) have shown different profiles between women with and those without CSA histories, and these differences are related to sexual function (Lorenz & Meston, 2012).

Recommended papers: 

Lorenz, T. A. & Meston, C. M. (2012). Acute exercise improves physical sexual arousal in women taking antidepressants. Annals of Behavioral Medicine, 43, 352-361. PDF (311 KB)

Lorenz, T. A., Harte, C. B., Hamilton, L. D., Meston, C. M. (2012). Evidence for a curvilinear relationship between sympathetic nervous system activation and women’s physiological sexual arousal. Psychophysiology, 49, 111-117PDF (152 KB)

Rellini, A. H. & Meston, C. M. (2006). Psychophysiological sexual arousal in women with a history of childhood sexual abuse. Journal of Sex & Marital Therapy, 32, 5-22. PDF (150 KB)

Rellini, A. H., Hamilton, L. D., Delville, Y., & Meston, C. M. (2009). The cortisol response during physiological sexual arousal in adult women with a history of childhood sexual abuse. Journal of Traumatic Stress22, 557-565. PDF (117 KB)

Meston, C. M. & Heiman, J. R. (1998). Ephedrine-activated physiological sexual arousal in women. Archives of General Psychiatry, 55, 652-656. PDF (821 KB)

Meston, C. M. & Gorzalka, B. B. (1996). Differential effects of sympathetic activation on sexual arousal in sexually dysfunctional and functional women. Journal of Abnormal Psychology105(4), 582. PDF (1.72 MB)

Meston, C. M. & Gorzalka, B. B. (1996). The effects of immediate, delayed, and residual sympathetic activation on sexual arousal in women. Behaviour Research and Therapy, 34,143-148. PDF (635 KB)

Meston, C. M., & Gorzalka, B. B. (1995). The effects of sympathetic activation on physiological and subjective sexual arousal in women. Behaviour Research and Therapy, 33(6), 651-664. PDF (1.87 MB)