T7: State-of-the-Science Conference on Community Integration for Persons with TBI
Roundtable Discussion - April 12, 2007
Topic Area: Intimacy/Sexual Functioning
Facilitators: Angelle Sander, Ph.D. and Stanley Ducharme, Ph.D.
Recorder: Mark Sherer, Ph.D.
- What research should be addressed in the future to further
the field and address the most relevant gaps in our knowledge? What models/methods
should be utilized?
- The existing research studies have been conducted primarily with outpatient clinic samples and convenience samples. There is a need for prospective studies conducted with consecutive trauma and/or inpatient rehabilitation samples. This research should document the natural course of changes in sexual functioning after TBI. Toward this end, longitudinal investigation of sexual functioning after TBI is recommended. Changes at each stage of the human sexual response cycle (desire, arousal, orgasm) should be documented. Inclusion of a control group of persons without TBI is important for comparison.
- Further research on the causes of sexual dysfunction is needed. This should include research on neuroendocrine disorders after TBI, medication side effects, and the relationship of physical changes (e.g., spasticity), cognitive changes (e.g., decreased attention and memory), and emotional changes (e,g., depression) to sexual functioning.
- Very few of the existing studies have included women in their sample. Research on sexual functioning in women with TBI is needed, including research on the effects of TBI on the natural course of women's sexual and reproductive cycles (e.g., ovulation, menopause).
- There is a lack of information on the impact of TBI on the sexual functioning of partners of persons with TBI. Since sexuality is an important component of intimate relationships, research on differences in perception of sexual functioning between persons with TBI and their partners could help clarify other relationship changes and could lead to improved couple/family interventions.
- Research on the impact of cognitive impairments on the capacity of persons with TBI to consent to sexual activity is needed.
- Sensitivity of rehabilitation staff with regard to sexual functioning of persons with TBI is an important issue that deserves empirical investigation. Researchers should survey professionals regarding views of sexuality across disability with particular focus on possible stigma associated with sexuality in persons with cognitive impairment. The effectiveness of staff sensitivity training in reducing attitudinal barriers and increasing comfort level of professionals in discussing sexuality is warranted. Impact of this type of training on the satisfaction of persons with TBI and their partners with educational services provided is recommended.
- There is a need for empirical studies investigating the effectiveness of interventions to improve sexual functioning and sexual satisfaction. These interventions should be based on those that have been shown to be successful in the sex therapy literature, as well as those that have been used with other disability groups, especially those with cognitive impairment (e.g., multiple sclerosis, mental retardation). This research should include an investigation of the correct timing of different levels of intervention. The level of intervention needed may differ at varying time points in the recovery process. For example, some persons with TBI may not be ready for interventions at an early time in the recovery process, but may be more open at a later time.
- Research on adaptive equipment that could improve sexual functioning, including mechanical aids, is needed.
- Investigation of cultural issues (such as attitudes) that impact intimacy is needed.
- What collaborations could be fostered to address this
topic area?
- Spinal Cord Injury researchers
- Developmental disabilities
- Psychiatric disabilities
- Partnering with sex therapists and agencies that work with persons
without injuries
- Funding issues – piggy backing on funding initiatives in other
areas (e.g., neuroendocrine disorders, quality of life research)
