Risky sexual behavior in a female patient with complex PTSD following childhood sexual abuse

Abstract

Risky sexual behavior in women with a history of childhood sexual abuse is often associated with prior abuse and is frequently accompanied by complex post-traumatic stress disorder (CPTSD). Despite the clinical significance of this association, detailed reports of psychotherapy for such patients are scarce. This article presents the case of a 32-year-old woman with a history of childhood sexual abuse, symptoms meeting the ICD-11 diagnostic criteria for complex PTSD, and risky sexual behavior, who underwent psychotherapy. Therapy was conducted in stages using stabilization, trauma-focused, and body-oriented techniques over 96 sessions. Change was assessed using the International Trauma Questionnaire (ITQ) and self-report scales. The total ITQ score decreased by 42%, the severity of shame and self-blame decreased from 8–9 to 2–3 points, and the frequency of risky sexual encounters fell to zero; the outcome was maintained over a 6-month follow-up. The case suggests that, in the presence of dissociative symptoms, sustained improvement may be associated not only with processing traumatic experiences but also with the gradual development of self-regulation skills and the capacity to establish interpersonal boundaries.