Associations Between Coerced Anal Sex and Psychopathology, Marital Distress and Non-Sexual Violence

Background. There is a dearth of scientific data on anal intercourse in heterosexual relationships. Likewise, anal sex within marital relationships has yet to be fully explored. Objectives. Among a representative sample of married women in the Iranian capital, Tehran, we aimed to determine the association of self-reported coerced anal sex with: (i) self-reported coerced vaginal sex; (ii) self-reported non-sexual violence; (iii) psychopathology; and (iv) marital attitude. Method. The data presented here were obtained from the Family Violence Survey conducted in Tehran in 2007. A total of 230 married Iranian women were selected via a multi-cluster sampling method from four different randomized regions. The subjects' sociodemographic data, psychological distress (Symptom Check List; SCL-90-R), personality, and relationship characteristics (Personal and Relationships Profile), and marital attitude (Marital Attitude Survey) were gathered. In addition, the participants' self-reported histories of lifetime victimization through all types of violence by the husband, including coerced anal and vaginal sex as well as psychological and physical assault (Conflict Tactic Scales-Revised; CTS-2), were collected. Results. There were associations between self-reported victimization through coerced anal and vaginal sex (P < 0.001), psychological (P < 0.001), and physical aggression (P < 0.001). Those reporting to have been forced into anal intercourse cited higher rates of paranoid and psychotic features, jealousy, attribution of problems to one's own behavior, conflict, and male dominance, as well as lower expectations of improvement in one's marital relationship. Conclusion. In marital relationships, women are at a higher risk of coerced anal sex if subjected to other types of sexual or non-sexual violence. Higher rates of psychopathology and poorer marital relationships are also allied to self-reported anal sexual coercion. Mohammadkhani P, Khooshabi KS, Forouzan AS, Azadmehr H, Assari S, and Lankarani MM. Associations between coerced anal sex and psychopathology, marital distress and non-sexual violence. J Sex Med 2009;6:1938-1946.