A Dyadic Perspective on Childhood Maltreatment for Women With Provoked Vestibulodynia and Their Partners: Associations With Pain and Sexual and Psychosocial Functioning

Childhood maltreatment is robustly associated with adult-onset vulvodynia, a common form of female genito-pelvic pain/penetration disorder. However, little is known about the impact of childhood maltreatment on current sexual, psychological, and relationship adaptation for couples with provoked vestibulodynia (PVD). This study examined the associations between childhood maltreatment and sexual and psychosocial functioning and pain in women with PVD, the most common subtype of vulvodynia, and their partners. A total of 49 couples (M_age women = 27.80, SD = 6.05; M_age men = 30.04; SD = 6.48) with PVD completed the Childhood Trauma Questionnaire (CTQ), as well as measures of sexual functioning, couple satisfaction, and anxiety. Women also reported on their pain during intercourse. Analyses were guided by the actor–partner interdependence model. Women’s higher reports of childhood maltreatment were associated with their lower sexual functioning and higher anxiety. Partners’ higher reports of childhood maltreatment were associated with their lower sexual functioning, lower couple satisfaction, and higher anxiety, as well as women’s lower couple satisfaction and higher anxiety. Both women’s and partners’ higher reports of childhood maltreatment were associated with higher affective pain for women. Findings suggest childhood maltreatment experienced by women with PVD and their partners should be considered as part of treatment planning.     

Sexual Well-Being in Older Women: The Relevance of Sexual Excitation and Sexual Inhibition

The aim of this study was to use the dual control model of sexual response (DCM) to investigate variation in sexual well-being among women 50 years of age and older. Data from 185 women 50 years of age and older (M = 59.46, SD = 6.96) were used to examine the relationships between sexual excitation (SE) and sexual inhibition (SI) and their lower-order factors to indicators of sexual well-being (i.e., sexual functioning, satisfaction, distress, frequency of sexual activity, and breadth of sexual behavior). Possible moderating factors were also explored. Independently, SE and SI were associated with the majority of the indicators of sexual well-being, and the directions of associations were consistent with the tenets of the DCM. SE and SI lower-order factors were significant predictors of sexual function, satisfaction, and frequency of sexual activity. Sexual distress was predicted more strongly by SI factors and breadth of sexual behavior by one SE lower-order factor (arousability). Partner physical and mental health and participant’s own mental health were identified as moderating variables of these associations. Findings of this study are discussed considering the contribution of the DCM to understanding the role of diversity in older women’s sexual well-being.     

Genito-Pelvic Pain Through a Dyadic Lens: Moving Toward an Interpersonal Emotion Regulation Model of Women’s Sexual Dysfunction

Researchers and clinicians alike widely acknowledge the inherently interpersonal nature of women’s sexual dysfunctions given that both partners impact and are impacted by these difficulties. Yet theoretical models for understanding the role of interpersonal factors in women’s sexual dysfunctions are severely lacking and have the potential to guide future research and inform more effective interventions. The most widely studied sexual dysfunction in women that has espoused a dyadic approach by including both members of affected couples is genito-pelvic pain/penetration disorder (GPPPD). In this article we use the example of GPPPD to introduce a novel interpersonal emotion regulation model of women’s sexual dysfunction. We first review current knowledge regarding distal and proximal interpersonal factors in GPPPD. Then, we describe our theoretical model and consider relevant pain and sex-related research on emotion regulation processes—emotional awareness, expression, and experience—in the context of GPPPD, including sexual function, satisfaction, and distress. Next, we review how existing theories from the fields of chronic pain and sex and relationships research have informed our model and how our model further builds on them. Finally, we discuss the implications of our model and its applications, including to other sexual dysfunctions in women.     

Sexual Satisfaction Among Couples: The Role of Attachment Orientation and Sexual Motives

The mediating effect of sexual motives between attachment orientation and sexual satisfaction and functioning was investigated among 128 couples (N = 256) using the actor-partner interdependence model (Campbell & Kashy, 2002). Actor effects between attachment orientation and sexual satisfaction and functioning, mediated by sexual motives, were found regarding men’s sexual satisfaction, sexual intimacy, and orgasmic responsivity. Partner effect revealed two significant paths in which the greater the women’s attachment avoidance, the lower the partners’ intimacy motivation, which in turn was linked with lower partners’ sexual satisfaction and increased lack of sexual intimacy. The analyses did not reveal significant mediation paths affecting women’s sexual satisfaction and functioning. These findings emphasize the importance of implementing a dyadic perspective on sexuality within practice. Recommendations for further research and additional clinical implications are discussed.     

The United States Economic Crisis: Young Adults’ Reports of Economic Pressures, Financial and Religious Coping and Psychological Well-Being

Using a sample of 222 young adults attending college, the present study examined the relative contribution of young adults’ perceived economic pressures, financial coping and religious meaning-making coping strategies in accounting for variation in their reports of psychological well-being within the context of the United States economic crisis. Results suggest a direct relationship between perceived economic pressure and psychological well-being such that young adults who reported having to make more economic adjustments as a result of economic crisis also reported higher levels of depressed mood and anxiety. Young men and women who reported having to make fewer economic adjustments and being able to meet their material needs reported higher levels of life satisfaction. Regardless of young adults’ self-reported level of economic pressures, the use of education and communication financial coping strategies was related to lower levels of self-reported anxiety and depressed mood and greater life satisfaction. Viewing the financial crisis as a punishment from God was generally associated with young adults’ reports of greater depressed mood and less life satisfaction. Implication of findings for research and practice are discussed.     

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women’s own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women’s rights, which are critical to overall well-being.     

Depressed Mood and Sexual Functioning

Abstract

Although some studies have reported substantial correlations between clinical depression and hypoactive sexual desire, thus far only a few studies have addressed the association between depressed mood and different facets of sexuality (such as sexual satisfaction, sexual activity and level of sexual problems) in close relationships. This study sought to fill this gap by examining 198 couples recruited through advertisement. The associations between depressed mood measured by the Beck Depression Inventory (BDI) and sexuality within one person (actor effects) and between partners (partner effects) were analyzed using the Actor-Partner Interdependence Model by Kenny and Cook (1999). Our findings show that actor effects of the BDI score on sexual experiences are somewhat higher than partner effects, and that depressed mood is mainly associated with one's own hyposexual desire, sexual aversion and sexual arousal problems. However, there were no substantial partner effects between depressed mood and sexual arousal problems.     

Development and Validation of the Sexual Contingent Self-Worth Scale

Sexual contingent self-worth (CSW) refers to self-worth that is dependent on maintaining a sexual relationship, and has not been studied previously. This novel construct may have implications for sexual, relationship, and psychological well-being, because it could affect the cognitions, affect, and behaviors of individuals in sexual relationships. The purpose of this study was to develop the Sexual Contingent Self-Worth Scale and examine its reliability and validity in community samples. Two separate online studies (N = 329 and N = 282) included men and women who were in committed, sexually active relationships. The Sexual CSW Scale was adapted from a validated measure of relationship CSW. In Study 1, participants completed the Sexual CSW Scale, whereas in Study 2, participants also responded to standardized measures of related constructs. In addition, participants completed the Sexual CSW Scale again two weeks later in Study 2. Factor analysis yielded two subscales: (a) sexual CSW dependent on positive sexual events in the relationship and (b) sexual CSW dependent on negative sexual events. Results indicated good construct validity, incremental validity, internal consistency, and test-retest reliability for the Sexual CSW Scale. This research contributes to the fields of both CSW and sexuality by introducing a novel domain of CSW.     

Attachment Insecurities and Women's Sexual Function and Satisfaction: The Mediating Roles of Sexual Self-Esteem,Sexual Anxiety,and Sexual Assertiveness

We examined the potential role of three mediators—sexual self-esteem, sexual anxiety, and sexual assertiveness—of the association between romantic attachment insecurities (anxiety and avoidance) and two aspects of women's sexual functioning: sexual function and sexual satisfaction. A sample of 556 women aged 18 to 30 agreed to complete an online series of validated questionnaires assessing attachment insecurities and several aspects of sexual functioning. Lower sexual self-esteem and higher sexual anxiety mediated the associations between attachment anxiety and lower sexual function and satisfaction. Lower sexual self-esteem and higher sexual anxiety also partially mediated the links between attachment-related avoidance and the two sexual functioning variables. Sexual assertiveness, however, did not mediate these associations. A significant interaction between attachment anxiety and avoidance was also found to predict sexual satisfaction, with women high in avoidance and low in anxiety being the least satisfied. Results are discussed in terms of theoretical and clinical implications.     

Psychiatric Symptoms and Same-Sex Sexual Attraction and Behavior in Light of Childhood Gender Atypical Behavior and Parental Relationships

This study explores the relation between the level of current symptoms of depression and anxiety and recalled childhood gender atypical behavior (GAB), and quality of relationships with parents among men and women who reported same-sex sexual attraction or engaged in same-sex sexual behavior and men and women who did not. Matched pairs, 79 men (n = 158) and 148 women (n = 296), with equal levels of GAB were created of Finnish participants with either same-sex sexual attraction or behavior and participants without. The measures used were retrospective questionnaires. Ratings of maternal and paternal over-control and coldness differed as a function of same-sex sexual attraction or behavior. Childhood GAB was correlated with negative ratings of parental relationships. Both same-sex sexual attraction or behavior and a history of childhood GAB affected the reported levels of current depression and anxiety. Only gender typical participants with no same-sex sexual attraction or behavior reported significantly lower levels of symptoms. The findings suggest that childhood GAB is related to later distress both among hetero- and homosexual individuals. The elevated level of psychological distress among homosexual individuals, reported in several studies, might—to some extent—be caused by their generally higher levels of childhood GAB as opposed to a homosexual orientation per se.     

Sexual Transformations and Intimate Behaviors in Romantic Relationships

To understand the association between sexual transformations (i.e., changes in sexual behavior for the partner), intimate behaviors, and relationship quality among couples in romantic relationships, this study used Actor Partner Interdependence Models to examine frequency of sexual transformations, feelings about sexual transformations, and intimate behaviors as predictors of relationship satisfaction among 96 couples (N = 192). Sexual transformations were also examined as a moderator of the association between intimate behavior and relationship satisfaction. Results indicated that relationship satisfaction was positively associated with partners’ frequent sexual transformations, actors’ positive feelings about sexual transformations, and intimate behavior from the partner. Further, in less intimate relationships, relationship satisfaction was greater when partners reported making more sexual transformations.     

Is High Sexual Desire a Risk for Women’s Relationship and Sexual Well-Being?

Historically, women’s sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality—which lists high sexual desire among its core components—poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18–60 years was used to examine whether high sexual desire is detrimental to women’s relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups—but not the HSD group—reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.     

Eye of the Beholder? Sociocultural Factors in the Body Image and Sexual Well-Being of Heterosexual Women

ABSTRACT. Participants (124 heterosexual women) completed measures of thin-ideal internalization, discrepancy between perceptions of actual and ideal figure (DISC_SELF), perceptions of the discrepancy between estimates of partner's view of actual and ideal female figure (DISC_PART), body image, and sexual well-being. We found support for the proposed perception-of-partner pathway in that greater DISC_PART was associated with poorer body image, which in turn was associated with poorer sexual well-being. However, we found little support for a link between thin-ideal internalization or DISC_SELF and sexual well-being. The results suggest that heterosexual women's beliefs about how their partners view them are important to their sexual well-being.     

A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia

The main objective of this article was to conduct a systematic review of the literature examining relationship adjustment and sexual satisfaction among women with provoked vestibulodynia (PVD). Although only a small number of studies have included partners, the literature regarding partner's relationship adjustment and sexual satisfaction was also examined. Relevant articles were identified by a literature search conducted between August 2008 and May 2010. Studies were included if they contained at least one group or subset of participants with PVD or dyspareunia (i.e., painful sexual intercourse), and if they assessed relationship adjustment or sexual satisfaction as a primary outcome measure. Within this review, the methodological quality of 33 studies was systematically rated, and effect sizes were calculated when possible. Methodological type and quality greatly varied across the studies, as did the pain samples included and the outcomes reported. Nevertheless, the results of controlled studies indicate that PVD is associated with decreased sexual satisfaction. The controlled results also suggest, however, that PVD is not necessarily associated with general relationship maladjustment for women and their partners. Future research, using various methodologies, is needed to further understand intimate relationships among women with PVD and the impact that this condition may have on couples.     

The risk of Telling: A Dyadic Perspective on Romantic Partners’ Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction

Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors’ perception of partner responses to their disclosure, and both partners’ sexual and relationship satisfaction. Participants completed self‐report questionnaires online. Results of path analyses within an actor–partner interdependence model indicated that survivors’ perceived partner responses of emotional support to disclosure were associated with their own and their partners’ higher sexual satisfaction. Survivors’ perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners’ poorer relationship satisfaction. Findings suggest that survivor‐perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners.     

Seeking Connection Versus Avoiding Disappointment: An Experimental Manipulation of Approach and Avoidance Sexual Goals and the Implications for Desire and Satisfaction

Previous correlational research has demonstrated an association between people’s reasons for having sex (i.e., their sexual goals) and their sexual desire and sexual and relationship satisfaction. Across two studies of people in romantic relationships (N = 396) we extend previous research and demonstrate, for the first time, that manipulating the salience of approach sexual goals (i.e., engaging in sex to pursue positive outcomes, such as enhanced intimacy) compared to avoidance sexual goals (i.e., engaging in sex to avert negative outcomes, such as a partner’s disappointment) or a control condition leads people to feel higher sexual desire for their romantic partners and to report higher sexual and relationship satisfaction. In addition, in Study 2 we demonstrate that focusing on approach sexual goals over the course of a week leads people to report more satisfying sexual experiences during that week, as well as higher desire and overall relationship satisfaction, compared to a control group. The current findings advance approach–avoidance theory by providing evidence that it is possible to manipulate people’s sexual goals and, in turn, impact their feelings of desire and satisfaction. Results are promising for the development of interventions to promote sexual and relational well-being.     

Attachment,Conflict Resolution,and Sexual Satisfaction in Adoptive Couples

Abstract

Attachment theory affirms that one’s partner is vital to fostering support and security. It is important for adoptive couples to be mindful of this support because it is at the forefront of healthy family functioning. With a sample of adoptive couples (n?=?166), this study examines the influence of attachment style on conflict resolution and sexual satisfaction. Significant findings indicate that an avoidant attachment style is directly associated with lower conflict resolution and sexual satisfaction. Better conflict resolution significantly predicts greater sexual satisfaction. These findings demonstrate the importance of establishing a more secure romantic attachment in clinical work with adoptive couples.     

Gender Differences in the Sexual Well-Being of Mexican Adolescents

Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high sexual satisfaction and refusal of unwanted sex among females. Conclusions: the findings suggest the relevance of overcoming traditional sex roles to achieve adolescent sexual well-being. In this sense, health and population policies should direct more substantial efforts in the promotion of gender equality among the adolescents and in the development of critical attitudes towards traditional gender norms.     

Reverberations of Racism and Sexism Through the Subjective Sexualities of Undergraduate Women of Color

Young women of color (among others) face both subtle and overt discrimination on a regular basis, but few studies have examined relations between discrimination and sexual outcomes using quantitative tools. We surveyed 154 self-identified undergraduate women of color to examine connections between race- and sex-based discrimination and subjective sexual well-being (i.e., condom use self-efficacy and sexual life satisfaction) and also tested whether sexual autonomy mediated these relations. When examined individually, each form of discrimination was related negatively to condom use self-efficacy and sexual life satisfaction, such that as women reported more discrimination, they reported poorer sexual well-being. However, when examining both racism and sexism as joint predictors, only racism remained significant and there were no racism × sexism interaction effects. In a path model, sexual autonomy mediated the relation between racism and each measure of subjective sexual well-being; racism was negatively related to sexual autonomy, which in turn was positively related to both condom use self-efficacy and sexual life satisfaction. These findings are consistent with the broader literature on the negative impact of discrimination on various aspects of mental and physical health. They also reinforce the position that redressing social inequality is a vital component of promoting individual health.