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Sexual Healing: Daily Diary Investigation of the Benefits of Intimate and Pleasurable Sexual Activity in Socially Anxious Adults
Archives of Sexual Behavior
Abstract
A growing literature attests to deficits in social and romantic life quality in people with elevated social anxiety, but no research to date has explored how intense intimate encounters influence social anxiety symptoms. This study investigated whether the presence and quality of sexual activity on a given day predicted less social anxiety and negative cognitions on a subsequent day. We also explored whether the benefits of sexual activity would be stronger for more socially anxious individuals. Over 21 days, 172 undergraduate students described the presence and quality of sexual activity, social anxiety symptoms, and use of social comparisons on the day in question. Time-lagged analyses determined that being sexually active on one day was related to less social anxiety symptoms and the generation of fewer negative social comparisons the next day. Furthermore, more intense experiences of pleasure and connectedness during sex predicted greater reductions in social anxiety the next day for people high in trait social anxiety, compared to those low in trait social anxiety. These results were similar regardless of whether sex occurred in the context of romantic relationships or on weekdays versus weekends. The results suggest that sexual activity, particularly when pleasurable and intimate, may mitigate some of the social anxiety and negative comparisons frequently experienced by people with high trait social anxiety.
... Couple's sexuality and mental health Kashdan et al. (2011Kashdan et al. ( , 2014, Kashdan, Goodman, Stiksma, Milius, & McKnight (2018) research focused on sexuality as a primary source for positive experiences in romantic relationships. In 2018, they showed that being sexually active on one day was unidirectionally related to greater well-being the next day. ...
... IOS served as the most robust moderator in predicting greater levels of meaning in life and positive affect following sexual activity. Similar results were found for socially anxious adults: Being sexually active was related to less social anxiety and fewer negative social comparisons on the next day (Kashdan et al., 2014). For people low on social anxiety, IOS enhanced feelings of connectedness during sexual activity (Kashdan et al., 2011). ...
... For this, the pictorial measure remained unchanged, while the instruction read: "please indicate the picture below which best describes how close and connected you felt to your partner during sex." (Kashdan et al., 2014(Kashdan et al., , p. 1420 or similar. In addition to the established (current) IOS scale, two studies measured ideal (desired) IOS, e.g. ...
To better understand the effect relationship closeness has on couple’s sexuality a scoping review was conducted, that focused on the inclusion of other in the self scale (IOS). Authors reviewed quantitative journal articles published between 2000 and 2020 by searching PsychInfo, Medline, and PubMed, resulting in 24 studies. Results suggest positive associations between IOS and sexual well-being, functioning, desire, frequency and satisfaction, and negatively related to sexual distress. Also, the benefits of positive sexual experiences expand well beyond the sexual domain onto different personal and relational factors of health and well-being. Sampling designs considerably limit the generalizability of results.
... Further, one study of appearance comparison asked only about those toward upward targets (Pila et al., 2016). Across populations, one study focused exclusively on instances of being the target of someone else's upward comparisons (Koch and Metcalfe, 2011, Study 1), one assessed only downward comparisons (Affleck et al., 2000), and one assessed only experiences of negative-outcome comparisons (i.e., those that resulted in negative affect or self-views; Kashdan et al., 2014). ...
... All of these studies included items assessing the occurrence and/or frequency of comparisons, as well as a range of follow-up questions. One study using interval-contingent methods asked participants to estimate the total number of comparisons they made that day and record an integer of their estimate (Pila et al., 2016); 4 intervalcontingent studies used rating scales to capture frequency [1-10 (Spence et al., 2011;Kashdan et al., 2014), 1-9 (Steers et al., 2014, Study 2), and 1-7 (Zuckerman and O'Loughlin, 2006)], and 1 study asked participants to indicate whether they had made any comparisons that day (yes/no; Arigo et al., 2019b). Studies using signal-contingent methods tended to begin each prompt by asking whether participants had made a social comparison (yes/no; 15) before asking follow-up questions about specific comparisons, with certain studies limiting the question to certain types of comparisons (e.g., appearance comparisons). ...
... A subset of studies described findings related to within-person predictors of comparison occurrence, though these predictors were idiosyncratic. At the day level, these included time spent on Facebook (Steers et al., 2014, Study 2), engaging in sexual activity with one's partner and feelings of connectedness (Kashdan et al., 2014), and pain intensity and positive and negative affect (Affleck et al., 2000). At the moment or event levels, predictors of interest were positive and negative affect (Wheeler and Miyake, 1992;Thøgersen-Ntoumani et al., 2018), comparison setting (i.e., during social interactions vs. alone -Locke, 2003, Study 3;Locke and Nekich, 2000;who was present-Lennarz et al., 2017), and state body dissatisfaction (Rogers et al., 2017). ...
Self-evaluations relative to others (i.e., social comparisons) have well-established implications for health and well-being, and are typically assessed via global, retrospective self-report. Yet, comparison is inherently a dynamic, within-person process; comparisons occur at different times, on a range of dimensions, with consequences that can vary by context. Global, retrospective assessment forces aggregation across contexts and reduces ecological validity, limiting its utility for informing a nuanced understanding of comparisons in daily life. Research across social and clinical psychology has implemented methods to assess comparisons naturalistically, involving intensive, repeated assessments of comparison occurrence, characteristics, and consequences in everyday life (via ecological momentary assessment or daily diaries). Although promising, this work to date lacks an overarching conceptual framework for guiding decisions about assessment design and implementation. To address this gap, the aims of this scoping review were: (1) to summarize available literature on within-person naturalistic assessment of social comparison, and (2) to provide a set of key considerations to inform future social comparison research using within-person naturalistic assessment. Searches in PubMed, PsycInfo, and CINAHL identified relevant articles published before June 2019. Articles were included if they described at least 3 comparison assessments within each participant, taken in the natural environment, and spaced no more than ~24 h apart (i.e., repeated momentary or daily assessment). In articles meeting these criteria (33 unique studies across 36 published papers), we summarized aspects of the comparison assessment, including recording methods, direction (e.g., upward, downward), target (e.g., friend, stranger), and dimension (e.g., status, appearance). Most studies assessed appearance comparisons (vs. other comparison dimensions) and collected information in response to signals (rather than initiated by participants). However, there was considerable heterogeneity in the number of assessments, assessment periods, recording modalities, and comparison predictors and outcomes assessed. Findings broadly establish heterogeneity in the aspects of comparison considered critical for within-person naturalistic assessment. We describe key decision points for future work to help advance within-person naturalistic assessment methods and improve the utility of such approaches to inform research, theory, and intervention.
... The experience of positive emotions, which facilitate approach-oriented motivation, may increase the effort devoted to finding and securing a suitable romantic partner for sexual activity. The dopaminergic activity and neurotransmitters and neuromodulators that are active during subjectively positive experiences influence the amount of pleasure experienced during a rewarding situation such as most sexual episodes; which would explain why episodes of intimate and pleasurable sexual activity have an uplifting effect on people suffering from emotional disturbances (e.g., Kashdan et al., 2014). Thus, there is a theoretical rationale on why positive affect might lead to a greater likelihood of having sex and high-quality sex, just as there are theories to suggest why sex, particularly high-quality sex, leads to positive affect and other well-being dimensions. ...
... Therefore, multiple episodes reported per day were collapsed into one day. For continuous variables (sexual pleasure and sexual intimacy) the mean of episodes 2 See Kashdan et al. ( , 2014 for additional detail on methodology. This document is copyrighted by the American Psychological Association or one of its allied publishers. ...
... These hormones are directly linked with the experience of positive mood states. In addition, prior research suggests that sex has a stress-response dampening effect (e.g., Kashdan et al., 2014). One daily diary study examined sexual behaviors and blood pressure and found people who had vaginal intercourse had better stress responses than people who did not have sex (Brody, 2006). ...
Sex is rarely discussed in theories of well-being and rarely empirically examined using methods other than cross-sectional surveys. In the present study, a daily diary approach was used (for 21 days with 152 adults) to explore the relationship between the presence and quality of sexual episodes and well-being (positive affect, negative affect, meaning in life). Time-lagged analyses demonstrated that sexual activity on 1 day was related to greater well-being the next. As for the quality of episodes, higher reported sexual pleasure and intimacy predicted greater positive affect and lower negative affect the following day. When the reverse direction was tested, well-being did not predict next-day sexual activity, pleasure, or intimacy. These results suggest a unidirectional relationship in which the presence and quality of sexual activity lead to gains in well-being the following day. Contextual moderators (gender, relationship status, relationship closeness, and relationship length) allowed for tests of conditions altering the link between sexuality and well-being. Relationship closeness was the most robust moderator in predicting greater levels of meaning in life and positive affect following sexual episodes. These data provide evidence to support the continual consideration of sex in empirical work and theoretical models of elements that comprise healthy relationships and a good life.
... It is also commonly accepted that penile-vaginal intercourse is linked with beneficial states in humans. PVI has been associated with a wide range of positive psychological factors, such as relationship satisfaction (Costa & Brody, 2007;Heiman et al., 2011), happiness (Blanchflower & Oswald, 2004;Laumann et al., 2006;Wadsworth, 2014), lower perceived and physiological stress levels (Brody, 2006;Burlesonetal.,2007), and mental health (Brody & Costa, 2009;Kashdan et al., 2014). It is important to note that these associations do not imply causation; more sexual intercourse could be a cause, consequence, or an epiphenomenon of the above states. ...
... With regard to stress and anxiety, Kim et al. (2013) found that, in mice, sexual intercourse counteracted the detrimental effects of chronic stress on hippocampal neurogenesis. In women, sex may also be beneficial for decreasing anxiety and stress, as negative associations have been found between these factors and PVI (Brody, 2006;Burleson et al., 2007;Kashdan et al., 2014). For instance, women report experiencing lower levels of anxiety symptoms the day after engaging in sex than when they did not have sex the previous day (Kashdan et al., 2014). ...
... In women, sex may also be beneficial for decreasing anxiety and stress, as negative associations have been found between these factors and PVI (Brody, 2006;Burleson et al., 2007;Kashdan et al., 2014). For instance, women report experiencing lower levels of anxiety symptoms the day after engaging in sex than when they did not have sex the previous day (Kashdan et al., 2014). Thus, it is possible that women who engage in sex benefit from higher rates of neurogenesis due to the decreased levels of stress and anxiety symptomatology they experience. ...
Previous studies have identified a number of factors that contribute to improved cognitive function, and to memory function specifically, in cognitively normal individuals. One such factor, frequency of penile-vaginal intercourse (PVI), has been reported in a number of animal studies to be advantageous to memory for previously presented objects by increasing neurogenesis in the dentate gyrus of the hippocampus. However, studies investigating the potential benefits of frequent PVI on memory function in young women are to the best of our knowledge absent from the literature. The current study thus investigated whether the self-reported frequency of sexual intercourse was related to memory function in healthy female college students. To determine whether variation in PVI would be associated with memory performance, we asked 78 heterosexual women aged 18-29 years to complete a computerized memory paradigm consisting of abstract words and neutral faces. Results showed that frequency of PVI was positively associated with memory scores for abstract words, but not faces. Because memory for words depends to a large extent on the hippocampus, whereas memory for faces may rely to a greater extent on surrounding extra-hippocampal structures, our results appear to be specific for memory believed to rely on hippocampal function. This may suggest that neurogenesis in the hippocampus is higher in those women with a higher frequency of PVI, in line with previous animal research. Taken together, these results suggest that PVI may indeed have beneficial effects on memory function in healthy young women.
... In this possibility, TMSI may lead to beneficial sexual wellbeing and other positive outcomes for those higher in social anxiety. Kashdan et al. [105] found that in-person sexual activity on one day, and especially sexual activity that is pleasurable and created feelings of connection, predicted fewer social anxiety symptoms on the following day for those with higher social anxiety [105]. Overall, the possibilities from the cognitive-behavioural framework provide many research questions and hypotheses to drive this area of inquiry for some time. ...
... In this possibility, TMSI may lead to beneficial sexual wellbeing and other positive outcomes for those higher in social anxiety. Kashdan et al. [105] found that in-person sexual activity on one day, and especially sexual activity that is pleasurable and created feelings of connection, predicted fewer social anxiety symptoms on the following day for those with higher social anxiety [105]. Overall, the possibilities from the cognitive-behavioural framework provide many research questions and hypotheses to drive this area of inquiry for some time. ...
Technology-mediated sexual interactions (TMSI) are interpersonal exchanges via technology of self-created sexual material, including photos, videos, and auditory or text messages. There is little research on the factors that predict both TMSI experiences and their sexual wellbeing outcomes. Social anxiety is anxiety experienced in response to social or performance situations. From a cognitive–behavioural perspective, people higher in social anxiety may avoid TMSI, preventing positive or negative consequences. They also may use TMSI to avoid the anxiety caused by in-person sexual interactions, benefiting from access to sexual interactions while perpetuating anxiety about them. The purpose of this scoping review was to explore the role of social anxiety in TMSI and its sexual wellbeing outcomes. We executed a comprehensive search strategy across eight academic databases and searched reference lists of included articles. We included 19 articles written in English or French that had a human sample and were published between 1991 and 2021 and evaluated connections between social anxiety constructs (e.g., shyness, anxiety) and TMSI-related experiences (e.g., sexting, internet sex addiction). The pattern of results suggested that social anxiety constructs may predict some but not all forms of TMSI. Future research from a cognitive–behavioural perspective will expand knowledge on social anxiety, TMSI, and its sexual wellbeing outcomes.
... Whereas negative emotional states, including clinical levels of depression and anxiety, are typically associated with women's decreased sexual desire and frequency [38,39], the opposite relationship has been documented among heterosexual men [39]. Daily experience studies find that coitus on 1 day is not linked with negative mood on the same-day [40], but is linked with lower next-day negative mood and anxiety [41,42]. In contrast, sexual activity (i.e., oral sex, passionate kissing, penetration) on 1 day is associated with increased positive mood on the same-day [40,43] and nextday [41,44]. ...
... However, the effects of positive and negative mood on next-day sexual activity are mixed: higher positive and negative moods on 1 day have been associated with higher [44] and lower [40] likelihoods of sexual activity on subsequent days, respectively. Other studies find no relationship between mood and next-day sexual activity [41,42]. ...
Purpose of Review
Emotion regulation is a key contributor to social functioning and mental health; yet, its influence on sexual well-being has only recently gained research attention. To elucidate correlates of women’s sexual satisfaction, desire, frequency, function, and distress and guide future study, the present review evaluates research at the intersection of emotion regulation and sexual well-being.
Recent Findings
There are clear associations between mood and sexual well-being, with the interference of negative emotion on sexual outcomes stronger for women relative to men. Although there is evidence that women’s poorer emotion regulation abilities are related to poorer sexual well-being, associations between specific emotion regulation strategies and sexual outcomes are less established, possibly due to the abundance of regulatory strategies and dearth of research on emotion regulation in sexual contexts. Still, our review suggests that women’s greater sexual well-being is positively associated with strategies characterized by adaptive engagement (e.g., problem solving, acceptance, reappraisal) and negatively associated with strategies characterized by disengagement (e.g., avoidance, suppression, distraction) and aversive cognitive perseveration (e.g., worry, rumination).
Summary
Extant research is consistent with models of women’s sexual response and offers preliminary support for the emotion regulation–sexual well-being link. While the explanatory power of the current literature is limited by a lack of dyadic and longitudinal studies, interventions targeting emotion regulation hold promise for improving women’s and couples’ sexual well-being.
... It aims to reflect a general perception of relationship closeness, influenced potentially by various conscious or unconscious processes (Aron et al., 1992). Close relationships, with high self-other inclusion, have been shown to be important for more positive mental health, relationship, and sexual outcomes (Kashdan et al., 2014, Kashdan, Goodman, Stiksma, Milius, & McKnight, 2018Pietras, Wiessner, & Briken, 2022). For individuals in a relationship, greater closeness has been associated with different aspects of relational well-being, such as relationship satisfaction (Frost & Forrester, 2013;Pascoal, Raposo, & Oliveira, 2015), reduced vigilance for relationship threats (Walsh & Neff, 2018), positive overall perception of the partner (Thai & Lockwood, 2015), and pair bonding (Branand, Mashek, & Aron, 2019). ...
The construct of inclusion of other in the self has been established as one of the most influential measures for relationship closeness in romantic relationships. It is regularly associated with relational well-being, sexual satisfaction, as well as mental health. However, the degree of closeness one desires in the present relationship is person-specific and can differ from the closeness one actually experiences. Exploring these discrepancies, the present study focused on the association between not enough closeness and too much closeness and relationship characteristics, parenting, and extradyadic sexual activity. Data from a population-based sample of 3,161 men and women from the German Health and Sexuality Survey were analyzed using structural equation modeling. Our results confirm closeness discrepancies as prevalent relationship phenomena, while identifying feelings of not enough closeness as much more problematic for the relationship.
... [43] Sexual inter-course has psychological effects such as happiness, wellbeing, less perception of psychological stress and mental health. [14,[44][45][46] Maunder et al., [47] in their study, found a correlation between frequency of sexual intercourse and verbal recognition performance. In our study, it was determined that female patients with FM had less depression than those with a higher frequency of sexual intercourse. ...
Objectives
Fibromyalgia is known to affect sexual function, but the effect of frequency of sexual intercourse on fibromyalgia symptom severity is unclear. This study investigated how frequently women with fibromyalgia engaged in sexual activity affected how severe the disease was.
Methods
The depression status of the participants was evaluated with the Beck Depression Inventory (BDI) and the mean monthly frequency of sexual intercourse in the last 3 months was noted. Pain levels of fibromyalgia patients were evaluated with Visual Analog Scale (VAS), pain prevalence Widespread Pain Index (WPI), symptom level Symptom Severity Scale (SSS), and fibromyalgia exposure status with Fibromyalgia Impact Questionnaire (FIQ).
Results
A hundred women with fibromyalgia with a mean age of 37.11±6.2 years and 100 healthy female controls with a mean age of 36.53 ± 5.85 years participated in the study. Female patients with fibromyalgia had higher BDI and VAS scores and lower frequency of sexual intercourse (p<0.001). While no significant relationship was observed between the frequency of sexual intercourse and VAS, FIQ, SSS and WPI scores, it was found that BDI was lower in those with an average monthly frequency of 8 or more sexual intercourses (p=0.02).
Conclusion
This study revealed that the frequency of sexual intercourse is low in female patients with FM and that depression is less common in women with FM who have a higher frequency of sexual intercourse.
... Sexual activity, especially during orgasm, also triggers the release of oxytocin, which promotes intimacy, helps relieve stress, and improves cardiovascular health. Not only does oxytocin reduce stress during sexual activity and orgasmic moments, but its effects may persist over time and have positive health effects [78] [79]. It has been reported that, in sexual activity, the key influencing factor for positive health outcomes is the frequency of sexual activity. ...
... A small set of experience-sampling studies offer ancillary support for this hypothesis. One daily diary study found that people with elevated social anxiety experienced larger reductions in anxiety on days following intimate sexual experiences than those with low social anxiety (Kashdan, Adams et al., 2014); one EMA study found that people with elevated social anxiety reported larger decreases in NA following social interactions with close companions (i.e., close friends, family, romantic partners), although they did not report changes in PA (Hur et al., 2020); and one EMA study found that people with elevated social anxiety reported greater psychological benefits (less anxiety, less motivation to avoid social situations, greater sense of belonging) following positive events than people with lower social anxiety (Doorley et al., 2020). For people with SAD, we might expect a "mood brightening" effect when they enter social situations, where PA increases to a greater degree than controls. ...
Quality contact with other people serves as a reliable mood enhancement strategy. We wondered if the emotional benefits of socializing are present even for those with a psychological disorder defined by social distress and avoidance: social anxiety disorder (SAD). We conducted two ecological momentary assessment (EMA) studies and analyzed 7,243 total surveys. In both studies, community adults diagnosed with SAD and healthy controls received five surveys each day for two weeks. Consistent with research on positivity deficits in SAD, between-person analyses in both studies suggest that, on average, participants with SAD reported lower positive and higher negative affect in social and non-social situations than healthy controls. Within-person analyses, however, revealed that in both studies participants with SAD and healthy controls reported higher positive affect when with others than when alone; no differences were found for negative affect. The difference in positive affect between social and nonsocial situations was smaller for participants with SAD in Study 1, suggesting that people with SAD may experience diminished reward responding when socializing. Our results suggest that even those with a mental illness defined by interpersonal distress can and do derive positive emotions from social interactions.
... On some views, sex is not a luxury; rather, it is a central ingredient in many people's conception of a good life (Jecker 2020). Sex of different kinds can facilitate extraordinary pleasure, vulnerability, exploration, and positive bodily awareness; and under the right conditions, it may have beneficial implications for physical and mental health (Brody 2010;Diamond and Huebner 2012;Kashdan et al. 2014). v That many people who desire sex are unable to experience it thus seems lamentable. ...
For the sake of this chapter, we will assume that sexbots of the future will be non-sentient and lack moral standing: they will be neither moral victims nor moral agents. That is, we will assume that sexbots are 'mere' machines that are reliably identifiable as such, despite their humanlike appearance and behaviour. Under these stipulations, sexbots themselves can no more be harmed, morally speaking, than your dishwasher. As we will explore, however, there may still be something wrong about the production, distribution, or use of such sexbots.
... In our study, we had unprecedented information on subjective well-being on days preceding and days following sexual assault. The only reason we could collect these data is that we included a question about non-consensual sex in a 21-day experience sampling study (Kashdan et al., 2014;Kashdan, Adams, Savostyanova, McKnight & Nezlek, 2011;Kashdan, Goodman, Stiksma, Milius, & McKnight, 2018). When data are available to capture the temporal course of traumatic events (see Fredrickson, Tugade, Waugh, & Larkin, 2003 for an examination of 46 people before to after the terrorist attacks on September 11, 2001), a small sample becomes meaningful, especially if the goal is to provide knowledge to spearhead future research. ...
Approximately 15-20% of adult women in the United States have been sexually assaulted. Given the high prevalence of sexual assault, it becomes increasingly important to understand immediate responses to sexual assault. A lack of information prior to sexual assaults contributes to a literature that is unable to showcase the presence and amount of change. A tendency to rely on comparisons between people, instead of the collection of multiple moments of a single person over time, will continue to point toward imprecise, statistical "average" reactions to sexual assaults. Prior methodological approaches lead to broad overgeneralizations about sexual assault survivors that may undermine their unique experiences in the aftermath of an assault. The present study extends the existing literature with access to unprecedented data gathered on the days before and immediately after someone survived a sexual assault. To our knowledge, there are no studies capturing prior functioning and near immediate psychological reactions of sexual assault survivors. In the present study, each night over the course of three weeks, we asked college students (n = 186) to report on their sexual activity and well-being. Six women and one man reported being sexually assaulted at least once. We examined psychological experiences on the days before and after sexual assaults (including negative and positive affect, social anxiety, self-esteem, emotion expressive suppression, and cognitive reappraisal). To examine sexual assault reactions, we used various descriptive approaches. Our results suggest that before and after being assaulted, survivors showed no consistent response in subjective well-being. We failed to find a prototypical psychological profile. Despite the small sample, our results raise important questions and offer future hypotheses about individual differences in responses to sexual assault.
... Hypothesis 3b: In contrast, recent research on social anxiety and other emotional disturbances motivates the competing hypothesis that individuals with elevated social anxiety will derive larger psychological benefits (i.e., amplified improvements in mood, social belonging, and social motivation) following momentary positive events (e.g., Kashdan et al., 2014;Morgan et al., 2017;Rottenberg, 2017). ...
Understanding how individuals with varying levels of social anxiety respond to daily positive events is important. Psychological processes that increase positive emotions are being widely used as strategies to not only enhance well-being but also reduce the symptoms and impairment tied to negative emotional dispositions and conditions, including excessive social anxiety. At present, it is unclear whether and how levels of social anxiety impact the psychological benefits derived from momentary positive events. We used ecological momentary assessment to examine the impact of trait social anxiety on momentary changes in emotions, sense of belonging, and social approach versus avoidance motivation following positive events in daily life. Over the course of a week, people with elevated social anxiety experienced greater momentary anxiety and social avoidance motivation and lower momentary happiness and sense of belonging on average. Despite these impairments, individuals with elevated social anxiety experienced greater psychological benefits-in the form of reduced anxiety and motivation to avoid social situations, and an increased sense of belonging-following positive events during the past hour that were rated as particularly intense. This pattern of findings was not specific to social anxiety, with evidence of similar effects for other forms of internalizing psychopathology (general anxiety and depression). These observations detail circumstances in which individuals with social anxiety, and other emotional disturbances, can thrive-creating potentially important targets for intervention. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
... In male veterans with PTSD, increased sexual frequency and pleasure seem to be meaningful components of sexual functioning that reduce suicide risk. Although previous research has not directly examined this association, the association between sexual intimacy and personal well-being has been well documented (Blanchflower & Oswald, 2004;Kashdan et al., 2014;Laumann et al., 2006) with current research finding that increased sexual activity and sexual pleasure lead to lower negative affect and higher positive affect over time (Kashdan et al., 2018). For men with PTSD, sexual connection may directly combat avoidance and emotional numbing potentially allowing for feelings of increased intimacy in the relationship. ...
Intimate relationship distress has been identified as one of the most common precipitants of suicidal thoughts for U.S. military populations. Sexual functioning is associated with relationship distress and has recently been identified as a predictor of suicidal ideation with female military personnel; however, no studies have examined this association among a treatment-seeking sample of male and female veterans and their partners. Couples (N = 138) completed baseline assessments of sexual functioning, relationship functioning, suicidal ideation, and mental health prior to evaluation for engagement in a couples-based PTSD treatment study. Analyses revealed that decreased sexual pleasure and decreased frequency of sexual intercourse were associated with more recent suicidal ideation for male veterans, whereas increased sexual frequency was marginally associated with increased suicidal ideation for female veterans, controlling for PTSD and depression symptoms, relationship satisfaction, and medications. These findings stress the importance of assessing sexual functioning as a risk factor for suicide and taking into consideration the possibility that sexual functioning may be protective or predictive of suicidality depending on the person and context.
... Such questions can be answered with qualitative data (i.e., collected during structuralized clinical interviews, as in Carpenter, Reid, Garos, & Najavits, 2013) and with a quantitative approach, using the diary assessment method (Kashdan et al., 2013). Diary assessment is considered to be highly ecologically valid for measuring individual daily states (e.g., anxiety level, mood, and sexual arousal) and activities (e.g., sexual behaviors). ...
Background and aims
Compulsive sexual behaviors (CSBs) are an important clinical and social issue. Despite the increasing number of studies, some of CSB’s aspects remain under-investigated. Here, we explore the nature of CSB, such as binge pornography use and masturbation (PuM), and verify the correspondence between self-perceived factors leading to such behavior with its measures obtained in a diary assessment.
Methods
Semi-structuralized interviews with nine treatment-seeking males aged 22–37 years (M = 31.7, SD = 4.85) were followed by a questionnaire and a 10-week-long diary assessment, allowing us to acquire real-life daily patterns of CSB.
Results
Six out of nine subjects experienced binge (multiple hours or times a day) PuM. All subjects presented a high level of anxiety and perceived PuM as a way to regulate mood and stress. Data collected in the diary assessment uncovered a high diversity in the patterns of sexual behaviors (such as frequency of regular and binge PuM) and its correlates. Binge PuM was related to decreased mood and/or increased stress or anxiety. The causal relation between these correlates remains undetermined.
Discussion and conclusions
Binge PuM seems to be one of the most characteristic behavior among males who are seeking treatment for CSB and is related to the feeling of losing control over one’s sexual activity. CSB individuals indicate a variety of binge triggers. Also, diary assessment data indicate that specific correlates of binge PuM (decreased mood, increased stress, and anxiety) differ between subjects. It suggests the existence of significant individual differences in binge PuM behaviors, and a need to study these differences, as it may help guide personalized treatment.
... Sexual pleasure supports an individual's health and wellbeing, increases sexual fulfillment, enhances intimate relationships, and lowers social anxiety (Erickson-Schroth, 2014; Kashdan et al., 2014;Tepper, 2000). This pleasure can be pursued in many forms and can occur in solitary and/ or partnered contexts (Rye & Meaney, 2007). ...
There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers' Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.
... How often do high SA women mate with low SA men? There is a growing body of work on intact romantic relationships when one partner is high in social anxiety (Kashdan, Adams, et al., 2011;Kashdan et al., 2014) but little to no knowledge exists on the prevalence of particular SA combinations and what is attractive about being in a relationship with a high SA partner. ...
Physical touch is central to the emotional intimacy that separates romantic relationships from other social contexts. In this study of 256 adults (128 heterosexual couples, mean relationship length = 20.5 months), we examined whether individual differences in social anxiety influenced comfort with and avoidance of physical touch. Because of prior work on sex difference in touch use, touch comfort, and social anxiety symptoms and impairment, we explored sex-specific findings. We found evidence that women with greater social anxiety were less comfortable with touch and more avoidant of touch in same-sex friendships. Additionally, a woman’s social anxiety had a bigger effect on a man’s comfort with touch and avoidance of touch in the romantic relationship than a man’s social anxiety had on the woman’s endorsement of touch-related problems. These effects were uninfluenced by the length of romantic relationships. Touch is a neglected emotional experience that offers new insights into the difficulties of individuals suffering from social anxiety problems, and their romantic partners.
... Sexual activity, especially orgasm, also triggers the release of oxytocin, which promotes bonding (Magon and Kalra 2011) and may help to relieve stress, thus enhancing cardiovascular health. Not only is stress relieved during intercourse and the moment of orgasm, but elevated mood may persist for some time and have a positive impact on health (Exton et al. 1999;Kashdan et al. 2014;Kruger et al. 1998). The physical act of sex may alleviate stress directly in the same way as does any exercise (Salmon 2001). ...
Working from a social relationship and life course perspective, we provide generalizable population-based evidence on partnered sexuality linked to cardiovascular risk in later life using national longitudinal data from the National Social Life, Health and Aging Project (NSHAP) (N = 2,204). We consider characteristics of partnered sexuality of older men and women, particularly sexual activity and sexual quality, as they affect cardiovascular risk. Cardiovascular risk is defined as hypertension, rapid heart rate, elevated C-reactive protein (CRP), and general cardiovascular events. We find that older men are more likely to report being sexually active, having sex more often, and more enjoyably than are older women. Results from cross-lagged models suggest that high frequency of sex is positively related to later risk of cardiovascular events for men but not women, whereas good sexual quality seems to protect women but not men from cardiovascular risk in later life. We find no evidence that poor cardiovascular health interferes with later sexuality for either gender.
... Although limited work has examined recent vaginal sex, one study found that college students reported a positive consequence (most commonly intimacy and satisfaction) on nearly all days they had vaginal sex, but a negative consequence (most commonly worry about health and guilt) on less than half of vaginal sex days (Vasilenko, Lefkowitz, & Maggs, 2012). Although not specific to consequences, other daily and ecological momentary assessment (EMA) studies have shown increased positive affect, decreased negative affect, and less social anxiety after reports of vaginal sex compared to measurement occasions when adolescents had not had sex (Fortenberry et al., 2005;Kashdan et al., 2014;Shrier, Shih, Hacker, & de Moor, 2007). ...
To fully understand late adolescents' experiences of oral sex, we must consider both risk and normative developmental perspectives. Sexual experiences include a range of behaviors, but research on sexual behaviors and consequences focuses primarily on vaginal sex. Oral sex occurs at rates similar to vaginal sex, and carries some, though less, risk than vaginal sex. The current study examined the event-level prevalence and consequences of oral sex compared to vaginal sex with other-sex partners in first-year college students. Daily data were from recently sexually active first-year college students (N = 253 people, 834 days; M age, 18.4 years; SD = 0.4; 56 % female; 31 % Hispanic/Latino; 17 % African American, 14 % Asian American/Pacific Islander, 25 % European American, 12 % multiracial) who reported on sexual behaviors and consequences. Both positive (intimacy, physical satisfaction) and negative (worrying about health, guilt) consequences were less common for oral than vaginal sex. Gender differences suggested that female adolescents may find vaginal sex more rewarding than oral sex, whereas male adolescents may find them equally rewarding.
This chapter focuses on the influences of lifelong sexual practice on health in later life. Human life expectancy has been continuously increasing in the past decades. Despite the recent decline in life expectancy in the United States, the number of older adults is rising globally, and our society is facing rapid aging overall. Sexual health is important for human health and well-being. Often being overlooked previously, sexuality and sexual health among older adults have become more important than ever. There are many forms of sexual behavior and types of sexual activity. In this chapter, we will discuss the positive influence of lifelong sexual practice on the physical, emotional, social, and cognitive aspects of health among older adults and the potential risk of sexually transmitted infections. Given that general health condition declines with age, we also discuss the health issues among older women and men that may affect their sexual functioning and satisfaction. Lastly, we specifically discuss sexual health among the underserved population, including older adults who self-identified as sexual and gender minorities and those who live with chronic conditions. In summary, it is essential not to assume that older individuals are indifferent to intimacy and sexual pleasure. Although sexual health-related problems in older adults are frequent, they are scarcely brought to the attention of physicians and other healthcare professionals. Thus, it is important to integrate a safe and nonjudgmental system within healthcare professionals where all sexually active older individuals have access to education, counseling, and treatment related to sexual health and safe sexual practices.
Background:
Social Anxiety Disorder (SAD) is associated with pervasive functional impairments and chronicity. Romantic relationship functioning and quality for individuals with SAD has been previously explored but existing studies have not been synthesised.
Aims:
This scoping review charted existing literature regarding the quality and functioning of romantic relationships for people with SAD and high sub-clinical social anxiety (SA).
Methods:
The review used a scoping approach to explore the current evidence base relating to SA, romantic relationship quality and functioning. Articles published in English after 1980 that reported either clinical or high sub-clinical SA were eligible. Double screening, data extraction, quality assessment, and thematic analysis of studies was conducted.
Results:
50 studies from 46 articles were identified, involving a range of community, college, adolescent, and clinical samples. Thematic analysis identified four themes; Relationship Quality, Satisfaction and Commitment; Communication and Self-Disclosure; Conflict, Social Support and Trust; Intimacy, Closeness and Sexual Satisfaction.
Conclusions:
The review highlights that evidence relating to romantic relationship functioning for individuals with SAD and high sub-clinical SA is heterogeneous, with relationship initiation in particular relatively under-explored. Further research is required to elucidate key constructs and interpersonal processes related to relationship functioning, and to inform treatment approaches with this group.
Judgments about the self compared to internalized standards are central to theoretical frameworks of social anxiety. Yet, empirical research on social comparisons-how people view themselves relative to others-and social anxiety is sparse. This research program examines the nature of everyday social comparisons in the context of social anxiety across 2 experience-sampling studies containing 8,396 unique entries from 273 adults. Hypotheses and analyses were preregistered with the Open Science Foundation (OSF) prior to data analysis. Study 1 was a 3-week daily diary study with undergraduates, and Study 2 was a 2-week ecological momentary assessment (EMA) study with a clinical sample of adults diagnosed with social anxiety disorder (SAD) and a psychologically healthy comparison group. In both studies, social anxiety was associated with less favorable, more unstable social comparisons. In both studies, favorable social comparisons were associated with higher positive affect and lower negative affect and social anxiety. In both studies, social comparisons and momentary affect/social anxiety were more strongly linked in people with elevated trait social anxiety/SAD compared to less socially anxious participants. Participants in Study 2-even those with SAD-made more favorable social comparisons when they were with other people than when alone. Taken together, results suggest that social anxiety is associated with unfavorable, unstable self-views that are linked to compromised well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Despite the increased attention that researchers have paid to social anxiety disorder (SAD), compared with other anxiety and mood disorders, relatively little is known about the emotional and social factors that distinguish individuals who meet diagnostic criteria from those who do not. In this study, participants with and without a diagnosis of SAD (generalized subtype) described their daily face-to-face social interactions for 2 weeks using handheld computers. We hypothesized that, compared with healthy controls, individuals diagnosed with SAD would experience fewer positive emotions, rely more on experiential avoidance (of anxiety), and have greater self-control depletion (feeling mentally and physically exhausted after socializing), after accounting for social anxiety, negative emotions, and feelings of belonging during social interactions. We found that compared with healthy controls, individuals with SAD experienced weaker positive emotions and greater experiential avoidance, but there were no differences in self-control depletion between groups. Moreover, the differences we found could not be attributed to comorbid anxiety or depressive disorders. Our results suggest that negative emotions alone do not fully distinguish normal from pathological social anxiety, and that assessing social anxiety disorder should include impairments in positive emotional experiences and dysfunctional emotion regulation (in the form of experiential avoidance) in social situations. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
The sex drive refers to the strength of sexual motivation. Across many different studies and measures, men have been shown to have more frequent and more intense sexual desires than women, as reflected in spontaneous thoughts about sex, frequency and variety of sexual fantasies, desired frequency of intercourse, desired number of part - ners, masturbation, liking for various sexual practices, willingness to forego sex, initi - ating versus refusing sex, making sacrifices for sex, and other measures. No contrary findings (indicating stronger sexual motivation among women) were found. Hence we conclude that the male sex drive is stronger than the female sex drive. The gender dif - ference in sex drive should not be generalized to other constructs such as sexual or or - gasmic capacity, enjoyment of sex, or extrinsically motivated sex. If the world were designed for the primary goal of maximizing human happiness, the sexual tastes of men and women would match up very closely. What could be more ideal than perfect attunement with one's mate, so that both people feel sexual desire at the same times, to the same degrees, and in the same ways? Yet there is ample evidence that romantic partners are sometimes out of synchrony with each other's sexual wishes and feelings. The continuing market for sexual advice, sex therapy, couple counseling, and similar offerings is a testimony to the fact that many people are not perfectly satisfied with their sex lives even within committed re- lationships. Infidelity and divorce may also sometimes reflect sexual dissatisfaction. The focus of this article is on one potential source of
In 2 studies, the Inclusion of Other in the Self (IOS) Scale, a single-item, pictorial measure of closeness, demonstrated alternate-form and test–retest reliability; convergent validity with the Relationship Closeness Inventory (E. Berscheid et al, 1989), the R. J. Sternberg (1988) Intimacy Scale, and other measures; discriminant validity; minimal social desirability correlations; and predictive validity for whether romantic relationships were intact 3 mo later. Also identified and cross-validated were (1) a 2-factor closeness model (Feeling Close and Behaving Close) and (2) longevity–closeness correlations that were small for women vs moderately positive for men. Five supplementary studies showed convergent and construct validity with marital satisfaction and commitment and with a reaction-time (RT)-based cognitive measure of closeness in married couples; and with intimacy and attraction measures in stranger dyads following laboratory closeness-generating tasks. In 3 final studies most Ss interpreted IOS Scale diagrams as depicting interconnectedness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The psychometric adequacy of the Social Interaction Anxiety Scale (SIAS; R. P. Mattick & J. C. Clark, 1989), a measure of social interaction anxiety, and the Social Phobia Scale (SPS; R. P. Mattick & J. C. Clark, 1989), a measure of anxiety while being observed by others, was evaluated in anxious patients and normal controls. Social phobia patients scored higher on both scales and were more likely to be identified as having social phobia than other anxious patients (except for agoraphobic patients on the SPS) or controls. Clinician-rated severity of social phobia was moderately related to SIAS and SPS scores. Additional diagnoses of mood or panic disorder did not affect SIAS or SPS scores among social phobia patients, but an additional diagnosis of generalized anxiety disorder was associated with SIAS scores. Number of reported feared social interaction situations was more highly correlated with scores on the SIAS, whereas number of reported feared performance situations was more highly correlated with scores on the SPS. These scales appear to be useful in screening, designing individualized treatments, and evaluating the outcomes of treatments for social phobia. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
W. James (1890) argued that the importance people attach to their self-views determines the impact of these self-views on people's global feelings of self-worth. Despite the intuitive appeal of this position, most research on the relation between people's specific self-views and their global self-esteem has failed to support this assertion. B. W. Pelham and W. B. Swann (1989) provided evidence in support for W. James's assertion, but H. W. Marsh (1993) criticized this evidence. In this article, further evidence is presented for W. James's (1890) assertion. In addition, the favorability of people's specific self-views is identified as a moderator of the extent to which belief importance is related to self-esteem. The theoretical implications and limitations of these findings are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Associations between exercise and mental well-being have been documented repeatedly over the last two decades. More recently, there has been application of exercise interventions to clinical populations diagnosed with depression, anxiety, and eating disorders with evidence of substantial benefit. Nonetheless, attention to the efficacy of exercise interventions in clinical settings has been notably absent in the psychosocial treatment literature, as have been calls for the integration of these methods within the clinical practice of psychologists. In this article, we provide a quantitative and qualitative review of these efficacy studies in clinical samples and discuss the potential mechanism of action of exercise interventions, with attention to both biological and psychosocial processes. The meta-analysis of 11 treatment outcome studies of individuals with depression yielded a very large combined effect size for the advantage of exercise over control conditions: g = 1.39 (95% CI: .89–1.88), corresponding to a d = 1.42 (95% CI: .92–1.93). Based on these findings, we encourage clinicians to consider the role of adjunctive exercise interventions in their clinical practice and we discuss issues concerning this integration.
For 21 days, 123 participants provided measures of their daily depressogenic adjustment, including Beck’s cognitive triad, causal uncertainty, control over the environment, self-esteem, and anxiety, and they described the positive and negative events that occurred. Daily adjustment negatively covaried with the number of negative events occurring each day and, except as measured by anxiety, positively covaried with positive events. The covariance between negative events and adjustment was stronger than the covariance between positive events and adjustment. Participants also provided measures of depressive symptoms. For the self-esteem and cognitive triad measures, adjustment covaried more strongly with negative and positive events for the depressed than they did for the nondepressed.
We agree with Schneider's claim (2003, this issue) that humanistic ideas and approaches are important for therapeutic change. However, we reiterate that their importance lies primarily in the “how” of therapy, not in the “what” of therapy. Available now are a variety of relatively simple treatments whose worth for mitigating psychological suffering has been empirically documented, in the same rigorous way and with the same standards that the worth of new medical treatments must be documented. Thus, we argue that psychotherapy's next “tier” involves the marriage of such proven techniques with the humanistically informed motivational prescriptions of self-determination theory.
Multilevel modeling is a technique that has numerous potential applications for social and personality psychology. To help realize this potential, this article provides an introduction to multilevel modeling with an emphasis on some of its applications in social and personality psychology. This introduction includes a description of multilevel modeling, a rationale for this technique, and a discussion of applications of multilevel modeling in social and personality psychological research. Some of the subtleties of setting up multilevel analyses and interpreting results are presented, and software options are discussed.
Effective treatments for social anxiety disorder (SAD) exist, but additional treatment options are needed for nonresponders as well as those who are either unable or unwilling to engage in traditional treatments. Mindfulness-based stress reduction (MBSR) is one nontraditional treatment that has demonstrated efficacy in treating other mood and anxiety disorders, and preliminary data suggest its efficacy in SAD as well.
Fifty-six adults (52% female; 41% Caucasian; age mean [M] ± standard deviation [SD]: 32.8 ± 8.4) with SAD were randomized to MBSR or an active comparison condition, aerobic exercise (AE). At baseline and post-intervention, participants completed measures of clinical symptoms (Liebowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Beck Depression Inventory-II, and Perceived Stress Scale) and subjective well-being (Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Self-Compassion Scale, and UCLA-8 Loneliness Scale). At 3 months post-intervention, a subset of these measures was readministered. For clinical significance analyses, 48 healthy adults (52.1% female; 56.3% Caucasian; age [M ± SD]: 33.9 ± 9.8) were recruited. MBSR and AE participants were also compared with a separate untreated group of 29 adults (44.8% female; 48.3% Caucasian; age [M ± SD]: 32.3 ± 9.4) with generalized SAD who completed assessments over a comparable time period with no intervening treatment.
A 2 (Group) x 2 (Time) repeated measures analyses of variance (ANOVAs) on measures of clinical symptoms and well-being were conducted to examine pre-intervention to post-intervention and pre-intervention to 3-month follow-up. Both MBSR and AE were associated with reductions in social anxiety and depression and increases in subjective well-being, both immediately post-intervention and at 3 months post-intervention. When participants in the randomized controlled trial were compared with the untreated SAD group, participants in both interventions exhibited improvements on measures of clinical symptoms and well-being.
Nontraditional interventions such as MBSR and AE merit further exploration as alternative or complementary treatments for SAD. © 2012 Wiley Periodicals, Inc. J. Clin. Psychol. 68:715-731, 2012
The current article examines how close relationships combine with individual differences in sex motives (Cooper, Shapiro, & Powers, 1998) to shape sexual experience. We first provide an overview of the motivational approach as it relates to sexual behavior and then describe 2 broad mechanisms (1 transactional, the other interactional) by which motives and relational context combine to shape behavior. Drawing on our past research, we review evidence showing that people select relationship contexts based partly on their motives and that these contexts in turn shape future motives and behavior; that partner motives shape sexual experience above and beyond one's own motives; and that both the broader relationship context and partner motives moderate the effects of one's own motives on sexual experience. We conclude that the nature of motivational pursuits cannot be adequately understood in the abstract, but rather we must take into account the relational context in which one's needs are pursued.
Despite longstanding debate over the nature of the boundary between social anxiety disorder (SAD) and less severe social anxiety, no study has tested directly whether the defining features of the disorder correspond to a latent category or dimension. The present study examined this question using data from the National Comorbidity Survey Replication (NCS-R), a nationally representative survey of the U.S. household population. Indicators representing the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) criteria for SAD were submitted to taxometric analyses in a subsample of adults (n = 2,166) who reported excessive social fear in their lifetime. Multiple taxometric procedures and consistency tests converged on a dimensional solution, suggesting that SAD is continuous with milder social anxiety. In follow-up analyses, a dimensional SAD diagnosis outperformed the DSM-IV diagnosis in predicting the subsequent onset of a range of clinically important outcomes. Large differences in associations with comorbid mood disorders, suicidality, and treatment seeking in particular favored the prognostic value of dimensional over categorical diagnosis. These findings support the validity and potential utility of a dimensional conceptualization of SAD that may inform efforts to revise the diagnosis for DSM-V.
Recent studies have shown that sexual functioning and sexually related personal distress are weakly related in women, with only a minority of sexual difficulties resulting in significant levels of distress. However, there has been little systematic research to date on which factors moderate the relationship between sexual functioning and sexual distress.
To assess the degree to which relational intimacy and attachment anxiety moderate the association between sexual functioning and sexual distress in college-age women.
Two hundred women (mean age=20.25) completed surveys assessing sexual functioning, relational intimacy, attachment anxiety, and sexual distress.
Participants completed the Sexual Satisfaction Scale for Women, the Female Sexual Function Index, the Dimensions of Relationship Quality Scale, and the Revised Experiences in Close Relationships Measure of Adult Romantic Attachment.
Relational intimacy and attachment anxiety moderated the association between multiple aspects of sexual functioning and sexual distress. For lubrication and sexual pain, functioning was more strongly associated with distress in low-intimacy vs. high-intimacy relationships, but only for women with high levels of attachment anxiety. Results regarding desire were mixed and neither intimacy nor attachment anxiety interacted with subjective arousal or orgasm in predicting distress.
Both relational intimacy and attachment anxiety are important moderators of the association between sexual functioning and subjective sexual distress in women. Theoretical and practical implications are discussed.
Sexual satisfaction and sexual distress are common outcome measures in studies of sexual health and well-being. However, confusion remains as to if and how the two constructs are related. While many researchers have conceptualized satisfaction and distress as polar opposites, with a lack of satisfaction indicating high distress and vice versa, there is a growing movement to view satisfaction and distress as relatively independent factors and measure them accordingly.
The study aimed to assess the level of independence between sexual satisfaction and distress in female clinical and nonclinical samples.
Ninety-nine women (mean age = 25.3) undergoing treatment (traditional sex therapy and/or gingko biloba) for sexual arousal disorder with or without coexistent hypoactive sexual desire disorder and/or orgasmic disorder completed surveys assessing sexual satisfaction, sexual distress, sexual functioning, and relational functioning at pretreatment, mid-treatment, posttreatment, and follow-up. Two hundred twenty sexually healthy women (mean age = 20.25) completed similar surveys at 1-month intervals.
Sexually dysfunctional women completed the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Dyadic Adjustment Scale. Sexually healthy women completed the SSS-W, the FSFI, the Relationship Assessment Scale, and the Dimensions of Relationship Quality Scale.
Sexual satisfaction and distress were generally closely and inversely related; however, distress was more closely related to sexual functioning variables than was satisfaction in the clinical sample, and satisfaction was more closely related to relational variables than was distress in the nonclinical sample. Additionally, satisfaction and distress showed partially independent patterns of change over time, and scales of distress showed a larger change in response to treatment than did scales of satisfaction.
Although sexual satisfaction and distress may be closely related, these findings suggest that they are, at least, partially independent constructs. Implications for research on sexual well-being and treatment outcome studies are discussed.
Although adults with anxiety disorders often report interpersonal distress, the degree to which anxiety is linked to the quality of close relationships remains unclear. The authors examined the relational impact of anxiety by sampling the daily mood and relationship quality of 33 couples in which the wife was diagnosed with an anxiety disorder. Use of a daily process design improved on prior methodologies by capturing relational processes closer to their actual occurrence and in the setting of the diagnosed partner's anxiety. Analyses revealed significant associations between wives' daily anxiety and both partners' perceptions of relationship quality. Associations were moderated by anxiety-specific support. Results also indicated significant concordance between wives' daily anxiety and husbands' distress. Concordance was stronger for husbands who reported frequent accommodation of wives' anxiety symptoms. Findings are discussed in the context of existing evidence on the social costs of anxiety disorders.
A meta-analysis of 205 studies involving 23,702 Ss was conducted to determine whether there are sex differences in self-disclosure. Across these studies, women disclosed slightly more than men (d = .18). This effect size was not homogeneous across studies. Several moderator variables were found. Sex of target and the interaction effect of relationship to target and measure of self-disclosure moderated the effect of sex on self-disclosure. Sex differences in self-disclosure were significantly greater to female and same-sex partners than to opposite-sex or male partners. When the target had a relationship with the discloser (i.e., friend, parent, or spouse), women disclosed more than men regardless of whether self-disclosure was measured by self-report or observation. When the target was a stranger, men reported that they disclosed similarly to women; however, studies using observational measures of self-disclosure found that women disclosed more than men.
W. James (1890) argued that the importance people attach to their self-views determines the impact of these self-views on people's global feelings of self-worth. Despite the intuitive appeal of this position, most research on the relation between people's specific self-views and their global self-esteem has failed to support this assertion. B. W. Pelham and W. B. Swann (1989) provided evidence in support for W. James's assertion, but H. W. Marsh (1993) criticized this evidence. In this article, further evidence is presented for W. James's (1890) assertion. In addition, the favorability of people's specific self-views is identified as a moderator of the extent to which belief importance is related to self-esteem. The theoretical implications and limitations of these findings are discussed.
Social anxiety is a universal phenomenon. When the level of anxiety, avoidance, and impairment in functioning reaches clinical proportions, a diagnosis of social anxiety disorder (SAD) (also known as SP)-and possibly APD-is made. The assessment methods described in this chapter can be used for assessing subdiagnostic social anxiety as well as SAD per se. Assessment measures for social anxiety have typically been divided into two broad groups: behavioral assessment methods, which include role-playing procedures and self-monitoring, and cognitive assessment procedures, including thought-listing and information-processing paradigms. Primary among these is the fact that whether any given measure is considered a behavioral or a cognitive assessment procedure is more a function of one's theoretical perspective than of the measure itself. The chapter elects various assessment procedures to organize according to the methodology of the procedure. Many of the tools described can be used for different purposes depending on one's goals (e.g., treatment planning in a clinical context, psychopathology research) and one's theoretical orientation (e.g., behaviorist, mediational, cognitivist). The chapter begins by describing a clinical interview, with particular attention to structured clinical interviews. This is followed by a review of the most commonly used self-report questionnaires for social anxiety. Role-playing procedures are then described, followed in turn by self-monitoring and thought-listing techniques. Finally, psychophysiological assessment is discussed briefly.
Social anxiety disorder (SAD) is one of the most common and impairing psychological disorders. To advance our understanding of SAD, several researchers have put forth explanatory models over the years, including one which we originally published almost two decades ago (Rapee & Heimberg, 1997), which delineated the processes by which socially anxious individuals are affected by their fear of evaluation in social situations. Our model, as revised in the 2010 edition of this text, is summarized and further updated based on recent research on the multiple processes involved in the maintenance of SAD.
Our purpose was to examine the effects of cognitive group therapy, aerobic exercise, or their combination on anxiety reduction. Seventy participants were divided into four groups: cognitive group therapy, aerobic exercise, both treatments, or control. Participants were administered the State-Trait Anxiety Inventory (STAI) before and after the study, and at a two-month follow-up. Results indicate that all interventions were equally effective in reducing anxiety as compared to no intervention. The combination of cognitive group therapy and exercise was not significantly more effective than either cognitive group therapy or aerobic exercise alone. Although effects were not maintained after two months, it is unclear whether this is attributable to the limitations of such interventions in changing more enduring traits. Possible mechanisms for change are discussed.
Insomnia commonly occurs along with other psychiatric disorders. I aim to address two issues that arise from this observation. First, insomnia is commonly assumed to be epiphenomenal to the so-called “primary” psychiatric disorder. On the basis of new evidence, I argue instead that insomnia may be an important but under-recognized mechanism in the multifactorial cause and maintenance of psychiatric disorders. Second, insomnia may be a transdiagnostic process—a process that is common across psychiatric disorders. The move to identify and study transdiagnostic processes contrasts with the standard “disorder focused” approach in which classification systems and research programs specialize in a single disorder. The latter approach can neglect the intriguing and potentially important similarities across disorders. If it were feasible to develop transdiagnostic treatments, the public health implications would be startling. Research on the role of sleep in psychiatric disorders and tests of the validity and utility of a transdiagnostic approach provide rich opportunities for improving our understanding of, and the treatment of, psychiatric disorders.
Self-determination Theory posits that psychological wellbeing stems from feeling autonomous, competent, and related. Prior research has found that people report that, on days in which they perceive these needs are met, they have good days, as evidenced by both positive mood and fewer physical symptoms. The current research examined the relationship between satisfaction of these needs and sexuality, hypothesizing that having sexual interactions in which these needs are met, will result in more satisfying and positive experiences. For 3 weeks, participants described and rated each of their sexual interactions. Results suggest that greater need satisfaction is related to more positive sexual experience. Differences in general-level needs were also examined as they moderated the above relationship.
Cognitive-behavioral theorists have proposed that fear of negative evaluation (FNE) is the core feature of social anxiety (Clark & Wells, 1995; Rapee & Heimberg, 1997). However, emerging evidence supports the notion that fear of evaluation in general is important in social anxiety, including fear of positive evaluation (FPE) as well as negative evaluation (e.g., see Weeks, Heimberg, & Rodebaugh, 2008; Weeks, Heimberg, Rodebaugh, & Norton, 2008). The purposes of the present study were to test several new hypotheses related to this expanded conceptualization of social anxiety, as well as to replicate the two-factor structural model consisting of separate factors for fears of positive and negative evaluation originally reported by Weeks, Heimberg, and Rodebaugh, et al. (2008). The present findings further support FPE and FNE as distinct latent constructs. FPE and FNE related similarly to social anxiety but demonstrated unique relationships with several social anxiety-related constructs and emerged as distinct from several discriminant constructs with strong thematic overlap to FPE/FNE. The findings from the present study provide additional support for the hypothesis that fear of evaluation in general is important in social anxiety.
The majority of definitions, research studies, and treatment programs that focus on social anxiety characterize the prototypical person with the disorder as shy, submissive, inhibited, and risk averse. This stereotype, however, has been challenged recently. Specifically, a subset of people with social anxiety who are aggressive, impulsive novelty seekers deviate from that prototype. People with this atypical profile show greater functional impairment and are less likely to complete or fare well in treatment compared with inhibited socially anxious people. The difference between these two groups of people with social anxiety cannot be explained by the severity, type, or number of social fears, nor by co-occurring anxiety and mood disorders. Conclusions about the nature, course, and treatment of social anxiety may be compromised by not attending to diverse behaviors and self-regulatory styles. These concerns may be compounded in neurobiological and clinical studies of people with social anxiety problems that rely on smaller samples to make claims about brain patterns and the efficacy of particular treatments.
Simple slopes, regions of significance, and confidence bands are commonly used to evaluate interactions in multiple linear regression (MLR) models, and the use of these techniques has recently been extended to multilevel or hierarchical linear modeling (HLM) and latent curve analysis (LCA). However, conducting these tests and plotting the conditional relations is often a tedious and error-prone task. This article provides an overview of methods used to probe interaction effects and describes a unified collection of freely available online resources that researchers can use to obtain significance tests for simple slopes, compute regions of significance, and obtain confidence bands for simple slopes across the range of the moderator in the MLR, HLM, and LCA contexts. Plotting capabilities are also provided.
Research from numerous corners of psychological inquiry suggests that self-assessments of skill and character are often flawed in substantive and systematic ways. We review empirical findings on the imperfect nature of self-assessment and discuss implications for three real-world domains: health, education, and the workplace.
In general, people's self-views hold only a tenuous to modest relationship with their actual behavior and performance. The correlation between self-ratings of skill and actual performance in many domains is moderate to meager—indeed, at times, other people's predictions of a person's outcomes prove more accurate than that person's self-predictions. In addition, people overrate themselves. On average, people say that they are “above average” in skill (a conclusion that defies statistical possibility), overestimate the likelihood that they will engage in desirable behaviors and achieve favorable outcomes, furnish overly optimistic estimates of when they will complete future projects, and reach judgments with too much confidence. Several psychological processes conspire to produce flawed self-assessments.
Research focusing on health echoes these findings. People are unrealistically optimistic about their own health risks compared with those of other people. They also overestimate how distinctive their opinions and preferences (e.g., discomfort with alcohol) are among their peers—a misperception that can have a deleterious impact on their health. Unable to anticipate how they would respond to emotion-laden situations, they mispredict the preferences of patients when asked to step in and make treatment decisions for them. Guided by mistaken but seemingly plausible theories of health and disease, people misdiagnose themselves—a phenomenon that can have severe consequences for their health and longevity.
Similarly, research in education finds that students' assessments of their performance tend to agree only moderately with those of their teachers and mentors. Students seem largely unable to assess how well or poorly they have comprehended material they have just read. They also tend to be overconfident in newly learned skills, at times because the common educational practice of massed training appears to promote rapid acquisition of skill—as well as self-confidence—but not necessarily the retention of skill. Several interventions, however, can be introduced to prompt students to evaluate their skill and learning more accurately.
In the workplace, flawed self-assessments arise all the way up the corporate ladder. Employees tend to overestimate their skill, making it difficult to give meaningful feedback. CEOs also display overconfidence in their judgments, particularly when stepping into new markets or novel projects—for example, proposing acquisitions that hurt, rather then help, the price of their company's stock. We discuss several interventions aimed at circumventing the consequences of such flawed assessments; these include training people to routinely make cognitive repairs correcting for biased self-assessments and requiring people to justify their decisions in front of their peers.
The act of self-assessment is an intrinsically difficult task, and we enumerate several obstacles that prevent people from reaching truthful self-impressions. We also propose that researchers and practitioners should recognize self-assessment as a coherent and unified area of study spanning many subdisciplines of psychology and beyond. Finally, we suggest that policymakers and other people who makes real-world assessments should be wary of self-assessments of skill, expertise, and knowledge, and should consider ways of repairing self-assessments that may be flawed.
This volume presents the most recent developments in this field of study [social comparison]. As described in the chapters that follow, the theory has gone through several iterations, taken on new problems and research paradigms, and reached out to other social-psychological areas of study. Some of this research addresses questions that are logical extensions of [Leon] Festinger's theory; some considers questions that derive from entirely different ways of construing the comparison process from Festinger's original approach. Although all questions are not settled, the work presented here shows how far the original social comparison theory has evolved and suggests where we are likely to find the next insights.
The book is organized into five major sections. The first part consists of five chapters describing general models of the comparison process. . . . Part II considers the extension of social comparison processes to important problems in social cognition. . . . Part III provides new insights on how comparison applies to social psychological phenomena. . . . Part IV involves recent developments in which social comparison theory has been tested in applied settings. . . . Finally, Part V provides a commentary in which the contributions are critically reviewed, some general questions raised, and suggestions for future study are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
a b s t r a c t The internecine war over the relative importance of persons and situations, triggered 40 years ago by Walter Mischel's Personality and Assessment, is largely over, so it is time for researchers to develop an agenda for personality psychology in the postwar era. The possibilities include a return to the status quo ante characterized by questionnaire-based research, focusing on narrower trait constructs than the ''global" traits that have undergone so much criticism, and concentrating upon within-person variance (as well as or even instead of between person variance) in behavior. Each of these possibilities offers some promise but also hazards that may be under-appreciated. The present article suggests that personality theory and research be re-organized in terms of the personality triad of persons, behaviors, and situations. A precondition for understanding the elements of this triad is better conceptualization and measurement of behavior and, especially, situations. While the interactions among these elements may turn out to be important, a first order of business is to understand the main effects of each element, a formidable but exciting research agenda that will entail a turn to broadly descriptive research rather than the testing of narrow, isolated hypotheses. Looking further ahead, a post-interactionist personality psychology may someday recognize that personality is a latent construct only indirectly indicated through behavior, and the ultimate understanding of that construct will be empirically tested by the ability to predict behavior in new and unique situations.
Many important research hypotheses concern conditional relations in which the ef- fect of one predictor varies with the value of another. Such relations are commonly evaluated as multiplicative interactions and can be tested in both fixed- and ran- dom-effects regression. Often, these interactive effects must be further probed to fully explicate the nature of the conditional relation. The most common method for probing interactions is to test simple slopes at specific levels of the predictors. A more general method is the Johnson-Neyman (J-N) technique. This technique is not widely used, however, because it is currently limited to categorical by continuous in- teractions in fixed-effects regression and has yet to be extended to the broader class of random-effects regression models. The goal of our article is to generalize the J-N technique to allow for tests of a variety of interactions that arise in both fixed- and random-effects regression. We review existing methods for probing interactions, ex- plicate the analytic expressions needed to expand these tests to a wider set of condi- tions, and demonstrate the advantages of the J-N technique relative to simple slopes with three empirical examples.
While most books on missing data focus on applying sophisticated statistical techniques to deal with the problem after it has occurred, this volume provides a methodology for the control and prevention of missing data. In clear, nontechnical language, the authors help the reader understand the different types of missing data and their implications for the reliability, validity, and generalizability of a study’s conclusions. They provide practical recommendations for designing studies that decrease the likelihood of missing data, and for addressing this important issue when reporting study results. When statistical remedies are needed--such as deletion procedures, augmentation methods, and single imputation and multiple imputation procedures--the book also explains how to make sound decisions about their use. Patrick E. McKnight's website offers a periodically updated annotated bibliography on missing data and links to other Web resources that address missing data.
This study used diaries to investigate social comparison processes in 59 individuals with social phobia (SP) and 58 nonclinical controls. Although groups did not differ on the total number of comparisons made during the 2-week study period, those with SP made significantly more upward comparisons (i.e., comparisons where the individual assesses him- or herself as not measuring up to others) and significantly fewer downward comparisons (i.e., comparisons where the individual assesses him- or herself as superior to others) relative to controls. SP was also associated with comparisons on a greater number of dimensions or attributes and more comparisons on particular dimensions. Those in the SP group tended to experience greater changes in affect following social comparisons than those in the comparison group. For example, upward comparisons tended to lead to increased anxiety and depression, particularly for the socially anxious participants. Implications for these findings are discussed.
We examined the association between social anxiety and interpersonal functioning. Unlike prior research, we focused specifically on close relationships, given the growing evidence of dysfunction in these relationships among people with psychopathology. We proposed that social anxiety would be associated with specific interpersonal styles. One hundred sixty-eight young adults with a range of social anxiety symptoms were interviewed regarding symptom severity, interpersonal styles, and chronic interpersonal stress. Results indicated that higher levels of social anxiety were associated with interpersonal styles reflecting less assertion, more conflict avoidance, more avoidance of expressing emotion, and greater interpersonal dependency. Moreover, lack of assertion and overreliance on others mediated the association between social anxiety and interpersonal stress. Associations held controlling for depressive symptoms. Implications of these findings for interpersonally oriented conceptualizations of social anxiety disorder are discussed.
The current study examined aspects of communication and intimacy between people with social phobia and their romantic partners. Forty-eight individuals with social phobia and 58 community controls completed a series of questionnaires to measure self-disclosure, emotional expression and levels of intimacy within their romantic relationships. Participants with social phobia reported less emotional expression, self-disclosure and intimacy than controls, even after controlling for a diagnosis of mood disorder. The group differences did not differ significantly by gender. A continuous measure of social anxiety also correlated significantly with the three relationship measures and these associations held for emotional expression and self-disclosure after controlling for levels of dysphoria. People with social phobia report reduced quality within their romantic relationships, which may have implications for impairment, social support and ultimately maintenance of the disorder.
This chapter describes a refinement and extension of the self-presentational theory of social anxiety, which explains social anxiety in terms of people's concerns with the impressions that other people are forming of them. Theoretical developments involving the need for belonging and acceptance demonstrate precisely why people worry so much about what other people think of them, identify the conditions under which such concerns do and do not cause people to feel socially anxious, and link social anxiety to the processes by which people assess the degree to which they are relationally valued by others. The revised self-presentational theory also explains the behaviors that accompany social anxiety and offers implications for clinical treatment of socially anxious clients.
This article elaborates a view of anxiety as deriving from a basic human need to belong to social groups. Anxiety is seen as a pervasive and possibly innately prepare form of distress that arises in response to actual or threatened exclusion from important social groups. The reasons groups exclude individuals (incompetence, deviance or immorality, and unattractiveness) therefore should all be linked to anxiety, and events that implicate the self as incompetent, guilty, or unattractive should create anxiety. This "exclusion theory" of anxiety can be considered a broader revision of separation anxiety theory and is distinguished from theories that base anxiety on fear of death, fear of castration, and perception of uncertainty. Current evidence from multiple sources is reviewed to show the explanatory power and utility of exclusion theory, and implications of this theory are developed in relation to culturally changing standards of sexual behaviour, the motivations underlying the Oedipus complex, and the formation and functions of the self.
Diminished positive experiences and events might be part of the phenomenology of social anxiety; however, much of this research is cross-sectional by design, limiting our understanding of the everyday lives of socially anxious people. Sexuality is a primary source of positive experiences. We theorized that people with elevated social anxiety would have relatively less satisfying sexual experiences compared to those who were not anxious. For 21 days, 150 college students described their daily sexual episodes. Social anxiety was negatively related to the pleasure and feelings of connectedness experienced when sexually intimate. The relationship between social anxiety and the amount of sexual contact differed between men and women-it was negative for women and negligible for men. Being in a close, intimate relationship enhanced the feelings of connectedness during sexual episodes for only individuals low in social anxiety. Depressive symptoms were negatively related to the amount of sexual contact, and the pleasure and feelings of connectedness experienced when sexually intimate. Controlling for depressive symptoms did not meaningfully change the social anxiety effects on daily sexuality. Our findings suggest that fulfilling sexual activity is often compromised by social anxiety.
Previous findings suggest that social anxiety disorder may be best characterized as having a dimensional latent structure (Kollman et al., 2006; Weeks et al., 2009). We attempted to extend previous taxometric investigations of social anxiety by examining the latent structure of social anxiety disorder symptoms in a large sample comprised of social anxiety disorder patients (i.e., putative taxon members) and community residents/undergraduate respondents (i.e., putative complement class members). MAXEIG and MAMBAC were performed with indicator sets drawn from a self-report measure of social anxiety symptoms, the Social Interaction Phobia Scale (Carleton et al., 2009). MAXEIG and MAMBAC analyses, as well as comparison analyses utilizing simulated taxonic and dimensional datasets, yielded converging evidence that social anxiety disorder has a taxonic latent structure. Moreover, 100% of the confirmed social anxiety disorder patients in our overall sample were correctly assigned to the identified taxon class, providing strong support for the external validity of the identified taxon; and k-means cluster analysis results corroborated our taxometric base-rate estimates. Implications regarding the conceptualization, diagnosis, and assessment of social anxiety disorder are discussed.
Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples.
We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions.
Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges's g = 0.63) and mood symptoms (Hedges's g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges's g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up.
These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.
Cognitive models of social anxiety suggest that fear of negative evaluation (FNE) is the central cognitive dimension underlying the disorder. The Fear of Positive Evaluation Scale (FPES; Weeks, Heimberg, & Rodebaugh, 2008) was recently developed to assess an additional cognitive dimension purported to underlie social anxiety disorder (SAD), but its psychometric properties have yet to be examined in clinical populations. The present study, with 133 treatment-seeking patients, examined the applicability of the FPES with a clinical sample. Results indicated that the FPES was factorially distinct from a measure assessing FNE, and patients with SAD (n=51) had higher mean scores on the FPES than patients with other anxiety disorders (n=82). The FPES also showed adequate reliability (internal consistency), good convergent and discriminant validity, acceptable criterion-related validity in predicting social interaction anxiety symptoms, and appropriate sensitivity to treatment. The FPES appears to have good psychometric properties and is a promising new assessment tool for better understanding SAD.