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The Relationship Between Daily Hassles and Sexual Function in Men and Women
Journal of Sex & Marital Therapy
Abstract
Abstract Psychological stressors can interfere with sexual functioning through both psychological and physiological mechanisms. Chronic stress, in particular, seems to have a negative effect on sexual functioning for both men and women. The present study was designed to identify categories of stressors that contribute to sexual difficulties as well as assess the role of anxiety and depression in the relationship between stress and sexual function. Participants were recruited for an online survey in which they completed questionnaires on daily stressors, anxiety, depression, and sexual functioning. Results indicated that daily stressors predicted lower scores on sexual satisfaction for men and women, and sexual activity for women. These effects were mediated by scores on the depression scale. Daily stressors, depression, and anxiety were highly correlated. A factor analysis of stressors resulted in 5 distinct categories of stressors. Of these, Financial Stressors and Low Socioeconomic Status (SES)-related stressors were related to lower scores on all aspects of sexual functioning for women, but not for men. Women's sexual functioning scores were more strongly related to stress and depression than men's scores. Results suggest that contextual factors, such as daily stressors and depression, are important considerations when assessing problems with sexual functioning.
... The impact of external stressors on human sexuality has been a subject of significant scholarly exploration, with a particular focus on the decline in sexual desire and behavior (Bodenmann et al., 2006(Bodenmann et al., , 2010Hamilton & Meston, 2013). While stress-related decreases in sexual activity are welldocumented in the literature (Hamilton & Julian, 2014;ter Kuile et al., 2007), the question of how war, a unique and extreme form of stress, is associated with the intimate lives of civilians remains a complex and understudied area. We sought not only to observe changes in sexual behavior during times of war but, crucially, to understand the underlying reasons behind these changes. ...
... During times of war, the anticipation of a decrease in dyadic sexual behaviors, masturbation, and pornography use is grounded in the well-established connections between stress, trauma, and changes in intimate behaviors (Bodenmann et al., 2006(Bodenmann et al., , 2010Hamilton & Julian, 2014;Hamilton & Meston, 2013;Yehuda et al., 2015). The pervasive and intense stressors associated with wartime conditions often lead to heightened anxiety, fear, and a focus on basic survival needs. ...
... Additionally, less than 10 percent indicated an increase in their sexual behaviors. This natural response to stress aligns with findings from prior studies (Bodenmann et al., 2006(Bodenmann et al., , 2010Hamilton & Julian, 2014;Hamilton & Meston, 2013;ter Kuile et al., 2007). The appearance of a limited percentage reporting an increase in sexual frequency, with an even smaller fraction noting a significant increase, hints at a nuanced reaction to the stressors linked to the ongoing crisis. ...
... College closures have created challenges for young adults' sexual and relationship development, such as difficulty obtaining confidential health care and decreases in privacy for those living with families (Lindberg et al., 2020). Additionally, major stressors like those experienced during the pandemic are known to affect sexual desire and satisfaction (Bodenmann et al., 2006(Bodenmann et al., , 2010Hamilton & Julian, 2014;Raisanen et al., 2018;Tavares et al., 2019). ...
... This prediction stems from effects of stress at physiological, cognitive, and relational levels: stress can inhibit the hypothalamic-pituitary-gonadal axis important for sexual response (Sapolsky, 2005), increase cognitive distractions that interfere with sexual experiences (Hamilton & Meston, 2013), and impair the quality of dyadic coping and communication between partners (Bodenmann et al., 2007;Yurkiw & Johnson, 2021). Stress can also contribute to feelings of depression or anxiety; research consistently suggests that depression is a risk factor for sexual problems including low desire, whereas findings on anxiety are more mixed Bancroft, Janssen, Strong, Carnes, et al., 2003;Carvalheira et al., 2014;Graham et al., 2004;Hamilton & Julian, 2014;Lykins et al., 2006;Nobre & Pinto-Gouveia, 2006;O'Loughlin et al., 2020). ...
... In line with the above predictions, past research generally suggests negative links between perceived stress and dyadic sexual desire (Abedi et al., 2015;Bodenmann et al., 2006;Tavares et al., 2019;cf. van Lankveld et al., 2021), or between perceived stress and related variables such as sexual satisfaction or arousal (Bodenmann et al., 2010;Hamilton & Julian, 2014;Hamilton & Meston, 2013). However, findings are nuanced: for example, Raisanen and colleagues (2018) found that higher perceived stress predicted lower dyadic desire for women but higher dyadic desire for men. ...
The COVID-19 pandemic resulted in unprecedented stressors for college students, and minority stress faced by LGBTQ+ college students has been exacerbated by the pandemic. Associations between stress and sexual desire are complex, but research suggests that stress may be associated with higher solitary sexual desire and lower dyadic sexual desire. The current study examined associations between sexual desire and a multidimensional measure of pandemic stress among LGBTQ+ and cisgender, heterosexual (cis-het) college students. Participants (N = 377, 57% LGBTQ+) completed an online survey during the Spring 2021 semester that included the Sexual Desire Inventory and a multidimensional COVID Stress Measure. LGBTQ+ students reported higher stress in multiple domains—isolation, academics, living situation, concerns about racism and prejudice, and health care access—relative to cis-het students. For LGBTQ+ and cis-het students, higher overall COVID stress, as well as higher stress related specifically to isolation and to the virus itself, were associated with higher solitary and dyadic sexual desire. Greater concern about racism and prejudice during the pandemic was associated with higher solitary sexual desire, especially for LGBTQ+ students. Our findings underscore the importance of sexuality as a means of seeking connection during an event that disrupted college students’ lives in many ways. We highlight implications for university professionals, particularly the need to support LGBTQ+-affirming organizations, mental health resources, and sexual health resources as students return to college campuses.
... Ten articles documented non-significant associations between socioeconomic and sexuality measures, De Graaf et al., 2015;Galinsky & Sonenstein, 2011;Hamilton & Julian, 2014;Hidalgo & Dewitte, 2021;Kontula & Miettinen, 2016;Mitchell et al., 2013;Traeen et al., 2018;Wikle et al., 2020), although seven also included positive associations De Graaf et al., 2015;Hamilton & Julian, 2014;Kontula & Miettinen, 2016;Mitchell et al., 2013;Traeen et al., 2018;Wikle et al., 2020). Three of these seven reported significant findings among women but not men, or vice versa (Castellanos-Torres; Hamilton; Wilke). ...
... Ten articles documented non-significant associations between socioeconomic and sexuality measures, De Graaf et al., 2015;Galinsky & Sonenstein, 2011;Hamilton & Julian, 2014;Hidalgo & Dewitte, 2021;Kontula & Miettinen, 2016;Mitchell et al., 2013;Traeen et al., 2018;Wikle et al., 2020), although seven also included positive associations De Graaf et al., 2015;Hamilton & Julian, 2014;Kontula & Miettinen, 2016;Mitchell et al., 2013;Traeen et al., 2018;Wikle et al., 2020). Three of these seven reported significant findings among women but not men, or vice versa (Castellanos-Torres; Hamilton; Wilke). ...
... Sexual satisfaction: Lower levels of general sexual satisfaction were associated with lower household income (Amiri et al., 2020;Babayan et al., 2018;Bancroft et al., 2011;Do et al., 2018;Jamali et al., 2018), perceived income insufficiency (Afzali et al., 2020), and economic pressures (Wikle et al., 2020) and stressors (for women but not men, Hamilton & Julian, 2014). Casique (2020) documented a significant association between higher income and satisfaction with first sexual intercourse experiences among young men, but not young women. ...
Sexual health includes positive aspects of sexuality and the possibility of having pleasurable sexual experiences. However, few researchers examine how socioeconomic conditions shape sexual wellbeing. This paper presents the concept of "erotic equity," which refers to how social and structural systems enable, or fail to enable, positive aspects of sexuality. In part one, we use this concept to consider potential pathways through which socioeconomic conditions, especially poverty, may shape sexuality. Part two builds from this theoretical framework to review the empirical literature that documents associations between socioeconomics and sexual wellbeing. This narrative review process located 47 studies from more than 22 countries. Forty-four studies indicated that individuals who reported more constrained socioeconomic conditions, primarily along the lines of income, education, and occupation, also reported poorer indicators of sexual wellbeing, especially satisfaction and overall functioning. Most studies used unidimensional measures of socioeconomic status, treating them as individual-level control variables; few documented socioeconomics as structural pathways through which erotic inequities may arise. Based on these limitations, in part three we make calls for the integration of socioeconomic conditions into sexuality researchers' paradigms of multi-level influences on sexuality.
... Everyday life stressors also have a negative impact. [16][17][18] Midlife women may be caring for children of their own, may have adult children return home, and/or be caring for aging parents. 18 Job-related stress and financial concerns are also common. ...
... [16][17][18] Midlife women may be caring for children of their own, may have adult children return home, and/or be caring for aging parents. 18 Job-related stress and financial concerns are also common. 18 Providers should be attuned to the effects of life stressors and work with women to develop stress reduction strategies, such as mindfulness meditation. ...
... 18 Job-related stress and financial concerns are also common. 18 Providers should be attuned to the effects of life stressors and work with women to develop stress reduction strategies, such as mindfulness meditation. ...
... Perceived stress refers to the degree to which a person appraises their life situations as stressful, overwhelming, unpredictable, and/or uncontrollable . Perceived stress from life events influences women's sexual functioning (Basson et al., 2019;Hamilton & Julian, 2014;Hamilton & Meston, 2013). For example, a study by Hamilton and Meston, (2013) found that women with high chronic stress experienced lower genital sexual arousal. ...
... Accordingly, they experienced less optimal sexual functioning. Several studies reported associations between women's psychological and sexual functioning (Basson et al., 2019;Hamilton & Julian, 2014;Hamilton & Meston, 2013;Maru et al., 2019). This study confirms similar relationships between these variables in a sample of Black women. ...
Objectives
This study examined the mediating role of sexual mindfulness on the relationship between indicators of Black women’s psychological functioning and sexual functioning.
Method
A total of 448 Black women (82% Black American, Mage = 34, SD = 8.71) completed an online survey between January and February of 2023. Self-report measures were demographic information, sexual functioning, indicators of psychological functioning (i.e., psychological distress, perceived stress, and post-traumatic stress symptoms), and sexual mindfulness (comprised of mindful awareness and mindful non-judgment during sex). Data analysis consisted of descriptives and frequencies, bivariate correlations, and mediation analysis.
Results
We observed a significant indirect effect of (1) psychological distress on sexual function via mindful awareness (B = -0.06, β = -0.07, CI = -0.10, -0.02) and mindful non-judgment (B = -0.06, β = -0.08, CI = -0.10, -0.03) during sex; and (2) perceived stress on sexual functioning via mindful awareness (B = -0.07, β = -0.09, CI = -0.13, -0.03) and mindful non-judgment (B = -0.05, β = -0.06, CI = -0.09, -0.02) during sex. Regarding post-traumatic stress, only mindful non-judgment during sex mediated the relationship between sexual functioning and intrusive symptoms (B = -0.18, β = -0.04, CI = -0.37, -0.04), avoidance-based symptoms (B = -0.25, β = -0.03, CI = -0.47, -0.06), and hypervigilance (B = -0.21, β = -0.03, CI = -0.44, -0.04).
Conclusions
Findings suggest that interventions aimed at enhancing sexual mindfulness could benefit Black women’s psychological and sexual functioning, providing valuable insights for sex therapists working with this population and researchers interested in the benefits of mindfulness-based interventions.
Preregistration
This study is not preregistered.
... Furthermore, in our measure of extradyadic stress, we used a questionnaire asking about stress levels in different life domains. Nevertheless, specific stressors (financial stressors and stressors related to social, health, and environmental factors) are related to lower levels of sexual functioning in women but not in men (Hamilton & Julian, 2014). In addition, previous research has revealed that depression mediates the link between stress and sexual functioning (Hamilton & Julian, 2014). ...
... Nevertheless, specific stressors (financial stressors and stressors related to social, health, and environmental factors) are related to lower levels of sexual functioning in women but not in men (Hamilton & Julian, 2014). In addition, previous research has revealed that depression mediates the link between stress and sexual functioning (Hamilton & Julian, 2014). Hence, stressors that are linked with increased depressive symptoms may impact sexual activity and function more so than others. ...
Sexuality is integral to most romantic relationships. Through stress spillover, however, factors such as individually experienced stress outside of the relationship (i.e., extradyadic stress) can negatively impact sexuality. In this study, we explored how a possible (mis)matching of both partners' levels of extradyadic stress is related to sexual activity and tested for gender differences. Analyzing 316 mixed-gender couples from Switzerland, we employed Dyadic Response Surface Analysis to assess how extradyadic stress is associated with sexual activity. Our results showed that extradyadic stress was positively linked to sexual activity for women (in general) and men (in the case of matching stress levels). As this result was surprising, we conducted additional exploratory analyses and split the measure of sexual activity into (1) exchange of affection and (2) eroticism (petting, oral sex, and intercourse) and controlled for age. Results from this second set of analyses showed that for women, matching stress levels were associated with higher exchange of affection, whereas men’s exchange of affection was higher if men reported higher stress levels than women. Notably, after accounting for age, the link between stress and eroticism dissipated. Our findings suggest that exchange of affection may serve as a coping mechanism for stress, with gender influencing this dynamic. However, future research investigating stress and sexual activity should consider additional factors such as age, relationship satisfaction, stressor type, and stress severity.
... CRH has been shown to have an adverse regulatory effect on Leydig cells, decreasing testosterone biosynthesis [45][46][47][48]. Multiple studies reported that stress could lead to a decrease in sexual desire and transient impotence in men, potentially due to the release of a brain chemical that constricts the smooth muscle of the penis and its arteries [49][50][51][52]. In the present study, decreased testosterone levels (P<0.001) and sexual desire compared to the control group may indicate a similar effect. ...
... The decreased sperm count has been attributed to decreased reproductive hormones secreted by the hypothalamic-pituitary-testicular axis and associated with testosterone, gonadotropin-releasing, follicular stimulating, and luteinizing hormones [50]. In addition, changes in sperm viability due to changes in the microenvironment in the epididymis and increased LPO are unfavorable to the normal state of sperm [36]. ...
Background: Infertility is a significant public health issue, but its impact on quality of life and treatment
efficacy is limited. Modern medicine lacks safe and effective drugs for male infertility, while traditional
medicine has explored herbal extracts like Oxitard, which contains multiple extracts and oils. This study
aimed to investigate the effects of Oxitard on male rats exposed to swimming (SW) stress.
Methods: Albino rats weighing 220-250 g were divided into five groups: control, SW stress, and SW treated
with Oxitard at low, medium, and high doses of 250, 500, and 750 mg/kg/day, respectively. The rats were
subjected to SW stress for 15 days and then assessed for body weight, reproductive organ weight,
testosterone, antioxidant status, sperm function, and histological changes in the testes, seminal vesicles,
and vas deferens.
Results: The results showed that SW stress significantly reduced body weight, seminal vesicle weight,
testosterone levels, superoxide dismutase (SOD), catalase (CAT), sperm count, sperm motility, sperm
viability, and significantly increased malondialdehyde (MDA) levels. The testes of the SW-stress group rats
also showed a significant decrease in spermatogenesis and the number of seminiferous tubules containing
sperm. In contrast, treatment with Oxitard, especially at the highest dose, demonstrated potent free radical
scavenging activity, recovering antioxidant status, and sperm function.
Conclusion: SW stress led to decreased sperm function, antioxidant status, and increased lipid peroxidation
(LPO) in male rats. Oxitard treatment, particularly in high doses, showed a potential role as a free radical
scavenger in treating oxidative stress (OS)-associated male infertility. Further studies are needed to
investigate the individual components of Oxitard and conduct clinical trials in human subjects.
... Whereas the effects of chronic and major life event stress on other important life aspects have been studied more extensively in gay men e.g., [23][24][25], strikingly little research has been conducted into the influence of daily stress on the sexual functioning of gay men in long-term relationships. Most prior research on the associations of daily stress and sexual functioning has been conducted in men and women in long-term mixed-sex relationships [15,[26][27][28]. In these populations, daily stress is robustly associated with sexual problems [26], specifically with an undesirably low level of sexual interest and low frequency of sexual activity [29]. ...
... Among heterosexual women, Abedi and colleagues [33] found a similar negative association between daily stress and sexual desire, whereas a positive association was found between daily stress and sexual desire in a study among men and women [34]. Sexual functioning in women was found to be more responsive to daily stressors, compared to men [28]. There is increasing evidence suggesting that being in a same-sex relationship does make a difference in this respect [23,35]. ...
We investigated the associations between daily stress, sexual desire and intimacy in gay men in long-term relationships. A daily diary method of data collection was used. Twenty-two adult participants completed brief questionnaires ten times per day during seven consecutive days. Multilevel regression analyses revealed significant negative associations of daily stress with sexual desire (p = 0.003); higher stress came with lower levels of sexual desire, and vice versa. The hypothesized moderation effect of the associations of stress with sexual desire by intimacy was found significant (p = 0.003). However, the effect was not as predicted: at higher levels of intimacy the negative effect of stress on sexual desire was shown to be stronger than at lower levels. Most temporal associations of stress and intimacy with sexual desire were not significant. Nevertheless, the present findings implicate that daily stress and intimacy are important factors in sexual functioning of gay men in long-term relationships.
... Psychological stressors are known factors that interfere with sexual function through both psychological and physiological mechanisms. 20 In particular, chronic stress has been described to have negative effects on sexual function in men. 20 Previous studies associated high levels of chronic stress with a decrease in sexual desire. ...
... 20 In particular, chronic stress has been described to have negative effects on sexual function in men. 20 Previous studies associated high levels of chronic stress with a decrease in sexual desire. 12 The COVID-19 pandemic and the associated anti-COVID-19 measures could very well be regarded as psychological stressors. ...
Introduction
The COVID-19 pandemic drastically altered the way of life around the world. Due to social distancing measures, contact restrictions and fears of infection, social life has changed significantly. These measures along with the stressors associated with the current worldwide situation, will inevitably have an effect on people's interpersonal and personal behaviors.
Aim
This study evaluates the effect the COVID-19 pandemic and nationwide German lockdown had on the sexual behavior of cis men.
Methods
An anonymous nationwide web-based questionnaire was conducted among cis men in Germany during the first COVID-19 home isolation (April 20, 2020–July 20, 2020). The questionnaire was distributed via e-mail, online chats and social-media platforms.
Main Outcome Measures
Data was collected on general characteristics including demographics and socio-economic backgrounds. To evaluate sexual health, questions from the Sexual Behavior Questionnaire were included.
Results
523 cis male participated. 414 met the inclusion criteria. Most were heterosexual (n = 248, 59.9%; vs homosexual n = 97, 23.4%; vs bisexual n = 69, 16.7%). 243 (59%) were employed, 153 (37.1%) were students and 16 (3.9%) were unemployed. Most of the participants reported an annual income lower than 75.000€. During the lockdown, average weekly frequency of sexual intercourse and masturbation was increased in all groups. Consistently, a significant rise of higher satisfaction with the frequency of sexual contacts during the quarantine was observed (P < .05). Furthermore, the level of sexual arousal increased significantly in all groups (P < .0005). Capability to enjoy sexual intercourse or masturbation increased significantly in heterosexual (P < .0005) and homosexual men (P < .005). Bisexual participants showed a significant increase in general satisfaction with sexual life (P < .05) and a significant decrease in satisfaction in relationship or single life (P < .05). Positive confounders in the changing of sexual behavior during the COVID-19 pandemic were: Being in a relationship or being single, parenthood and being employed.
Conclusion
Our study firstly describes how COVID-19 pandemic related restrictions and social distancing measurements altered sexual behavior amongst cis male in Germany. Further studies, including sexual minorities specifically, are needed to clarify if the behavior in the first German nationwide quarantine has persisted or transformed as the pandemic proceeded. Mumm J-N, Vilsmaier T, Schuetz JM, et al. How the COVID-19 Pandemic Affects Sexual Behavior of Hetero-, Homo-, and Bisexual Males in Germany. Sex Med 2021;XX:XXXXXX.
... However, literature indicated that psychological stressors may interfere with sexual function through psychological and physiological mechanisms. Hamilton and Julian (2014) indicated that daily stressors predicted lower scores on sexual satisfaction and sexual activity and that daily stressors, depression, and anxiety were highly correlated with one another. Additionally, older adults with high levels of daily hassles were at an increased risk of dying early, and were more exposed to serious life events (e.g., diseases, incapacity and losing a loved one) (Aldwin et al., 2014). ...
... Additionally, research has reiterated both negative and restrictive attitudes regarding sexuality among old adults (Gott, 2005;Hinrichs & Vacha-Haase, 2010). Moreover, financial stressors and stressors related to low socioeconomic status were related to lower scores on a number of aspects of sexual functioning, in particular for women (Hamilton & Julian, 2014). ...
Objectives: To analyze the contributors to Sexual Unwellness (SU) and to explore the latent constructs that can work as major determinants in SU for a cross-national older community-dwelling population.Methods: Study design: Complete data were available for 109 English and Portuguese older adults, aged between 65 and 87 years old (M=70.1, SD=5.99). Data was subjected to content analysis. Representation of the associations and latent constructs were analyzed by a Multiple Correspondence Analysis. A socio-demographic and health questionnaires were completed, assessing participants’ background information. Interviews were completed, focused on the contributors to SU.Results: The most frequent response of these participants was “lack of intimacy and affection” (25.1%) whereas “poor sexual health” was the least referred indicator of SU (11.2%). A two-dimension model formed by “poor affection, intimacy and sexual health”, and “poor general health and financial instability” was presented as a best-fit solution for English older adults. SU for Portuguese older adults were explained by a two-factor model: “daily hassles and health issues”, “poor intimacy and financial instability”.Conclusions: These outcomes uncovered the perspective of older adults concerning SU and the need of including these factors when considering the sexual well-being of older cross-national samples.
... Early research on stress predominantly concentrated on life-event stress, which can considerably affect an individual's daily routine [60][61][62]. However, since the 1990s, daily hassles, though they may not seem as severe as other types of stress, have been recognized as contributing factors that increase the likelihood of chronic stress, leading to more significant negative impacts on personal health compared with major life events [28,[63][64][65][66][67][68][69][70][71][72]. In this study, daily hassles are operationally defined, based on previous research, as "stress commonly experienced by individuals in everyday life". ...
This study aims to evaluate the restorative effects of walking tourism by investigating the influence of the perceived restorativeness of walking tourist attractions on recovery experience and satisfaction with walking tourism. Additionally, the study aims to determine any significant differences based on levels of daily hassles and types of walking tourist attractions as moderating variables. An online survey was conducted among walking tourists, focusing on Bukhansan National Park (mountainous), Haeparang Coastal Road and Namparang Coastal Road (coastal), and urban walking destinations, resulting in 330 valid responses. Results reveal that perceived restorativeness (being away, compatibility, fascination, coherence, and legibility) had a partially positive effect on recovery experience (restoration and emotional separation). Furthermore, recovery experience positively influenced walking tourism satisfaction. A multiple-group analysis indicated that, although no significant differences were found in the influence of perceived restorativeness on recovery experience based on daily hassle levels, the relationship between recovery experience and walking tourism satisfaction varied significantly depending on daily hassle levels. Additionally, the effects of perceived restorativeness on recovery experience and the impact of recovery experience on walking tourism satisfaction differed significantly among urban, mountainous, and coastal tourist attractions. These results provide valuable insights into the restorative effects of walking tourism and offer practical implications for tourism-related businesses, local governments, and managers.
... However, it is widely recognized that MS are at high risk of experiencing increased levels of stress, depression, and anxiety symptoms (Dyrbye et al., 2006). These symptoms are also commonly associated with CSB (Schultz et al., 2014;Ciocca et al., 2022;Walton et al., 2017;Reid et al., 2014) and SFP (Gonçalves et al., 2023;Hamilton and Julian, 2014;Velurajah et al., 2022). Previous research suggests that the presence of sexuality-related problems can be a risk factor for developing and maintaining harmful substance use, which is especially important to emphasize in this connection, as physicians are a vulnerable group for developing problematic substance use patterns and substance dependencies (Dyrbye et al., 2006). ...
Sexual problems relevant to psychotherapy, such as compulsive sexual behavior (CSB) and sexual functioning problems (SFP), have been related to harmful substance use in several studies. Substance use is prevalent among medical students (MS) and is often considered a maladaptive coping strategy for stress, as well as a risk factor for mental health issues. Sexual problems and substance use share trauma exposure and post-traumatic symptoms as risk factors for their development. This study aimed to explore the interaction effects between problematic sexual behaviors, substance use, and trauma among German MS. A cross-sectional study (n = 359; 69% women, 29% men) was conducted using an online questionnaire. MS at a German university were recruited via email. CSB (CSBD-19), SFP (SBQ), harmful alcohol (AUDIT) and drug use (DAST), childhood trauma exposure (CTQ), and current post-traumatic symptoms (IES-R) were assessed. Multivariate linear and ordinal regressions, as well as path analyses, were conducted to investigate associations between the study variables. CSB was identified in 3% of all MS. The most commonly reported SFPs were decreased sexual desire and difficulties achieving orgasms among women and premature ejaculation among men. Higher CSBD scores were predicted by male sex, elevated AUDIT scores, and increased frequencies of hyperarousal (IES-R). Path analyses revealed associations between the severity of emotional/sexual abuse, the intensity of post-traumatic symptoms, and both CSBD and AUDIT scores. Among female MS, less severe emotional abuse and more severe physical abuse in childhood predicted higher frequencies of orgasmic difficulties. The frequency of SFPs was correlated with the use of benzodiazepines among female MS, with cannabis and MDMA/ecstasy among male MS, and with cocaine/crack, speed, and AUDIT among both sexes. No interaction effects were found between SFPs, substance use, or trauma-related factors in the path analyses. To some extent, there appears to be a relationship between substance use, childhood trauma exposure, and currently persisting post-traumatic symptoms with problematic sexual behaviors among MS. However, further research is required to explore these relationships in greater depth and to identify the underlying pathways. Mental health support measures should incorporate the factors of sexuality, substance use, and trauma while also exploring their relationships with workload, career-related anxieties, and other curriculum-related factors.
... Their research indicated that improvements in marital quality were linked to decreases in sexual distress over a four-year period. Conversely, research indicates that daily stressors related to financial strain are associated with lower levels of sexual function [42]. ...
Objectives
The impact of sexual intimate partner violence (SIPV) on female genital self-image and sexual distress is not well understood. We aimed to assess whether women with and without SIPV experiences differed in terms ofgenital self-image and sexual distress.
Methods
An online survey was conducted among married, reproductive-age women registered at healthcare centers in Amol, northern Iran. A total of 722 eligible women completed the survey between March and June 2022. Genital self-image and sexual distress were measured using the Female Genital Self-Image Scale (FGSIS) and the Female Sexual Distress Scale-Revised (FSDS-R), respectively.
Results
Overall, 28.7 % of the women reported experiencing SIPV. Independent t-tests revealed significant differences between the SIPV and non-SIPV groups in mean FGSIS and FSDS-R scores (21.18 ± 3.92 vs. 21.91 ± 3.76, p = 0.002 and 13.18 ± 11.45 vs. 7.54 ± 9.75, p < 0.001, respectively). In multivariate regression analysis, income satisfaction remained independently associated with both FGSIS and FSDS-R scores. Age and having a child were associated with FGSIS, while SIPV experience was only associated with FSDS-R.
Conclusion
Women with SIPV experiences had lower mean FGSIS scores and higher mean FSDS-R scores than those without such experiences. However, in multivariate analysis, only the FSDS-R score remained significantly associated with SIPV experience.
... Chronic stress negatively impacts sexual function (186,187). Patients with GI disorders share the same risks as any individual (e.g., work, family, current events), with the addition of the stress of living with a chronic condition. Stress, GI illness, and SD are likely interrelated in many GI patients. ...
... Thus, it is plausible that the results may have been different if the participants were in their sexual prime (e.g., mid-twenties). In addition, numerous research studies have shown that under high-stress situations, both female and male sex drives decrease [51][52][53]. Thus, it is possible that the intensity of the harsh environment scenario stories used in this study could lead to a decrease in product desire for both females and males. ...
Both biological and environmental factors can affect consumer behavior. Consumer behavior can also be a product of an interaction between one’s evolved biology and environmental factors. If marketers aim to increase healthy consumption behavior and decrease unhealthy behavior, they need to identify whether the behavior is a product of one’s evolved biology or environmental factors acting in isolation, or if the behavior is a product of a biology–environment interaction. Therefore, the purpose of this study is to examine the effect of biology–environment interactions on product desire. This study comprises two experiments that used a repeated-measures design. The first experiment included 315 females and examined the effect of perceived physical safety, economic well-being, and social support on the desire for beautifying and wealth-signalling products. The second experiment included 314 men and examined the effect of perceived physical safety, economic well-being, and social support on the desire for products that are used to signal wealth and toughness. The results showed that under harsh economic conditions, product desire generally decreased. However, there were significant differences in the amount of decrease between product categories in different environmental conditions.
... Though Wesche et al. (2020), Hamilton et al. (2014), Lew-Starowicz et al. ...
The study aimed to investigate the potential connection between negative emotional states (NES) and sexual behavior (SB) among engineering students at Rizal Technological University - Boni Campus. The researchers used a quantitative and descriptive correlational design, employing purposive sampling to select participants. The study explored how negative emotional states in the categories of depression, anxiety, and stress impact a person's sexual behavior. The results yielded in using Spearman Rho indicated that there are no significant correlations between sexual behavior and depression (rs(352) = -0.005, p = 0.923) or anxiety (rs(352) = -0.009, p = 0.859). Similarly, the correlation between stress and sexual behavior (rs (352) = 0.040, p = 0.452) was found to be negligible and non-significant, indicating that the relationship between the two variables is not very strong. So as the strength of the variables are mentioned to be very weak or negligible, this may imply that the variations in sexual behavior do not appear to be strongly linked towards changes in negative emotional states of the respondents. The obtained p-values were above the set alpha level of 0.05, indicating that the researchers failed to reject the null hypothesis of the study concluding that there is no significant relationship between the respondents’ Negative Emotional State and Sexual Behavior. This may suggest that factors other than sexual behavior may be more influential in determining an individual's negative emotional states. Further research may be needed to explore these alternative factors and their impact on negative emotional states and on sexual behavior as well.
... Numerous studies have identified stress as a significant factor associated with lower sexual functioning (Basson et al., 2019;Hamilton & Julian, 2014;Traeen et al., 2007), negatively impacting sexual arousal as measured The improvement in HPA regulation, as measured by the steeper diurnal slope observed after both treatments at 6 months, was no longer statistically significant at the 12 month follow-up. By contrast, the improvement in both perceived stress and sexual desire (Brotto et al., 2021) were maintained at the 12-month follow-up. ...
Low desire in women is the most common sexual difficulty, and stress has been identified as a significant predictor of symptoms. We evaluated a mindfulness-based cognitive therapy (MBCT) group treatment versus a sex education comparison group treatment (STEP) on self-reported stress and on the physiological stress response measured via morning-to-evening cortisol slope in 148 women with a diagnosis of sexual interest/arousal disorder (SIAD). Perceived stress decreased following treatment in both groups, and significantly more after MBCT. The cortisol slope was steeper (indicative of better stress system regulation) from pre-treatment to 6-month follow-up, with no differences between the groups. As an exploratory analysis, we found that the reduction in perceived stress predicted increases in sexual desire and decreases in sex-related distress for participants after MBCT only. These findings suggest that group mindfulness targeting women with low sexual desire leads to improvements in self-reported and physiological stress, with improvements in self-reported stress partially accounting for improvements in sexual desire and distress.
... For example, mixed-gender samples in the United Kingdom (Wignall et al. 2021) and Egypt (Omar et al. 2021) reported more significant declines in sexual desire and heightened sexual stress for women than for men during the pandemic. These results were consistent with earlier findings from Hamilton and Julian (2014) showing that daily stressors were related to lower sexual satisfaction for both men and women, though women's sexual functioning was more strongly related to stress and depression than men's. Thus, we expect gender that has played a primary role in moderating contextual effects on sexual satisfaction trajectories during the COVID-19 pandemic. ...
The recent global pandemic provides a natural experiment “intervention” to examine how differing baseline social dynamics such as gender, education, and politics shaped diverging patterns of well-being during rapidly shifting societal conditions. Using married adults from a nationally representative panel study in the United States from August 2019 to August 2021, discontinuous growth curves reveal a large drop in average married sexual satisfaction in both quality and frequency directly following the pandemic onset. Moreover, sexual satisfaction remained largely suppressed for the subsequent 18 months, apart from a brief “optimism blip” in the fall of 2020. Race, age, income, employment, parenthood, education, and political affiliation all appear as meaningful predictors, but these differ across various phases of the pandemic and by gender. These results reveal evidence of lingering changes in subjective sexual well-being as well as patterns of catastrophe risk and resilience moderated by social location factors.
... In fact, sharing fewer concerns worsened their sexual quality and contributed to a decreased frequency of sexual activity. Considering that sexual responses are disrupted by stressful experiences [57,58] and by disease avoidance motives [59], people more focused on prevention might have been more prone to disruptions in their sex life particularly when they felt their partner was not worried about the severity of the pandemic. ...
Research has shown mixed findings regarding the effect of the COVID-19 pandemic on relationship and sexual quality and activity. We argue that some of these findings might be understood considering people’s predisposition to maintain safety (i.e., prevention focus) or take risks (i.e., promotion focus), and sharing concerns with one’s partner about the pandemic. A longitudinal study (N = 153) tested if regulatory focus before the pandemic (November 2019) was associated with relationship quality, sexual quality, and joint sexual activity later on (June 2020) and whether these effects were moderated by shared concerns over the pandemic. Results showed that participants more focused on prevention experienced higher relationship quality later on, but also less sexual quality and less frequent joint sexual activity, when they shared fewer (vs. more) concerns with their partner. In contrast, participants more focused on promotion experienced higher relationship quality later on when they shared more (vs. less) concerns with their partner. These results indicate how individuals’ regulatory focus and shared concerns in times of crisis, such as the COVID-19 pandemic, can have downstream consequences on people’s relational and sexual dynamics. We offer insights for mental health professionals to improve psychosocial health and well-being when people are faced with critical events.
... According to Hamilton et al., stress and depression were strongly associated with sexual dysfunction in women. (26) In addition to the sexual dysfunction related depression, anxiety also leads to FSD in women. (27) In the study Burri et al. there was a strong genetic component between anxiety and SF and a relatively weaker genetic component between anxiety sensitivity and FSD. ...
Purpose:
To investigate the direct and indirect effects of demographic characteristics, relationship satisfaction, and psychological factors on female sexual distress (FSD) using path analysis.
Materials and methods:
This study was conducted in two stages. Initially we obtained the FSD predictor factor's conceptual model through a literature review and expert panel. In the Second stage, a population-based cross-sectional study on 207 non-pregnant and married women (without any age restriction) in Zanjan, Iran was conducted. FSDs-R, FSFI-6, DASS-21, and GEMREL Standard questionnaires and the demographic researcher-made questionnaire were used in this study. The data undergone path analysis based on the initial conceptual model.
Results:
Sexual function (SF) had the strongest relationship with FSD from the direct path (β = -.49) and overall effect (β = -.58). The highest indirect effect belonged to depression-anxiety-stress level (β = .284) mediated by SF (β = -.42) and relationships satisfaction with spouse (β = -.20). Age difference (β = -.13) and relationships satisfaction with spouse (β = -.19) had only a direct effect on FSD. Marriage Duration had only indirect effect on FSD through mediating role on SF (β = -.26) and depression-anxiety-stress level (β = -.15).
Conclusion:
Among the predictor factors investigated in this study, sexual dysfunction is the most important predictor of FSD. In addition; men older than their spouses, longer marriage duration, relationship dissatisfaction with the spouse and higher rate of depression-anxiety-stress have positive correlation with SD. Therefore, we should offer a combination of the mentioned factors in providing care for women with SD.
... Financial problems seem to be linked to a poor sexual functioning. Older people with a lower socioeconomical status, especially women, are more likely to rate their sexual performance as poor (Hamilton & Julian, 2014). Attitudes and beliefs towards aging can also impact older people's sex lives. ...
... Financial problems seem to be linked to a poor sexual functioning. Older people with a lower socioeconomical status, especially women, are more likely to rate their sexual performance as poor (Hamilton & Julian, 2014). Attitudes and beliefs towards aging can also impact older people's sex lives. ...
Objective
To analyze the perspectives of sexual unwellness (SU) of Portuguese and Slovenian older adults was the objective of this study. A qualitative research was carried out, in which these perceptions were analyzed at a cultural level.
Methods
The sample of this study consisted of 136 older participants, between 65 and 96 years of age. Participants were of two different nationalities and lived in the community. Participants were interviewed, and all interviews were carried out through the process of literal transcription and subsequent content analysis.
Results
Eight key mutually exclusive themes emerged from the interviews: unavailability of partner; traditional values; body restrictions; low self-esteem and well-being; poor social support; dissatisfaction with physical appearance; pain during sex; and difficulties meeting new people. Unavailability of partner was the most important theme (17.9%) for the studied sample and specifically among Portuguese participants. Conversely, difficulties meeting new people were the least reported theme (6.8%) for the entire sample. For Slovenians traditional values were most relevant with respect to feeling sexually unwell.
Conclusions
Older adults from two different countries reported diverse sexual experiences. Eight mutual-exclusive themes were extensively illustrated.
Policy Implications
These findings are evidence for cultural-adapted interventions and policy making in the context of older adults’ sexual well-being, particularly in terms of its relation with aging well.
... This aligns with recent research suggesting that health and relationship functioning contribute to associations between CST and sexual difficulties in adulthood [28,33]. In general, interrelationships among life stressors, relationship quality, and psychological health may facilitate sexual difficulties [29,73,74]. It is possible that CST further complicates these relationships through adverse effects on stress response processes and coping strategies [30,75,76]. ...
Research has linked childhood sexual trauma (CST) with adverse adult outcomes (AAOs) that span physical, psychological, and social domains of functioning. Differences in conceptualizing and measuring CST, however, have inhibited the examination of trauma-related variables hypothesized to impact adult outcomes. We used National Sexual Health Survey (NSHS; 1995–1996) data to examine trauma chronicity (i.e., duration) and AAOs (domains: physical and mental health, close relationships, and achievement). The NSHS (N = 6537, 18–70 years) assessed duration using perpetrator-specific CST reports. Adjusting for background characteristics, we examined CST duration in relation to AAOs and CST-related help-seeking. Approximately 8% of participants reported CST. Chronic (vs. single-exposure) CST survivors were at substantially higher risk of experiencing AAOs [i.e., mean AAOs and specific AAOs (e.g., physical and emotional health problems, divorce/separation, and poverty)]. CST had direct effects on sexual dysfunction and satisfaction, and on relationship stressors which may impact sexual relationship quality. Although 62% of CST survivors did not seek help, those with more chronic CST histories reported a higher prevalence of trauma-related help-seeking. Our work underscores the importance of examining CST chronicity in relation to long-term developmental outcomes. Chronicity assessment may be an important screening tool in the therapeutic context and in broader community screening efforts.
... Hamilton et al demonstrated that daily stressors predict lower scores in sexual satisfaction and sexual activity in women. 35 In contrast, a study on the influence of stress and depression on the quantity of sexual contacts found higher levels of frequency of sexual contacts in 18-to 20-year-old women with depression symptoms. 36 However, as a natural disaster, the COVID-19 pandemic creates anxiety and chronic stress, which causes poorer mental health and negatively influences sexual life. ...
Background: Preliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare.
Aim: The objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany.
Methods: An anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms.
Main Outcome Measures: Demographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected.
Results: A total of 1368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic.
Clinical Implications: The findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups.
Strengths & Limitations: This is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46.
Conclusion: This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises.
... One closely related recurring theory is that stress has a shared effect on sexual behaviour as well as sleep (Afsahri et al., 2018;Nozoe et al., 2014;Seehuus & Pigeon, 2018). There is abundant evidence regarding the effects of stress on sleep (Kalmbach et al., 2018;Kim & Dimsdale, 2007) and some evidence concerning its effects on sexual behaviour (Abedi et al., 2015;Hamilton & Julian, 2014;Randall & Bodenmann, 2009). This theory might be supported by those studies that found no direct correlation between sexual variables and sleep quality but found impaired sexual functioning or altered sexual risk behaviour in those who also experience worse sleep quality (Afsahri et al., 2018;Nozoe et al., 2014;Ogunbajo et al., 2020;Seehuus & Pigeon, 2018). ...
Prior research suggests that different types of touch can affect sleep, but whether there is a consistent association between tactile intimacy and sleep quality is unclear. Here, we report a pre-registered systematic review (International Prospective Register of Systematic Reviews [PROSPERO], CRD42020158683) of studies examining the association between tactile intimacy and sleep quality in healthy adults. The databases PsycINFO, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials and EMBASE were searched on August 7, 2020. A total of 13 studies met the inclusion criteria and were synthesised qualitatively. Most commonly, articles researched sexual intimacy in relation to sleep quality, but some studies also investigated non-sexual affective touch and emotionally neutral touch. Some evidence for a connection between sexual function, sexual satisfaction and masturbation with sleep quality was found; however, no evidence for an association between sexual frequency or sexual positions and sleep was found. Interestingly, studies employing more subjective approaches were more likely to report an association between touch and sleep, potentially highlighting a discrepancy between self-reported and the objectively measurable association between touch and sleep.
... Mindfulness-based therapy can also lessen women's tendency to evaluate their sexual responsiveness, which is tied to gendered sexual scripts that women must experience (or perform) arousal and pleasure or else fail to satisfy men partners (Cacchioni, 2007;Frith, 2013;Nicolson & Burr, 2003;Nobre & Pinto-Gouveia, 2008). Mindfulness-based therapy can also lessen women's tendency to follow distracting thoughts, many of which relate to the extensive chore lists that stem from prescriptive gender roles for women (Bodenmann et al., 2006;Hamilton & Julian, 2014;Hochschild & Machung, 1989;Sims & Meana, 2010). Accordingly, mindfulness-based therapy may be an effective treatment for low desire in women partnered with men-not because it fixes women's psychological problems, innate or not-but because it happens to address the negative side effects of gendered structures that shape women's lives more broadly. ...
Low sexual desire in women partnered with men is typically presumed to be a problem—one that exists in women and encourages a research agenda on causation and treatment targeting women. In this paper, we present a distinct way forward for research on low sexual desire in women partnered with men that attends to a more structural explanation: heteronormativity. A heteronormative worldview assumes that relationships and structures are heterosexual, gender (usually conflated with sex) is binary and complementary, and gender roles fit within narrow bounds including nurturant labor for women. We propose the heteronormativity theory of low sexual desire in women partnered with men, arguing that heteronormative gender inequities are contributing factors. We outline four hypotheses and their predictions related to: inequitable divisions of household labor, blurring of partner and mother roles, objectification of women, and gender norms surrounding sexual initiation. We discuss some mechanisms—social, physiological, and otherwise—for the heteronormativity theory, especially related to stress, objectification, and nurturance. We close by noting some limitations of our paper and the ways that the heteronormativity theory of low sexual desire in women partnered with men provides a rigorous, generative, and empirical way forward.
... Si l'on sait dire que la satisfaction est la dernière étape du cycle de réponse sexuelle ( Nous connaissons plusieurs facteurs susceptibles d'influencer la satisfaction sexuelle. Il s'agit de facteurs sociaux tels que le genre (Carpenter, Nathanson, et Kim, 2009 ;Stulhofer, Busko, et Brouillard, 2010), l'âge (Carpenter, Nathanson, et Kim, 2009 ;Trompeter, Bettencourt, et Barrett-Connor, 2012 ;Young et al., 2000), le statut marital et le niveau de revenus (Christopher et Sprecher, 2000 ;Hamilton et Julian, 2014 ;Ji et Norling, 2004), ou la religiosité (Davidson, Darling, et Norton, 1995 ;Higgins et al., 2010 ;Young et al., 2000). Des facteurs psychologiques ont également été rapportés, tels que l'estime de soi (Larson et al., 1998 ;Stephenson, Ahrold, et Meston, 2011), l'image corporelle Pujols, Meston, et Seal, 2010), et la culpabilité sexuelle (Abbott, Harris et Mollen, 2016 ;. ...
Dans cette thèse de doctorat, nous avons souhaité mettre à jour les différentes habiletés érotiques favorables à la fonctionnalité sexuelle féminine, afin de tester un protocole de traitement des dysfonctions sexuelles féminines, basé sur le développement de ces habiletés. Ces dernières sont utilisées avec succès dans certaines thérapies sexuelles, telles que la thérapie Sexofonctionnelle ou l’approche Sexocorporelle. Pour cela, nous avons dans un premier temps, identifié les habiletés érotiques auprès d’une population de femmes satisfaites sexuellement en comparaison de femmes insatisfaites. Puis dans un deuxième temps, nous avons testé les liens entre ces habiletés et la fonctionnalité sexuelle, c’est-à-dire le fonctionnement et la satisfaction sexuelle, selon différentes méthodologies. Enfin, nous avons construit, puis testé avec de bons résultats, un protocole de traitement des dysfonctions sexuelles féminines basé sur le développement de ces habiletés érotiques.
... The empirical findings on the association between daily hassles-related stress and sexual functioning were thus far contradictory. In a cross-sectional study in Iran, a negative association between event-related stress, including daily hassles, within the last month and sexual desire was found (Abedi, Afrazeh, Javadifar, & Saki, 2015), whereas no association was found between daily hassles-related stress and sexual desire in another cross-sectional study (Hamilton & Julian, 2014). Unexpectedly, daily hassles were found to be positively related to sexual desire in a study of Morokoff and Gillilland (1993). ...
In the present study we investigated the temporal associations between emotional intimacy, daily hassles, and sexual desire of individuals in long-term relationships, and examined the direct and moderating effects of attachment orientation. We investigated these variables by reanalyzing an existing data set. Experience sampling methodology was used to collect data 10 times per day, across seven days. Attachment orientation was assessed with the Experiences in Close Relationships questionnaire. Age, gender, and relationship duration were added as predictors. Data of 134 participants (Nfemale = 87) were analyzed. Only one of the partners of a couple participated. Men overall reported higher sexual desire than women. Longer relationship duration was associated with lower sexual desire, but age was not associated with sexual desire. Increased level of intimacy predicted sexual desire across measurements with an average time interval of 90 min, but this effect was no longer significant when assessment points were 180 min apart. Daily hassles did not predict sexual desire at subsequent assessments. Avoidant and anxious attachment were not associated with sexual desire level. No interaction effects of gender, stress, intimacy and attachment orientation on sexual desire were found. Speculative explanations are offered for the absence of stress effects.
... First, these findings point to the possibility of a shared risk factor between HSDD and PTSD. As chronic life stress and atypical stress responsiveness (i.e., HPA axis dysregulation) have been associated with both low levels of sexual desire (Basson et al., 2019;Hamilton & Julian, 2014) and PTSD (Brewin, Andrews, & Valentine, 2000;Yehuda, 1997), there is reason to believe these to be factors in the heightened risk of PTSD development in women with HSDD. That women with HSDD demonstrated more severe PTSD symptomatology compared to women with no sexual desire concerns indicates the possibility of a higher degree of HPA axis dysregulation among women in the HSDD group. ...
Research suggests that posttraumatic stress disorder (PTSD) is associated with sexual dysfunction; however, there is a paucity of research examining the relations among trauma exposure, PTSD, and low sexual desire, specifically. Thus, the goal of the present study was to investigate whether women with hypoactive sexual desire disorder (HSDD; n = 132) were more likely to meet criteria for a diagnosis of current or lifetime PTSD relative to women with no sexual desire concerns (n = 137). We also sought to compare the type, frequency, and intensity of PTSD symptoms between the two groups. Finally, we examined whether women in the two groups were exposed to more, or different types of, potentially traumatic events. Compared to women with no sexual health concerns, women with HSDD were more likely to meet criteria for current PTSD, odds ratio (OR) = 5.50, 95% CI [1.18, 25.61]; and lifetime PTSD, OR = 2.78, 95% CI [1.56, 4.94]. Women in the HSDD group also had higher odds of meeting criteria for avoidance (5.10 times) and hyperarousal symptoms (4.48 times) and scored higher on measures of past‐month PTSD symptom frequency, d = 0.62, and intensity, d = 0.57. No group differences were observed regarding reexperiencing symptoms, the associated features of PTSD, or type or frequency of exposure to potentially traumatic events. The findings indicate PTSD symptomatology may be a predisposing or perpetuating contributor to low sexual desire, and low sexual desire and PTSD may be related through an alteration in stress adaptability.
... A history of childhood trauma may also lead to underdeveloped stress coping skills (McCrory, De Brito, & Viding, 2010), thereby impairing the ability to react in effective ways to daily stressors (Zollman, Rellini, & Desrocher, 2013). This is highly relevant to sexual functioning, as there is increasing empirical support for the negative effects of chronic stress, including daily hassles, on sexual function (Hamilton & Julian, 2014;Hamilton & Meston, 2013). Indeed, in women, chronic daily stressors were found to have a stronger association with psychological symptoms and negative affect than the effects of a single traumatic event (Kanner, Coyne, Schaefer, & Lazarus, 1981). ...
The relationship between childhood trauma and adult sexual dysfunction is well documented; however, there is a paucity of research that examines the physiological and psychological mechanisms that may potentiate this relationship. As depression, perceived stress, and hypothalamic pituitary adrenal (HPA) axis dysregulation are correlates of childhood trauma and sexual dysfunction, the current study sought to examine the association of each of these domains with low sexual desire in a sample of (N = 275 [n = 137 women with low sexual desire; n = 138 sexually healthy women]) non-clinically depressed women. First, we assessed the relative contributions of HPA axis dysregulation (as indexed by the diurnal cortisol slope), childhood trauma, depression symptoms and perceived daily stress on low sexual desire. Next, we examined the degree to which HPA axis dysregulation, perceived stress, and depressive symptoms, respectively, mediated the relationship between childhood trauma and sexual desire. Results indicate that diurnal cortisol slope and depression symptoms contribute to low desire over and above perceived stress and childhood trauma and that childhood trauma is associated with low sexual desire predominantly through depressive symptomatology. Theoretical and clinical implications of the findings are discussed.
... Anahtar Kelimeler: Cinsel sağlık, cinsel disfonksiyon, prematür ejakülasyon eğitim-öğretim hizmetlerindeki öğrenci-öğretmen ve okul-aile çatışmaları, disiplin sorunları, kalabalık sınıflar, fiziki koşullardaki yetersizlik, bürokratik işlerin çokluğu, toplumun eleştirileri, eğitim kurumları üzerindeki sosyal ve politik baskılar, ödüllendirme ve karara katılımın yetersizliği gibi sorunlardır. [10] Araştırmalarda psikolojik stres, erkeklerde libidonun azalması, testosteronun salınımı ve sperm üretiminin baskılanmasıyla ilişkilendirilmiştir. [11] Psikolojik stresin yarattığı bu sonuçlar erkeklerde cinsel fonksiyon bozukluğu görülme riskini artırmaktadır. Bodenmann ve ark., stres ile cinsel işlev arasındaki ilişkiyi inceleyen çalışmalarında, günlük stres faktörlerinin cinsel problemlere büyük yaşam olaylarından daha fazla neden olduğunu göstermişlerdir. ...
... The first result shows that there is a positive relationship between DH and anxiety. This result is congruent with the literature [6,13,33,34]. The second main result was a positive relationship between DH and physical symptoms. ...
Background: Daily hassles (DH) correlate positively with physical and psychological outcomes. Hemispheric lateralization (HL) is the tendency to activate or utilize functions associated with one hemisphere versus parallel regions in the other side. Right-HL is related to longer stress responses and left-HL was found to moderate relationships between DH and mental health. The purpose of this study was to investigate whether coping styles can explain the protective role of Left HL.
... Everyday life stressors also have a negative impact. [59][60][61] Midlife women may be caring for children of their own, having adult children return home, and/or be caring for aging parents. 59 Job-related stress and financial concerns are also common. ...
Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition to anatomic factors related to estrogen deficiency, such as genitourinary syndrome of menopause, vulvovaginal atrophy, and pelvic organ prolaps, psychosocial factors, including prior sexual trauma, play an important role in sexual function in women. Several treatments have emerged for female sexual dysfunction; long-term studies and head-to-head comparisons are lacking.
... This leads to the prediction that stress and sexuality should be negatively correlated. However, empirical findings about the association between sexual variables and measures of stress (e.g., self-reports, cortisol levels) are mixed, with some studies showing that stress is positively associated with sexuality (Goldey & van Anders, 2012;Hamilton, Rellini, & Meston, 2008;Lopez, Hay, & Conklin, 2009;Roney, Lukaszewski, & Simmons, 2007) and others showing that stress is negatively associated with sexual activity or functioning (Bodenmann, Atkins, Schar, & Poffet, 2010;Hamilton et al., 2008;Hamilton & Julian, 2013;Hamilton & Meston, 2011;Hou, Xiong, Wang, Chen, & Yuan, 2014;Meston & Lorenz, 2013;Minnen & Kampman, 2000). These mixed directions of findings between desire and stress may reflect differences in how stress is operationalized (Goldey & van Anders, 2012), as there is evidence that measures of self-reported stress and cortisol diverge (Rosal, King, Ma, & Reed, 2004). ...
Sexual desire and testosterone are widely assumed to be directly and positively linked to each other despite the lack of supporting empirical evidence. The literature that does exist is mixed, which may result from a conflation of solitary and dyadic desire, and the exclusion of contextual variables, like stress, known to be relevant. Here, we use the Steroid/Peptide Theory of Social Bonds as a framework for examining how testosterone, solitary and partnered desire, and stress are linked over time. To do so, we collected saliva samples (for testosterone and cortisol) and measured desire as well as other variables via questionnaires over nine monthly sessions in 78 women and 79 men. Linear mixed models showed that testosterone negatively predicted partnered desire in women but not men. Stress moderated associations between testosterone and solitary desire in both women and men, but differently: At lower levels of stress, higher average testosterone corresponded to higher average solitary desire for men, but lower solitary desire on average for women. Similarly, for partnered desire, higher perceived stress predicted lower desire for women, but higher desire for men. We conclude by discussing the ways that these results both counter presumptions about testosterone and desire but fit with the existing literature and theory, and highlight the empirical importance of stress and gender norms.
... When couples experience greater economic strain, they report lower levels of marital happiness (Conger, Rueter, & Elder, 1999), and higher income is associated with higher and more stable marital quality trajectories (Birditt et al., 2012). Further, daily stressors resulting from financial strains predict lower levels of sexual functioning in men and women (Hamilton & Julian, 2014). Given the recent evidence and theory indicating that lower levels of income and education are associated with higher stress, lower marital quality, and lower sexual functioning, couple SES may be an important factor to consider when helping couples avoid sexual distress and foster healthy marital relationships. ...
Objective
Drawing from the vulnerability–stress–adaptation model, we explored sexual distress as a lack of adaptive processes within marriage by assessing whether sociodemographic variables associated with stress moderated the association between sexual distress and marital quality.
Background
Sexual intimacy and marital quality are strongly linked, but it remains unclear what role sexual distress (distinct from low sexual satisfaction) plays in marital quality and whether this role differs across sociodemographic characteristics (race, socioeconomic status, premarital childbearing).
Method
Data are from in‐person and telephone interviews of 199 African American and 174 European American couples across their first 4 years of marriage. Dyadic multilevel modeling was used to analyze longitudinal associations between sexual distress and marital quality and to test whether these associations were moderated by race, socioeconomic status, and premarital childbearing, while controlling for joyful sex and pregnancy.
Results
Sexual distress and marital quality were bidirectionally linked. Sexual distress was a stronger predictor of marital quality for African American husbands compared with European American husbands. Socioeconomic status and premarital childbearing were not statistically significant moderators.
Conclusion
High sexual distress is distinct from low sexual satisfaction and may indicate insufficient adaptive processes for partners experiencing chronic stress. Social context and factors beyond marital processes may influence the role sexual intimacy plays in marital quality.
Implications
Findings contribute to practitioners' understanding of how sexual distress relates to marital quality in diverse newlywed couples.
... Being satisfied with one's intimate relationships and sexual life is important for mental and physical health. Sexual satisfaction is associated with better self-perceived general health, greater psychological well-being and happiness [1][2][3][4], lower levels of depression and anxiety [5][6][7], as well as greater partnership satisfaction [8]. While experience of low desire for or interest in sexual activities, difficulties with sexual arousal or orgasm, and genito-pelvic pain are common sexual problems among women, men are most likely to be concerned about obtaining or maintaining an erection or early ejaculation [9]. ...
Purpose of Review
The dual control model of sexual response aims to explain sexual behavior and response through two factors, labeled sexual excitation and sexual inhibition. Sexual dysfunctions are common among women and men and pose a threat to the sexual health of both genders. The main objective of this paper was to review the latest findings concerning the predictive value of sexual excitation and sexual inhibition for sexual function and dysfunction in men and women.
Recent Findings
Most relevant studies have been conducted in North America and Europe using non-clinical samples. Women and men with high sexual inhibition related to performance concerns and distractibility during sex report lower sexual function. In addition, high sexual excitation is associated with higher sexual function in both genders.
Summary
Sexual excitation and sexual inhibition are predictors of sexual function in women and men. More prospective and clinical studies are needed to evaluate the usefulness of both propensities as predictors or moderators of treatment success.
Stressful events can disrupt couples’ emotional connection, yet prior research is mixed regarding whether stress also disrupts couples’ physical intimacy. This study considered whether stress must reach a critical threshold before hindering couples’ sexual activity and physical affection (i.e., a curvilinear association). Couples ( N = 144 couples plus four additional wives) completed two 14-day daily diary tasks during the early years of marriage. Multilevel modeling revealed a within-person curvilinear association between daily stress and sexual activity. Contrary to expectations, the likelihood of sexual activity declined as stress increased from low to moderate, then leveled off as stress continued to increase. For physical affection, a linear effect emerged. On days of greater stress, women, but not men, reported less affection. Further analyses suggested that women’s stress is more influential than men’s stress for couple’s physical intimacy. Findings highlight the nuanced ways in which stress is linked to a vital component of satisfying relationships.
Efficacy outcomes are only informative to the extent that they are validated. We examined the measurement properties of efficacy measures from the phase III (“RECONNECT”) bremelanotide trials for hypoactive sexual desire disorder (HSDD) in women. Continuous efficacy outcomes, including a) the Female Sexual Function Index (FSFI) and its Desire domain (FSFI-D) and b) the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) and its item assessing distress due to low desire (FSDS-DAO #13) have questionable, at best, validity evidence for women with HSDD. We found no validity evidence for previously published categorical treatment response outcomes from the RECONNECT trials. All efficacy results should be reported, but results on 8 of the 11 clinicaltrials.gov-specified efficacy outcomes were heretofore unpublished (including FSDS-DAO total score, FSFI total score, FSFI arousal domain, and items from the Female Sexual Encounter Profile-Revised). We analyzed these outcomes, upon which effect sizes ranged from nil to small. Several other continuous and categorical outcomes generated modest apparent benefits, though nearly all of these outcomes were likely derived post-hoc. Across RECONNECT trial data from two prior publications and the current study, bremelanotide's benefits are statistically modest and limited to outcomes for which scant evidence of validity among women with HSDD exists.
The COVID-19 pandemic and the resulting social distancing measures have caused widespread social and economic disruptions, resulting in spikes in unemployment and financial instability, along with drastic changes to people's ability to feel socially connected. Many of the changes resulting from the COVID-19 pandemic are risk factors for depressive symptoms, which are associated with lower levels of sexual desire. The current research (N = 4,993) examined whether responses to external stressors brought on by COVID-19 (i.e., financial concern, worry, loneliness, stress) were associated with sexual desire among a multi-national sample of people in relationships (Studies 1–2), and whether this association was, in part, due to reports of depressive symptoms (Study 2). In the period immediately following the onset of the pandemic, more financial concern (Study 1) and worry (Study 2) were associated with higher sexual desire, while other factors, like stress (Studies 1–2), were associated with lower desire. We also followed a subset of participants every two weeks during the initial stages of the pandemic and at times when people reported greater stress, loneliness, financial strain, or worry than their average, they reported greater depressive symptoms, which was, in turn, associated with lower sexual desire. Results suggest that the social isolation and stress resulting from the COVID-19 pandemic have mixed associations with sexual desire at the onset of the pandemic. But over time, when people report heightened COVID-related stressors, they tend to report lower sexual desire for their partner, in part because these stressors are associated with more depressive symptoms.
Purpose
Whether public members feel satisfied with law enforcement is a fundamental determinant of their willingness to cooperate with the police, and comply with the law. Numerous studies have uncovered predictors of citizen satisfaction with the police, including race and procedural justice. To date though, the role of strain in affecting this outcome has been largely ignored.
Methods
Electronic survey data were collected from a convenience sample of university students to determine if respondent strain levels shared any empirical association with their satisfaction with the police.
Results
Ordinary least squares regression equations uncovered a negative and statistically significant relationship between strain and satisfaction with law enforcement, net of controls.
Discussion
If strain is an antecedent to eventual criminal behavior, whereby possibly involving police contact, officers are encouraged to deploy therapeutic policing strategies to address the underlying distress affecting citizens.
Background
Preliminary evidence indicates that acute and chronic psychological stress affect sexual arousal and satisfaction. African American women, in particular, are vulnerable to the impacts of gender- and race-related stress, given their socially constructed identities as African Americans and as women.
Aim
We examined associations between minority stress and sexual function using data from 248 African American women.
Methods
Surveys were conducted with 248 African American women in South LA with male partners at risk for acquiring HIV. We analyzed self-reports on (i) stress indicators: chronic burden, perceived racism/sexism, and histories of trauma/sexual abuse; (ii) Female Sexual Function Index domains: desire, arousal, and satisfaction; and (iii) potential moderators: social support and spirituality. We used multiple regression, adjusting for potential confounding factors, to examine the relationships between stress indictors, potential moderators, and sexual function domains. Outcomes: The outcomes were the female sexual function index domains of desire, arousal, and satisfaction.
Results
This largely low-income sample experienced significant chronic and acute stressors, was highly spiritual and reported strong social support. Moderate-high chronic burden and increasing sexism scores were independently associated with decreased arousal (B = -0.38, 95%CI = -0.75, -0.02) and satisfaction (B = -0.03, 95%CI = -0.06, 0.00) scores, respectively.
Clinical Implications
Providers may want to explore chronic burden in patients who complain about low sexual arousal. Additionally, to develop effective HIV- and other STI-related interventions that impact behaviors that can confer sexual risk, prevention strategies are needed that either reduce contextual stressors or mitigate their impact.
Strengths
Strengths of this research are that it focuses on sexual function among previously under-studied, low-income African American women and that it takes into account the unique set of stressors faced by these women.
Limitations
A limitation is that the sample size may have been too small to capture the effects of potential moderators.
Conclusions
Low-income African American women accumulate life stressors that may harm sexual function.
Schrode K, Poareo E, Li M, et al. Minority Stress and Sexual Functioning Among African American Women With At-Risk Partners in South Los Angeles. J Sex Med 2021;XX:XXX–XXX.
Résumé
En sexothérapie, l’insatisfaction sexuelle des femmes est souvent le moteur de la demande de soins. Certaines thérapies sexuelles, telles que la thérapie Sexofonctionnelle, font l’hypothèse, que chaque individu développe plus ou moins d’habiletés érotiques favorisant la satisfaction sexuelle, qui peuvent être classées selon trois composantes : les habiletés érotiques cognitives, les habiletés érotiques comportementales et les ressentis (émotions et sensations corporelles). Ces hypothèses restent à ce jour sans validation scientifique.
Objectifs
Cette étude exploratoire a pour objectifs d’identifier les habiletés érotiques émotionnelles, cognitives et comportementales des femmes satisfaites sexuellement, en comparaison de celles qui ne le sont pas.
Méthode et matériel
Lors d’un entretien semi-directif, vingt-trois femmes (dont onze se déclarant satisfaites sexuellement) ont été invitées à répondre à des questions construites à partir de la théorie Sexofonctionnelle. Les réponses des femmes satisfaites sexuellement ont été comparées à celles des femmes insatisfaites au moyen d’une analyse de contenu par une méthode des juges experts.
Résultats
Les résultats montrent que dans l’exercice de leur sexualité, les femmes se déclarant satisfaites pratiquent plus l’auto-stimulation, rapportent des comportements sexuels plus diversifiés, et sont actives, au sens où elles utilisent leur bassin et les muscles de leur plancher pelvien. Elles ne font état d’aucune émotion ou sensation désagréable, mais perçoivent plus de sensations sexuelles. Enfin, au niveau cognitif, les femmes satisfaites rapportent nettement plus de cognitions positives en lien avec les stimuli sexuels.
Aims
The main purpose of this study is to analyse the relationship between sexual difficulties and factors of sexual arousal, excitement, and sexual inhibition among men and women.
Method
A total of 1,878 participants, of whom 983 were men (52%) and 895 were women (48%), with a mean age of 35.9 years (SD = 11.9; range = 18-79), were recruited online. The study’s instruments included a socio-demographic questionnaire, a questionnaire about sexual difficulties, and the Sexual Excitation/Sexual Inhibition Inventory for Women and Men (SESII-W/M).
Results
Women with and without sexual difficulties differed significantly on all subscales of the SESII-W/M. Men with sexual difficulties scored significantly higher in the dimensions of Inhibitory Cognitions and the Dyadic Elements of the Sexual Interaction than men without difficulties. Inhibitory Cognitions was the strongest predictor of sexual difficulties for both men and women. Relationship Importance was also a strong predictor of sexual difficulties in women.
Conclusions
Sexual inhibition serves as a predictor of sexual difficulties. The SESII-W/M seems to work better in determining the factors of sexual inhibition as predictors of sexual difficulties among women, than in identifying causes of sexual difficulties among men.
The article consists of 6 sections written by separate authors that review female genital anatomy, the physiology of female sexual function and the pathophysiology of female sexual dysfunction but excluding hormonal aspects.
Aim. To review female sexual function - physiology and pathophysiology- especially since 2010 and to make specific recommendations with levels of evidence ( Oxford Centre) where relevant.
Conclusion. Despite numerous lab assesssments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
There are a number of psychosocial, relational, and contextual factors that impact female sexual arousal. Although there are no studies that establish causality, numerous significant correlational relationships exist and it follows that addressing these variables in evaluation and psychological treatment can help improve sexual functioning in women. For example, treatment of a female patient whose dysfunction stems from changes related to aging should have a different focus than that of a survivor of abuse. This chapter offers an exploration of the factors that affect sexual desire and arousal disorders in women, as well as tools available for diagnosis and treatment of sexual dysfunction.
Das Leben ist ein ständiger Anpassungsprozess. Misslingt diese Anpassung, entsteht Unzufriedenheit. Ebenso steigt das Risiko für zahlreiche chronisch-degenerative Erkrankungen. Das vorliegende Kapitel hat zum Ziel, einen repräsentativen Überblick über den Stand der Forschung zum Thema Stress und gesundheitliche Beeinträchtigungen zu liefern. Ausgehend von der Frage, ob ein Zusammenhang zwischen der Stressbelastung und dem Mortalitätsrisiko besteht, werden nacheinander verschiedene Krankheiten und Beschwerden (kardiovaskuläre Erkrankungen, metabolisches Syndrom, Übergewicht/Adipositas, Krebs, Infektionserkrankungen, HIV/AIDS, chronisch-entzündliche Darmerkrankungen, Asthma bronchiale, kognitive Leistungsfähigkeit, Migräne/Kopfschmerzen, Sexualfunktion, psychische Störungen) in den Blick genommen. Damit soll Forschenden die Vielfalt der Zugänge aufgezeigt werden, aus denen heraus man sich dem Thema Stress und Gesundheitsbeeinträchtigungen annähern kann.
Das Leben ist ein ständiger Anpassungsprozess. Misslingt diese Anpassung, entsteht Unzufriedenheit. Ebenso steigt das Risiko für zahlreiche chronisch-degenerative Erkrankungen. Das vorliegende Kapitel hat zum Ziel, einen repräsentativen Überblick über den Stand der Forschung zum Thema Stress und gesundheitliche Beeinträchtigungen zu liefern. Ausgehend von der Frage, ob ein Zusammenhang zwischen der Stressbelastung und dem Mortalitätsrisiko besteht, werden nacheinander verschiedene Krankheiten und Beschwerden (kardiovaskuläre Erkrankungen, metabolisches Syndrom, Übergewicht/Adipositas, Krebs, Infektionserkrankungen, HIV/AIDS, chronisch-entzündliche Darmerkrankungen, Asthma bronchiale, kognitive Leistungsfähigkeit, Migräne/Kopfschmerzen, Sexualfunktion, psychische Störungen) in den Blick genommen. Damit soll Forschenden die Vielfalt der Zugänge aufgezeigt werden, aus denen heraus man sich dem Thema Stress und Gesundheitsbeeinträchtigungen annähern kann.
The human female orgasm bestows the greatest pleasure without recourse to drugs. Despite numerous studies there are many aspects of the activity that are poorly understood. These include its neurophysiology and pharmacology, while even its typology, induction, and function(s) are contentious issues. It can be induced by a variety of agencies that include genital and non-genital sites and even by exercise. While there are similarities with the male orgasm, there are a few differences, the major one being that women can have repeated multiple orgasms while males cannot. Despite recurrent speculative claims in the literature, it does not mediate or facilitate sperm transport through its uterine contractions. Brain imaging that measures cerebral regional blood flow has revealed that there is no single orgasm center, but rather specific areas are either activated, inhibited, or unaffected during orgasm. However, no consensus has yet been achieved due to experimental procedural differences and data handling by researchers.
Chronic stress is known to have negative effects on reproduction, but little is known about how it affects the sexual response cycle. The present study examined the relationship between chronic stress and sexual arousal and the mechanisms that mediate this relationship.
The aim of this study is to test the relationship between chronic stress and sexual arousal and identify mechanisms that may explain this relationship. We predicted that women experiencing high levels of chronic stress would show lower levels of genital arousal and dehydroepiandrosterone (DHEAS) and higher levels of cortisol and cognitive distraction compared with women with average levels of stress.
Women who were categorized as high in chronic stress (high stress group; n = 15) or average in chronic stress (average stress group; n = 15) provided saliva samples and watched an erotic film while having their genital and psychological arousal measured.
Main outcome measures were vaginal pulse amplitude, psychological arousal, salivary cortisol, salivary DHEAS, and heart rate and compared them between women with high and average levels of chronic stress.
Women in the high stress group had lower levels of genital, but not psychological arousal, had higher levels of cortisol, and reported more distraction during the erotic film than women in the average stress group. The main predictor of decreased genital sexual arousal was participants' distraction scores.
High levels of chronic stress were related to lower levels of genital sexual arousal. Both psychological (distraction) and hormonal (increased cortisol) factors were related to the lower levels of sexual arousal seen in women high in chronic stress, but distraction was the only significant predictor when controlling for other variables. Hamilton LD and Meston CM. Chronic stress and sexual function in women. J Sex Med **;**:**-**.
The relationship of stress to sexual functioning and marital satisfaction was investigated in 165 men and women, age 21–84, approximately half of whom were unemployed. Adults completed inventory measures of life experiences, hassles, marital satisfaction, and sexual functioning. Regression analysis showed that for men, unemployment was associated with difficulty attaining an erection. This effect increased significantly with age. Wives of unemployed men also reported greater erectile difficulties for their spouses than wives of employed men. This result was mediated by marital satisfaction: For women whose husbands were unemployed, marital satisfaction had a strong negative relationship to reported erectile difficulty. Contrary to expectations, hassles scores were positively related to sexual desire for both men and women. Although unemployment in women was not related to any sexual dysfunction, desired frequency of intercourse declined with age more sharply for women who were unemployed than for those who were employed. Results were interpreted with respect to the psychological significance of specific stressors.
Using data from 198 couples, this study examines whether associations between stress occurring outside of the dyad and key indicators of relationship functioning are mediated by stress arising within the dyad. Findings suggest that relationship satisfaction and sexual activity are governed by hassles and problems experienced within the dyad that are in turn related to stress arising outside the dyad. Associations between external stress and relationship functioning are stronger for daily hassles than for critical life events. Higher levels of daily stress predicted less sexual activity for maritally dissatisfied women and more sexual activity for maritally dissatisfied men. Self-reports of stress covaried with self-reported indexes of satisfaction and sexuality, suggesting that contextual influences are broadly influential in intimate relationships.
In an attempt to detail cognitive processes during anxiety and sexual arousal, 16 heterosexual males were presented with brief erotic audiotapes simultaneous with four levels of shock threat (no shock, half tolerance, tolerance, and twice tolerance threat). Subjects were instructed to pay close attention to the audiotapes, following which a sentence recognition task was administered to assess stimulus-focused attention. Additionally at these times, they were given a thought-listing task and completed a series of affect ratings. Tumescence and subjective arousal were monitored continuously during the erotic stimuli. Results revealed that tolerance shock threat decreased tumescence (p<.05). In contrast, recognition memory was greatest during tolerance shock threat and diminished during twice tolerance shock threat, which also produced increased reports of emotional stales. Issues regarding the relation between cognition and sexual arousal are discussed, including implications for understanding sexual dysfunction.
We report surprising findings from a pilot study aimed at assessing the psychological price paid by female medical students who are also involved in serious romantic relationships. Sixty female medical students were assessed as to their depressive symptoms, level of self-criticism, sexual satisfaction, role commitment, and perceived rewards derived from their professional, marital, and domestic roles. The high levels of depressive symptoms found among participants in this study were the sole predictor of low sexual satisfaction. Professional role reward was positively associated with depressive symptoms. Consistent with the notion of multiple roles conflict among self-critical students, role commitment and reward in the professional and domestic domains interacted to predict depressive symptoms. Results suggest that female medical students involved in romantic relationships pay a high emotional price for their conflicting role demands.
The concept of stress has a long and perhaps foundational history in health psychology. However, it is also not without its detractors, who point out imprecise and simplistic use of the concept. Four challenges for stress research in health psychology delineate the nuanced and contextualised future. First, 'stress' can be located in the environment, in appraisal or in response (e.g., emotions or physiology). Careful conceptualisation and assessment can differentiate among these locales, as well as reveal interactions among them. Second, coping refers to the transaction between stress and the affected person. Understanding exactly why coping moderates the effects of stress is a major challenge for coping research. Third, stress happens to different people with different personalities and temperaments and at different stages of their lives. People may even be different from themselves at different life stages. These individual differences can impact all manner of stress and coping. Fourth, stress is dynamic. Minor events come and go, and major events create a cascade of changes in the individual's life. Understanding how stress, coping and health change over time within individuals (i.e., in a multi-level framework) will be a major advance for the field.
The development of a 21-item self-report inventory for measuring the severity of anxiety in psychiatric populations is described. The initial item pool of 86 items was drawn from three preexisting scales: the Anxiety Checklist, the Physician’s Desk Reference Checklist, and the Situational Anxiety Checklist. A series of analyses was used to reduce the item pool. The resulting Beck Anxiety Inventory (BAI) is a 21-item scale that showed high internal consistency (α = .92) and test—retest reliability over 1 week, r (81) = .75. The BAI discriminated anxious diagnostic groups (panic disorder, generalized anxiety disorder, etc.) from nonanxious diagnostic groups (major depression, dysthymic disorder, etc). In addition, the BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale, r (150) = .51, and was only mildly correlated with the revised Hamilton Depression Rating Scale, r (153) = .25.
One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for 8 standard statistical tests: (1) the difference between independent means, (2) the significance of a product-moment correlation, (3) the difference between independent rs, (4) the sign test, (5) the difference between independent proportions, (6) chi-square tests for goodness of fit and contingency tables, (7) 1-way analysis of variance (ANOVA), and (8) the significance of a multiple or multiple partial correlation.
Research has shown that stressors and experienced stress are negatively correlated with sexual activity (i.e., behavior and satisfaction) within couples. Thus far, most studies have been cross-sectional and report correlations only. This study is one of the first to examine the covariation between self-perceived stress and daily sexual activity within a time period of 3 months by collecting data on stress, sexual activity, sexual satisfaction, and sexual fulfillment as well as individual and dyadic coping. The association among these variables was tested in a multilevel model that included cyclical terms to capture the regular variation of sexual behavior over the days of the week. One hundred and three female students completed questionnaires and diaries 12 times during a 3-month period just prior to a major exam. Findings suggest that higher self-reported stress in daily life was associated with lower levels of sexual activity and satisfaction and a decrease in relationship satisfaction. In addition, dyadic coping was positively associated with sexual outcomes but did not moderate the association of experienced stress and sexuality. Implications for sexuality research in close relationships and methods for studying cyclical processes are discussed.
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The literature on the role of attention in sexual arousal is reviewed, especially that which has implications for noninvasive treatment of sexual dysfunction. Findings suggest that voluntary control of sexual arousal can be achieved through attentional focus on nonsexual cognitions or sexual fantasy. Cognitive biases may direct attention and thus facilitate or impede sexual arousal. Sexual arousal may be influenced by directed attentional focus, and preliminary evidence suggests that mindfulness techniques may result in longer-term changes in attentional focus; these changes, in turn, may improve sexual response. Information-processing models of sexual arousal developed in light of such findings are discussed. This research establishes the central role of attentional processes in facilitating physiological and, especially, subjective sexual arousal. Implementing approaches that capitalize on attentional processes could advance noninvasive treatment of sexual dysfunction. Future avenues of research might investigate how play, mammalian play circuits, and flow states are relevant to sexual response and satisfaction.
Describes the development of a new instrument, the Life Experiences Survey (LES), for the measurement of life changes. The LES is a 57-item self-report measure that is divided into 2 sections: Section 1 consists of 47 items that refer to life changes in a wide variety of situations; Section 2 consists of 10 items that are designed primarily for use with students. It was designed to eliminate certain shortcomings of previous life stress measures and allows for separate assessment of positive and negative life experiences as well as individualized ratings of the impact of events. The reliability and possible sex differences of the LES are discussed, and the LES is compared with the State-Trait Anxiety Inventory, the Marlowe-Crowne Social Desirability Scale, the Psychological Screening Inventory, the Beck Depression Inventory, Rotter's Internal–External Locus of Control Scale, and the Schedule of Recent Experiences using undergraduate samples. Several studies bearing on the usefulness of the Life Experiences Survey are presented and the implications of the findings are discussed.
Recent research findings have implicated, in a preliminary manner, five factors that seem to differentiate sexually functional subjects from sexually dysfunctional subjects suffering from inhibited sexual excitement. These factors include differences in affect during sexual stimulation, differences in self-reports of sexual arousal and perception of control over arousal, distractibility during sexual stimulation, and differential sexual responding while anxious. These findings suggest a working model of sexual dysfunction that is based on cognitive interference and anxiety. Implications of this model for the treatment of sexual dysfunction are suggested.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
12 21–30 yr old males who were trained to expect tolerance-level electric shocks viewed an erotic film under 3 counterbalanced conditions. In 1 condition, Ss viewed the erotic film in conjunction with a signal light indicating threat of shock. A 2nd light indicated threat of shock if Ss did not achieve an erection of a certain size. A 3rd light indicated no shock. Both anxiety-inducing shock-threat conditions increased penile size response over and above the no-shock-threat condition. Furthermore, shock threat contingent on size of erection produced more arousal than noncontingent-shock threat. (22 ref)
The secretion of glucocorticoids (GCs) is a classic endocrine response to stress. Despite that, it remains controversial as to what purpose GCs serve at such times. One view, stretching back to the time of Hans Selye, posits that GCs help mediate the ongoing or pending stress response, either via basal levels of GCs permitting other facets of the stress response to emerge efficaciously, and/or by stress levels of GCs actively stimulating the stress response. In contrast, a revisionist viewpoint posits that GCs suppress the stress response, preventing it from being pathologically overactivated. In this review, we consider recent findings regarding GC action and, based on them, generate criteria for determining whether a particular GC action permits, stimulates, or suppresses an ongoing stress-response or, as an additional category, is preparative for a subsequent stressor. We apply these GC actions to the realms of cardiovascular function, fluid volume and hemorrhage, immunity and inflammation, metabolism, neurobiology, and reproductive physiology. We find that GC actions fall into markedly different categories, depending on the physiological endpoint in question, with evidence for mediating effects in some cases, and suppressive or preparative in others. We then attempt to assimilate these heterogeneous GC actions into a physiological whole.
We conducted an exploratory study comparing 47 college-aged women reporting depressive symptoms but not receiving antidepressant medication to 47 age-matched controls. We examined various dimensions of sexual functioning, including sexual desire, arousal, orgasm, pain, pleasure, and satisfaction. The women with depressive symptoms reported more inhibited sexual arousal, more inhibited orgasm, more sexual pain problems, and less sexual satisfaction and pleasure than control participants. Novel to this study, the women with depressive symptoms reported greater desire for sexual activity alone (masturbation) than the nondepressed women. The findings are discussed in terms of primary reinforcers and depressive symptomology.
This study examined the impact of state anxiety, trait anxiety, and anxiety sensitivity on physiological and self-report measures of sexual arousal and sexual function in a non-clinical sample of women. Physiological sexual responses to an erotic stimulus were assessed using vaginal photoplethysmography, and subjective reactions were measured using questionnaires. Results suggested a curvilinear relationship between state anxiety and physiological sexual arousal (vaginal pulse amplitude; VPA). Trait anxiety and anxiety sensitivity were correlated with self-reported sexual arousal outside the laboratory. The findings may be interpreted in light of sympathetic nervous system (SNS) influences on sexual arousal and potential cognitive interference mechanisms associated with anxiety.
This study addresses the question of how stress is linked to sexual problems among women and men in close relationships. Psychological symptoms, relationship quality, internal daily stress (i.e., originating within the couple such as conflicts, worry for the partner), external daily stress (i.e., stress arising outside the couple such as job stress, stressful relatives, and so forth), and critical life events were examined with regard to their association with different sexual problems. The results support the hypotheses that (1) there is an incremental effect of stress on sexual problems after controlling for psychological symptoms and relationship quality, and that (2) it is primarily internal daily stress and in some cases critical life events rather than external daily stress that are related to sexual problems, particularly hypoactive sexual desire in women and men, sexual aversion in women, vaginismus in women, and premature ejaculation in men. Our findings indicate that the treatment of these sexual problems should address relationship issues and include a focus on helping individuals improve their stress management skills within their couple relationship.
Most psychological theories predict associations among processes that transpire within individuals. However, these theories are often tested by examining relationships at the between-persons (BP) rather than the within-persons (WP) level. The authors examined the WP and BP relationships between daily stress and daily variability in cognitive performance. Daily stress and cognitive performance were assessed on 6 occasions in 108 older adults and 68 young adults. WP variability in stress predicted WP variability in response times (RTs) on a 2-back working memory task in both younger and older adults. That is, RTs were slower on high-stress days compared with low-stress days. There was evidence of an amplified WP stress effect in the older adults on a serial attention task. There was no evidence of stress effects on simple versions of these tasks that placed minimal demands on working memory. These results are consistent with theories that postulate that stress-related cognitive interference competes for attentional resources.
Adult volunteers (N = 234) responded to a “decontaminated” hassles scale plus measures of trait anxiety, perceived stress, psychiatric symptomatology, and minor physical ailments. All but the anxiety scale were time-referenced to the past month. Major findings were as follows: (1) Hassles and trait anxiety contributed positively to perceived stress, both individually and interactively, accounting altogether for 55% of the variance; highly anxious subjects showed lower increments in perceived stress with increasing hassles-exposure than did low anxious subjects. (2) Hassles and trait anxiety had a positive synergistic effect on psychiatric symptomatology which, along with the nonsignificant marginal main effects, accounted for 64% of the variance. (3) Hassles and trait anxiety had a positive synergistic effect on minor physical ailments in men; however, highly anxious women, who showed very high levels of illness under even low hassles-exposure, responded less to incremental stress than did low-anxious women. The significant Sex x Hassles x Trait-Anxiety interaction effect and all the implicated lower-order effects jointly accounted for 22% of the variance in minor ailments.
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
Few studies have objectively examined the relationship between depression and various stages of sexual function. Here we associate depression and sexual function using validated questionnaires. A retrospective review of 186 men was performed; demographics and serum hormone levels were obtained. Responses to questionnaires evaluating depressive symptoms (Patient Health Questionnaire (PHQ-9)), sexual function (International Index of Erectile Function (IIEF)) and hypogonadal symptoms (quantitative Androgen Decline in the Aging Male (qADAM)) completed by each patient were correlated using Spearman's rank correlation. Mean±s.d. subject age: 52.6±12.7 years; mean serum hormone levels: TT 429.8±239.2 ng dl-1, free testosterone 9.72±7.5 pg ml-1 and estradiol 34.4±22.8 pg ml-1. Negative correlations were observed between total PHQ-9 score and the sexual desire (ρ=-0.210, P=0.006), intercourse satisfaction (ρ=-0.293, P<0.0001) and overall satisfaction (ρ=-0.413, P<0.0001) domains of the IIEF and individual IIEF questions pertaining to erectile function. Men with a PHQ-9 score 10 (mild depression or worse), had lower sexual desire and sex life satisfaction. A negative correlation between PHQ-9 score and qADAM score (ρ=-0.634, P<0.0001) was observed and men with higher PHQ-9 score had lower qADAM scores. Depressive symptoms in men correlate with both psychological as well as physical aspects of sexual function.International Journal of Impotence Research advance online publication, 7 March 2013; doi:10.1038/ijir.2013.4.
Previous research regarding anxiety and female sexual functioning has yielded conflicting conclusions. This study examined the effect of state/trait anxiety and anxiety sensitivity on sexual responding and the propensity toward sexual inhibition/excitation in women without an anxiety disorder (n = 100, M age = 28.8 years) compared with women with an anxiety disorder (panic disorder or generalized anxiety disorder, n = 30, M age = 30.2 years). Participants completed self-report measures of state and trait anxiety, anxiety sensitivity, sexual functioning, and sexual inhibition/excitation. Women with an anxiety disorder reported worse sexual functioning compared with those without an anxiety disorder (except for desire, lubrication, and pain) and a greater propensity toward sexual inhibition, because of the threat of performance failure and its consequences. Dispositional anxiety and related worries significantly predicted various types of sexual dysfunctions. Findings suggested the importance of considering the relation between anxiety and sexual functioning to design optimal prevention and therapeutic interventions for women with anxiety disorders.
RÉSUMÉ
L'objectif principal de cette recherche était de déterminer si les embêtements de la vie quotidienne sont plus fortement reliés au bien-être physique et psychologique chez les personnes âgées que les événements majeurs. Les modèles de prédiction du bien-être physique et psychologique ont été déterminés en fonction de la contribution des embêtements et des événements majeurs ainsi que d'autres variables incluant l'évaluation subjective de la santé. Deux cents personnes âgées ont rapporté les événements majeurs des trois dernières années et les embêtements survenus au cours du dernier mois. Les sujets ont également évalué leur état de santé et le degré d'incapacité dans les activités quotidiennes conséquente à chacune de leurs maladies chroniques. Des analyses de régression multiple par étapes ont montré que (1) l'évaluation subjective de la santé, l'incapacité dans les activités quotidiennes et la fréquence des embêtements sont reliées au bien-être physique et que (2) le bien-être psychologique est associé à la fréquence des embêtements, l'âge et l'incapacité dans les activités de la vie quotidienne. La fréquence des événements majeurs récents ne contribue pas significativement à l'un ou l'autre des modèles. Des résultats similaires ont été obtenus selon que l'Échelle des Embêtements ou seulement les items de cette échelle qui ne correspondent pas à des symptômes étaient utilisés dans les analyses de régression. Les résultats suggèrent que la fréquence des embêtements est plus fortement reliée au bien-être chez les personnes âgées que la fréquence des événements majeurs.
This study examines the roles of life stress, hassles, and self-efficacy in the prediction of adjustment in aging. Twenty-six men and 26 women between the ages of 65 and 75 participated in an initial structured interview and a follow-up interview one year later. Measures of negative life change events, daily hassles, and self-efficacy were used to predict depression, psychosomatic symptoms, and negative well-being both in concurrent and time-lag designs. Frequency of hassles was the strongest predictor, showing significant relationships with depression and psychosomatic symptoms both concurrently and one year later, even when initial distress was controlled. Perceived self-efficacy was also shown to be predictive of current and subsequent depression, even after initial depression was controlled. Frequency of negative life events was a weak predictive factor. The only area where life events related significantly to health was in time-lag analyses with negative well-being, even when initial distress was controlled.
Depression is frequently associated with sexual dysfunction in both men and women.
To examine whether depression predicts sexual dysfunction and, conversely, whether sexual dysfunction predicts depression.
A systematic review and meta-analysis was conducted. PubMed and EMBASE biomedical answers electronic databases were searched for relevant studies up to November 2011. Reference lists of relevant articles were hand-searched and expert opinions were sought. Studies identified for inclusion had to be prospective cohort studies in adult populations that reported an association between depression and sexual dysfunction variables.
Odds ratios (ORs), prioritized where available, or relative risks (RRs) were pooled across studies using random-effects meta-analysis models.
Eight citations included for review yielded six studies on depression and risk of sexual dysfunction in 3,285 participants followed for 2-9 years, and six studies on sexual dysfunction and risk of depression in 11,171 participants followed for 1-10 years. Depression increased the risk of sexual dysfunction in pooled unadjusted (RR/OR 1.52 with 95% confidence intervals [1.02, 2.26]) and adjusted (RR/OR 1.71 [1.05, 2.78]) meta-analyses but not in the partially adjusted model (RR/OR 1.41 [0.90, 2.23]). There was significant heterogeneity between studies, but after removal of a single outlying study was diminished and the pooled partially adjusted, RR/OR increased to 1.69 (1.15, 2.47). Sexual dysfunction increased the odds of depression in the pooled unadjusted (OR 2.30 [1.74, 3.03]), adjusted (OR 3.12 [1.66, 5.85]), and partially adjusted (OR 2.71 [1.93, 3.79]) meta-analyses; heterogeneity was significant only in the adjusted model. Meta-regression analyses did not detect significant sources of heterogeneity in either examination.
Clinicians should be aware of a bidirectional association between depression and sexual dysfunction. Patients reporting sexual dysfunction should be routinely screened for depression, whereas patients presenting with symptoms of depression should be routinely assessed for sexual dysfunction.
The following paper reports an investigation of the relationship between various life event measures and some important measures of anxiety and its cognitive correlates. The results suggest that (i) measures of both trait anxiety and worrying are significantly related to measures of daily hassles, but are unrelated to other life event measures such as negative life events or world events, and (ii) both the tendency to interpret events as threatening and the tendency to seek out threat-relevant information (‘monitoring’) were significantly related to measures of daily hassles but unrelated to other life event measures. These results suggest that the relationship between daily hassles and trait anxiety extends to some of the important cognitive phenomena associated with anxiety, and they provide a means of conceptualizing the relationship between daily hassles and trait anxiety as an interactive one.
We report a study of sexual function in outpatient men with major depressive disorder (n = 42), compared with healthy control men (n = 37) and a clinic sample complaining of erectile dysfunction (n = 13). A principal-components factor analysis of the Brief Sexual Function Questionnaire confirmed differences in the clinical dimensions of sexual activity/performance, interest, satisfaction, and physiological competence. The four factors accounted for 72% of the variance in the analysis. Acceptable test-retest reliability, construct validity, and concurrent validity (with the Derogatis Sexual Function Inventory and a self-report behavioral log) were demonstrated. Parallel observations with findings from previous nocturnal penile tumescence studies in these same men are discussed.
Stressors are theorized to be associated with higher allostatic load (AL), a concept of physiological wear measured as a composite of physical biomarkers. Risk of high AL may vary by gender and may be intensified in places with significant environmental risks, otherwise known as 'environmental riskscapes'. Yet, no study has examined the relationship between stressors, gender, and allostatic load in an environmental riskscape. Using primary data collected in a sample (N=1072) exposed to various environmental and social stressors, we find that long-term residence in Texas City (30 or more years), residential proximity to petrochemical plants, perceived poor neighborhood conditions, and daily hassles are associated with higher allostatic load components. Variation in AL differs by gender and the types of biomarkers examined. Gender moderates the effect of length of residence in Texas City on cardiovascular health risk. We discuss our findings in light of current research on stressors, gender, allostatic load, and double jeopardy within environmental riskscapes.
One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided here. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for eight standard statistical tests: (a) the difference between independent means, (b) the significance of a product-moment correlation, (c) the difference between independent rs, (d) the sign test, (e) the difference between independent proportions, (f) chi-square tests for goodness of fit and contingency tables, (g) one-way analysis of variance, and (h) the significance of a multiple or multiple partial correlation.
Rumination in response to stressful events and depressed mood leads to harmful outcomes. In addition to intra-psychic processes, depression is also associated with daily hassles and major life events. Self-regulatory beliefs such as goal linking could mediate the link between life events, daily hassles, rumination and major depression.
The relationships between depressed mood, rumination, goal linking, life events and daily hassles were investigated in a between-groups design. Standardized questionnaire measures of these constructs were used to compare depressed participants with a group of people experiencing psychological distress, but not major depression, and a never-depressed group.
Participants with major depression experienced similar numbers of life events as the other groups, though the impact of these was greater for the depressed group than either the psychological distress group or the healthy controls. Depressed participants also experienced greater daily hassles than either of the other two groups. Depressed participants were also higher in goal linking and rumination. Regression analysis demonstrated that neither life events nor goal linking predict rumination or depressed mood. Rumination appears to moderate the relationship between daily hassles and depressed mood.
Theoretical and clinical implications are discussed.
This study investigated the role of major stressful life events vs. minor life events (i.e., daily hassles) in the persistence of primary headache. It was hypothesized that chronic headache patients (n = 83) would be characterized not so much by exposure to a continued surfeit of inherently major life events as by a tendency to appraise cognitively and emotionally any ongoing microstressor or daily hassle as being more arousing or impactful than headache-free controls (n = 51). As predicted, chronic headache patients reported a significantly higher frequency (P < 0.01) and density (P < 0.01) of daily hassles, but not of major life events, than controls. Furthermore, minor life events were significantly correlated with headache frequency (P < 0.001) and density (P < 0.001) but not with gender, age and headache history. In terms of item content, health-related hassles (e.g., trouble relaxing) were perceived as being the most stressful. Significant differences between headache subgroups (chronic tension-type headache, migraine, mixed headache) were found, with tension-type and mixed headache sufferers reporting a higher incidence and density of daily hassles than migrainous patients. It was concluded that daily hassles were significantly associated with the persistence of headache and might be a better life event approach to chronic headache than major stressful events.
Physiological and subjective patterns of sexual arousal were compared for sexually functional and dysfunctional women. Previous studies revealed seemingly contradictory findings: Some found significant group differences on physiological but not on subjective responses to erotic stimuli, whereas others found the opposite. To reconcile this discrepancy, subjects were presented with edited versions of the three erotic videotapes used in previous studies. Sexual arousal was measured physiologically with a vaginal photoplethysmograph, and subjectively with a self-report rating scale. Previous methodology was systematically replicated and extended by developing alternate physiological data collection and reduction techniques, employing alternate methods of subjective assessment, evaluating the arousal-eliciting capacity of the erotic stimuli, and designing scripts to reduce social demand. Results indicated that dysfunctional women exhibited significantly less physiological and subjectively experienced sexual arousal than functional women in all three stimulus conditions. Dysfunctional women also reported significantly less autonomic arousal. Results (i) replicate several seemingly contradictory findings in the literature, (ii) reconcile and provide evidence supporting an explanation for the apparent discrepancy, and (iii) reveal that subjective experience and genital vasocongestion are two primary components of sexual arousal that reliably discriminate dysfunctional from functional patterns of sexual response in women.
The standard life events methodology for the prediction of psychological symptoms was compared with one focusing on relatively minor events, namely, the hassles and uplifts of everyday life. Hassles and Uplifts Scales were constructed and administered once a month for 10 consecutive months to a community sample of middle-aged adults. It was found that the Hassles Scale was a better predictor of concurrent and subsequent psychological symptoms than were the life events scores, and that the scale shared most of the variance in symptoms accounted for by life events. When the effects of life events scores were removed, hassles and symptoms remained significantly correlated. Uplifts were positively related to symptoms for women but not for men. Hassles and uplifts were also shown to be related, although only modestly so, to positive and negative affect, thus providing discriminate validation for hassles and uplifts in comparison to measures of emotion. It was concluded that the assessment of daily hassles and uplifts may be a better approach to the prediction of adaptational outcomes than the usual life events approach.
Previous self-report measures of female sexual function have been either overly restrictive or inappropriate for use in large-scale clinical trials. Accordingly, we have developed the Brief Index of Sexual Functioning for Women (BISF-W), a 22-item, self-report instrument for the assessment of current levels of female sexual functioning and satisfaction. The BISF-W was administered at monthly intervals to a standardization sample of 269 women, ages 20-73 years. A principal components analysis yielded a three-factor solution--interest/desire, sexual activity, and satisfaction--which accounted for 51.2% of the variance. Concurrent validity was demonstrated by means of a comparison with the Derogatis Sexual Function Inventory. In addition, the BISF-W was compared to the Brief Sexual Function Questionnaire, a similar self-report measure of sexual functioning for men. Major advantages of the BISF-W are its ease of administration and scoring, suitability for use in both clinical and nonclinical samples, and assessment of key dimensions of female sexuality. However, based on its moderate test-retest reliability and internal consistency, further development of the instrument is indicated.
To investigate the association of sexual problems with social, physical, and psychological problems.
An anonymous postal questionnaire survey.
Four general practices in England.
789 men and 979 women responding to a questionnaire sent to a stratified random sample of the adult general population (n = 4000).
Strong physical, social, and psychological associations were found with sexual problems. In men, erectile problems and premature ejaculation were associated with increasing age. Erectile problems were most strongly associated with prostate trouble, with an age adjusted odds ratio of 2.6 (95% confidence intervals 1.4, 4.7), but hypertension and diabetes were also associated. Premature ejaculation was predominantly associated with anxiety (age adjusted odds ratio 3.1 (95% confidence intervals 1.7, 5.6)). In women, the predominant association with arousal, orgasmic, and enjoyment problems was martial difficulties, all with odds ratios greater than five. All female sexual problems were associated with anxiety and depression. Vaginal dryness was found to increase with age, whereas dyspareunia decreased with age.
This study indicates that sexual problems cluster with self reported physical problems in men, and with psychological and social problems in women. This has potentially important consequences for the planning of treatment for sexual problems, and implies that effective therapy could have a broad impact on health in the adult population.
Chronic exposure to stressors increases HPA axis activity and concomitantly reduces HPG axis activity. This antagonistic relationship between both these axes has been proposed to underlie the inhibition of reproductive function due to stress. Sexual behavior in males may be the most vulnerable aspect of male reproduction to acute and chronic stress and it has been suggested that alterations in sexual behavior during stress are due to the antagonistic relationship between testosterone and corticosteroids. However, only in a few studies has a correlation between the levels of testosterone and corticosterone, and sexual behavior been made. In this study, we evaluated the effects of different stressors, applied both acute and chronically, on masculine sexual behavior and whether or not these effects on sexual behavior are accompanied by changes in plasma levels of corticosterone and testosterone. Additionally, we evaluated the effect of testosterone treatment on the effects of stress on sexual behavior. Sexually experienced male rats were exposed to one of the following stressors: immobilization (IMB), electric foot shocks (EFS) or immersion in cold water (ICW). Sexual behavior and plasma levels of testosterone and corticosterone were assessed on days 1, 5, 10, 15, and 20 of stress. In a second experiment, males were castrated, treated with 3 different doses of testosterone propionate (TP) and exposed to ICW for 20 consecutive days. Sexual behavior was assessed on days 1, 5, 10, 15, and 20 and steroids were evaluated on day 20. Parameters of masculine sexual behavior were modified depending on the characteristics of each stressor. Mount, intromission and ejaculation latencies increased significantly, the number of mounts increased, and ejaculations decreased significantly in males exposed to EFS and to ICW but not in males exposed to IMB. Associated with these effects, testosterone decreased in the EFS and ICW groups on days 1, 15, and 20. However, corticosterone increased only in males exposed to ICW. In castrated males, TP treatment failed to block the effects of stress by ICW on sexual behavior and corticosterone. These results indicate that the effects of stress on sexual behavior depend on the characteristics of each stressor, and these effects, as well as the decrease in testosterone are not necessarily associated with the increase in corticosterone. The fact that testosterone treatment did not prevent the effects of stress on sexual behavior suggests that other mediators could be involved in the alterations of sexual behavior caused by stress.
Depression and erectile dysfunction (ED) have a complex and bi-directional relationship. We examined the relationships between erectile dysfunction and depressive symptoms or diagnosed depression, sexual activity and sexual satisfaction.
A population survey of men aged 40-70 years was carried out in Brazil, Italy, Japan and Malaysia in 1997-1998. A questionnaire was used to collect life style, sexual behaviors and medical data. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. ED was classified as moderate or complete if the men reported they were "sometimes" or "never" able to achieve and maintain an erection satisfactory for sexual intercourse. Only men with a sexual partner and not taking psychoactive drugs were considered.
Diagnosed depression was reported by 2.0% of the men, depressive symptoms by 21.0%. The prevalence of moderate or complete ED was 17.8%. Sexual satisfaction related to the frequency of sexual intercourse and inversely related to depressive symptoms. Depressive symptoms were positively associated with being single (odds ratio [OR] 1.7), widowed, separated or divorced (OR 2.2), moderate or complete ED (1.8), heart disease (1.6) and smoking (1.6), and negatively associated with age, physical activity and frequency of sexual intercourse.
Cross-sectional studies cannot establish a temporal cause-effect relationship. However, the confirmation of known associations reassures about the validity of the original findings.
The findings suggest that depressive symptoms are linked to ED by the mediation of decreased sexual activity and the dissatisfaction generated by the inability to have a healthy sexual life.
It is assumed that psychological stress may inhibit sexual arousal in women. Research on the effect of (acute and chronic) psychological stressors on genital and subjective sexual arousal, however, is scarce. To investigate whether psychological stressors indeed inhibit sexual responding, sexually functional women were randomly assigned to an experimental condition (n=30) in which acute psychological stress was induced by a frustrating computer task or a control condition (n=29). After the acute psychological stress or control induction women were exposed to an erotic stimulus. Genital sexual arousal was assessed using vaginal photoplethysmography. Self-report ratings of subjective sexual arousal were collected after the erotic stimulus. Furthermore, women were post hoc divided into a 'low' and a 'high' chronic stress group, based on their pre-assessment scores on a chronic daily stress questionnaire. As predicted, it was found that women in the acute stress condition responded with lower levels of genital and subjective sexual arousal to an erotic stimulus than women in the control condition. In addition, women with high levels of chronic stress responded with lower levels of genital sexual arousal to an erotic stimulus than women with low levels of chronic stress. Chronic stress did not affect the level of subjective sexual arousal.
The study examined similarities and differences between people having individualist and collectivist cultural orientations in terms of what they perceive as stressful and uplifting experiences in their daily lives, and the relation between daily experiences and family and life satisfaction. Data were collected from two representative community samples (697 Jews and 303 Arabs). Each sample was grouped into individualist and collectivist cultural orientations. The two cultural orientation groups differed with respect to the appraisal of positive and negative daily experiences. A structural equation modeling (SEM) multi-group analysis indicated a similar factor structure for hassles and uplifts in both groups. However, the two groups differed in the effects of positive and negative daily occurrences on family and life satisfaction.
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