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Abstract

Diminished positive experiences and events might be part of the phenomenology of social anxiety; however, much of this research is cross-sectional by design, limiting our understanding of the everyday lives of socially anxious people. Sexuality is a primary source of positive experiences. We theorized that people with elevated social anxiety would have relatively less satisfying sexual experiences compared to those who were not anxious. For 21 days, 150 college students described their daily sexual episodes. Social anxiety was negatively related to the pleasure and feelings of connectedness experienced when sexually intimate. The relationship between social anxiety and the amount of sexual contact differed between men and women-it was negative for women and negligible for men. Being in a close, intimate relationship enhanced the feelings of connectedness during sexual episodes for only individuals low in social anxiety. Depressive symptoms were negatively related to the amount of sexual contact, and the pleasure and feelings of connectedness experienced when sexually intimate. Controlling for depressive symptoms did not meaningfully change the social anxiety effects on daily sexuality. Our findings suggest that fulfilling sexual activity is often compromised by social anxiety.

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... Depression is a prevalent and impairing mental health disorder that affects women nearly twice more than men [1]. The high prevalence of depression has led to it being labeled as the "common cold" of mental disorders [2]. Depression has become a major societal concern because of the direct costs to healthcare and medical services, as well as the indirect costs of lowered productivity and disability [3]. ...
... Studies indicate that psychological factors play important roles in the sexual desire, activity, and satisfaction of women [2,17,18]. However, during the transition to menopause, women may experience changes in sexual functions due to several biopsychosocial risk factors, which can be identified in three major factors. ...
... In anguish over what one has lost, destroying one's health would be equivalent to someone selling up their capital for a small profit. (2). To look around and realize that none in this world has perpetual enjoyment and happiness, none never loss of anything or anyone. ...
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Aims: Previous research has shown the efficacy of culturally adapted Cognitive Behavioral Therapy (CA-CBT) in reducing depression, yet its effect on increasing sexual satisfaction is not well documented. In this study, an embedded randomized controlled trial design was used to examine the effect of group and individual CA-CBT on depression and sexual satisfaction among perimenopausal women. Method: A total of 64 depressed Iranian perimenopausal women were randomly assigned to two formats of treatments; sixteen sessions of group CA-CBT and eight sessions of individual CA-CBT, as well as a waitlist control group. Depression and sexual satisfaction were measured using BDI-II and ENRICH, respectively, at T1 (pre-treatment), T2 (post-treatment) and T3 (follow-up). Results: Repeated measures ANOVA indicated that the women who underwent both group and individual CA-CBT had effectively reduced depression and increased sexual satisfaction between pre-treatment and post-treatment, and it was sustained after six months of follow-ups with large effect sizes of significant differences (p < 0.001), but the control group did not. Conclusion: The results showed promising evidence for the efficacy of both treatment groups of CA-CBT for depression and sexual satisfaction among perimenopausal women. The population mental health burden among perimenopausal women may likely be reduced by propagating this effective treatment.
... Extant literature on SAD has observed two symptom presentations of the disorder: Social observation anxiety, which refers to fear of public speaking and performances, and social interaction anxiety, which relates to interpersonal interactions (APA, 2013). Symptoms associated with social interaction anxiety, in particular, relate to social avoidance or withdrawing behavior (Kashdan et al. 2011a) and a depressive affect profile (Brown et al. 1998;Chorpita et al. 2000;Kashdan 2004; Kashdan et al. 2011b;Watson et al. 1988). This relates to increased loneliness and inhibition, as well as decreased energy, pleasure, well-being, and relationship satisfaction (Kashdan 2004;Kashdan et al. 2011a;Kashdan et al. 2011b;Safren et al. 1996;Schneier et al. 1994;Stein and Kean 2000). ...
... Symptoms associated with social interaction anxiety, in particular, relate to social avoidance or withdrawing behavior (Kashdan et al. 2011a) and a depressive affect profile (Brown et al. 1998;Chorpita et al. 2000;Kashdan 2004; Kashdan et al. 2011b;Watson et al. 1988). This relates to increased loneliness and inhibition, as well as decreased energy, pleasure, well-being, and relationship satisfaction (Kashdan 2004;Kashdan et al. 2011a;Kashdan et al. 2011b;Safren et al. 1996;Schneier et al. 1994;Stein and Kean 2000). ...
... This likely relates to fears of intimacy, rejection, and expressing emotions, as well as low self-efficacy to communicate needs. Indeed, individuals with social interaction anxiety report fearing judgement and rejection for expressing emotions, believing they are weak when expressing emotions, and perceiving themselves as failing in interactions (Clark and Wells 1995;Hackmann et al. 1998;Kashdan et al. 2011a;Spokas et al. 2009;Wells and Papageorgiou 1999). ...
Article
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Social anxiety disorder is prevalent and negatively impacts adolescents and young adults. People with social interaction anxiety, a presentation category of social anxiety disorder pertaining to social relationships, tend to be more withdrawn, avoidant, and sexually dissatisfied. Some individuals with social interaction anxiety are more likely to engage in health-risk sexual behavior (HRSB), likely associated with individual differences. The present study used finite mixture modeling to discern profiles comprised of social interaction anxiety and individual differences previously associated with HRSB, replicating and extending previous findings (Rahm-Knigge et al. 2018). We also examined differences in sexual satisfaction among profiles. We replicated identifying two profiles high in social interaction anxiety that substantively differed in response to positive and negative emotions, emotion-regulation strategies, risk seeking, and non-acceptance of emotions. The profile high in social interaction anxiety and these individual differences was likelier to engage in HRSB than the other high social anxiety profile. Both high social interaction anxiety profiles were similarly low in sexual satisfaction. Despite differences in individual differences and engagement in HRSB, profiles high in social interaction anxiety reported similarly lower sexual satisfaction than the profiles low in social interaction anxiety.
... Couple's sexuality and mental health Kashdan et al. (2011Kashdan et al. ( , 2014, Kashdan, Goodman, Stiksma, Milius, & McKnight (2018) research focused on sexuality as a primary source for positive experiences in romantic relationships. In 2018, they showed that being sexually active on one day was unidirectionally related to greater well-being the next day. ...
... Similar results were found for socially anxious adults: Being sexually active was related to less social anxiety and fewer negative social comparisons on the next day (Kashdan et al., 2014). For people low on social anxiety, IOS enhanced feelings of connectedness during sexual activity (Kashdan et al., 2011). ...
... This helps to put self-reports into context and makes recollection easier and more precise. Although IOS did not predict whether a participant would reach orgasm during a sexual episode (Kashdan et al., 2011), Denes et al. (2019 showed, that participants who experienced orgasm reported significantly more IOS than both individuals who pretended to orgasm and individuals who did not have an orgasm. Additionally, greater sexual IOS was found to be robustly and significantly associated with more positive evaluations of the experienced orgasm frequency, and sexual satisfaction and well-being (Frost et al., 2017). ...
Article
To better understand the effect relationship closeness has on couple’s sexuality a scoping review was conducted, that focused on the inclusion of other in the self scale (IOS). Authors reviewed quantitative journal articles published between 2000 and 2020 by searching PsychInfo, Medline, and PubMed, resulting in 24 studies. Results suggest positive associations between IOS and sexual well-being, functioning, desire, frequency and satisfaction, and negatively related to sexual distress. Also, the benefits of positive sexual experiences expand well beyond the sexual domain onto different personal and relational factors of health and well-being. Sampling designs considerably limit the generalizability of results.
... Positive correlations between depressive symptoms and ID as well as between anxiety and ID have been replicated reliably [50,[53][54][55][56][57]. Loss of libido and FSD have been shown to be typical symptoms of (sub)clinical depressive disorders and dysthymia [23,31,58,59]. Even years after a depressive episode, some women still reported FSD [60]. ...
... Therefore, ID-induced depressive mood should have a detrimental effect on sexual function. Similarly, anxiety may be a cause of FSD with particularly negative effects on sexual appetence [4,58,59,[61][62][63][64][65][66][67]. Pronounced anxiety disorders can even lead to sexual aversion [31]. ...
... Eventually, alterations in neuroendocrine metabolism may lead to certain behaviours. ID-induced emotional and social interactive deficits [50, 53-57, 68-77, 79, 80] may increase the risk for depression and anxiety which all together are risk factors for developing FSD [4,23,31,[58][59][60][61][62][63][64][65][66][67][82][83][84]. However, such complex psychological phenomena are prone to bias and, therefore, must be interpreted carefully. ...
Article
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Purpose: Both iron deficiency (ID) and female sexual dysfunction (FSD) affect more than 25% of the world population. The aim of this study was to identify a connection between these two conditions based on the existing literature and to investigate this interrelation in a small pilot cross-sectional study. Methods: A database search for publications referring to ID and FSD was conducted. The resulting common denominators were used to formulate hypotheses regarding the interaction of these diseases. Simultaneously, 45 healthy middle-aged women completed questionnaires about their sexual function and provided a blood sample for the purpose of determining ferritin and haemoglobin levels. The main outcome measures included an analysis of responses to questions on sexuality and partnership and of blood ferritin and haemoglobin levels. The secondary outcomes included an assessment of further influences on libido, such as sex hormones, menopausal status, health, and life satisfaction. Results: Altered monoaminergic cerebral metabolism, hyperprolactinaemia and hypothyroidism, impaired socioemotional interaction, increased anxiety, and depression in both, ID and FSD, account for the most comprehensive explanations for the postulated association between the two conditions. Despite a feasible assumption, our empirical findings failed to demonstrate any correlation between ID and FSD. We identified a certain impact of menopausal hormonal status on sexual function. Conclusion: ID has no influence on FSD in the given population, although the literature suggests that FSD may at least be partly due to ID. Further research seems justified given the potential advantages for sexual health, considering that ID is an easily treatable disease.
... Obraz kliniczny FS obejmuje koncentrację na własnych wadach, zachowaniach i uczuciach oraz występowanie znacznego napięcia lękowego (od uczucia dyskomfortu do napadu paniki) w określonych sytuacjach ekspozycji społecznej, takich jak bycie w centrum uwagi, wystąpienia w grupie (Dzwonkowska, 2009;Hinrichsen i Clark, 2003). Początek FS przypada średnio na wiek 15-16 lat (Landowski i Cubała, 2012;Poag, 2007), dlatego może ona ograniczać osobom w wieku młodzieńczym eksperymentowanie w budowaniu relacji rówieśniczych, w tym damsko-męskich, i następnie hamować w nawiązywaniu kontaktów intymnych (Porter i Chambless, 2017), opóźniać inicjację seksualną (Araszkiewicz i Krzemińska, 2003), wpływać na obniżenie przyjemności i poczucia więzi w kontaktach seksualnych (Kashdan et al., 2011), czyli obniżać poziom satysfakcji seksualnej. Według Davis i wsp. ...
... The clinical picture of SP involves focusing on one's disadvantages, behaviour and emotions, significant anxiety-related tension (from discomfort to panic attacks) in specific social situations such as being in the centre of attention, group exposure (Dzwonkowska, 2009;Hinrichsen and Clark, 2003). Because the onset of SP usually occurs at the ages of 15 to 16 (Landowski and Cubała, 2012;Poag, 2007), it probably reduces young people's ability to experiment in building peer relationships, including male-female relationships, and inhibits the development of intimate relationships at later stages (Porter and Chambless, 2017), delays the age of sexual initiation (Araszkiewicz and Krzemińska, 2003), and lowers the sense of bond during sexual intercourse (Kashdan et al., 2011), thus reducing the level of sexual satisfaction. According to Davis et al. (2006), there are three components of sexual satisfaction (SS): physical (PSS) -the evaluation of sexual experience in a relationship, sexual skills and the fulfilment of sexual needs; emotional (ESS) -the feelings towards one's partner, emotions regarding sex and one's partner's behaviour; and resulting from the sense of control (CSS) -the influence on how, when and whether a sexual intercourse will take place. ...
... Pozwoliło to na dalsze analizy uwarunkowań SS w badanych grupach. Stwierdzono istotnie niższy poziom SSE w badanej grupie osób z FS niż w grupie porównawczej, co odzwierciedliło doniesienia, że lęk społeczny negatywnie koreluje z przyjemnością i uczuciami związanymi z kontaktami seksualnymi (Kashdan et al., 2011;Sparrevohn i Rapee, 2009). Jednocześnie, wbrew oczekiwaniom opartym na danych literaturowych (np. ...
Article
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Cel: W badaniu wstępnie przeanalizowano poziom satysfakcji seksualnej osób z fobią społeczną, stanowiącej aspekt jakości funkcjonowania w bliskich kontaktach społecznych. Weryfikowano też osobowościowe korelaty lęku społecznego, jakie wiążą się z wymiarami seksualnej satysfakcji. Kontrolowano wybrane aspekty aktywności seksualnej. Metoda: Przebadano 26 osób dorosłych ze zdiagnozowaną fobią społeczną i 35 osób zdrowych za pomocą Kwestionariusza Osobowości Eysencka [Eysenck Personality Questionnaire, EPQ-R(S)], Skali Nieśmiałości Cheeka i Bussa (Cheek and Buss Shyness Scale, CBSS), Kwestionariusza Zachowań Związanych z Wystąpieniami Publicznymi (Public Speaking Anxiety Questionnaire, GFER), Skali Satysfakcji Seksualnej (Sexual Satisfaction Scale, SSS). Wyniki: Osoby z fobią społeczną doświadczały niższego poziomu emocjonalnej satysfakcji seksualnej niż osoby z grupy porównawczej, ale grupy nie różniły się pod względem satysfakcji seksualnej ogólnej, fizycznej i związanej z poczuciem kontroli. Najsilniejszy związek z satysfakcją emocjonalną w badanej próbie wykazano w przypadku nieśmiałości, nie odnotowano korelacji poziomu tej satysfakcji z objawami lęku w sytuacji społecznej ekspozycji. Wnioski: Wstępne rezultaty zachęcają do dalszej eksploracji tematu – sugerują dominację aspektu emocjonalnego w uwarunkowaniach satysfakcji seksualnej osób z fobią społeczną.
... In general, sexual functioning and mental health disorders appear to have a bidirectional associative relationship; that is mental health disorders have been shown to influence sexual activity, and vice versa (Ein-Dor and Hirschberger, 2012; Kashdan et al., 2011;Laurent and Simons, 2009). Kashdan et al. (2011) examined the effects of anxiety and depression on sexual activity of 150 college students over 3 weeks, and found both social anxiety and depression to be associated with less pleasure and connectedness during sexual activity. ...
... In general, sexual functioning and mental health disorders appear to have a bidirectional associative relationship; that is mental health disorders have been shown to influence sexual activity, and vice versa (Ein-Dor and Hirschberger, 2012; Kashdan et al., 2011;Laurent and Simons, 2009). Kashdan et al. (2011) examined the effects of anxiety and depression on sexual activity of 150 college students over 3 weeks, and found both social anxiety and depression to be associated with less pleasure and connectedness during sexual activity. Furthermore, the frequency of sexual contact was negatively associated with depressive symptoms (Kashdan et al., 2011), indicating that sexual contact may have a protective effect against depressive symptoms, although this aspect was not investigated in the study. ...
... Kashdan et al. (2011) examined the effects of anxiety and depression on sexual activity of 150 college students over 3 weeks, and found both social anxiety and depression to be associated with less pleasure and connectedness during sexual activity. Furthermore, the frequency of sexual contact was negatively associated with depressive symptoms (Kashdan et al., 2011), indicating that sexual contact may have a protective effect against depressive symptoms, although this aspect was not investigated in the study. ...
Article
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Obesity has profound medical, psychological, and emotional consequences and is associated with sexual difficulties. Little is known regarding the interrelationship between obesity and sexual functioning from a psychological perspective, and less is known regarding treatment options. This review examines these issues and considers various treatments. Literature searches were conducted to locate original research, reviews, systematic reviews, and meta-analyses of obesity, overweight, sexual function, sexual dysfunction, psychological health, mental health, and weight loss. Research demonstrates an association between obesity, mental health, and sexual functioning, but has failed to identify casual pathways between these conditions. Clarifying such pathways is necessary to inform treatment guidelines for clinical practice.
... Lack of reward responsiveness may affect both the subjective experience of sexual activity and the physiological arousal accompanying sexual activity (Frohlich & Meston, 2002). Indeed, depressive symptoms are independently associated with quality of sexual experiences and sexual dysfunction (Kashdan et al., 2011;Laurent & Simons, 2009;Shindel, Eisenberg, Breyer, Sharlip, & Smith, 2011). Event-level analyses have found that depressive symptoms are related to less pleasure and connectedness during sex (Kashdan et al., 2011). ...
... Indeed, depressive symptoms are independently associated with quality of sexual experiences and sexual dysfunction (Kashdan et al., 2011;Laurent & Simons, 2009;Shindel, Eisenberg, Breyer, Sharlip, & Smith, 2011). Event-level analyses have found that depressive symptoms are related to less pleasure and connectedness during sex (Kashdan et al., 2011). It is not clear whether depression is a contributor to sexual dysfunction or an outcome because depressive symptoms may both decrease the likelihood of having sexual partners and decrease quality of sex due to stress (Shindel et al., 2011). ...
... Limited research has examined how a sexual assault history and depressive symptoms interact to affect sexual experiences. With some exceptions (Kashdan et al., 2011), investigations examining these constructs have overwhelmingly relied on global questionnaires and cross-sectional methodology. Longitudinal analyses allow for more robust inferences regarding the relationship between depressive symptoms and sexual assault history on sexual experiences. ...
Article
Depressive symptoms are one consequence of adult/adolescent sexual victimization (ASV) and are linked to sexual health. Female non-problem drinkers (N = 440) with an ASV history participated in a one-year longitudinal study. Participants completed measures of lifetime ASV severity and four quarterly assessments of depressive symptoms, ASV severity, and sexual experience quality. Multilevel models revealed that depressive symptoms interacted with ASV severity: Women with low lifetime ASV severity reported higher ratings of sexual pain as depressive symptoms increased. ASV reported during assessment months predicted sexual experience quality. Interventions to improve survivors' sexual experiences should consider incorporating treatment for depressive symptoms.
... However, another study found no such differences among those with high and low social anxiety (Beck, Davila, Farrow, & Grant, 2006). Related research suggests those with higher social anxiety are more likely to have insecure adult attachment styles (Eng, Heimberg, Hart, Schneier, & Liebowitz, 2001;Wenzel, 2002) and engage in less frequent and less intimate sexual behaviors with their romantic partners (Bodinger et al., 2002;Kashdan et al., 2011). Considering the above findings, it is important to note the methods used to collect data on social anxiety and romantic processes. ...
... hate), and sexual content (e.g. horny); the first six were chosen due to their affective nature, as social anxiety has been linked with both negative and positive affect (Brown, Chorpita, & Barlow, 1998), and sexual content was chosen due to studies documenting a relationship between social anxiety and decreased sexual functioning (Bodinger et al., 2002;Kashdan et al., 2011). ...
... Similarly, we expected that the distinction between individuals higher in social anxiety and those lower in social anxiety would be more pronounced when individuals were presented with attractive subliminal faces; in other words, we hypothesized a significant interaction between social anxiety and subliminal prime type in predicting linguistic variables. Our second hypothesis reflects the accumulating research that individuals higher in social anxiety may experience romantic relationship difficulties (Bodinger et al., 2002;Cuming & Rapee, 2010;Kashdan et al., 2011;Schneier et al., 1994;Sparrevohn & Rapee, 2009). Our final hypothesis is related to the role of gender: We hypothesized that women higher in social anxiety would use positive and negative emotion words less frequently than their male counterparts; this hypothesis is based on Cuming and Rapee's (2010) research showing that women higher in social anxiety showed a limited self-disclosure style, particularly in terms of negative and positive emotions, in romantic relationships. ...
Article
The current study used computerized linguistic analysis of stories about either going on a date or taking a walk down a street to examine linguistic correlates of social anxiety in a sample of undergraduate students. In general, linguistic analysis revealed associations of social anxiety with several linguistic variables, including negative emotion, affect, and anxiety words. Participants higher in social anxiety wrote fewer affect words. The relationship between social anxiety and anxiety words depended on gender, whereas the relationship between social anxiety and negative emotion words depended on both gender and the nature of primes (supraliminal vs. subliminal) received. Overall, our findings highlight the potential utility and benefits of using linguistic analysis as another source of information about how individuals higher in social anxiety process romantic stimuli.
... Regarding sexual satisfaction, the results support the conclusions drawn in prior studies in relation to the positive influence of the inclusion of the other in the self on sexual satisfaction (Pietras & Briken, 2021;Pietras et al., 2022;Traeen & Kvalem, 2023). This association may be due to the fact that connection levels increase during sexual relations (Kashdan et al., 2011) and the partners have more orgasms (Denes et al., 2019), as well as more positive emotions after sexual relations (Denes, 2012). Furthermore, the results presented in this study show that considering the partner integrated into one's own self-concept is related to higher levels of life satisfaction, and even though this is the first study to analyse this effect, it could be due to the close connections between satisfaction with the relationship, sexual satisfaction and life satisfaction (Dyrenforth et al., 2010;Stephenson & Meston, 2015). ...
... Dicha asociación podría Tabla 3. La IOS de cada miembro de la relación y la similitud en ios como predictores de la calidad relacional y vital. deberse a que aumentan los niveles de conexión durante las relaciones sexuales (Kashdan et al., 2011) y tienen más orgasmos (Denes et al., 2019), así como emociones más positivas tras las relaciones sexuales (Denes, 2012). Además, los resultados presentados en este estudio demuestran que el hecho de considerar a la pareja integrada en el propio autoconcepto se relaciona con mayores niveles de satisfacción vital, y pese a que este es el primer estudio en analizar dicho efecto, esto se puede deber a las estrechas conexiones existentes entre la satisfacción con la relación, la satisfacción sexual y la satisfacción vital (Dyrenforth et al., 2010;Stephenson & Meston, 2015). ...
Article
When forming a relationship, people can to some extent include their partner’s resources, perspectives and identities in their own identity (i.e., inclusion of the other in the self, or IOS). In this study, which was conducted with 169 couples, we examine the association of three sources of IOS: (a) the IOS of one member of the relationship; (b) the IOS of their partner; and (c) the similarity of both partners’ IOS with indicators of relational quality (partner conflicts, satisfaction with the relationship and sexual satisfaction) and quality of life (life satisfaction and stress). Using a multilevel approach, the results showed that higher IOS was related to higher levels of relational quality in the person and their partner, and with higher levels of quality of life in the person but not in their partner. Likewise, couples showed a strong similarity in IOS, which was indicative of higher relational quality and quality of life. These results underscore the importance of analysing the (inter)personal mechanisms and their consequences at different levels (i.e., individual and couple).
... 10 The relationship between depression/anxiety and sexual dysfunction is well known, and sexual dysfunction is a common comorbidity of depression in women. 73,74 In fact, sexual dysfunction may still be present long after a depressive episode has resolved. In women with anxiety, the most common form of sexual dysfunction is a loss of motivation/desire. ...
... In women with anxiety, the most common form of sexual dysfunction is a loss of motivation/desire. 73,74 The impairment of sexual function in women with anxiety or depression may be exacerbated by iron deficiency, which may favor avoidance behavior, a blunted positive affect, and a lower tendency to initiate social contact and sexual activity. 10 ...
Article
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Introduction: Sexual dysfunction negatively affects approximately 40% to 50% of adult women across various stages of life. Common risk factors include sexual traumas, relationship problems, chronic conditions, medication side effects, and poor physical health, including iron deficiency. Objectives: This review summarizes a presentation from a symposium that discussed the types and causes of sexual dysfunction at key times in women's lives, focusing on the relationship between iron deficiency and sexual dysfunction. Methods: The symposium was held at the XV Annual European Urogynaecological Association Congress, Antibes, France, in October 2022. Symposium content was identified through literature searches of PubMed. Original research, review articles, and Cochrane analyses discussing sexual dysfunction in association with iron deficiency/anemia were included. Results: Iron deficiency in women is commonly caused by abnormal uterine bleeding, but women may develop iron deficiency anemia (IDA) because of increased iron needs or reduced iron intake/absorption. Treatment with oral iron supplementation has been shown to improve sexual function in women with IDA. Ferrous sulphate is considered as a standard of care for oral iron treatment; prolonged-release iron formulations have improved tolerability, enabling lower doses and better tolerability. Conclusion: IDA and sexual dysfunction are related, so the identification of sexual dysfunction or iron deficiency in a woman should prompt an investigation of the other condition. Testing for iron deficiency is an inexpensive and simple step that can be routinely included in the workup of women with sexual dysfunction. Once identified, IDA and sexual dysfunction in women should be treated and followed to optimize quality of life.
... Because socially anxious women are less sensitive to reward cues, we theorize that, during sex, the sexual meanings attached to stimuli may not be strong enough to hold attentional focus, and in turn, this may impede sexual pleasure and arousal. This theorizing is in line with previous research indicating that socially anxious individuals experience fewer orgasms (Leary & Dobbins, 1983) and less sexual pleasure (Kashdan et al., 2011). ...
... This threat sensitivity and undervaluing of positive experiences may interfere with attending to erotic cues and lead to beliefs that one's partner negatively perceives one's genitals, appearance, and sexual performance. Although previous studies suggest that social anxiety is associated with sexual function (e.g., Kashdan et al., 2011), this is the first study demonstrating that social anxiety may heighten the negative impact of genital self-image on sexual pleasure and function. ...
Article
Women with negative genital self-image are more likely to experience sexual dysfunction , but the processes underlying this association are unknown. We theorized that this association is mediated by distraction from the arousing sexual cues that foster pleasure and orgasm . In a sample of 1,619 women who had sex in the previous four weeks, women with negative genital self-image were more likely to be distracted by self-critical concerns (i.e., appearance- and performance-based distraction and embarrassment) during sex, and in turn, experienced less sexual pleasure and worse sexual function. Additionally, this indirect effect via appearance-based distraction was strongest among women with trait-level anxiousness and social anxiety. We found a similar pattern of results when investigating the indirect effect of genital self-image on sexual function. Implications for understanding sexual function and therapeutic approaches are discussed.
... Specifically in romantic relationship contexts, researchers have found evidence of decreased emotional expression, self-disclosure, and intimacy in SA individuals (e.g. Kashdan, Adams, et al., 2011;Sparrevohn & Rapee, 2009). Thus there is broad evidence to believe that high SA individuals will react differently to the experience of physical touchone of the most intimate and emotionally expressive acts. ...
... How often do high SA women mate with low SA men? There is a growing body of work on intact romantic relationships when one partner is high in social anxiety (Kashdan, Adams, et al., 2011;Kashdan et al., 2014) but little to no knowledge exists on the prevalence of particular SA combinations and what is attractive about being in a relationship with a high SA partner. ...
Article
Physical touch is central to the emotional intimacy that separates romantic relationships from other social contexts. In this study of 256 adults (128 heterosexual couples, mean relationship length = 20.5 months), we examined whether individual differences in social anxiety influenced comfort with and avoidance of physical touch. Because of prior work on sex difference in touch use, touch comfort, and social anxiety symptoms and impairment, we explored sex-specific findings. We found evidence that women with greater social anxiety were less comfortable with touch and more avoidant of touch in same-sex friendships. Additionally, a woman’s social anxiety had a bigger effect on a man’s comfort with touch and avoidance of touch in the romantic relationship than a man’s social anxiety had on the woman’s endorsement of touch-related problems. These effects were uninfluenced by the length of romantic relationships. Touch is a neglected emotional experience that offers new insights into the difficulties of individuals suffering from social anxiety problems, and their romantic partners.
... Studies of patients with MDD suggest that people experiencing depression typically experience decreased levels of sexual desire and interestas high as 87% of patients in some cases (Bossini et al. 2007;Casper et al. 1985;Kennedy et al. 1999). Depressive symptoms are also related to decreased frequency in sexual contact, decreased sexual pleasure and satisfaction (Clayton et al. 2012;Kashdan et al. 2011;Mosack et al. 2011), and increased sexual dysfunction (Perlman et al. 2007). Importantly, impaired cognition and memory, comorbid substance use, and negative beliefs about the self in depressive episodes may also impact the ability to implement safe sex practices or increase vulnerability to sexual exploitation. ...
... These results partially confirm the predictions of hypothesis 2. On the one hand, the emotional impact explained part of the worsening of the sex lives of heterosexual and sexual minority men. Previous studies had already determined that mood affects sexuality (Bancroft et al., 2003;Kashdan et al., 2011). On the other hand, living with a partner during the lockdown was more associated with improved sex lives of heterosexual men compared to sexual minority men. ...
Article
Full-text available
Background: The pandemic affected the psychological well-being and sexuality of the population, especially among vulnerable groups such as men from sexual minorities. Method: In Spain, a total of 320 heterosexual men and 151 sexual minority men, aged between 18 and 60, answered an ad hoc online questionnaire about sexual behavior during the lockdown. Results: Compared to heterosexual men, during the lockdown, sexual minority men masturbated more, engaged in more sexual activities online, and had more sex with non-cohabitants. Heterosexual men had more sexual relations with their partners. Living with a partner during the lockdown predicted an improvement in sex life, especially for heterosexual men. Furthermore, the emotional impact of lockdown was a predictor of a worsening sex life regardless of sexual orientation. Conclusions: Future interventions should take into account that men’s sex lives are mediated by the emotional impact of the moment, especially among sexual minority men, since the quality of their sex life shows a weaker relationship with some of the protective variables studied (living with a partner).
... The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, includes a specifier for performance-only social anxiety (APA, 2013), and research has supported two presentation categories of social anxiety: social interaction anxiety, which relates to apprehension about coming into contact with or speaking with others, and social observation or social performance anxiety, which concerns circumstances in which people are observed by others, presenting, or performing (see Kashdan, 2004). People who have high degrees of social interaction anxiety report losing interest in enjoyable activities, having less energy, being less satisfied in their relationships, and having more behavioural inhibition (Kashdan, 2004;Kashdan et al. 2008;Kashdan et al., 2011a;Kashdan et al., 2011b). ...
Article
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According to literature, a person's level of social connection greatly influences how brave they will be when speaking in front of others. In the twenty-first century, speaking up in public with confidence is crucial for all undergraduate students. Therefore, after completing their university degree, every undergraduate student needs to have sufficient social interaction. Additionally, a student's level of social anxiety affects how much they engage with others. The amount of social interaction anxiety experienced by undergraduate students at Nigerian universities, however, has received less attention in the literature. This study investigated the undergraduate students at the University of Nigeria, Nsukka's level of social interaction anxiety. A sample of 223 undergraduate students from the University of Nigeria was used in this cross-sectional survey study. Data were gathered using the social interaction anxiety scale (α = .86), and frequency, percentage, and bar charts were utilized to analyze the results. The findings showed that most undergraduate students reported very high levels of social interaction anxiety. This means that if this high degree of social interaction anxiety is not addressed, undergraduate students will not be able to properly develop their social interaction.
... Everyone might experience anxiety in social settings to a certain degree; however, some people feel this anxiety much more intensely in their interactions with others (Leary & Kowalski, 1995). When this anxiety is high, there is an effort to hide these concerned situations as much as possible or avoid such social environments (Kashdan et al., 2011). It is noted that people with social interaction anxiety constantly relive disturbing experiences in their minds and experience negative emotions (Kashdan & Roberts, 2007). ...
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In this research, the serial mediating effect of interaction anxiety and insight in the relationship between self-esteem and approval dependence in university students was examined. The study group of the research consists of 511 university students. Research data was collected via “Two-Dimensional Self-Esteem Scale”, “the Scale of Interpersonal Relationship Dimensions”, “Interaction Anxiousness Scale” and “Insight Scale”. Descriptive statistics were used in the analysis of the data, while Pearson Correlation Coefficient was used in determining the relationship between the variables, and Bootstrap method was used to test the mediation model. According to the mediation analysis results, it was revealed that interaction anxiousness and insight functioned as mediation variables in the relationship between self-esteem and approval dependence. According to the findings, increase in self-esteem causes a decline in interaction anxiousness, which causes an increase in insight, which in turn leads to a decline in approval dependence. Findings related to the model that was tested were discussed in accordance with the literature. Suggestions for researchers and field practitioners were listed. here to enter text.
... In turn, people higher in social anxiety may have fewer opportunities to benefit from TMSI than those lower in social anxiety; however, they also have fewer opportunities to experience detrimental TMSI outcomes. These findings would be in line with research that suggests that people higher in social anxiety are less likely to engage in interpersonal sexual activity in-person, do so less frequently, and report less sexual satisfaction and pleasure than people lower in social anxiety (e.g., [101][102][103][104]). Yet, if TMSI is used as a safety behaviour, it may be the only sexual outlet for some people higher in social anxiety. ...
Article
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Technology-mediated sexual interactions (TMSI) are interpersonal exchanges via technology of self-created sexual material, including photos, videos, and auditory or text messages. There is little research on the factors that predict both TMSI experiences and their sexual wellbeing outcomes. Social anxiety is anxiety experienced in response to social or performance situations. From a cognitive–behavioural perspective, people higher in social anxiety may avoid TMSI, preventing positive or negative consequences. They also may use TMSI to avoid the anxiety caused by in-person sexual interactions, benefiting from access to sexual interactions while perpetuating anxiety about them. The purpose of this scoping review was to explore the role of social anxiety in TMSI and its sexual wellbeing outcomes. We executed a comprehensive search strategy across eight academic databases and searched reference lists of included articles. We included 19 articles written in English or French that had a human sample and were published between 1991 and 2021 and evaluated connections between social anxiety constructs (e.g., shyness, anxiety) and TMSI-related experiences (e.g., sexting, internet sex addiction). The pattern of results suggested that social anxiety constructs may predict some but not all forms of TMSI. Future research from a cognitive–behavioural perspective will expand knowledge on social anxiety, TMSI, and its sexual wellbeing outcomes.
... Everyone might experience anxiety in social settings to a certain degree; however, some people feel this anxiety much more intensely in their interactions with others (Leary & Kowalski, 1995). When this anxiety is high, there is an effort to hide these concerned situations as much as possible or avoid such social environments (Kashdan et al., 2011). It is noted that people with social interaction anxiety constantly relive disturbing experiences in their minds and experience negative emotions (Kashdan & Roberts, 2007). ...
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AR TICLE INFO ABSTRACT Article History Re ce ived 11.08.2021 Re ce ived in re vised form 08.01.2022 Acce pte d 11.02.2022 Article Type : Research Article This re search e xamined the serial me diating e ffe ct of inte raction anxiety and insight in to the re lationship be tween self-esteem and approval de pendence in unive rsity stude nts. The research group comprise d 511 volunteer university stude nts, of whom 78,7% were females and 21,3% were male s. Re search data was collected via "The Two-Dimensional Se lf-Esteem Scale", "The Scale of Inte rpe rsonal Re lationship Dimensions", "Inte raction Anxiousness Scale", and "Insight Scale". In analysing the data, descriptive statistics were examined and the relationship between variables was calculated using the Pe arson correlation coefficient. The bootstrap me thod was used to te st the me diation mode l.The me diation analysis re sults re ve aled that inte raction anxiety and insight functione d as mediation variables in the relationship between self-esteem and approval dependence. According to the findings, an incre ase in se lf-esteem causes a decline in inte raction anxiousness, which causes an increase in insight, which in turn le ads to a de cline in approval de pe ndence. Findings re lated to the model that was tested were discussed following the lite rature. Sugge stions for re se arche rs and fie ld practitione rs we re liste d. © 2022 IJPES. All rights re se rved Ke ywords: Se lf-e steem, inte rpersonal re lationships, approval de pendence, inte raction anxiety, insight, serial me diator mode l.
... One study found that those with MDD are less likely to engage in sexual contact (Kashdan et al., 2011). If those with probable MDD in our study engaged in less sexual contact, they may have been less likely to report problems with sexual pain or desire. ...
Article
Background Sexual health among service women remains understudied, yet is related to health and quality of life. This study examined if the associations between recent combat and sexual assault with sexual health difficulties were mediated by mental disorders and identified factors associated with sexual health difficulties among service women. Methods Data from two time points (2013 and 2016) of the Millennium Cohort Study, a large military cohort, were used. The outcome was self-reported sexual health difficulties. Mediation analyses examined probable posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) as intermediate variables between recent combat and sexual assault with the sexual health difficulties. Multivariable logistic regression modeling was used to examine the association of demographic, military, historical mental health, life stressors, and physical health factors with sexual health difficulties. Results Of the 6,524 service women, 13.5% endorsed experiencing sexual health difficulties. Recent combat and sexual assault were significantly associated with sexual health difficulties. Probable PTSD mediated the associations of recent combat and sexual assault with sexual health difficulties; probable MDD did not mediate these relationships. Other significant factors associated with sexual health difficulties included enlisted rank, historical mental disorders, childhood trauma, and disabling injury. Limitations Use of self-reported data, outcome not assessed using a standardized measure and future studies may benefit from examining other mediators. Conclusion Our findings that combat and sexual assault may have negative effects on service women's sexual health suggest that treatment options and insurance coverage for sexual health problems should be expanded.
... Regarding psychopathological symptoms, the literature has widely acknowledged the negative effects that some psychological conditions (such as depression (DEP), anxiety (ANX), somatization (SOM), control, and low self-esteem) may have on sexual functioning, independently from obesity [9,12,16,17]. Studies showed ANX and DEP as significantly associated with higher BMI classifications, erectile dysfunction, lower frequency of sexual intercourse, premature ejaculation, and reduced sexual enjoyment [18][19][20]. Men with extreme obesity tend to report heightened levels of body image dissatisfaction, with direct negative effects on sexual functioning and intimacy [21]. Obese men may significantly suffer from poor QoL in physical, psychological, social, and sexual domains, whereas individuals who lose weight usually report improvements in QoL [22,23]. ...
Article
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Obesity produces a significant deterioration in general and sexual health. The aim of this cross-sectional study was to investigate the impact of obesity on sexuality, illustrating the psychological constructs that may play a significant role in determining sexual functioning and satisfaction. During the psychological assessment for bariatric surgery eligibility, 171 obese men filled out a socio-demographic questionnaire, the International Index of Erectile Function (IIEF), the 20 Item-Toronto Alexithymia Scale, the Symptom Checklist-90-Revised, the Body Uneasiness Test, and the Obesity-related Disability test. A series of hierarchical multiple regression analyses highlighted how obese men sexual desire (F(11,159) = 10.128, p < 0.001), erectile function (F(10,160) = 63.578, p < 0.001), orgasmic function (F(10,160) = 33.967, p < 0.001), intercourse satisfaction (F(7,163) = 159.752, p < 0.001), and general satisfaction (F(10,160) = 18.707, p < 0.001) were significantly associated with other IIEF sexual domains, difficulties in identifying feelings, psychopathological symptoms (such as depression and paranoid ideation), body image, and quality of life. Findings are useful for deepening understanding of obese male sexual response, and more generally, for analyzing the complex and multivariate relation between obesity and sexuality, supporting the need of a multidisciplinary approach to obesity care that includes professionals with specific training in sexology.
... In our study, we had unprecedented information on subjective well-being on days preceding and days following sexual assault. The only reason we could collect these data is that we included a question about non-consensual sex in a 21-day experience sampling study (Kashdan et al., 2014;Kashdan, Adams, Savostyanova, McKnight & Nezlek, 2011;Kashdan, Goodman, Stiksma, Milius, & McKnight, 2018). When data are available to capture the temporal course of traumatic events (see Fredrickson, Tugade, Waugh, & Larkin, 2003 for an examination of 46 people before to after the terrorist attacks on September 11, 2001), a small sample becomes meaningful, especially if the goal is to provide knowledge to spearhead future research. ...
Article
Approximately 15-20% of adult women in the United States have been sexually assaulted. Given the high prevalence of sexual assault, it becomes increasingly important to understand immediate responses to sexual assault. A lack of information prior to sexual assaults contributes to a literature that is unable to showcase the presence and amount of change. A tendency to rely on comparisons between people, instead of the collection of multiple moments of a single person over time, will continue to point toward imprecise, statistical "average" reactions to sexual assaults. Prior methodological approaches lead to broad overgeneralizations about sexual assault survivors that may undermine their unique experiences in the aftermath of an assault. The present study extends the existing literature with access to unprecedented data gathered on the days before and immediately after someone survived a sexual assault. To our knowledge, there are no studies capturing prior functioning and near immediate psychological reactions of sexual assault survivors. In the present study, each night over the course of three weeks, we asked college students (n = 186) to report on their sexual activity and well-being. Six women and one man reported being sexually assaulted at least once. We examined psychological experiences on the days before and after sexual assaults (including negative and positive affect, social anxiety, self-esteem, emotion expressive suppression, and cognitive reappraisal). To examine sexual assault reactions, we used various descriptive approaches. Our results suggest that before and after being assaulted, survivors showed no consistent response in subjective well-being. We failed to find a prototypical psychological profile. Despite the small sample, our results raise important questions and offer future hypotheses about individual differences in responses to sexual assault.
... Imaging studies on patients with anxiety, albeit mostly in men, reveal consistent abnormal hyperactivation of the amygdala in response to threat, and decreased connectivity between emotion processing and regulatory regions [6•, 49], hence the characteristic hypervigilant features observed in patients with anxiety disorder. Under this condition, rather than being attentive to arousing cues, patients instead suffer from marked distraction and intrusive thoughts such as erection concerns and uneasiness about being evaluated by their partner [50,51]. Several studies have identified [52] the comorbidity between social anxiety disorder and premature ejaculation [50,53,54]. ...
Article
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Purpose of Review With a growing focus on mental health, it is imperative that healthcare providers seek to understand how psychiatric comorbidities affect sexual health. The purpose of this review is to identify and fill knowledge gaps in our understanding of the relationship between psychiatric comorbidities, their treatments, and sexual health, expanding on management approaches that are geared toward optimizing patient outcomes. Recent Findings Following increased interest in sexual medicine and growing research on sexuality, we have deepened our understanding of sexual health. Affective disorders and their treatments are linked to sexual dysfunction, which manifest differently in men and women as well as in individuals with concurrent psychiatric disorders. Merging current knowledge on sexual health with neuroscientific findings on affective disorders may provide a better approach to assessing and treating specific sexual complaints. Summary Failure to investigate a patient’s psychiatric background negatively influences treatment goals. Clinicians who seek to improve overall patient health must endeavor to consider patient characteristics such as gender differences and concurrent comorbid psychiatric conditions with regard to effectiveness of treatment and side effect profiles. A better understanding of sexual function and psychiatric disorders in terms of neuroimaging and neurobiology may assist healthcare providers in choosing treatment options that are best suited to specific patient concerns.
... In contrast, sexual activity (i.e., oral sex, passionate kissing, penetration) on 1 day is associated with increased positive mood on the same-day [40,43] and nextday [41,44]. More pleasurable sexual activity is linked with lower next-day negative mood and anxiety [41,45] and higher next-day positive mood [41]. Longitudinal studies reveal similar patterns [46]. ...
Article
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Purpose of Review Emotion regulation is a key contributor to social functioning and mental health; yet, its influence on sexual well-being has only recently gained research attention. To elucidate correlates of women’s sexual satisfaction, desire, frequency, function, and distress and guide future study, the present review evaluates research at the intersection of emotion regulation and sexual well-being. Recent Findings There are clear associations between mood and sexual well-being, with the interference of negative emotion on sexual outcomes stronger for women relative to men. Although there is evidence that women’s poorer emotion regulation abilities are related to poorer sexual well-being, associations between specific emotion regulation strategies and sexual outcomes are less established, possibly due to the abundance of regulatory strategies and dearth of research on emotion regulation in sexual contexts. Still, our review suggests that women’s greater sexual well-being is positively associated with strategies characterized by adaptive engagement (e.g., problem solving, acceptance, reappraisal) and negatively associated with strategies characterized by disengagement (e.g., avoidance, suppression, distraction) and aversive cognitive perseveration (e.g., worry, rumination). Summary Extant research is consistent with models of women’s sexual response and offers preliminary support for the emotion regulation–sexual well-being link. While the explanatory power of the current literature is limited by a lack of dyadic and longitudinal studies, interventions targeting emotion regulation hold promise for improving women’s and couples’ sexual well-being.
... The term vaginismus was first used by Marion Sims in 1862, Sims defined the term as a contraction of the muscle building of the vagina (Marshania, 2017). Women with this problem have severe pain during marital relationships, which is usually due to severe pelvic floor muscle contraction (Hubin et al., 2011;Jha & Thakar, 2010;Kashdan et al., 2011). The American Psychiatric Association defines vaginismus as an uncontrollable contraction of the muscle of one third of the external vagina that prevents intercourse. ...
Article
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Objectives: Evaluating the effect of botox injections on the satisfactory penetrating in women with vaginismus. Methods: A comprehensive systematic search in the electronic databases carried out up to September 2018. All studies that used botox to treat vaginismus were included in this review. Results: Nine cohort studies were included in meta-analysis. Our results indicate that botox can be an option for effective treatment of patients with vaginismus (event rate = 0.855, 95% confidence interval = 0.764 to 0.915; p-value < 0.001). Conclusion: Botox injection can improve vaginismus. However, because of the lack of randomized clinical trials, this conclusion should be carefully interpreted.
... Lutfey et al. (2008) found that a history of adult sexual abuse was significantly and positively associated with sexual dysfunction even after controlling for depression. However, it is unclear whether depression is an outcome to sexual dysfunction or a contributor, particularly as symptoms of depression are independently associated with sexual functioning (Kashdan et al., 2011). One longitudinal study with women who reported a history of sexual assault victimization found that the interaction of depressive symptoms with lifetime assault severity predicted pain experienced during sex over 1 year (Neilson, Norris, Bryan, & Stapenbeck, 2017). ...
Chapter
Sexual victimization is a pervasive problem associated with immediate and long-term psychopathology and sexual health impairment. The impact of sexual assault on mental health has been extensively examined. Findings indicate that women who experience sexual assault are more likely to use illicit drugs, report symptoms of anxiety, depression, or posttraumatic stress disorder (PTSD), and interpersonal difficulties in comparison to the general population (Briere & Jordan, 2004; Tolin & Foa, 2006). Ample evidence indicates that sexual victimization is also associated with negative sexual health outcomes including orgasm difficulties, inhibited arousal or desire, fear of sex, negative attitudes about sex, and engaging in risky sexual behaviors (Leonard & Follette, 2002; Lutfey et al., 2008; Rellini & Meston, 2007). Although there is little disagreement that sexual assault is associated with negative mental health sequelae, the treatment of sexual dysfunction is subject to considerable debate. Evidence-based treatments for trauma-related sequelae have been extensively examined, and variations of cognitive behavioral therapy (CBT) have been demonstrated to successfully treat commonly experienced trauma-related psychopathology (i.e. depression, anxiety, and PTSD; Resick et al., 2002). There is a dearth of research on protocols assessing and treating female sexual functioning following experiences of sexual victimization. As such, the aim of this chapter is to identify the key findings and gaps in the literature regarding the treatment and prevention of sexual dysfunction and discuss strategies for intervention. The chapter will begin with a brief overview of the prevalence rates of sexual assault and sexual dysfunction disorders, followed by an examination of evidence-based treatments of sexual dysfunction including best practices for assessment and intervention.
... In a study by et al. et al. et al., et al Ramezanzadeh (2004) the prevalence of anxiety was reported 86.8%, similarly prevalence mentioned sexual dysfunction in infertile women as to be 87.1% (Jamali 2013)..Few studies in Iran reported this prevalence to be 74.5% to 56% (Mirblouk , 2016;Pakpour , 2012). Women under stress fail to express their feelings and desire properly, as cortisol prevents oxytocin in female's brain and inhibits the willingness for the sexual and physical relationship (Kring & Johnson, 2017;Kashdan , 2011). Kashdan (2011) established a relationship between social anxiety and sexual relationships and was found to be negligible among women and reverse among men. ...
Article
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Infertility acts as a psychological blow in a couple's life. It also reduces sexual satisfaction in infertile women. The present study aimed to compare the effect of infertility treatment while face-to-face and educational booklet teaching methods on anxiety levels and sexual function among infertile women by conducting a clinical trial on 111 randomly selected infertile women. Total subjects were grouped into three categories of 37 each. Those who received face-to-face training and/or booklet training were placed in experimental groups while the control group received no training. The data collection instruments consisted of a demographic questionnaire, the Female Sexual Function Index, and Spiel Berger Anxiety Inventory. In personal training group, sexual function score and anxiety score altered significantly, but in training group by the booklet distribution, the sexual function score increased whereas anxiety score decreased. After the intervention, there were statistically significant differences also revealed between groups of intervention and control in five domains of sexual function; desire, arousal, lubrication, orgasm, and dyspareunia. Finally, methods of infertility treatment by experienced specialists either by personal training or via distributing educational booklet both were seen to be effective for infertile women.
... For instance, concerns about being evaluated and devalued by others may impede women with social anxiety disorder from giving partners sexual access [26]. Among men with social anxiety disorder, the sexual dysfunction generally occurs in the arousal phase, possibly reflecting a specific performance anxiety [25]. ...
Article
Purpose of review: Sexual dysfunction is a frequent issue in patients with affective disorders, affecting its quality of life and posing challenges to the approach of these patients. Recent findings: In recent years, human sexuality has attracted interest from the scientific community, and today we have a much deeper knowledge of the mechanisms involved in the sexual response. Paraphilias or sexual dysfunctions like low sexual desire, premature ejaculation, and erectile dysfunction, are frequent in affective disorders, and the frequency of each sexual problem varies according to the affective disorder. Comparing what is currently known about the sexual response with the main neurobiological findings of depressive, anxiety, obsessive-compulsive and posttraumatic stress disorders, it is possible to better understand specific sexual complaints of patients with these disorders. Summary: A better understanding of sexual function in affective disorders may help clinicians to choose treatments more suited to specific needs of these patients. Although the current state of science already allows us to have some understanding about sexual function in affective disorders, this critical area of research is still in its infancy, waiting for more investment.
... In the general population, individuals who endorse depressive symptoms also often report diminished sexual activity (Kashdan et al., 2011;Nicolosi, Moreira, Villa, & Glasser, 2004) and increased sexual dysfunction (Atlantis & Sullivan, 2012;Kennedy, Dickens, Eisfeld, & Bagby, 1999;Williams & Reynolds, 2006). Only two studies have explored this relationship among individuals with lower extremity amputation (LEA); one study found that depressive symptoms were highly correlated with decreased sexual activity (Williamson & Walters, 1996), while another found no significant associations between depressive symptoms and sexual outcomes (Bodenheimer et al., 2000). ...
Article
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Objective: This study examined the prevalence and correlates of sexual activity among individuals experiencing their first dysvascular lower extremity amputation. Design: A prospective cohort was recruited from 4 Veterans Affairs Medical Centers. Of 198 potential participants who met inclusion criteria, 113 (57%) agreed to participate within 7 days of amputation (baseline) and 6 weeks, 4 months, and 12 months post-amputation; 105 completed the sexual activity items at baseline. Measures included self-reported frequency of sexual activity; desire for more or less sexual activity; importance of sexual activity to satisfaction with life; Patient Health Questionnaire-9; Locomotor Capability Index-5; pain intensity/frequency; quality of life. Results: Depending on the time period post-amputation, 11%-24% reported engaging in any sexual activity, although a majority indicated that sexual activity is very important to their satisfaction with life. Frequency of sexual activity increased between 6 weeks and 4 and 12 months post-amputation. In univariate analyses, older age was associated with decreased sexual activity at all time points; at 4 and 12 months, greater mobility was associated with increased sexual activity. In multivariable models, mobility was associated with sexual activity at 4 and 12 months; age and race remained associated with sexual activity at 4 and 12 months, respectively. At all time points, frequency and importance of sexual activity were significantly associated with one another. Conclusions: Although a minority of individuals engaged in any sexual activity during the study period, it remained an important factor in overall satisfaction with life. Younger age and improved mobility were associated with increased sexual activity. Rehabilitation specialists are encouraged to address sexuality and, if relevant, incorporate it into rehabilitation goals. (PsycINFO Database Record
... Even the most intimate of relationships appear to be affected by these positivity deficits. In a 21-day experience sampling study of sexual activity, socially anxious people reported less intense pleasure and feelings of connectedness during sexual encounters, regardless of the closeness of their relationship (Kashdan et al., 2011). It is noteworthy that gender moderated the effects of social anxiety on the frequency of sexual experiences, while the degree of relationship closeness moderated the effects of social anxiety on the quality of social experiences. ...
Chapter
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The primary purpose of this chapter is to review neglected, under-appreciated elements of positivity that are relevant to the phenomenology and treatment of social anxiety disorder (SAD), and distinguish SAD from other emotional disorders. We present theory and research on infrequent positive events, attenuated positive experiences, impaired attention to positive stimuli, atypical reactions to overtly positive social situations, and a meaningful subset of individuals who show signs of impulsive, short-lived positive events. Methodological advances are introduced along with new avenues for enhancing positive experiences, positive events, and a sense of meaning and purpose in life in individuals with social anxiety difficulties. Taken together, this chapter broadens theory, research, and treatment efforts to encapsulate the positive spectrum of human functioning.
... Similarly, findings from a study in which college students kept daily accounts of their sexual experiences indicated a negative relationship between social anxiety and plea- sure and feelings of connectedness when sexually intimate -suggesting that social anxiety could interfere with the satisfaction derived from sexual activity (Kashdan et al., 2011). Also, Montesi and colleagues (2013) found that higher social anxiety was JWST417-c27 ...
Chapter
Sexual activity, beyond the biological imperative, represents an important opportunity for couples to enhance physical and emotional proximity, as well as to find pleasure in one another. Given its complexity, ascertaining the true prevalence of sexual anxiety is challenging. Research to date explores the way in which anxiety permeates sexual function, as well as the presence of sexual difficulties in the face of anxiety. It may come as no surprise that clinically significant sexual anxiety is often associated with sexual dysfunction. Research results highlight the way in which anxiety permeates the multiple dimensions of intimacy and sexuality, and eventually interferes with the expression of one's sexual self in a dyadic context. Anxiety can be an important predisposing, precipitating, and perpetuating factor in the experience of painful sexual intercourse. When sexual anxiety becomes problematic to the point of rendering sexual activity a negative experience, psychological interventions may be helpful.
Article
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Background There has been an increased interest in understanding social anxiety (SA) and SA disorder (SAD) antecedents and consequences as they occur in real time, resulting in a proliferation of studies using ambulatory assessment (AA). Despite the exponential growth of research in this area, these studies have not been synthesized yet. Objective This review aimed to identify and describe the latest advances in the understanding of SA and SAD through the use of AA. Methods Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature search was conducted in Scopus, PubMed, and Web of Science. Results A total of 70 articles met the inclusion criteria. The qualitative synthesis of these studies showed that AA permitted the exploration of the emotional, cognitive, and behavioral dynamics associated with the experience of SA and SAD. In line with the available models of SA and SAD, emotion regulation, perseverative cognition, cognitive factors, substance use, and interactional patterns were the principal topics of the included studies. In addition, the incorporation of AA to study psychological interventions, multimodal assessment using sensors and biosensors, and transcultural differences were some of the identified emerging topics. Conclusions AA constitutes a very powerful methodology to grasp SA from a complementary perspective to laboratory experiments and usual self-report measures, shedding light on the cognitive, emotional, and behavioral antecedents and consequences of SA and the development and maintenance of SAD as a mental disorder.
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This study examined whether being bullied by peers in childhood and adolescence was associated with sexual depression in adulthood, and whether this relationship was mediated by shame, social anxiety, and body dissatisfaction, and moderated by gender. A large sample of adults ( N = 1210, M age = 27.07 years, SD = 7.87, 44.8% cisgender men, 47.9% cisgender women, 7.3% other genders) completed an online questionnaire on various sexual and life experiences. Data analysis was done in SPSS. Linear regression of sexual depression on the incidence of bullying was statistically significant ( β = .08, p = .001), as was our moderated mediation model ( R ² = .42, F(21, 1188) = 40.15, p < .001). Bullying was positively associated with shame ( B = .09, p < .001) and social anxiety ( B = .06, p < .001), and negatively associated with body satisfaction ( B = −.06, p < .001). Furthermore, shame ( B = .35, p < .001), social anxiety ( B = .15, p = .011) and lower body satisfaction ( B = −.25, p < .001) were positively associated with sexual depression. One interaction was significant with p = .0497: shame was more strongly associated with sexual depression for cisgender men ( B = .03, 95% CI = [.02, .05]) than for cisgender women ( B = .01, 95% CI = [.00, .02]). Altogether, shame, social anxiety, and low body satisfaction fully mediated the relationship between bullying in youth and later sexual depression. Implications for strengthening anti-bullying measures in schools and for promoting sexual well-being are discussed.
Article
Personality can be explored hierarchically with higher- and lower-order factors. Recent research suggests the personality hierarchy is comprised of higher-order Big Five traits with two lower-order “aspects” for each Big Five trait. There appears to be a lack of research examining the relationship between these lower-order aspects and social anxiety (SA) severity. To better understand these relationships, 443 university undergraduate students (72.2 % female; mean age = 20.48, SD = 4.64) completed the Big Five Aspects Scale (BFAS) and the Social Phobia and Anxiety Inventory-23, and were retained following exclusionary criteria. Path analysis, covarying for sex, age, and general anxiety severity, was used to examine the relationship between social anxiety severity and the 10 aspect scores from the BFAS (i.e., volatility, withdrawal, compassion, politeness, industriousness, orderliness, enthusiasm, assertiveness, intelligence, openness). Significant relationships with SA severity were found for withdrawal (positive), orderliness (positive), enthusiasm (negative), and assertiveness (negative). Findings suggest that a unique pattern of lower-order personality is associated with SA severity. Further research is needed to clarify whether personality profiles differ according to diagnostic versus dimensional social anxiety.
Article
Background: Social Anxiety Disorder (SAD) is associated with pervasive functional impairments and chronicity. Romantic relationship functioning and quality for individuals with SAD has been previously explored but existing studies have not been synthesised. Aims: This scoping review charted existing literature regarding the quality and functioning of romantic relationships for people with SAD and high sub-clinical social anxiety (SA). Methods: The review used a scoping approach to explore the current evidence base relating to SA, romantic relationship quality and functioning. Articles published in English after 1980 that reported either clinical or high sub-clinical SA were eligible. Double screening, data extraction, quality assessment, and thematic analysis of studies was conducted. Results: 50 studies from 46 articles were identified, involving a range of community, college, adolescent, and clinical samples. Thematic analysis identified four themes; Relationship Quality, Satisfaction and Commitment; Communication and Self-Disclosure; Conflict, Social Support and Trust; Intimacy, Closeness and Sexual Satisfaction. Conclusions: The review highlights that evidence relating to romantic relationship functioning for individuals with SAD and high sub-clinical SA is heterogeneous, with relationship initiation in particular relatively under-explored. Further research is required to elucidate key constructs and interpersonal processes related to relationship functioning, and to inform treatment approaches with this group.
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Aim: Pathological jealousy toward spouse is one of the most common complaints of couples referring for couple therapy. The research aimed to study the effectiveness of integrated cognitive-behavioral therapy and mindfulnes on decreasing of marital conflict and anxiety in women withpathological jealousy toward spouse. Methods: For this purpose, a quasi-experimental pretest, posttest and follow up design with control group was used. The study sample included 34 women with Pathological jealousy who were selected through purposive sampling among women referredto counseling centers in Isfahan. The intervention method included10integrated sessions of cognitive-behaviorla therapy and mindfulness that was implemented for experimental group. In order to assess variables Marital Conflict Questionnaire (Barati & Sanayi, 2000) and State Anxiety Inventory (Spielberger, et al., 1983) were used. The data analysis conducted by multivariate analysis of variance with pretest and control. Findings: The findings showed a significant decline in the mean scores of experimental group, both in anxiety and in marital conflict, in pretest and follow-up stages, but no tangible changes were observed in the control group scores. (p<0.0005). Conclusion: Thus, integration of cognitive-behavioral therapy and mindfulness has been effective in reducing marital conflict and anxiety in women with pathological jealousy toward spouse, and could be used by couple therapists and other psychotherapists.
Article
This study describes transgender and gender diverse (TGD) youth perceptions of parental messages regarding sexuality and sexual/romantic relationships and how those messages impact feelings and decisions about their sexual health. Eight in-depth, semi-structured interviews (mean = 66 minutes) with TGD young people (16-23 years) were included in this qualitative analysis. Illustrated by participant quotes, four themes are discussed: (1) parent’s sexual values as context and a critical testing ground, (2) LGBTQ sexuality, (3) youths’ futures through cisnormative and heteronormative lenses, and (4) impact of parental messaging on youth’s sexual health. Implications include working with families to de-center cisgender perspectives in messaging.
Article
Sexual activity is important role in life of men. Decreased sexual function has a negative impact on the quality of life of the patients and their partners. In this study, we aimed to evaluate the relationship of erectile dysfunction (ED) with self‐esteem, symptom severity and depression. The 80 patients were evaluated prospectively. Group 1 (cases group) included 40 patients who with ED an age range of up to 18–70 years. Group 2 (healthy control group) included 40 patients who apply to the urology clinic for various reasons without ED. All patients were filled international index of erectile function‐5 (IIEF‐5), Beck Depression questionnaire (BDI‐2) and Rosenberg self‐esteem questionnaires (RESQ). Demographic characteristics and inventory results of the patients were compared between the two groups. Significant differences were found between the two groups in IIEF‐5, RESQ and BDI‐2 scores. In Group 1, IIEF‐5 score was low, RESQ, BDI‐2 scores were significantly higher (All scores p < 0.001). As a result people significantly reflect their sexual satisfaction in their social life. The patients with mild ED are not entirely satisfied in spite of normal sexual frequency. This situation causes significantly low the self‐esteem of men. Prevention of ED will contribute to increased self‐esteem and happy lives.
Article
Background In addition to factors intrinsic to bipolar disorder (BD), sexual functioning (SF) can be affected by extrinsic causes, such as psychotropic drugs. However, the effect of mood stabilizers on SF and quality of life (QoL) is an underexplored research area. Aim To analyze SF in BD outpatients in euthymia for at least 6 months treated only with mood stabilizers and the association between SF and QoL. Methods A multicenter cross-sectional study was conducted in 114 BD outpatients treated with (i) lithium alone (L group); (ii) anticonvulsants alone (valproate or lamotrigine; A group); (iii) lithium plus anticonvulsants (L+A group); or (iv) lithium plus benzodiazepines (L+B group). The Changes in Sexual Functioning Questionnaire Short Form (CSFQ-14) was used. Statistical analyses were performed to compare CSFQ-14 scores among the pharmacological groups. An adaptive lasso was used to identify potential confounding variables, and linear regression models were used to study the association of the CSFQ-14 with QoL. Main Outcome Measures Self-reports on phases of the sexual response cycle (ie, desire, arousal, and orgasm) and QoL were assessed. Results The A group had better total SF scores than the L group and the L+B group. Relative to the A group, the L and L+B groups had worse sexual desire; the L group had worse sexual arousal; and the L+A group and the L+B group had worse sexual orgasm. Regarding sociodemographic factors, being female and older age were associated with worse total SF and all subscale scores. Among all subscales scores, higher sexual arousal scores were associated with better QoL. Clinical Implications Potential modified extrinsic factors such as psychotropic medication that can affect SF can be addressed and adjusted to lessen side effects on SF. Strengths & Limitations Sample of patients with euthymic BD in treatment with mood stabilizers and no antipsychotics or antidepressants, substance use as an exclusion criterion, and use of a validated, gender-specific scale to evaluate SF. Major limitations were cross-sectional design, sample size, and lack of information about stability of relationship with partner. Conclusions Lithium in monotherapy or in combination with benzodiazepines is related to worse total SF and worse sexual desire than anticonvulsants in monotherapy. While the addition of benzodiazepines or anticonvulsants to lithium negatively affects sexual orgasm, sexual arousal (which plays a significant role in QoL) improves when benzodiazepines are added to lithium. Anticonvulsants in monotherapy have the least negative effects on SF in patients with BD. García-Blanco A, García-Portilla MP, Fuente-Tomás L de la, et al. Sexual Dysfunction and Mood Stabilizers in Long-Term Stable Patients With Bipolar Disorder. J Sex Med 2020;XX:XXX–XXX.
Article
Background: Individuals with social interaction anxiety, a facet of social anxiety disorder, are heterogeneous with respect to approaching or avoiding risky behaviors, including substance use. Additionally, the relation between social anxiety and cannabis use frequency has been inconsistent in the literature. Objective: The present study aimed to clarify the relation between social interaction anxiety and cannabis use by examining the effects of personality traits known to differentially predict substance use, including sensation seeking, emotion dysregulation, urgency, behavioral approach, and behavioral inhibition. Methods: We explored heterogeneity in social interaction anxiety using finite mixture modeling to discern profiles differing in mean scores on measures of social interaction anxiety and personality. We then examined how profiles differed in their likelihood of cannabis use. Results: The profile with low social interaction anxiety and high scores on personality measures was the most likely to use cannabis at all time periods. Two profiles with high social interaction anxiety scores were discerned. Between these two profiles, the profile with the highest levels of social interaction anxiety and most measured personality traits was more likely to use cannabis across all measured time periods. The profile with the high social interaction anxiety and low scores on personality measures was the least likely to use cannabis. Conclusions: Results of the present study identified personality traits most associated with increased risk of cannabis use for people high and low in social interaction anxiety, including facets of emotion regulation, urgency, and sensation seeking.
Chapter
The chapter sheds light on the linkages between technology-driven innovation, innovative capabilities, activities, and their impact on innovation performance in Dubai Municipality. The methodology adopted is qualitative research using various sources of data, including reports, academic papers, and a survey of visitors and residents. The chapter aims to depict the relationship among a set of elements that foster innovation in the urban context, which is an integral part of an overarching strategy for mainstreaming public sector innovation. Leadership, culture, and infrastructure are critical determinants for an innovative municipality. A set of policy recommendations concludes the chapter to enhance innovation performance and sustainable innovation in cities by investing in digital transformation, smart infrastructure, and e-governance.
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For decades, researchers and practitioners have theorized psychological disorder and health as opposite ends of a single continuum. We offer a more nuanced, data driven examination into the various ways that people with psychological disorders experience well-being. We review research on the positive emotions, meaning and purpose in life, and social relationships of people diagnosed with major depressive disorder, bipolar disorder, social anxiety disorder, schizophrenia, and trauma-related disorders. We also discuss when and how friends, family members, and caregivers of these people are adversely impacted in terms of their well-being. Throughout, we highlight important, often overlooked findings that not all people with mental illness are devoid of well-being. This review is meant to be illustrative as opposed to comprehensive, synthesizing existing knowledge and inspiring explorations of unclear or undiscovered territory.
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African American youth are often stereotyped as being more aggressive than and experience more severe negative social sanctions relative to their European American peers. This cross-sectional study assessed self-reported levels of aggression among a sample of 538 low-income African American youth in Chicago, and employed latent class analysis to determine groups of aggression. Major study findings showed low, middle high aggression group. The largest number of youth fell within the low aggression group. Social factors (e.g., low student-teacher connectedness, high risky peer norms, neighborhood violence, and family conflict) were associated with inclusion in the high aggression group. Intrapersonal factors (e.g., depression, anxiety, post-traumatic stress disorder) were associated with inclusion in the middle aggression group. Future longitudinal research should examine what factors are associated with movement across aggression groups and capitalize upon knowledge gained in the current study to develop interventions.
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Most research on the link between social anxiety and alcohol consumption has examined problematic outcomes without consideration of potential adaptive functions. Alcohol is an anxiolytic that has the short-term benefit of reducing anxiety; consumption may act as a social lubricant that facilitates higher quality social interactions. Using experience-sampling methodology, we examined how consuming alcohol attenuates the adverse effects of social anxiety in naturally occurring social interactions. Participants (N = 160) completed demographic and trait measures, then completed daily assessments for 14 consecutive days. Results from multilevel model analyses revealed that during face-to-face social interactions, state social anxiety was inversely related to 10 indicators of healthy social interactions (e.g., enjoyment, laughter, feelings of acceptance). Alcohol consumption moderated seven of these associations, such that when participants consumed alcohol in social situations, state social anxiety was no longer associated with social interaction quality. The quantity of alcoholic drinks consumed moderated two of these associations. Furthermore, we found evidence for directionality, such that social anxiety in a given social interaction predicted alcohol consumption in a subsequent social interaction, but not the reverse (i.e., alcohol consumption did not prospectively predict state social anxiety). In social situations that involved alcohol, experiences of social anxiety no longer thwarted one's ability to derive social benefits. These results should be interpreted in the context of a participant sample with relatively low levels of trait social anxiety and frequency of alcohol use. Nonetheless, obtaining social rewards may be a reinforcement mechanism that maintains the link between social anxiety and alcohol consumption.
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El objetivo de este estudio fue determinar la relación de variables sociodemográficas, físicas y emocionales con la satisfacción sexual. Los datos fueron recabados de octubre de 2014 a abril de 2015. La muestra fue de 300 mujeres de 18 a 50 años que vivieran en la comunidad de Xalapa, Veracruz, México y respondieran un cuestionario en línea y al Índice de Satisfacción Sexual. El análisis estadístico para encontrar la relación entre variables se realizó mediante la prueba estadística de independencia chi- cuadrada de Pearson. Los resultados muestran que el 59.3 % de las mujeres se encuentra sexualmente satisfechas y el 40.6 % no satisfechas. Se determinó la asociación de variables entre la satisfacción sexual y variables sociodemográficas (estado civil) variables físicas (presencia y frecuencia de diferentes tipos de orgasmos) y variables emocionales (tipo de actividad sexual y prejuicio ante el sexo). El presente trabajo aporta datos relevantes en relación a la satisfacción y el deseo sexual de mujeres de Xalapa, Ver., México
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Sex is rarely discussed in theories of well-being and rarely empirically examined using methods other than cross-sectional surveys. In the present study, a daily diary approach was used (for 21 days with 152 adults) to explore the relationship between the presence and quality of sexual episodes and well-being (positive affect, negative affect, meaning in life). Time-lagged analyses demonstrated that sexual activity on 1 day was related to greater well-being the next. As for the quality of episodes, higher reported sexual pleasure and intimacy predicted greater positive affect and lower negative affect the following day. When the reverse direction was tested, well-being did not predict next-day sexual activity, pleasure, or intimacy. These results suggest a unidirectional relationship in which the presence and quality of sexual activity lead to gains in well-being the following day. Contextual moderators (gender, relationship status, relationship closeness, and relationship length) allowed for tests of conditions altering the link between sexuality and well-being. Relationship closeness was the most robust moderator in predicting greater levels of meaning in life and positive affect following sexual episodes. These data provide evidence to support the continual consideration of sex in empirical work and theoretical models of elements that comprise healthy relationships and a good life.
Article
Heavy college drinking is associated with risky sexual behavior. It is therefore important to identify groups that are especially vulnerable to alcohol-influenced sexual risk (e.g., unplanned/unexpected sex). Undergraduates with elevated social anxiety represent one such vulnerable group given that social anxiety is associated with fear of intimacy and heavier drinking in intimate situations and situations with expected negative affect. Drinking to cope with negative affect induced by fear of intimacy might render socially anxious undergraduates vulnerable to risky sexual behavior, yet no known studies have examined this relationship. The current study tested whether social anxiety was related to alcohol-related sexual behaviors among current (past-month) drinking undergraduates (88.1% female; 77.6% non-Hispanic Caucasian) with higher (i.e., clinically elevated) social anxiety (HSA; n=40) or lower (more normative) social anxiety (LSA; n=94). Coping motives were examined as a moderator of the social anxiety-risky sexual behavior relationship. Gender was a covariate. HSA students reported more frequent alcohol-influenced sexual risk including regretted sexual situations, unprotected sex, sex with unwanted partners, unwanted sex, pressured/forced to have sex, and pressured someone to have sex. Coping motives significantly interacted with social anxiety group in the prediction of risky sexual behaviors except regretted sexual situations, such that HSA students with greater coping motives experienced more frequent sexual risk when drinking. Findings indicate that HSA students may be particularly vulnerable to risky sexual behaviors and suggest that coping motivated drinking may be an important target for therapeutic interventions geared toward reducing risky sexual behaviors among this high-risk population. http://www.tandfonline.com/doi/full/10.1080/16066359.2017.1306057
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Exposure to childhood religious affiliations where the majority of members discourage homosexuality may have negative psychological impacts for Black men who have sex with men. This study tested the hypothesis that exposures to these environments during childhood were associated with adulthood human immunodeficiency virus (HIV)/sexually transmitted infection (STI) behavioral risk and HIV infection, because these exposures influenced HIV/STI risk by undermining race/sexual identity congruence and increasing internalized homophobia and interpersonal anxiety. Structural equation modeling as well as logistic and Poisson regressions were performed using baseline data from HIV Prevention Trials Network 061 (N = 1,553). Childhood religion affiliations that were more discouraging of homosexuality were associated with increased likelihood of HIV infection; however, the association was no longer significant after adjusting for age, income, and education. Having a childhood religion affiliation with high prevalence of beliefs discouraging homosexuality was associated with increased numbers of sexual partners (adjusted odds ratio = 4.31; 95% confidence interval [3.76, 4.94], p < .01). The hypothesized path model was largely supported and accounted for 37% of the variance in HIV infection; however, interpersonal anxiety was not associated with HIV/STI risk behaviors. Structural interventions are needed that focus on developing affirming theologies in religious institutions with Black men who have sex with men congregants.
Chapter
The current chapter aims to (a) discuss major issues in the evaluation of self-report assessment tools, focusing specifically on reliability and validity, (b) discuss the advantages and disadvantages of self-report assessment tools related to social anxiety and social anxiety disorder (SAD), (c) provide the reader with a detailed list of major social anxiety self-report assessment tools and their respective psychometric properties, and (d) lay groundwork for future conceptualizations of social anxiety assessment.
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When there is an opportunity to engage in an activity that can generate positive experiences, people with emotional disturbances might be expected to be less successful than other people. Despite the appeal of this formulation, there is reason to believe that attenuated positive experiences are only relevant to a selective number of disturbances. This chapter discusses recent advances in the phenomenology of social anxiety. This includes data showing that social anxiety is associated with low intensity, short-lived positive experiences, infrequent positive events, and distinct cognitive biases that restrict the quality of life. For decades, psychologists have advocated a single, bipolar continuum with positive emotions and approach behavior at one endpoint, and negative emotions and avoidance behavior as the other endpoint. However, recent research in personality, motivation, and social neuroscience suggests that there are two separate biobehavioral systems that reflect very different purposes. Specifically, on the one hand, there is an avoidance system whose purpose is to prevent people from being exposed to danger. To meet this aim, behavior that might lead to pain, punishment, or other undesirable outcomes is inhibited. On the other hand, independent from the avoidance system, there is an approach system whose purpose is to guide people toward situations that might offer rewards. To meet this aim, attention and energy are mobilized to pursue activities that can generate resources such as food, the cooperation of others, sexual partners, and knowledge that provides an evolutionary advantage for survival and reproduction.
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This meta-analysis surveyed 177 usable sources that reported data on gender differences on 21 different measures of sexual attitudes and behaviors. The largest gender difference was in incidence of masturbation: Men had the greater incidence (d = .96). There was also a large gender difference in attitudes toward casual sex: Males had considerably more permissive attitudes (d = .81). There were no gender differences in attitudes toward homosexuality or in sexual satisfaction. Most other gender differences were in the small-to-moderate range. Gender differences narrowed from the 1960s to the 1980s for many variables. Chodorow's neoanalytic theory, sociobiology, social learning theory, social role theory, and script theory are discussed in relation to these findings.
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Using outpatients with anxiety and mood disorders (N = 350), the authors tested several models of the structural relationships of dimensions of key features of selected emotional disorders and dimensions of the tripartite model of anxiety and depression. Results supported the discriminant validity of the 5 symptom domains examined (mood disorders; generalized anxiety disorder, GAD; panic disorder; obsessive-compulsive disorder; social phobia). Of various structural models evaluated, the best fitting involved a structure consistent with the tripartite model (e.g., the higher order factors, negative affect and positive affect, influenced emotional disorder factors in the expected manner). The latent factor, GAD, influenced the latent factor, autonomic arousal, in a direction consistent with recent laboratory findings (autonomic suppression); Findings are discussed in the context of the growing literature on higher order trait dimensions (e.g., negative affect) that may be of considerable importance to the understanding of the pathogenesis, course, and co-occurrence of emotional disorders.
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Although sexuality is an important component of personal relationships, there has been relatively little research on relationships between personality and everyday sexual behavior. Moreover, existing research on sexual behavior and personality (defined in terms of the Five-Factor Model, FFM) has found weak and inconsistent relationships. We hypothesized that sexual behavior can be better understood in terms of a model of personality that focuses on sexuality rather than in terms of a general model of personality. The present study examined relationships between two models of personality and daily sexual behavior. For 3 weeks, two different samples described their sexual interactions and they completed a measure of the FFM (N = 104) and the Sexy Seven (N = 48). A series of multilevel modeling analyses found that personality as measured by both models was related to both positive (e.g., feeling desired) and negative (e.g., feeling guilty) reactions to sexual experiences. As predicted, comparisons of the strength of the relationships between reactions to daily sexual experience and the two models found reactions to sexual experience were related more strongly to the Sexy Seven than to the FFM. The importance of considering both domainspecific and general measures of personality is discussed in terms of understanding sexual behavior.
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Although an impressive body of knowledge exists about the attitudes toward and correlates of short-term sex, little is known about men's and women's motives for seeking casual sex partners and for engaging in casual sexual encounters. Men and women college students who had entered casual sexual liaisons were asked to describe the reasons or motives that prompted their behavior in a free response, essay format. As expected, men and women generated similar reasons. Specifically, both genders emphasized intraindividual factors (e.g., sexual desire, sexual experimentation, physical pleasure, alcohol use) and factors associated with the casual sex partner (e.g., attractiveness) as reasons for their short-term sexual encounter(s). In addition, however, a number of gender differences were found. Men more than women emphasized social environmental reasons (e.g., status enhancement, normative peer group behavior), whereas women more than men cited interpersonal reasons (e.g., increase probability of long-term commitment from sex partner) for casual sex. These results are in accord with predictions generated by social context and evolutionary models of human mating.
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In 2 studies, the Inclusion of Other in the Self (IOS) Scale, a single-item, pictorial measure of closeness, demonstrated alternate-form and test–retest reliability; convergent validity with the Relationship Closeness Inventory (E. Berscheid et al, 1989), the R. J. Sternberg (1988) Intimacy Scale, and other measures; discriminant validity; minimal social desirability correlations; and predictive validity for whether romantic relationships were intact 3 mo later. Also identified and cross-validated were (1) a 2-factor closeness model (Feeling Close and Behaving Close) and (2) longevity–closeness correlations that were small for women vs moderately positive for men. Five supplementary studies showed convergent and construct validity with marital satisfaction and commitment and with a reaction-time (RT)-based cognitive measure of closeness in married couples; and with intimacy and attraction measures in stranger dyads following laboratory closeness-generating tasks. In 3 final studies most Ss interpreted IOS Scale diagrams as depicting interconnectedness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The psychometric adequacy of the Social Interaction Anxiety Scale (SIAS; R. P. Mattick & J. C. Clark, 1989), a measure of social interaction anxiety, and the Social Phobia Scale (SPS; R. P. Mattick & J. C. Clark, 1989), a measure of anxiety while being observed by others, was evaluated in anxious patients and normal controls. Social phobia patients scored higher on both scales and were more likely to be identified as having social phobia than other anxious patients (except for agoraphobic patients on the SPS) or controls. Clinician-rated severity of social phobia was moderately related to SIAS and SPS scores. Additional diagnoses of mood or panic disorder did not affect SIAS or SPS scores among social phobia patients, but an additional diagnosis of generalized anxiety disorder was associated with SIAS scores. Number of reported feared social interaction situations was more highly correlated with scores on the SIAS, whereas number of reported feared performance situations was more highly correlated with scores on the SPS. These scales appear to be useful in screening, designing individualized treatments, and evaluating the outcomes of treatments for social phobia. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Increasingly, social and personality psychologists are conducting studies in which data are collected simultaneously at multiple levels, with hypotheses concerning effects that involve multiple levels of analysis. In studies of naturally occurring social interaction, data describing people and their social interactions are collected simultaneously. This article discuses how to analyze such data using random coefficient modeling. Analyzing data describing day-to-day social interaction is used to illustrate the analysis of event-contingent data (when specific events trigger or organize data collection), and analyzing data describing reactions to daily events is used to illustrate the analysis of interval-contingent data (when data are collected at intervals). Different analytic strategies are presented, the shortcomings of ordinary least squares analyses are described, and the use of multilevel random coefficient modeling is discussed in detail. Different modeling techniques, the specifics of formulating and testing hypotheses, and the differences between fixed and random effects are also considered.
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This article provides a rationale for using multilevel random coefficient modeling (MRCM) to analyze social interaction diary data, and describes how to conduct such analyses. This description includes how to examine relationships between individual differences in social interaction and other trait-level individual differences such as personality scales. Analyzing relationships among different ratings of interactions and analyzing differences among types of interactions are also described, including techniques to examine how relationships between trait-level individual differences and reactions to interaction vary across different types of interactions (e.g., interactions with different relational partners). Different types of analyses are illustrated using data from actual studies. Although this article focuses on the analysis of data collected using variants of the Rochester Interaction Record, the techniques described can be used to analyze data collected using other methods and protocols.
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Multilevel modeling is a technique that has numerous potential applications for social and personality psychology. To help realize this potential, this article provides an introduction to multilevel modeling with an emphasis on some of its applications in social and personality psychology. This introduction includes a description of multilevel modeling, a rationale for this technique, and a discussion of applications of multilevel modeling in social and personality psychological research. Some of the subtleties of setting up multilevel analyses and interpreting results are presented, and software options are discussed.
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In 1993 Oliver and Hyde conducted a meta-analysis on gender differences in sexuality. The current study updated that analysis with current research and methods. Evolutionary psychology, cognitive social learning theory, social structural theory, and the gender similarities hypothesis provided predictions about gender differences in sexuality. We analyzed gender differences in 30 reported sexual behaviors and attitudes for 834 individual samples uncovered in literature searches and 7 large national data sets. In support of evolutionary psychology, results from both the individual studies and the large data sets indicated that men reported slightly more sexual experience and more permissive attitudes than women for most of the variables. However, as predicted by the gender similarities hypothesis, most gender differences in sexual attitudes and behaviors were small. Exceptions were masturbation incidence, pornography use, casual sex, and attitudes toward casual sex, which all yielded medium effect sizes in which male participants reported more sexual behavior or permissive attitudes than female participants. Most effect sizes reported in the current study were comparable to those reported in Oliver and Hyde's study. In support of cognitive social learning theory, year of publication moderated the magnitude of effect sizes, with gender differences for some aspects of sexuality increasing over time and others decreasing. As predicted by social structural theory, nations and ethnic groups with greater gender equity had smaller gender differences for some reported sexual behaviors than nations and ethnic groups with less gender equity. Gender differences decreased with age of the sample for some sexual behaviors and attitudes.
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People with higher social anxiety tend to reveal less information about themselves in interactions with strangers, and this appears to be part of a self-protective strategy adopted in situations in which the risk of negative evaluation is judged to be particularly high. This research examined whether a similar style of communication may be adopted by people with higher social anxiety in their close relationships, and whether it may be associated with decrements in the quality (support, depth, conflict) of these relationships. Over 300 people from the community completed a series of online questionnaires measuring social anxiety and depression, and disclosure in and quality of their close friendships and romantic relationships. After controlling for levels of depression, social anxiety was associated with a paucity of disclosure in both romantic relationships and close friendships in females, but not males. There was an indirect association between higher social anxiety and lower relationship quality (lower support, with a trend towards greater conflict) via lower self-disclosure in women's romantic relationships, but not their close friendships. Addressing disclosure in the context of close relationships may assist socially anxious women to develop more fulfilling and harmonious close relationships.
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Sexual dysfunction is often implicated in depression and anxiety disorders, but the current nosology of sexual dysfunction, depression, and anxiety (i.e., DSM-IV) does not adequately address these relationships. Because recent papers (Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111-133) have suggested and provided evidence for latent internalizing and externalizing dimensions that help explain high comorbidity between mental disorders, the current paper suggests that sexual dysfunction might conceptually belong to a latent internalizing factor. To address this, evidence is presented for the relationship among disorders of sexual desire, arousal, and orgasm comorbid with depression and anxiety. A review of sexual disorders is also presented along with a critical examination of the way the current DSM is organized with respect to sexual dysfunction, depression, and anxiety.
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We review psychometric and other evidence relevant to mixed anxiety-depression. Properties of anxiety and depression measures, including the convergent and discriminant validity of self- and clinical ratings, and interrater reliability, are examined in patient and normal samples. Results suggest that anxiety and depression can be reliably and validly assessed; moreover, although these disorders share a substantial component of general affective distress, they can be differentiated on the basis of factors specific to each syndrome. We also review evidence for these specific factors, examining the influence of context and scale content on ratings, factor analytic studies, and the role of low positive affect in depression. With these data, we argue for a tripartite structure consisting of general distress, physiological hyperarousal (specific anxiety), and anhedonia (specific depression), and we propose a diagnosis of mixed anxiety-depression.
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Two hundred and sixty college students completed a questionnaire that provided information regarding their sexual experience, knowledge, and attitudes; their self-evaluations on dimensions related to sexuality; and their level of heterosocial anxiety (anxiety experienced in social interactions with members of the other sex). Compared with subjects low in heterosocial anxiety, highly anxious respondents were less sexually experienced, engaged in sexual activity less frequently, had fewer sexual partners, were less likely to have engaged in oral sex, expressed a higher degree of apprehension about sex, and had a somewhat higher incidence of sexual dysfunctions. In addition, low socially anxious women tended to use the pill, whereas highly anxious women preferred the condom. High and low heterosocially anxious respondents also differed on self-ratings related to their sexuality but did not differ in their attitudes or knowledge regarding sex. The results are discussed in terms of the cognitive, behavioral, and affective concomitants of social anxiety.
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Using outpatients with anxiety and mood disorders (N = 350), the authors tested several models of the structural relationships of dimensions of key features of selected emotional disorders and dimensions of the tripartite model of anxiety and depression. Results supported the discriminant validity of the 5 symptom domains examined (mood disorders: generalized anxiety disorder, GAD; panic disorder; obsessive-compulsive disorder; social phobia). Of various structural models evaluated, the best fitting involved a structure consistent with the tripartite model (e.g., the higher order factors, negative affect and positive affect, influenced emotional disorder factors in the expected manner). The latent factor, GAD, influenced the latent factor, autonomic arousal, in a direction consistent with recent laboratory findings (autonomic suppression). Findings are discussed in the context of the growing literature on higher order trait dimensions (e.g., negative affect) that may be of considerable importance to the understanding of the pathogenesis, course, and co-occurrence of emotional disorders.
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When there is an opportunity to engage in an activity that can generate positive experiences, people with emotional disturbances might be expected to be less successful than other people. Despite the appeal of this formulation, there is reason to believe that attenuated positive experiences are only relevant to a selective number of disturbances. This chapter discusses recent advances in the phenomenology of social anxiety. This includes data showing that social anxiety is associated with low intensity, short-lived positive experiences, infrequent positive events, and distinct cognitive biases that restrict the quality of life. For decades, psychologists have advocated a single, bipolar continuum with positive emotions and approach behavior at one endpoint, and negative emotions and avoidance behavior as the other endpoint. However, recent research in personality, motivation, and social neuroscience suggests that there are two separate biobehavioral systems that reflect very different purposes. Specifically, on the one hand, there is an avoidance system whose purpose is to prevent people from being exposed to danger. To meet this aim, behavior that might lead to pain, punishment, or other undesirable outcomes is inhibited. On the other hand, independent from the avoidance system, there is an approach system whose purpose is to guide people toward situations that might offer rewards. To meet this aim, attention and energy are mobilized to pursue activities that can generate resources such as food, the cooperation of others, sexual partners, and knowledge that provides an evolutionary advantage for survival and reproduction.
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Assessing sexual behavior with self-report is essential to research on a variety of health topics, including pregnancy and infertility, sexually transmitted infections, and sexual health and functioning. Recent methodological research has provided new insights regarding the accuracy of self-reports of sexual behavior. We review these studies, paying particular attention to a promising new development: the use of computer-assisted assessments. The collection of sexual risk behavior data with computers has increased dramatically in recent years, but little is known about the accuracy of such assessments. We summarize the evidence, discuss methodological issues that arise in studies evaluating the accuracy of self-reports, and offer recommendations for future research.
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Socially anxious people often report high negative affect (NA) and low positive affect (PA). This mood state may be associated with elevated or undesired social evaluation, such as interactions with unfamiliar people or poor quality communication. In this study, high and low anxious undergraduates completed structured diaries assessing interaction partner familiarity, quality of communication, PA, and NA after conversations in their natural environment. Results supported hypotheses of higher NA and lower quality of communication in the anxious group. In addition, quality of communication and familiarity were differently related to NA in the high versus low anxious groups. Results suggest that social-interaction parameters affect high anxious individuals' mood. Implications of the current social interaction based results are contrasted with time-interval diary research.
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The majority of definitions, research studies, and treatment programs that focus on social anxiety characterize the prototypical person with the disorder as shy, submissive, inhibited, and risk averse. This stereotype, however, has been challenged recently. Specifically, a subset of people with social anxiety who are aggressive, impulsive novelty seekers deviate from that prototype. People with this atypical profile show greater functional impairment and are less likely to complete or fare well in treatment compared with inhibited socially anxious people. The difference between these two groups of people with social anxiety cannot be explained by the severity, type, or number of social fears, nor by co-occurring anxiety and mood disorders. Conclusions about the nature, course, and treatment of social anxiety may be compromised by not attending to diverse behaviors and self-regulatory styles. These concerns may be compounded in neurobiological and clinical studies of people with social anxiety problems that rely on smaller samples to make claims about brain patterns and the efficacy of particular treatments.
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Nothing is more familiar to people than their moods and emotions. Oddly, however, it is not clear how these two kinds of affective processes are related. Intuitively, it makes sense that emotional reactions are stronger when they are congruent with a preexisting mood, an idea reinforced by contemporary emotion theory. Yet empirically, it is uncertain whether moods actually facilitate emotional reactivity to mood-congruent stimuli. One approach to the question of how moods affect emotions is to study mood-disturbed individuals. This review describes recent experimental studies of emotional reactivity conducted with individuals suffering from major depression. Counter to intuitions, major depression is associated with reduced emotional reactivity to sad contexts. A novel account of emotions in depression is advanced to assimilate these findings. Implications for the study of depression and normal mood variation are considered.
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A practical methodology is presented for creating closeness in an experimental context. Whether or not an individual is in a relationship, particular pairings of individuals in the relationship, and circumstances of relationship development become manipulated variables. Over a 45-min period subject pairs carry out self-disclosure and relationship-building tasks that gradually escalate in intensity. Study 1 found greater postinteraction closeness with these tasks versus comparable small-talk tasks. Studies 2 and 3 found no significant closeness effects, inspite of adequate power, for (a) whether pairs were matched for nondisagreement on important attitudes, (b) whether pairs were led to expect mutual liking, or (c) whether getting close was made an explicit goal. These studies also illustrated applications for addressing theoretical issues, yielding provocative tentative findings relating to attachment style and introversion/extraversion.
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According to David Buss's evolutionary theory of sex differences in sexual strategies men prefer short term, promiscuous sexual encounters because each encounter may result in the conception of a child and the perpetuation of the man's genes. On the other hand, women prefer long term, committed relationships. Only having sex with a man with resources who is willing to commit those resources to the woman and their child is a much more adaptive strategy with respect to perpetuating the woman's genes than promiscuous sex. As a result of these different strategies men and women desire different things in a mate. Men desire youth and beauty because these are indices of a woman's fertility; women desire status, resources, and commitment. Both men and women value desirable personalities. Applying social exchange theory to the desires of men and women it was theorized that women exchange physical attractiveness for men with status, resources, commitment, and desirable personalities. Women of varying degrees of attractiveness were asked to rate their romantic partners, past and present, with respect to resource potential, commitment, and desirable personality. It was hypothesized that the attractive women would have romantic partners with greater resource potential and commitment, and more desirable personalities. The hypothesis was supported.
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The development and validation of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) two companion measures for assessing social phobia fears is described. The SPS assesses fears of being scrutinised during routine activities (eating, drinking, writing, etc.), while the SIAS assesses fears of more general social interaction, the scales corresponding to the DSM-III-R descriptions of Social Phobia—Circumscribed and Generalised types, respectively. Both scales were shown to possess high levels of internal consistency and test–retest reliability. They discriminated between social phobia, agoraphobia and simple phobia samples, and between social phobia and normal samples. The scales correlated well with established measures of social anxiety, but were found to have low or non-significant (partial) correlations with established measures of depression, state and trait anxiety, locus of control, and social desirability. The scales were found to change with treatment and to remain stable in the face of no-treatment. It appears that these scales are valid, useful, and easily scored measures for clinical and research applications, and that they represent an improvement over existing measures of social phobia.
Article
According to cultural stereotypes, men are more eager for sex than are women; women are more likely to set limits on such activity. In this paper, we review the work of theorists who have argued in favor of this proposition and review the interview and correlational data which support this contention. Finally, we report two experimental tests of ihis hypothesis. In these experiments, conducted in 1978 and 1982, male and female confederates of average attractiveness approached potential partners with one of three requests: "Would you go out tonight?" "Will you come over to my apartment?" or "Would you go to bed with me?" The great majority of men were willing to have a sexual liaison with the women who approached them. Women were not. Not one woman agreed to a sexual liaison. Many possible reasons for this marked gender difference were discussed. These studies were run in 1978 and 1982. It has since become important to track how the threat of AIDS is affecting men and women's willingness to date, come to an apartment, or to engage in casual sexual relations.
Article
This . . . book is the first to present a unified theory of human mating behavior. [It] is based on the most massive study of human mating ever undertaken, encompassing more than 10,000 people of all ages from thirty-seven cultures worldwide. If we all want love, why is there so much conflict in our most cherished relationships? To answer this question, we must look into our evolutionary past, according to David M. Buss. The book discusses casual sex and long-term relationships, sexual conflict, the elusive quest for harmony between the sexes, and much more. Buss's research leads to a radical shift from the standard view of men's and women's sexual psychology. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
In a study of the accuracy of self-reports of sexual behavior and condom use, 285 single, young adults in a large metropolitan area were interviewed once a week for 52 weeks, reporting on their sexual behavior each week. At 1-, 3-, 6-, and 12-month intervals, the individuals also provided self-reports of the number of times they had engaged in sex and the number of times they had used condoms since they began participating in the study. These self-reports were compared with aggregates of the weekly data, which served as a comparison standard for accuracy evaluation. The results indicate a fairly high level of accuracy in self-reports, but with 2% to 5% outliers who are highly inaccurate. The results tend to favor the assessment of sexual behavior over moderate time durations (3 or 6 months) rather than short or long durations (1 month or 12 months) when trying to maximize self-report accuracy. Accuracy was attenuated for individuals who tended to engage in sex frequently, especially at the 12-month time durations.
Article
This investigation examined the perceived benefits and costs of romantic (i.e., reciprocal dating) relationships. In Study 1, subjects provided open-ended reports regarding the benefits and costs associated with romantic involvement. Different groups of subjects ranked (Study 2) and rated (Study 3) these benefits and costs for importance. Companionship, happiness, and feeling loved or loving another were among the most important benefits accompanying romantic involvement. The most serious costs included stress and worry about the relationship, social and nonsocial sacrifices, and increased dependence on the partner. Compared to males, females regarded intimacy, self-growth, self-understanding, and positive self-esteem as more important benefits, and regarded loss of identity and innocence about relationships and love as more important costs Alternatively, males regarded sexual gratification as a more important benefit, and monetary losses as a more serious cost than did females Implications for exchange theory are highlighted.
Article
Rumination is engaging in a passive focus on one's symptoms of distress and on the possible causes and consequences of these symptoms. Women are more likely than men to engage in rumination. This study examined whether gender differences in the following beliefs would mediate the gender difference in rumination: the controllability of emotions, the appropriateness of rumination as a coping strategy, responsibility for the emotional tone of relationships, and mastery over negative events. The sample was 740 community-dwelling adults between 25 and 75 years of age, who completed a survey by mail. The combination of beliefs about control of emotions, responsibility for the emotional tone of relationships, and mastery over negative events fully mediated the gender difference in rumination. Alternative hypotheses that the gender difference in rumination was due to gender differences in distress, emotional expressivity, and the tendency to give socially desirable answers were not supported.
Article
We examined the association between social anxiety and interpersonal functioning. Unlike prior research, we focused specifically on close relationships, given the growing evidence of dysfunction in these relationships among people with psychopathology. We proposed that social anxiety would be associated with specific interpersonal styles. One hundred sixty-eight young adults with a range of social anxiety symptoms were interviewed regarding symptom severity, interpersonal styles, and chronic interpersonal stress. Results indicated that higher levels of social anxiety were associated with interpersonal styles reflecting less assertion, more conflict avoidance, more avoidance of expressing emotion, and greater interpersonal dependency. Moreover, lack of assertion and overreliance on others mediated the association between social anxiety and interpersonal stress. Associations held controlling for depressive symptoms. Implications of these findings for interpersonally oriented conceptualizations of social anxiety disorder are discussed.
Article
The current study examined aspects of communication and intimacy between people with social phobia and their romantic partners. Forty-eight individuals with social phobia and 58 community controls completed a series of questionnaires to measure self-disclosure, emotional expression and levels of intimacy within their romantic relationships. Participants with social phobia reported less emotional expression, self-disclosure and intimacy than controls, even after controlling for a diagnosis of mood disorder. The group differences did not differ significantly by gender. A continuous measure of social anxiety also correlated significantly with the three relationship measures and these associations held for emotional expression and self-disclosure after controlling for levels of dysphoria. People with social phobia report reduced quality within their romantic relationships, which may have implications for impairment, social support and ultimately maintenance of the disorder.
Article
Sociometer theory proposes that the self-esteem system evolved as a monitor of social acceptance, and that the so called self-esteem motive functions not to maintain self-esteem per se but rather to avoid social devaluation and rejection. Cues indicating that the individual is not adequately valued and accepted by other people lower self-esteem and motivate behaviours that enhance relational evaluation. Empirical evidence regarding the self-esteem motive, antecedents of self-esteem, the relation between low self-esteem and psychological problems, and the consequences on enhancing self-esteem is consistent with the theory.