When are sexual difficulties distressing for women? The selective protective value of intimate relationships

Childhood sexual abuse moderates the association between sexual functioning and sexual distress in women

OBJECTIVE

To assess the degree to which a history of childhood sexual abuse (CSA) moderates the association between sexual functioning and sexual distress in women.

METHOD

Women with (n=105, M age=33.71, 66.1% Caucasian) and without (n=71, M age=32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed self-report questionnaires at intake including the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Trauma History Questionnaire (THQ).

RESULTS

Desire, arousal, lubrication, and orgasm interacted with sexual abuse status in predicting sexual distress such that sexual functioning was more weakly associated with distress for women with a history of CSA. This disconnect was more pronounced for women who were abused by a family member.

CONCLUSION

CSA status serves as an important moderator of the association between sexual functioning and sexual distress in women. Specifically, women with a history of CSA show higher levels of distress in the context of good sexual functioning as compared to women without a history of CSA. Possible explanations and clinical implications are discussed.

The young and the restless? Age as a moderator of the association between sexual desire and sexual distress in women

The authors aimed to assess the degree to which age moderates the association between sexual desire and sexual distress in women. The authors combined 4 independent data sets that yielded a total sample of 771 women (M age = 27.76, SD age = 9.64) who had completed the Sexual Satisfaction Scale for Women and the Female Sexual Function Index. Desire interacted with age quadratically in predicting personal and relational sexual distress such that desire was more strongly associated with distress for younger women as compared with middle-aged and older women. Age is an important moderator of the association between sexual functioning and sexual distress in women. Research and clinical implications are discussed.

Genetic and environmental risk factors for sexual distress and its association with female sexual dysfunction

BACKGROUND

The DSM-V Working Group is currently re-evaluating distress as a primary diagnostic criterion for female sexual dysfunction (FSD). Here, for the first time, we explored the epidemiology of sexual distress and its putative aetiological relationship to FSD by estimating the influence of genetic and environmental risk factors.

METHOD

Questionnaire data on a representative sample of 930 British female twins using validated scales of FSD and sexual distress were subject to variance components analyses to quantify latent genetic and environmental factors influencing phenotypic variation and covariation. Multiple regression analyses were used to identify other potential risk factors of sexual distress.

RESULTS

Of 319 women with any sexual problems, only 36.5% reported distress. Of women classified as functional, 16.5% felt sexual distress. Sexual distress had a heritability of 44% [95% confidence interval (CI) 0.33-0.54]. Bivariate analysis suggested that the majority (91% CI 86-99%) of the covariance between sexual distress and FSD was due to unique environmental effects common to both traits. Associations were found between sexual distress and other risk variables, including relationship dissatisfaction [odds ratio (OR) 1.6, p<0.001], anxiety sensitivity and obsessive-compulsive symptomatology (OR 1.2, p<0.01, for both).

CONCLUSIONS

There seems to be a weak phenotypic and genetic basis for including sexual distress as a diagnostic indicator of FSD. Instead, the data indicate that unrelated psychological factors play an important role in sexual distress and tentatively suggest that sexual distress is less a consequence of FSD and more related to general anxiety among women.

Different perspectives on the sex-attachment link: towards an emotion-motivational account

Although the link between sex and attachment was made decades ago (Hazan & Shaver, 1987), theories on sexual and attachment functioning have been developed in relative isolation. Recent efforts to integrate both literatures have been complicated by the fact that the sex-attachment link has been approached from very different perspectives, including biological, evolutionary, developmental, cognitive, and social psychology approaches. Also, at the empirical level, research on sex and attachment lacks overarching synthesis. This article gives an overview of the most important theoretical ideas and empirical insights on sex and attachment. It starts with describing general models that approach the sex-attachment link from an evolutionary and neurobiological perspective. Then, it summarizes theoretical and empirical ideas of attachment theory and describes how attachment style differences are manifested in intimate and sexual relationships. Research so far has been limited to studying the predicted link between sex and attachment in terms of broad descriptives, and it would benefit the literature to specify the processes and pathways that mediate the sex-attachment link. After a short discussion of the functional similarities between the sexual and the attachment systems, the article describes some specific--dynamical--models that focus on the emotional and cognitive-motivational processes through which attachment schemas influence sexual experiences. Such an emotion-motivational perspective on sex and attachment can help to organize theoretical ideas and empirical findings and eventually promote an integrative view on how attachment dynamics can interact with sexual experiences.

Should we take anodyspareunia seriously? A descriptive analysis of pain during receptive anal intercourse in young heterosexual women

Anal sex is becoming increasingly prevalent among heterosexual women and men. Although pain related to receptive anal intercourse is not uncommon, little is known about its phenomenology. This article aims to assess the prevalence and correlates of pain during anoreceptive intercourse, including anodyspareunia, its most severe form, among young women. An online survey focusing on anal eroticism was carried out in March and April 2010 on a convenience sample of 2,002 women 18-30 years of age. Participants who reported 2 or more episodes of anal intercourse in the past year were asked about the level and frequency of pain at anoreceptive penetration; those who reported unbearable (too painful to continue) or strong pain at every such occasion were classified as anodyspareunic. The experience of receptive anal intercourse was reported by 63.2% (n = 1,265) of participants. Although almost half (48.8%) had to discontinue their first anoreceptive intercourse because of pain or discomfort, a majority of women (62.3%; n = 788) continued anal sex. Of the 505 participants who reported 2 or more episodes of anal intercourse in the past year, the women (8.7%; n = 44) who reported severe pain during every anoreceptive penetration were classified as anodyspareunic; all others were classified as non-anodyspareunic. For more than two thirds of women with anodyspareunia, the current pain level remained unchanged from their first experience with anal sex. Inability to relax was the most frequent self-hypothesized cause of pain among the anodyspareunic and nonanodyspareunic groups. Compared with other women, those with anodyspareunia reported substantially lower levels of sexual satisfaction (odds ratio = .95; p < .001) and were less sexually assertive (odds ratio = .80; p < .01). The findings that a substantial proportion of women reported pain at first and subsequent anoreceptive intercourse highlight a need for more information and education about anal eroticism.