Positive Body Image and Sexual Functioning in Dutch Female University Students: The Role of Adult Romantic Attachment

Romantic attachment, infertility-related stress, and positive body image of women dealing with infertility

Introduction

Infertility is a condition that can affect the physical, emotional, social, and relational well-being of women. Women's bodies seem to assume a crucial relevance as part of the experience of infertility and its treatments. An extended body of literature supports the role of romantic attachment orientations in facing infertility-related stress. However, the association between romantic attachment orientations, infertility-related stress, and women's body image has not been explored.

Methods

This cross-sectional study aimed to investigate the role of romantic attachment and infertility-related stress concerning positive body image in 113 women dealing with infertility. Data were analyzed with correlation and mediation path analyses.

Results

Results showed that high levels of attachment anxiety, attachment avoidance, and infertility-related stress were negatively associated with positive body image. Path analyses indicated that positive body image may be directly associated with romantic attachment anxiety. The negative association of attachment avoidance with body image appeared to be mediated by infertility-related stress.

Discussion

Findings suggest that romantic attachment insecurities and infertility-related stress are significantly associated with a worsened body image in infertile women. Implications for future research are discussed.

Anxiety in Attachment and Sexual Relationships in Adolescence: A Moderated Mediation Model

Adolescence is characterized by several transformations, such as identity construction, progressive estrangement from parents, relational interest in peers, and body changes that also involve sexuality issues. In this process, attachment patterns play a fundamental role in relationships, and when these are dysfunctional, they can result in internalizing and externalizing problems. Often, females show their relational difficulties through internalizing expressions and males through externalizing expressions. Additionally, given the sexual progress involved in this life moment, psychological symptomatology may influence adolescents’ perception of sex and performance. Our purpose is to study the mediating role of internalizing and externalizing symptomatology in the relationship between attachment patterns and sexual and psychological dimensions. In addition, we investigated the moderating effect of the sex assigned at birth on this mediation model. n = 493 adolescents (38.3% males; Mage = 16.51; SD = 1.17) participated in the study. The results show a significant mediation effect of internalizing symptomatology on the relationship between attachment and sexual anxiety. Additionally, this effect is moderated significantly by assigned-at-birth sex. These results confirm that in adolescence, attachment patterns can influence adolescents’ perception of sex. The connection between these two psychological dimensions is influenced by symptomatologic expression. Further investigations are needed.

Factors influencing low sexual desire and sexual distress in pregnancy: A cross-sectional study

BACKGROUND

Sexual desire and sexual distress are determined by emotional, psychosocial, hormonal, and anatomical factors during pregnancy.

OBJECTIVE

To identify the factors contributing to female low sexual desire and sexual distress during pregnancy separately and concurrently.

MATERIALS AND METHODS

Overall, 295 pregnant women were enrolled in this cross-sectional study. Sexual desire and distress were assessed by the sexual interest and desire inventory-female (score ≤ 33.0 indicates low sexual desire) and the female sexual distress scale-revised (score ≥ 11 indicates sexual distress).

RESULTS

56.3% and 17.3% of pregnant women met the clinical cut-off for low sexual desire and sexual distress, respectively. After adjusting for the effect of the confounding variables by logistic regression multivariate analysis, satisfaction with body image before and during pregnancy, frequency of sexual intercourse, and satisfaction with foreplay were found to be significantly associated with low sexual desire. Factors related to sexual distress were similar to those noted for common sexual desire, except for satisfaction with foreplay. Other factors related to sexual distress included increased age, fear of abortion, and pregnancy trimester. Factors linked to concurrent low sexual desire and sexual distress were similar to those found for sexual distress, except for pregnancy trimester.

CONCLUSION

Low sexual desire and sexual distress are relatively common sexual experiences during pregnancy. Several factors could predict low sexual desire but were not associated with sexual distress, and conversely. Comprehensive attention to all of these factors is essential while screening for sexual health during pregnancy.

Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women

BACKGROUND

Sexual self-esteem and communication on sexual issues with a partner contribute greatly to an individual's quality of sex life; however, their effects on the relationship between body image and sexual function are underexplored.

AIM

To test a serial mediating pathway of sexual self-esteem and sexual communication underlying the relationship between body image and sexual function.

METHODS

A total of 510 women aged 18-53 years (mean = 28, SD = 5.5) who were involved in an intimate relationship completed an online survey.

OUTCOMES

Women's (i) body appreciation, (ii) body image self-consciousness during sexual intimacy, (iii) sexual self-esteem, (iv) dyadic sexual communication, (v) negative disclosure apprehension, and (vi) sexual function were assessed.

RESULTS

Findings revealed that sexual self-esteem and dyadic sexual communication played a serial mediating role in the relationship between body image (body appreciation and body image self-consciousness during sexual intimacy) and sexual function, and the relationship between body image and arousal, lubrication, orgasm, satisfaction, and pain. Sexual self-esteem and negative disclosure apprehension also played a serial mediating role in the relationship between body image and sexual pain. In addition, dyadic sexual communication played a unique mediating role in the relationship between body image and sexual function, which is isolated from the effect of sexual self-esteem.

CLINICAL IMPLICATIONS

Women's sexual self-esteem and sexual communication with their partner can make beneficial contributions to the relationship between body image and sexual function. Therefore, promoting women's positive body image, sexual self-esteem, and sexual communication skills deserves attention from women themselves and clinicians.

STRENGTHS & LIMITATIONS

This study used a robust method of data analysis to test the mediating effect of sexual self-esteem and sexual communication to clarify the mechanism underlying the relationship between body image and sexual function among Chinese women; however, causal conclusions cannot be drawn. Furthermore, various demographics including participants' age, education level, sexual orientation-factors such as relationship status and length, relationship functioning, and partner-related variables-and other aspects of sexual self-concept and sexual communication should be examined in future research.

CONCLUSION

The current study indicates that women's thoughts and feelings regarding sexuality and communicating sexual issues with their partner are associated closely with their body image and sexual function. Wu T, Zheng Y. Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women. J Sex Med 2021;18:474-486.

Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction

Introduction

This study explored the role of body image dissatisfaction on orgasmic response during partnered sex and masturbation and on sexual relationship satisfaction. The study also described typologies of women having different levels of body image satisfaction.

Methods

A sample of 257 Norwegian women responded to an online survey assessing body image dissatisfaction, problems with orgasm, and sexual relationship satisfaction. Using structural equation modeling and factor mixture modeling, the relationship between body image dissatisfaction and orgasmic response was assessed, and clusters of sexual response characteristics associated with varying levels of body image dissatisfaction were identified.

Main Outcome Measure

Orgasmic function during partnered sex and masturbation, along with sexual relationship satisfaction, were assessed as a function of body image.

Results

Body image dissatisfaction, along with a number of covariates, predicted higher levels of “problems with orgasm” during both partnered sex and masturbation, with no significant difference in the association depending on the type of sexual activity. Varying levels of body image dissatisfaction/satisfaction were associated with differences in orgasmic incidence, difficulty, and pleasure during partnered sex; with one orgasmic parameter during masturbation; and with sexual relationship satisfaction.

Conclusion

Body image dissatisfaction and likely concomitant psychological distress are related to impaired orgasmic response during both partnered sex and masturbation and may diminish sexual relationship satisfaction. Women with high body image dissatisfaction can be characterized by specific sexual response patterns.

Horvath Z, Smith BH, Sal D, et al. Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction. Sex Med 2020;8:740–751.

Impact of Bariatric Surgery on Female Sexual Function in Obese Patients: a Meta-Analysis

We aimed to make a meta-analysis regarding the effect of bariatric surgery on female sexual function. PubMed, EMBASE, and CENTRAL were searched from database inception through August 2019. Articles were eligible for inclusion if they examined the effect of bariatric surgery on obese women's sexual function assessed by the Female Sexual Functioning Index (FSFI) or/and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Twenty articles were included into meta-analysis. Bariatric surgery was associated with significant increase in the total FSFI score. When parameters included in the FSFI scoring system were separately evaluated, significant improvements were observed in sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and sexual pain. However, the PISQ-12 and FSFI scores in women with pelvic floor disorders (PFDs) were not significantly changed postoperatively. Bariatric surgery improves female sexual function in obese patients, but not in women with PFD.

A review of research linking body image and sexual well-being

The link between body image and sexual well-being is intuitive and increasingly supported by psychological research: individuals, particularly women, with greater body satisfaction and body appreciation tend to report more positive sexual experiences. Although both perceptions of one's body and one's sexual life are central to most adults' experiences, this area of research has remained somewhat understudied. In this review, we discuss the findings that are available and suggest directions for future research and applied implications of this work. We highlight Thomas Cash's contributions to this area of study, given his significant contributions to moving our understanding of body image and sexual well-being forward.

The relationship between body mass index, body image, and sexual function: A survey on Iranian pregnant women

Background

The prevalence of sexual problems is high during pregnancy. Despite this, there are limited data about the impact of physical and psychological factors such as body weight and body image on sexual function in pregnant women.

Objective

To investigate the relationship between body mass index, body image, and sexual function among pregnant women.

Materials and Methods

In this cross-sectional study, a total of 206 Iranian pregnant women (106 with normal weight and 100 overweight women) in their 2nd and 3rd trimesters of pregnancy were surveyed. Survey instruments included the Female Sexual Function Index and Multidimensional Body-Self Relations Questionnaire.

Results

The prevalence of female sexual disorder was 72.3% in this survey. Diminished sexual desire/appetite was the most common problem reported by the participants (37.9%). The mean score of sexual problem and body image were not significantly different among overweight and normal weight women in the 2nd (p = 0.945 and p = 0.800, respectively) and 3rd trimesters of pregnancy (p = 0.310 and p = 0.507, respectively). Further, there were no relationships between the body mass index plus body image and the total female sexual function score (p = 0.44 and p = 0.837, respectively). However, the relationship between the appearance evaluation with lubrication (p = 0.043) and subjective weight with two subscales of sexual satisfaction (p = 0.005) and orgasm (p = 0.019) were significant.

Conclusion

The findings from this study revealed that there were no relationships between body mass index plus body image score and the sexual function in pregnancy. Therefore, a further research is recommended to study other potential factors affecting sexual function during pregnancy.

Attachment Styles and Employee Performance: The Mediating Role of Burnout

Researchers are becoming increasingly interested in how early experiences within the family are relevant to an individual's behavior at work. Drawing on Bowlby's attachment theory, the present study addresses this topic by examining the relationship between attachment in adulthood and job performance, and the mediating role of burnout in that relationship. We used data from two samples (201 Dutch employees and 178 Romanian working students) and structural equation modeling to test this mediation model and its possible invariance across both samples. The results showed that in both samples, attachment-related anxiety was positively related to burnout, which was in turn negatively related to job performance. Attachment-related avoidance was not significantly associated with burnout or performance. These results were similar in both samples, thus increasing their validity. The results suggest that childhood and early socialization experiences play a role in shaping the employee's behavior and well-being at work. The study is one of the few examining attachment styles in relation to burnout and performance.

Examining the unique contribution of body appreciation to heterosexual women's sexual agency

Although numerous studies demonstrate links between negative body image and sexual well-being, recent research has emphasized studying the positive aspects of these constructs. The current study built upon this prior research by examining the association between body appreciation and sexual agency among a US community sample of 355 heterosexual women aged 18-40. This study also examined whether body appreciation is uniquely associated with sexual agency above and beyond levels of self-objectification. Regression analyses demonstrated that women who reported greater body appreciation also reported greater condom use self-efficacy, sexual satisfaction, sexual assertiveness, and feelings of entitlement to sexual pleasure, and lower levels of body self-consciousness during intimacy. These findings remained consistent even when self-objectification was entered into the model as a covariate. Results highlight the importance of studying how body appreciation may promote women's sexual agency.

Out of "Objectification Limelight"? The Contribution of Body Appreciation to Sexual Adjustment in Midlife Women

According to objectification theory, women become culturally desexualized during midlife and have the opportunity to let go of their propensity to self-objectify. In young women, self-objectification is negatively related to sexual adjustment. Yet little is known about what could ameliorate this relationship or whether it continues after midlife. Body appreciation (i.e., acceptance and positive regard for the body) has been substantiated as a contributor to improved sexual adjustment in young and older women alike. Hence, this study was designed to examine whether it helps mitigate the deleterious effect of self-objectification on sexual function, satisfaction, and distress in women over the age of 50 (n = 193). Path analyses revealed that self-surveillance is related to body shame and appearance anxiety, the latter of which was related to body self-consciousness during sex. In turn, body self-consciousness during sex mediated the relationship between body shame, appearance anxiety, and all three indicators of sexual adjustment. Furthermore, high body appreciation attenuated the negative associations between self-objectification constructs, body self-consciousness during sex, and sexual satisfaction and distress. Overall, this study supports the use of objectification theory in midlife and older women. Sex therapy interventions that incorporate mindfulness and body appreciation principles are discussed.

Sexual anxiety and sexual beliefs as mediators of the association between attachment orientation with sexual functioning and distress in university men and women

Previous research has demonstrated the association between sexual functioning and attachment orientation in women. However, the mechanisms of this relation are not yet well understood, and this effect has not been substantially investigated in men. The current study examines the role of sexual anxiety and dysfunctional beliefs about sexuality as mediators of the correlation of attachment orientation with sexual functioning and distress in both women and men. A university sample of men (n=307) and women (n=716) completed questionnaires assessing attachment orientation, sexual functioning, sexual distress, sexual anxiety, and dysfunctional sexual beliefs. Multiple regression analyses indicated that insecure attachment orientation significantly predicted poorer sexual functioning and higher sexual distress in both men and women. Path analyses showed partial mediation of these effects by sexual anxiety and dysfunctional sexual beliefs. Gender differences existed in the specific pattern of associations between the variables. These results suggest that attachment difficulties may facilitate the development of sexual difficulties through an increased vulnerability to maladaptive cognitions and negative affect (specifically anxiety) regarding sexuality.

Appearance Dissatisfaction, Body Appreciation, and Sexual Health in Women Across Adulthood

Risk and protective factors are equally important to the promotion of sexual health. Yet, in body image and sexuality research, most of the focus has been placed on the deleterious effects of appearance dissatisfaction and body mass index (BMI) at the expense of more adaptive dimensions. Furthermore, although age can affect appearance and sexual function, little is known regarding the experience of older women. Therefore, this study was aimed at comparing how positive body image (operationalized as body appreciation) and negative body image (operationalized as appearance dissatisfaction) each contribute to indicators of sexual health when controlling for BMI in a sample of age-varied women. Cross-sectional data were collected online from 215 heterosexual women aged 18-88 years. Results showed that body appreciation was a unique predictor of sexual function, satisfaction, and distress, above and beyond the effect of BMI and appearance dissatisfaction. Body appreciation was not found to fluctuate with age. Further, body appreciation moderated the relationship between age and sexual satisfaction, but not sexual distress. Post hoc analyses showed that high body appreciation may serve as a buffer against age-related changes in sexual satisfaction only in women with clinically significant sexual function difficulties. Increasing body appreciation may be a promising clinical intervention in the treatment of sexual problems in older adult women.

Vinculação aos pais e imagem corporal em jovens universitários

A segunda metade do século XX assiste ao aumento de perturbações alimentares em jovens. Os desafios desenvolvimentais põem à prova a dialética entre autonomia/dependência, num mundo ocidental cheio de contradições e pressões para a excelência, como se se vivesse em constante exposição; a imagem do corpo parecendo assumir-se como representando o valor do sujeito. Este trabalho avalia relações entre vinculação aos pais e imagem corporal, em 424 universitários entre 18-25 anos; mostrando relações significativas entre dimensões da vinculação aos pais e a satisfação e preocupação com o corpo. Os resultados são discutidos à luz dos modelos da vinculação.

On the Link Between Benevolent Sexism and Orgasm Frequency in Heterosexual Women

Previous research on subclinical orgasmic difficulties among women has focused on intrapsychic and interpersonal variables, but little attention has been paid to the more distal ideological factors that might indirectly constrain sexual pleasure. We hypothesized that women's endorsement of a benevolently sexist worldview would be negatively associated with orgasm frequency. Specifically, we predicted that benevolent sexism would be associated with increased perceptions of male sexual selfishness. This perception of men as interested in their own sexual pleasure would then predict decreased willingness to ask a partner for sexual pleasure, which in turn would be associated with less frequent orgasms. We found support for our model across two studies (Study 1: N = 339; Study 2: N = 323). We did not, however, find a direct effect of benevolent sexism on orgasm frequency. We discuss possible additional variables linking benevolent sexism with orgasm frequency, implications, and future directions.

Sexual Function Is Correlated With Body Image and Partnership Quality in Female University Students

INTRODUCTION

According to the World Health Organization definition, sexual health is more than mere physical sexual function; it also encompasses emotional, mental, and social well-being in relation to sexuality and is not merely the absence of dysfunction or disease. In line with this definition, various studies have reported that female sexual function is associated with partnership quality, body image, and body self-acceptance.

AIM

To investigate whether female sexual function is influenced by (i) body self-acceptance and (ii) partnership quality, as important factors in psychosocial well-being, and (iii) whether the effects of body self-acceptance are moderated by partnership quality.

METHODS

In total, 2,685 female medical students no older than 35 years from Germany, Austria, and Switzerland completed an anonymous online questionnaire comprising the Female Sexual Function Index (FSFI) and the Self-Acceptance of the Body Scale. Respondents were asked to state whether they had been in a steady partnership in the preceding 6 months. When present, the quality of the partnership status was rated (enamoredness, love, friendship, or conflicted). To determine correlations, group differences, and moderating effects among body self-acceptance, partnership quality, and sexual function, the data were analyzed using Spearman correlations, Kruskal-Wallis tests, and analyses of variance.

MAIN OUTCOME MEASURES

Female sexual function (FSFI total score).

RESULTS

(i) In sexually active women, higher FSFI scores were significantly associated with greater body self-acceptance and a steady partnership during the preceding 6 months. (ii) Total FSFI scores were highest in women who described their partnership as enamored (29.45) or loving (28.55). Lower scores were observed in single women (26.71) and in women who described their partnerships as friendship (25.76) or as emotionally conflicted (23.41). (iii) Total FSFI score was affected by an interaction between body self-acceptance and partnership quality. Body self- acceptance was positively associated with FSFI total scores, particularly in single women and women in emotionally conflicted partnerships.

CONCLUSION

Our findings suggest that in young women, body self-acceptance and partnership quality are positively associated with better sexual function, and that high body self-acceptance might buffer the negative impact on sexual function of partnership quality. The present data suggest that psychological interventions to improve the body image of younger women can positively affect sexual function and thereby improve sexual health.