Associations between affect, context, and sexual desire in depressed young women

In the Mood: How Sexual Desire Predicts and is Predicted by Romantic Partners' Mood

The association between mood and sexual desire has been the object of significant scientific and public interest. How mood shapes and is shaped by sexual desire is typically studied within one and the same individual, yet sexual desire is often experienced in the context of a romantic relationship. To obtain a more complete picture of the relation between mood and sexual desire, we examined the temporal interplay between mood and sexual desire both within and between partners in a romantic relationship. Using data from an experience sampling study involving both partners of mixed-gender romantic couples (N = 188; Mage = 26.34, SDage = 5.33), we investigated how each partner's mood (in terms of positive and negative affect) predicted their own sexual desire as well as that of their partner and vice versa. Results of both concurrent and temporal analyses confirmed bidirectional associations between mood and sexual desire both within and between partners, such that (1) both a person's own and their partner's positive mood predicted an increase in sexual desire, and a person's own and their partner's negative mood predicted a decrease in sexual desire. In addition, (2) both a person's own and their partner's sexual desire predicted an increase in positive mood, and a person's own and their partner's sexual desire predicted a decrease in negative mood. Only a few gender differences were found. The results underscore how sexual desire can predict and be predicted by both romantic partners' mood, highlighting the need for interactional models of sexual desire.

The Relation of Mood and Sexual Desire: An Experience Sampling Perspective on the Dual Control Model

We investigated the effect of fluctuations in negative and positive affect on momentary sexual motivation in a sample of women and men in a steady relationship (n = 133). Sexual motivation was regarded as the aggregate of sexual desire, subjective sexual arousal and openness to sexual contact. Experience sampling methodology was used to collect up to 70 measurements per participant over a period of seven consecutive days of sexual motivation, and negative and positive affect. Using multilevel analysis, we investigated cross-level interactions between affect and trait measures as specified in the dual control model (DCM). This model postulates sexually excitatory and inhibitory mechanisms as relatively independent systems that together can explain individual differences in sexual motivation and behavior. Results implicated that any intensification of feelings, positive or negative, was associated with a momentary increase in sexual motivation for participants more prone to sexual excitation. In the lagged analysis, higher preceding negative affect, measured 1-2 h earlier, forecasted an increase in current sexual motivation for participants more prone to sexual excitation. The lagged analysis included the autoregressive effect or inertia of sexual motivation. Inertia reflects the extent to which sexual motivation lingers and persists at similar levels. Our findings showed that sexual motivation levels persisted less in individuals with higher sexual inhibition proneness due to threat of performance failure. This study demonstrated how experience sampling methodology can be used to extend research on associations between mood and sexual motivation and implicates that DCM factors moderate these associations.

Effects of the COVID-19 Pandemic on LGBTQ+'s Sexual Behaviors in Turkey: "Everything about Sex Had Become A Black Box"

The COVID-19 pandemic has forced changes in the behavior patterns of many population groups due to restrictive measures all over the world. In this study, qualitative research method based on a phenomenological approach was used to determine the changes in the sexual behavior of a group of LGBTQ+ people living in Turkey. The COVID-19 pandemic has culminated in changes in the sexual life of LGBTQ+s. It has been determined that feelings such as the need of emotional support, loneliness, devaluation and helplessness were experienced, and quarantine and curfew restrictions were effective on sexuality and sexual behaviors. In addition, it has been determined that LGBTQ+s have changed in the standards of determining partners during the pandemic process. The use of sex toys has increased, the sensitivity toward self-care and hygiene rules has increased, the tendency to have sexual fantasies has changed, the sexual behavior of people in their social environment has changed, and the disruptions in health services have posed negative effects. It is recommended to carry out studies focusing on the sexual behavior of LGBTQ+s and to develop counseling services regarding the sexual behaviors of LGBTQ+s and the situations that occur in their sexual lives.

Levels of depressed mood and low interest for two years after response to cognitive therapy for recurrent depression

BACKGROUND

Major depressive disorder (MDD) involves depressed mood (high negative affect, predominantly) and low interest/pleasure (low positive affect). In past research, negative affect has improved more than positive affect during acute-phase antidepressant medication or cognitive therapy (CT). We extended this literature by differentiating depressed mood and two dimensions of low interest (general and sexual), assessing persistence of symptom differences after acute-phase CT response, and testing whether continuation treatment acted differently on depressed mood versus low interest.

METHODS

We analyzed data from two randomized controlled trials. Patients with recurrent MDD first received acute-phase CT. Then, responders were randomized to 8-month continuation treatments and assessed for 16-24 additional months.

RESULTS

Depressed mood and low general interest improved more than low sexual interest during acute-phase CT. Among responders, these symptom differences persisted for at least 2 years and were not changed by continuation CT or antidepressant medication.

LIMITATIONS

Generalization of findings to other patient populations and treatments is uncertain. Depressed mood and low interest scales were constructed from standard symptom measures and overlapped empirically.

CONCLUSIONS

Less improvement during CT, and persistent low sexual interest despite continuation treatment, highlights the need for MDD treatments more effectively targeting this positive affective symptom.

Development and pilot testing of a counseling-plus-mHealth intervention to reduce risk for pregnancy and sexually transmitted infection in young women with depression

BACKGROUND

Depressed young women have elevated rates of unintended pregnancy and sexually transmitted infections (STIs). The objective of this study was to develop and pilot-test a counseling-plus-mHealth intervention to reduce sexual and reproductive health (SRH) risk in young women with depressive symptoms.

METHODS

Using the Behavior-Determinants-Intervention logic model, we developed the Momentary Affect Regulation-Safer Sex Intervention (MARSSI) to address the challenges that depression imposes on SRH risk reduction efforts of high-risk young women: (I) in-person counseling using motivational interviewing (MI) to elicit motivation for safer sex and develop a behavior change plan, and teaching cognitive-behavioral skills to manage negative thoughts and affective states; (II) 4-week Ecological Momentary Intervention (EMI) on a smartphone to report momentary phenomena related to depression and SRH risk, and receive personalized, tailored messages prompting healthy behaviors and encouraging cognitive-behavioral skill use when risk-related cognitions and negative affect are reported; and (III) booster counseling to review behavior change goals and plans and teach a new cognitive-behavioral skill. We developed the counseling through iterative interviews with 11 participants and developed the EMI through a 2-week trial with three participants, then revised MARSSI to reflect participant feedback. We next conducted a pilot-test among depressed, high-risk female adolescent clinic patients age 15-24. Pilot participants completed mental health, motivation to change behavior, and SRH behavior assessments and provided feedback at baseline, post-EMI, and at 3-month follow-up. We analyzed participant retention, counseling duration, app engagement, intervention quality ratings, and participant feedback, and compared mental health and SRH risk behavior across the study.

RESULTS

Seventeen participants completed the initial counseling session, 15 participated in the EMI, 14 returned for the booster session, and 14 completed the 3-month follow-up. App engagement was high for all 4 EMI weeks (≥1 report/day for median ≥6 days/week). Post-intervention, most or all participants agreed with each positive statement about the messages, reported "Excellent" MARSSI usefulness, and attributed improvements to MARSSI. Compared to baseline, post-EMI depressive symptoms, confidence to change self-selected risk behavior, and confidence to use the cognitive restructuring skill improved. At 3 months, depressive symptom scores remained lower and confidence to use cognitive restructuring remained higher, compared to baseline. Participants also reported lower frequency of sex, lower proportion of condom-unprotected sex events, and, among those using effective contraception, more consistent condom use at 3-month follow-up vs. baseline.

CONCLUSIONS

MARSSI was feasible, acceptable, and engaging to young women with depression and SRH risk behavior, and was associated with increased confidence to reduce SRH risk, decreased SRH risk behaviors, increased confidence to use cognitive restructuring, and decreased depressive symptoms over 3 months. Future research is warranted to evaluate MARSSI's efficacy to improve motivation, skills, affect, and behaviors, as well as reproductive health outcomes in high-risk depressed young women.

Automatic Thoughts During Sexual Activity, Distressing Sexual Symptoms, and Sexual Orientation: Findings from a Web Survey

Studies with heterosexual samples have supported the role of cognitions on sexual functioning in men and women. However, there is no research on the impact of automatic thoughts on sexual functioning in sexual-minority samples. Therefore, the current study aimed to analyze the differences in automatic thoughts during sexual activity between gay and heterosexual men, and lesbian and heterosexual women, with and without distressing sexual symptoms, in order to establish similarities and differences between samples. A web survey was completed by 156 men and 168 women. A group of men and women with distressing sexual symptoms (78 men and 84 women) and a group without distressing sexual symptoms (78 men and 84 women) equally distributed in terms of sexual orientation and matched for sociodemographic variables were constituted. Participants answered a sociodemographic questionnaire, a questionnaire about sexual symptoms, and an automatic thoughts measure. Main findings suggested that men and women with distressing sexual symptoms reported significantly more negative automatic thoughts and fewer erotic thoughts during sexual activity, regardless of sexual orientation. Overall, current findings were consistent with previous research with heterosexual samples, suggesting a similar pattern in heterosexual samples, and gay men and lesbian women samples.

Momentary Desire for Sexual Intercourse and Momentary Emotional Intimacy Associated With Perceived Relationship Quality and Physical Intimacy in Heterosexual Emerging Adult Couples

Sexual desire and emotional intimacy are central to relationships, yet little is known about how these feelings vary within and between partners or relate to dyad functioning. We explored magnitude and stability of momentary sexual desire and emotional intimacy in relation to quality and functioning of heterosexual relationships. After reporting perceived relationship quality and physical intimacy enjoyment, members of 18 emerging adult heterosexual couples reported momentary partner-specific sexual desire and emotional intimacy several times a day for two weeks (2,224 reports). Mean and mean squared successive difference (MSSD) characterized magnitude and stability, respectively, of the momentary states. Regression models of relationship outcomes examined influence of the male versus female partner having greater or more stable desire and intimacy. Sexual desire and emotional intimacy magnitude and stability were associated with relationship quality and physical intimacy enjoyment differently for men versus women. Gender-specific differences between partners also predicted relationship outcomes. Men particularly perceived higher relationship quality and enjoyed physical intimacy more when they had higher and more stable sexual desire and their female partners had more stable emotional intimacy. Partner differences in momentary sexual desire and emotional intimacy may contribute to understanding quality and functioning of heterosexual relationships.

The Relationship between Sexual Cues and Sexual Desire in Women

Sexual desire is one of the most studied dimensions of sexual response. There is extensive research on bio-medical, psychosocial, and relationship predictors of desire particularly in women. Despite this accumulated knowledge, there is a lack of studies investigating the ability of sexual cues to predict sexual desire. A sample of 546 heterosexual and premenopausal Portuguese women, aged between 18 and 53 years old, completed a web survey assessing socio-demographic variables, medical conditions, psychopathology, relationship dimensions, sexual cues and sexual desire. Findings from hierarchical regression analyses indicated that sexual cues significantly predict sexual desire. In particular, explicit/arousal cues (β = .321, p < .001) were the most significant predictor of female sexual desire. Additionally, somatization (β = .188, p < .001), relationship satisfaction (β = .159, p < .001), anxiety (β = -.165, p = .006), and antidepressant medication (β = -.094, p = .014) were also significant predictors. Results emphasize the strong ability of explicit/arousal cues to predict sexual desire in women above and beyond other known factors. These findings suggest that the assessment of sexual desire problems in women as well as treatment approaches should take into consideration the role of sexual cues and particularly explicit/arousal cues.

Positive and Negative Affect During Sexual Activity: Differences Between Homosexual and Heterosexual Men and Women, With and Without Sexual Problems

Empirical research suggests that emotional response during sexual activity discriminates between sexually functional and dysfunctional heterosexual men and women, with clinics presenting lower positive and higher negative affect. However, there is no evidence about the role of emotions in gay men and lesbian women with sexual problems. The present study analyzed affective states during sexual activity in homosexual and heterosexual men and women, with and without sexual problems. Participants in this study were 156 men and 168 women. A 2 (group) × 2 (sexual orientation) multivariate analysis of variance was performed. Participants completed a web-survey assessing sexual functioning and the Positive Affect-Negative Affect Scale. Findings indicated a main effect of group, with groups with sexual problems reporting significantly more negative and lower positive affect compared with men and women without sexual problems, regardless of sexual orientation. However, findings have also shown an interaction effect in the male sample with gay men, contrary to heterosexual men, reporting similar affective responses regardless of having a sexual dysfunction or not. Overall, findings emphasize the role of affective responses during sexual activity in men and women with sexual problems, suggesting the importance of addressing emotional responses in assessment and treatment of sexual problems in individuals with different sexual orientations.