Feasibility of a Cognitive-Behavioral Couple Therapy Intervention for Sexual Interest/Arousal Disorder

Female sexual interest/arousal disorder (SIAD) is strongly influenced by interpersonal factors; however, there are no empirically-supported, couple-based sex therapy interventions for this disorder. This pre-registered study tested the feasibility of a cognitive-behavioral couple therapy (CBCT) intervention for SIAD. A sample of 19 couples in which a female partner was diagnosed with SIAD completed a 16-session CBCT intervention delivered online by therapists with PhD-level training in clinical psychology. Women with SIAD (Mage = 43.47, SD = 12.76) and their partners (Mage = 43.74, SD = 11.68) were in long-term relationships (M = 13.86, SD = 9.15). The CBCT sessions were video recorded and independently coded for treatment manual adherence and therapists reported on the completion of in-session and homework exercises. Participants completed measures of treatment satisfaction following the intervention as well as dyadic sexual desire (women with SIAD only) and sexual distress prior to treatment, post-treatment, and at 6 months follow-up. The therapists exhibited a high level of adherence to the treatment manual and couples had high rates of homework completion. Moreover, couples had low dropout rates, high attendance rates, and reported moderately high global treatment satisfaction and high satisfaction with virtual care. Women with SIAD reported large improvements in dyadic sexual desire and sexual distress from pre-treatment to post-treatment and pre-treatment to 6-month follow-up. Partners reported moderate and small improvements in sexual distress for post-treatment and 6-month follow-up, respectively. Results support the feasibility of an evidence-based CBCT intervention for SIAD and the need for a randomized clinical trial of the intervention.

Motivation When Desire Is Low: Associations Between Sexual Motivation and Sexual Intimacy, Sexual Satisfaction, and Sexual Distress for Men with Hypoactive Sexual Desire Disorder and Their Partners

Hypoactive sexual desire disorder (HSDD) in men, characterized by chronically low sexual desire, is associated with poor sexual well-being, such as lower sexual satisfaction and higher sexual distress. Additionally, despite their low desire, men with HSDD often report wanting sexual intimacy and validation within their sexual lives/relationships. Studies that apply self-determination theory to sexual relationships demonstrate that adopting more autonomous (e.g., engaging in sex for its inherent pleasure) and less controlled (e.g., engaging in sex for some external reward or consequence) motives for engaging in sex is associated with greater sexual well-being for both members of the couple. Given that autonomous motivation in relationships is associated with intimacy and sexual satisfaction, and lower sexual distress, having sex for autonomous reasons may allow men with HSDD and their partners to feel more sexually intimate despite their lower sexual desire, whereas having sex for controlled reasons may hinder sexual intimacy and satisfaction and augment sexual distress. In this dyadic cross-sectional study, we examined the associations between types of sexual motivation and sexual intimacy, sexual satisfaction, and sexual distress for men with HSDD and their partners (n = 64 couples). Men with HSDD who reported having sex for more autonomous reasons reported more sexual satisfaction and both partners reported more sexual intimacy. Men with HSDD who had sex for more controlled reasons had partners who felt less sexual intimacy and satisfaction, and both partners were more sexually distressed. Promoting autonomous sexual motivation and decreasing controlled motivation may help couples navigating HSDD to feel closer in their relationship, more sexually satisfied, and less sexually distressed.

Responsiveness in the Face of Sexual Challenges: The Role of Sexual Growth and Destiny Beliefs

Implicit--or lay--sexual beliefs have been associated with how people respond to sexual challenges in romantic relationships. People who endorse sexual destiny beliefs view a satisfying sex life as the result of finding the right partner and report poorer sexual, relationship, and personal well-being when there are sexual challenges. In comparison, people who endorse sexual growth beliefs view satisfying sexual relationships as requiring hard work and effort to maintain and tend to report high sexual, relationship, and personal well-being even when facing sexual challenges. High sexual responsiveness - being motivated to meet a partner's sexual needs - is associated with maintaining high sexual satisfaction, even when couples face sexual challenges in a relationship. In the current research, we tested whether sexual growth and destiny beliefs are associated with general and sexual responsiveness and whether the associations are moderated by the presence of sexual challenges. Across three (clinical and non-clinical) samples (N = 820) facing different types of sexual challenges (Study 1 (Mage = 31.64, SD = 8.53), clinically low sexual desire; Studies 2 (Mage = 32.63, SD = 10.19) and 3 (Mage = 32.40, SD = 9.31), unmet sexual ideals; Study 3, changes in sex since the onset of the COVID-19 pandemic), we found that sexual growth beliefs were associated with higher sexual responsiveness and perceived partner sexual and general responsiveness, even when couples were coping with sexual challenges, whereas sexual destiny beliefs were not associated with responsiveness, and at times were associated with lower sexual responsiveness and perceived partner sexual and general responsiveness. This research provides initial evidence about how implicit sexual beliefs are associated with sexual and general responsiveness when couples are coping with sexual challenges in a romantic relationship.

Hooked on a feeling: Downregulation of negative emotion during sexual conflict is associated with sexual well-being among long-term couples

Intimate partners experience more negative emotion in response to sexual versus nonsexual conflicts in their relationship. Negative emotions hinder communication and sexual well-being. In a laboratory-based observational study, we tested the prediction that couples who took longer to downregulate negative emotion during a sexual conflict discussion would report lower sexual well-being. Long-term couples (N = 150) were video recorded while they discussed the most contentious problem within their sexual relationship. Participants subsequently viewed their filmed discussion and used a joystick to continuously report on their emotional experience during their disagreement. Trained coders continuously coded the valence of participants' emotional behavior. Downregulation of negative emotion was assessed by calculating how quickly, on average, an individual's negative emotional experience and behavior returned to neutral during their discussion. Participants also completed measures assessing sexual distress, satisfaction, and desire prior to the discussion and 1 year later. Analyses were conducted per the Actor-Partner Interdependence Model. For both women and men, we found that a person's slower downregulation of negative emotional experience was concurrently associated with their own greater sexual distress and lower sexual desire and with their partner's lower sexual satisfaction. Downregulation of negative emotional experience also predicted one's own lower sexual satisfaction and, surprisingly, higher sexual desire for both members of the couple 1 year later. People who took longer to downregulate their negative emotional behavior during the conflict also reported higher sexual desire 1 year later. Findings suggest that greater difficulty shifting out negative emotional states during sexual conflict is concurrently linked with poorer sexual well-being for long-term couples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is Spontaneous Sex Ideal? Beliefs and Perceptions of Spontaneous and Planned Sex and Sexual Satisfaction in Romantic Relationships

Sexual satisfaction is critical for relationship quality and people hold lay beliefs (implicit theories) about what makes for satisfying sex. A common belief in Western culture is that spontaneous sex is most satisfying, but this idea has not yet been studied. In pre-registered analyses of two studies - a cross sectional (N = 303 individuals) and a 21-day daily experience study (N = 121 couples) - we found support for two distinct beliefs (spontaneous sex as satisfying; planned sex as satisfying). Across both studies, people held stronger beliefs that spontaneous sex is satisfying compared to planned sex, but stronger spontaneous sex beliefs were only associated with higher sexual satisfaction in Study 1. In Study 1, when people perceived their most recent sexual experience as planned (versus spontaneous), they felt less sexually satisfied, but this was not the case for those who endorsed stronger planned sex beliefs. In Study 2, endorsing stronger planned sex beliefs was associated with a partner's lower sexual satisfaction at baseline. There were no associations between perceptions of the extent to which sex was spontaneous and sexual satisfaction at baseline or in daily life. Future research could test whether beliefs about spontaneity and planning have value in clinical settings.

What Does a Pregnancy Loss Mean for Sex? Comparing Sexual Well-Being Between Couples With and Without a Recent Loss

It is unclear whether sexual well-being, which is an important part of individual and relational health, may be at risk for declines after a pregnancy loss given the limits of prior work. Accordingly, in a cross-sectional study, we used structural equation modeling to (1) compare sexual well-being levels-satisfaction, desire, function, distress, and frequency-of both partners in couples who had experienced a pregnancy loss in the past four months (N = 103 couples) to their counterparts in a control sample of couples with no history of pregnancy loss (N = 120 couples), and (2) compare sexual well-being levels of each member of a couple to one another. We found that gestational individuals and their partners in the pregnancy loss sample were less sexually satisfied than their control counterparts but did not differ in sexual desire, problems with sexual function, nor sexual frequency. Surprisingly, we found that partners of gestational individuals had less sexual distress than their control counterparts. In the pregnancy loss sample, gestational individuals had lower levels of sexual desire post-loss than their partners but did not differ in sexual satisfaction, problems with sexual function, nor sexual distress. Our results provide evidence that a recent pregnancy loss is associated with lower sexual satisfaction and greater differences between partners in sexual desire, which may be useful information for clinicians working with couples post-loss. Practitioners can share these findings with couples who may find it reassuring that we did not find many aspects of sexual well-being to be related to pregnancy loss at about three months post-loss.

Comparing Responses to Sexual Rejection and Sexual and Relationship Well-Being in Couples Coping with Sexual Interest/Arousal Disorder and Community Couples

Four distinct partner responses to sexual rejection - sexual advances that are declined by a partner - have been identified. This study assessed the frequency of these responses between and within North American couples coping with Sexual Interest/Arousal Disorder (SIAD) and community couples and - in line with the Interpersonal Emotion Regulation Model - compared the associations between responses to sexual rejection and sexual and relationship well-being across the two samples. Individuals with SIAD and their partners (n = 241) and community couples (n = 105) completed online measures of sexual rejection responses, sexual satisfaction, sexual desire, sexual distress, sexual frequency, and relationship satisfaction. Results showed that after accounting for sexual rejection frequency, individuals with SIAD and their partners reported greater resentful and insecure partner responses to sexual rejection than individuals in the community sample, and individuals with SIAD perceived less understanding responses than their own partners reported. For both groups, more understanding and less resentful and insecure responses were associated with greater sexual and relationship well-being. Clinicians might encourage couples to reflect on their rejection responses and to shift to more helpful ways of responding to sexual rejection.

What to Expect When You're Expecting: Perinatal Sexual Education Is Linked with Couples' Sexual Well-Being in Pregnancy and the Postpartum

Up to 88% of expectant and new parents report problems with their sexual well-being, yet less than 30% of individuals receive information about potential sexual problems from health-care professionals. Lack of information may contribute to difficulty adjusting to sexual challenges, and in turn, to poorer sexual well-being. The current study examined the following: 1) the amount of perinatal sexual health information individuals receive/access; 2) gaps between desired and received information; 3) barriers to accessing information; and 4) links between the quantity of information received/accessed and sexual well-being outcomes in one sample of pregnant couples (N = 102) and another sample of couples in the postpartum (N = 102). Results revealed that most participants reported receiving/accessing little-to-no sexual health information, despite most participants wanting to receive a variety of information related to their perinatal sexuality. On average, expectant and new parents were indifferent regarding how easy/comfortable they felt discussing their sexuality with health-care professionals. Overall, when gestational parents received/accessed more pregnancy-related sexual health information and when either parent received/accessed more postpartum-related sexual health information, both members of the couples reported greater sexual well-being. Access to information might not only address couples' needs and concerns but may also bolster sexual well-being during a vulnerable period.

Unmet and Exceeded Expectations for Sexual Concerns across the Transition to Parenthood

Expectations play a key role in shaping sexual and relationship well-being. Across the transition to parenthood, couples navigate many changes to their sexual relationships, yet little is known about their expectations related to sex. This longitudinal study investigated how unmet and exceeded expectations for postpartum sexual concerns - assessed in pregnancy and compared to experiences at 3-months postpartum - affect sexual and relationship well-being. Data were collected from 200 new-parent couples mid-pregnancy and at 3, 6, 9, and 12-months postpartum. Mothers' unmet expectations (i.e., sexual experiences were worse than expected) were associated with their own lower sexual and relationship satisfaction at 3-months postpartum. Partners' unmet expectations were associated with their own lower sexual satisfaction, higher sexual distress and relationship conflict, and mothers' lower sexual satisfaction. Mothers' exceeded expectations (i.e., sexual experiences were not as bad as they expected) were linked to their own and their partners' higher sexual satisfaction and lower sexual distress and relationship conflict at 3-months postpartum. Partners' exceeded expectations were only associated with mothers' lower sexual distress at 3-months postpartum. Expectations did not predict change in outcomes over time. Findings provide novel evidence that expectations for one's sexual relationship are associated with new parents' sexual and relationship adjustment during a vulnerable period for sexuality and well-being.

Self-Compassion and Compassionate Love Are Positively Associated with Sexual and Relational Well-Being Among Expectant and New Parent Couples

Pregnancy and the postpartum period can be a challenging time for many couples' relationships. Outside of pregnancy and the postpartum period, being more attentive and sensitive to one's own suffering (i.e., high in self-compassion) and showing love that centers on another person's well-being (i.e., compassionate love) has been linked with greater sexual and relationship satisfaction and lower sexual distress. Both self-compassion and compassionate love may benefit couples during the perinatal period by facilitating more adaptive coping and greater responsiveness to one's own and one's partner's needs. The goal of this study was to examine associations between self-compassion and compassionate love and sexual and relationship satisfaction and sexual distress in two samples of (1) expectant (n = 102) and (2) new parent (n = 102) couples. During pregnancy, self-compassion and compassionate love were linked with higher relationship and sexual satisfaction and lower sexual distress. In the postpartum, higher self-compassion and compassionate love were associated with greater relationship satisfaction, but were less consistently linked with sexual satisfaction and sexual distress. Consistent with theory, self-compassion and compassionate love may allow expectant and new parent couples to adjust to the demands of new parenthood more easily, with benefits for their sexual and relationship wellbeing. Given our data and the established benefits of self-compassion and compassionate love for facilitating adjustment during stressful life events, educating couples about the importance of fostering self-compassion and compassionate love during pregnancy, and after the baby is born, may cultivate resilience which, in turn, may promote stronger relationships.

Associations between New Mothers' Partner-Oriented Sexual Values and Sexual Distress in the Transition to Parenthood

Women commonly experience heightened sexual distress in pregnancy and postpartum, and there is limited knowledge of protective factors. Women report declines in the importance of sexuality during this time, suggesting that valuing sexuality could be a relevant individual difference factor. It may be particularly protective for women to feel successful in living in line with their sexual values. In a longitudinal study, we examined associations between the extent to which women valued their role as a sexual partner, and their success living in line with this partner-oriented sexual value, with their sexual distress. Women (N = 367) reported the importance of their role as a sexual partner, success living according to this value, and sexual distress during pregnancy (18-20 weeks) and at 3, 6, 12 and 24-months postpartum. More strongly valuing one's role as a sexual partner was associated with more sexual distress, both between-person (i.e., across women) and within-person (i.e., variation within women over time). Above and beyond these effects, greater success at living in line with one's partner-oriented sexual value was associated with less sexual distress. Finding ways to live in line with one's sexual values may protect against sexual distress for new mothers in the transition to parenthood.

Sexual growth and destiny beliefs: Longitudinal associations with dyadic coping among couples seeking medically assisted reproduction

BACKGROUND

Medically assisted reproduction is a vulnerable time for couples' sexual health. Believing that sexual challenges can be worked through (i.e., sexual growth beliefs) or that these challenges indicate incompatibility (i.e., sexual destiny beliefs) may be related to dyadic coping-the strategies couples use to cope-with the physical and psychological stressors of medically assisted reproduction.

AIM

In the current study we aimed to examine the longitudinal associations between typical (i.e., average) levels of sexual growth and destiny beliefs and positive and negative facets of dyadic coping and how greater than typical levels of these constructs predicted each other across time.

METHODS

Couples (n = 219) seeking medically assisted reproduction were recruited for an online longitudinal, dyadic study.

OUTCOMES

Couples completed online measures of sexual growth and destiny beliefs and positive and negative dyadic coping at baseline, 6-and 12-months.

RESULTS

Random intercept cross-lagged panel models demonstrated that at the within-person level, reporting higher sexual growth beliefs at baseline, relative to their average across time points, was associated with lower negative dyadic coping at 6 months. Higher negative dyadic coping at 6 months, relative to their average, was linked to lower sexual growth beliefs at 12-months. When individuals reported higher sexual destiny beliefs at 6-months, relative to their average, they and their partners reported higher negative dyadic coping at 12 -months. At the between-person level, higher overall levels of sexual destiny beliefs were related to higher overall levels of negative dyadic coping. No associations with positive dyadic coping were identified.

CLINICAL IMPLICATIONS

Couples may benefit from identifying and reducing unhelpful beliefs about sex and negative dyadic coping.

STRENGTHS AND LIMITATIONS

Strengths of this study include our large, inclusive sample, engagement of community partners, and novel analytical approach to assess change over time. However, following couples in 6-month increments and not using questionnaires specific to medically assisted reproduction may have limited our ability to detect nuanced changes that couples experience during this time.

CONCLUSION

Lower sexual growth and higher sexual destiny beliefs may promote couples' engagement in less adaptive coping behaviors as they seek medically assisted reproduction.

Being Responsive and Self-Determined When it Comes to Sex: How and Why Sexual Motivation is Associated with Satisfaction and Desire in Romantic Relationships

Couples experience greater satisfaction and desire when they are motivated to meet each other's sexual needs (sexual communal strength); however, doing so at the expense of one's own sexual needs (unmitigated sexual communion) can detract from satisfaction and desire. Self-determination theory suggests engaging in sex for pleasure and value (autonomous reasons) versus out of pressure and obligation (controlled reasons) may account for these differences. Across two dyadic studies, one cross-sectional (N = 103 couples) and one longitudinal (N = 147 couples), people higher in sexual communal strength had sex for more autonomous and less controlled reasons, and in turn, reported greater satisfaction and desire, overall, in daily life, and over time. In contrast, people higher in unmitigated sexual communion endorsed more controlled reasons for engaging in sex, and in turn reported lower satisfaction. Partners of people higher in sexual communal strength reported less controlled reasons for engaging in sex, and in turn, both partners felt more satisfied, whereas partners of people high in unmitigated sexual communion endorsed more controlled reasons and reported lower satisfaction. This research furthers our understanding of when and why being motivated to be responsive to a partner's sexual needs enhances or detracts from sexual and relationship quality.

Partner Knowledge of Solitary Pornography Use: Daily and Longitudinal Associations with Relationship Quality

Pornography use is a common sexual activity engaged in mostly alone, including for partnered individuals. Evidence concerning the benefits and costs of solitary pornography use for romantic relationship quality is mixed and may vary depending on the circumstances of pornography use, including partner knowledge of one's solitary use. Adopting a dyadic daily diary and longitudinal design, we examined the associations between knowledge of a partner's solitary pornography use and one's own and the partner's relationship satisfaction and intimacy on the same day, and trajectories over one year. A convenience sample of 217 couples completed daily surveys over 35 days and self-reported measures three times over one year. Each participant reported if they used pornography today and whether their use was known by their partner. Findings showed that when an individual's solitary pornography use was unknown by their partner, they reported lower same-day relationship satisfaction and intimacy as well as a lower initial level of relationship satisfaction. When an individual's solitary pornography use was known, they reported higher intimacy over one year and their partner reported lower intimacy over one year. Findings underscore the complexity of the relational context surrounding solitary pornography use in couples, in particular the partner's knowledge of pornography use.

Partner responses to low desire among couples coping with male hypoactive sexual desire disorder and associations with sexual well-being

BACKGROUND

Hypoactive sexual desire disorder (HSDD) is characterized by persistently low desire and associated distress. Low desire is one of the most common sexual complaints among men and is associated with poor well-being. Interpersonal factors are key to understanding low desire, yet there are few dyadic studies of HSDD in men. Previous work on genito-pelvic pain and low desire in women has established that greater facilitative (eg, affectionate) partner responses are associated with greater sexual satisfaction and function and that more negative (eg, critical) or solicitous (eg, sympathetic, avoidant) partner responses are associated with lower sexual satisfaction and function. Examining how partner responses are associated with adjustment to HSDD may shed light on the interpersonal dynamics of this understudied sexual dysfunction.

AIM

In a cross-sectional study, we examined whether partner responses to low desire in men were associated with sexual desire, sexual satisfaction, and sexual distress for both members of the couple.

METHODS

Men with HSDD and their partners (N  =  67 couples) completed measures of facilitative, negative, and avoidant partner responses to men's low sexual desire-as perceived by the man with HSDD and self-reported by their partner-and sexual desire, sexual satisfaction, and sexual distress. Data were analyzed using multilevel modeling guided by the actor-partner interdependence model.

OUTCOMES

Outcomes included the partner-focused subscale of the Sexual Desire Inventory-2, Global Measure of Sexual Satisfaction, and Sexual Distress Scale-Revised.

RESULTS

When men with HSDD perceived more facilitative partner responses to their low desire, they and their partners reported greater sexual satisfaction. When men with HSDD perceived and their partners self-reported more negative partner responses, they each reported lower sexual satisfaction. In addition, when men with HSDD perceived more avoidant partner responses, their partners reported greater sexual distress. Partner responses were not associated with sexual desire for either member of the couple.

CLINICAL IMPLICATIONS

Findings support the importance of the interpersonal context for HSDD in men and suggest potential future targets of treatment when working with affected couples.

STRENGTHS AND LIMITATIONS

This study is one of the only dyadic studies of HSDD in men, as assessed via clinical interview or self-report symptoms reviewed by the clinical team. Despite our best efforts to recruit this sample over 6 years, the small size limited power to detect all predicted effects.

CONCLUSION

More facilitative and fewer negative or avoidant partner responses to low desire are associated with greater sexual well-being in couples coping with HSDD.

Sexual script flexibility and sexual well-being in long-term couples: a dyadic longitudinal study

BACKGROUND

Couples in long-term relationships often face sexual challenges (eg, sexual response difficulties) that may disrupt their typical sexual routine or sexual script. Individuals with more rigid sexual scripts (eg, sex must include penile-vaginal intercourse) may struggle to navigate their sexual difficulties, potentially resulting in lower sexual well-being for themselves and their partners.

AIM

In a dyadic longitudinal study, we examined whether individuals' greater sexual script flexibility when coping with recent sexual challenges was associated with their own and their partner's greater sexual well-being (ie, dyadic sexual desire, sexual satisfaction, low sexual distress).

METHODS

Seventy-four mixed- and same-gender/sex couples in long-term relationships completed online surveys about sexual script flexibility and facets of sexual well-being at baseline and 4 months later. Dyadic data were treated as indistinguishable and analyzed using multilevel modeling guided by the actor-partner interdependence model.

OUTCOMES

Self-report measures of dyadic sexual desire (Sexual Desire Inventory-2), sexual satisfaction (Global Measure of Sexual Satisfaction), and sexual distress (Sexual Distress Scale-Short Form) were assessed at baseline and follow-up.

RESULTS

Cross-sectional results showed that when individuals reported greater sexual script flexibility in response to recent sexual challenges, they and their partners reported greater sexual satisfaction. Individuals' greater sexual script flexibility was also linked to their own greater dyadic sexual desire and lower sexual distress. Unexpectedly, individuals' greater sexual script flexibility was associated with their partner's lower dyadic sexual desire at baseline and their own lower dyadic sexual desire 4 months later. No other associations were found between sexual script flexibility and sexual outcomes 4 months later and there were no interactions between individuals' gender and sexual script flexibility for the cross-sectional models.

CLINICAL IMPLICATIONS

The cross-sectional associations between sexual script flexibility and sexual well-being provides some support for the idea that modifying rigid sexual scripts in sex and couple therapy may promote contemporaneous sexual well-being.

STRENGTHS AND LIMITATIONS

This is the first dyadic study, to our knowledge, to assess the assumed benefits of greater sexual script flexibility for couples' sexual well-being. The relatively small and homogeneous sample of community couples who had largely intact sexual well-being limits generalizability.

CONCLUSION

Findings provide preliminary evidence of cross-sectional links between sexual script flexibility and sexual well-being for individuals and couples, lending empirical support to the convention of promoting sexual script flexibility to help couples cope with sexual challenges. The mixed findings for the association between sexual script flexibility and dyadic sexual desire warrant additional study and replication.

Biopsychosocial Predictors of Couples' Trajectories of Sexual Function and Sexual Distress Across the Transition to Parenthood

The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents' sexual well-being.

Perceived financial burden is indirectly linked to sexual well-being via quality of life among couples seeking medically assisted reproduction

Introduction

Medically assisted reproduction is a difficult treatment process for couples both financially and sexually. Yet, these two domains have not been examined together among couples seeking treatment, leaving couples and practitioners without guidance on how to address these domains together.

Methods

In line with Couples and Finance Theory, we tested the hypothesis that perceived financial burden and couple income would predict quality of life during medically assisted reproduction, which would then predict four domains of sexual well-being (i.e., sexual satisfaction, desire, distress, and frequency). We also examined if the results differed by treatment status—that is, between partners who were receiving treatment and those who were not. Cross-sectional data from 120 couples who had undergone medically assisted reproduction in the past six months were analyzed via structural equation modeling through an actor-partner interdependence mediation model.

Results

An individual’s greater perceived financial burden predicted their own lower quality of life during medically assisted reproduction, which in turn predicted their lower sexual satisfaction, desire and distress, as well as their partner’s lower sexual satisfaction. Household income did not indirectly predict any sexual well-being domains, and results regarding treatment status were inconclusive.

Discussion

Clinicians can discuss with couples how perceived financial strain of medically assisted reproduction affects their quality of life and what ramifications that may have for their sexual well-being.

Indirect associations between infant sleep, parental sleep, and sexual well-being in new parent couples

New parents' sexual frequency and desire fluctuate throughout the transition to parenthood (i.e., the first year after childbirth). Poorer infant sleep and parental sleep are each associated with lower sexual frequency and desire in cross-sectional research. According to the theory, infant sleep might shape new parents' sexual frequency and desire in so far as it disrupts parental sleep, though this pathway has yet to be examined. We examined the role of parental sleep in the indirect pathway between infant sleep and sexual frequency and sexual desire in couples, both within and between-person, during the first-year postpartum. In a dyadic longitudinal study, 203 first-time mothers and their partners reported on infant sleep quality, parental sleep, sexual frequency, and sexual desire at 3-, 6-, 9-, and 12-months postpartum. Poorer infant sleep was associated with mothers' (within-couple) and partners' (between-couple) poorer sleep and, in turn, lower sexual frequency for the couple. For both mothers (within-person) and partners (between-person), poorer infant sleep was associated with their own lower sexual desire through poorer parental sleep via the indirect pathway. Ongoing assessment of infant sleep and parental sleep may reveal opportunities to mitigate the negative effects of poor sleep on new parents' sexual relationships. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Regulate and Communicate: Associations between Emotion Regulation and Sexual Communication among Men with Hypoactive Sexual Desire Disorder and their Partners

Hypoactive Sexual Desire Disorder (HSDD) is characterized by a persistent and distressing lack of sexual desire. Affected men report lower sexual well-being and romantic partners may also experience consequences. According to the Interpersonal Emotion Regulation Model of sexual dysfunction, how couples manage their emotions in relation to sexual problems may promote or hinder sexual communication. In the first dyadic study to date of men with HSDD and their partners (n = 64 couples), we investigated associations between two emotion regulation strategies - reappraisal and suppression - and couples' communication about their sexual relationship. Participants completed measures assessing use of reappraisal and suppression about their sexual relationship, sexual communication, and sexual assertiveness. Men with HSDD who reported greater suppression also reported lower sexual assertiveness and both partners reported poorer sexual communication. Partners of men with HSDD who used greater suppression were less sexually assertive. In contrast, while reappraisal was only marginally associated with perceived quality of sexual communication, men with HSDD who employed more reappraisal were also more sexually assertive. While suppression may hinder sexual communication, reappraisal may allow men with HSDD to better assert their sexual needs. Findings may inform interventions to help couples navigate impactful emotional experiences associated with HSDD.

Longitudinal associations between mindfulness and changes to body image in first-time parent couples

Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness-a recognized contributor to psychological well-being-buffered against declines in both partners' perceptions of mothers' body. Mothers' positive body image and partners' perception of mothers' body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners' mindfulness facets-observing, describing, awareness acting, non-judgement, and non-reactivity-were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners' perceptions of mothers' body were positively correlated at all moments; however, mothers' positive body image worsened over time, whereas partners' perception of mothers' body remained stable. Mindfulness facets were positively associated with mothers' positive body image (observe, describe, and non-judging) and fathers' (non-judging) perceptions of mothers' body in pregnancy. Mothers' mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image.

Mediators of change in cognitive-behavioral couple therapy for genito-pelvic pain: Results of a randomized clinical trial

OBJECTIVE

A novel cognitive-behavioral couple therapy (CBCT) has shown efficacy for treating provoked vestibulodynia (PVD), the most common type of genito-pelvic pain, in comparison to topical lidocaine. However, mechanisms of therapeutic change have not been determined. We examined women's and partners' pain self-efficacy and pain catastrophizing as mediators of change in CBCT, using topical lidocaine as a control group.

METHOD

108 couples coping with PVD were randomized to 12-week CBCT or topical lidocaine and assessed at pre-treatment, post-treatment, and six-month follow-up. Dyadic mediation analyses were conducted.

RESULTS

CBCT was not more effective in increasing pain self-efficacy than topical lidocaine, so this mediator was discarded. In women, decreases in pain catastrophizing at post-treatment mediated improvement in pain intensity, sexual distress, and sexual function. In partners, decreases in pain catastrophizing at post-treatment mediated improvement in sexual function. Partners' decreases in pain catastrophizing also mediated reductions in women's sexual distress.

CONCLUSIONS

Pain catastrophizing may be a mediator specific to CBCT for PVD, explaining improvements in pain and sexuality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Maltreatment in Childhood and Perceived Partner Responsiveness in Adult Romantic Relationships: A Dyadic Daily Diary and Longitudinal Study

This study examined the associations between childhood maltreatment (CM) and the mean-level of perceived partner responsiveness (PPR; the extent to which individuals feel cared for, understood, and validated by their partner) over 35 days, the day-to-day variability in PPR, and the initial levels and trajectories of PPR over 1 year in community couples. Both members of 228 couples completed a self-reported measure of CM and provided daily reports of PPR over 35 days and retrospective reports of PPR at three time points over 1 year. A person's greater CM was related to a lower mean level of PPR over 35 days and to a lower initial level of their own PPR. A person's sexual abuse, physical neglect, and emotional neglect had an effect over and above other forms of CM in these associations. A person's greater CM was also related to higher day-to-day variability in their own and their partner's PPR, and a person's greater emotional neglect was associated with a sharper decrease over time in their own PPR. These findings provide a more fine-grained understanding of how CM may affect the perceptions of being cared about, accepted, and validated by a partner on a daily basis and over time.

Longitudinal associations between relational and sexual well-being in couples transitioning to parenthood

There is limited understanding of the dynamic between relational and sexual well-being as couples adjust to new parenthood, despite this being a vulnerable period for couples' relationships. This study was aimed at examining the bidirectional links between relationship quality and sexual well-being (i.e., sexual satisfaction, sexual distress) across the transition to parenthood. We assessed new parent couples (N = 257) across four time points (two prenatal) from mid-pregnancy through 6 months postpartum. Parallel dyadic latent growth curve modeling was employed to examine the associations between trajectories of perceived relationship quality, sexual satisfaction, and sexual distress. New parents' declines in relationship quality were associated with declines in own and partners' sexual satisfaction and with increases in own sexual distress. Mothers' prenatal relationship quality and sexual distress predicted subsequent changes in own sexual distress and fathers' relationship quality, respectively. Results indicate that changes to new parents' relational and sexual well-being mutually influence each other over time. Current results indicate that the impact of the transition on couples' relationships is partly determined by own and partners' prenatal factors, to which clinicians and researchers can attend to early on. Cross-domain links between relational and sexual well-being should be considered in research and clinical practice.

Few Differences in Sexual Talk by Gender/Sex and Dyad Type: A Retrospective and Daily Diary Study with Couples

Sexual talk is a type of verbal communication that occurs exclusively during sexual activity and that is specific to the sexual activity itself. Previous research has identified two types of sexual talk: individualistic (i.e., self-focused) and mutualistic (i.e., sharing/partner-focused), which have generally been linked to greater sexual and relationship well-being. Whether sexual talk use varies by gender/sex (i.e., men, women, gender/sex diverse individuals; GSD) or dyad type (i.e., same- vs. mixed-gender/sex) has not been examined. Given initial evidence that the types of sexual talk may contribute differently to sexual and relationship well-being, it is important to identify factors (e.g., gender/sex) that may be associated with the amount of sexual talk used. We examined differences by gender/sex and dyad type in the average sexual talk use among long-term couples (N = 229; 69 same-gender/sex) using retrospective cross-sectional dyadic data. We also examined these differences in the same sample (N = 217) using a 35-day dyadic daily diary study. Retrospectively, but not daily, women reported using more mutualistic talk than men, especially when partnered with a woman. There were no significant gender/sex or dyad type differences in use of individualistic talk retrospectively or daily. Exploratory analyses with the GSD couples suggested that there may be gender/sex and dyad type differences retrospectively and daily, for individualistic and not mutualistic talk; however, these analyses must be interpreted with caution due to the small subsample size of GSD couples.

Sexual communication mediates cognitive-behavioral couple therapy outcomes: A randomized clinical trial for provoked vestibulodynia

Provoked vestibulodynia (PVD) is a chronic vulvovaginal pain condition affecting 8%-10% of women and is associated with negative sexual sequalae. Our randomized clinical trial comparing cognitive-behavioral couple therapy (CBCT) to a medical intervention (lidocaine) found that both treatments improved affected women's pain and both affected women's and partners' sexual outcomes, with CBCT demonstrating more benefits (Bergeron et al., 2021). The goal of this study was to examine two putative mediators of CBCT's treatment effects: collaborative and negative sexual communication patterns (SCPs). Women with PVD and their partners were randomly assigned to 12 weeks of CBCT (N = 53) or lidocaine (N = 55). Outcome measures (sexual satisfaction, function, and distress) were collected at pre-treatment, post-treatment, and 6-month follow-up, and in-treatment measures of the mediators were taken at Weeks 1, 4, 8, and 12 of treatment. Results showed that affected women's reports of improving collaborative communication mediated the effect of CBCT, but not lidocaine, on post-treatment sexual satisfaction (women with PVD and partners), sexual function (women with PVD), and sexual distress (women with PVD). For partners, collaborative communication improved equally in both treatments. Given that there were no differences in negative SCPs between the CBCT and lidocaine conditions, it was not possible to examine negative communication as a potential mediator. From the perspective of women with PVD, CBCT helped couples communicate about their sexual problems in more collaborative ways, which was in turn beneficial for improving the sexual well-being of both members of the couple. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Will you be happy for me? Associations between self-reported, perceived, and observed responses to positive events and sexual well-being in cohabiting couples

Whereas greater levels of intimacy have been shown to promote couples' sexual well-being, recent theories suggest that satisfying sex is maintained via the capacity to encourage the partner's individuality, while remaining intimately connected. Responses to capitalization attempts (i.e., the disclosure of a positive personal event) provide an opportunity to strengthen both the couple's intimacy and each partner's autonomy. Although responses to capitalization attempts are linked to couples' greater relationship adjustment, very little is known about their relation to couples' sexual well-being. The aim of this study was to examine the associations between self-reported, perceived, and observed responses to capitalization attempts and sexual satisfaction, sexual distress, and sexual function in 151 cohabiting couples who participated in a filmed discussion in the laboratory. They also completed self-report questionnaires pertaining to their responsiveness and to that of the partner during the discussion, as well as their sexual well-being. Results indicated that one's higher levels of self-reported and partner-perceived active-constructive responses (enthusiasm/elaboration) during the discussion were associated with one's own greater sexual satisfaction. Higher levels of perceived passive-constructive responses (quiet but interested) from one's partner were associated with one's own lower sexual satisfaction, and one's higher levels of self-reported and perceived passive-destructive responses (lack of interest/self-focus) were associated with one's own greater sexual distress. Finally, higher levels of observed active-destructive responses (undermines/denies the positive nature of the event) were associated with one's own lower sexual function, while in women, they were associated with their lower sexual satisfaction. Findings contribute to a growing body of literature underscoring the importance of intimacy for sexual well-being in long-term relationships.

A Longitudinal Investigation of Couples' Sexual Growth and Destiny Beliefs in the Transition to Parenthood

Beliefs about sexuality tend to become more salient during sexual challenges and are associated with how individuals respond to these difficulties and, in turn, their sexual well-being. The transition to parenthood is marked by significant changes to couples' sexuality. As such, this period of vulnerability may be an important context in which these beliefs impact how couples manage sexual stressors and may have implications for their sexual well-being. In a longitudinal dyadic study, we examined whether couples' sexual growth beliefs (e.g., beliefs that sexual problems can be resolved through effort) and sexual destiny beliefs (e.g., beliefs that sexual problems reflect incompatibility with their partner) correspond with changes to various facets of couples' sexual well-being over time. First-time parent couples (N = 203) completed online surveys assessing these beliefs in pregnancy (32 weeks) and measures of sexual well-being (satisfaction, desire, and distress) in pregnancy (20 and 32 weeks) and across the postpartum period (3, 6, 9, 12 months). Dyadic latent growth curve models showed that expectant mothers who reported stronger sexual destiny beliefs in pregnancy reported higher sexual distress and lower sexual satisfaction at 3 months postpartum. When partners reported stronger sexual destiny beliefs in pregnancy, both they and new mothers reported greater sexual desire at 3 months postpartum. Unexpectedly, partners' higher sexual growth beliefs in pregnancy predicted mothers' lower sexual desire at 3 months postpartum. Sexual growth and destiny beliefs were not associated with change in couples' sexual well-being beyond 3 months postpartum. Findings shed light on the potential benefits and costs of sexual growth and destiny beliefs for couples' sexual well-being early in the postpartum period, but not over time.

Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia

BACKGROUND

Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD.

AIM

The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality.

METHODS

One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up.

OUTCOMES

(1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index.

RESULTS

Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition.

CLINICAL IMPLICATIONS

Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress.

STRENGTHS & LIMITATIONS

Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties.

CONCLUSION

Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity. V Charbonneau-Lefebvre, M-P Vaillancourt-Morel, NO Rosen, et al. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022;19:479-495.

A Longitudinal Examination of Common Dyadic Coping and Sexual Distress in New Parent Couples during the Transition to Parenthood

New parents experience significant disruption to their sexual relationships such as lower desire and sexual frequency relative to prepregnancy. Little is known about the sexual distress new parents feel related to these changes, how sexual distress evolves over time, or how coping with stress relates to this distress. New parent couples who engage in more adaptive, joint coping with mutual stressors-common dyadic coping (CDC)-may be better able to manage distress related to their sexuality and thus, experience less sexual distress at 3-months postpartum and experience more marked improvement over time. In 99 first-time parent couples, we examined the link between CDC measured at 3-months postpartum and trajectories of sexual distress across 3-, 6-, and 12-months postpartum. Analyses used dyadic latent growth curve modeling informed by the actor-partner interdependence model. Mothers' sexual distress at 3-months postpartum was clinically elevated and higher than their partner's. Mothers' sexual distress declined significantly over time, whereas partners' sexual distress remained low and stable. An individual's higher perceptions of CDC was significantly associated with their own (but not their partner's) lower sexual distress at 3-months postpartum. No significant associations were found between CDC and change in sexual distress over time. How new parents jointly cope with stressors early in the postpartum period may lessen the distress they have about their sexuality at a time when most couples have just resumed sexual activity. Results identify CDC as a possible novel target for interventions aimed at helping couples manage sexual distress during the transition to parenthood.

Is Expectant Couples' Similarity in Attitudes to Sex during Pregnancy Linked to Their Sexual Well-being? A Dyadic Study with Response Surface Analysis

Despite sexual activity being safe for the majority of expectant couples (i.e., the pregnant individual and their partner), negative attitudes toward having sex during pregnancy are common and are related to lower sexual well-being across this vulnerable life period. Using dyadic response surface analysis in a sample of 254 first-time expectant couples, we examined the degree to which expectant partners demonstrated similar versus dissimilar attitudes to sex during pregnancy and whether specific patterns of couples' similarity in attitudes may uniquely contribute to their sexual satisfaction and sexual distress. Couples' more positive attitudes (i.e., the more both partners perceived sexual activity as non-threatening to their pregnancy), rather than partners' similarity in attitudes, were associated with lower sexual distress for both partners and higher sexual satisfaction for male partners. In couples where partners held more dissimilar attitudes, men demonstrated greater distress when their female partner's attitudes were more positive than their own. To promote sexual well-being during pregnancy, interventions should assist couples to attain stronger positive attitudes to sex during pregnancy by targeting concerns about sex in both expectant partners.

Longitudinal Associations between Depressive Symptoms and Postpartum Sexual Concerns Among First-time Parent Couples

Most first-time parents experience novel concerns about their sexuality such as worries about the effects of labor and delivery on their sex lives. The link between postpartum depressive symptoms and problems with sexual function is bidirectional; however, associations with postpartum sexual concerns (i.e., worries about one's sexuality that are not necessarily related to sexual function) have not been examined. First-time parent couples (N = 99) completed measures assessing their postpartum sexual concerns and depressive symptoms at 3, 6, and 12 months postpartum. Dyadic latent growth curve modeling revealed that mothers' and partners' initial frequencies of postpartum sexual concerns were positively associated, with significant declines in the frequency of these concerns over time for both partners. Mothers' and partners' initial depressive symptoms were also positively associated; however, mothers' depressive symptoms did not change over time whereas partner's depressive symptoms worsened. Mothers' and partners' higher initial depressive symptoms were associated with partners' higher frequency of postpartum sexual concerns. Mothers' depressive symptoms at 3 months postpartum and the degree to which these symptoms changed over time were associated with a steeper decline in partners' postpartum sexual concerns over time. Results provide preliminary support for depressive symptoms as a risk factor for partners' postpartum sexual concerns.

Comparing Self-Reported Pain During Intercourse and Pain During a Standardized Gynecological Exam at 12- and 24-Month Postpartum

BACKGROUND

There is limited information about the physical indicators and biopsychosocial predictors of self-reported pain during intercourse and pain during a gynecological examination at 12- and 24-month following childbirth.

AIM

This longitudinal study aimed to (i) Compare the findings from gynecological exams at 12- and 24-month postpartum for women with minimal vs clinically significant pain during intercourse; (ii) Assess the biomedical and psychosocial correlates of self-reported pain during intercourse and the vestibular pain index (VPI) from the cotton-swab test at 12- and 24-month postpartum; (iii) Establish the relationship between self-reported pain during intercourse and the cotton-swab test.

METHODS

Women (N = 97 at 12 months postpartum and N = 44 at 24-month postpartum) recruited from a local women's hospital completed online surveys in their first trimester of pregnancy and at 12- and 24-month postpartum to assess pain during intercourse and biopsychosocial variables. Those with clinically significant (pain ≥4/10 on a visual analogue scale) were matched with those reporting minimal pain (pain <3/10) and underwent a gynecological exam including a cotton-swab test. Descriptive analyses, multiple regressions, and bivariate correlations were conducted to address each of the study aims, respectively.

MAIN OUTCOME MEASURES

(i) Findings from the gynecological examination (ii) Numerical rating scale for the VPI; (iii) Visual analogue scale of pain during intercourse.

RESULTS

The majority of women in both pain groups had normal physical findings in the gynecological exam. Greater sexual distress and pain catastrophizing at 12- and 24-month postpartum were significantly associated with greater pain during intercourse at each time-point, respectively. Greater pain catastrophizing at 12 months postpartum was significantly associated with greater pain during the cotton-swab test at that time-point. Lower relationship satisfaction at 12 months postpartum was associated with greater VPI ratings at 24 months postpartum. Pain during intercourse and the VPI were moderately and positively correlated.

CLINICAL IMPLICATIONS

Addressing psychosocial variables may interrupt the maintenance of postpartum pain. Following an initial assessment, self-reported pain intensity may be a suitable proxy for repeated examinations.

STRENGTHS & LIMITATIONS

This study is the first to describe the physical findings and psychosocial predictors of pain during intercourse and the VPI at 12- and 24-month postpartum. The homogenous and small sample may limit generalizability.

CONCLUSION

There were no observable physical indicators of clinically significant postpartum pain during intercourse. Psychosocial variables were linked to women's greater postpartum pain during intercourse and VPI ratings.

Navigating Women's Low Desire: Sexual Growth and Destiny Beliefs and Couples' Well-Being

People's beliefs about how to maintain sexual satisfaction have been associated with how they navigate sexual differences, but research has yet to explore the consequences of these beliefs for couples facing a distressing sexual issue. The current research extends past work on sexual growth beliefs (i.e., the view that sexual satisfaction requires continuous effort to maintain) and sexual destiny beliefs (i.e., the view that sexual satisfaction is the result of natural sexual compatibility with a partner) to couples for whom these beliefs might be especially consequential - those coping with sexual dysfunction. In a dyadic longitudinal study of 97 couples coping with women's clinically significant low desire and arousal, we tested how sexual growth and destiny beliefs are associated with sexual, relationship, and personal well-being. We found that endorsing greater sexual growth beliefs was associated with higher sexual desire for both partners, whereas, with some exceptions, endorsing greater sexual destiny beliefs was linked to lower sexual desire and relationship satisfaction, more conflict, and more depressive and anxious symptoms. However, these effects did not persist one year later. Our findings highlight the implications of sexual growth and destiny beliefs for both couple members when navigating a chronic sexual difficulty.

Discrepancy in Dyadic Sexual Desire Predicts Sexual Distress over Time in a Community Sample of Committed Couples: A Daily Diary and Longitudinal Study

In long-term relationships, sexual desire discrepancy (SDD) occurs frequently between partners. For many, this discrepancy is persistent and significant, and a source of distress. However, the dynamics of SDD in couples and, specifically, its implications for sexual distress have received scant empirical attention. This study examined the associations between SDD and sexual distress from one day to the next and over a 12-month span, in a community sample of 229 same-sex/gender and mixed-sex/gender couples. Two datasets were collected: A 35-day daily diary and a 12-month longitudinal survey. In both, dyadic sexual desire and sexual distress were measured, and SDD was calculated as the absolute value of the difference in sexual desire between partners. Directional associations between SDD at one time point and sexual distress at the next time point were assessed using multilevel, 2-pane autoregressive cross-lagged models, controlling for within-variable changes, dependencies between partners, and partner age. Results were consistent with the study's hypotheses: Couples' SDD on one day predicted sexual distress on the next day. Similarly, SDD at baseline predicted sexual distress 12 months later. Participant gender, partner gender, and couple type did not significantly moderate these associations, nor did differentiating partners based on higher and lower average sexual desire. The reverse associations (i.e., sexual distress predicting SDD) were non-significant. The associations' directionality and the fact that they remained significant over days and months were consistent with the proposal that SDD is a precursor of sexual distress. The present study provides support for dyadic conceptualizations of sexual desire. Clinically, findings suggest that therapeutic approaches should address issues with sexual desire and sexual distress by focusing not on the individual, but on the couple.

Predictors and Moderators of Provoked Vestibulodynia Treatment Outcome Following a Randomized Trial Comparing Cognitive-Behavioral Couple Therapy to Overnight Lidocaine

Provoked vestibulodynia is a vulvar pain condition causing sexual dysfunction, affecting 8% to 10% of women. Our recently published randomized clinical trial (N = 108 couples) found that cognitive behavioral couple therapy (CBCT) and topical lidocaine reduced women's pain and associated sexual symptoms, with CBCT showing more benefits. Little is known about pretreatment predictors of treatment outcomes in couples sex therapy. In the current study, we examined women and their partners' pretreatment demographic (age, relationship length), clinical (pain duration, anxiety) and interpersonal (partner responses to pain, sexual goals) predictors/moderators of women's pain intensity, pain unpleasantness, and sexual function at posttreatment and 6-month follow-up. Longer relationship duration, lower anxiety in women, partner higher solicitousness and partner higher approach sexual goals predicted better pain outcomes for women with PVD irrespective of treatment condition. CBCT was more effective than lidocaine for improving women's sexual function at posttreatment when, at pretreatment, women had partners with higher anxiety and women reported lower approach sexual goals, whereas lidocaine was more effective for improving women's sexual function at follow-up when partners had higher approach sexual goals. Findings can assist clinicians in determining what treatment will be most beneficial for whom.

Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics

BACKGROUND

Research to date suggests that couples undergoing assisted reproductive technology (ART) are at a high risk of experiencing sexual difficulties.

AIM

This dyadic cross-sectional study aimed to provide a better understanding of the infertility-specific personal (ie, emotional, mind-body) and relational stressors associated with the sexual desire, orgasm, arousal, and sexual satisfaction of infertile couples seeking ART.

METHODS

The sample included 185 mixed-sex infertile couples seeking ART. Participants completed online the Fertility Quality of Life tool and either the Female Sexual Function Index or the International Index of Erectile Function. Data were analyzed using path analyses based on the Actor-Partner Interdependence Model.

OUTCOMES

Individuals' own and their partners' sexual function (desire, orgasm, arousal domains) and sexual satisfaction.

RESULTS

For men and women, infertility-related emotional stressors were associated with their own and their partner's lower sexual desire. For women, experiencing greater infertility-related emotional stressors was also associated with their partner's lower sexual satisfaction. While experiencing greater infertility-related mind-body stressors was not associated with men and women's own sexual desire, arousal, orgasm, and satisfaction, for women, it was associated with their partner's lower sexual arousal. Lastly, for men and women, infertility-related relational stressors were associated with their own lower sexual arousal, as well as with their own and their partner's lower sexual satisfaction. For women, experiencing greater relational stressors was also associated with their own lower sexual desire and orgasm.

CLINICAL IMPLICATIONS

Interventions addressing the emotional, mind-body, and relational spheres of infertile couples seeking ART may help facilitate improvements in sexual function and satisfaction and better serve their needs.

STRENGTHS & LIMITATIONS

This study included a large sample of couples. Our sample was heterogeneous with regards to couples' cause of infertility and treatment stage. The use of an infertility-related measure allowed us to better capture personal and relational stressors specific to couples seeking ART. Given the cross-sectional design of our study, causality between infertility-related stressors and sexual function and satisfaction cannot be inferred. Our sample included predominantly White, mixed-sex individuals with a high level of education, which may reduce the generalizability of our findings.

CONCLUSION

Couples' subjective experience of infertility and treatment (personal and relational stressors) seems to be strongly associated with their sexual health, allowing us to identify potential targets of intervention with couples seeking ART. S.E. Amiri, A Brassard, N.O. Rosen, et al. Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics. J Sex Med 2021;18:1984-1997.

Associations Between Postpartum Depressive Symptoms and Couples' Sexual Function and Sexual Distress Trajectories Across the Transition to Parenthood

BACKGROUND

The transition to parenthood is associated with changes to new parents' mood and sexual health. Sexual dysfunction-problems with sexual function accompanied by sexual distress (i.e., worries and concerns about one's sex life)-is linked to poorer overall health, yet few studies have examined how sexual dysfunction unfolds for couples during this transition. Postpartum depression is a risk factor for sexual dysfunction; however, the association between depressive symptoms and how postpartum sexual dysfunction evolves has not been examined.

PURPOSE

To establish trajectories of sexual function and sexual distress for mothers and partners and to examine if postpartum depressive symptoms were associated with these trajectories.

METHODS

Data were collected from 203 first-time parent couples from midpregnancy until 12-months postpartum. Sexual function and sexual distress were assessed at six time points (two prenatal) and depressive symptoms were assessed at 3-months postpartum.

RESULTS

Dyadic latent piece-wise growth curve models revealed significant declines in mothers' and partners' sexual function between pregnancy and 3-months postpartum and significant improvements from 3- to 12-months postpartum. Mothers' sexual distress increased between pregnancy and 3-months postpartum and decreased thereafter, whereas partner's sexual distress remained stable. Depressive symptoms were associated with poorer sexual function and higher sexual distress at 3-months postpartum for both partners but did not predict change over time.

CONCLUSIONS

Mothers and their partners experience changes to their sexual function during the transition to parenthood; however, mothers are at greater risk of sexual dysfunction. Depressive symptoms are a risk factor for poorer sexual health at 3-months postpartum for both parents.

Perceived partner responsiveness is associated with sexual well-being in couples with genito-pelvic pain

Intimacy is vital to romantic relationships, yet is often thwarted by relational challenges, such as sexual difficulties. With prevalence estimates ranging from 10% to 28%, genito-pelvic pain/penetration disorder (GPPPD) is an important sexual problem resulting in negative consequences for affected women and their partners, including significant sexual dysfunction and dissatisfaction. Findings from cross-sectional studies indicate that higher levels of intimacy are associated with better sexuality outcomes in couples coping with GPPPD. However, single-occasion measurements may not capture the daily variations in intimacy that could have important implications for couples' sexual well-being. The present study focused on a key intimacy-building component-perceived partner responsiveness (PPR)-and its daily associations with women's pain and both partners' sexual function and satisfaction. Using daily diaries over an 8-week period, 160 women (M_age = 26.23, SD = 6.26) with GPPPD and their partners (M_age = 27.73, SD = 7.35) reported on PPR, sexual function and satisfaction, as well as women's pain, on days when sexual activity occurred (M = 8.87, SD = 5.87). Drawing on the Actor-Partner Interdependence Model, a multivariate multilevel modeling approach was adopted. Controlling for trait-level PPR, when women and partners reported greater PPR, women reported greater sexual function and satisfaction and partners reported greater sexual function. When partners reported greater PPR, they reported greater sexual satisfaction. No association was found between PPR and women's pain. PPR may facilitate better sexual function and satisfaction and could be an important target in sex and couple therapy for GPPPD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cognitive-behavioral couple therapy versus lidocaine for provoked vestibulodynia: A randomized clinical trial

OBJECTIVE

This randomized clinical trial compared a novel cognitive-behavioral couple therapy (CBCT) and topical lidocaine for provoked vestibulodynia.

METHOD

Participants were 108 women (M age = 27.06) and their partners randomized to one of two treatments and assessed at pre- and post-treatment and 6-month follow-up via questionnaires pertaining to the primary outcomes of women's pain (numerical rating scales of pain intensity and unpleasantness), and secondary outcomes of pain anxiety (Pain Anxiety Symptoms Scale), both partners' sexual function (Female Sexual Function Index; International Index of Erectile Function), sexual distress (Female Sexual Distress Scale Revised), pain-related psychological distress (Pain Catastrophizing Scale), treatment satisfaction, and global ratings of improvements in pain and sexuality.

RESULTS

Intent-to-treat multilevel analyses showed that for women, CBCT yielded significantly more improvements than lidocaine in pain unpleasantness at 6-month follow-up, pain anxiety and pain catastrophizing at post-treatment and 6-month follow-up, and sexual distress at post-treatment, and resulted in better treatment satisfaction and global sexuality improvements at both time points. Partners significantly improved in their sexual function, sexual distress, and pain catastrophizing from pre- to post-treatment and pre-treatment to 6-month follow-up, with no significant group differences. Partners in the CBCT condition reported significantly greater treatment satisfaction at both time points, and greater sexuality improvements at post-treatment.

CONCLUSIONS

CBCT yielded better outcomes on more dimensions of provoked vestibulodynia than lidocaine. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trajectories of sexual well-being among couples in the transition to parenthood

Sexual well-being is an important contributor to romantic relationship quality, health, and quality of life, yet couples face significant disruptions to their sexuality during the transition to parenthood. While there is evidence of variability in the sexual well-being of new parents, distinct classes of dyadic trajectories have not been established. Sexual frequency, desire, satisfaction, and distress are each unique components of sexual well-being and may follow different patterns of change within couples. We sought to establish classes of trajectories of four aspects of sexual well-being for couples in the transition to parenthood as well as the associations among identified classes. Couples (N = 203) expecting their first child completed online standardized measures of sexual well-being at 20 and 32 weeks in pregnancy and at 3, 6, 9, and 12 months postpartum. Dyadic latent class growth analyses were conducted to identify classes of trajectories for each facet of sexual well-being, and dual trajectory analyses examined the probability of group membership across classes. Couples' sexual well-being over time was heterogeneous. Sexual frequency had two classes: high (33%) and low (67%); sexual desire had three classes: moderate (36%), high (25%), and discrepant (39%); sexual satisfaction had two classes: high (64%) and low (36%); and sexual distress had two classes: low (76%) and discrepant (24%). Overlap in classes of sexual well-being was variable such that high and low or discrepant (between partners) classes did not always co-occur. Findings provide more nuanced information about new parents' postpartum sexual health, which may facilitate early assessment and intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The association between labour epidural analgesia and postpartum depressive symptoms: a longitudinal cohort study

BACKGROUND

Pain is a risk factor for postpartum depression (PPD) and labour epidural analgesia (LEA) may lower the incidence of PPD. We evaluated depressive symptoms risk at three, six, and 12 months postpartum in women with LEA compared with women without LEA.

METHODS

With ethics approval, hypotheses were tested using data from a longitudinal prospective observational cohort study between January 2015 and January 2019 in nulliparous women aged ≥ 18 yr with uncomplicated, singleton pregnancies. Email surveys were completed at baseline (18-20 weeks' gestation) and at three-, six- and 12 months postpartum, including the Edinburgh Postpartum Depression Scale (EPDS). Maternal, infant, and anesthesia characteristics were abstracted from electronic databases. The EPDS scores at three, six, and 12 months postpartum were analyzed using generalized estimating equations with and without covariates.

RESULTS

Of the 909 women who consented to participate, 709 women were included in the study. Antenatal EPDS scores, not LEA, predicted postpartum depressive symptom risk (P < 0.001). The adjusted 95% confidence intervals suggest mean EPDS scores differ from 1.0 point lower in the LEA group at 12 months to 1.5 points higher in the no LEA group at three months on its 0-30 scale. All the confidence intervals included zero at three, six, and 12 months, so were considered non-significant (P > 0.05).

CONCLUSION

This study did not identify an association between LEA and risk of depressive symptoms postpartum, although small mean differences between groups cannot be ruled out. Future studies should focus on other modifiable variables that influence the development of PPD.

Validation of the Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) in Portugal: Assessing Dyadic Interdependence and Associations with Sexual Behaviors

BACKGROUND

The Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) are self-report measures of expectant couples' attitudes towards sex during pregnancy.

AIM

This study aimed to examine dyadic non-independence of MSP/PSP scores in a sample of expectant couples, while providing an evaluation of factor structure, validity, and reliability of the Portuguese versions of the MSP/PSP. The association between partners' attitudes and frequency of sexual behaviors was also examined.

METHODS

A total of 189 expectant couples completed a survey that included a sociodemographic questionnaire, the MSP/PSP, frequency of sexual behaviors, as well as validated measures of attitudes to sex, sexual function, sexual satisfaction, depression, and perceived social support.

OUTCOMES

Dyadic interdependence was tested via Pearson correlation between MSP/PSP scores; between-dyads variability was tested via intraclass correlation of the unconditional model including only MSP/PSP scores using a multi-level model. Associations between attitudes and sexual behavior were tested using regression analysis (between-dyads outcomes) or APIM (mixed outcomes). Factor structure, internal consistency, and validity (convergent, discriminant, and concurrent) of the Portuguese versions of the scales were assessed.

RESULTS

MSP/PSP scores were interdependent within-dyads. Male partners presented significantly more positive attitudes towards sex during pregnancy than pregnant women. Attitudes were linked to indices of sexual well-being for both partners (sexual functioning, sexual satisfaction) and, for both partners, more positive attitudes were associated with higher frequencies of most partnered sexual behaviors. The Portuguese MSP/PSP scales showed good factor structure, and good to excellent indices of reliability and validity.

CLINICAL IMPLICATIONS

The Portuguese MSP/PSP is adequate for use in couples. The scales can be used to screen partners with negative attitudes towards sex during pregnancy and evaluate how these attitudes relate to intra- and inter-individual sexual well-being during pregnancy.

STRENGTHS & LIMITATIONS

A strength of this study is the inclusion of both expectant partners and the use of dyadic analysis. Couples who participated in the study were all in mixed-gender/sex relationships, although this was not defined as an inclusion criterion. Future studies should use the MSP/PSP in more diverse samples in order to further determine how the scale performs for couples with different characteristics.

CONCLUSION

Scores in the MSP/PSP are interdependent between mixed-sex/gender expectant couple members. More positive attitudes towards sex during pregnancy are linked to higher frequencies of partnered sexual behaviors and to both partners' greater sexual well-being. Tavares Inês M., Heiman Julia R., Rosen Natalie O., et al. Validation of the Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) in Portugal: Assessing Dyadic Interdependence and Associations with Sexual Behaviors. J Sex Med Rev 2021;18:789-799.

A Mixed-Method Analysis of Women's Attributions about Their Partner's Pornography Use

We used a mixed-method design to examine the attributions women in mixed-gender/sex relationships make for their partner's perceived pornography use and whether such attributions covary with women's relationship and sexual satisfaction. A final sample of 199 women completed measures of relationship satisfaction, sexual satisfaction, and their perceptions of partner's pornography use. Participants also completed three open-ended questions assessing their attributions of their partner's perceived pornography use. Qualitative analyses revealed 11 themes in women's attributions of their partner's perceived pornography use; some of the themes reflected on women themselves (e.g., being open-minded and accepting), whereas other themes reflected on the partner (e.g., partner is sexually bored) or the relationship (e.g., strong and trusting relationship). Furthermore, the women made positive, negative, and neutral attributions. Quantitative analyses showed that positive attributions were significantly more frequent than neutral or negative attributions and the latter two categories did not differ significantly from each other. Also, greater frequency of positive and neutral attributions and lower frequency of negative attributions were associated with higher relationship satisfaction and sexual satisfaction. Our results suggest that women make a range of attributions about their partner's pornography use and that this variation relates meaningfully to indices of relationship functioning.

An Attachment Perspective on Partner Responses to Genito-pelvic Pain and Their Associations with Relationship and Sexual Outcomes

Although facilitative and negative partner responses are known to impact couples' adaptation to provoked vestibulodynia (PVD), a chronic genito-pelvic pain condition, it is still unknown what leads individuals to adopt or perceive such adaptative or detrimental behaviors. Attachment influences sexual and relationship adjustment, emotional reactivity and perceived support in romantic relationships, and as such could be associated with partner responses. This study aimed at examining the mediating role of facilitative and negative partner responses in the associations between attachment and relationship and sexual adjustment in 125 couples coping with PVD. Couples completed self-report questionnaires on attachment, partner responses, sexual satisfaction and distress, and relationship satisfaction. Results indicated that partners' attachment avoidance was negatively associated with facilitative partner-reported responses, which in turn was associated with partners' sexual and relationship satisfaction. Attachment anxiety in women and partners was associated with greater women-perceived negative partner responses, which in turn was associated with women's and partners' greater sexual distress and lower sexual satisfaction, and women's lower relationship satisfaction. Partners' greater attachment anxiety was also associated with greater partner-reported facilitative responses, which was associated with partners' lower and women's greater relationship satisfaction. Assessing attachment orientations may help clinicians better understand couples' dyadic coping.

Pornography Use and Sexual Health among Same-Sex and Mixed-Sex Couples: An Event-Level Dyadic Analysis

A large number of partnered individuals regularly use or are in a relationship with someone who uses pornography. However, knowledge concerning the association between pornography use and partnered sexual health-sexual satisfaction, distress, and function-is fragmentary. The current study used an event-level dyadic design to examine the associations between pornography use and sexual satisfaction, distress, and function on days when partnered sexual activity occurred. A convenience sample of 217 couples (M_age = 30.2; SD = 8.3; 72 same-sex couples) completed a short survey on days of sexual activity with their partner, over a 35-day period. Self-report measures included questions about daily pornography use and masturbation as well as daily sexual satisfaction, distress, and function. Using pornography on days of partnered sexual activity was reported by half of the couples. An individual's solitary pornography use on days of partnered sexual activity was related to their partner's higher sexual distress and, for women's use only, to their own higher quality of lubrication, compared to sex days without solitary pornography use. There was no evidence of an association between pornography use on sex days, whether alone or with the partner, and all other aspects of sexual health including sexual satisfaction. Our findings capture the complexity of the associations between pornography and sexual health. Men and women's pornography use may create idealized fantasies around appearance and performance, which may lead the partner to feel distressed about their sex life. Women's pornography use might facilitate their sexual responsiveness during partnered sexual activity.

#postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.