Journal of Sex & Marital Therapy最新文献

Sexual safety behaviors (SSB) may constitute a relevant factor for the development and maintenance of sexual dysfunctions. The present study aims to improve the understanding of SSB in women. A total of N = 923 women completed an online survey consisting of the Questionnaire on Behaviors Before and During Sexual Activities, a measure of SSB, and a set of other questionnaires that assessed sexual dysfunctions, anxiety, depression, and other clinically relevant variables. Exploratory and confirmatory factor analyses of the QBSA revealed a robust three-factor solution with 1) cognitive and behavioral avoidance, 2) use of lubricants, and 3) thought and body control. While some SSB were generally common in women, others discriminated well between women with sexual dysfunctions, women with sexual problems, and women without impairment. SSB was significantly negatively associated with women's level of sexual functioning and positively with repetitive and negative thought processes, depression, and anxiety. Overall, the concept of SSB can be reliably measured and SSBs correlate meaningfully with variables measuring women's mental health. We argue that the concept of SSB should be further developed as it can enrich present sexual therapeutic treatment approaches, especially in the context of cognitive-behavioral therapy.

A randomized controlled clinical trial conducted in Iran from April 2020-2021 involved 100 eligible breast cancer survivors (BCSs). The study examined the impact of sexual counseling using a modified "Good Enough Sex" (GES) model on BCSs' sexual health variables. The intervention group, consisting of BCSs and their spouses, participated in four weekly group counseling sessions lasting 90-120 min each. The control group attended routine medical checkups. The intervention was designed based on a previous qualitative study assessing sexual needs and concerns in BCSs, as well as the GES model. Sexual satisfaction, function, and communication were evaluated at baseline, two, and three months follow-ups. Most participants (77%) had undergone a mastectomy, with diagnoses typically occurring between ages 39-49 and 5-7 years post-diagnosis. Initially low sexual satisfaction and function significantly improved in the intervention group (p < 0.001), reaching high satisfaction and moderate function levels. After three months, significant differences in sexual health variables were observed between the intervention and control groups (p < 0.001), indicating substantial positive effects, particularly in sexual satisfaction (0.99). Given the challenges in improving sexual function due to cancer complications, sex education based on sexual dialogue and realistic expectations can promote sexual well-being.

RCT Number: IRCT20120609009975N8, dated 2020-04-18, https://en.irct.ir/trial/42030.

In this theoretical paper the authors explore the connections between BDSM (i.e., practices involving bondage, discipline, dominance, submission, sadism, masochism) and CSA (childhood sexual abuse) in order to investigate the potential unconscious mechanisms at play and the therapeutic functions of BDSM practices among CSA victims. Drawing on the embodiment framework, the authors address how BDSM may serve as a form of unconscious repetition of traumatic experiences for certain CSA victims, with the aim of processing trauma and healing. A review of the empirical evidence regarding the links between BDSM and CSA trauma, along with the potential of BDSM to trigger trauma and elicit dissociation, guilt, or shame, is conducted. Finally, BDSM practices are reviewed through the concept of trauma-play, which involves deliberate rescripting. In short, the complex relationship between BDSM and CSA is highlighted, as well as its implications for understanding and potentially addressing trauma experiences in therapy.

Common conceptions of romantic love suggest that romantic love is associated with increased sexual activity with more frequent sex in the earlier stages of a romantic relationship. To our knowledge, no studies have investigated individual-level factors and sexual frequency using a validated measure of romantic love. This study tested a number of hypotheses about the factors associated with sexual frequency among 720 sexually active young adults experiencing romantic love from the Romantic Love Survey 2022. We hypothesized that relationship duration, the intensity of romantic love and obsessive thinking about a loved one, commitment, and hypomanic-like features would be associated with sexual frequency. Using hierarchical linear regression, controlling for known covariates, we found no significant associations between any of our variables of interest and the sexual frequency and our entire model of 14 well-reasoned predictors explained only 4.06% of the variation in sexual frequency. The findings are surprising and highlight how little is currently known about sexual activity and sexual desire among individuals experiencing romantic love.

In China, HIV transmission increasingly affected men who have sex with men (MSM) and those in heterosexual marriages. This study addressed a critical gap in understanding HIV and sexual orientation disclosure within conventional heterosexual marriages, framed within a family-oriented cultural context. Heterosexually married MSM living with HIV (HIV+ MMSM) faced complex identity dynamics and interactions between "gay circles" and marital life. Such disclosure was fraught with potential repercussions, including accusations of "marriage fraud", HIV-related stigma, and divorce. This descriptive qualitative study, conducted in 2022, aimed to explore the common factors influencing HIV status disclosure to wives among Chinese HIV+ MMSM. Sixteen semi-structured interviews were conducted to analyze the factors related to the disclosure process model. Four key themes emerged: (a) concern for wives' well-being, (b) perceived marriage strength, (c) the degree of social support they had, and (d) a desire to maintain their status in a heterosexual society. The decision to (non)disclose was shaped by both approach-focused and avoidant-focused goals related to these four themes. The findings underscored the need for culturally sensitive strategies that balance family dynamics, stigma reduction, and HIV care management, emphasizing tailored approaches to effectively support this population.

Several questionnaires have been developed to evaluate female sexual dysfunction (FSD) and sexual health problems. However, there is a lack of validated versions of these questionnaires in Arabic. One of the most used instruments is the female version of The Sexual Dysfunctional Beliefs Questionnaire (SDBQ). The current study aimed to validate an Arabic version of the SDBQ. The Arabic version of SDBQ-Female was incorporated into an online questionnaire using and distributed among Jordanian Facebook groups and women-only groups. Factor analysis was performed to investigate evidence for the validity of the questionnaire. 530 females (mean age 30 years, SD = 9) completed the questionnaire. Principal component analysis produced the final model composed of 24 items distributed across four factors: Sexual Desire & Pleasure, Affection Primacy, Sexual Conservatism and Age-Related Beliefs. Confirmatory factor analysis was conducted, and fit indices were acceptable (CMIN/DF = 2.52, GFI = 0.91, AGFI = 0.89, CFI = 0.90, SRMR = 0.05 and RMSEA = 0.05). Income level and marital status both influenced FSD beliefs, with higher scores associated with higher income and being single. The Arabic version of the SDBQ-female demonstrated evidence of validity and reliability. Additional research is necessary to explore beliefs related to FSD within an Arabic context.

The rising incidence of trans youth throughout the world and the new policy of many European countries and 25 US states that psychotherapy should be the first therapeutic response to Gender Dysphoria have made a reexamination of a comprehensive psychiatric evaluation (CPE) urgently relevant. Two conflicting views of the purpose of the CPE exist based on etiologic beliefs and convictions about the best therapeutic approach. This paper provides one clinician's synthesis of the elements, processes, goals, values, benchmarks of CPE and its usual recommendation for psychotherapy. The CPE recommended herein provides cogent hypotheses about the origins of the intrapsychic creation of a trans identity that are to be strengthened, weakened, or supplanted by explanations that emerge from psychotherapy. It also strengthens familial bonds and clarifies the intention to improve the mental health, social function, and autonomy of the minor. The inescapable ethical tensions that surround trans minor health care are discussed. The recommended CPE does not prevent subsequent medical interventions.

This study investigated patterns of sexual agreement for extra-dyadic sex and their associations with sexual risk behaviors among men who have sex with men (MSM) having a regular male sex partner (RP) in China. A cross-sectional telephone survey was conducted among 530 MSM recruited through multiple sources in Hong Kong, China, between April and December 2020. This study was based on a subsample of 368 participants who had an RP in the past 6 months. Logistic regression models were fitted. Among the participants, 27.2%, 13.0%, and 3.0% had a closed agreement, an in-between agreement, and an open agreement, respectively. Compared to no agreement, a closed agreement was associated with fewer extra-dyadic partners and fewer instances of condomless sex with extra-dyadic partners. Those who had more positive attitudes toward a closed agreement, perceived more support from significant others to create a closed agreement, and perceived higher behavioral control of refraining from sex with extra-dyadic partners were more likely to have a closed agreement with RP. Those who were concerned that a closed agreement would impair freedom and sexual desire were less likely to have such an agreement. A closed agreement is a potentially useful risk reduction strategy for Chinese MSM with an RP.

Psoriasis is a chronic disease, involving skin and joints, characterized by inflamed lesions. Psoriasis negatively impacts the patients' quality of life due to the physical, emotional, and social burden that accompanies this condition. Also, psoriasis is associated with a number of psychiatric comorbidities, including sexual dysfunctions. The present study investigates the variables associated with sexual functioning in psoriasis patients. One-hundred-three psoriasis patients and 101 matched control subjects took part in the present study. Each participant completed five self-report measures investigating the presence of depression, anxiety and stress symptoms, body image, quality of life, and sexual experience. Our results show that differences in sexual activity, but not in sexual functioning, emerged between groups. In men with psoriasis, more sexual difficulties were associated with more negative automatic thoughts about sexuality. In women, more sexual difficulties were associated with more negative automatic thoughts; anxiety, depression, and stress; severity of symptoms; comorbid disease; age; quality of life. Our findings expand the current knowledge about sexual functioning in psoriasis and shed light on specific cognitive, psychological, and demographic variables associated with sexual impairment in men and women with psoriasis.