Journal of Sex & Marital Therapy最新文献

Sanctification theory posits that normal aspects of life can take on special meaning or significance beyond the ordinary. One way that people may experience the sacred and connect with the divine is through sexuality. Sexual sanctification has been connected to beneficial sexual outcomes. However, current literature is lacking on clarifying the mechanisms through which sexual sanctification may lead to those outcomes. In this study, we looked at the dyadic data of 452 heterosexual committed couples who have been in a relationship for at least two years. Structural equation modeling was used to assess possible pathways through which sexual sanctification related to sexual satisfaction and harmonious sexual passion including sexual mindfulness, sexual intercourse frequency, sexual communication, and orgasmic consistency. Sexual sanctification had statistically significant associations with all four mechanisms for females but not for males; however, sexual intercourse frequency did not have a significant relationship with either sexual outcome. Communication was the strongest mechanism through which sexual sanctification influenced sexual satisfaction and harmonious sexual passion, followed by orgasmic consistency and then sexual mindfulness. These findings indicate the importance of sexual communication and orgasmic consistency as mechanisms for sexual sanctification and positive sexual outcomes.

Mental health disparities among nonbinary and genderqueer (NBGQ) individuals are consistently observed and reflect the impact of intrapersonal and social stressors described by gender minority stress (GMS) theory. This qualitative study extends this framework by exploring how GMS-related stressors are experienced by NBGQ individuals seeking gender-affirming medical care (GAMC). We conducted interviews with 15 participants (aged 18-53) representing diverse nonbinary identities and GAMC pathways. We analyzed the data using thematic analysis and identified key challenges across three contextual layers. At the individual level, participants encountered challenges in exploring and defining their nonbinary identity, due to a lack of nonbinary-sensitive language, representation, and information. Interpersonally, they stressed the continuous pressure to explain and defend their nonbinary identity while facing identity invalidation by others. Systemically, nonbinary individuals faced difficulties navigating societal binary norms, frequently feared for their safety, and were negatively affected by policies and legislation that failed to recognize or protect their identities. Our findings highlight the need for greater attention to NBGQ-specific nuances within existing gender minority stress frameworks, alongside improved NBGQ representation, supportive interpersonal networks, and nonbinary inclusive social structures - all crucial for enhancing mental health and resilience in NBGQ individuals.

This study aimed to develop and validate the Sexual Five-Facet Mindfulness Scale (FFMQ-S), a 19-item measure assessing sexual mindfulness in a sample of Arab married women. Initial items were translated and culturally adapted through a bilingual committee approach. The FFMQ-S was tested using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), measurement invariance testing, and exploratory graph analysis (EGA) with a sample of 720 married Arab women. A five-factor model was found to best fit the data, with all items retained. The FFMQ-S demonstrated excellent internal consistency (Cronbach's α > .85) and evidence of convergent and discriminant validity, with higher sexual mindfulness associated with lower sexual distress and greater sexual satisfaction. Measurement invariance confirmed the stability of the factor structure across different marriage durations. Network analysis further supported the interrelations among the five facets. Findings suggest that sexual mindfulness, as a multi-dimensional construct, is linked to positive sexual outcomes. The FFMQ-S can serve as a valuable tool for assessing sexual mindfulness and guiding clinical interventions aimed at improving sexual well-being in women.

Research suggests that some people who are attracted to children experience urges to engage in child sexual abuse (CSA) and therefore engage in various coping strategies. Other research indicates that many experience stigma-related stressors related to their attraction (e.g., internalized stigma), which affects their well-being. Such experiences may also lead to high levels of self-criticism. This study aimed to examine whether internalized stigma and self-critical rumination are associated with the proclivity to engage in CSA beyond other risk-relevant factors. A sample of 123 people who were attracted to children was recruited online and completed measures assessing their attraction to children, CSA-supportive beliefs, self-control, sexual fantasy functions, internalized stigma, self-critical rumination regarding their attraction to children, and their propensity to engage in CSA. The results revealed that CSA propensity was correlated with CSA-supportive beliefs, lower self-control, fantasizing for emotional closeness, and self-critical rumination. Regression analyses showed that the belief that sex with children is harmless and self-critical rumination predicted CSA propensity scores. The findings provide new insights into the experiences of people attracted to children. The limitations of this study and future research directions are discussed.

The study aimed to explore the relative importance of socio-ecological predictors of risky sexual behavior among Chinese adolescents based on the socio-ecological systems theory. A total of 1,781 adolescents (mean age 17.76 years, range 15-21) were recruited from Shandong Province using a multistage cluster stratified sampling method. Participants included 400 males (22.46%) and 1381 females (77.54%). Dominance analysis was used to examine the relative importance of socio-ecological factors in predicting adolescent risky sexual behavior. Adolescents had a lower prevalence of sexual behavior (9.8%) but a higher prevalence of risky sexual behavior (87.36%). There were correlations among the socio-ecological predictors. Binary logistic regression showed that peer influence resistance had the strongest association with risky sexual behavior, but dominance analysis indicated that the strongest predictor was social norms cognition, followed by family support, peer influence resistance, self-efficacy, and sexual knowledge, accounting for 66.0%, 13.9%, 9.6%, 8.6%, and 1.9% of the predicted variance, respectively. Socio-ecological factors played different predictive roles in adolescent risky sexual behavior. To prevent risky sexual behaviors, related interventions need to focus on improving social norms cognition, emphasize the influence of family and peers, and mitigate the negative impact of high self-efficacy and sexual knowledge on risky sexual behavior.

Assisted reproductive technology (ART) represents a significant life challenge that can impact psychological well-being and intimate relationships. This cross-sectional study examined whether psychological resilience mediates the association between adult attachment insecurity (anxiety and avoidance) and sexual dysfunction in 198 Italian individuals (99 heterosexual couples) undergoing ART. Path analyses were conducted separately by gender. Results showed that attachment anxiety (βmen = -.35, p < .001; βwomen= -.34, p < .001) and avoidance (βmen = -.48, p < .001; βwomen = -.57, p < .001) were significantly and negatively associated with resilience, which in turn was strongly linked to sexual dysfunction (βmen = -.66, p < .001; βwomen = -.74, p < .001). The indirect effects of anxious attachment (women: estimate = 0.127, p < .001, 95% CI [0.063, 0.192], men: estimate = 0.233, p < .001, 95% CI [0.189, 0.562]), and avoidant attachment (women: estimate = 0.273, p < .001, 95% CI [0.171, 0.376], men: estimate = 0.375, p = .015, 95% CI [0.046, 0.420]) on sexual functioning via resilience were significant. The models explained 53% of the variance in female sexual dysfunction and 44% in male sexual dysfunction. These findings highlight the role of psychological resilience as a key mechanism linking insecure attachment to sexual difficulties during ART and support its potential as a target for couple-based interventions.

Pelvic floor evaluation is essential for assessing its mechanical and elastic properties to guide treatment decisions. The lack of objective instrumental tools creates challenges in both clinical practice and research. This study aimed to evaluate the diagnostic validity of subjective palpation for classifying pelvic floor muscle tone in comparison to biomechanical parameters obtained with myotonometry in healthy young women. A secondary aim was to explore the consistency of measurements between a novice and an experienced examiner. An observational study was conducted in the laboratories of the Universidad Europea de Madrid. Forty-nine healthy women (mean age 24.4 ± 7.23 years) were recruited. Each participant underwent pelvic floor assessment by palpation and myotonometry, performed independently by one novice and one experienced examiner. ROC analysis showed that tone and dynamic stiffness were reliable markers for identifying hypertonicity in subjective palpation. Significant differences were found across hypotonic, normotonic, and hypertonic classifications for both the novice (F = 24.581, p < 0.001, η²p = 0.517) and experienced (F = 28.219, p < 0.001, η²p = 0.551) examiners. Myotonometry measurements demonstrated significant alignment with palpation-based classifications of perineal body tone. Minimal differences between novice and experienced examiners suggest that myotonometry can provide consistent results regardless of experience.

Introduction: Fibromyalgia is a prevalent rheumatologic condition affecting adults. It is observed in ∼2.7% of the whole population. Sexual health is a complex and multifaceted condition that, like general health, cannot be explained solely by the absence of negative aspects. Considering the complex nature of sexual health, fibromyalgia patients are at higher risk of sexual dysfunction.

Materials and methods: The study included female patients aged 25-60 who had been married for at least two years. Participants were divided into two groups: the case group, which consisted of patients diagnosed with fibromyalgia and receiving treatment at the physical therapy outpatient clinic, and the control group, which included women attending the urology outpatient clinic for reasons unrelated to fibromyalgia or any other comorbid conditions.

Findings: A total of 140 female patients participated in the study, with 75 diagnosed with fibromyalgia and 65 without fibromyalgia. When comparing the GRISS total and subscale scores between the two groups, the fibromyalgia group had significantly higher scores across all subscales, including anorgasmia, vaginismus, non-communication, infrequency, avoidance, non-sensuality and dissatisfaction (p < 0.001 for all).

Conclusion: Sexual dysfunction is significantly more prevalent in patients with fibromyalgia compared to those in the control group.

Many detransitioners struggle with significant regret and trauma. They deserve to be offered compassionate and trauma-informed care that is difficult for them to access, despite predictable harms that can occur without adequate preparation for the possibility of regret associated with irreversible side effects of gender medicine, including loss of sexual function. Medical care for detransitioners remains undefined and is not covered by insurance. Psychosexual recovery is a long-term process that will not restore what has been lost but should be facilitated via access to trauma informed psychotherapy as well as existentially focused sex therapy to promote post-traumatic growth and healing.