Journal of Sex & Marital Therapy最新文献

In the present study, we test the model of moral incongruence by examining whether moral disapproval of pornography mediates the relationship between organizational religious activity and self-reported CSB and whether the frequency of viewing pornography moderates the relationship between moral disapproval and self-reported CSB in two samples: a general population sample and a sample of members of the Church of Jesus Christ of Latter-day Saints ("Mormons"). Analyses revealed that, among both samples, frequency of pornography viewing moderated the indirect effect of organizational religious activity on perceived CSB via morally disapproving of pornography. Specifically, moral disapproval of pornography mediated the relationship between organizational religious activity and compulsive sexual behavior when participants viewed pornography approximately monthly or more (mean and +1 SD among the general population sample, +1 SD among the Latter-day Saint sample). Findings suggest that individuals who attend worship services more frequently are more likely to perceive their pornography viewing as compulsive at higher frequencies of usage - even when their frequency of pornography viewing is unlikely to be associated with actual functional impairment - and that this distress is better understood in relation to experiences of moral incongruence.

Hypoactive sexual desire dysfunction (HSDD) is prevalent among women. This retrospective cohort study aimed to verify the results of the strategies used by Gynecologists and Obstetricians (Ob-gyn) residents in the management of female HSDD. For this, we conducted a data collection of patient medical records of women with HSDD from the Human Sexuality Studies outpatient clinic of the Human Reproduction Center, Department of Gynecology and Obstetrics of FMRP-USP, from 2005 to 2019. Among the 437 women included, 361 (82.6%) answered the question concerning the effect of the protocol to which they were submitted, whereas 234 (64.8%) reported improvements in sexual desire. The univariate model showed that patients without chronic pelvic pain were 19.0% less likely to report improvements in HSDD than those with chronic pelvic pain (p = 0.03). Patients without depression and without orgasmic dysfunction were, respectively 32% and 23% more likely to show improvements in their HSDD than those who had depression or orgasmic dysfunction (respectively p = 0.001, p = 0.008). However, the multivariate model did not identify any associations. The assistance regarding HSDD by the Ob-gyn resident in training to deal with female sexual complaints may be effective in improving sexual complaints.

Perimenopausal symptoms adversely impacting women's sexual health are often unacknowledged or even dismissed by healthcare professionals (HCP). Using semi-structured interviews with 23 women experiencing perimenopause, we aimed to understand how HCPs address women's sexual health needs and concerns during this transition. Thematic data analysis was employed with the reduction of data into themes. Several major themes were identified concerning participants' experiences with a HCP and sexual health, including insufficient sexual health information and preventative education; the lack of open discussion about sexual health; the need for enhanced support and treatment options; feeling dismissed by a healthcare professional; and sexual pleasure not addressed by healthcare professionals. Additionally, women expressed concerns regarding medical education and training in healthcare professionals on approaching sexual health conversations. There appears to be a need for more formal training, both within medical school and continuing medical education (CME), to address these important aspects of women's sexual and reproductive health.

Approximately 1 in 3 women experience low sexual desire. Despite this being a common concern, many women never seek professional help for their difficulties and will instead turn to online resources for information. We sought to address this need for digitally-accessible, evidence-based information on low sexual desire by creating a social media Knowledge Translation (KT) campaign called #DebunkingDesire. Our team led a 10 month social media campaign where our primary outcomes for the campaign were impressions, reach, and engagement. We generated over 300,000 social media impressions; appeared on 11 different podcasts that were listened to/downloaded 154,700 times; hosted and participated in eight online events; and attracted website users from 110 different countries. Over the course of the campaign we compiled lessons learned on what worked for disseminating our key messages and the importance of creating community for this population. These findings point to the utility of using social media as part of KT campaigns in sexual health, and to the importance of collaborating with patient partners and considering social media ads and podcasts to meet reach goals.

Increased research attention to interpersonal factors in genitopelvic pain conditions, such as vulvodynia, have led to more comprehensive understanding of couple dynamics in pain, sexual, and relationship outcomes. There has been very little examination of interpersonal factors in Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD), a distressing condition involving persistent sensations of arousal and often pain. The aims of the present study were to examine whether individuals disclose their symptoms to intimate partners and whether interpersonal variables (e.g., partner responses, symptom disclosure, and catastrophizing) are related to relationship adjustment and symptom severity. Seventy-six individuals with symptoms of PGAD/GPD participated in a one-time anonymous online survey. Over three-quarters (85.5%) of the sample disclosed their symptoms to their partners in some way. Greater supportive partner responses and lower symptom catastrophizing were related to better relationship adjustment among participants with PGAD/GPD symptoms. Greater symptom catastrophizing also predicted greater PGAD/GPD symptom severity. Partner responses were not related to PGAD/GPD symptom severity. Although interpersonal factors have been linked to symptom severity in chronic pain and genitopelvic pain conditions, the results of the current study suggest that interpersonal factors may play a slightly different role in PGAD/GPD symptom experiences and in the conceptualization of PGAD/GPD more broadly.

Problematic pornography use and its adverse consequences are prevalent, but little is known about its psychosocial contributors. Drawing on the Differential Susceptibility to Media Effects Model (DSMM), this study explores whether and how perceived problematic Internet pornography use is associated with psychological factors from three domains: social (i.e., family adaptability), dispositional (i.e., self-acceptance), and development factors (i.e., impulse control difficulties). Analysis of an anonymous survey of 1,483 Chinese emerging adults showed that family adaptability and self-acceptance were negatively correlated with perceived problematic pornography use, whereas impulse control difficulties were positively correlated with perceived problematic pornography use. Self-acceptance mediated the association between family adaptability and perceived problematic pornography use. Impulse control difficulties moderated such mediation effect, in which the protective effect of family adaptability on self-acceptance and that of self-acceptance on perceived problematic pornography use were attenuated by impulse control difficulties. These findings advance understanding of the complex underlying psychosocial mechanisms of perceived problematic pornography use by providing evidence to the applicability of DSMM on such problematic use and clarifying the direct, indirect, and/or moderating role(s) of family adaptability, self-acceptance, and impulse control difficulties in those mechanisms. They also provide insights for targeted approaches in future intervention programs among emerging adults.

Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.

Mindfulness during sex has shown many positive relational and sexual outcomes. However, little is known about the ways in which sexual mindfulness works to improve an individual's experience. This study investigated the mediating role of emotion regulation strategies in the relationship between sexual mindfulness and relational quality in a sample of Iranian women. Using a multi-stage cluster sampling method, we examined data from 265 women aged 19 to 50 years (M = 31.76, SD = 8.47). Results showed a significant positive relationship between relational quality and sexual mindfulness (p < .001, β = .13), sexual mindfulness and reappraisal strategy (p < .001, β = .65), and relational quality and reappraisal strategy (p < .001, β = .78). The reduction of the path coefficient in the full mediation model compared to the direct model indicating a partial mediation role of the reappraisal strategy was confirmed in relation to sexual mindfulness and relational quality. These findings may help identify one path, emotion regulation, through which sexual mindfulness works. This study provides psychologists and counselors evidence that both sexual mindfulness and emotion regulation are positive skills that likely improve the quality of their clients' relationships.

How gender-affirming treatments (GAT) influence the experienced sexuality of transgender, gender non-conforming, and non-binary (TGNB) individuals remains understudied. The aim of this research was to discern factors contributing to a satisfying sexual experience for TGNB individuals, explore the influence of GAT on this process, and identify potential areas for improvement in transition-related care. We conducted interviews with 21 participants at various stages of GAT. Participants identified as (trans)men (12), (trans)women (7), transgender (1), and genderqueer/gender non-conforming/non-binary (1). Thematic analysis was conducted and involved multiple researchers. Three themes emerged from the data: (i) the role sexuality plays in understanding and affirming one's gender, (ii) satisfaction with one's physical sexual function, (iii) positive communication about sex and its subsequent influence on relationships. Many participants associated satisfaction with physical sexual function with positive sexual experiences, often describing GAT-induced changes in sexual arousal, drive, and orgasm as gender-affirming. Emotional connection and affirmation from sexual partners also contributed to positive experiences. The ability to (re-)define what sex meant individually increased satisfaction levels. Moreover, understanding and affirming one's gender identity were closely related to a satisfactory sex life. This study offers valuable insights for healthcare providers working with TGNB individuals during GAT, particularly concerning their sexuality.

The current study investigated the correlates of post-coital dysphoria (PCD) in men and women. Moreover, the study explored the PCD prevalence in the sexual contexts of a relationship, casual sex, and masturbation. An online survey was completed by 156 participants, 51 males and 105 females. All participants were over 18 and have had sex in and out of relationships, as well as having engaged in masturbation. Results showed that PCD was prevalent in each of the three sexual contexts, for both males and females. Furthermore, some previously identified correlates were replicated and found to be statistically significant predictors of PCD. A previously unexplored variable that was also found to significantly predict PCD were negative attitudes toward masturbation. The current research established that PCD occurs in multiple sexual contexts - something previously unknown. Prevalence rates of PCD after sex within a relationship, casual sex, and masturbation, for males were 21.6, 49 and 72.5, respectively. For females, prevalence rates were 11.4, 77.1 and 51.4%, respectively. Additionally, it identified which factors predict the experience of PCD for each of the different sexual contexts for each gender. This has potentially huge implications in formulating a focus for the treatment of PCD, dependent upon the gender and sexual context it is experienced in.