Orgasm Consistency in Mixed-Gender Couples: Actor, Partner, and Discrepancy Effects from Dyadic Response Surface Analysis.

The potential link between orgasm consistency (i.e., the percentage of time an individual experiences orgasm during sexual interactions with a partner) and sexual satisfaction in mixed-gender sexual relationships remains underexamined in the literature. We combined two dyadic samples (N = 725 couples) and utilized Dyadic Response Surface Analysis (DRSA) to examine how both partners' orgasm consistency and their discrepancy of orgasm consistency predict both partners' sexual satisfaction. We found that partners' discrepancy in orgasm consistency was not uniquely connected to higher sexual satisfaction for either women or men; rather, the overall consistency of orgasm was connected to better sexual satisfaction for both partners. In addition, there was some evidence tentatively suggesting that men were more likely than women to report lower sexual satisfaction if his partner was orgasming more consistently than he was, as opposed to her reporting lower sexual satisfaction from him orgasming more consistently than she was; though this appears to be a rare scenario as only 5.9% of couples had women who orgasmed more consistently than men. This study may assist educators and clinicians as they help couples consider the sexual scripts surrounding orgasm consistency, and how they can attend to each others' desires in a way that maximizes sexual satisfaction for both partners.

Sexual Behaviors as a Mediator Between Pornography Use and Heterosexual Relationship Outcomes.

This study seeks to build on previous research about how pornography use is associated with relationship outcomes. Using the 3AM model (Wright, 2011) as a theoretical guide, sexual behaviors were tested as a possible mediator of the association between pornography use and relationship well-being. Using a national data set of individuals in heterosexual relationships (n = 2519), associations between different types of pornography use (alone use vs. joint use), sexual behaviors, and relationship outcomes were analyzed. Results showed that pornography use with a partner is a distinct activity when compared to pornography use alone. Additionally, significant indirect relationships between pornography use and relationship outcomes were found through sexual behaviors. Both vaginal sex and oral sex had positive effects, while anal sex had a unique, negative effect (use of sex toys was not significantly related). Future research should continue to examine the context of pornography use and how it is related to behaviors and outcomes in relationships.

Context Matters: Moderating Effects in the Associations between Pornography Use, Perceived Addiction, and Relationship Well-being.

While perceived addiction and religiosity have been key contextual factors in understanding the link between pornography use and personal distress, these contextual factors have been explored less in the relational literature. Using a large nonprobability convenience sample from the United States, a moderated mediation model of the association between pornography use alone and two key indicators of relationship quality (relationship satisfaction and relationship stability) was explored. Results suggested that both general and aggressive pornography use alone were associated with less relationship satisfaction and relationship stability even when accounting for a range of potentially confounding variables. Perceived addiction partially mediated these associations, while both religiosity and gender moderated them. Generally, higher religiosity and being male were linked to compounding negative associations between pornography use and lower relationship quality. Findings suggest the importance of considering both religiosity and perceived addiction as important contextual factors when studying associations between pornography use and both relational and individual outcomes.

Associations of Adolescents' Pornography Viewing with their Romantic Relationship Skills and Behaviors.

Research into adolescent pornography use has identified numerous individual-level behavioral and attitudinal correlates. However, associations between adolescents' pornography viewing and their romantic relationships remain understudied. Furthermore, very little is known about adolescents' watching pornography with their romantic partners (i.e., joint pornography use). The present study of adolescents (n = 755, 59.9% girls, M age = 15.72 years old [SD = 1.34]) is among the first attempts to link adolescents' pornography viewing behaviors to their romantic relationship attitudes and behaviors. We hypothesized that adolescents' viewing would be associated with poorer self-reported relationship skills, more negative relationship behaviors, and increased involvement in sexual activity, such as sexting. Partial support for these hypotheses was found. Frequency of overall viewing was associated with lower relationship and refusal skills. Lifetime joint pornography viewing was associated with higher rates of dating violence victimization and perpetration in the past six months and with more abusive behaviors from one's partner and more verbal conflict in the current dating relationship. Results, though cross-sectional, suggest that pornography viewing in adolescence is associated with poorer romantic outcomes. Implications for adolescent development and for healthcare providers and educators are discussed.

One Line of Sexual Decline? Growth Mixture Modeling for Midlife Sexual Satisfaction.

Most research has shown that sexual satisfaction in long-term relationships tends to decline over time. Studies showing the average trajectory, however, are limited by only assessing one slope. With longitudinal data from the Flourishing Families Project, Marital Instability Dataset, and the Iowa Youth and Families Project, we utilized growth mixture modeling to assess what trajectories of sexual satisfaction exist in midlife marriages. In the three samples (one individual, two dyadic), we found clear evidence for heterogeneous sexual satisfaction trajectories, for both wives and husbands. Through the datasets, we found some trajectories did decline over time. We also found stably high, stably medium, stably low, and some trajectories that showed an increase in sexual satisfaction over time. Overall, trajectories were similar for wives and husbands, though some classes had one partner with variability while the other was stable, some classes had trajectories with wives having higher sexual satisfaction than husbands, and some classes had trajectories with husbands having higher sexual satisfaction than wives. Demographic variables were not strong distinguishers of these differing trajectories. Both marital satisfaction and perceived marital stability trajectories (based on sexual satisfaction classes) generally had similar patterns to sexual satisfaction trajectories, with a few exceptions. Both marital satisfaction and perceived marital stability were less likely to significantly change over time, have discrepancies between wives and husbands, and have either low marital satisfaction or high perceived marital instability, even if sexual satisfaction was low. These data can help couples recognize various possibilities for sexual satisfaction over time, perhaps helping them to avoid cultural myths of inevitably declining sexual satisfaction.

Silicone Scaffold Support Using a Bilayer Dermal Regeneration Matrix Template for Correction of Primary or Recurrent Eyelid Retraction.

PURPOSE: To evaluate the efficacy and safety of a bilayer dermal regenerative matrix for primary or complex/recurrent eyelid retraction. METHODS: Retrospective review of patients undergoing eyelid retraction repair using the bilayer dermal regenerative matrix from 2005 to 2019. Nineteen eyelid surgeries from 15 patients were identified. Collected data included patient demographics, symptoms, preoperative/postoperative lower eyelid position, inferior scleral show, lagophthalmos, etiology of retraction, history of prior retraction surgeries, major/minor complications, and follow-up duration (minimum 6 months). Postoperative measurements were taken at a minimum of 1 week, 3-6 weeks, 2-4 months, and 6 months. RESULTS: Postoperatively, 90% of cases had good improvement of lower eyelid retraction (defined as 1 mm or less below the inferior limbus). Postoperative elevation of the lower eyelid ranged 1-3.5 mm compared with preoperative measurements. When used in the upper eyelid for conjunctival scarring, the implant improved the superior fornix depth. Complications were minimal and included transient conjunctival injection, eyelid edema, and foreign body sensation. No patients requested early removal of the silicone layer due to ocular pain. CONCLUSIONS: The bilayer dermal regeneration matrix template may be considered a reasonable alternative to other spacers to reduce the vertical palpebral fissure and eyelid malposition in primary, complex, or recurrent cases. It also worked well for first-line correction of thyroid retraction, which tend to be more challenging due to globe proptosis. Suboptimal results may have occurred due to active cicatrizing conjunctival disease, or residual negative vector of the cheek and orbit. High cost may be a consideration, and the bilayer dermal regeneration matrix template was not studied directly against hard palate and other spacer materials.

Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples.

BACKGROUND: While links between pornography use and couple relational well-being have been the subject of multiple research studies, less attention has been paid to the associations between pornography use and specific sexual behavior within the relationship. AIM: This study aimed to explore associations between each partner's pornography use, sexual desire, sexual satisfaction, and intercourse/non-intercourse sexual behavior. The confounding and moderating role of religiosity was also explored. METHODS: A dyadic sample of 240 heterosexual couples was used. Measurement assessed pornography use, sexual desire, sexual satisfaction, and sexual behavior. OUTCOMES: Sexual satisfaction as well as intercourse and non-intercourse sexual behaviors were examined. RESULTS: Results suggested consistent gendered differences where female pornography use was directly associated with higher reports of female sexual desire, whereas male pornography use was directly associated with more male but less female partner desire and lower overall male sexual satisfaction. Male pornography use was also indirectly associated with sexual satisfaction for both partners and non-intercourse behaviors within the relationship through sexual desire. Overall, religiosity had little impact on the results of the study. CLINICAL TRANSLATION: The complex associations between pornography use, sexual desire, and sexual behaviors suggested by our results highlight the importance of comprehensive and systemic assessment and education around sexuality when working with individuals and couples. STRENGTHS & LIMITATIONS: The main strength of this study is the use of dyadic data. The main limitation is the cross-sectional nature of the data CONCLUSION: The associations between pornography use and a variety of outcomes are highly nuanced. This study provides an important step forward in more fully accounting for the complications of pornography use in a relationship. Willoughby BJ, Leonhardt ND, Augustus RA. Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples. J Sex Med 2021;18:179-192.

Measuring the Multidimensional Construct of Pornography: A Long and Short Version of the Pornography Usage Measure.

With the increase in the availability and usage of pornography, the research on the effects of pornography has also increased. This research has uncovered several controversies in the field regarding how pornography usage influences attitudes, sexual behaviors, and relationships. However, many of the measures of pornography are problematic as there is often little reliability and validity information for them and it is not clear that participants in these research studies are referring to the same types of materials when they answer pornography usage questions. Consequently, many of the research findings are suspect and it is crucial to develop reliable and valid scales to measure general pornography usage. In this study, we present both a 20-item and a 7-item version of the Pornography Usage Measure (PUM) that is based on extensive previous research on what types of materials individuals consider pornographic and that indicates pornography is a multidimensional construct. We evaluated the reliability and validity of both versions by using an MTurk sample of 934 males and 705 females (N =1639 total) to conduct confirmatory factor analyses, item response analyses, and structural equation model analyses. These analyses demonstrated that there were adequate reliability and early evidence for content, construct, concurrent, and predictive validity for both versions of the PUM. This measure could improve the quality of future research on pornography by providing more consistency between different studies about what is being measured when individuals indicate their pornography usage patterns.

Revising Premarital Relationship Interventions for the Next Generation.

In this article, we review research on contemporary social trends that influence the next generation's ability to form and sustain a healthy marriage. As a result, we argue for greater attention to premarital interventions for engaged couples to help the next generation address the potential challenges created by these trends. After we briefly review the current state of premarital education and counseling, we examine four general, interrelated social trends: individualism and commitment ambivalence, changing attitudes about marriage, premarital relationship histories, and the omnipresent media environment. In addition, we offer four general proposals corresponding to these trends that we believe will enhance the future effectiveness of premarital interventions. We urge premarital educators and counselors to evaluate their current interventions with these proposals in mind.

Behind Closed Doors: Individual and Joint Pornography Use Among Romantic Couples.

Most previous research on the associations between pornography use and relational well-being has utilized individual data sets that have limited scholars' ability to truly understand the dyadic nature of pornography use within romantic couples. Using a dyadic data set of 240 committed heterosexual couples from the United States, we explored actor and partner associations between pornography use, sexual dynamics, and relational well-being. We also explored how couple pornography use and partner knowledge of pornography use were associated with well-being. Results suggested that female pornography use was associated with higher female sexual desire but no other dependent variables. Male pornography use was associated with a wide array of negative well-being indicators, including less male and female relationship satisfaction, lower female sexual desire, and lower male positive communication. Couple pornography use was associated with higher reported sexual satisfaction for both partners but no other well-being indicators. Partner knowledge of use had little direct association with well-being, but some evidence suggested that unknown individual use may be associated with less sexual satisfaction but more relationship satisfaction. Results suggest that different configurations of use among heterosexual couples are associated with varying relational well-being indicators.

Longitudinal influence of shared marital power on marital quality and attachment security.

Spouses perceiving that they have shared power in marriage has been linked to higher marital quality and attachment security. Existing research, however, is limited in assessing how these perceptions influence both spouses and whether these influences endure over time. To address these limitations, we analyzed the longitudinal relationship reports from 319 couples from the Flourishing Families Project (FFP) to estimate biyearly (Waves 1, 3, and 5) and yearly (Waves 3-5) longitudinal actor-partner interdependence models. Reporting shared power in marriage was linked to the actors' higher marital quality and lower attachment insecurity over time (although less consistently for attachment insecurity). Longitudinal partner effects and indirect effects were also found from reports of shared marital power on both marital quality and attachment insecurity over time. The combined evidence suggests that power dynamics in a marriage are an important predictor of changes in couples' overall relational well-being. Accordingly, marriages appear to benefit from husbands and wives mutually seeking to help each other feel empowered in a relationship as equal and full partners. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Home Base: Family of Origin Factors and the Debut of Vaginal Sex, Anal Sex, Oral Sex, Masturbation, and Pornography Use in a National Sample of Adolescents.

Because early initiation of sexual behavior can lead to negative health outcomes, it is important to understand the influence of family of origin (FOO) on adolescent sexual debut. This brief report explores the relationship between time spent living with both biological parents, overall quality of FOO experience, and various sexual behaviors (vaginal sex, oral sex, anal sex, masturbation, and pornography use) in adolescence and emerging adulthood. We hypothesized that participants reporting higher quality FOO experiences and more time with biological parents would be (a) more likely to delay the debut of these behaviors and (b) less likely to have participated in these behaviors at all. A demographically diverse national sample of 2,556 18-19-year-old U.S. residents was surveyed. Results showed that more time with biological parents was associated with a lower likelihood of experiencing vaginal, oral, and anal sex. Across analyses, higher quality FOO experience was consistently associated with a lower likelihood of pornography access, masturbation, and oral sex and inconsistently associated with a lower likelihood of anal and vaginal sex. Higher quality FOO and more time with biological parents predicted delayed debut of pornography access, masturbation, vaginal sex, and oral sex. Implications for future research and practice are discussed.

Untangling the Porn Web: Creating an Organizing Framework for Pornography Research Among Couples.

Research exploring the correlates, moderators, and potential consequences of viewing pornography for romantic couples has surged in recent years. Research in this area has primarily focused on the question of whether viewing pornography for either partner (or together) is related to enhanced, diminished, or has no effect on relational well-being. However, this narrow scholarly focus and the continued methodological limitations of research in this area have made synthesizing or drawing broad conclusions about pornography use from this scholarship difficult. One specific limitation of this area is the lack of any broad organizational framework that could help scholars categorize existing research while also laying the groundwork for future scholarship. In this paper, we argue for such a framework and suggest that relational pornography scholarship could be organized across five broad dimensions: the nuances of the content viewed, individual background factors, personal views and attitudes, a couple's relational context, and couple processes. We provide a justification for these five areas and then discuss how this framework could help organize and structure the research in this area moving forward.

The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience.

BACKGROUND: Self-reported orgasm, perception of partner's orgasm, and misperception of partner's orgasm have each been correlated with individual sexual and relationship satisfaction, but these associations have rarely included dyadic data, have not fully accounted for potentially confounding variables such as sexual communication, and have never been simultaneously studied with a nationally representative sample. AIM: To provide a more complete picture of how the orgasmic experience within the heterosexual couple influences individual and partner sexual and relationship satisfaction. METHODS: Using a nationally representative dyadic sample of 1,683 newlywed heterosexual couples, a structural equation model was estimated to test associations between husband and wife self-reported orgasm frequency, husband and wife report of the other partner's orgasm frequency, and husband and wife misperception of their partner's orgasm frequency, as correlates of relationship and sexual satisfaction. OUTCOMES: Both husband and wife completed the Couples Satisfaction Index to assess their own relationship satisfaction, and completed a sexual satisfaction instrument designed for the CREATE study. RESULTS: 87% of husbands and 49% of wives reported consistently experiencing orgasm. 43% of husbands misperceived how often their wives experienced orgasm. The final structural equation model, including sexual communication, explained moderate amounts of variance in wives' and husbands' relationship satisfaction, and a high level of variance for wives' and husbands' sexual satisfaction. Wives' relationship satisfaction was positively associated with wives' and husbands' sexual communication. Wives' sexual satisfaction was positively associated with self-reported orgasm frequency, and both wives' and husbands' sexual communication. Husbands' relationship satisfaction was positively associated with husbands' and wives' sexual communication. Husbands' sexual satisfaction was positively associated with husbands' perception of wives' orgasm frequency, and both husbands' and wives' sexual communication. CLINICAL TRANSLATION: When counseling couples, clinicians should give particular attention to the wife's orgasm experiences, to potentially help both husbands and wives have higher sexual satisfaction. STRENGTHS & LIMITATIONS: Strengths of this study include the use of a nationally representative sample and dyadic data. Limitations include cross-sectional data, and the assessment of sexual experiences only in newlywed couples. CONCLUSION: Wives' orgasm (wives' self-report of frequency and husbands' perception of frequency) has a unique positive association with sexual satisfaction, even after taking into account other aspects of the orgasm experience and sexual communication. Leonhardt ND, Willoughby BJ, Busby DM, et al. The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience. J Sex Med 2018;15:1140-1148.

A Dyadic Approach to Pornography Use and Relationship Satisfaction Among Heterosexual Couples: The Role of Pornography Acceptance and Anxious Attachment.

The majority of research on pornography use within committed relationships has found such use to be associated with negative outcomes. However, given the variability in pornography use among couples, the current study sought to examine moderators in the association between pornography use and relationship satisfaction in a large sample of heterosexual matched-paired couples (N = 6,626). Actor-partner interdependence models (APIMs) revealed that for men who are more anxiously attached, more pornography use is associated with higher relationship satisfaction; whereas for women who are more anxiously attached, more pornography use is associated with lower relationship satisfaction. For men who are more accepting of pornography, more pornography use is associated with more relationship satisfaction; however, for men who are less accepting of pornography, more pornography use is associated with less relationship satisfaction. There was little difference in relationship satisfaction at differing levels of pornography use for women who are high in pornography acceptance. For women who are low in pornography acceptance, pornography use is associated with less relationship satisfaction. Results are discussed and recommendations for practitioners are made through the lens of symbolic interaction theory.

Cross-Disorder Cognitive Impairments in Youth Referred for Neuropsychiatric Evaluation.

OBJECTIVES: Studies suggest that impairments in some of the same domains of cognition occur in different neuropsychiatric conditions, including those known to share genetic liability. Yet, direct, multi-disorder cognitive comparisons are limited, and it remains unclear whether overlapping deficits are due to comorbidity. We aimed to extend the literature by examining cognition across different neuropsychiatric conditions and addressing comorbidity. METHODS: Subjects were 486 youth consecutively referred for neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. First, we assessed general ability, reaction time variability (RTV), and aspects of executive functions (EFs) in youth with non-comorbid forms of attention-deficit/hyperactivity disorder (ADHD), mood disorders and autism spectrum disorder (ASD), as well as in youth with psychosis. Second, we determined the impact of comorbid ADHD on cognition in youth with ASD and mood disorders. RESULTS: For EFs (working memory, inhibition, and shifting/ flexibility), we observed weaknesses in all diagnostic groups when participants' own ability was the referent. Decrements were subtle in relation to published normative data. For RTV, weaknesses emerged in youth with ADHD and mood disorders, but trend-level results could not rule out decrements in other conditions. Comorbidity with ADHD did not impact the pattern of weaknesses for youth with ASD or mood disorders but increased the magnitude of the decrement in those with mood disorders. CONCLUSIONS: Youth with ADHD, mood disorders, ASD, and psychosis show EF weaknesses that are not due to comorbidity. Whether such cognitive difficulties reflect genetic liability shared among these conditions requires further study. (JINS, 2018, 24, 91-103).

Exploring Trajectories of Pornography Use Through Adolescence and Emerging Adulthood.

While the scholarly literature on pornography use is growing, much of this literature has examined pornography use as a static feature that does not change. Despite this trend, pornography use, like most sexual behaviors, is likely best viewed as a dynamic feature that may shift across the developmental life span. Using a sample of 908 adults from the United States, retrospective data on pornography use through adolescence and emerging adulthood were gathered to explore trajectories of pornography use across these developmental periods. Latent mixture models suggested the presence of common patterns of use across both developmental periods. Adolescence patterns appeared to largely be distinguished by those who either engaged or did not engage with pornography, while emerging adulthood data revealed the presence of a group of experimenters who engaged in pornography through adolescence but then decreased use through their 20s. Men were found to be more likely to have consistent profiles of pornography use, while single adults were likely to have delayed entry into pornography use. Associations with adult mental health and pornography use were found, suggesting that early exposure to pornography was related to elevated current pornography use patterns and, to a lesser extent, dysfunctional pornography use. Trajectories also had a weak association with life satisfaction, with individuals reporting trajectories involving consistent pornography use reporting lower life satisfaction after controls.

Damaged Goods: Perception of Pornography Addiction as a Mediator Between Religiosity and Relationship Anxiety Surrounding Pornography Use.

Recent research on pornography suggests that perception of addiction predicts negative outcomes above and beyond pornography use. Research has also suggested that religious individuals are more likely to perceive themselves to be addicted to pornography, regardless of how often they are actually using pornography. Using a sample of 686 unmarried adults, this study reconciles and expands on previous research by testing perceived addiction to pornography as a mediator between religiosity and relationship anxiety surrounding pornography. Results revealed that pornography use and religiosity were weakly associated with higher relationship anxiety surrounding pornography use, whereas perception of pornography addiction was highly associated with relationship anxiety surrounding pornography use. However, when perception of pornography addiction was inserted as a mediator in a structural equation model, pornography use had a small indirect effect on relationship anxiety surrounding pornography use, and perception of pornography addiction partially mediated the association between religiosity and relationship anxiety surrounding pornography use. By understanding how pornography use, religiosity, and perceived pornography addiction connect to relationship anxiety surrounding pornography use in the early relationship formation stages, we hope to improve the chances of couples successfully addressing the subject of pornography and mitigate difficulties in romantic relationships.

Delivering irrigation to the anterior ethmoid region: evaluation of a lacrimal diversion device in a cadaver model.

BACKGROUND: Topical solutions to the sinus cavity are primarily administered via a transnasal route with inherent limitations of distribution. Here we describe an alternate method of sinus access via lacrimal sinus diversion using a novel lacrimal diversion device (LDD). METHODS: A cadaveric study was performed using 12 disarticulated fresh heads. The LDD was implanted in 23 sides meeting insertion criteria. Time to placement was recorded and patency was assessed via nasal endoscopy. Methylene blue was administered via the LDD and 16 sides underwent surgical ethmoidectomy to assess distribution of mucosal staining. Four cadavers underwent computed tomography (CT) imaging to demonstrate stent position. RESULTS: Mean time of placement was 3.66 ± 2.37 minutes (mean ± standard deviation [SD]). Patency rate was 100%. Six sides (37.5%) had anterior ethmoid staining, 6 sides (37.5%) had posterior ethmoid staining, and the remaining 4 sides (25%) had mixed anterior and posterior ethmoid staining. Stents placed optimally resulted in anterior ethmoid staining without complication. Malpositioned stents resulted in posterior ethmoid staining and some inadvertent ethmoid vertical lamella trauma in 2 instances. CONCLUSION: Sinus irrigation can be delivered to the ethmoid sinuses directly via a lacrimal diversion stent. Technique modification or image guidance may be helpful in ensuring optimal placement.