Do Demand-Withdrawal Communication Patterns During Sexual Conflict Predict Couples' Relationship Satisfaction, Sexual Satisfaction, and Sexual Distress? An Observational and Prospective Study.

Sexual conflict is common, yet it is one of the most challenging topics for couples because it provokes more negative emotions relative to other conflicts. Such challenges might prompt couples to rely on less adaptive sexual communication styles. Communication patterns during sexual conflict - such as demand-withdrawal - have received little attention, and studies that do exist relied on self-report measures. Demand-withdrawal communication refers to when one partner exerts pressure to talk about a problem while the other withdraws, and is associated with poorer psychological and relationship well-being. In an observational dyadic study, we examined associations between demand-withdrawal patterns during a sexual conflict and sexual and relationship outcomes concurrently and over time. Couples (N = 151, Mage = 31.92, SDage = 9.07) in long-term relationships completed measures of relationship satisfaction, sexual satisfaction, and sexual distress at baseline (T1) and 12 months later (T2). One week after T1, they engaged in an in-lab discussion of an important sexual conflict, coded by trained observers for degree of demand-withdrawal. Individuals in a couple who were observed to display higher demand-withdrawal reported lower relationship and sexual satisfaction and higher sexual distress at T1, as well as lower relationship satisfaction at T2. Effects were not moderated by gender. Findings demonstrate the relevance of demand-withdrawal patterns during sexual conflict.

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).

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.

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.

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.

Suicide behaviors during the COVID-19 pandemic: A meta-analysis of 54 studies.

COVID-19, and efforts to mitigate its spread, are creating extensive mental health problems. Experts have speculated the mental, economic, behavioral, and psychosocial problems linked to the COVID-19 pandemic may lead to a rise in suicide behavior. However, a quantitative synthesis is needed to reach an overall conclusion regarding the pandemic-suicide link. In the most comprehensive test of the COVID-19-suicidality link to date, we meta-analyzed data from 308,596 participants across 54 studies. Our results suggested increased event rates for suicide ideation (10.81%), suicide attempts (4.68%), and self-harm (9.63%) during the COVID-19 pandemic when considered against event rates from pre-pandemic studies. Moderation analysis indicated younger people, women, and individuals from democratic countries are most susceptible to suicide ideation during the COVID-19 pandemic. Policymakers and helping professionals are advised that suicide behaviors are alarmingly common during the COVID-19 pandemic and vary based upon age, gender, and geopolitics. Strong protections from governments (e.g., implementing best practices in suicide prevention) are urgently needed to reduce suicide behaviors during the COVID-19 pandemic.

Partner Responses to Low Desire: Associations With Sexual, Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder.

BACKGROUND: The experience of distressing low sexual interest/arousal-female sexual interest/arousal disorder (FSIAD)-is prevalent in women of all ages and is associated with poorer sexual, relationship, and psychological well-being than women without this difficulty. Women who are partnered are almost 5 times more likely to be distressed by low desire and to receive a diagnosis of FSIAD than unpartnered women, indicating that interpersonal factors are highly relevant, although largely neglected in past research. AIM: In a dyadic cross-sectional and longitudinal study, we examined whether partner responses to FSIAD were associated with the sexual, relationship, and psychological well-being of couples, and whether any effects persisted 1 year later. METHODS: Women diagnosed with FSIAD (N = 89) completed a validated measure of perceived partner positive vs negative responses to their low sexual interest/arousal and their partners reported on their own responses, as well as measures of sexual desire, sexual satisfaction, relationship satisfaction, sexual distress, and anxiety. 1 year later, couples (N = 66) completed the outcome measures again. Data were analyzed according to the Actor-Partner Interdependence Model. OUTCOMES: Outcomes included were the Sexual Desire Inventory-Solitary and Partner-Focused Subscales; Global Measure of Sexual Satisfaction; Female Sexual Distress Scale; Couple Satisfaction Index; and State-Trait Anxiety Inventory-Short-Form. RESULTS: When women with FSIAD perceived more positive partner responses (eg, warm, supportive, compassionate) than negative responses (eg, hostile, unsupportive, indifferent), they were more satisfied with the relationship and they and their partners reported lower anxiety. When partners reported more positive than negative responses, they had greater relationship and sexual satisfaction and lower sexual distress and anxiety. Exploratory analyses revealed that women's perceptions of their partners' responses accounted for the link between partners' own responses and women's relationship satisfaction and anxiety. Partner responses did not predict any change in outcomes over time. CLINICAL IMPLICATIONS: Findings support interpersonal conceptualizations of FSIAD and may inform the development of future couple-based interventions. STRENGTHS & LIMITATIONS: This study is one of the few dyadic investigations of FSIAD, as diagnosed via a clinical interview. Significant associations were only observed cross-sectionally, limiting causal conclusions. There was limited power to detect longitudinal effects. CONCLUSION: More positive responses to women's low sexual interest/arousal by partners is linked to better adjustment among couples affected by FSIAD. Rosen NO, Corsini-Munt S, Dubé JP, et al. Partner Responses to Low Desire: Associations With Sexual, Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder. J Sex Med 2020;17:2168-2180.

Emotion Regulation in Couples Affected by Female Sexual Interest/Arousal Disorder.

Female sexual interest/arousal disorder (FSIAD) is associated with psychological, relational, and sexual consequences for affected women, and their romantic partners also suffer repercussions. Prior research suggests that women with FSIAD report more difficulties with emotion regulation than controls. Yet, whether emotion regulation is associated with the psychological, relational, and sexual well-being of both members of affected couples is unknown. Eighty-seven women diagnosed with FSIAD via a clinical interview and their male partners completed standardized measures of difficulties in emotion regulation, depression, anxiety, relationship satisfaction, dyadic conflict, sexual desire, and sexual distress. A subset (n = 71 couples) also completed measures of emotional suppression and reappraisal in relation to sex. Analyses used multilevel modeling guided by the actor-partner interdependence model. When women reported greater difficulties regulating negative emotion, they reported greater depression and anxiety, and when men reported more of these difficulties, they had greater depression, anxiety, and sexual distress, and the women with FSIAD reported lower relationship satisfaction. When women reported greater emotional suppression, they reported greater depression and anxiety, and lower relationship satisfaction; when they reported greater use of emotional reappraisal, they had fewer symptoms of depression and anxiety, and their partners reported lower dyadic conflict. When men reported greater emotional suppression, they had greater depression, lower relationship satisfaction, and sexual desire; when they reported greater emotional reappraisal, they had lower depression and anxiety, higher relationship satisfaction, lower dyadic conflict, higher sexual desire and women reported higher relationship satisfaction and lower dyadic conflict. Emotion regulation may be an important target for interventions to help couples cope with FSIAD.

Partners Experience Consequences, Too: A Comparison of the Sexual, Relational, and Psychological Adjustment of Women with Sexual Interest/Arousal Disorder and Their Partners to Control Couples.

INTRODUCTION: Women diagnosed with female sexual interest/arousal disorder (FSIAD) report lower health-related quality of life, more depressive symptoms, and lower sexual and relationship satisfaction compared with healthy control subjects. Despite the impact of FSIAD on women's sexuality and the inherently interpersonal nature of the sexual problem, it remains unclear whether the partners of women with FSIAD also face negative consequences, as seen in other sexual dysfunctions. AIM: The aim of this study was to compare the sexual, relational, and psychological functioning of partners of women with FSIAD (as well as the women themselves) to their control counterparts. We also compared women with their partners within the FSIAD and control groups. METHODS: Woman diagnosed with FSIAD and their partners (n = 97) and control couples (n = 108) independently completed measures of sexual desire, sexual distress, sexual function, sexual satisfaction, sexual communication, relationship satisfaction, depression, and anxiety. MAIN OUTCOME MEASURE: Main outcomes included: Sexual Desire Inventory-2; Female Sexual Distress Scale; Female Sexual Functioning Index; International Index of Erectile Functioning (IIEF), Global Measure of Sexual Satisfaction; Dyadic Sexual Communication Scale; Couple Satisfaction Index; Beck Depression Inventory-II; State-Trait Anxiety Inventory-Short Form. RESULTS: Partners of women with FSIAD reported lower sexual satisfaction, poorer sexual communication, and higher sexual distress compared with control partners. Male partners of women with FSIAD reported more difficulties with orgasmic and erectile functioning and lower overall satisfaction and intercourse satisfaction on the IIEF compared with control partners. Women with FSIAD reported lower sexual desire and satisfaction, and higher sexual distress and depressive and anxiety symptoms, in comparison to both control women and their own partners, and they reported poorer sexual communication compared with control women. Women with FSIAD also reported lower sexual desire, arousal, lubrication, and satisfaction, and greater pain during intercourse on the Female Sexual Function Index compared with control women. CLINICAL IMPLICATIONS: The partners of women with FSIAD also experience negative consequences-primarily in the domain of sexuality. Partners should be included in treatment and future research. STRENGTH & LIMITATIONS: This is the first study, to our knowledge, to document consequences for partners of women with FSIAD in comparison to control subjects. This study is cross-sectional, and causation cannot be inferred. Most couples were in mixed-sex relationships and identified as straight and cis-gendered; results may not generalize. CONCLUSION: Findings suggest that partners of women with FSIAD experience disruptions to many aspects of their sexual functioning, as well as lower overall sexual satisfaction and heightened sexual distress. Rosen NO, Dubé JP, Corsini-Munt S, et al. Partners Experience Consequences, Too: A Comparison of the Sexual, Relational, and Psychological Adjustment of Women with Sexual Interest/Arousal Disorder and Their Partners to Control Couples. J Sex Med 2019;16:83-95.

A Comparison of Approach and Avoidance Sexual Goals in Couples With Vulvodynia and Community Controls.

BACKGROUND: Provoked vestibulodynia (PVD) is a prevalent form of vulvodynia that interferes with the sexual and relational functioning of affected couples. Approach and avoidance sexual goals are associated with the sexual and relationship well-being of women with PVD and their partners. However, whether sexual goals differ in couples coping with PVD compared with community couples is unknown. AIMS: To compare the approach and avoidance sexual goals of women with PVD and their partners with a control sample of community women and their partners to build on an established motivational model and to compare the sexual goals of women with PVD with those of their partners. METHODS: Women diagnosed with PVD and their partners (n = 161) and control couples (n = 172) completed measures of approach and avoidance sexual goals. OUTCOME: Approach and Avoidance Sexual Goals Questionnaire. RESULTS: Women with PVD reported lower approach and higher avoidance sexual goals than control women, whereas partners of women with PVD did not differ from control partners in their sexual goals. Women with PVD also reported lower approach and higher avoidance sexual goals compared with their partners, whereas there were no differences between partners in the control sample. CLINICAL IMPLICATIONS: Given that avoidance sexual goals have been linked to negative sexual and relational outcomes, clinicians could strive to help couples with PVD become aware of their sexual motives, with the aim of weakening avoidance sexual goals and bolstering approach sexual goals. STRENGTHS AND LIMITATIONS: This is the first study to empirically document differences in sexual goals between couples affected by PVD and community couples. Limitations include the study's correlational design, differences in demographic characteristics between samples, and the homogeneity of participants' sexual orientation. CONCLUSIONS: Findings suggest that the sexual goals of women affected by PVD differ from those of community women and from their partners and support sexual goals as targets for psychological interventions to help couples coping with PVD. Dubé JP, Bergeron S, Muise A, et al. A Comparison of Approach and Avoidance Sexual Goals in Couples With Vulvodynia and Community Controls. J Sex Med 2017;14:1412-1420.

Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions.

Vulvodynia, an idiopathic chronic vulvar pain, is a prevalent genital pain condition that results in significant impairment to sexual, relational, and psychological functioning of affected women and their romantic partners. Despite its high prevalence, there remain gaps in knowledge and health care access for women coping with vulvodynia, given its varied clinical presentation and no widely accepted treatment protocol. The past several decades have seen important advancements in understanding vulvodynia and developing effective treatments; however, progress has been impeded due to clinical and methodological challenges in conducting research with this vulnerable population. This review presents a brief overview of vulvodynia correlates, consequences, etiology, and treatment, and then turns its attention to considering the clinical and methodological challenges that hinder vulvodynia research. Identifying these barriers alongside potential mitigating solutions is essential to developing empirically supported treatments for all women affected by vulvodynia, across all age and minority groups. Potential solutions will require researchers to broaden eligibility criteria, examine subgroups of women, and expand definitions of treatment outcomes, and may be best facilitated by more active collaboration among research groups and across relevant disciplines. Engagement in these solutions may contribute to more representative findings and the development and dissemination of empirically based treatment options for this complex pain condition.