Time for a Measurement Check-Up: Testing the Couple's Satisfaction Index and the Global Measure of Sexual Satisfaction Using Structural Equation Modeling and Item Response Theory.

Relationship and sexual satisfaction are two central outcomes in the study of relationships and are commonly used in both academia and applied practice. However, relationship and sexual satisfaction measures infrequently undergo specific psychometric investigation. Ensuring that measures display strong psychometric performance is an important but under-tested element of replication that has come under more scrutiny lately, and adequate measurement of constructs is an important auxiliary assumption underpinning theory-testing empirical work. A measurement check-up was conducted, including Confirmatory Factor Analysis (CFA) to test factorial validity, measurement invariance to test for group comparability, and Item Response Theory (IRT) to assess the relationship between latent traits and their items/indicators. This format was used to evaluate the psychometric properties of the Couple's Satisfaction Index (CSI) and the Global Measure of Sexual Satisfaction (GMSEX), two commonly used scales of relationship and sexual satisfaction with a sample of 640 midlife (40-59 years old) married Canadians who were recruited by Qualtrics Panels. Results of CFA suggested that both models were satisfactory. Invariance testing provided robust support for intercept invariance across all the groupings tested. IRT analysis supported the CSI and GMSEX, however, there was evidence that the GMSEX provided somewhat less information for those high on sexual satisfaction. This measurement check-up found that the CSI and GMSEX were reasonably healthy with some caveats. Implications are discussed in terms of replicability and meaning for scholars and practitioners.

Motives between the Sheets: Understanding Obligation for Sex at Midlife and Associations with Sexual and Relationship Satisfaction.

Reasons for sex are associated with sexual and relational outcomes. This study investigated reasons for sex at last sex, with a focus on obligation (an avoidance motivation) and doing something nice for a partner (an approach motivation), and their associations with sexual and relationship satisfaction, while controlling for marital duration, age, and sexual desire. We investigated these reasons among married, midlife Canadian women (n = 324), men (n = 275), and 25 non-binary/gender queer participants 40 to 59 years of age. Participants were recruited from a Qualtrics analytics panel and completed an online questionnaire. Obligation was reported as a reason for having sex by 12.4% of women and 1.8% of men; "doing something nice" was reported by 10.2% of women and 9.5% of men. In regression analyses, women who reported having sex for obligation had significantly lower relationship satisfaction and sexual satisfaction than women who did not report this reason. In contrast, having sex to do something nice for one's partner was associated with higher sexual satisfaction among women. Findings indicate that having sex when feeling obligated may be associated with negative sexual and relational outcomes among midlife women.

Authority in therapeutic interaction: A conversation analytic study.

A paradigmatic shift toward postmodern, collaborative practice in family therapy raises questions about how therapists can use professional authority to facilitate change and how clients can assert their knowledge and agency. We used conversation analysis to investigate how the authority to know and to determine here-and-now action (i.e., who does what, and how, in therapy) was negotiated and accomplished in 10 sessions of emotion-focused therapy involving chair work. Therapists were observed to rely on a particular interactional sequence structure: stepwise entry into a directive, in which directives were preceded by a question-answer sequence. We show how instances where clients' views were elicited prior to the delivery of a directive resulted in different interactional consequences from instances where therapists straightforwardly directed clients to perform some action. The study offers evidence concerning how therapists can facilitate chair work collaboratively and responsively.

Development and Psychometric Evaluation of the Concerns of Grieving Caregivers Scale (COGCS) with Two Clinical Samples.

The Concerns of Grieving Caregivers Scale (COGCS) is the first of its kind to explore caregivers' concerns about their own parenting, as well as their relationships with, and specific behaviours of their bereaved child(ren). Using exploratory factor analysis, we evaluate grieving parents' and caregivers' concerns using data collected across clinical populations from two community organizations supporting grieving families (i.e., a children's grief centre and a community hospice). Two identified factors were established: Concerns about Caregiving and Concerns about the Child. The COGCS demonstrates good internal consistency and criterion validity in its application with two distinct clinical samples. The use of this scale could be of value to clinicians supporting bereaved caregivers and their families as they can integrate concern-specific resources into their practice to better support their clients' presenting concerns.

A dyadic examination of self-determined sexual motives, need fulfillment, and relational outcomes among consensually non-monogamous partners.

Intimate and sexual relationships provide opportunity for emotional and sexual fulfillment. In consensually non-monogamous (CNM) relationships, needs are dispersed among multiple partners. Using Self-Determination Theory (SDT) and dyadic data from 56 CNM partnerships (112 individuals), we tested how sexual motives and need fulfillment were linked to relational outcomes. We drew from models of need fulfillment to explore how sexual motives with a second partner were associated with satisfaction in the primary relationship. In a cross-sectional and daily experience study we demonstrated that self-determined reasons for sex were positively associated with sexual satisfaction and indirectly linked through sexual need fulfillment. Self-determined reasons for sex predicted need fulfillment for both partners at a three-month follow up. The association between sexual motives and need fulfillment was stronger on days when participants engaged in sex with an additional partner, though this was not related to satisfaction in the primary relationship. Implications for need fulfillment are discussed.

Sameness and Difference in Psychological Research on Consensually Non-Monogamous Relationships: The Need for Invariance and Equivalence Testing.

Comparative research involving consensually non-monogamous (CNM) relationships and outcomes related to well-being continues to grow as an area of interest within sexual science. However, claims of sameness and/or difference between groups rely on two critical, yet widely under-appreciated assumptions: that the concepts being compared between groups are the same (i.e., measurement invariance), and that logically and statistically coherent procedures are used for evaluating sameness (i.e., equivalence testing). We evaluated the state of measurement invariance and equivalence across three studies, involving different types of CNM comparisons (i.e., relationship types, partner types) and designs (analysis of primary individual data, primary dyadic data, and secondary data). Our invariance tests of CNM compared to monogamous individuals (Study 1) and "primary" compared to "secondary" partners in dyadic appraisal of CNM individuals (Study 2) revealed that many measures of well-being failed to replicate their measurement models and were not generalizable across relationship types or partner types. Our reanalyses of existing comparative CNM effects using individual and meta-analyzed equivalence tests (Study 3), meanwhile, indicated that this literature requires more consistent reporting practices and larger samples, as most studies produced uninformative tests of equivalence. Our results illustrate the importance of auxiliary hypothesis evaluation and statistical procedure selection for generating informative comparative tests. Our findings also highlight potential divergences in social construction of well-being. We offer suggestions for researchers, reviewers, and editors in terms of needed methodological reforms for future comparative CNM research.

High Emotional and Sexual Satisfaction Among Partnered Midlife Canadians: Associations with Relationship Characteristics, Sexual Activity and Communication, and Health.

Despite midlife adults accounting for a substantial and growing segment of the population, few large-scale studies have investigated factors which distinguish highly satisfying relationships from less satisfying ones in midlife. In a subsample of partnered 40-59-year-old Canadians (705 men, 743 women), relationship characteristics, sexual activity and communication, and health were investigated individually and simultaneously as predictors of high emotional and sexual satisfaction. Though the vast majority of participants reported being at least somewhat satisfied in their current relationship, less than half reported high satisfaction. For men and women, high emotional and sexual satisfactions were strongly linked. Logistic regressions indicated that longer relationships, dating relationships, and greater subjective overall health predicted high emotional satisfaction for men, whereas older age, married or cohabiting relationships, and frequent sexual communication predicted high emotional satisfaction for women. All types of sexual activities (minus penile-anal intercourse) were bivariately related to high emotional and sexual satisfaction. More frequent partnered sexual activity predicted high emotional and sexual satisfaction for men and women in regression analyses. More frequent sexual communication predicted high emotional satisfaction for women and high sexual satisfaction for both men and women. Newer relationships were more sexually satisfying for men. Postmenopausal women were less likely to be highly sexually satisfied. Findings suggest that physical health conditions are not generally related to high levels of satisfaction in midlife couples and that frequently discussing sex and engaging in (any) sexual activity with a partner are key components of highly satisfying relationships.

Introducing the Expectations and Preference Scales for Couple Therapy (EPSCT): Development, Psychometric Evaluation, and Suggested Use in Practice and Research.

While it is known that client factors account for the largest proportion of outcome variance across treatment modalities, little is known about how clients' characteristics affect the process and effectiveness of couple therapy. To further knowledge in this area, we created a brief, practice-friendly measure, the Expectation and Preference Scales for Couple Therapy (EPSCT). Three self-report scales assess clients' Outcome expectations (e.g., I expect our relationship to improve as a result of couple therapy) and role expectations for Self (e.g., I expect to listen to my partner's concerns) and Partner (e.g., I expect my partner to blame me). Three Cognitive-Behavioral, Emotionally Focused, and Family Systems preference scales use a forced-choice format to measure the comparative strength of respondents' preferences for interventions broadly reflective of each approach. A large item pool was developed from relevant literature and clinical experience and refined based on face and content analyses with two panels of experienced couple therapists and researchers. Across four studies with 1,175 participants, the scales' internal consistency reliabilities were similar and their construct validity was supported with confirmatory factor analyses and significant correlations with several established measures, including expectation measures developed for individual psychotherapy and measures of attitudes toward professional help seeking and valuing personal growth. Across all studies, participants had stronger role expectations for themselves than their partners, although gender effects differed by sample. We discuss how to use the 15-item EPSCT in clinical practice and in future research as a predictor of couple therapy processes and outcomes.

Aunque se sabe que los factores de los clientes representan la mayor parte de la variación en los resultados a través de las modalidades de tratamiento diversas, no se sabe mucho acerca de cómo las características de los clientes afectan el proceso y efectividad de la terapia de pareja. Para avanzar el conocimiento en este campo, hemos creado una breve medida favorable a la práctica, las Escalas de expectativas y preferencias para terapia de pareja (EPSCT en inglés). Tres escalas de autoinforme evalúan las expectativas de resultados de los clientes (p.ej. Espero que nuestra relación mejore como resultado de la terapia de pareja) y las expectativas de roles para sí mismo (p.ej. Espero escuchar las preocupaciones de mi pareja) y para la pareja (p.ej. Espero que mi pareja me culpe). Tres escalas de preferencias cognitivo-conductiva, enfocada en emociones y de sistemas familiares emplean un formato de elección forzada para medir la fortaleza comparativa de las preferencias de los interrogados por intervenciones que reflejan cada enfoque a grandes rasgos. Se elaboró un conjunto amplio de ítems a partir de la literatura y experiencia clínica pertinentes y se refinó a base de análisis de apariencia y contenido con dos paneles de terapistas de pareja e investigadores experimentados. En la totalidad de cuatro estudios con 1175 participantes, las fiabilidades de coherencias internas fueron similares y su validez de constructo fue respaldada por análisis factoriales confirmatorios y correlaciones significativas con varias medidas ya establecidas, incluyendo medidas de expectativas desarrolladas para psicoterapias individuales y medidas de actitudes hacia la búsqueda de ayuda profesional y la valoración del crecimiento personal. En todos los estudios, los participantes mostraron expectativas de roles más fuertes para sí mismos que para sus parejas, aunque hubo diferencias en los efectos de género por muestra. Discutimos cómo usar el EPSCT con sus 15 ítems en la práctica clínica e investigaciones futuras como predictor de procesos y resultados de la terapia de pareja.

Prevalence and Predictors of Sexual Problems Among Midlife Canadian Adults: Results from a National Survey.

BACKGROUND: Sexual problems are common among midlife men and women, and studies have identified a range of demographic, health, and relational correlates. Research on prevalence of these sexual problems within Canada is sparse and is warranted given the unique context related to provision of health care services in contrast to other countries. AIM: We investigated sexual problems (women's low desire, orgasm difficulties, and vaginal pain, as well as men's low desire, erection difficulties, and ejaculation difficulties) and their correlates among a large sample of Canadian men and women aged 40-59 years. METHODS: A national sample of Canadians was recruited (N = 2,400). Prevalence statistics for the sexual problems, and odds ratios for correlates were computed using logistic regression to identify demographic, health, and behavioral correlates of men' and women's sexual problems. OUTCOMES: Self-reported experiences in the last 6-months of low desire, vaginal dryness, vaginal pain, and orgasm difficulties for women, and low desire, erectile difficulties, and ejaculation problems for men. RESULTS: Sexual problems were relatively common; low desire was the most common sexual problem, particularly for women, with 40% reporting low sexual desire in the last 6 months. Women who were post-menopausal were much more likely to report low desire, vaginal pain, and vaginal dryness. Low desire and erectile difficulties for men, and low desire and orgasm difficulties for women were significant predictors of overall happiness with sexual life. CLINICAL TRANSLATION: Given the prevalence and impact of sexual problems indicated in our study, physicians are encouraged to routinely assess for and treat these concerns. CONCLUSIONS: Strengths include a national sample of an understudied demographic category, midlife adults, and items consistent with other national studies of sexual problems. Causal or directional associations cannot be determined with these cross-sectional data. Results are largely consistent with previous national samples in the United States and the United Kingdom. Sexual problems are common among Canadian men and women, with many being associated with self-reported sexual happiness. Quinn-Nilas C, Milhausen RR, McKay A, et al. Prevalence and Predictors of Sexual Problems Among Midlife Canadian Adults: Results from a National Survey. J Sex Med 2018;15:873-879.

Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.

Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis-and of conversation analytic inquiry more generally-for the practice of family therapy.

Reasons why undergraduate women comply with unwanted, non-coercive sexual advances: A serial indirect effect model integrating sexual script theory and sexual self-control perspectives.

This study explored the predictors of young women's compliance with unwanted sexual activities, integrating the social with the cognitive and behavioral correlates of sexual compliance. In total, 222 young heterosexual women completed measures examining the Sexual Self-Control model, including reasons for consenting, sexual resourcefulness, and compliance with unwanted sex, as well as gender role measures pertaining to sexual script theory, including the sexual double standard, gender role stress, and virginity scripts. An exploratory analysis of serial indirect effects demonstrated that women scoring lower in sexual resourcefulness endorsed higher female gender role stress, which in turn was associated with higher endorsement of reasons for consent, translating into more frequent compliance with unwanted sexual activities. The relationship between one's ability to refuse and their decision to refuse appears quite complex. Understanding one's decision requires consideration of the social aspects of gender role endorsement.

The Relationship Between Body Image and Domains of Sexual Functioning Among Heterosexual, Emerging Adult Women.

INTRODUCTION: Research suggests that body image affects sexual functioning, but the relationship between specific types of body image (evaluative, affective, and behavioral) and domains of sexual functioning (desire, arousal, and orgasm) has not been investigated. AIM: To determine whether, and to what degree, body image concerns (evaluative, affective, and behavioral) influence aspects of women's sexual functioning (desire, arousal, and orgasm). METHODS: Eighty-eight sexually active women in heterosexual romantic relationships completed surveys assessing evaluative, affective, and behavioral body image and sexual functioning. Body composition data also were collected using dual energy x-ray absorptiometry. MAIN OUTCOME MEASURES: Sexual functioning was assessed using the desire, arousal, and orgasm subscales of the Female Sexual Functioning Index. RESULTS: Hierarchical multiple regression analysis indicated that poor evaluative, affective, and behavioral body image were detrimental to women's sexual functioning. Specifically, dissatisfaction with one's body predicted decrements in desire (ß = -0.31, P < .05) and arousal (ß = -0.35, P < .01). Similarly, feeling that others evaluate one's body negatively predicted decrements in desire (ß = 0.22, P < .05) and arousal (ß = 0.35, P < .01). Feeling negatively about one's appearance predicted decrements in arousal (ß = 0.26, P < .05). Negative thoughts and feelings about one's body during a sexual encounter (body image self-consciousness) predicted decrements in arousal (ß = -0.37, P < .01) and orgasm (ß = -0.25, P < .05). CONCLUSION: Findings from this study suggest important linkages between body image and sexual functioning constructs and indicates that interventions to improve body image could have concomitant benefits related to sexual experience.

Validation of the Sexual Communication Self-Efficacy Scale.

This study assessed a newly developed Sexual Communication Self-Efficacy Scale designed to measure the sexual communication self-efficacy of adolescent men and women. Three-hundred and seventy-four U.K. adolescents completed this new scale, along with several other validity measures. Factor analysis revealed that the Sexual Communication Self-Efficacy Scale consisted of five underlying factors: contraception communication, positive sexual messages, negative sexual messages, sexual history, and condom negotiation. These factors demonstrated high internal consistency and presents evidence to support construct validity. This scale may have utility in assessing the effectiveness of interventions designed to enhance sexual communication and sexual health behaviors among young people.