Dissociation and Sexual Concerns in Male Survivors of Childhood Sexual Abuse: The Role of Identity Cohesion.

Research on male survivors of childhood sexual abuse is notably deficient when it comes to addressing their sexual concerns, such as experiences of sexual distress, negative thoughts, and feelings related to their sexuality. Dissociation, a known consequence of childhood sexual abuse, could be associated with higher sexual concerns through identity cohesion. Precisely, dissociation can potentially be related to lower identity cohesion (e.g., not knowing what you want or need). In return, lower identity cohesion may be related to higher sexual concerns by impeding the capacity to know and accept oneself, which tends to promote a positive and healthy sexuality. This study aimed to examine the role of identity cohesion in the link between dissociation and sexual concerns in 105 men consulting for their history of childhood sexual abuse. Men completed questionnaires assessing dissociation, sexual concerns, and identity cohesion at admission in a community setting. Results of a path analysis revealed an indirect association between dissociation and higher sexual concerns through lower identity cohesion. The model explained 27.6% of the variance in sexual concerns. This study highlights the relevance of interventions targeting dissociative symptoms to improve identity cohesion and sexual health in male survivors of childhood sexual abuse.

Associations Between Pornography Use Frequency and Intimate Partner Violence Perpetration Among Young Adult Couples: A 2-Year Longitudinal Study.

Pornography use is a common sexual activity for many individuals including those in a romantic relationship. Some studies have shown that violent content depicted in pornography is a risk factor for perpetration of violence in real life. Even if most of these studies examined perpetration of violent behaviors in general, not specifically toward the intimate partner, some studies have shown that pornography use frequency is related to a greater perpetration of intimate partner violence (IPV), while other studies have found that it is not significantly related. However, most previous studies were cross-sectional, sampled individuals rather than couples, and did not include separately forms of IPV (e.g., physical, psychological, and sexual). The present study examined the associations between pornography use frequency and the perpetration of physical and psychological IPV, and sexual coercion among young adult couples. A convenience sample of 113 couples aged between 16 and 29 years old completed self-reported online questionnaires two times over a 2-year period. The results of autoregressive cross-lagged models showed that a person's pornography use frequency at Time 1 was related to their own higher sexual coercion perpetration 2 years later and that a person's sexual coercion perpetration was related to their partner's lower pornography use frequency 2 years later. However, no significant association between pornography use frequency and physical and psychological IPV emerged. In line with previous studies, our results suggest that pornography use represents an important risk factor for the perpetration of sexual coercion. Findings support the need to include education around pornography use in sexual violence prevention programs to avoid that young adults reproduce pornographic scripts in their sexuality.

Associations Between Contents of Pornography and Sexual Satisfaction and Function Among Young Adults.

Pornography offers a wide variety of sexual contents and has documented potential positive (e.g., higher sexual satisfaction) and negative associations (e.g., lower sexual function) with sexuality. The aims of this study were to describe the proportion of use of five different contents of pornography (i.e. group sex, passion and romance, gender-bending, taboo transgression and forbidden sex, power, control, and rough sex pornography), to examine gender-based differences in the frequency of use of these contents, and to examine the associations between the frequency of use of these contents and sexual satisfaction and function, considering potential differences among genders and individuals with and without a romantic or sexual partner, and controlling for frequency of masturbation. A sample of 827 young adults (503 women; Mage = 23.44) completed online self-report questionnaires. Results of path analysis indicated that, controlling for frequency of masturbation, the use of passion and romance pornography was associated with higher sexual satisfaction, whereas the use of power, control, and rough sex pornography was associated with lower sexual satisfaction. Cisgender men's use of power, control, and rough sex pornography was also associated with lower sexual function. These findings suggest different associations between pornography use and sexual satisfaction and function depending on the pornographic contents used.

Attachment as an intermediary variable between childhood maltreatment and perceived partner responsiveness in adolescents and young adults.

Cumulative childhood maltreatment (CCM) is associated with relationship difficulties including lower perceived partner responsiveness (PPR)-the degree of feeling cared for, understood, and validated by a person's partner. Attachment theory is understood via its representations of self and others and could offer a better understanding of how CCM effects continue into adulthood and affect PPR. We examined whether CCM is related to PPR via attachment in French-speaking adolescents and young adults. A sample of 427 individuals in a romantic relationship and another sample of 159 couples completed self-report measures. In both samples, a person's CCM was associated with their own lower PPR via their higher attachment anxiety and avoidance. In the dyadic sample, a person's CCM was associated with their partner's lower PPR via their own higher attachment anxiety. Attachment insecurities help understand the associations between CCM and PPR and may represent an important intervention target.

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).

Partner Effects of Childhood Maltreatment: A Systematic Review and Meta-Analysis.

Although several studies have shown that childhood maltreatment (CM) is associated with a host of negative consequences including romantic relationship difficulties for victims in adulthood, most overlooked the potential effects on the romantic partner. This systematic review and meta-analysis aims to comprehensively synthesize the literature on the association between a person's CM and their partner's individual and couple outcomes. We searched PubMed, PsycNET, Medline, CINAHL, and Eric using search strings related to CM and partner. We identified 3,238 articles after removal of duplicates; 28 studies met the inclusion criteria and relied on independent sample. The studies reported associations between a person's CM and a wide breadth of partner's negative couple outcomes (e.g., communication, sexuality) as well as intra-individual psychological difficulties (e.g., psychological distress, emotion, and stress reactivity). Meta-analytic results showed significant, but trivial to small associations between a person's CM and their partner's lower relationship satisfaction (r = -.09, 95% CI [-.14, -.04]), higher intimate partner violence (r = .08, [.05, .12]), and higher psychological distress (r = .11, [.06, .16]). These associations were similar for women and men and did not differ as a function of sample's mean age, proportion of cultural diversity, and publication year. These findings suggest that a person's CM is related to their partner's outcomes including to the partner's intra-individual outcomes. Prevention and intervention strategies should acknowledge that a person's CM may also affect their romantic partner, considering the couple as a reciprocal system, and offer victims' romantic partners specific services.

Is Sexual Aversion a Distinct Disorder or a Trans-Diagnostic Symptom across Sexual Dysfunctions? A Latent Class Analysis.

Sexual aversion disorder (SAD) is a chronic condition that impacts sexual and psychological well-being. However, the relevance of SAD as a discrete disorder remains highly debated. This study aimed to clarify the status of SAD as either a distinct disorder or a trans-diagnostic symptom shared among sexual dysfunctions. This cross-sectional study used a latent class analysis approach among a Canadian community sample (n = 1,363) to identify how patterns of SAD symptoms (i.e., sexual fear, disgust, and avoidance) emerge across different spheres of sexual functioning (i.e., desire and arousal, erection or lubrication, genito-pelvic pain, and orgasm) and examine sociodemographic and psychosexual correlates of the identified classes. Examination of fit indices suggested four classes: Sexually functional, Impaired desire and responsiveness, Sexual aversion, and Comorbid sexual dysfunctions. Sexual aversion class members were more likely to be single, had experienced sexual assault in adulthood, and report lower levels of sexual satisfaction and psychological well-being, compared to Sexually functional class members. Results suggest that SAD is a distinct clinical syndrome, while its symptoms may co-occur with other sexual dysfunctions. To ensure that the needs of people with SAD are met with tailored treatment options, future nosography might consider reclassifying SAD as a specific disorder.

Adolescents' Self Perceptions: Connecting Psychosocial Competencies to the Sexual Self-Concept.

Adolescence is a crucial period for the development of the sexual self-concept. While existing research shows that adolescents' sexual self-concept varies, few studies have examined its relation with psychosocial competencies such as the general self-concept, interpersonal skills, and self-control capacities. The objective of this study was to examine the association between dimensions of the sexual self-concept (sexual self- and body esteem, self-efficacy, and anxiety) and psychosocial competencies among Canadian adolescents. Self-reported data from 1584 adolescents aged between 14 and 18 years (49.7% girls) were analyzed using path analysis. Results show that adolescents whose general self-concept was characterized by more internally consistent self-beliefs and greater self-worth, and who perceived their interpersonal skills as more developed, displayed higher sexual self- and body esteem, higher sexual self-efficacy, and lower sexual anxiety. Self-control capacities were positively correlated with sexual body-esteem and negatively correlated with sexual anxiety. These associations were, however, minimal and, when significant, exhibited a counterintuitive relationship with the sexual self-concept in the path model. Age, gender and sexual experience did not moderate these associations. Findings from the study highlight the need to pursue research on the interface between sexuality and psychosocial functioning to increase current understanding of adolescent development.

Partner Knowledge of Solitary Pornography Use: Daily and Longitudinal Associations with Relationship Quality.

Pornography use is a common sexual activity engaged in mostly alone, including for partnered individuals. Evidence concerning the benefits and costs of solitary pornography use for romantic relationship quality is mixed and may vary depending on the circumstances of pornography use, including partner knowledge of one's solitary use. Adopting a dyadic daily diary and longitudinal design, we examined the associations between knowledge of a partner's solitary pornography use and one's own and the partner's relationship satisfaction and intimacy on the same day, and trajectories over one year. A convenience sample of 217 couples completed daily surveys over 35 days and self-reported measures three times over one year. Each participant reported if they used pornography today and whether their use was known by their partner. Findings showed that when an individual's solitary pornography use was unknown by their partner, they reported lower same-day relationship satisfaction and intimacy as well as a lower initial level of relationship satisfaction. When an individual's solitary pornography use was known, they reported higher intimacy over one year and their partner reported lower intimacy over one year. Findings underscore the complexity of the relational context surrounding solitary pornography use in couples, in particular the partner's knowledge of pornography use.

Mediators of change in cognitive-behavioral couple therapy for genito-pelvic pain: Results of a randomized clinical trial.

OBJECTIVE: A novel cognitive-behavioral couple therapy (CBCT) has shown efficacy for treating provoked vestibulodynia (PVD), the most common type of genito-pelvic pain, in comparison to topical lidocaine. However, mechanisms of therapeutic change have not been determined. We examined women's and partners' pain self-efficacy and pain catastrophizing as mediators of change in CBCT, using topical lidocaine as a control group. METHOD: 108 couples coping with PVD were randomized to 12-week CBCT or topical lidocaine and assessed at pre-treatment, post-treatment, and six-month follow-up. Dyadic mediation analyses were conducted. RESULTS: CBCT was not more effective in increasing pain self-efficacy than topical lidocaine, so this mediator was discarded. In women, decreases in pain catastrophizing at post-treatment mediated improvement in pain intensity, sexual distress, and sexual function. In partners, decreases in pain catastrophizing at post-treatment mediated improvement in sexual function. Partners' decreases in pain catastrophizing also mediated reductions in women's sexual distress. CONCLUSIONS: Pain catastrophizing may be a mediator specific to CBCT for PVD, explaining improvements in pain and sexuality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Stressed and distressed: how is the COVID-19 pandemic associated with sexual frequency, sexual satisfaction, and relationship satisfaction?

BACKGROUND: The Canadian government's response to the ongoing COVID-19 pandemic included the implementation of several restrictive measures since March 2020. These actions sought to decrease social contact and increase physical distancing, including that within universities. Such constraints were required to impede the transmission of the virus; however, concerns remain about their impact on the sexual and intimate relationships of university employees and students. AIM: This study examined the associations between COVID-19-related stress and sexual frequency, sexual satisfaction, and relationship satisfaction, also testing the mediating role of psychological distress. METHODS: The models were tested with Canadian data collected from university employees and students in 2 phases: the first wave in April-May 2020 (T1; n = 2754) and the second wave in November-December 2021 (T2; n = 1430), 18 months afterward. Participants completed self-report questionnaires online. Path analyses were performed to test the associations of the mediation models. OUTCOMES: The principal outcomes included psychological distress determined via the Patient Health Questionnaire-4, relationship satisfaction measured via the Dyadic Adjustment Scale, and sexual satisfaction and sexual frequency ascertained through a single item each. RESULTS: Overall, COVID-19-related stress was associated with higher psychological distress, which in turn was related to lower sexual frequency, sexual satisfaction, and relationship satisfaction. Similar results were obtained with T1 and T2 data, indicating the mediating effect of psychological distress. CLINICAL IMPLICATIONS: These findings increase scholarly comprehension of the negative associations between stress/distress and sexual and romantic relationships. Sexuality and close relationships are vital to the quality of human life; thus, targeted interventions should be developed to reduce COVID-19-related stress and its impact on sexual and romantic relationships to mitigate the long-term influences of this unique global challenge. STRENGTHS AND LIMITATIONS: To our knowledge, this study is the first to use a large sample size and replicate findings in 2 waves. Nonetheless, it is limited by the use of cross-sectional data. Longitudinal studies with the same participants are mandated to better understand the evolution of these outcomes. CONCLUSION: COVID-19-related stress and psychological distress were found among participating university students and employees and were associated with lower sexual satisfaction, sexual frequency, and intimate relationship satisfaction. These results were observed at the early onset of the pandemic and 18 months afterward, suggesting that the stress generated by the pandemic were not mere reactions to the onset of the pandemic but persisted over time.

Social Reactions to Disclosure of Sexual Violence in Adulthood and Women's Sexuality: The Mediating Role of Shame and Guilt.

This study examined the mediating role of emotions related to sexual violence in adulthood in the associations between social reactions to sexual violence disclosure and sexual outcomes. Self-reported data were collected from 324 women reporting sexual violence and path analyses were conducted among the 264 women (81.5%) who disclosed their most recent sexual violence experience. Results showed that emotional support was associated with higher sexual satisfaction. Victim blame was associated with greater guilt related to the sexual violence, which, in turn, was associated with higher sexual compulsivity. Stigmatization was associated with greater shame related to the sexual violence, which, in turn, was associated with higher sexual distress and avoidance, and lower sexual satisfaction and function. Our findings highlight the importance of social reactions to sexual violence disclosure in women's sexuality.

Associations between Conflict Negotiation Strategies, Sexual Comfort, and Sexual Satisfaction in Adolescent Romantic Relationships.

Achieving healthy and satisfying sexual relationships is a major developmental task in adolescence, but factors promoting sexual satisfaction among adolescent romantic relationships remain underexplored. Since sexuality is shaped by relational experiences, strategies mobilized to negotiate conflicts in romantic relationships could be related to sexual satisfaction through comfort in negotiating sexual experiences. Sexual comfort refers to the ease of discussing sexuality, and feeling comfortable with one's own sexual life and with others' sexual behaviors. This cross-sectional dyadic study examined the mediating role of sexual comfort in the associations between perceived conflict negotiation strategies and sexual satisfaction among adolescent romantic dyads. The actor-partner interdependence model guided the analyses of self-reported questionnaires from 104 mixed- and same-sex dyads (Mage = 18.99 years, SD = 1.51). An adolescent's higher compromise and lower submission were related to their own higher sexual satisfaction via their own higher sexual comfort. The results also revealed a direct association between an adolescent's higher domination and their own lower sexual satisfaction. These findings underscore the importance of considering conflict negotiation strategies and sexual comfort as key factors related to adolescents' sexual satisfaction.

Maltreatment in Childhood and Perceived Partner Responsiveness in Adult Romantic Relationships: A Dyadic Daily Diary and Longitudinal Study.

This study examined the associations between childhood maltreatment (CM) and the mean-level of perceived partner responsiveness (PPR; the extent to which individuals feel cared for, understood, and validated by their partner) over 35 days, the day-to-day variability in PPR, and the initial levels and trajectories of PPR over 1 year in community couples. Both members of 228 couples completed a self-reported measure of CM and provided daily reports of PPR over 35 days and retrospective reports of PPR at three time points over 1 year. A person's greater CM was related to a lower mean level of PPR over 35 days and to a lower initial level of their own PPR. A person's sexual abuse, physical neglect, and emotional neglect had an effect over and above other forms of CM in these associations. A person's greater CM was also related to higher day-to-day variability in their own and their partner's PPR, and a person's greater emotional neglect was associated with a sharper decrease over time in their own PPR. These findings provide a more fine-grained understanding of how CM may affect the perceptions of being cared about, accepted, and validated by a partner on a daily basis and over time.

Child Maltreatment and Couples' Sexual Health: A Systematic Review.

INTRODUCTION: Childhood maltreatment (CM) is an interpersonal trauma reported by 35% to 40% of individuals in population-based studies in North America. It refers to physical, sexual, and emotional abuse, as well as physical and emotional neglect. Although there is a growing body of cross-sectional work focusing on associations between CM and sexual health, most studies have ignored the broader relationship context in which sexuality is experienced. OBJECTIVES: The current review sought to systematically and critically appraise all studies that reported on the association between CM and couples' sexual health, to inform clinical care and recommendations for research. METHODS: The electronic literature search was conducted using PubMed, PsycNET (PsycINFO, PsychArticles), Medline, CINAHL, and Eric for peer-reviewed journal articles published before September 2021. Eligible studies had to report on the association between any form of CM and any dimension of sexual health in couples or individuals in a romantic relationship. RESULTS: In total, 13 studies (18 articles) were included in this systematic review: 4 studies pertained to clinical couples and 9, to community couples; 2 studies used a longitudinal design and 11, a cross-sectional design; 3 studies examined CM as a whole, 2 studies examined multiple subtypes of CM separately, 1 study examined both CM as a whole and its subtypes separately, whereas the other 7 studies focused on childhood sexual abuse. Results indicated that studies using valid measures of sexual health outcomes found significant associations between CM and worse outcomes - including declines over time - in both clinical and community samples. Mediators and moderators of these associations were also identified. CONCLUSIONS: Findings provide preliminary support for the role of CM in couples' sexual health. There is a need for future longitudinal studies involving both members of the couple, valid and multidimensional measures of sexual health, and potential mediators and moderators. Bergeron S, Bigras N, Vaillancourt-Morel M-P. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022;10:567-582.

Will you be happy for me? Associations between self-reported, perceived, and observed responses to positive events and sexual well-being in cohabiting couples.

Whereas greater levels of intimacy have been shown to promote couples' sexual well-being, recent theories suggest that satisfying sex is maintained via the capacity to encourage the partner's individuality, while remaining intimately connected. Responses to capitalization attempts (i.e., the disclosure of a positive personal event) provide an opportunity to strengthen both the couple's intimacy and each partner's autonomy. Although responses to capitalization attempts are linked to couples' greater relationship adjustment, very little is known about their relation to couples' sexual well-being. The aim of this study was to examine the associations between self-reported, perceived, and observed responses to capitalization attempts and sexual satisfaction, sexual distress, and sexual function in 151 cohabiting couples who participated in a filmed discussion in the laboratory. They also completed self-report questionnaires pertaining to their responsiveness and to that of the partner during the discussion, as well as their sexual well-being. Results indicated that one's higher levels of self-reported and partner-perceived active-constructive responses (enthusiasm/elaboration) during the discussion were associated with one's own greater sexual satisfaction. Higher levels of perceived passive-constructive responses (quiet but interested) from one's partner were associated with one's own lower sexual satisfaction, and one's higher levels of self-reported and perceived passive-destructive responses (lack of interest/self-focus) were associated with one's own greater sexual distress. Finally, higher levels of observed active-destructive responses (undermines/denies the positive nature of the event) were associated with one's own lower sexual function, while in women, they were associated with their lower sexual satisfaction. Findings contribute to a growing body of literature underscoring the importance of intimacy for sexual well-being in long-term relationships.

Sexual communication mediates cognitive-behavioral couple therapy outcomes: A randomized clinical trial for provoked vestibulodynia.

Provoked vestibulodynia (PVD) is a chronic vulvovaginal pain condition affecting 8%-10% of women and is associated with negative sexual sequalae. Our randomized clinical trial comparing cognitive-behavioral couple therapy (CBCT) to a medical intervention (lidocaine) found that both treatments improved affected women's pain and both affected women's and partners' sexual outcomes, with CBCT demonstrating more benefits (Bergeron et al., 2021). The goal of this study was to examine two putative mediators of CBCT's treatment effects: collaborative and negative sexual communication patterns (SCPs). Women with PVD and their partners were randomly assigned to 12 weeks of CBCT (N = 53) or lidocaine (N = 55). Outcome measures (sexual satisfaction, function, and distress) were collected at pre-treatment, post-treatment, and 6-month follow-up, and in-treatment measures of the mediators were taken at Weeks 1, 4, 8, and 12 of treatment. Results showed that affected women's reports of improving collaborative communication mediated the effect of CBCT, but not lidocaine, on post-treatment sexual satisfaction (women with PVD and partners), sexual function (women with PVD), and sexual distress (women with PVD). For partners, collaborative communication improved equally in both treatments. Given that there were no differences in negative SCPs between the CBCT and lidocaine conditions, it was not possible to examine negative communication as a potential mediator. From the perspective of women with PVD, CBCT helped couples communicate about their sexual problems in more collaborative ways, which was in turn beneficial for improving the sexual well-being of both members of the couple. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Longitudinal Study of Adolescents' Pornography Use Frequency, Motivations, and Problematic Use Before and During the COVID-19 Pandemic.

Since the beginning of the COVID-19 pandemic, an increase in pornography use has been reported based on cross-sectional findings, raising concerns about associated adverse outcomes, such as problematic pornography use (PPU). The aims of the present study were to document potential changes in adolescents' pornography use frequency, motivations, and PPU before and during the COVID-19 pandemic. As part of an ongoing study on adolescents' sexual health, we used a large sample (NTime 1 = 1771; 47.6% girls, Mage = 15.42 years, SD = 0.59) to examine changes from baseline (before the COVID-19 pandemic) to one year later (during the COVID-19 pandemic) in adolescents' self-reported pornography use frequency, motivations, and PPU, using latent change models and examining potential gender differences. No significant changes were observed in adolescents' pornography use frequency and pornography use motivations, and no gender differences were present in these trends. Although statistically significant, slight decrease was observed in boys' PPU levels, and a statistically significant, slight increase was observed in girls' PPU levels, these changes were very small, providing no practical or clinical relevance. In sum, despite previous propositions, concerns, and cross-sectional findings, longitudinal results suggest that adolescents' pornography use characteristics were rather stable between November 2019 and June 2021, and the COVID-19 pandemic and related lockdowns might not have led to general increases in adolescents' pornography use as it was expected.

Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia.

BACKGROUND: Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD. AIM: The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality. METHODS: One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up. OUTCOMES: (1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index. RESULTS: Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition. CLINICAL IMPLICATIONS: Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress. STRENGTHS & LIMITATIONS: Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties. CONCLUSION: Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity. V Charbonneau-Lefebvre, M-P Vaillancourt-Morel, NO Rosen, et al. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022;19:479-495.

A latent profile analysis of romantic attachment anxiety and avoidance.

We conducted latent profile analyses on community (n = 1663) and clinical (n = 575) samples to determine whether continuous scores of attachment anxiety and avoidance would lead to the identification of theoretically consistent and clinically useful profiles. We then compared these profiles according to gender, relationship status, psychological distress, and relationship satisfaction. Analysis on the community sample yielded four profiles: secure, preoccupied, dismissive, and fearful individuals; whereas, the clinical sample yielded three profiles: secure, preoccupied, and fearful individuals. In the community sample, there was a higher proportion of women under the preoccupied profile and a higher proportion of men under the dismissive profile compared with the other profiles. Overall, insecure individuals reported higher levels of relationship dissatisfaction and psychological distress, and a relationship status reflecting lower commitment. Our findings suggest that the Experiences in Close Relationships scale could be useful in assisting therapists in conceptualizing their cases according to their patients' attachment profile.