Do Sex Toys Make Me Satisfied? The Use of Sex Toys in Denmark, Norway, Sweden, Finland, France, and the UK.

Sex toys are easily accessible in many countries in the Western world. Yet, cross-country studies on sex toy ownership and use and their association with relationship, sexual, and life satisfaction are rare. Using a cross-country convenience sample of 11,944 respondents from six European countries (Denmark, Sweden, Norway, Finland, France, UK), we investigated the rate and factors linked to sex toy ownership and use and their associations with sexual, relationship, and life satisfaction. Data were collected in May and June 2022 through respondent panels by Cint, a market research software platform. Participants received an e-mail invitation for the study and completed an online self-report survey. We found that more than half of respondents owned or had owned a sex toy, with the most common sex toys owned being dildos and vibrators, followed by handcuffs, penis rings, and anal sex toys. Across countries, the majority of sex toy owners reporting using these either alone or with a steady partner (55-65%) and a minority with casual partners (10-15%). Controlling for socio-demographics, parental status, sexual orientation, number of sex partners, and relationship status and length, we found that sex toy ownership and use were significantly associated with higher sexual and life satisfaction, while higher relationship satisfaction was only significantly associated with currently owning a sex toy (but not number of sex toys) and frequency of use with a partner (but not alone). Across results, we generally found little cross-country variation.

Using Pornography, Paying for Sex, and Violence: A Danish National Survey Study.

Only a few national cohort studies on using online pornography and buying sex have been published. The overall aim of this study, which analyzed data from a representative Danish national survey, was to provide an overview of incidence and associated population characteristics. The key aims were: first, to analyze frequencies of using online pornography and buying sex stratified by gender and other background characteristics; and, second, to investigate if and how using online pornography and buying sex were associated with sexual satisfaction, sexual activity, and violence. The findings revealed that having ever paid for sex and higher use of pornography were each associated with being male, younger, and not being in a relationship. Further, among men, having ever paid for sex and higher use of pornography were associated with not being sexually satisfied and, in part of the analysis, having committed violence to another person in the last year; however, these particular relationships were not statistically significant in the appropriately controlled regression analysis. We discuss gender, age, sexual aggression, and sexual satisfaction as factors associated with higher pornography use and buying sex.

Symptoms of anxiety and depression in Denmark during the first year of the COVID-19 pandemic: A two-wave matched-control study.

Subsequent to the restriction measures taken to curb the COVID-19 infection rate, researchers theorized these would have detrimental mental health consequences. This two-wave matched-control study investigates depression and anxiety symptoms during the first 12 months of the pandemic (March 2020-March 2021) in Denmark with data from the I-SHARE and Project SEXUS studies. The I-SHARE study includes 1,302 (Time period 1 only n = 914, Time period 2 only n = 304, both time periods 1 and2 n = 84) Danish participants, and the sex and birth year-matched control participants from the Project SEXUS study comprise 9,980 Danes. During the first year of the pandemic, the study populations' anxiety and depression symptom mean levels did not significantly differ from pre-pandemic matched controls. Younger age, female gender, fewer children in the same household (depression only), lower education level, and not being in a relationship (depression only) were associated with increased anxiety and depression symptom scores. The key COVID-19-related variable linked with significantly higher anxiety and depression symptom scores was COVID-19-related loss of income. Contrary to initial concerns, we did not find a significant effect of the pandemic on anxiety and depression symptom scores. However, the results underscore the importance of structural resources to prevent income loss to safeguard mental health during crises such as a pandemic.

Temporal Associations Between Depression and Hostility in the Context of a Divorce Intervention.

Divorce interventions have been found to be effective in reducing negative outcomes for newly divorced people, including depression and hostility. Typically, divorce interventions cover a variety of issues that may influence people's level of depression and hostility. However, it is unclear whether the interventions differentially affect the outcomes. That is, it may be that intervention participation leads to a reduction in depression, which is associated with a prospective reduction in hostility-or vice versa. The current study used a sample of 1,856 recently divorced Danes, who completed questionnaires at baseline, 3-, 6-, and 12-month post-divorce. Structural equation modeling revealed that while depression and hostility were concurrently associated, there were no prospective associations, except for baseline depression predicting 3-month hostility. Moreover, the associations did not differ by gender. The results suggest that the intervention content may have influenced both depression and hostility. These findings may be useful in guiding future divorce intervention developments.

Mental health trajectories after juridical divorce: Does personality matter?

INTRODUCTION: This study investigated whether the Big Five personality dimensions were associated with mental health trajectories and/or intervention effects of a digital divorce intervention from juridical divorce to 12 months following juridical divorce. The study utilized a randomized controlled trial study design (N = 676) and measured mental health outcomes (anxiety, depression, somatization, and stress) at study inclusion (i.e., at juridical divorce) and 3-, 6-, and 12 months after juridical divorce. Big Five personality dimensions were measured 1 month post study inclusion. RESULTS: The study found that neuroticism is the personality dimension most predictive of post-divorce mental health outcomes. Specifically, divorcees with higher neuroticism scores indicated worse mental health immediately following divorce, but their symptom levels decreased more rapidly over a 12 months period after juridical divorce compared with lower neuroticism divorcees. It is also notable that their mean scores for the mental health outcomes remained higher at all time points (3, 6, and 12 months post baseline), relative to those lower in neuroticism. CONCLUSION: Findings are discussed in light of divorce-adjustment-theory and the stress-buffering model.

The "In It Together" digital intervention to treat distress among older adults with sensory loss and their spouses: Study protocol for a randomized controlled trial study.

Sensory impairment is common in older age and may be associated with intra- and interpersonal struggles. Treatment and intervention efforts may be hampered by functional difficulties or unwillingness to receive face-to-face mental health services. The current study seeks to assess the efficacy of an online psychological intervention for older adults with sensory loss and their spouses in Denmark, using a two-arm, parallel-group, randomized controlled trial study design. Participants will be randomly assigned to the intervention group or waiting list control group. The intervention consists of four digital, sequential modules that contain psychoeducation and Acceptance and Commitment Therapy inspired therapeutic activities. Individuals will be assessed at baseline, 6 weeks, and 10 weeks post-baseline, and for the intervention group only, at 18-weeks. The outcomes are well-being (primary), relationship satisfaction (secondary), and depressive symptoms (tertiary). The data will be analyzed using multilevel modeling to account for non-independence of data (nesting within participant and within couple). This is the first randomized controlled trial study of an online psychological intervention for older adults with sensory loss and their spouses and it will provide valuable knowledge regarding whether internet-delivered intervention is effective for this population group.

The future of divorce support: Is "digital" enough in presence of conflict?

Divorce conflict is the main driver of adverse postdivorce health adjustments among divorcing families. Despite the growing potential of online divorce support programs, there is concern that such solutions might not be sufficient to impact health-related disparities among high-conflict divorcees. The present study examined the effectiveness of the digital "Cooperation after Divorce" intervention as a function of conflict among 1856 recently divorced Danish residents. Linear mixed-effect regression modeling suggested that, although higher levels of divorce conflict at judicial divorce predicted worse health outcomes up to 1 year following divorce, the effectiveness of the digital divorce intervention did not vary as a function of the initial level of divorce conflict. Individuals in the intervention group with higher conflict in divorce still reported worse health at 12 months follow-up than those with lower levels of divorce conflict; however, much lower than the control group.

Anxiety, depression and associated factors among recently divorced individuals.

BACKGROUND: In divorce research, studies using large samples, very recently divorced individuals and validated measures of depression and anxiety with available background populations for comparison are missing. AIMS: This study aimed to investigate symptoms of depression and anxiety among recently divorced Danes and assess the explanatory power of relevant sociodemographic- and divorce-related variables on these symptoms. METHODS: The study utilized an online cross-sectional design and a total of 1856 Danish citizens recruited through the Danish State Administration. Average scores for depression and anxiety were compared to the Danish background population and regression analyses were conducted to assess the explanatory power of sociodemographic- and divorce characteristics on symptoms of depression and anxiety. RESULTS: Divorcees reported significantly higher levels of both depressive and anxiety symptoms than the background population with a large proportion of the sample scoring equal to or higher than generally recommended cut-off values for risk of suffering from a psychiatric diagnosable case of depression or anxiety. Both sociodemographic- and divorce characteristics were predictive of symptoms of depression and anxiety. CONCLUSION: The findings underline the relevance of public health intervention targeting symptoms of depression and anxiety among recently divorced individuals.

Examining gender effects in postdivorce adjustment trajectories over the first year after divorce in Denmark.

Research into gender and postdivorce mental and physical health has been highly inconsistent. The Gender Similarities Hypothesis suggests there are more similarities than differences and the Divorce Stress Adjustment Perspective suggests that structural inequalities may contribute to adverse postdivorce outcomes. We conducted secondary analyses from an RCT study to investigate if there were gender-specific trajectories and whether gender was associated with outcomes (self-perceived stress, symptoms of anxiety, depression, and somatization, general hostility, and overall mental and physical health) after controlling for effects of the intervention, income, and number of children using linear mixed-effect regression modeling, and whether number of children and income influenced these outcomes. Participants were 1,239 women and 617 men from the Cooperation after Divorce (CAD) study, conducted in Denmark, a country with less income disparity, high gender equality, shared childrearing by men and women, and societal acceptance of divorce. The analyses assessing the relationship between gender and 12-month postdivorce adjustment in terms of physical and mental health outcomes revealed that for self-perceived stress, symptoms of anxiety, depression, and somatization, hostility, and overall mental and physical health in this sample postdivorce adjustment trajectories were not gender-specific, and gender was only significantly associated with stress and somatization as a time-invariant additive effect. These findings suggest gender similarities in postdivorce adjustment and contribute to the Gender Similarities Hypothesis and the Divorce-Stress-Adjustment-Perspective by assessing individuals' postdivorce adjustment in a low-stigma and relatively egalitarian setting, providing a clearer assessment of the role of gender without potentially confounding issues of structural inequalities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

BDSM: Does it Hurt or Help Sexual Satisfaction, Relationship Satisfaction, and Relationship Closeness?

This national web-population study from Norway (N = 4,148) assessed 1) the prevalence of BDSM and role-play interests and behaviors, 2) the socio-demographic characteristics of the BDSM-oriented participants, and 3) the associations between a) BDSM and b) role-play interests and behaviors, and sexual satisfaction, relationship satisfaction, and relationship closeness. Over one in three study participants endorsed at least one BDSM interest or behavior variable. There were no gender nor educational level differences between the BDSM-oriented participants and their traditional "vanilla" (non-BDSM-oriented) counterparts, though BDSM and interests were more common among younger and self-identified LGBQ+ participants. Sexual satisfaction was positively associated with role-play and BDSM behaviors while interest in role-play (but not having previously engaged in it) was negatively associated with this outcome. Lower relationship closeness was associated with an interest in role-play (but not having tried it). No BDSM-related variables were significantly associated with relationship closeness. The findings suggest that BDSM interests and behaviors are relatively common and are linked with sexual and relationship satisfaction.

Prevalence of Masturbation and Associated Factors Among Older Adults in Four European Countries.

Solitary sexual activity is a free, safe, and accessible way to experience sexual pleasure. Despite these advantages, research on masturbation in later life is highly understudied. Using data from a cross-sectional probability-based survey of 3816 European adults (mean age 67 years; range 60-75 years), we explored several sociodemographic, health, attitudinal, and sexual behavioral factors associated with reported masturbation frequency. Across all countries, between 41% and 65% of men and 27% and 40% of women reported any masturbation in the preceding month. Satisfaction with sexual activity and attitudes related to disapproval of sex without love were significant predictors of reported masturbation in almost all countries and in both genders. Age, education, self-perceived health, and depression were for the most part predictive of men's reported masturbation, but not women's. Generally, those believing sex is beneficial to older people were more likely to masturbate, while less permissive attitudes decreased the likelihood of reporting masturbation. To improve healthy sexual aging, misinformation about masturbation and sexual attitudes in older people need to be addressed.

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress.

INTRODUCTION: Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction. AIM: This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction. METHODS: A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey. OUTCOMES: Participants reported on their experience of five different sexual problems and associated level of distress. RESULTS: We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations. CLINICAL TRANSLATION: These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment. STRENGTHS AND LIMITATIONS: Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales. CONCLUSION: The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;18:1532-1544.

Self-Assessed Effects of Pornography Use on Personal Sex Life: Results from a Large-Scale Study of Norwegian Adults.

Objectives: The study explored characteristics associated with the self-assessed effects of pornography use on one's personal sex life. Methods: Data were collected in a probability-based sample of Norwegian adults (n = 4,160). Results: Most participants (41.3%) did not believe that pornography affected their sex life. More participants reported positive (33.2%) than mixed/negative (25.5%) effects of pornography use. Sociodemographic and sexual characteristics that predicted these self-assessments were examined. Among participants in a steady relationship, emotional intimacy and relationship satisfaction were unrelated to the self-assessed effects. Conclusions: The current study findings add to scant literature about the self-assessed effects of pornography usage.

When Love Hurts - Mental and Physical Health Among Recently Divorced Danes.

The last decades of research have consistently found strong associations between divorce and adverse health outcomes among adults. However, limitations of a majority of this research include (a) lack of "real-time" research, i.e., research employing data collected very shortly after juridical divorce where little or no separation periods have been effectuated, (b) research employing thoroughly validated and population-normed measures against which study results can be compared, and (c) research including a comprehensive array of previously researched sociodemographic- and divorce-related variables. The current cross-sectional study, including 1,856 recently divorced Danes, was designed to bridge these important gaps in the literature. Mental and physical health were measured using the Short Form 36 (SF-36)-2. Analyses included correlational analyses, t-test comparisons, and hierarchical multiple regression analyses. The study found that the health-related quality of life of Danish divorcees was significantly worse than the comparative background population immediately following divorce. Across gender, higher levels of divorce conflict were found to predict worse mental health, and worse physical health for women, even when controlling for other socio-demographic variables and divorce characteristics. Among men, lower age and higher income predicted better physical health, while more children, more previous divorces, participant divorce initiation, new partner status, and lower levels of divorce conflict predicted better mental health. Among women, higher income, fewer previous divorces, new partner status, and lower levels of divorce conflict predicted better physical health while higher income, participant divorce initiation, new partner status, and lower levels of divorce conflict predicted better mental health. The findings underscore the relevance of providing assistance to divorcees who experience higher levels of divorce conflict immediately following divorce, in seeking to reduce potential long-term negative health effects of divorce.

A Randomised Controlled Trial Study of the Effects of a Digital Divorce Platform on Mental and Physical Health.

BACKGROUND: Two decades of divorce research has consistently documented adverse mental and physical health effects of divorce. Responding to calls for evidence-based online divorce interventions, this study tests effects of the "Cooperation after Divorce" (CAD) digital intervention platform on divorcees' mental and physical health. METHODS: Randomised control trial 12-month longitudinal study using a sample of 1,856 newly divorced Danes. Mental and physical health were measured using the SF-36 at baseline and 3, 6, and 12 months from baseline. Intervention effects were investigated using linear mixed effect models and Cohen's (d) for effect sizes. RESULTS: The study found significant treatment effects of the CAD intervention on mental and physical health. These effects were evident across all eight health domains constituting the mental and physical health components. The study also found that the intervention group had significantly better mental health than the control group at subsequent 6- and 12-month assessments from baseline while for physical health, the intervention group had significantly better physical health at the 6-month assessment from baseline only. CONCLUSION: The results indicate that digital solutions allowing for individually tailored user experiences may hold great potential in reducing well-known adverse health effects of divorce. PRACTITIONER'S POINTS: The study finds highly significant treatment effects of the "CAD" digital divorce intervention on mental and physical health indicating that online interventions may be successfully integrated into help offered to divorcees post-divorce.

Seeking help for sexual difficulties: findings from a study with older adults in four European countries.

Sexual well-being is an important part of life for many people aged 60 and older. However, older adults often face barriers to seeking and receiving help for sexual difficulties. This study used data from a probability survey (n = 3820) on sexuality and ageing to examine help-seeking in 60-75-year-olds in Norway, Denmark, Belgium, and Portugal. More men (12.2%) than women (6.8%) had sought professional help for a sexual difficulty in the past 5 years. The main reason for help-seeking was that sex was important to the participant and/or their relationship. The main source of professional help was the primary care physician. Of those who had sought professional help, 48% were satisfied or very satisfied with the help received, 31.6% were neither satisfied nor dissatisfied, and 20.4% were dissatisfied or very dissatisfied. Others had sought help from informal sources, particularly partners, friends, or websites. The main reasons for not seeking professional help included not being distressed by the symptoms, and thinking that the difficulty would clear up on its own. Multivariable regression analysis revealed that significant correlates of seeking professional help for women and men were level of distress about the sexual difficulty. With regard to women, those who were married, and/or from Portugal were more likely to have sought help. And regarding men, those who attended religious services were more likely to have sought professional help. These results have important implications for healthcare and can be used to inform the development and delivery of services for older adults who experience sexual difficulties.

The role of body image in sexual satisfaction among partnered older adults: a population-based study in four European countries.

Body image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60-75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further.

Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal.

There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.

"Divorce burnout" among recently divorced individuals.

Traditionally, the concept of burnout has been applied to the workspace but recent research suggests its applicability to more general contexts such as the family sphere. The present study applies burnout to the divorce context and (a) proposes and statistically tests the Divorce Burnout Model (DBM), (b) investigates the contribution of sociodemographic variables and divorce characteristics to burnout scores, and (c) investigates the relationship between burnout scores and the number of sick days and days of absence from work. Using a cross-sectional design and a sample of 1,856 recently divorced Danish citizens, multigroup confirmatory factor analysis verified the DBM´s good fit to data. Using this model, for men, it was found that fewer previous divorces, former spouse initiation of divorce, not having a new partner and a higher degree of conflict significantly predicted higher levels of divorce burnout. For women, lower income, former spouse divorce initiation, not having a new partner, and a higher level of conflict significantly predicted higher levels of divorce burnout. Across gender, burnout scores were found to significantly predict number of sick days and days of absence from work in the past 3 months over and above sociodemographic variables, divorce related characteristics, and depressive symptoms.

Randomized controlled trial study of the effects of an online divorce platform on anxiety, depression, and somatization.

Divorce is associated with a range of negative psychological consequences, including increased symptoms of anxiety, depression, and somatization. The current study presents the results of a 1-year longitudinal randomized controlled trial study of the Cooperation After Divorce online intervention platform for adults going through a divorce. Participants included 1,856 Danish divorcees who, on average, began the intervention within 1 week of legal divorce and responded to the Symptom Checklist-90-Revised anxiety, depression, and somatization subscales at baseline, 3, 6, and 12 months after juridical divorce. Data analyses consisted of linear mixed-effect model analyses, mean group comparisons, and 1-sample t tests to compare the 12-month follow-up with national normative data. The study found that the intervention platform significantly reduced anxious, depressive, and somatization symptoms among divorcees in the intervention group over a 1-year period and that the magnitude of these effects was large in effect size (Cohen's d > .78). Further, it was found that at 1 year after divorce, symptom levels of all 3 outcomes were close to the population norms for participants in the intervention group but still considerably elevated for participants in the control group. The findings suggest that online intervention platforms may be effective in reducing adverse mental health related effects of divorce and thereby offer long-term human and public health benefits. (PsycInfo Database Record (c) 2020 APA, all rights reserved).