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Abstract available in the Annals of Behavioral Medicine.

Introduction: Over 74,000 US women are diagnosed annually with endometrial or cervical cancers and experience significant treatment-related difficulties with body image, sexuality, and sexuality. The aims of the research were to examine relationships among body image, sexuality, and sexual functioning, and understand women’s views of these concepts. A novel theoretical framework encompassing these three concepts and contextual variables guided the research. Methods: A non-experimental cross-sectional pilot study was conducted with pre-menopausal women in an academic medical center who had stages I-III cervical or endometrial cancer, were 3-36 months post-treatment, and had no mental health diagnoses. Participants completed the Body Image Scale, Female Sexual Function Index, Female Sexuality Questionnaire, a demographic questionnaire, and open-ended questions and the researchers collected clinical data from the medical record. Results: Twenty women participated, and most reported disruption in body image, sexuality, and sexual functioning. Significant relationships were found between body image and sexuality (p = 0.0244) and sexuality and sexual functioning (p <0.0003). Stages II-III disease were significantly (p= 0.0371) associated with worse body image. Women reported issues with body image, sexuality, sexual functioning, psychosocial areas, reproduction, and communication with healthcare providers and personal caregivers. Discussion: This study is one of the first to examine relationships among body image, sexuality, and sexual functioning simultaneously, highlighting the importance of this approach. Despite design and sample limitations, results demonstrate a need for longitudinal studies using larger samples to further examine relationships among these concepts and selected contextual variables, explore communication issues, and refine the theoretical framework.

According to Barlow’s model of sexual dysfunction (1986; Sbrocco & Barlow, 1996), anxiety in sexual situations leads to attentional focus on sexual performance at the expense of erotic cues, which compromises sexual arousal. This negative experience will enhance anxiety in future sexual situations, and non-erotic thoughts (NETs) relevant to performance will receive attentional priority. Previous research with student samples (Purdon & Holdaway, 2006; Purdon & Watson, 2009) has found that people experience many types of NETs in addition to performance-relevant thoughts, and that, consistent with Barlow’s model, the frequency of and anxiety evoked by these thoughts is negatively associated with sexual functioning. Extending this previous work, the current study found that in a community sample of women (N= 81) and men (N= 72) in long-term relationships women were more likely to report body image concerns and external consequences of the sexual activity, while men were more likely to report performance-related concerns. Equally likely among men and women were thoughts regarding the emotional consequences of the sexual activity. Regardless of thought content, experiencing more frequent NETs was associated with more sexual problems in both women and men. Moreover, as per Barlow’s model, greater negative affect in anticipation of and during sexual activity predicted greater frequency of NETs and greater anxiety during sex was associated with greater difficulty dismissing the thoughts. However, greater difficulty in refocusing on erotic thoughts during sexual activity uniquely predicted more sexual problems above the frequency and dismissability of NETs. Together these data support the cognitive interference mechanism implicated by Barlow’s causal model of sexual dysfunction and have implications for the treatment of sexual problems.

According to Barlow’s model of sexual dysfunction (1986; Sbrocco & Barlow, 1996), anxiety in sexual situations leads to attentional focus on sexual performance at the expense of erotic cues, which compromises sexual arousal. This negative experience will enhance anxiety in future sexual situations, and non-erotic thoughts (NETs) relevant to performance will receive attentional priority. Previous research with student samples (Purdon & Holdaway, 2006; Purdon & Watson, 2009) has found that people experience many types of NETs in addition to performance-relevant thoughts, and that, consistent with Barlow’s model, the frequency of and anxiety evoked by these thoughts is negatively associated with sexual functioning. Extending this previous work, the current study found that in a community sample of women (N= 81) and men (N= 72) in long-term relationships women were more likely to report body image concerns and external consequences of the sexual activity, while men were more likely to report performance-related concerns. Equally likely among men and women were thoughts regarding the emotional consequences of the sexual activity. Regardless of thought content, experiencing more frequent NETs was associated with more sexual problems in both women and men. Moreover, as per Barlow’s model, greater negative affect in anticipation of and during sexual activity predicted greater frequency of NETs and greater anxiety during sex was associated with greater difficulty dismissing the thoughts. However, greater difficulty in refocusing on erotic thoughts during sexual activity uniquely predicted more sexual problems above the frequency and dismissability of NETs. Together these data support the cognitive interference mechanism implicated by Barlow’s causal model of sexual dysfunction and have implications for the treatment of sexual problems.

Researchers have found that self-esteem and weight status can impact numerous aspects of an individual’s life, including reproductive health issues. However, there has been limited research specifically examining how self-esteem may affect female sexual functioning. The current study aims to examine whether self-esteem is a significant predictor of sexual functioning, and whether this relationship may change as a function of women’s weight status. Participants consisted of 730 women ranging from 18 to 49 years of age, who were recruited through an online questionnaire. Results indicate that higher levels of self-esteem predict better sexual functioning and weight status was found to be a significant moderator of this relationship; specifically, self-esteem was only found to predict sexual functioning for individuals at average or below-average weight status, and not for individuals who were of higher-than-average weight status. Findings have potential implications for physical and mental health professionals working with individuals trying to improve their sexual functioning.

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No description available.

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Sexual assault (SA) has been associated with various negative psychological consequences for survivors. Recent studies have shown an association between the history of sexual assault and sexual dysfunction among female survivors of sexual victimization. Specifically, sexual assault survivors experience difficulties with aspects of sexual functioning, sexual satisfaction, and sexual self-schemas (Rellini & Meston, 2011). The purpose of the present study was to examine the relationship between sexual victimization severity and sexual functioning and sexual satisfaction. In addition, we tested a sequential mediational model in which sexual self-schema followed by depressive and PTSD symptoms would mediate the relationship between sexual victimization severity and sexual satisfaction and sexual functioning. Seventy-three female college students with a history of sexual victimization were asked to complete a series of self-report questionnaires designed to assess the history of sexual victimization, sexual functioning, sexual satisfaction, sexual self-schemas and psychological distress levels (i.e., depression and posttraumatic stress disorder symptom severity). Results revealed no significant associations between severity of sexual victimization and sexual satisfaction and sexual functioning. Additionally, our sequential mediational models, in which sexual self-schema followed by depressive and PTSD symptoms would mediate the relationship between sexual victimization severity and sexual satisfaction and functioning were non-significant. Our findings may have been limited due to the lack of variability in sexual victimization severity. Future studies further investigating the role of sexual self-schema, depression, and PTSD on sexual functioning and sexual satisfaction among sexual assault survivors are warranted.