After individuals sustain a spinal cord injury, all aspects of their lifestyle must change for them to manage their new life roles. One important area of recovery that is often not addressed during the rehabilitation process is sexual functioning. The purpose of this quantitative study was to examine how doctor communication about sexual health with women who have sustained spinal cord injuries predicts their levels of sexual functioning and sexual self-esteem. The theoretical framework was the sexual health model. Questionnaires were used to gather data from 45 women who had completed rehabilitation from spinal cord injuries. Level of current sexual functioning was measured using the Female Sexual Function Index. Sexual self-esteem was measured using the Multidimensional Sexual Self-Concept Questionnaire. Satisfaction with doctor-patient communication was measured using the Patient Satisfaction Questionnaire and Perceived Self-Efficacy in Patient-Physician Interactions-Sex. Findings from correlation analysis indicated a positive correlation between general satisfaction with doctor-patient communication and confidence to communicate with the doctor about sexual health. Results also indicated a negative correlation between sexual self-esteem and sexual functioning. Findings may be used to improve communication between doctors and patients about sexual health, which may reduce the stigma of talking about sexuality and may promote more holistic treatment for women recovering from spinal cord injuries.

Research supports a link between poor body esteem, depression, and sexual dysfunction among childhood sexual abuse (CSA) survivors. Though the interplay of these factors also impacts nonabused women, it is possible that the impact is differentially affects these populations. The present study examined the degree to which body esteem may act as psychological mechanism through which CSA impacts adult sexuality, while controlling for the effects of depression – a problem that affects many abuse survivors. Data were collected from 108 women, 73 of who reported CSA. Women with CSA reported poorer body esteem, lower sexual functioning, less sexual satisfaction, and higher depression than women without CSA. Multivariate regression analysis revealed that body esteem significantly predicted sexual functioning and sexual satisfaction and there were significant interactions between body esteem and abuse history, and among body esteem and marital status. Depressive symptom severity was not a moderator in the relationship between body esteem and sexual functioning-satisfaction. These findings suggest that treatments for CSA survivors with sexual difficulties might benefit from addressing body esteem concerns. / text

The objective of this thesis was to determine whether evaluative body image, affective body image, and behavioural body image were predictive of women’s sexual desire, arousal and orgasm. Results are based on self-report and body composition data from 88 women (a subset of a larger data set including men) in heterosexual romantic relationships at the time of data collection. Hierarchical multiple regression indicated that poor evaluative, affective and behavioural body image were detrimental to women’s sexual functioning. Specifically, dissatisfaction with one’s body predicted decrements in desire (β = -.31, p <.05) and arousal (β = -.35, p <.01). Similarly, feeling that others evaluate one’s body negatively, predicted decrements in desire (β = .22, p <.05) and arousal (β = .35, p <.01). Feeling negatively about one’s appearance predicted decrements in arousal (β = .26, p <.05). Negative thoughts and feelings about one’s body that influence sexual behaviours (body image self-consciousness) predicted decrements in arousal (β = -.37, p <.01) and orgasm (β = -.25, p <.05). Implications for public health messages, treatment programs, sexual problem assessments and directions for future research are discussed. / Social Sciences and Humanities Research Council

The most commonly reported sexual concerns for women are low desire and orgasm difficulties (Laumann, Paik & Rosen, 1999; Laumann et al., 2005). Previous research indicates that women with sexual problems may have different reasons for engaging in sex than women with healthy sexual functioning (Giles & McCabe, 2009; Sand & Fisher, 2007). The current study investigated whether motivations for sex differed by levels of sexual functioning overall and specifically among women with and without problems with sexual desire or orgasm. Seven hundred and eight heterosexual women completed an online questionnaire assessing reasons for sex and sexual functioning. Women with sexual functioning concerns were more likely to endorse insecurity reasons for sex, while women without were more likely to endorse physical reasons for sex. Women experiencing low desire were less likely to endorse emotional and physical reasons for sex. Women experiencing orgasm difficulties were more likely to endorse insecurity reasons. The limitations and implications of the results are discussed.

Provoked vestibulodynia (PVD), or recurrent vulvar pain, is a prevalent condition among women. Although research has documented that PVD is associated with sexual problems, little research has systematically examined the intimate relationships of affected women. The general purpose of the current studies was to comprehensively examine sexual and relationship functioning among women with provoked vulvar pain. In order to do so, three related studies were conducted. The first study was a systematic review of the literature examining sexual and relationship satisfaction among PVD-affected women. Secondly, an online study was conducted using both standardized and qualitative measures to examine sexual, relationship, and psychological functioning among women with self-reported provoked vulvar pain and their male partners in comparison to controls. The online study also examined associations between affected women’s pain and women and partner’s functioning. The final study was a laboratory-based study that included women with PVD and matched control women and examined psychosexual functioning, including sexual and relationship satisfaction, and vestibular pain sensitivity; additionally, this study examined potential associations between women’s pain and self-reported functioning. Overall, these studies suggest that women with provoked vulvar pain experience decreased sexual functioning, sexual satisfaction, and psychological functioning in comparison to control women, and that pain-affected partners experience decreased sexual functioning and sexual satisfaction. The findings also indicate that some aspects of women’s pain experiences are related to their self-reported functioning and to that of their partners. This research has implications for understanding the potential sexual and relationship consequences associated with provoked vulvar pain, and is among the first to comprehensively examine affected partners’ functioning. It is hoped that these studies will contribute novel information to the vulvar pain literature, and that they will encourage future research examining sexual and relationship functioning among women with provoked vulvar pain and their partners. / Thesis (Ph.D, Psychology) -- Queen's University, 2010-08-25 12:02:29.446

Introduction: Provoked vestibulodynia is a common life impacting disease. Research hasshown higher pain intensity and anxiety levels in primary (pain present since first penetrativeattempt) provoked vestibulodynia (PVD1) compared to secondary provoked vestibulodynia(PVD2) and mixed results regarding age and female sexual functioning when comparing thegroups.Aim: The aim of this study was to further investigate the differences between PVD1 andPVD2 regarding pain intensity, sexual functioning, age and anxiety levels. The secondary aimwas to analyze how PVD group, age, anxiety and pain intensity associates with sexualfunctioning.Method: A total of 57 women from the Netherlands and Sweden were recruited via socialmedia, advertisement and regional caregivers. This study was part of a larger study oncognitive behavioral group therapy for women with provoked vestibulodynia. Data wasextracted from a survey assessing intensity of pain, sexual functioning, age and anxiety levels.A t-test was used to compare the PVD1 and PVD2 groups and a multivariate regressionanalysis was used to analyze the variables association with sexual functioning.Results: No statistically significant differences were found regarding pain intensity, sexualfunctioning, age and anxiety levels between PVD1 and PVD2. Decreased sexual functioningwas significantly related to higher age and pain intensity.Conclusion: We found no significant differences between PVD1 and PVD2. Increased ageand higher pain intensity seems to associate with lower sexual functioning. Longitudinalstudies with a greater sample size are needed for further investigation.

Sexual dysfunction can lead to a negative impact upon a person’s mental and relational health, including relational and overall distress, poor relationship and sexual satisfaction, and clinical mood disorders such as depression. Moving upstream to identify factors that may predict sexual dysfunction would therefore be beneficial for early intervention in at-risk populations. History of childhood trauma is one such factor that may influence sexual functioning later in life. While adverse childhood experiences (ACEs) have been less studied in association with sexual dysfunction, there is some evidence to indicate that they may be related. ACEs have been shown to increase the risk of physical and psychological conditions (such as physical inactivity, obesity, heart disease, substance use, depression, and anxiety) which can then impede sexual functioning; further, a study of sex therapy patients found that their ACE scores were significantly higher than those in community samples. Additionally, difficulties in emotion regulation (DERS) may also play an important role in this relationship, as they have been shown to mediate the relationship between ACEs and several subsequent health risks. The purpose of this study was to determine whether there was a significant relationship between ACEs and sexual problems, and further, if emotion regulation difficulties mediated this relationship. College students (N = 696) were recruited to complete an online survey of their health behaviors. The overall mediated model was significant, F(2, 692) = 5.78, p = .003, but explained only 1.6% of the variance in sexual functioning. Although ACEs significantly predicted both sexual functioning (b = 0.60, t(694) = 3.40, p < 0.001) and DERS (b = 2.08, t(694) = 4.83, p < 0.001), DERS did not significantly predict sexual functioning (b = -0.01, t(694) = -0.63, p = 0.52), and did not emerge as a significant mediator of the relationship between ACEs and sexual functioning (b = -.02, CI [-.08,.05]). Further, in contrast to hypotheses, participants with higher ACE scores actually reported higher sexual functioning relative to participants with lower ACE scores in this sample. Results highlight the complexities of the relationship between ACEs and current sexual functioning. While difficulties in emotion regulation are still likely to be clinically significant for individuals with trauma histories, they do not appear to be a major contributing factor to difficulties in sexual functioning.

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Studies suggest that nearly two-thirds of women fake or have faked orgasm, yet few researchers have explicitly examined this phenomenon. Previous studies have identified some group differences between women who fake orgasm and those who do not on dimensions of sexual experience, emotion regulation, intimacy, relationship status, and sexual functioning. To date, research into this phenomenon has relied solely on variable-centered analyses (e.g., exploratory factor analysis, correlation, and regression). This study used a person-centered approach (i.e., latent class analysis; LCA) to explore differences in women's motives across individuals, using scores from the Faking Orgasm Scale. A 5-class model was determined to be most interpretable and the best fitting to the data. Classes included low, moderate, and high frequency faking orgasm, partner-focused faking orgasm, and pleasure-focused faking orgasm. These classes were then compared on dimensions of sexual functioning, intimacy, and emotion regulation, as well as demographic variables (e.g., age, length of relationship, number of sexual partners). Significant differences were found in sexual desire, sexual activity, and orgasmic consistency, but not in sexual satisfaction. Significant differences were also evidenced in intimacy, general level of emotion dysregulation, and across various dimensions of emotion regulation. No differences across classes were revealed on age, length of relationship, or number of sexual partners. These findings can serve as the foundation for further exploration into understanding women's various styles of interacting sexually with a partner and may have implications for couples therapy, sex therapy, and individual interventions for women struggling with physical and/or emotional intimacy with a partner. / Psychology