This study examined sexual frequency, sexual satisfaction, and marital satisfaction in connection with the emotional climate within which it exists, using data from a 13-year longitudinal study about marriage. First, affection and negativity were used to predict sexual frequency. Second, affection, negativity and sexual frequency were used to predict spouses' sexual satisfaction. Third, sexual frequency and spouses' sexual satisfaction were used to predict marital satisfaction. A positive association was found between affection and sexual frequency, whereas no association was found between negativity and sexual frequency. Affection was found to be associated with higher sexual satisfaction for husbands in the early years of marriage and negativity was associated with lower sexual satisfaction for both spouses. An association was also found between one's own sexual satisfaction and marital satisfaction. No association was found between sexual frequency and marital satisfaction when the emotional climate was considered. / text

Background Relational intimacy is hypothesized to underlie the association between female sexual functioning and various sexual outcomes, and married women and women with sexual dysfunction have been generally absent from prior studies investigating these associations, thus restricting generalizability. Aim To investigate whether relational intimacy mediates sexual outcomes (sexual satisfaction, coital frequency, and sexual distress) in a sample of married women with and without impaired sexual functioning presenting in clinical settings. Methods Using a cross-sectional design, 64 heterosexual married women with (n = 44) and without (n = 20) impaired sexual functioning completed a battery of validated measurements assessing relational intimacy, sexual dysfunction, sexual frequency, satisfaction, and distress. Intimacy measurements were combined using latent factor scores before analysis. Bias-corrected mediation models of the indirect effect were used to test mediation effects. Moderated mediation models examined whether indirect effects were influenced by age and marital duration. Outcomes Patients completed the Female Sexual Function Index, the Couple's Satisfaction Index, the Sexual Satisfaction Scale for Women, the Inclusion of the Other in the Self Scale, and the Miller Social Intimacy Test. Results Mediation models showed that impaired sexual functioning is associated with all sexual outcomes directly and indirectly through relational intimacy. Results were predominantly independent of age and marital duration. Clinical Implications Findings have important treatment implications for modifying interventions to focus on enhancing relational intimacy to improve the sexual functioning of women with impaired sexual functioning. Strengths and Limitations The importance of the role relational intimacy plays in broad sexual outcomes of women with impaired sexual functioning is supported in clinically referred and married women. Latent factor scores to improve estimation of study constructs and the use of contemporary mediation analysis also are strengths. The cross-sectional design precludes any causal conclusions and it is unknown whether the results generalize to male partners, partners within other relationship structures, and non-heterosexual couples. Conclusion Greater relational intimacy mitigates the adverse impact of impaired sexual functioning on sexual behavior and satisfaction in women. Witherow MP, Chandraiah S, Seals SR, et al. Relational Intimacy Mediates Sexual Outcomes Associated With Impaired Sexual Function: Examination in a Clinical Sample. J Sex Med 2017;14:843–851.

Using latent growth curve modeling, this longitudinal study examined the patterns of the discrepancy between desired and actual frequency of sexual intercourse for 331 married couples over a period of 5 years. In addition, couple insecure attachment and control variables such as age, length of relationship, income, race, and education were used to predict each partner's sexual desire discrepancy (SDD) and its change over the 5 year time period. Participants were asked to report their actual frequency of sexual intercourse and their desired frequency in each wave of data collection. Discrepancy scores were created for each year by subtracting the reported actual frequency from the reported desired frequency separately for wives and for husbands. In terms of change over time, findings showed a significant change across time for wives with a trend toward less discrepancy over time. Husbands' discrepancy scores were higher than wives and remained stable over the five years. Insecure attachment predicted the average SDD for husbands. Wife income predicted the change in SDD over the five years for husbands but not for wives. Wife race predicted the average SDD for husbands. Implications for research and clinical use are highlighted.