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.

Indiana University-Purdue University Indianapolis (IUPUI) / Sexual behaviors in adolescence establish the initial resources an individual carries into sexual relationships in adulthood. Current definitions of sexual resilience in adolescence are defined from a negative, risk-based lens. Resilience theory, more generally defined, considers both internal and external factors that promote adaptation to challenging situations. A direct, capital-based approach to studying adolescent sexual resilience has not been found in the extant literature and I propose that a new, more inclusive definition of sexual resilience in adolescence will be more strongly correlated with sexual health in young adults than the risk-based definition. This study creates mutually exclusive risk-based and capital-based measures of adolescent sexual resilience and examines their associations with sexual health outcomes in young adulthood. The data did not produce significant findings, yet descriptive results provide direction for future research. Research in this area is of critical importance as adolescence and young adulthood are unique life stages that involve significant development in areas that influence health, both short and long term. This research, through a proper resilience lens, will better guide adolescent sexual education to develop internal resources as well as provide adequate external resources for adolescents that promote better sexual health and agency outcomes in adulthood.