Insecure Attachment Style and Dysfunctional Sexual Beliefs Predict Sexual Coercion Proclivity in University Men

The Role of Men's Sexual Beliefs on Sexual Function/Dysfunction: A Systematic Review

Cognitive models of sexual dysfunction postulate that inflexible, unrealistic, and erroneous sexual beliefs work as a vulnerability factor for the development of sexual dysfunctions and existing studies give some support to this hypothesis. However, to date, there is no published systematic review of studies testing the association between men's sexual beliefs and sexual functioning. This systematic review was conducted from searches using EBSCO, PubMed, and Web of Science databases identifying peer-reviewed studies and gray literature sources from inception to November 2021. Twenty cross-sectional studies, assessing correlations between the degree of endorsement of sexual beliefs and sexual functioning and comparing endorsement of sexual beliefs in men with and without sexual problems were included. Despite the small effect sizes, results indicate that higher endorsement of inflexible/unrealistic/erroneous sexual beliefs is associated with poorer sexual functioning and that men presenting with sexual problems tend to report higher endorsement of these sexual beliefs. Further research with clinical samples as well as longitudinal studies are necessary to explore the ways these associations emerge and develop. The state of evidence on this research topic, including gaps and limitations, is discussed.

Erectile Dysfunction and Sexual Coercion: The Role of Sperm Competition Risk

Erectile dysfunction (ED) has been shown to be associated with several negative aspects of intimate relationships. Our goal for the present research was to examine whether ED was associated with men's use of sexual coercion in their intimate relationships (which may include the use of physical coercion, psychological manipulation, or emotional manipulation to gain sexual access) and if perceived sperm competition risk (i.e., perceived risk of partner infidelity, which may place a man's sperm into competition with sperm from another man) played a role in this association. These associations were examined in Study 1 using self-reports provided by men (N = 202) who had a mean age of 30.48 years (SD = 5.03) and were recruited through Amazon's Mechanical Turk (MTurk). ED was found to have a large positive association with sexual coercion. However, men's self-reports did not provide support for sperm competition risk moderating the association between ED and sexual coercion, but an exploratory analysis revealed that sperm competition risk mediated this association. We attempted to replicate and extend these results in Study 2 by using partner-reports provided by women (N = 151) who had a mean age of 30.41 years (SD = 4.77) and were recruited through MTurk. Women's partner-reports provided support for sperm competition risk moderating the association between ED and sexual coercion. In addition, an exploratory analysis found that sperm competition risk also mediated the association between ED and sexual coercion, similar to Study 1. Discussion explores the implications of these results for understanding the role that sperm competition risk may play in the connection between ED and sexual coercion.

Anxiety in Attachment and Sexual Relationships in Adolescence: A Moderated Mediation Model

Adolescence is characterized by several transformations, such as identity construction, progressive estrangement from parents, relational interest in peers, and body changes that also involve sexuality issues. In this process, attachment patterns play a fundamental role in relationships, and when these are dysfunctional, they can result in internalizing and externalizing problems. Often, females show their relational difficulties through internalizing expressions and males through externalizing expressions. Additionally, given the sexual progress involved in this life moment, psychological symptomatology may influence adolescents' perception of sex and performance. Our purpose is to study the mediating role of internalizing and externalizing symptomatology in the relationship between attachment patterns and sexual and psychological dimensions. In addition, we investigated the moderating effect of the sex assigned at birth on this mediation model. n = 493 adolescents (38.3% males; Mage = 16.51; SD = 1.17) participated in the study. The results show a significant mediation effect of internalizing symptomatology on the relationship between attachment and sexual anxiety. Additionally, this effect is moderated significantly by assigned-at-birth sex. These results confirm that in adolescence, attachment patterns can influence adolescents' perception of sex. The connection between these two psychological dimensions is influenced by symptomatologic expression. Further investigations are needed.

Sexual Health and the Pandemic Crisis: Testing the Role of Psychological Vulnerability/Protective Factors on Sexual Functioning and Sexual Distress During a Critical Life Period in Portugal

Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.

[French validation of the Acceptance of Modern Myths about Sexual Aggression scale (AMMSA) and experience of close relationships with students and perpetrators of domestic violence]

INTRODUCTION

Acceptance of the rape myths (ARM) refers to a set of attitudes, beliefs and stereotypes that tend to make women responsible for rapes or sexual assaults, and to rationalize, minimize or justify the behaviors of sexual offenders. ARM can also promote intimate partner violence (spousal rape). Domestic violence is generally associated with an insecure attachment style (avoidant or ambivalent) in both perpetrators and victims. The attachment insecurity of perpetrators of spousal violence can favor the use of violence against partners. The perpetrators also have a tendency to attribute the responsibility of their acts to their partners. Gerger, Kley, Bohner and Siebler (2007) developed the "Acceptance of Modern Myths about Sexual Aggression Scale" to measure the ARM in a more subtle way, in particular by reducing social desirability bias. The aim of this study is both to explore the psychometric qualities of the French version of the AMMSA and to study the relationships between the ARM, attachment styles and spousal violence in young adults and perpetrators of domestic violence (with the hypothesis that the latter have a greater ARM and a more insecure attachment style with the intimate partner).

METHODS

Participants. The participants (n=275) were divided into two samples: sample 1 comprised 243 French psychology students and psychiatry residents, mean age 26.94years (±4.06years, range 19 to 38), with 79 % females (173 women and 50 men). The majority (69%) were in a relationship, and their level of study ranged from 13th grade to 19th grade; sample 2 comprised 32 men treated in a therapy center for perpetrators of spousal violence (in the "Centre-Val-de-Loire" region in France). They had a mean age of 40.84years (±11.06years, range 22 to 61). The majority (59%) was in a relationship and their level of study ranged from 5th grade to 18th grade (mean level=11).

INSTRUMENTS

To measure the ARM Myths, we used the AMMSA, which is composed of 30 items structured into a single overarching factor. To assess the styles of attachment to the partner, we used the Experiences in Close Relationships (ECR) scale, which comprises 36 items structured in two dimensions: (i) attachment-related anxiety, and (ii) attachment-related avoidance in the couple. The tools were self-administered. Students completed the questionnaire via the Internet using the Sphinx software during an online survey. Clinical subjects completed the questionnaire in their therapy center. All participants were volunteers and gave their informed consent before anonymously completing the paper or online self-assessment questionnaire.

RESULTS

We carried out a principal components factor analysis using Varimax rotation on the data obtained from the answers to the 30 items of the AMMSA of all respondents. The analysis identified a single factor with an eigenvalue of 9.04 and which explained more than 30% of the total variance. This factor saturated (>0.30) 29 of the 30 items of the AMMSA, and the Cronbach alpha (which assesses internal consistency) was 0.91. The comparison of AMMSA scores between the clinical group (men with a history of spousal abuse) and male and female students showed differences, while there were no significant gender differences in the non-clinical group. The mean level of insecurity of attachment to the partner was also higher for the men in the clinical group than those in the non-clinical group (students). Results found correlations between the ARM and ECR for attachment-related anxiety in the non-clinical group (both men and women), a weak and negative correlation between age and attachment-related anxiety, and a correlation between age and AMMSA only for women.

DISCUSSION

The results concerning the qualities of the AMMSA are consistent with previous work. In addition, perpetrators of spousal violence have a stronger ARM. The links between (a) older age and a low level of education and (b) the ARM have already been highlighted. However, psychology students and psychiatry residents are probably more likely than others to develop pro-social, egalitarian, sensitive and tolerant attitudes, and therefore to be less in touch with rape myths. Both men and women have sexist representations and acceptance of the rape myths. The ARM is associated with common negative gender stereotypes, notably ambivalent sexism (with its two dimensions: hostile and benevolent sexism). This study has limitations linked both to the small clinical sample and the recruitment of non-clinical subjects from psychological and medical academic fields (with a specialty in psychiatry). Nonetheless, it is also one of the interests of this study to show that the ARM concerns everyone, including students, regardless of their academic or professional orientation.

CONCLUSION

The AMMSA, which has been validated in different languages and in different contexts, has always shown good psychometric qualities. This French adaptation shows the same characteristics in terms of unifactorial structure, saturation of scale items and internal consistency. Further studies are needed to confirm external validity and test-retest reliability. It would also be desirable to conduct studies with larger and more representative samples. The AMMSA could be an excellent prevention tool by raising awareness of the continuing extent of negative gender stereotypes, violence against women and rape myths.

A Meta-Analysis on the Association Between Rape Myth Acceptance and Sexual Coercion Perpetration

Sexual coercion is an important public health issue. One in three women and one in ten men report having been the victim of sexual coercion. Rape myth acceptance (RMA) is recognized as a risk factor for sexual coercion perpetration. The present meta-analysis sought to establish the strength of the association between RMA and sexual coercion perpetration, and determine if the association is moderated by gender, age, sample source and year of publication, or influenced by methodological decisions. A literature search was performed through electronic platforms, Google Scholar and backward snowballing. Twenty-eight studies met full inclusion criteria for the meta-analysis. A random-effect meta-analysis rendered a statistically significant pooled effect size of r = .23 (95% CI = .19, .27; Z = 11.16, p < .0001). Moderator analyses performed through random-effect meta-regression revealed that age and sample source were significant moderators and that methodological decisions may impact the detection of the association. Findings from this meta-analysis expose a moderate relationship between sexual coercion perpetration and RMA which is consistent across gender and persistent over time despite social changes and on-campus efforts. These results consolidate RMA's role as a significant risk factor for sexual coercion perpetration and should promote reflection on ways of optimizing on-campus sexual coercion prevention programs.

A Pilot Study of Gender Differences in Sexual Arousal of Patients With OCD: The Moderator Roles of Attachment and Contamination Symptoms

Sexual arousal is often impaired in patients with obsessive-compulsive disorder (OCD). However, little is known about the factors related to this impairment: no study focused on the role of gender-based effects of attachment styles and contamination symptoms. The Dual Control Model assumes three processes driving sexual arousal: sexual excitation (SE), sexual inhibition (SI) due to threat of performance failure, and SI due to threat of performance consequences (e.g., getting contaminated with sexually transmitted diseases). In a group of OCD patients, we hypothesized that (a) women report lower SE and higher SI than men; (b) patients with insecure (both anxious and avoidant) attachment styles show lower SE and higher SI; (c) attachment styles moderate the relation between gender and sexual arousal (respectively, for women, higher attachment anxiety, and for men higher attachment avoidance were related to impaired sexual arousal (higher SE and SI) controlling for OCD severity); and (d) contamination symptoms moderate the relation between gender and sexual impairment (women with contamination symptoms show impaired sexual arousal). Seventy-two OCD patients (37.50% women) completed the Obsessive-Compulsive Inventory-Revised, Attachment Styles Questionnaire and Sexual Inhibition/Sexual Excitation Scales. In contrast with our hypotheses, women reported higher SE and lower SI due to threat of performance consequences than men. Patients with higher attachment avoidance (discomfort with intimacy) but also confidence in self and others had higher SE. Women with attachment avoidance (i.e., discomfort with intimacy) had lower SE, while women with attachment anxiety (i.e., preoccupations with relationships) had higher SI due to negative performance consequences. Women with contamination symptoms had higher SI due to performance failure but lower SI due to performance consequences. The present preliminary findings suggest that sexual arousal impairment should be evaluated during the assessment of OCD patients, and gender-based effects of attachment styles and contamination symptoms should be considered during personalized treatment planning.

Depression, Sexual Dysfunction, and Medical Comorbidities in Young Adults Having Nicotine Dependence

Background:

Nicotine dependence, depression, diabetes mellitus, hypertension, and hypothyroidism are risk factors of sexual dysfunction.

Aims and Objectives:

The present study aims to find the prevalence of sexual dysfunction and the various sexual response cycle domains in individuals with nicotine dependence with and without comorbidities.

Materials and Methods:

A total of 52 individuals attending the tobacco cessation clinic were included in the study. To assess the primary outcome, Fagerstrom test for nicotine dependence, Arizona Sexual Experiences Scale, and Hamilton's Depression Rating Scale ₁₇had been administered after validation in local vernacular.

Results:

In the sample, 32 (61.5%) were male and 20 (38.5) were female. The 17 participants (32.7%) met the criteria of low nicotine dependence, 5 (9.6%) participants met low to moderate, 11 participants (21.2%) had moderate dependence, and 19 (36.5%) participants met the criteria of high nicotine dependence.

Conclusions:

The nicotine dependence is directly related to sexual dysfunction, and it affects various stages of the sexual response cycle. One-quarter of individuals of nicotine dependence also met the threshold criteria of depression. The interventions as primary and primordial preventions with awareness building and health education may be a cost-effective measure to prevent tobacco-related deaths.

Sexual anxiety and sexual beliefs as mediators of the association between attachment orientation with sexual functioning and distress in university men and women

Previous research has demonstrated the association between sexual functioning and attachment orientation in women. However, the mechanisms of this relation are not yet well understood, and this effect has not been substantially investigated in men. The current study examines the role of sexual anxiety and dysfunctional beliefs about sexuality as mediators of the correlation of attachment orientation with sexual functioning and distress in both women and men. A university sample of men (n=307) and women (n=716) completed questionnaires assessing attachment orientation, sexual functioning, sexual distress, sexual anxiety, and dysfunctional sexual beliefs. Multiple regression analyses indicated that insecure attachment orientation significantly predicted poorer sexual functioning and higher sexual distress in both men and women. Path analyses showed partial mediation of these effects by sexual anxiety and dysfunctional sexual beliefs. Gender differences existed in the specific pattern of associations between the variables. These results suggest that attachment difficulties may facilitate the development of sexual difficulties through an increased vulnerability to maladaptive cognitions and negative affect (specifically anxiety) regarding sexuality.