The role of body image in sexual satisfaction among partnered older adults: a population-based study in four European countries

Body Image, Self-Esteem, and Attitudes Toward Sexuality in Older Adults with Chronic Illnesses

This study aimed to examine the effect of the association between body image and self-esteem levels on attitudes toward sexuality in older adults with chronic illnesses. The research was descriptive, cross-sectional, and correlational. The study sample comprised 1,004 people over the age of 65 who visited family health centers in a province in the east of Türkiye. The Older Person's Description Form, the Body-Cathexis Scale, the Rosenberg Self-Esteem Scale Short Form, and the Sexual Attitude Scale for Elderly People were used for data collection. For the data analysis, Pearson's r correlation test, simultaneous multiple linear regression, and binary logistic regression were employed. The mean age of the participants was 69.97 ± 5.74 years, and 66.9% were between 65 and 74 years of age. Furthermore, 53.8% of the participants were male and 56.2% had two chronic illnesses. It was found that the participants' age, body image, and self-esteem explained 84% of the total variance in their permissive attitudes toward sexuality. Furthermore, as the age of the older adults with chronic illnesses increased, there were negative effects on their permissive attitudes toward sexuality. However, as their body image and self-esteem levels improved, there was a positive effect on their permissive attitudes toward sexuality. These findings will be of benefit in encouraging and developing sexual health in older adults with chronic illnesses.

Successful sexual aging: conceptualization and Bi-Country (Croatia and Germany) measure validation

BACKGROUND

The increasing importance of sexual expression among older Europeans calls for a more comprehensive understanding of the process of sexual aging. Combining social gerontological and sexological theories, the current study aimed to conceptualize and operationalize a process-focused model of successful sexual aging (the SSAM).

METHODS

Using a Croatian sample of older partnered individuals (n = 200; Mage = 71.2) and a large-scale German sample of both partnered (n = 442; Mage = 69.2) and non-partnered individuals (n = 971; Mage = 69.2), we developed and validated a 9-item measure of successful sexual aging.

RESULTS

The 3-dimensional Successful Sexual Aging Scale (SSAS) reflects two internal processes (acceptance of and adaptation to aging-related changes) and an external one (opportunities for sexual expression). The measure was age, gender, and (to a large extent) culture invariant in older partnered individuals. With a minor adjustment (re-wording of a single item), the SSAS assessed positive sexual aging comparably well in non-partnered individuals. As hypothesized, the measure was significantly related to positive attitudes about older people's sexuality, life and relationship satisfaction, subjective age, and self-reported health. SSAS scores, which were lower among Croatian than German participants, were also linked to lower levels of social isolation, as well as depression and anxiety symptoms.

CONCLUSIONS

The new measure can be useful in a range of quantitative assessments of older people's sexuality and well-being. Furthermore, the concept of successful sexual aging may assist in challenging ageism and in interventions focusing on positive sexual aging.

CLINICAL TRIAL NUMBER

Not applicable.

Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men

The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.

Academicians' Metaphorical Perceptions of Older Adult Sexuality: An Example of Metaphor Analysis

Sexuality is one of the most natural aspects of life that continues throughout life and is within the scope of basic human needs. Sexual life can be affected by many factors such as individual characteristics, diseases, society's values, attitudes, and cultural and religious characteristics. The objective of this research is to identify the metaphorical perceptions of older adults' sexuality held by academics, employing a phenomenological methodology. This study was conducted with the participation of 164 academicians. The research data were collected between March-April 2022. The evaluation of the metaphors created about the concept of older adults' sexuality employed content analysis techniques. The metaphors pertaining to the perceptions of academics regarding the sexuality of older adults were classified into four categories and 11 sub-themes: "Perceptions that sexuality as natural," "Diminishing sexuality," "Sexuality as love, affection and friendship," and "Sexuality as hidden and stigmatized." The majority of the metaphors created by the academic researchers were found to contain negative themes related to the sexuality of older adults. It can be suggested to organize seminars to increase the awareness of academicians on sexuality, older adults' sexuality, and sexual health.

Sexual satisfaction and oversexualization among adults. The moderating role of self-esteem

BACKGROUND

In the contemporary world, there is excessive creation and exposure of one's own sexuality among adults. Taking this into account, the determinants of sexualization are being sought. The aim of this research was to assess the significance of selected demographic variables and the number of sexual partners, as well as psychological variables (self-esteem and sexual satisfaction) for revealing behaviours related to over-sexualization. We also investigated whether self-esteem can moderate the relationship between sexual satisfaction and over-sexualization.

PARTICIPANTS AND PROCEDURE

Seven hundred persons, including 403 women (298 heterosexual and 105 gay) and 297 men (199 heterosexual and 98 gay) were surveyed. The respondents were aged from 18 to 45 years (M = 22.90, SD = 4.62). In the study the following tools were used: the Oversexualization Questionnaire, the Sexual Satisfaction Questionnaire and the Self-Esteem Scale.

RESULTS

It was found that sexualized appearance was more important for homosexual persons than heterosexual ones and seduction differentiated women and men and was correlated with the age and the number of sexual partners. Oversexualization demonstrated in appearance and message contents was correlated with low self-esteem and low sexual satisfaction. Low self-esteem was found to be a significant moderator in the relationship between sexual satisfaction and sexualized appearance.

CONCLUSIONS

The present study indicates the importance of self-esteem and sexual satisfaction for sexualized appearance. Low self-esteem moderates the relationship between sexual satisfaction and sexualized appearance.

Sexual Activity of Older Adults: A Systematic Review of the Literature

Objective: The goal was to conduct a literature review of studies that examined sexual activity in older adults. Method: A systematic search was conducted to identify studies that had examined sexual activity in adults aged 60 years and older. The main characteristics of each study and results were examined and reported according to PRISMA guidelines. Results: Sixty-three articles were found. These articles were classified into three main groups based on the results they presented: percentage of older adults that were sexually active; frequency of sexual activity; and type of sexual activities. The results show that older adults are sexually active, engage in frequent sexual activity, and participate in a wide variety of activities. Conclusions: Although older adults remain sexually active, differences in the way sexual activity is assessed limit the drawing of firm conclusions and our understanding of the sexual activity of older adults. We propose a series of recommendations to gain a better understanding of this topic.

Body image as a global mental health concern

Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data. Given the harmful consequences of body image concerns in terms of mental and physical health, their global burden is high. Interventions to mitigate these concerns at the individual and systemic level are warranted.

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress

INTRODUCTION

Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction.

AIM

This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction.

METHODS

A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey.

OUTCOMES

Participants reported on their experience of five different sexual problems and associated level of distress.

RESULTS

We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations.

CLINICAL TRANSLATION

These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment.

STRENGTHS AND LIMITATIONS

Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales.

CONCLUSION

The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;XX:XXX-XXX.

Refinement and Validation of the Head and Neck Lymphedema and Fibrosis Symptom Inventory

PURPOSE

Lymphedema and fibrosis (LEF) are common yet overlooked late effects of head and neck cancer and its therapy. Lack of reliable and valid measures of head and neck LEF is a critical barrier to the timely identification and management of head and neck LEF. To fill this gap, we developed and pilot tested a 64-item patient-reported outcome measure ( Lymphedema Symptom Intensity and Distress Survey-Head and Neck, LSIDS-H&N). This article aims to report the process of further validation and refinement of the tool.

METHODS AND MATERIALS

A prospective, longitudinal study was conducted, and 120 patients with oral cavity and oropharyngeal cancer were recruited. Participants completed the LSIDS-H&N at pretreatment, end of treatment, and every 3 months up to 12 months after treatment. SAS PROC VARCLUS was used to generate preliminary clusters of item responses. Internal consistency of the item responses within each cluster was assessed using Cronbach's alpha.

RESULTS

A total of 117 patients completed the study. The participants reported that the LSIDS-H&N was easy to understand and captured their symptoms and medical conditions. However, >50% of participants indicated that the survey was burdensome due to length. Thus, we proceeded with item reduction, and the shortened tool (33-item) was named Head and Neck Lymphedema and Fibrosis Symptom Inventory (HN-LEF Symptom Inventory). The subsequent exploration of symptom clusters identified 7 symptom domain clusters (eg, soft tissue and neurologic toxicity), all of which demonstrated good internal consistency.

CONCLUSIONS

The HN-LEF Symptom Inventory has been carefully developed and refined to allow clinicians and researchers to capture LEF-associated symptom burden and function impairments. Additional rigorous psychometric testing of the tool is ongoing to further validate the strength and internal validity of this tool.