Abstract
Objectives
Research has shown the role of mindfulness and self-compassion in promoting resilience while living with a disabling condition. However, little is known on the influence of these variables on sexual and relationship satisfaction of people with physical disabilities. This cross-sectional study aimed to explore the contribution of mindfulness, self-compassion, and acceptance in predicting sexual and relationship satisfaction, above and beyond experiencing physical disability.
Methods
A sample of 377 participants, aged between 18 and 55 years old, took part in a survey. Of these, 189 participants had a self-reported physical disability, the majority (70.1%) being either motor or neuromuscular health conditions.
Results
Findings showed that higher levels of mindfulness, self-compassion, and acceptance significantly predicted higher sexual (ΔR2 = between .081 and .166; p < .05) and relationship satisfaction (ΔR2 = between .072 and .106; p < .05), above and beyond the physical condition of the participants. Additionally, the physical condition was a moderator for the relationship between the mindfulness dimension of self-compassion and sexual satisfaction (ΔR2 = .024; p = .037), as this association was only significant for people with physical disabilities.
Conclusions
This study explores possible vulnerability and protective psychological mechanisms that may be involved in sexual and relationship satisfaction, above and beyond the effects of the physical disability. Despite its limitations, findings call into attention for the importance of further research on mindfulness-related variables in optimizing sexual health in people with and without physical disabilities.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
Due to the nature of this research (i.e., data containing sensitive information), participants did not agree for their data to be shared publicly, so raw data is not available. Supporting materials for data collection and analysis are available at the Open Science Framework at https://doi.org/10.17605/OSF.IO/ETJQP.
References
Ahumuza, S., Matovu, J., Ddamulira, J., & Muhanguzi, F. (2014). Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda. Reproductive Health, 11(1), 1–9. https://doi.org/10.1186/1742-4755-11-59.
Baer, R. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143. https://doi.org/10.1093/clipsy.bpg015.
Baer, R., Smith, G., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504.
Bond, F., Hayes, S., Baer, R., Carpenter, K., Guenole, N., Orcutt, H., Waltz, T., & Zettle, R. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688. https://doi.org/10.1177/0748175614538064.
Brotto, L., & Heiman, J. (2007). Mindfulness in sex therapy: applications for women with sexual difficulties following gynecologic cancer. Sexual and Relationship Therapy, 22(1), 3–11. https://doi.org/10.1080/14681990601153298.
Brotto, L., Basson, R., Smith, K., Driscoll, M., & Sadownik, L. (2015). Mindfulness-based group therapy for women with provoked vestibulodynia. Mindfulness, 6(3), 417–432. https://doi.org/10.1007/s12671-013-0273-z.
Brown, K., & Ryan, R. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822.
Castilho, P., & Pinto-Gouveia, J. (2011). Auto-compaixão: Estudo da validação da versão portuguesa da Escala da Auto-compaixão e da sua relação com as experiências adversas na infância, a comparação social e a psicopatologia. Psychologica, 54, 203–230.
Crewe, N., & Krause, J. (1988). Marital relationships and spinal cord injury. Archives of Physical Medicine and Rehabilitation, 69(6), 435–438.
Dahm, K., Meyer, E., Neff, K., Kimbrel, N., Gulliver, S., & Morissette, S. (2015). Mindfulness, self-compassion, posttraumatic stress disorder symptoms, and functional disability in U.S. Iraq and Afghanistan war veterans. Journal of Traumatic Stress, 28(5), 460–464. https://doi.org/10.1002/jts.22045.
Esmail, S., Darry, K., Walter, A., & Knupp, H. (2010). Attitudes and perceptions towards disability and sexuality. Disability and Rehabilitation, 32(14), 1148–1155. https://doi.org/10.3109/09638280903419277.
García, A., & Álvarez, C. (2014). Sexuality and functional diversity: an analysis from a gender perspective. Procedia - Social and Behavioral Sciences, 161, 299–305. https://doi.org/10.1016/j.sbspro.2015.01.078.
Germer, C., & Neff, K. (2013). Self-compassion in clinical practice. Journal of Clinical Psychology, 69(8), 856–867. https://doi.org/10.1002/jclp.22021.
Goodrich, E., Wahbeh, H., Mooney, A., Miller, M., & Oken, B. (2015). Teaching mindfulness meditation to adults with severe speech and physical impairments: an exploratory study. Neuropsychological Rehabilitation, 25(5), 708–732. https://doi.org/10.1080/09602011.2014.970201.
Gregório, S., & Pinto-Gouveia, J. (2011). Facetas de mindfulness: características psicométricas de um instrumento de avaliação. Psychologica, 54, 259–280 https://doi.org/10.14195/1647-8606_54_10.
Hayes, S. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639–665. https://doi.org/10.1016/S0005-7894(04)80013-3.
Hayes, A. (2012). PROCESS: a versatile computational tool for observed variable mediation, moderation, and conditional process modeling. https://www.semanticscholar.org/paper/PROCESS-%3A-A-Versatile-Computational-Tool-for-%2C-%2C-1-Hayes/862dd61cccad6b39ffe890557db19a6356bbe8ca
Hayes, S., Strosahl, K., & Wilson, K. (1999). Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press.
Hayter, M., & Dorstyn, D. (2014). Resilience, self-esteem and self-compassion in adults with spina bifida. Spinal Cord, 52(2), 167–171. https://doi.org/10.1038/sc.2013.152.
Hocaloski, S., Elliott, S., Brotto, L., Breckon, E., & McBride, K. (2016). A mindfulness psychoeducational group intervention targeting sexual adjustment for women with multiple sclerosis and spinal cord injury: a pilot study. Sexuality and Disability, 34(2), 183–198. https://doi.org/10.1007/s11195-016-9426-z.
Johnston, D. (2012). Mindfulness: A proposed couple-based intervention for the altered self-identity of breast cancer survivors. Mindfulness, 3(4), 282–290. https://doi.org/10.1007/s12671-012-0093-6.
Kabat-Zinn, J., & Burney, R. (1981). The clinical use of awareness meditation in the self-regulation of chronic pain. Pain, 11, S273. https://doi.org/10.1016/0304-3959(81)90541-8.
Kedde, H., van de Wiel, H., Schultz, W., Vanwesenbeeck, I., & Bender, J. (2012). Sexual health problems and associated help-seeking behavior of people with physical disabilities and chronic diseases. Journal of Sex and Marital Therapy, 38(1), 63–78. https://doi.org/10.1080/0092623X.2011.569638.
Kelland, M. D. (2009). Psicología, discapacidad física y la aplicación de la consciencia plena budista a los programas de artes marciales. Revista de Artes Marciales Asiáticas, 4(4), 8–17.
Kocsis, A., & Newbury-Helps, J. (2016). Mindfulness in sex therapy and intimate relationships (MSIR): clinical protocol and theory development. Mindfulness, 7(3), 690–699. https://doi.org/10.1007/s12671-016-0506-z.
Lawrance, K., & Byers, S. (1992). Development of the interpersonal exchange model of sexual satisfaction in long term relationships. Canadian Journal of Human Sexuality, 1(3), 123–128.
Lawrance, K., & Byers, S. (1995). Sexual satisfaction in long-term heterosexual relationships: the interpersonal exchange model of sexual satisfaction. Personal Relationships, 2(4), 267–285. https://doi.org/10.1111/j.1475-6811.1995.tb00092.x.
Leavitt, C. E., Lefkowitz, E. S., & Waterman, E. A. (2019). The role of sexual mindfulness in sexual wellbeing, relational wellbeing, and self-esteem. Journal of Sex & Marital Therapy, 45(6), 497–509. https://doi.org/10.1080/0092623X.2019.1572680.
Lucena-Santos, P., Pinto-Gouveia, J., & Silva Oliveira, M. (2015). Terapias comportamentais de 3ageração: Guia para profissionais. Synopsis Editora.
McCabe, M., & Taleporos, G. (2003). Sexual esteem, sexual satisfaction, and sexual behavior among people with physical disability. Archives of Sexual Behavior, 32(4), 359–369.
McClelland, S. (2014). “What do you mean when you say that you are sexually satisfied?” A mixed methods study. Feminism & Psychology, 24(1), 74–96. https://doi.org/10.1177/0959353513508392.
McCracken, L., & Vowles, K. (2014). Acceptance and commitment therapy and mindfulness for chronic pain model, process, and progress. American Psychologist, 69(2), 178–187. https://doi.org/10.1037/a0035623.
Mosalanejad, F., Afrasiabifar, A., & Zoladl, M. (2018). Investigating the combined effect of pelvic floor muscle exercise and mindfulness on sexual function in women with multiple sclerosis: a randomized controlled trial. Clinical Rehabilitation, 32(10), 1340–1347. https://doi.org/10.1177/0269215518777877.
Neff, K. (2003a). Self-compassion: an alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101. https://doi.org/10.1080/15298860390129863.
Neff, K. (2003b). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860390209035.
Neff, K., & Dahm, K. (2015). Self-compassion: what it is, what it does, and how it relates to mindfulness. In B. O. M. Robinson & B. Meier (Eds.), Handbook of mindfulness and self-regulation (pp. 121–140). Berlin: Springer.
Neff, K., & Germer, C. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44. https://doi.org/10.1002/jclp.21923.
Nezhad, M., & Shameli, L. (2017). The effect of acceptance and commitment therapy on sexual satisfaction of couples in Shiraz. International Journal of Medical Research & Health Sciences, 6(1), 58–65.
Pascoal, P., Narciso, I., Pereira, N., & Ferreira, A. (2013). Processo de validação da Global Measure of Sexual Satisfaction em três amostras da população portuguesa. Psicologia: Reflexão e Crítica, 26(4), 691–700. https://doi.org/10.1590/S0102-79722013000400009.
Pascoal, P., Narciso, I., & Pereira, N. (2014). What is sexual satisfaction? Thematic analysis of lay people’s definitions. Journal of Sex Research, 51(1), 22–30. https://doi.org/10.1080/00224499.2013.815149.
Pascoal, P., Oliveira, L., & Raposo, C. (2015). Evidências de validade da Global Measure of Relationship Satisfaction (GMREL) em três amostras da população portuguesa. Psicologia: Reflexão e Crítica, 28(1), 41–48. https://doi.org/10.1590/1678-7153.201528105.
Peixoto, M., & Nobre, P. (2015a). Prevalence of sexual problems and associated distress among gay and heterosexual men. Sexual and Relationship Therapy, 30(2), 211–225. https://doi.org/10.1080/14681994.2014.986084.
Peixoto, M., & Nobre, P. (2015b). Prevalence of sexual problems and associated distress among lesbian and heterosexual women. Journal of Sex & Marital Therapy, 41(4), 427–439. https://doi.org/10.1080/0092623X.2014.918066.
Pinto-Gouveia, J., Gregório, S., Dinis, A., & Xavier, A. (2012). Experiential avoidance in clinical and non-clinical samples: AAQ-II Portuguese version. International Journal of Psychology and Psychological Therapy, 12(2), 139–156.
Reeve, D. (2004). Psycho-emotional dimensions of disability and the social model. In C. Barnes & G. M. (Eds.), Implementing the social model of disability: theory and research (pp. 83–100). Leeds: The Disability Press.
Rowen, T., Stein, S., & Tepper, M. (2015). Sexual health care for people with physical disabilities. Journal of Sexual Medicine, 12(3), 584–589. https://doi.org/10.1111/jsm.12810.
Sánchez-fuentes, M., Santos-iglesias, P., & Sierra, J. C. (2014). A systematic review of sexual satisfaction. International Journal of Clinical and Health Psychology, 14, 67–75. https://doi.org/10.1016/S1697-2600(14)70038-9.
Senders, A., Wahbeh, H., Spain, R., & Shinto, L. (2012). Mind-body medicine for multiple sclerosis: a systematic review. Autoimmune Diseases, 1(1), 1–12. https://doi.org/10.1155/2012/567324.
Shakespeare, T. (2006). Disability Rights and Wrongs. Abingdon: Routledge.
Smith, S. (2009). Social justice and disability: competing interpretations of the medical and social models. In K. Kristiansen, S. Vehmas, & T. Shakespeare (Eds.), Arguing about disability: philosophical perspectives (pp. 15–29). Abingdon: Routledge.
Stuntzer, S. (2014). Self-compassion and sexuality: a new model for women with disabilities. Ideas and Research You Can Use: VISTAS 2014, 67(August).
Stuntzner, S., & Hartley, M. (2015). Balancing self-compassion with self-advocacy: a new approach for persons with disabilities. http://self-compassion.org/wp-content/uploads/2015/08/Stuntzner_Hartley.pdf
Stuntzner, S., Dalton, J., & Macdonald, A. (2018). The therapeutic triad of disability. https://ct.counseling.org/2018/07/the-therapeutic-triad-of-disability/
Swain, J., & French, S. (2008). Affirming identity. In J. Swain & S. French (Eds.), Disability on equal terms (pp. 65–78). Thousand Oaks: SAGE Publications Ltd..
Taleporos, G., & McCabe, M. (2003). Relationships, sexuality and adjustment among people with physical disability. Sexual and Relationship Therapy, 18(1), 25–43. https://doi.org/10.1080/1468199031000061245.
World Health Organization. (2001a). International classification of functioning, disability and health. http://psychiatr.ru/download/1313?view=name=CF_18.pdf
World Health Organization. (2001b). Disability Assessment Schedule 2.0 (WHODAS 2.0). World Health Organization. http://www.who.int/classifications/icf/whodasii/en/
World Health Organization. (2006). Defining sexual health: report of technical consultation on sexual health 28-31 January 2002, Geneva. Sexual Health Document Series, (January), 0–30.
World Health Organization. (2011). What do we know about disability? World Health Organization. http://www.who.int/disabilities/world_report/2011/report/en/
Acknowledgments
The authors would like to thank the Centro de Reabilitação Profissional de Gaia (Professional Rehabilitation Centre of Gaia) for the help in the recruitment procedures. We would also like to thank to all the institutions and associations that shared our study and helped us reach more participants. Finally, a special thank you to all the volunteers and their willingness in participating in the survey.
Funding
This work was funded by the Portuguese Scientific Foundation with a grant attributed to the first author (CPUP/FCT: UIDB/00050/2020; SFRH/BD/112168/2015).
Author information
Authors and Affiliations
Contributions
RP designed and executed the study, collected and analyzed the data, and wrote and revised the manuscript; IA collaborated in recruitment procedures, and collaborated in editing and reviewing the final manuscript; PT supervised the study design, collaborated in data analysis, and reviewed the final manuscript; PN supervised the study design, collaborated in data analysis and discussion of the findings, and reviewed the final manuscript. All authors approved the final version of the manuscript for submission.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Previous approval was obtained from the University Ethics Committee and from the Portuguese National Commission for Data Protection.
Informed Consent
Informed consent was obtained from all the participants included in the study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Pereira, R., Almeida, I., Teixeira, P.M. et al. Mindfulness-Related Variables and Sexual/Relationship Satisfaction in People with Physical Disabilities. Mindfulness 11, 1993–2006 (2020). https://doi.org/10.1007/s12671-020-01414-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-020-01414-6