Abstract
Body satisfaction predicts sexual quality among women and men; however, mechanisms of the association are largely unknown. We hypothesized that sexual anxiety would mediate average associations over 1 year between individuals’ body satisfaction and their own and their partner’s sexual quality, which is comprised of their sexual satisfaction and dissatisfaction, in 123 mixed-sex cohabiting couples. Results of Actor–Partner Interdependence Models extended to Mediation (APIMeM) and tested via multilevel modelling partially supported the hypotheses. Specifically, individuals’ body satisfaction indirectly predicted their own and their partner’s sexual satisfaction through individuals’ sexual anxiety, and indirectly predicted their own, but not their partner’s sexual dissatisfaction through individuals’ sexual anxiety. Thus, when individuals are relatively less satisfied with their bodies, they may experience anxiety during sexual encounters, which then interferes with their own and their partner’s sexual quality.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of Data and Material
Available upon request.
References
Ackard, D. M., Kearney-Cooke, A., & Peterson, C. B. (2000). Effect of body image and self-image on women’s sexual behaviors. International Journal of Eating Disorders, 28, 422–429. https://doi.org/10.1002/1098-108X(200012)28:4%3c422::AID-EAT10%3e3.3.CO;2-T.
Albertsen, E. R., Neff, K. D., & Dill-Shackleford, K. E. (2014). Self-compassion and body dissatisfaction in women: A randomized control trial of a brief meditation intervention. Mindfulness, 6, 444–454. https://doi.org/10.1007/s12671-014-0277-3.
Alleva, J. M., Sheeran, P., Webb, T. L., Martijn, C., & Miles, E. (2015). A meta-analytic review of stand-alone interventions to improve body image. PLoS ONE, 10, e0139177. https://doi.org/10.1371/journal.pone.0139177.
Banfield, S. S., & McCabe, M. P. (2002). An evaluation of the construct of body image. Adolescence, 37, 373–393.
Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54, 140–148. https://doi.org/10.1037//0022-006x.54.2.140.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. Psychological Corporation.
Bonferroni, C. E. (1936). Teoria statistica delle classi e calcolo delle probabilità. Pubblicazioni del R Istituto Superiore di Scienze Economiche e Commerciali di Firenze, 8, 3–62.
Bouchard, K. N., Stewart, J. G., Boyer, S. C., Holden, R. R., & Pukall, C. F. (2019). Sexuality and personality correlates of willingness to participate in sex research. Canadian Journal of Human Sexuality, 1, 26–37. https://doi.org/10.3138/cjhs.2018-0028.
Bowsfield, M. L., Cobb, R. J., Millman, R. D., Pink, J. C., & Logan, J. M. (2015). Validation of the Body Image Questionnaire. Poster presented at the annual conference of the Canadian Sex Research Forum, Kelowna, BC.
Bowsfield, M. L., Cobb, R. J., & Girme, Y. U. (2019). The roles of truth, projection, and directional bias in predicting individuals’ perceptions of partners’ satisfaction with individuals’ bodies and implications for sexual satisfaction. Canadian Journal of Human Sexuality, 28, 120–133. https://doi.org/10.3138/cjhs.2019-0019
Bradford, A., & Meston, C. M. (2006). The impact of anxiety on sexual arousal in women. Behaviour Research and Therapy, 44, 1067–1077. https://doi.org/10.1016/j.brat.2005.08.006.
Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57, 43–54. https://doi.org/10.1016/j.brat.2014.04.001.
Byers, S. E. (2011). Beyond the birds and the bees and was it good for you?: Thirty years of research on sexual communication. Canadian Psychology, 52, 20–28. https://doi.org/10.1037/a0022048.
Campbell, L., Loving, T. J., & LeBel, E. P. (2014). Enhancing transparency of the research process to increase accuracy of findings: A guide for relationship researchers. Personal Relationships, 21, 531–545. https://doi.org/10.1111/pere.12053.
Cash, T. F. (2011). Cognitive-behavioral perspectives on body image. In T. F. Cash & L. Smolak (Eds.), Body image: A handbook of science, practice, and prevention (2nd ed., pp. 39–47). Guilford Press.
Cash, T. F. (2002). Beyond traits: Assessing body image states. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 163–170). Guilford Press.
Cash, T. F., & Pruzinsky, T. (Eds.). (2002). Body image: A handbook of theory, research, and clinical practice. Guilford Press
Cash, T. F., Maikkula, C., & Yamamiya, Y. (2004a). “Baring the body in the bedroom”: Body image, sexual self-schemas, and sexual functioning among college women and men. Electronic Journal of Human Sexuality, 7. http://www.ejhs.org/volume7/bodyimage.html
Cash, T. F., & Pruzinsky, T. (Eds.). (2002). Body image: A handbook of theory, research, and clinical practice. Guilford Press.
Cash, T. F., Thériault, J., & Annis, N. M. (2004b). Body image in an interpersonal context: Adult attachment, fear of intimacy, and social anxiety. Journal of Social and Clinical Psychology, 23, 89–103. https://doi.org/10.1521/jscp.23.1.89.26987.
Collins, L. M., Schafer, J. L., & Kam, C. M. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330–351. https://doi.org/10.1037/1082-989X.6.4.330.
Coutts, J. J., Hayes, A. F., & Jiang, T. (2019). Easy statistical mediation analysis with distinguishable dyadic data. Journal of Communication, 69, 612–649. https://doi.org/10.1093/joc/jqz034.
Davis, D., Shaver, P. R., Widaman, K. F., Vernon, M. L., Folette, W. C., & Beitz, K. (2006). “I can’t get no satisfaction”: Insecure attachment, inhibited sexual communication, and sexual dissatisfaction. Personal Relationships, 13, 465–483. https://doi.org/10.1111/j.1475-6811.2006.00130.x.
Dong, Y., & Peng, C. J. (2013). Principled missing data methods for researchers. Springerplus, 2, 1–17. https://doi.org/10.1186/2193-1801-2-222.
Enders, C. K. (2003). Using the expectation maximization algorithm to estimate coefficient alpha for scales with item-level missing data. Psychological Methods, 8, 322–337. https://doi.org/10.1037/1082-989X.8.3.322.
Fletcher, G. J. O., & Thomas, G. (1996). Close relationship lay theories: Their structure and function. In G. J. O. Fletcher & J. Fitness (Eds.), Knowledge structures in close relationships: A social psychological perspective (pp. 3–24). Erlbaum.
Frederick, D. A., Forbes, G. B., Grigorian, K. E., & Jarcho, J. M. (2007). The UCLA Body Project I: Gender and ethnic differences in self-objectification and body satisfaction among 2,206 undergraduates. Sex Roles, 57, 317–327. https://doi.org/10.1007/s11199-007-9251-z.
Fredrickson, B. L., & Roberts, T. A. (1997). Objectification theory: Toward understanding women’s lived experiences and mental health risks. Psychology of Women Quarterly, 21, 173–206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x.
Funk, J. L., & Rogge, R. D. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. Journal of Family Psychology, 21, 572–583. https://doi.org/10.1037/0893-3200.21.4.572.
Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76, 408–420. https://doi.org/10.1080/03637750903310360.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press.
Holt, A., & Lyness, K. P. (2007). Body image and sexual satisfaction: Implications for couple therapy. Journal of Couple and Relationship Therapy, 6, 45–68. https://doi.org/10.1300/J398v06n03_03.
Impett, E. A., Peplau, L. A., & Gable, S. L. (2005). Approach and avoidance sexual motives: Implications for personal and interpersonal well-being. Personal Relationships, 12, 465–482. https://doi.org/10.1111/j.1475-6811.2005.00126.x.
Impett, E. A., & Tolman, D. L. (2006). Late adolescent girls’ sexual experiences and sexual satisfaction. Journal of Adolescent Research, 21, 628–646. https://doi.org/10.1177/0743558406293964.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10, 144–156. https://doi.org/10.1093/clipsy.bpg016.
Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. Guilford Press.
La Rocque, C. L., & Cioe, J. (2011). An evaluation of the relationship between body image and sexual avoidance. Journal of Sex Research, 48, 397–408. https://doi.org/10.1080/00224499.2010.499522.
Laurent, S. M., & Simons, A. D. (2009). Sexual dysfunction in depression and anxiety: Conceptualizing sexual dysfunction as part of an internalizing dimension. Clinical Psychology Review, 29, 573–585. https://doi.org/10.1016/j.cpr.2009.06.007.
Ledermann, T., Macho, S., & Kenny, D. A. (2011). Assessing mediation in dyadic data using the actor–partner interdependence model. Structural Equation Modeling, 18, 595–612.
Linschoten, M., Weiner, L., & Avery-Clark, C. (2016). Sensate focus: A critical literature review. Sexual and Relationship Therapy, 31, 230–247. https://doi.org/10.1080/14681994.2015.1127909.
Mark, K. P., Herbenick, D., Fortenberry, J. D., Sanders, S., & Reece, M. (2014). A psychometric comparison of three scales and a single-item measure to assess sexual satisfaction. Journal of Sex Research, 51, 159–169. https://doi.org/10.1080/00224499.2013.816261.
Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little.
Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470. https://doi.org/10.1016/S0005-7967(97)10031-6
McCreary, D., & Sadava, S. (2001). Gender differences in relationships among perceived attractiveness, life satisfaction, and health in adults as a function of body mass index and perceived weight. Psychology of Men and Masculinity, 2, 108–116. https://doi.org/10.1037/1524-9220.2.2.108.
McNulty, J. K., Wenner, C. A., & Fisher, T. D. (2014). Longitudinal associations among relationship satisfaction, sexual satisfaction and frequency of sex in early marriage. Archives of Sexual Behavior, 45, 85–97. https://doi.org/10.1007/s10508-014-0444-6.
Meana, M., & Nunnink, S. E. (2006). Gender differences in the content of cognitive distraction during sex. Journal of Sex Research, 43, 59–67. https://doi.org/10.1080/00224490609552299.
Meltzer, A. L., & McNulty, J. K. (2010). Body image and marital satisfaction: Evidence for the mediating role of sexual frequency and sexual satisfaction. Journal of Family Psychology, 24, 156–164. https://doi.org/10.1037/a0019063.
Milhausen, R. R., Buchholz, A. C., Opperman, E. A., & Benson, L. E. (2015). Relationships between body image, body composition, sexual functioning, and sexual satisfaction among heterosexual young adults. Archives of Sexual Behavior, 44, 1621–1633. https://doi.org/10.1007/s10508-014-0328-9.
Miloyan, B., Pachana, N. A., & Suddendorf, T. (2014). The future is here: A review of foresight systems in anxiety and depression. Cognition and Emotion, 5, 795–810. https://doi.org/10.1080/02699931.2013.863179.
Penhollow, T. M., & Young, M. (2008). Predictors of sexual satisfaction: The role of body image and fitness. Electronic Journal of Human Sexuality, 11, 1–14. http://www.ejhs.org/volume11/Penhollow.htm.
Peplau, L. A., Fredrick, D. A., Yee, C., Maisel, N., Lever, J., & Ghavami, N. (2009). Body image satisfaction in heterosexual, gay, and lesbian adults. Archives of Sexual Behavior, 38, 713–725. https://doi.org/10.1007/s10508-008-9378-1.
Pujols, Y., Meston, C. M., & Seal, B. N. (2010). The association between sexual satisfaction and body image in women. Journal of Sexual Medicine, 7, 905–916. https://doi.org/10.1111/j.1743-6109.2009.01604.x.
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.
Rubin, D. B. (1987). Multiple imputation for nonresponse in surveys. Wiley.
Runfola, C. D., Von Holle, A., Trace, S. E., Brownley, K. A., Hofmeier, S. M., Gagne, D. A., & Bulik, C. M. (2013). Body dissatisfaction in women across the lifespan: Results of the UNC-SELF and Gender Body Image (GABI) Studies. European Eating Disorders Review, 21, 52–59. https://doi.org/10.1002/erv.2201.
Sanchez, D. T., & Kiefer, A. K. (2007). Body concerns in and out of the bedroom: Implications for sexual pleasure and problems. Archives of Sexual Behavior, 36, 808–820. https://doi.org/10.1007/s10508-007-9205-0.
Shaw, A. M., & Rogge, R. D. (2016). Evaluating and refining the construct of sexual quality with item response theory: Development of the Quality of Sex Inventory. Archives of Sexual Behavior, 45, 249–270. https://doi.org/10.1007/s10508-015-0650-x.
Snell, W. E., Fisher, T. D., & Walters, A. S. (1993). The Multidimensional Sexuality Questionnaire: An objective self-report measure of psychological tendencies associated with human sexuality. Annals of Sex Research, 6, 27–55. https://doi.org/10.1177/107906329300600102.
Statistics Canada. (2011a). Education in Canada: Attainment, field of study and location of study (Catalogue number 99-012-XIE2011001). http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-012-x/2011001/c-g/c-g04-eng.cfm
Statistics Canada. (2011b). Immigration and ethnocultural diversity in Canada, table 2: Visible minority population and top three visible minority groups, selected census metropolitan areas, Canada, 2011 (Catalogue number 99-010-XX). http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/2011001/tbl/tbl2-eng.cfm
Statistics Canada. (2011c). Income in 2010, age groups, sex and highest certificate, diploma or degree for the population aged 15 years and over in private households of Canada, provinces, territories, census metropolitan areas and census agglomerations, 2011 national household survey (Catalogue number 99-014-X2011040). http://www12.statcan.gc.ca/nhs-enm/2011/dp-pd/dt-td/Rp-eng.cfm?TABID=2&LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GK=0&GRP=0&PID=106637&PRID=0&PTYPE=105277&S=0&SHOWALL=0&SUB=0&Temporal=2013&THEME=98&VID=0&VNAMEE=&VNAMEF=
Steer, A., & Tiggeman, M. (2008). The role of self-objectification in women’s sexual functioning. Journal of Social and Clinical Psychology, 27, 205–225. https://doi.org/10.1521/jscp.2008.27.3.205.
Sterne, J. A. C., White, I. R., Carlin, J. B., Spratt, M., Royston, P., Kenward, M. G., Wood, A. M., & Carpenter, J. R. (2009). Multiple imputation for missing data in epidemiological and clinical research: Potential and pitfalls. British Medical Journal, 338. https://doi.org/10.1136/bmj.b2393.
Stinson, R. D. (2009). The behavioral and cognitive-behavioral treatment of female sexual dysfunction: How far we have come and the path left to go. Sexual and Relationship Therapy, 24, 271–285. https://doi.org/10.1080/14681990903199494.
Tiggeman, M., Martins, Y., & Churchett, L. (2008). Beyond muscles: Unexplored parts of men’s body image. Journal of Health Psychology, 13, 1163–1172. https://doi.org/10.1177/1359105308095971.
Træen, B., Markovic, A., & Kvalem, I. L. (2016). Sexual satisfaction and body image: A cross-sectional study among Norwegian young adults. Sexual and Relationship Therapy, 31, 123–137. https://doi.org/10.1080/14681994.2015.1131815.
van den Brink, F., Smeets, M. A. M., Hessen, D. J., Talens, J. G., & Woertmen, L. (2013). Body satisfaction and sexual health in Dutch female university students. Journal of Sex Research, 50, 786–794. https://doi.org/10.1080/00224499.2012.684250.
Vencill, J. A., Tebbe, E. A., & Garos, S. (2015). It’s not the size of the boat or the motion of the ocean: The role of self-objectification, appearance anxiety, and depression in female sexual functioning. Psychology of Women Quarterly, 39, 741–483. https://doi.org/10.1177/0361684315587703.
Weaver, A. D., & Byers, S. E. (2006). The relationships among body image, body mass index, exercise, and sexual functioning in heterosexual women. Psychology of Women Quarterly, 30, 333–339. https://doi.org/10.1111/j.1471-6402.2006.00308.x.
Wiederman, M. W. (1999). Volunteer bias in sexuality research using college student participants. Journal of Sex Research, 36, 59–66. https://doi.org/10.1080/00224499909551968.
Wiederman, M. W. (2000). Women’s body image self-consciousness during physical intimacy with a partner. Journal of Sex Research, 37, 60–79. https://doi.org/10.1080/00224490009552021.
Yeh, H., Lorenz, F. O., Wickrama, K. A. S., Conger, R. D., & Elder, G. H., Jr. (2006). Relationships among sexual satisfaction, marital quality, and marital instability at midlife. Journal of Family Psychology, 20, 339–343. https://doi.org/10.1037/0893-3200.20.2.339.
Zhaoyang, R., & Cooper, M. L. (2013). Body satisfaction and couple’s daily sexual experience: A dyadic perspective. Archives of Sexual Behavior, 42, 985–998. https://doi.org/10.1007/s10508-013-0082-4.
Acknowledgements
This project is based on Marissa Bowsfield’s M.A. thesis and was funded by an institutional Vice President’s Research Grant (4A) through the Social Sciences and Humanities Research Council of Canada. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Simon Fraser University, 2013s0647, 2017s0495) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Funding
Provided by the Social Sciences and Humanities Research Council of Canada (Internal Vice President’s Research Grant [4A]).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Human participants and/or animals
This article, which includes a study involving human participants, was approved by the Simon Fraser University Research Ethics Board (reference numbers: 2013s0647, 2017s0495). This article does not contain any studies with animals performed by any of the authors.
Informed consent
Informed consent was obtained from all individual 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.
Appendix
Rights and permissions
About this article
Cite this article
Bowsfield, M.L., Cobb, R.J. Sexual Anxiety Mediates Dyadic Associations Between Body Satisfaction and Sexual Quality in Mixed-Sex Couples. Arch Sex Behav 50, 2603–2619 (2021). https://doi.org/10.1007/s10508-021-01999-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-021-01999-6