Contemporary Family Therapy

, Volume 34, Issue 3, pp 376–390 | Cite as

The Impact of Depressive Symptoms and Health on Sexual Satisfaction for Older Couples: Implications for Clinicians

  • Victoria C. Scott
  • Jonathan G. Sandberg
  • James M. Harper
  • Richard B. Miller
Original Paper

Abstract

This study of 535 older married couples examined the relationship between depression and health and sexual satisfaction directly and when mediated by communication. The sample included 535 older couples who completed a survey questionnaire known as Project Couple Retire. Among the items in the questionnaire were measures of depression, health, perception of sexual intimacy, communication and other demographic information. Results from Structural Equation Modeling indicated that for women, health was a significant predictor of sexual satisfaction. For both genders, the results suggest that depression, when mediated by communication, is a predictor of sexual satisfaction among older couples. Implications for clinicians are discussed.

Keywords

Sexual satisfaction Health Depression Older adults 

References

  1. AARP. (1999). AARP/Modern maturity sexuality survey: Summary of findings. Online document available at http://www.aarp.org/mmaturity/sept_Oct99/greatsex.html. Assessed 2005.
  2. Andreson, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventative Medicine, 10(2), 77–84.Google Scholar
  3. Arbuckle, J. L. (2006). Amos (Version 7.0) [Computer Program]. Chicago: SPSS.Google Scholar
  4. Barrett, L. L. (2005). Prescription drug use among midlife and older Americans. Washington, DC: American Association of Retired Persons.Google Scholar
  5. Berman, L. A., Wood, E. L., & Hartmann, D. (2008). Women’s sexual health. The guidebook of sexual medicine (pp. 191–211). California: A&W Publishing Group.Google Scholar
  6. Butler, M. H., Davis, S. D., & Seedal, R. B. (2008). Common pitfalls of beginning therapists using enactments. Journal of Marital and Family Therapy, 34(3), 329–352.PubMedCrossRefGoogle Scholar
  7. Butler, M. H., & Gardner, B. C. (2003). Adapting enactments to couples reactivity: Five developmental stages. Journal of Marital Family Therapy, 29, 311–327.CrossRefGoogle Scholar
  8. Byers, E. S. (2005). Relationship satisfaction and sexual satisfaction: A longitudinal study of individuals in long-term relationships. Journal of Sex Research, 42(2), 113–118.PubMedCrossRefGoogle Scholar
  9. Byrne, B. (2001). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Mahwah, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
  10. Camacho, M., & Reyes-Ortiz, C. (2005). Sexual dysfunction in the elderly: Age or disease? Sealy Center on Aging, 17, 52–56.Google Scholar
  11. Carstensen, L. L., Gottman, J. M., & Levenson, R. W. (1995). Emotional behavior in long-term marriage. Psychology and Aging, 10, 140–149.PubMedCrossRefGoogle Scholar
  12. Cavanaugh, J. C., & Blanchard-Fields, F. (2010). Adult development and aging (6th ed.). Belmont, CA: Wadsworth.Google Scholar
  13. Christopher, R. S., & Sprecher, S. (2000). Sexuality in marriage, dating, and other relationships: A decade review. Journal of Marriage and the Family, 62, 999–1017.CrossRefGoogle Scholar
  14. Clement, J. P., Fray, E., Paycin, S., Leger, J. M., Therme, J. F., & Dumont, D. (1999). Detection of depression in elderly hospitalized patients in emergency wards in France using the CES-D and the Mini-GDS: Preliminary experiences. International Journal of Geriatric Psychiatry, 14, 373–378.PubMedCrossRefGoogle Scholar
  15. Davison, S. L., Bell, R. J., LaChina, M., Holden, S. L., & Davis, S. R. (2008). Sexual function in well women: Stratification by sexual satisfaction, hormone use, and menopause status. Journal of Sexual Medicine, 5(5), 1214–1222. doi: 10.1111/j.1743-6109.2008.00780.x.PubMedCrossRefGoogle Scholar
  16. Davison, S. L., Bell, R. J., LaChina, M., Holden, S. L., & Davis, S. R. (2009). The relationship between self-reported sexual satisfaction and general well-being in women. Journal of Sexual Medicine, 6(10), 2690–2697. doi: 10.1111/j.1743-6109.2009.01406.x.PubMedCrossRefGoogle Scholar
  17. DeLamater, J., Hyde, J. S., & Fong, M. (2008). Sexual satisfaction in the seventh decade of life. Journal of Sex and Marital Therapy, 34(5), 439–454. doi: 10.1080/00926230802156251.PubMedCrossRefGoogle Scholar
  18. DeLamater, J., & Sill, M. (2005). Sexual desire in later life. Journal of Sex Research, 42, 138–149.PubMedCrossRefGoogle Scholar
  19. Dillman, D. A. (2007). Mail and internet surveys: The tailored design method. New York: Wiley.Google Scholar
  20. Dunn, K. M., Croft, P. R., & Hackett, G. I. (1999). Association of sexual problems with social, psychological, and physical problems in men and women: A cross sectional population survey. Journal of Epidemiology and Community Health, 53, 144–148.PubMedCrossRefGoogle Scholar
  21. Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136.PubMedCrossRefGoogle Scholar
  22. Engel, G. L. (1980). The clinical application of the biopsychosocial model. The American Journal of Psychiatry, 137, 535–544.PubMedGoogle Scholar
  23. Ferraro, K. F., & Famer, M. M. (1999). Utility of health data from social surveys: Is there a gold standard for measuring morbidity? American Sociological Review, 64, 303–315.CrossRefGoogle Scholar
  24. Garos, S., Kluck, A., & Aronoff, D. (2007). Prostate cancer patients and their partners: Differences in satisfaction indices and psychological variables. Journal of Sex Medicine, 4(5), 1394–1403.CrossRefGoogle Scholar
  25. Harper, J. M., & Sandberg, J. G. (1999). Depression in mature marriages: Impact and implications for marital therapy. Journal of Marital and Family Therapy, 25(5), 393–406.PubMedGoogle Scholar
  26. Harper, J. M., & Sandberg, J. G. (2009). Depression and communication processes in later life marriages. Aging and Mental Health, 13(4), 546–556.PubMedCrossRefGoogle Scholar
  27. Hertlein, K. M., Weeks, G. R., & Sendak, S. K. (2009). A clinician’s guide to systemic sex therapy. New York: Routledge.Google Scholar
  28. Hillman, J. (2008). Sexual issues and aging within the context of work with older adult patients. Professional Psychology: Research and Practice, 39(3), 290–297. doi: 10.1037/0735-7028.39.3.290.CrossRefGoogle Scholar
  29. Himes, C. L. (2010). Aging. New York, NY: Mc-Graw-Hill.Google Scholar
  30. Hoyle, R. H., & Panter, A. T. (1995). Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 158–176). Thousand Oaks, CA: Sage Publications.Google Scholar
  31. Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.PubMedCrossRefGoogle Scholar
  32. Jacoby, S. (2005). Sex in America. Retrieved February 26, 2008 from http://aarpmagazine.org/lifestyle/relationships/sex_in_america.html.
  33. Johnson, S. M., & Zuccarini, D. (2011). EFT for sexual issues: An integrated model of couple and sex therapy. In J. Furrow, B. Bradley, & S. Johnson (Eds.), The emotionally focused casebook (pp. 219–246). New York: Brunner Routledge.Google Scholar
  34. Kalayjian, L. D., & Morrell, M. (2000). Female sexuality and neurological disease. Journal of Sex Education and Therapy, 25(1), 89–95.Google Scholar
  35. Katzin, L. (1990). Chronic illness and sexuality. The American Journal of Nursing, 90(1), 54–59.PubMedGoogle Scholar
  36. Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York: Guilford Publications.Google Scholar
  37. Laidlaw, K., & Pachana, N. A. (2009). Aging, mental health, and demographic change: Challenges for psychotherapists. Professional Psychology: Research and Practice, 40(6), 601–608. doi: 10.1037/a0017215.CrossRefGoogle Scholar
  38. Laumann, E. O., Paik, A., Glasser, D. B., Kang, J. H., Wang, T., Levinson, B., et al. (2006). A cross-national study of subjective sexual well-being among older men and women: Findings from the global study of sexual attitudes and sexual behaviors. Archives of Sexual Behavior, 35, 145–161.PubMedCrossRefGoogle Scholar
  39. Laumann, E. O., Paik, A., & Rosen, R. D. (1999). Sexual dysfunction in the United States: Prevalence and predictors. JAMA, 281, 537–544.PubMedCrossRefGoogle Scholar
  40. Lindau, S. T., Schumm, P., Laumann, E. O., Levinson, W., O’Muircheartaigh, C., & Waite, L. J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357(8), 762–774.PubMedCrossRefGoogle Scholar
  41. Litzinger, S., & Gordon, K. C. (2005). Exploring relationships among communication, sexual satisfaction, and marital satisfaction. Journal of Sex and Marital Therapy, 31(5), 409–424. doi: 10.1080/00926230591006719.PubMedCrossRefGoogle Scholar
  42. Markman, H. J., Renick, M. J., Floyd, F. J., Stanley, S. M., & Clements, M. (1993). Preventing marital distress through communication and conflict management training: A 4-and 5-year follow up. Journal of Consulting and Clinical Psychology, 61, 10–11.CrossRefGoogle Scholar
  43. Maurice, W. (1999). Sexual medicine in primary care. New York: Mosby.Google Scholar
  44. Metz, M. E., & Dwyer, S. M. (1993). Relationship conflict management patterns among sex dysfunction, sex offender, and satisfied couples. Journal of Sex and Marital Therapy, 19, 104–122.PubMedCrossRefGoogle Scholar
  45. Metz, M. E., & Epstein, N. (2002). Assessing the role of relationship conflict and in sexual dysfunction. Journal of Sex and Marital Therapy, 28, 139–164.PubMedCrossRefGoogle Scholar
  46. Mills, T. L. (2001). Comorbid depressive symptomatology: Isolating the effects of chronic medical conditions on self-reported depressive symptoms among community-dwelling older adults. Social Science and Medicine, 53, 569–578.PubMedCrossRefGoogle Scholar
  47. Mulligan, T., Retchin, S. M., Chinchilli, V. M., & Bettinger, C. B. (1988). The role of aging and chronic disease on sexual dysfunction. Journal of the American Geriatics Society, 36, 522–524.Google Scholar
  48. Murrell, S. A., Meeks, S., & Walker, J. S. (1991). Protective functions of health and self esteem against depression in older adults facing illness or bereavement. Psychology and Aging, 6, 352–360.PubMedCrossRefGoogle Scholar
  49. National Women’s Health Information Center. (2008) Understanding menopause. Retrieved September 11, 2008 from http://www.womenshealth.gov/menopause/stages/perimenopause.cfm.
  50. Newcomb, M. D., & Locke, T. F. (2001). Intergenerational cycle of maltreatment: A popular concept obscured by methodological limitations. Child Abuse and Neglect, 25, 1219–1240.PubMedCrossRefGoogle Scholar
  51. Nicolosi, A., Moreira, E. D., Jr, Villa, M., & Glasser, D. B. (2004). A population study of the association between sexual function, sexual satisfaction and depressive symptoms in men. Journal of Affective Disorders, 82, 235–243.PubMedCrossRefGoogle Scholar
  52. Offman, A., & Matheson, K. (2005). Sexual compatibility and sexual functioning in intimate relationships. Canadian Journal of Human Sexuality, 14(1), 31–39.Google Scholar
  53. Olson, D. H., & Schaefer, M. T. (1981). Assessing intimacy: The PAIR inventory. Journal of Marriage and Family Therapy, 7(1), 47–60.CrossRefGoogle Scholar
  54. Parashos, I. A., Stamouli, S., Rogakou, E., Theodotou, R., Nikas, I., & Mougias, A. (2002). Recognition of depressive symptoms in the elderly: What can help the patient and the doctor? Depression and Anxiety, 15(3), 111–116.PubMedCrossRefGoogle Scholar
  55. Poorman, S. G. (1988). Human sexuality and the nursing process. Norwalk, CT: Appleton & Lange.Google Scholar
  56. Preacher, K., & Leonardelli, G. (2006). Calculation for the sobel test. Retrieved from http://people.ku.edu/~preacher/sobel/sobel.htm.
  57. Purnine, D. M., & Carey, M. P. (1997). Interpersonal communication and sexual adjustment: The roles of understanding and agreement. Journal of Consulting and Clinical Psychology, 65, 1017–1025.PubMedCrossRefGoogle Scholar
  58. Radloff, L. S., & Teri, L. (1986). Use of the center for epidemiological studies-depression scale with older adults. Clinical Gerontologist, 5(2), 119–136.CrossRefGoogle Scholar
  59. Rolland, J. S., & Walsh, F. (2005). Systemic training for healthcare professionals: The Chicago Center for Family Health approach. Family Process, 44(3), 283–301.PubMedCrossRefGoogle Scholar
  60. Rosen, R. C., & Leiblum, S. R. (1988). A sexual scripting approach to problems of desire. In S. R. Leiblum & R. C. Rosen (Eds.), Sexual desire disorders (pp. 168–191). New York: Guilford.Google Scholar
  61. Santor, D. A., Zuroff, D. C., Ramsay, J. O., Cervantes, P., & Palacios, J. (1995). Examining scale discriminability in the BDI and CES-D as a function of depressive severity. Psychological Assessment, 7, 131–139.CrossRefGoogle Scholar
  62. Schulz, R., Martire, L. M., Beach, S. R., & Scheier, M. F. (2000). Depression and mortality in the elderly. Current Directions in Psychological Science, 9, 204–208.CrossRefGoogle Scholar
  63. Seidman, S. M. (2003). The aging male: Androgens, erectile dysfunction, and depression. Journal of Clinical Psychology, 64, 31–37.Google Scholar
  64. Snyder, D. K. (1979). Multidimensional assessment of marital satisfaction. Journal of Marriage and the Family, 41, 813–823.CrossRefGoogle Scholar
  65. Snyder, D. K. (1997). Marital satisfaction inventory, revised. Los Angeles: Western Psychological Services.Google Scholar
  66. Snyder, D. K., & Regts, J. M. (1990). Personality correlates of marital dissatisfaction: A comparison of psychiatric, martially distressed, and nonclinic samples. Journal of Sex and Marital Therapy, 16(1), 34–43.PubMedCrossRefGoogle Scholar
  67. Spence, S. H. (1997). Sex and relationships. In W. K. Halford & H. J. Markman (Eds.), Clinical handbook of marriage and couples interventions (pp. 73–105). New York: Wiley.Google Scholar
  68. Sprecher, S., & Cate, R. M. (2004). Sexual satisfaction and sexual expression as predictors of relationship satisfaction and stability. In J. H. Harvey, A. Wenzel, & S. Sprecher (Eds.), The handbook of sexuality in close relationships (pp. 235–256). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  69. Waite, L. J., & Joyner, K. (2001). Emotional Satisfaction and Physical Pleasure in Sexual Unions: Time Horizon, Sexual Behavior, and Sexual Exclusivity. Journal of Marrisage and the Family, 63, 247–264.CrossRefGoogle Scholar
  70. Young, M., Denny, G., Luquis, R., & Young, T. (1998). Correlates of sexual satisfaction in marriage. The Canadian Journal of Human Sexuality, 7, 115–127.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Victoria C. Scott
    • 1
  • Jonathan G. Sandberg
    • 1
  • James M. Harper
    • 1
  • Richard B. Miller
    • 1
  1. 1.School of Family LifeBrigham Young UniversityProvoUSA

Personalised recommendations