Archives of Sexual Behavior

, Volume 43, Issue 7, pp 1417–1429 | Cite as

Sexual Healing: Daily Diary Investigation of the Benefits of Intimate and Pleasurable Sexual Activity in Socially Anxious Adults

  • Todd B. Kashdan
  • Leah M. Adams
  • Antonina S. Farmer
  • Patty Ferssizidis
  • Patrick E. McKnight
  • John B. Nezlek
Original Paper


A growing literature attests to deficits in social and romantic life quality in people with elevated social anxiety, but no research to date has explored how intense intimate encounters influence social anxiety symptoms. This study investigated whether the presence and quality of sexual activity on a given day predicted less social anxiety and negative cognitions on a subsequent day. We also explored whether the benefits of sexual activity would be stronger for more socially anxious individuals. Over 21 days, 172 undergraduate students described the presence and quality of sexual activity, social anxiety symptoms, and use of social comparisons on the day in question. Time-lagged analyses determined that being sexually active on one day was related to less social anxiety symptoms and the generation of fewer negative social comparisons the next day. Furthermore, more intense experiences of pleasure and connectedness during sex predicted greater reductions in social anxiety the next day for people high in trait social anxiety, compared to those low in trait social anxiety. These results were similar regardless of whether sex occurred in the context of romantic relationships or on weekdays versus weekends. The results suggest that sexual activity, particularly when pleasurable and intimate, may mitigate some of the social anxiety and negative comparisons frequently experienced by people with high trait social anxiety.


Social anxiety Social comparison Sexuality Daily diary methodology 



The first author received funding from the Center for Consciousness and Transformation, George Mason University. We are grateful to William Breen for his involvement in earlier stages of this research.


  1. Addis, I. B., Stephen, K., Eeden, V. D., Christina, L., Vittinghoff, E., Jeanette, S., et al. (2006). Sexual activity and function in middle-aged and older. Obstetrics and Gynecology, 107, 755–764. doi: 10.1097/01.AOG.0000202398.27428.e2.PubMedCentralCrossRefPubMedGoogle Scholar
  2. Affleck, G., Zautra, A., Tennen, H., & Armeli, S. (1999). Multilevel daily process designs for consulting and clinical psychology: A preface for the perplexed. Journal of Consulting and Clinical Psychology, 67, 746–754. doi: 10.1037/0022-006X.67.5.746.CrossRefPubMedGoogle Scholar
  3. Alden, L. E., & Taylor, C. T. (2004). Interpersonal processes in social phobia. Clinical Psychology Review, 24, 857–882. doi: 10.1016/j.cpr.2004.07.006.CrossRefPubMedGoogle Scholar
  4. Alden, L. E., Taylor, C. T., Mellings, M. J. B., & Laposa, J. M. (2008). Social anxiety and the interpretation of positive events. Journal of Anxiety Disorders, 22, 577–590. doi: 10.1016/j.janxdis.2007.05.007.CrossRefPubMedGoogle Scholar
  5. Alden, L. E., & Wallace, S. T. (1995). Social phobia and social appraisal in successful and unsuccessful interactions. Behaviour Research and Therapy, 33, 497–506. doi: 10.1016/0005-7967(94)00088-2.CrossRefPubMedGoogle Scholar
  6. Antony, M. M., Rowa, K., Liss, A., Swallow, S. R., & Swinson, R. P. (2005). Social comparison processes in social phobia. Behavior Therapy, 36, 65–75. doi: 10.1016/S0005-7894(05)80055-3.CrossRefGoogle Scholar
  7. Aron, A., Aron, E. N., & Smollan, D. (1992). Inclusion of other in the Self Scale and the structure of interpersonal closeness. Journal of Personality and Social Psychology, 63, 596–612. doi: 10.1037/0022-3514.63.4.596.CrossRefGoogle Scholar
  8. Bauer, D. J., & Curran, P. J. (2005). Probing interactions in fixed and multilevel regression: Inferential and graphical techniques. Multivariate Behavioral Research, 40, 373–400. doi: 10.1207/s15327906mbr4003_5.CrossRefGoogle Scholar
  9. Baumeister, R. F. (2000). Gender differences in erotic plasticity: The female sex drive as socially flexible and responsive. Psychological Bulletin, 126, 347–374. doi: 10.1037/0033-2909.126.3.347.CrossRefPubMedGoogle Scholar
  10. Baumeister, R. F., Catanese, K. R., & Vohs, K. D. (2001). Is there a gender difference in strength of sex drive? Theoretical views, conceptual distinctions, and a review of relevant evidence. Personality and Social Psychology Review, 5, 242–273. doi: 10.1207/S15327957PSPR0503_5.CrossRefGoogle Scholar
  11. Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117, 497–529. doi: 10.1037/0033-2909.117.3.497.CrossRefPubMedGoogle Scholar
  12. Baumeister, R. F., & Tice, D. M. (1990). Anxiety and social exclusion. Journal of Social and Clinical Psychology, 9, 165–195. doi: 10.1521/jscp.1990.9.2.165.CrossRefGoogle Scholar
  13. Beck, J. G., Davila, J., Farrow, S., & Grant, D. (2006). When the heat is on: Romantic partner responses influence distress in socially anxious women. Behaviour Research and Therapy, 44, 737–748. doi: 10.1016/j.brat.2005.05.004.CrossRefGoogle Scholar
  14. Bodinger, L., Hermesh, H., Aizenberg, D., Valevski, A., Marom, S., Shiloh, R., … Weizman, A. (2002). Sexual function and behavior in social phobia. Journal of Clinical Psychiatry, 63, 874–879. doi: 10.4088/JCP.v63n1004
  15. Brown, E. J., Turovsky, J., Heimberg, R. G., Juster, H. R., Brown, T. A., & Barlow, D. H. (1997). Validation of the Social Interaction Anxiety Scale and the Social Phobia Scale across the anxiety disorders. Psychological Assessment, 9, 21–27. doi: 10.1037/1040-3590.9.1.21.CrossRefGoogle Scholar
  16. Brunswik, E. (1955). Representative design and probabilistic theory in a functional psychology. Psychological Review, 62, 193–217. doi: 10.1037/h0047470.CrossRefPubMedGoogle Scholar
  17. Burleson, M. H., Trevathan, W. R., & Todd, M. (2006). In the mood for love or vice versa? Exploring the relations among sexual activity, physical affection, affect, and stress in the daily lives of mid-aged women. Archives of Sexual Behavior, 36, 357–368. doi: 10.1007/s10508-006-9071-1.CrossRefGoogle Scholar
  18. Carmichael, M. S., Warburton, V. L., Dixen, J., & Davidson, J. M. (1994). Relationships among cardiovascular, muscular, and oxytocin responses during human sexual activity. Archives of Sexual Behavior, 23, 59–79. doi: 10.1007/BF01541618.CrossRefPubMedGoogle Scholar
  19. Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York: Guilford Press.Google Scholar
  20. Cooper, M. L., Barber, L. L., Zhaoyang, R., & Talley, A. E. (2011). Motivational pursuits in the context of human sexual relationships. Journal of Personality, 79, 1031–1066. doi: 10.1111/j.1467-6494.2010.00713.x.CrossRefGoogle Scholar
  21. Coté, S., & Moskowitz, D. S. (1998). On the dynamic covariation between interpersonal behavior and affect: Prediction from neuroticism, extraversion, and agreeableness. Journal of Personality and Social Psychology, 75, 1032–1046. doi: 10.1037/0022-3514.75.4.1032.CrossRefPubMedGoogle Scholar
  22. Cox, B. J., Ross, L., Swinson, R. P., & Direnfeld, D. M. (1998). A comparison of social phobia outcome measures in cognitive-behavioral group therapy. Behavior Modification, 22, 285–297. doi: 10.1177/01454455980223004.CrossRefPubMedGoogle Scholar
  23. Davila, J., & Beck, J. G. (2002). Is social anxiety associated with impairment in close relationships? A preliminary investigation. Behavior Therapy, 33, 427–446. doi: 10.1016/S0005-7894(02)80037-5.CrossRefGoogle Scholar
  24. Dindia, K., & Allen, M. (1992). Sex differences in self-disclosure: A meta-analysis. Psychological Bulletin, 112, 106–124. doi: 10.1037/0033-2909.112.1.106.CrossRefPubMedGoogle Scholar
  25. Dunning, D., Heath, C., & Suls, J. (2004). Flawed self-assessment: Implications for health, education, and the workplace. Psychological Science in the Public Interest, 5(3), 69–106. doi: 10.1111/j.1529-1006.2004.00018.x.CrossRefPubMedGoogle Scholar
  26. Fergus, T. A., Valentiner, D. P., McGrath, P. B., Stephenson, K., Gier, S., & Jencius, S. (2009). The Fear of Positive Evaluation Scale: Psychometric properties in a clinical sample. Journal of Anxiety Disorders, 23, 1177–1183. doi: 10.1016/j.janxdis.2009.07.024.CrossRefPubMedGoogle Scholar
  27. Figueira, I., Possidente, E., Marques, C., & Hayes, K. (2001). Sexual dysfunction: A neglected complication of panic disorder and social phobia. Archives of Sexual Behavior, 30, 369–377. doi: 10.1023/A:1010257214859.CrossRefPubMedGoogle Scholar
  28. Fortenberry, J. D., Temkit, M., Tu, W., Graham, C. A., Katz, B. P., & Orr, D. P. (2005). Daily mood, partner support, sexual interest, and sexual activity among adolescent women. Health Psychology, 24, 252–257. doi: 10.1037/0278-6133.24.3.252.CrossRefPubMedGoogle Scholar
  29. Funder, D. C. (2009). Persons, behaviors and situations: An agenda for personality psychology in the postwar era. Journal of Research in Personality, 43, 120–126. doi: 10.1016/j.jrp.2008.12.041.CrossRefGoogle Scholar
  30. Harvey, A. G. (2008). Insomnia, psychiatric disorders, and the transdiagnostic perspective. Current Directions in Psychological Science, 17, 299–303. doi: 10.1111/j.1467-8721.2008.00594.x.CrossRefGoogle Scholar
  31. Hayes, S. C., Luoma, J., Bond, F., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44, 1–25. doi: 10.1016/j.brat.2005.06.006.CrossRefPubMedGoogle Scholar
  32. Heimberg, R. G., Brozovich, F. A., & Rapee, R. M. (2010). A cognitive-behavioral model of social anxiety disorder: Update and extension. In S. G. Hofmann & P. M. DiBartolo (Eds.), Social anxiety: Clinical, developmental, and social perspectives (pp. 395–422). New York: Elsevier. doi: 10.1016/B978-0-12-375096-9.00015-8.CrossRefGoogle Scholar
  33. Herbert, J. D., Rheingold, A., & Brandsma, L. (2010). Assessment of social anxiety and social phobia. In S. G. Hofmann & P. M. DiBartolo (Eds.), Social anxiety: Clinical, developmental, and social perspectives (pp. 24–64). New York: Elsevier. doi: 10.1016/B978-0-12-375096-9.00002-X.Google Scholar
  34. Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36, 193–209. doi: 10.1080/16506070701421313.PubMedCentralCrossRefPubMedGoogle Scholar
  35. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 169–183. doi: 10.1037/a0018555.PubMedCentralCrossRefPubMedGoogle Scholar
  36. Jazaieri, H., Goldin, P. R., Werner, K., Ziv, M., & Gross, J. J. (2012). A randomized trial of MBSR versus aerobic exercise for social anxiety disorder. Journal of Clinical Psychology, 68, 715–731. doi: 10.1002/jclp.21863.PubMedCentralCrossRefPubMedGoogle Scholar
  37. Joiner, T., Sheldon, K., Williams, G., & Pettit, J. (2003). The integration of self-determination principles and scientifically informed treatments is the next tier. Clinical Psychology: Science & Practice, 10, 318–319. doi: 10.1093/clipsy/bpg028.Google Scholar
  38. Kashdan, T. B. (2007). Social anxiety spectrum and diminished positive experiences: Theoretical synthesis and meta-analysis. Clinical Psychology Review, 27, 348–365. doi: 10.1016/j.cpr.2006.12.003.CrossRefPubMedGoogle Scholar
  39. Kashdan, T. B., Adams, L., Savostyanova, A. A., Ferssizidis, P., McKnight, P. E., & Nezlek, J. B. (2011a). Effects of social anxiety and depressive symptoms on the frequency and quality of sexual activity: A daily process approach. Behaviour Research and Therapy, 49, 352–360. doi: 10.1016/j.brat.2011.03.004.CrossRefPubMedGoogle Scholar
  40. Kashdan, T. B., Farmer, A. S., Adams, L., Ferssizidis, P., McKnight, P. E., & Nezlek, J. B. (2013). Distinguishing healthy adults from people with social anxiety disorder: Evidence for the value of experiential avoidance and positive emotions in everyday social interactions. Journal of Abnormal Psychology. doi: 10.1037/a0032733.PubMedGoogle Scholar
  41. Kashdan, T. B., & McKnight, P. E. (2010). The darker side of social anxiety: When aggressive impulsivity prevails over shy inhibition. Current Directions in Psychological Science, 19, 47–50. doi: 10.1177/0963721409359280.CrossRefGoogle Scholar
  42. Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: An experience sampling assessment of positive emotions and events, and emotion suppression. Psychological Science, 17, 120–128. doi: 10.1111/j.1467-9280.2006.01674.x.CrossRefPubMedGoogle Scholar
  43. Kashdan, T. B., Weeks, J. W., & Savostyanova, A. A. (2011b). Whether, how, and when social anxiety shapes positive experiences and events: A self-regulatory framework and treatment implications. Clinical Psychology Review, 31, 786–799. doi: 10.1016/j.cpr.2011.03.012.CrossRefPubMedGoogle Scholar
  44. Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York: Guilford Press.Google Scholar
  45. Kirsch, P., Esslinger, C., Chen, Q., Mier, D., Lis, S., Siddhanti, S., … Meyer-Lindenberg, A. (2005). Oxytocin modulates neural circuitry for social cognition and fear in humans. Journal of Neuroscience, 25, 11489–11493. doi: 10.1523/JNEUROSCI.3984-05.2005 Google Scholar
  46. Kollman, D. M., Brown, T. A., Liverant, G. I., & Hofmann, S. G. (2006). A taxometric investigation of the latent structure of social anxiety disorder in outpatients with anxiety and mood disorders. Depression and Anxiety, 23, 190–199. doi: 10.1002/da.20158.CrossRefPubMedGoogle Scholar
  47. Leary, M. R. (2000). Social anxiety as an early warning system: A refinement and extension of the self-presentational theory of social anxiety. In S. G. Hofmann & P. M. DiBartolo (Eds.), Social phobia and social anxiety: An integration (pp. 321–334). New York: Allyn & Bacon. doi: 10.1016/B978-0-12-375096-9.00018-3.Google Scholar
  48. Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.CrossRefPubMedGoogle Scholar
  49. Mattick, R. P., & Clark, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470. doi: 10.1016/S0005-7967(97)10031-6.CrossRefPubMedGoogle Scholar
  50. McEntee, D. J., & Halgin, R. P. (1999). Cognitive group therapy and aerobic exercise in the treatment of anxiety. Journal of College Student Psychotherapy, 13, 39–58. doi: 10.1300/J035v13n03_04.CrossRefGoogle Scholar
  51. McKnight, P. E., McKnight, K. M., Sidani, S., & Figueredo, A. J. (2007). Missing data: A gentle introduction. New York: Guilford Press.Google Scholar
  52. Meston, C. M. (2006). The effects of state and trait self-focused attention on sexual arousal in sexually functional and dysfunctional women. Behaviour Research and Therapy, 44, 515–532. doi: 10.1016/j.brat.2005.03.009.PubMedCentralCrossRefPubMedGoogle Scholar
  53. Nezlek, J. B. (2002). Day-to-day relationships between self-awareness, daily events, and anxiety. Journal of Personality, 70, 105–131. doi: 10.1111/1467-6494.05005.Google Scholar
  54. Nezlek, J. B. (2011). Multilevel modeling for social and personality psychology. In J. B. Nezlek (Ed.), The SAGE library in social and personality psychology methods (pp. 3–8). London: Sage.Google Scholar
  55. Nezlek, J. B., & Gable, S. L. (2001). Depression as a moderator of relationships between positive daily events and day-to-day psychological adjustment. Personality and Social Psychology Bulletin, 27, 1692–1704. doi: 10.1177/01461672012712012.CrossRefGoogle Scholar
  56. Pelham, B. W. (1995). Self-investment and self-esteem: Evidence for a Jamesian model of self-worth. Journal of Personality and Social Psychology, 69, 1141–1150. doi: 10.1037/0022-3514.69.6.1141.CrossRefGoogle Scholar
  57. Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31, 437–448. doi: 10.3102/10769986031004437.CrossRefGoogle Scholar
  58. Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756. doi: 10.1016/S0005-7967(97)00022-3.CrossRefPubMedGoogle Scholar
  59. Raudenbush, S. W., Bryk, A. S., Cheong, Y. F., & Congdon, R. T. (2000). HLM (Version 6.0). Lincolnwood, IL: Scientific Software International.Google Scholar
  60. Reis, H. T., & Gable, S. L. (2000). Event-sampling and other methods for studying daily experience. In H. T. Reis & C. M. Judd (Eds.), Handbook of research methods in social and personality psychology (pp. 190–222). New York: Cambridge University Press.Google Scholar
  61. Ruscio, A. M. (2010). The latent structure of social anxiety disorder: Consequences of shifting to a dimensional diagnosis. Journal of Abnormal Psychology, 119, 662–671. doi: 10.1037/a0019341.PubMedCentralCrossRefPubMedGoogle Scholar
  62. Schneier, F. R., Heckelman, L. R., Garfinkel, R., Campeas, R., Fallon, B. A., Gitow, A., … Liebowitz, M. R. (1994). Functional impairment in social phobia. Journal of Clinical Psychiatry, 55, 322–331.Google Scholar
  63. Smith, C. V. (2007). In pursuit of ‘good’ sex: Self-determination and the sexual experience. Journal of Social and Personal Relationships, 24, 69–85. doi: 10.1177/0265407507072589.CrossRefGoogle Scholar
  64. Sparrevohn, R. M., & Rapee, R. M. (2009). Self-disclosure, emotional expression and intimacy within romantic relationships of people with social phobia. Behaviour Research and Therapy, 47, 1074–1078. doi: 10.1016/j.brat.2009.07.016.CrossRefPubMedGoogle Scholar
  65. Stathopoulou, G., Powers, M. B., Berry, A. C., Smits, J. A. J., & Otto, M. W. (2006). Exercise interventions for mental health: A quantitative and qualitative review. Clinical Psychology: Science and Practice, 13, 179–193. doi: 10.1111/j.1468-2850.2006.00021.x.Google Scholar
  66. Stephenson, K. R., & Meston, C. M. (2010). Differentiating components of sexual well-being in women: Are sexual satisfaction and sexual distress independent constructs? Journal of Sexual Medicine, 7, 2458–2468. doi: 10.1111/j.1743-6109.2010.01836.x.CrossRefPubMedGoogle Scholar
  67. Stich, F. A. (1998). A meta-analysis of physical exercise as a treatment for symptoms of anxiety adults from the general population. Journal of Psychosomatic Research, 33, 537–547.Google Scholar
  68. Suls, J., & Wills, T. (1991). Social comparison: Contemporary theory and research. Hillsdale, NJ: Erlbaum.Google Scholar
  69. Weeks, J. W., Carleton, R. N., Asmundson, G. J. G., McCabe, R. E., & Antony, M. M. (2010a). “Social anxiety disorder carved at its joints”: evidence for the taxonicity of social anxiety disorder. Journal of Anxiety Disorders, 24, 734–742. doi: 10.1016/j.janxdis.2010.05.006.CrossRefPubMedGoogle Scholar
  70. Weeks, J. W., Jakatdar, T. A., & Heimberg, R. G. (2010b). Comparing and contrasting fears of positive and negative evaluation as facets of social anxiety. Journal of Social and Clinical Psychology, 29, 68–94. doi: 10.1521/jscp.2010.29.1.68.CrossRefGoogle Scholar
  71. Wenzel, A., Graff-Dolezal, J., Macho, M., & Brendle, J. R. (2005). Communication and social skills in in socially anxious and nonanxious individuals in the context of romantic relationships. Behaviour Research and Therapy, 43, 505–519. doi: 10.1016/j.brat.2004.03.010.CrossRefPubMedGoogle Scholar
  72. Zaider, T. I., Heimberg, R. G., & Iida, M. (2010). Anxiety disorders and intimate relationships: A study of daily processes in couples. Journal of Abnormal Psychology, 119, 163–173. doi: 10.1037/a0018473.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Todd B. Kashdan
    • 1
  • Leah M. Adams
    • 1
  • Antonina S. Farmer
    • 1
  • Patty Ferssizidis
    • 1
  • Patrick E. McKnight
    • 1
  • John B. Nezlek
    • 2
    • 3
  1. 1.Department of PsychologyGeorge Mason UniversityFairfaxUSA
  2. 2.Department of PsychologyCollege of William and MaryWilliamsburgUSA
  3. 3.Faculty in PoznańUniversity of Social Sciences and HumanitiesPoznanPoland

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