Use of an Ecological Model to Study Sexual Satisfaction in a Heterosexual Spanish Sample

Abstract

Sexual satisfaction is a key factor in sexual health and has been associated with quality of life. However, few studies have focused on the factors related to sexual satisfaction in the population in Spain. The main goal of this research was to analyze the predictive capacity of an ecological model for the study of sexual satisfaction in a Spanish sample of 723 men and 851 women, with mean age equal to 36.28 (SD = 12.59) and who were in a heterosexual relationship. We analyzed, using structural equation modeling, the degree to which sexual satisfaction was related to different variables. These variables were the following: personal variables (depression and sexual attitudes); interpersonal variables (relationship satisfaction, sexual function, and sexual assertiveness); social variables (social support, parenthood, and annual income); and cultural variables (political ideology, religion, and religious practice). In men, sexual satisfaction was directly predicted by relationship satisfaction and sexual function. Furthermore, political ideology, religious practice, social support, annual income, initiation sexual assertiveness, and sexual attitudes were indirectly associated with sexual satisfaction. In women, sexual satisfaction was directly predicted by relationship satisfaction, sexual function, sexual assertiveness, and sexual attitudes. In addition, political ideology, religious practice, and social support were indirectly associated with sexual satisfaction. Implications for research and therapy are also discussed.

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References

  1. AARP. (1999). AARP/Modern Maturity Sexuality Survey. Retrieved February 12, 2015 from http://www.aarp.org/research/reference/publicopinions/aresearch-import-726.html.

  2. Ahlborg, T., Dahlöf, L. G., & Hallberg, L. R. (2005). Quality of intimate and sexual relationship in first-time parents six months after delivery. Journal of Sex Research, 42, 167–174. doi:10.1080/00224490509552270.

    Article  PubMed  Google Scholar 

  3. Ahlborg, T., Dahlöf, L. G., & Strandmark, M. (2000). First-time parents’ sexual relationships. Scandinavian Journal of Sexology, 3, 127–139.

    Google Scholar 

  4. Allen, E. S., Atkins, D. C., Baucom, D. H., Snyder, D. K., Gordon, K. C., & Glass, S. P. (2005). Intrapersonal, interpersonal, and contextual factors in engaging in and responding to extramarital involvement. Clinical Psychology: Science and Practice, 12, 101–130. doi:10.1093/clipsy.bpi014.

    Google Scholar 

  5. Amato, P. R., Booth, A., Johnson, D. R., & Rogers, S. J. (2007). Alone together: How marriage in America is changing. Cambridge, MA: Harvard University Press.

    Google Scholar 

  6. Antonucci, T. C., & Akiyama, H. (1987). An examination of sex differences in social support among older men and women. Sex Roles, 17, 737–749. doi:10.1007/BF00287685.

    Article  Google Scholar 

  7. Bancroft, J., Loftus, J. L., & Long, S. J. (2003). Distress about sex: A national survey of women in heterosexual relationships. Archives of Sexual Behavior, 32, 193–208. doi:10.1023/A:1023420431760.

    Article  PubMed  Google Scholar 

  8. Basson, R., & Schultz, W. W. (2007). Sexual sequelae of general medical disorders. Lancet, 369, 409–424. doi:10.1016/S0140-6736(07)60197-4.

    Article  PubMed  Google Scholar 

  9. Bronfenbrenner, U. (1994). Ecological models of human development. In T. Husten & T. N. Postlethewaite (Eds.), International encyclopedia of education (2nd ed., Vol. 3, pp. 1643–1647). New York: Elsevier.

    Google Scholar 

  10. Byers, E. S. (2005). Relationship satisfaction and sexual satisfaction: A longitudinal study of individuals in long-term relationships. Journal of Sex Research, 42, 113–118. doi:10.1080/00224490509552264.

    Article  PubMed  Google Scholar 

  11. Byers, E. S., & Demmons, S. (1999). Sexual satisfaction and sexual self-disclosure within dating relationships. Journal of Sex Research, 36, 180–189. doi:10.1080/00224499909551983.

    Article  Google Scholar 

  12. Byers, E. S., & MacNeil, S. (2006). Further validation of the interpersonal exchange model of sexual satisfaction. Journal of Sex and Marital Therapy, 32, 53–69. doi:10.1080/00926230500232917.

    Article  PubMed  Google Scholar 

  13. Byers, E. S., & Rehman, U. S. (2014). Sexual well-being. In D. Tolman & L. Diamond (Eds.), APA handbook of sexuality and psychology (pp. 317–337). Washington, DC: APA books.

    Google Scholar 

  14. Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming (2nd ed.). New York: Taylor and Francis.

    Google Scholar 

  15. Carpenter, L. M., Nathanson, C. A., & Kim, Y. J. (2009). Physical women, emotional men: Gender and sexual satisfaction in midlife. Archives of Sexual Behavior, 38, 87–107. doi:10.1007/s10508-007-9215-y.

    Article  PubMed  Google Scholar 

  16. Castellanos-Torres, E., Álvarez-Dardet, C., Ruiz-Muñoz, D., & Pérez, G. (2013). Social determinants of sexual satisfaction in Spain considered from the gender perspective. Annals of Epidemiology, 23, 150–156. doi:10.1016/j.annepidem.2012.12.010.

    Article  PubMed  Google Scholar 

  17. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357. doi:10.1037/0033-2909.98.2.310.

    Article  PubMed  Google Scholar 

  18. Conger, R. D., Conger, K. J., & Martin, M. J. (2010). Socioeconomic status, family processes, and individual development. Journal of Marriage and Family, 72, 685–704. doi:10.1111/j.1741-3737.2010.00725.x.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cutrona, C. E. (1996). Social support as a determinant of marital quality. In G. R. Pierce, B. R. Sarason, & I. G. Sarason (Eds.), Handbook of social support and the family (pp. 173–194). New York: Plenum Press.

    Chapter  Google Scholar 

  20. Davidson, J. K., Darling, C. A., & Norton, L. (1995). Religiosity and the sexuality of women: Sexual behavior and sexual satisfaction revisited. Journal of Sex Research, 32, 235–243. doi:10.1080/00224499509551794.

    Article  Google Scholar 

  21. Davidson, J. K., Moore, N. B., & Ullstrup, K. M. (2004). Religiosity and sexual responsibility: Relationships of choice. American Journal of Health and Behavior, 28, 335–346. doi:10.5993/AJHB.28.4.5.

    Article  Google Scholar 

  22. Dehle, C., Larsen, D., & Landers, J. E. (2001). Social support in marriage. American Journal of Family Therapy, 29, 307–324. doi:10.1080/01926180126500.

    Article  Google Scholar 

  23. del Río, F. J., Cabello, F., & Fernández, I. (2015). Influence of substance use on the erectile response in a sample of drug users. International Journal of Clinical and Health Psychology, 15, 37–43. doi:10.1016/j.ijchp.2014.10.002.

    Article  Google Scholar 

  24. del Río-Olvera, F. J., López-Vega, D., & Cabello-Santamaría, F. (2013). Adaptación del cuestionario Sexual Opinion Survey: Encuesta revisada de Opinión Sexual. Revista Internacional de Andrología, 11, 9–16. doi:10.1016/j.androl.2012.09.003.

    Article  Google Scholar 

  25. Diéguez, J. L., Diz, M. C., Sueiro, E., & Chas, M. D. (2003). Actitudes hacia la sexualidad de adolescentes que residen en el medio rural gallego (2a parte). Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace, 66, 56–67.

    Google Scholar 

  26. Fava, M., Rankin, M. A., Alpert, J. E., Nierenberg, A. A., & Worthington, J. J. (1998). An open trial of oral sildenafilin antidepressant-induced sexual dysfunction. Psychotherapy and Psychosomatics, 67, 328–331. doi:10.1159/000012299.

    Article  PubMed  Google Scholar 

  27. Field, N., Mercer, C. H., Sonnenberg, P., Tanton, C., Clifton, S., Mitchell, K. R., … Johnson, A. (2013). Associations between health and sexual lifestyles in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 382, 1830–1844. doi:10.1016/S0140-6736(13)62222-9.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Finney, S. J., & DiStefano, C. (2006). Non-normal and categorical data in structural equation modeling. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (pp. 269–314). Greenwich, CT: Information Age.

    Google Scholar 

  29. Fisher, W. A., Byrne, D., White, L. A., & Kelley, K. (1988). Erotophobia-erotophilia as a dimension of personality. Journal of Sex Research, 25, 123–151. doi:10.1080/00224498809551448.

    Article  Google Scholar 

  30. Goldfarb, M. C., Trudel, G., Boyer, R., & Preville, M. (2007). Marital relationship and psychological distress: Its correlates and treatments. Sexual and Relationship Therapy, 22, 109–126. doi:10.1080/14681990600861040.

    Article  Google Scholar 

  31. Graham, C. A., Sanders, S. A., & Milhausen, R. R. (2011). Sexual excitation/sexual inhibition inventory for women. In T. D. Fisher, C. M. Davis, W. L. Yarber, & S. L. Davis (Eds.), Handbook of sexuality-related measures (3rd ed., pp. 239–249). New York: Routledge.

    Google Scholar 

  32. Grav, S., Hellzèn, O., Romild, U., & Stordal, E. (2012). Association between social support and depression in the general population: The HUNT study, a cross-sectional survey. Journal of Clinical Nursing, 21, 111–120. doi:10.1111/j.1365-2702.2011.03868.x.

    Article  PubMed  Google Scholar 

  33. Greene, K., & Faulkner, S. L. (2005). Gender, belief in the sexual double standard, and sexual talk in heterosexual dating relationships. Sex Roles, 53, 239–251. doi:10.1007/s11199-005-5682-6.

    Article  Google Scholar 

  34. Haavio-Mannila, E., & Kontula, O. (1997). Correlates of increased sexual satisfaction. Archives of Sexual Behavior, 26, 399–419. doi:10.1023/A:1024591318836.

    Article  PubMed  Google Scholar 

  35. Hassebrauck, M., & Fehr, B. (2002). Dimensions of relationship quality. Personal Relationships, 9, 253–270. doi:10.1111/1475-6811.00017.

    Article  Google Scholar 

  36. Heiman, J. R., Long, J. S., Smith, S. N., Fisher, W. A., Sand, M. S., & Rosen, R. C. (2011). Sexual satisfaction and relationship happiness in midlife and older couples in five countries. Archives of Sexual Behavior, 40, 741–753. doi:10.1007/s10508-010-9703-3.

    Article  PubMed  Google Scholar 

  37. Henderson, A. W., Lehavot, K., & Simoni, J. M. (2009). Ecological models of sexual satisfaction among lesbian/bisexual and heterosexual women. Archives of Sexual Behavior, 38, 50–65. doi:10.1007/s10508-008-9384-3.

    Article  PubMed  Google Scholar 

  38. Higgins, J. A., Trussell, J., Moore, N. B., & Davidson, J. K. (2010). Virginity lost, satisfaction gained? Physiological and psychological sexual satisfaction at heterosexual debut. Journal of Sex Research, 47, 384–394. doi:10.1080/00224491003774792.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Hurlbert, D. F., Apt, C., & Rabehl, S. M. (1993). Key variables to understanding female sexual satisfaction: An examination of women in nondistressed marriages. Journal of Sex and Marital Therapy, 19, 154–165. doi:10.1080/00926239308404899.

    Article  PubMed  Google Scholar 

  40. King, M., Nazareth, I., Levy, G., Walker, C., Morris, R., Weich, S., … Torres-Gonzales, T. (2008). Prevalence of common mental disorders in general practice attendees across Europe. British Journal of Psychiatry, 192, 362–367. doi:10.1192/bjp.bp.107.039966.

    Article  PubMed  Google Scholar 

  41. Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford Press.

    Google Scholar 

  42. Lawrance, K., & Byers, E. S. (1995). Sexual satisfaction in long-term heterosexual relationships: The Interpersonal Exchange Model of Sexual Satisfaction. Personal Relationships, 2, 267–285. doi:10.1111/j.1475-6811.1995.tb00092.x.

    Article  Google Scholar 

  43. Lawrance, K., Byers, E. S., & Cohen, J. N. (2011). Interpersonal Exchange Model of Sexual Satisfaction questionnaire. In T. D. Fisher, C. M. Davis, W. L. Yarber, & S. L. Davis (Eds.), Handbook of sexuality-related measures (3rd ed., pp. 525–530). New York: Routledge.

    Google Scholar 

  44. Lewis, R. W., Fugl-Meyer, K. S., Bosch, R., Fugl-Meyer, A. R., Laumann, E. O., Lizza, E., … Martin-Morales, A. (2004). Definitions/epidemiology/risk factors for sexual dysfunction. Journal of Sexual Medicine, 1, 35–39. doi:10.1111/j.1743-6109.2004.10106.x.

    Article  PubMed  Google Scholar 

  45. Lewis, R. W., Fugl-Meyer, K. S., Corona, G., Hayes, R. D., Laumann, E. O., Moreira, E. D., … Segraves, T. (2010). Definitions/epidemiology/risk factors for sexual dysfunction. Journal of Sexual Medicine, 7, 1598–1607. doi:10.1111/j.1743-6109.2010.01778.x.

    Article  PubMed  Google Scholar 

  46. Lorant, V., Deliège, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157, 98–112. doi:10.1093/aju/kwf182.

    Article  PubMed  Google Scholar 

  47. MacNeil, S., & Byers, E. S. (2005). Dyadic assessment of sexual self-disclosure and sexual satisfaction in heterosexual dating couples. Journal of Social and Personal Relationships, 22, 169–181. doi:10.1177/0265407505050942.

    Article  Google Scholar 

  48. MacNeil, S., & Byers, E. S. (2009). Role of sexual self-disclosure in the sexual satisfaction of long-term heterosexual couples. Journal of Sex Research, 46, 3–14. doi:10.1080/00224490802398399.

    Article  PubMed  Google Scholar 

  49. Marina, P., García-Portilla, M. P., Jiménez, L., Palicio, L., Trabajo, P., & Bobes, J. (2013). Función sexual en pacientes deprimidos: relación entre síntomas depresivos y disfunción sexual. Revista Neuropsiquiatria, 76, 161–172.

    Article  Google Scholar 

  50. Mark, K. P., & Jozkowski, K. N. (2013). The mediating role of sexual and nonsexual communication between relationship and sexual satisfaction in a sample of college-age heterosexual couples. Journal of Sex and Marital Therapy, 39, 410–427. doi:10.1080/0092623X.2011.644652.

    Article  PubMed  Google Scholar 

  51. Mark, K. P., Milhausen, R. R., & Maitland, S. B. (2013). The impact of sexual compatibility on sexual and relationship satisfaction in a sample of young adult heterosexual couples. Sexual and Relationship Therapy, 28, 201–214. doi:10.1080/14681994.2013.807336.

    Article  Google Scholar 

  52. Markovic, D. (2007). Working with sexual issues in systematic therapy. Australian and New Zealand Journal of Family Therapy, 28, 200–2009. doi:10.1375/anft.28.4.200.

    Article  Google Scholar 

  53. Markovic, D. (2013). Multidimensional psychosexual therapy: A model of integration between sexology and systemic therapy. Sexual and Relationship Therapy, 28, 311–323. doi:10.1080/14681994.2013.845656.

    Article  Google Scholar 

  54. Matud, M. P. (1998). Investigación del estrés y su impacto en la salud de las mujeres en Canarias. Tenerife: Informe del Proyecto de Investigación Instituto Canario de la Mujer.

    Google Scholar 

  55. Matud, M. P., Ibáñez, I., Bethencourt, J. M., Marrero, R. J., & Carballeira, M. (2003). Structural differences in perceived social support. Personality and Individual Differences, 35, 1919–1929. doi:10.1016/S0191-8869(03)00041-2.

    Article  Google Scholar 

  56. Ménard, A. D., & Offman, A. (2009). The interrelationships between sexual self-esteem, sexual assertiveness and sexual satisfaction. Canadian Journal of Human Sexuality, 18, 35–45.

    Google Scholar 

  57. Metz, M. E., & McCarthy, B. W. (2007). The “Good-enough sex” model for couple sexual satisfaction. Sexual and Relationship Therapy, 22, 351–362. doi:10.1080/14681990601013492.

    Article  Google Scholar 

  58. Morokoff, P. J., Quina, K., Harlow, L. L., Whitmire, L., Grimley, D. M., Gibson, P. R., … Burkholder, G. J. (1997). Sexual Assertiveness Scale (SAS) for women: Development and validation. Journal of Personality and Social Psychology, 73, 790–804. doi:10.1037/0022-3514.73.4.790.

    Article  PubMed  Google Scholar 

  59. Nicolosi, A., Laumann, E. O., Glasser, D. B., Moreira, E. D., Paik, A., Gingell, C., … Global Study of Sexual Attitudes and Behaviors Investigators’ Group. (2004). Sexual behavior and sexual dysfunctions after age 40: The Global Study of Sexual Attitudes and Behaviors. Urology, 64, 991–997. doi:10.1016/j.urology.2004.06.055.

    Article  PubMed  Google Scholar 

  60. Oattes, M. K., & Offman, A. (2007). Global self-esteem and sexual self-esteem as predictors of sexual communication in intimate relationships. Canadian Journal of Human Sexuality, 16, 89–100.

    Google Scholar 

  61. Ortega, V., Sierra, J. C., & Zubeidat, I. (2004). Evaluación de algunos factores determinantes del deseo sexual: Estado emocional, actitudes sexuales y fantasías sexuales. Análisis y Modificación de Conducta, 30, 105–130.

    Google Scholar 

  62. Pastuszak, A. W., Dabhiwala, N., & Khera, M. (2013). Depression is correlated with the psychological and physical aspects of sexual dysfunction in men. International Journal of Impotence Research, 25, 194–199. doi:10.1038/ijir.2013.4.

    Article  PubMed  Google Scholar 

  63. Pedersen, W., & Blekesaune, M. (2003). Sexual satisfaction in young adulthood: Cohabitation, committed dating or unattached life? Acta Sociologica, 46, 179–193. doi:10.1177/00016993030463001.

    Article  Google Scholar 

  64. Radloff, J. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  65. Ramiro, M. T., Teva, I., Bermúdez, M. P., & Buela-Casal, G. (2013). Social support, self-esteem and depression: Relationship with risk for sexually transmitted infections/HIV transmission. International Journal of Clinical and Health Psychology, 13, 181–188. doi:10.1016/S1697-2600(13)70022-X.

    Article  Google Scholar 

  66. Rosen, N. O., Bergeron, S., Sadikaj, G., Glowacka, M., Baxter, M. L., & Delisle, I. (2014). Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: A dyadic daily experience study. Pain, 155, 1374–1383. doi:10.1016/j.pain.2014.04.017.

    Article  PubMed  Google Scholar 

  67. Ruiz-Muñoz, D., Wellings, K., Castellanos-Torres, E., Álvarez-Dardet, C., Casals-Cases, M., & Pérez, G. (2013). Sexual health and socioeconomic-related factors in Spain. Annals of Epidemiology, 23, 620–628. doi:10.1016/j.annepidem.2013.07.005.

    Article  PubMed  Google Scholar 

  68. Sánchez-Fuentes, M. M., & Santos-Iglesias, P. (2015). Sexual satisfaction in Spanish heterosexual couples: Testing the Interpersonal Exchange Model of Sexual Satisfaction. Journal of Sex & Marital Therapy. doi:10.1080/0092623X.2015.1010675.

    Google Scholar 

  69. Sánchez-Fuentes, M. M., Santos-Iglesias, P., Byers, E. S., & Sierra, J. C. (2015). Validation of the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire (EMSSQ) in a Spanish sample. Journal of Sex Research, 52, 1028–1041. doi:10.1080/00224499.2014.989307.

    Article  Google Scholar 

  70. Sánchez-Fuentes, M. M., Santos-Iglesias, P., & Sierra, J. C. (2014). A systematic review of sexual satisfaction. International Journal of Clinical and Health Psychology, 14, 67–75. doi:10.1016/S1697-2600(14)70038-9.

    Article  Google Scholar 

  71. Sánchez-Fuentes, M. M., & Sierra, J. C. (2015). Sexual satisfaction in a heterosexual and homosexual Spanish sample: The role of socio-demographic characteristics, health indicators, and relational factors. Sexual and Relationship Therapy, 30, 226–242. doi:10.1080/14681994.2014.978275.

    Article  Google Scholar 

  72. Santos-Iglesias, P., & Sierra, J. C. (2010). El papel de la asertividad sexual en la sexualidad humana: una revisión sistemática. International Journal of Clinical and Health Psychology, 10, 553–577.

    Google Scholar 

  73. Santos Iglesias, P., Sierra, J. C., García, M., Martínez, A., Sánchez, A., & Tapia, M. I. (2009). Índice de Satisfacción Sexual (ISS): un estudio sobre su fiabilidad y validez. International Journal of Psychology and Psychological Therapy, 9, 259–273.

    Google Scholar 

  74. Santos-Iglesias, P., Sierra, J. C., & Vallejo-Medina, P. (2013). Predictors of sexual assertiveness: The role of sexual desire, arousal, attitudes, and partner abuse. Archives of Sexual Behavior, 42, 1043–1052. doi:10.1007/s10508-012-9998-3.

    Article  PubMed  Google Scholar 

  75. Saunders, J. M., & Edwards, J. N. (1984). Extramarital sexuality: A predictive model of permissive attitudes. Journal of Marriage and the Family, 46, 825–835. doi:10.2307/352530.

    Article  Google Scholar 

  76. Shackelford, T. K., & Buss, D. M. (2000). Marital satisfaction and spousal cons-infliction. Personality and Individual Differences, 28, 917–928. doi:10.1016/S0191-8869(99)00150-6.

    Article  Google Scholar 

  77. Sierra, J. C., Ortega, V., & Gutiérrez-Quintanilla, J. R. (2008). Encuesta de Opinión Sexual: Fiabilidad, validez y datos normativos de una versión reducida en muestras salvadoreñas. Revista Mexicana de Psicología, 25, 139–150.

    Google Scholar 

  78. Sierra, J. C., Santos-Iglesias, P., & Vallejo-Medina, P. (2012). Evaluación de la equivalencia factorial y métrica de la Sexual Assertiveness Scale (SAS) por sexo. Psicothema, 24, 316–322.

    PubMed  Google Scholar 

  79. Sierra, J. C., Vallejo-Medina, P., & Santos-Iglesias, P. (2011). Propiedades psicométricas de la versión española de la Sexual Assertiveness Scale (SAS). Anales de Psicología, 27, 17–26. doi:10.6018/113431.

    Google Scholar 

  80. Sierra, J. C., Vallejo-Medina, P., Santos-Iglesias, P., & Lameiras-Fernández, M. (2012). Validación del Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) en población española. Atención Primaria, 44, 516–526. doi:10.1016/j.aprim.2012.02.004.

    Article  PubMed  Google Scholar 

  81. Simon, W., & Gagnon, J. H. (1986). Sexual scripts: Permanence and change. Archives of Sexual Behavior, 15, 97–120. doi:10.1007/BF01542219.

    Article  PubMed  Google Scholar 

  82. Simon, W., & Gagnon, J. H. (2003). Sexual scripts: Origin, influences, and change. Qualitative Sociology, 26, 491–497. doi:10.1023/B:QUAS.0000005053.99846.e5.

    Article  Google Scholar 

  83. Smith, A. M. A., Patrick, K., Heywood, W., Pitts, M. K., Richters, J., Shelley, J., … Ryall, R. (2012). Body mass index, sexual difficulties and sexual satisfaction among people in regular heterosexual relationships: A population-based study. Internal Medicine Journal, 42, 641–651. doi:10.1111/j.1445-5994.2011.02597.x.

    Article  PubMed  Google Scholar 

  84. Soler, J., Pérez-Sola, V., Puigdemont, D., Pérez-Blanco, J., Figueres, M., & Álvarez, E. (1997). Estudio de validación del Center for Epidemiologic Studies-Depression (CES-D) en una población española de pacientes con trastornos afectivos. Actas Luso-Españolas de Neurología Psiquiatría y Ciencias Afines, 25, 243–249.

    Google Scholar 

  85. Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Allyn and Bacon.

    Google Scholar 

  86. Tanaka, J. S. (1993). Multifaceted conceptions of fit in structural models. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 10–39). Thousand Oaks, CA: Sage.

    Google Scholar 

  87. Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Review, 107, 411–429. doi:10.1037/0033-295X.107.3.411.

    Article  PubMed  Google Scholar 

  88. Vallejo-Medina, P., Granados, M. R., & Sierra, J. C. (2014). Propuesta y validación de una versión breve del Sexual Opinion Survey en población española. Revista Internacional de Andrología, 12, 47–54. doi:10.1016/j.androl.2013.04.004.

    Article  Google Scholar 

  89. van Anders, S. M., & Dunn, E. J. (2009). Are gonadal steroids linked with orgasm perceptions and sexual assertiveness in women and men? Hormones and Behavior, 56, 206–213. doi:10.1016/j.yhbeh.2009.04.007.

    Article  PubMed  Google Scholar 

  90. van Daalen, G., Sanders, K., & Willemsen, T. M. (2005). Sources of social support as predictors of health, psychological well-being and life satisfaction among Dutch male and female dual-earners. Women and Health, 41, 43–62. doi:10.1300/J013v41n02_04.

    Article  PubMed  Google Scholar 

  91. von Sydow, K. (1999). Sexuality during pregnancy and after childbirth: A metacontent analysis of 59 studies. Journal of Psychosomatic Research, 47, 27–49. doi:10.1016/S0022-3999(98)00106-8.

    Article  Google Scholar 

  92. Walfish, S., & Myerson, M. (1980). Sex role identity and attitudes toward sexuality. Archives of Sexual Behavior, 9, 199–203. doi:10.1007/BF01542246.

    Article  PubMed  Google Scholar 

  93. Wang, J. L., Schmitz, N., & Dewa, C. S. (2010). Socioeconomic status and the risk of major depression: The Canadian National Population Health Survey. Journal of Epidemiology Community Health, 64, 447–452. doi:10.1136/jech.2009.090910.

    Article  PubMed  Google Scholar 

  94. World Health Organization. (2010). Measuring sexual health: Conceptual and practical considerations and related indicators. Retrieved from http://whqlibdoc.who.int/hq/2010/who_rhr_10.12_eng.pdf?ua=1.

  95. Wright, K. B. (2006). Researching Internet-based populations: Advantages and disadvantages of Online survey research, Online questionnaire authoring software packages, and web survey services. Journal of Computer-Mediated Communication. doi:10.1111/j.1083-6101.2005.tb00259.x.

    Google Scholar 

Download references

Acknowledgments

This study was funded through a research project granted to the third author by the Spanish Ministry of Science and Innovation (Grant number PSI 2010-15719).

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Correspondence to Juan Carlos Sierra.

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del Mar Sánchez-Fuentes, M., Salinas, J.M. & Sierra, J.C. Use of an Ecological Model to Study Sexual Satisfaction in a Heterosexual Spanish Sample. Arch Sex Behav 45, 1973–1988 (2016). https://doi.org/10.1007/s10508-016-0703-9

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Keywords

  • Sexual satisfaction
  • Men
  • Women
  • Heterosexual
  • Ecological model