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Anxiousness and Distractibility Strengthen Mediated Associations Between Men’s Penis Appearance Concerns, Spectatoring, and Sexual Difficulties: A Preregistered Study

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Abstract

Men with penis appearance concerns are more likely to experience sexual difficulties because they engage in spectatoring (i.e., negative self-critical attentional focus during sex). This preregistered study investigated whether anxious and distractible personality traits make men with penis appearance concerns more likely to engage in spectatoring and, in turn, experience sexual difficulties. In a sample of 858 sexually active men in predominantly mixed-gender relationships, we replicated previous findings that penis appearance concerns were associated with greater spectatoring, and in turn greater problems with erection and orgasm. Additionally, our novel hypotheses that anxiousness and distractibility would strengthen these associations were partially supported. Anxiousness strengthened associations between penis appearance concerns and sexual embarrassment, and in turn was associated with greater reports of erectile and orgasmic difficulties. However, anxiousness did not strengthen the mediated associations between penis appearance concerns, self-focus, and erectile and orgasmic difficulties. Distractibility strengthened associations between sexual embarrassment and erectile difficulties, and in turn strengthened the mediated associations between penis appearance concerns, sexual embarrassment, and erectile difficulties. However, distractibility did not strengthen associations between sexual embarrassment and orgasmic difficulties, between sexual self-focus and erectile difficulties, nor between sexual self-focus and orgasmic difficulties. Implications for therapeutic treatments are discussed.

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Notes

  1. Pornography consumption was assessed at the end of the survey; however, we had no hypotheses regarding pornography use, conducted no analyses with this variable, and it will not be discussed further.

  2. Historically, mediation was most commonly tested using the causal steps approach (Baron & Kenney, 1986). However, current literature suggests that this approach has several limitations. First, significant a, b, and c paths are not required for significance of mediation, so long as ab (i.e., the indirect effect) is significant (Hayes & Rockwood, 2017). Further, an observed reduction in c to c′ is also unnecessary for significance of mediation, Rather, only ab need be significant, as ab is a direct measure of changes in Y by X through M (Hayes & Rockwood, 2017).

References

  • Baer, R. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.

    Google Scholar 

  • Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54, 140–148.

    Google Scholar 

  • Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Google Scholar 

  • Beck, A. T., & Clark, D. A. (1996). The information processing model of anxiety: Automatic and strategic processes. Behaviour Research and Therapy, 35, 49–58.

    Google Scholar 

  • Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2006). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.

    Google Scholar 

  • Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57, 43–54.

    Google Scholar 

  • Brown, T. A., & Barlow, D. H. (2009). A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: Implications for assessment and treatment. Psychological Assessment, 21, 256–271.

    Google Scholar 

  • Corona, G., Petrone, L., Mannucci, E., Jannini, E. A., Mansani, R., Magini, A., & Maggi, M. (2004). Psycho-biological correlates of rapid ejaculation in patients attending an andrologic unit for sexual dysfunctions. European Urology, 46, 615–622.

    Google Scholar 

  • de Jong, D. C. (2009). The role of attention in sexual arousal: Implications for treatment of sexual dysfunction. Journal of Sex Research, 46, 237–248.

    Google Scholar 

  • Dosch, A., Ghisletta, P., & Van der Linden, M. (2015). Body image in dyadic and solitary sexual desire: The role of encoding style and distracting thoughts. Journal of Sex Research, 53, 1193–1206.

    Google Scholar 

  • Eysenck, H. J. (1971). Personality and sexual adjustment. British Journal of Psychiatry, 118, 593–608.

    Google Scholar 

  • Faith, M. S., & Schare, M. L. (1993). The role of body image in sexually avoidant behavior. Archives of Sexual Behavior, 22, 345–365.

    Google Scholar 

  • Gomes, A. L. G., & Nobre, P. (2011). Personality traits and psychopathology on male sexual dysfunction: An empirical study. Journal of Sexual Medicine, 8, 461–469.

    Google Scholar 

  • Gopher, D., & Iani, C. (2003). Attention. In L. Nadel (Ed.), Encyclopedia of cognitive science (pp. 220–226). New York: Nature Publication Group.

    Google Scholar 

  • Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Hayes, A. F., & Rockwood, N. J. (2017). Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. Behaviour Research and Therapy, 98, 39–57.

    Google Scholar 

  • Herbenick, D., Schick, V., Reece, M., Sanders, S. A., & Fortenberry, J. D. (2013). The development and validation of the Male Genital Self-Image Scale: Results from a nationally representative probability sample of men in the United States. Journal of Sexual Medicine, 10, 1516–1525.

    Google Scholar 

  • Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94, 319–340.

    Google Scholar 

  • Hopwood, C. J., Wright, A. G. C., Krueger, R. F., Schade, N., Markon, K. E., & Morey, L. C. (2013). DSM-5 pathological personality traits and the personality assessment inventory. Assessment, 20, 269–285.

    Google Scholar 

  • Janssen, E., Everaerd, W., Spiering, M., & Janssen, J. (2000). Automatic processes and the appraisal of sexual stimuli: Toward an information processing model of sexual arousal. Journal of Sex Research, 37, 8–23.

    Google Scholar 

  • Johnston, L., McLellan, T., & McKinlay, A. (2014). (Perceived) size really does matter: Male dissatisfaction with penis size. Psychology of Men and Masculinity, 15, 225–228.

    Google Scholar 

  • Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., et al. (2017). The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126, 454–477.

    Google Scholar 

  • Kreuger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42, 1879–1890.

    Google Scholar 

  • Kreuger, R. F., & Markon, K. E. (2014). The role of the DSM-5 personality trait model and moving toward a quantitative and empirically based approach to classifying personality and psychopathology. Annual Review of Clinical Psychology, 10, 477–501.

    Google Scholar 

  • Lebel, E. P., Campbell, L., & Loving, T. J. (2017). Benefits of open and high-powered research outweigh costs. Journal of Personality and Social Psychology, 113, 230–243.

    Google Scholar 

  • Loehle, B., McKie, R. M., Levere, D., Bossio, J. A., Humphreys, T. P., & Travers, R. (2017). Predictors of men’s genital self-image across sexual orientation and geographic region. Canadian Journal of Human Sexuality, 26, 130–141.

    Google Scholar 

  • Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Boston: Little, Brown.

    Google Scholar 

  • McDonagh, L. K., Bishop, C., Brockman, M., & Morrison, T. G. (2014). A systematic review of sexual dysfunction measures for gay men: How do current measures measure up? Journal of Homosexuality, 61, 781–816.

    Google Scholar 

  • 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.

    Google Scholar 

  • Nobre, P. J. (2010). Psychological determinants of erectile dysfunction: Testing a cognitive emotional model. Journal of Sexual Medicine, 7, 1429–1437.

    Google Scholar 

  • Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822–830.

    Google Scholar 

  • Simmons, J. P., Nelson, L. D., & Simonsohn, U. (2012). A 21 word solution. Available at SSRN: https://ssrn.com/abstract=2160588. Retrieved 11 May 2019.

  • Tiggemann, M., Martins, Y., & Churchett, L. (2008). Beyond muscles: Unexplored parts of men’s body image. Journal of Health Psychology, 13, 1163–1172.

    Google Scholar 

  • van Lankveld, J. J. D. M., Geijen, W. E. H., & Sykora, H. (2008). The Sexual Self-Consciousness Scale: Psychometric properties. Archives of Sexual Behavior, 37, 925–933.

    Google Scholar 

  • Veale, D., Eschkevari, E., Read, J., Miles, S., Troglia, A., Phillips, R., & Muir, G. (2014). Beliefs about penis size: Validation of a scale for men ashamed about their penis size. Journal of Sexual Medicine, 11, 84–92.

    Google Scholar 

  • Veale, D., Miles, S., Read, J., Bramley, S., Troglia, A., Carmona, L., & Muir, G. (2016). Relationship between self-discrepancy and worries about penis size in men with body dysmorphic disorder. Body Image, 17, 48–56.

    Google Scholar 

  • Veale, D., Miles, S., Read, J., Troglia, A., Carmona, L., Fiorito, C., & Muir, G. (2015a). Penile dysmorphic disorder: Development of a screening scale. Archives of Sexual Behavior, 44, 2311–2321.

    Google Scholar 

  • Veale, D., Miles, S., Read, J., Troglia, A., Wylie, K., & Muir, G. (2015b). Sexual functioning and behavior of men with body dysmorphic disorder concerning penis size compared with men anxious about penis size with controls: A cohort study. Sexual Medicine, 3, 147–155.

    Google Scholar 

  • Velten, J., Margraf, J., Chivers, M. L., & Brotto, L. A. (2017). Effects of mindfulness task on women’s sexual response. Journal of Sex Research, 55, 747–757.

    Google Scholar 

  • Wiegel, M., Scepkowski, L. A., & Barlow, D. H. (2007). Cognitive-affective processes in sexual arousal and sexual dysfunction. In E. Janssen (Ed.), The psychophysiology of sex (pp. 143–165). Bloomington: Indiana University Press.

    Google Scholar 

  • Winter, H. C. (1989). An examination of the relationships between penis size and body image, genital image, and perception of sexual competency in the male. Dissertation Abstracts International, 50, 1225.

    Google Scholar 

  • Wyatt, R. B., de Jong, D. C., & Holden, C. J. (2018). Spectatoring mediates associations between penis appearance concerns and sexual dysfunction. Journal of Sex and Marital Therapy, 45, 328–338.

    Google Scholar 

  • Wylie, K. R., & Eardley, I. (2007). Penis size and the small penis syndrome. BJU International, 99, 1149–1155.

    Google Scholar 

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Correspondence to David C. de Jong.

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This study was reviewed by the Western Carolina University Institutional Review Board and determined to be exempt from IRB review according to federal regulations. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Western Carolina University, 1424452-1) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Wyatt, R.B., de Jong, D.C. Anxiousness and Distractibility Strengthen Mediated Associations Between Men’s Penis Appearance Concerns, Spectatoring, and Sexual Difficulties: A Preregistered Study. Arch Sex Behav 49, 2981–2992 (2020). https://doi.org/10.1007/s10508-020-01753-4

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