Practicing Psychologists’ Sexual Intervention Self-Efficacy and Willingness to Treat Sexual Issues

Many clients who are not seeking sex therapy experience sexual concerns that affect their overall psychological well-being. However, they may be hesitant to broach them if clinicians do not ask about these issues. The current study assessed a model of how sex education and training affect clinicians’ sexual intervention self-efficacy (confidence addressing sexual issues) and, in turn, their willingness to address sexual issues. Participants who had completed their graduate work and internship and had been working for more than a year providing therapy to adults were recruited for an on-line survey from the Canadian Registrar of Health Service Providers, the American Psychological Association, and provincial licensing organizations; 110 psychologists completed the survey. Psychologists were found to lack self-efficacy, particularly related to their ability to directly address clients’ sexual concerns (Skills Self-Efficacy) and ability to relay accurate information (Information Self-Efficacy). They also did not routinely ask clients about sexual issues. Bootstrapping analysis showed that, consistent with the proposed model, participants who had more graduate level sex education obtained significantly more sex education following internship. This, in turn, was associated with significantly higher Skills Self-Efficacy and Information Self-Efficacy and, ultimately, to clinicians engaging in significantly more intervention behaviors. Sex education and training did not relate to self-efficacy regarding appearing comfortable and being unbiased when addressing sexual issues with clients (Comfort/Bias Self-Efficacy). The results were discussed in terms of the role of graduate education in enhancing sexual intervention self-efficacy as well as the role of self-efficacy in psychologists’ willingness to treat their clients’ sexual problems and concerns.     

Assessment of Sexual Behavior,Sexual Attitudes,and Sexual Risk in Sweden (1989–2003)

To assess changes in sexual behavior, sexual attitudes, and sexual risk related to HIV, we conducted mailed questionnaire surveys in random samples of the Swedish general population in 1989, 1994, 1997, 2000, and 2003 (total N = 13,762). Each sample consisted of 4,000–6,000 subjects aged 16–44 years, stratified by age: 16–17, 18–19, 20–24, 25–34, and 35–44 years. The overall participation rate was 63.8% (for men, 55.9%; for women, 71.9%). The prevalence of three or more sexual partners and casual sexual contacts without the use of a condom was comparatively high for men, for persons aged 16–24 years, single persons with and without a regular partner, and persons living in towns and urban areas. The prevalence of multiple sexual partners and casual sexual contacts increased significantly over time. There was a significant decrease in the proportion of participants who agreed with the statement Sexual intercourse should only take place in a stable relationship. Personal risk assessments related to HIV did not change significantly over time. The study shows that risky sexual behavior related to HIV/AIDS increased in the Swedish population between 1989 and 2003, and that attitudes concerning casual sexual relations became more permissive.     

Social Identities as Predictors of Women’s Sexual Satisfaction and Sexual Activity

While much research has examined sexual problems and dysfunction, far less research has examined intersections between sexual satisfaction and sexual activity, particularly as it relates to social identities. This study utilized secondary analysis of 1,473 women from the National Health and Social Life Survey to examine the way sexual satisfaction and sexual activity are at times misaligned. Using factor and cluster analyses, four groups of women defined by being high or low on satisfaction and activity were predicted by nine demographic variables, including socioeconomic class, racial/ethnic identity, age, marital status, education, sexual identity, geographical “coming of age” location, employment status, and number of children. Results showed that lower status women (women of color, working-class women, younger women, less educated women, women who worked full-time) reported low satisfaction and high activity. Women who reported high satisfaction and low activity represented the largest cluster of women, indicating that more women reported a disjuncture between satisfaction and activity than did those reporting a match between satisfaction and activity. Implications for clinical, sexuality, and social identity literatures are discussed.     

Birth Order and First Sexual Experience: Do Siblings Influence Sexual Debut in Adolescents?

Archives of Sexual Behavior - Birth order may foster specific roles for individuals within the family and set in train a dynamic that influences the development of specific behaviors. In this...     

Linking Sexual Mindfulness to Mixed-Sex Couples’ Relational Flourishing,Sexual Harmony,and Orgasm

Archives of Sexual Behavior - Marriage is an important adult relationship, and recent research indicates that sexual mindfulness, awareness and non-judgment, may be an important tool in helping...     

Single and Partnered Individuals’ Sexual Satisfaction as a Function of Sexual Desire and Activities: Results Using a Sexual Satisfaction Scale Demonstrating Measurement Invariance Across Partnership Status

Although some evidence exists to suggest that single (i.e., unpartnered) individuals are less sexually satisfied on average than are partnered individuals, it is unclear whether the variables correlating with each group’s sexual satisfaction are similar or different. This research sought to examine how desire for and actual engagement in solitary and partnered sexual activities are associated with both groups’ sexual satisfaction. We first conducted a preliminary study (n?=?572) to test and refine existing measures of sexual satisfaction for applicability across relationship status. In two follow-up studies (N?=?1,238), measurement invariance (across relationship status and gender) of the resulting 4-item sexual satisfaction scale was established. Further, results across the studies showed that for singles dyadic sexual desire was negatively related to sexual satisfaction, whereas no significant link was found with solitary desire. For individuals in romantic relationships, having higher sexual desire involving a partner and lower solitary desire were both associated with greater sexual satisfaction. When analyzing participants’ responses on the desired and actual frequency of engaging in specific sexual acts, we found that for both single and partnered individuals, frequent engagement in partnered acts was associated with greater sexual satisfaction. Wanting frequent engagement in partnered acts was associated with lower sexual satisfaction for both groups, but only if the current frequency of engaging in these acts was low. These findings suggest that at least during the COVID-19 pandemic, meeting desires for partnered sex plays an important role in maintaining a sexually satisfying life, regardless of one’s relationship status.

     

Long-Term Care Preferences and Sexual Orientation–A Systematic Review and Meta-Analysis

ObjectivesThe number of sexual and gender minority older adults who require long-term care is steadily increasing. The purpose of this systematic review and meta-analysis was to synthesize the evidence related to preference for long-term care with regard to sexual orientation and gender identity.DesignSystematic review and meta-analysis.Setting and ParticipantsWe searched PubMed/MEDLINE, Ovid/PsycINFO, and Web of Science from inception to July 2020 (updated in July 2021). Search terms embraced 3 themes (1) sexual and gender minorities, (2) long-term care, and (3) preferences. Quantitative studies of the adult population were included.MethodsScreening, data extraction, and quality assessment followed the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The proportions were pooled using meta-analysis and random effects models.ResultsA total of 17 articles were included out of 5944 studies of potential relevance. The perception of nursing homes (NHs) that emerges from these studies is predominantly negative for heterosexuals and lesbian, gay, bisexual and trans (LGBT) individuals (n = 11). Across 6 studies (10 outcomes), the pooled estimate for the proportion of individuals with a preference to move into a NH was 10.6% [95% confidence interval (CI) 7.88%?13.22%, I² = 97.4%]; 13.7% (95% CI 8.6%?18.7%) for LGBT individuals and 7.3% (95% CI 3.14%?11.50%) for heterosexuals. LGBT-friendly NHs were preferred by between 55% and 98% of LGBT respondents. Informal care provided by partner or family was one of the preferred options (n = 6). It was preferred by 33% to 70% of various groups of LGBT respondents.Conclusions and ImplicationsThe preference to move into a NH is relatively low among both heterosexuals and sexual and gender minority adults. Findings showed negligible differences in preferences to move into a NH between heterosexuals and sexual and gender minorities. LGBT-friendly long-term care facilities where every member feels welcomed and not discriminated against seem to be one of the favorable long-term care choices among LGBT individuals. This knowledge is important to inform nursing services and policy makers about the preferred long-term care options. Providing LGBT-friendly facilities is usually less expensive than providing care in newly created LGBT-only facilities.     

Sexual Liberalism–Conservatism: The Effect of Human Values, Gender, and Previous Sexual Experience

Despite theoretical associations, there is a lack of empirical studies on the axiological basis of sexual liberalism–conservatism. Two studies demonstrated important associations between these constructs for young adults. In Study 1, participants were 353 undergraduate students with a mean age of 20.13 (SD = 1.84), who completed the Sexual Liberalism–Conservatism Scale and the Basic Values Survey. In Study 2, participants were 269 undergraduate students, with a mean age of 20.3 (SD = 1.82), who completed a social desirability scale in addition to Study 1 instruments. Results showed how values can predict sexual liberalism–conservatism after controlling for social desirability. Attitudes towards one’s own sexual behavior were more conservative whereas attitudes towards other’s sexual behavior were more liberal. Gender was not a significant predictor of sexual attitudes whereas previous sexual experience showed a significant association to this construct. In general, results corroborated previous findings, showing that participants with a tendency to present socially desirable answers also tended to present themselves as sexually conservative.     

Test–Retest Reliability of Self-Reported Sexual Behavior, Sexual Orientation, and Psychosexual Milestones Among Gay, Lesbian, and Bisexual Youths

Despite the importance of reliable self-reported sexual information for research on sexuality and sexual health, research has not examined reliability of information provided by gay, lesbian, and bisexual (GLB) youths. Test–retest reliability of self-reported sexual behaviors, sexual orientation, sexual identity, and psychosexual developmental milestones was examined among an ethnically diverse sample of 64 self-identified GLB youths. Two face-to-face interviews were conducted approximately 2 weeks apart using the Sexual Risk Behavior Assessment Schedule for Homosexual Youths (SERBAS-Y-HM). Overall, the mean of the test–retest reliability coefficients was substantial for 6 of the 7 domains: lifetime sexual behaviors (M=.89), sexual behavior in the past 3 months (M=.96), unprotected sexual behavior in the past 3 months (M=.93), sexual identity (κ=.89), sexual orientation (M=.82), and ages of various psychosexual developmental milestones (M=.77). Inconsistent reliability was found for reports of sexual behaviors while using substances. A small number of gender differences emerged, with lower reliability among female youths in the lifetime number of same-sex partners. The overall findings suggest that a wide range of self-reported sexual information can be reliably assessed among GLB youths by means of interviewer-administered questionnaires, such as the SERBAS-Y-HM.

Women’s Sexual Responses to Heterosexual and Lesbian Erotica: The Role of Stimulus Intensity,Affective Reaction,and Sexual History

Past research has demonstrated that women do not show a “category-specific” genital response to erotic stimuli. That is, on average, heterosexual and lesbian women are indistinguishable in terms of their physiological genital responses to heterosexual versus lesbian erotica. In two studies with heterosexual women (n = 28 for Study 1; n = 30 for Study 2) and lesbians (n = 24 for Study 1; n = 25 for Study 2), results confirmed that, on average, women did not show category-specific genital responses or category-specific subjective sexual arousal. However, there was evidence of notable within-group variability; many women did respond to the stimuli in a category-specific manner. Heterosexual women were more likely than lesbian women to demonstrate category-specificity. Findings also revealed that category-specificity was associated with multiple factors, including affective responses to the erotic stimuli and sexual history. Results of this study highlight the complexity of women’s sexual identities and sexual responses.     

University Students’ Definitions of Sexual Abstinence and Having Sex

We asked 298 heterosexual Canadian university students about their definitions of the terms abstinence and having sex. For both terms, students were provided with a list of 17 sexual behaviors and indicated whether they would include each in their definition. The majority of both male and female students included activities that did not involve genital stimulation in their definition of sexual abstinence and did not include these activities in their definition of having sex. Conversely, most students did not include bidirectional sexual stimulation (penile–vaginal intercourse or penile–anal intercourse) in their definitions of sexual abstinence but did include them in their definitions of having sex. Students were quite mixed in whether activities involving unidirectional genital stimulation (e.g., oral sex, genital fondling) constituted abstinence, having sex, or neither abstinence nor having sex. However, they were more likely to see these behaviors as abstinent than as having sex. Students were more likely to rate a behavior as abstinence if orgasm did not occur. A canonical correlation analysis was used to examine the patterns of association between a number of predictors and inclusions of behaviors involving no genital stimulation, unidirectional stimulation, and bidirectional genital stimulation in abstinence definitions. The results indicated that male participants who were more involved with their religion and sexually conservative, less sexually experienced, and who had not received sexual health education at home were more likely to define bidirectional genital stimulation and less likely to define no genital stimulation and unidirectional sexual stimulation as sexual abstinence. The research and health promotion implications of these results are discussed.     

Male Escorts’ and Male Clients’ Sexual Behavior During Their Last Commercial Sexual Encounter: Comparing and Contrasting Findings from Two Online Studies

Much of what is known about commercial sexual encounters between men is based on data gathered from escorts. With few exceptions, studies have not compared male clients’ reports of behavior during commercial sexual encounters with male escorts’. The present study draws from two datasets, a 2012 survey of clients (n = 495) and a 2013 survey of escorts (n = 387)—both used virtually identical measures of sexual behavior during the most recent commercial sexual encounter. For clients and escorts, the majority eschewed having sex without a condom, and kissing and oral sex were among the most common behaviors reported. Using logistic regression, both samples were compared across 15 sexual behaviors, finding significant differences in six—the escort sample had greater odds of reporting their last commercial sexual encounter involved watching the client masturbate, viewing porn, role play (dad/son, dominant/submissive), and having prior sexual experience with their commercial partner. The escort sample had lower odds of reporting that the client watched the escort masturbate, and being told partner’s HIV status. In multivariable modeling, both samples did not significantly differ in reports of condomless anal sex. Male–male commercial sexual encounters appear to be involved in a wide range of sexual behaviors, many of which convey low-to-no risk of HIV transmission.     

A Prospective Study of Young Females’ Sexual Subjectivity: Associations with Age,Sexual Behavior,and Dating

Sexual self-perceptions are important aspects of sexuality, which can undergo significant change during adolescence and early adulthood. The purpose of this study was to describe these changes among girls (N = 251; ages 16–25) over one year, and to examine associations of sexual self-perceptions (sexual subjectivity) with age, sexual behavior, and romantic status. Sexual body-esteem, perceptions of entitlement to desire and pleasure, sexual efficacy, and sexual self-reflection were investigated as elements of sexual subjectivity. All sexual subjectivity elements were higher among girls who had more sexual experience and/or had steady romantic partners during the study. Perception of entitlement to desire and pleasure increased over time, whereas sexual body-esteem showed the most stability and had minimal associations with sexual or romantic experiences. The greatest increases in sexual subjectivity were found among girls who began the study with the least sociosexual experience and self-reflection also increased for girls who had first coitus after the start of the study. Overall, girls who had sexual intercourse the earliest (before age 16) had the highest sexual subjectivity, but sexual subjectivity increased the most among girls without coital experience or who had more recent first coitus.     

Newlywed Couples’ Own and Partner Sexual Disgust Sensitivities Interact to Predict Their Marital Satisfaction Through Their Sexual Satisfaction

Archives of Sexual Behavior - Sex is integral to maintaining a satisfying long-term romantic relationship such as marriage. It is thus important to identify the factors that promote sexual...     

Effects of Alcohol Intoxication and Instructional Set on Women’s Sexual Arousal Vary Based on Sexual Abuse History

The influence of alcohol intoxication and arousal instructional set on psychophysiological measures of sexual responding was examined in a non-clinical sample of sexually abused (SA) and non-sexually abused (NSA) women. Participants (n=42) were randomly assigned to consume alcoholic (target blood alcohol level = .08%) or non-alcoholic drinks and to receive instructions to maximize or suppress their sexual response to erotic films. Measures included vaginal pulse amplitude (VPA), self-reported sexual arousal, and mood. SA classification interacted with instruction condition such that NSA women's VPA scores were higher under maximize than suppress instructions, but this did not occur for SA women. SA classification interacted with alcohol such that, compared to their sober counterparts, intoxicated NSA women reported less sexual arousal, whereas intoxicated SA women reported more sexual arousal than their sober counterparts. Moreover, positive mood ratings were highest among intoxicated SA women. Findings indicate that alcohol may affect women differently based on SA history and imply that SA history may be associated with differences in response to subsequent sexual situations.