Department of Sexology, Faculty of Social Sciences, Université du Québec à Montréal, Montréal, H2L 2C4, Québec, Canada.
School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, 3498838, Israel.
J Sex Med. 2024 Sep 28;21(10):951-960. doi: 10.1093/jsxmed/qdae095.
Sexual distress (eg, feeling distressed, unhappy, frustrated, stressed, dissatisfied, or bothered about their sexuality) is a central concern reported by patients seeking sex therapy, and might be related to sexual self-esteem and mindfulness disposition, yet research is needed to examine the links among those variables within the specific population of patients seeking therapy.
This study aimed to examine the indirect role of sexual self-esteem in the relationship between dispositional mindfulness and sexual distress.
The study was conducted among 696 patients undergoing sexual therapy (mean age 34.19 ± 11.21 years, age range 18-78 years). Participants identified as women (57.3%), men (38.5%), or nonbinary (4.2%). They completed self-report questionnaires assessing dispositional mindfulness (Five Facet Mindfulness Questionnaire), sexual self-esteem (Multidimensional Sexuality Questionnaire), and sexual distress (Sexual Distress Scale-Revised), during their first few sessions (ie, first to third sessions [the assessment phase]).
Sexual distress was the main outcome, as measured with the Sexual Distress Scale-Revised.
Results indicated that 54% (n = 376) of patients reported elevated sexual distress based on the questionnaire threshold score. Path analyses indicated an indirect effect in which higher dispositional mindfulness was associated with higher levels of sexual self-esteem, which in turn was associated with lower sexual distress. Results also highlighted that specific facets of mindfulness were related to higher sexual self-esteem (ie, describing, and nonreacting) and lower sexual distress (ie, nonjudgment and acting with awareness). The integrative model explained 23% of the variance of sexual distress scores.
Findings suggest that addressing specifically sexual self-esteem and mindfulness may represent relevant clinical avenues to reduce sexual distress among sex therapy patients.
Strengths of this study include the novel examination of the role of sexual self-esteem in the link between mindfulness disposition and sexual distress in a large clinical sample of patients seeking sex therapy. Limitations includes reliance on patient self-report and a cross-sectional design that limit conclusion regarding causality.
This study makes a valuable contribution to the existing body of research highlighting the pivotal roles of sexual self-esteem in the link between dispositional mindfulness and reduced sexual distress among adults undergoing sex therapy, allowing us to identify potential targets of intervention.
性困扰（例如，感到苦恼、不快乐、沮丧、有压力、不满意或对自己的性感到困扰）是寻求性治疗的患者报告的一个核心关注点，并且可能与性自尊和正念倾向有关，但需要研究来检查特定治疗患者群体中这些变量之间的联系。
本研究旨在探讨性自尊在特质正念与性困扰之间的关系中的间接作用。
该研究在 696 名接受性治疗的患者中进行（平均年龄 34.19±11.21 岁，年龄范围 18-78 岁）。参与者自认为是女性（57.3%）、男性（38.5%）或非二进制性别（4.2%）。他们在首次几次治疗期间（即第一次到第三次治疗[评估阶段]）完成了自我报告问卷，评估特质正念（五因素正念量表）、性自尊（多维性问卷）和性困扰（修订后的性困扰量表）。
结果表明，根据问卷阈值得分，54%（n=376）的患者报告存在较高的性困扰。路径分析表明，较高的特质正念与较高的性自尊呈正相关，而较高的性自尊又与较低的性困扰呈正相关。结果还强调，正念的特定方面与较高的性自尊（即描述和不反应）和较低的性困扰（即不评判和有意识地行动）有关。综合模型解释了性困扰评分 23%的方差。
研究结果表明，专门解决性自尊和正念问题可能是减少性治疗患者性困扰的重要临床途径。
本研究的优势在于，在寻求性治疗的大量临床患者样本中，首次检查性自尊在特质正念与性困扰之间的关系中的作用。局限性包括依赖于患者的自我报告和横断面设计，限制了对因果关系的结论。
本研究对现有研究做出了有价值的贡献，强调了性自尊在特质正念与接受性治疗的成年人性困扰减轻之间的联系中的关键作用，使我们能够确定潜在的干预目标。
