Responses to sexual rejection and sexual and relationship well-being in couples coping with Sexual Interest/Arousal Disorder

Abstract

Sexual Interest/Arousal Disorder (SIAD) is the most common sexual problem reported by women. Affected individuals often encounter higher sexual desire from partners, resulting in frequent sexual rejection (i.e., declining a partner’s sexual advances). Despite clinical and theoretical models conceptualizing sexual desire challenges in the context of relationship dynamics, no studies have investigated the implications of partner responses to sexual rejection for couples’ sexual well-being (e.g., sexual satisfaction, dyadic sexual desire, sexual distress, and sexual frequency) and relationship satisfaction. In my dissertation, I addressed this gap by examining four distinct partner responses to sexual rejection: understanding (e.g., responsiveness), resentful (e.g., guilt-tripping), insecure (e.g., feeling hurt), and enticing (e.g., attempting to re-initiate). Using a cross-sectional design in Study 1, I compared the frequency of each response and their associations with sexual well-being and relationship satisfaction among couples coping with SIAD (N = 241) and community couples (N = 105). After controlling for sexual rejection frequency, couples coping with SIAD reported greater resentful and insecure responses to sexual rejection than community couples, and individuals with SIAD perceived less understanding responses than their partners reported. For both groups, more understanding and less resentful and insecure responses were associated with greater sexual and relationship well-being, with mixed findings for enticing responses. In Study 2, I examined daily (56 daily diaries, N = 200 couples) and prospective (6-month follow-up, N = 170 couples) associations between responses to sexual rejection, sexual well-being, and relationship satisfaction in couples coping with SIAD. Generally, in both analyses, higher understanding and lower resentful and insecure responses were associated with both couple members’ greater sexual well-being and relationship satisfaction, with mixed results for enticing responses. Unexpectedly, at the daily level, greater understanding responses than usual were linked to both couple members’ greater sexual distress, and prospectively, individuals with SIAD’s greater perceived insecure responses predicted their partners’ greater sexual satisfaction, six months later. Collectively, these results support and expand upon models of dyadic sexual desire and models for treating sexual desire challenges; moreover, they provide initial evidence for targeting responses to sexual rejection in therapeutic interventions for couples experiencing frequent sexual rejection.