Young women's sexual adjustment: the role of sexual self-schema, sexual self-efficacy, sexual aversion and body attitudes.

ABSTRACT: Recent epidemiological studies have revealed high prevalence rates for sexual dysfunction among young women. This study investigated the role of sexual self-schema, sexual aversion, sexual self-efficacy, and body attitudes in the sexual adjustment of a sample of 84 women between the ages of 18 and 29. Linear regression path analyses indicated that sexual self-efficacy mediated the association between sexual self-schema and sexual adjustment. Body attitudes did not appear to be related directly to sexual self-schema, sexual self-efficacy, and sexual adjustment. However, a more negative body attitude was associated with an increase in sexual aversion, which in turn was associated with negative sexual adjustment. The findings suggest that modifying negative sexual self-schema by increasing sexual self-efficacy may be an effective intervention for preventing the maintenance and/or exacerbation of sexual difficulties in young women.

Key words. Female sexuality Sexual self-schema Sexual aversion Sexual self-efficacy Body image

INTRODUCTION

Experimentation with romantic relationships and sexuality is considered an important milestone in a young woman's psychosocial development (Ernst, Foldenyi & Angst, 1993). A satisfying sexual life has been found to be associated with overall quality of life and relationship adjustment, as well as mental and physical health (Fugl-Meyer & Sjogren Fugl-Meyer, 1999; Leiblum & Rosen, 2000; Stevenson, 2004; Ventegodt, 1998). Generally, it is assumed that the majority of young women exploring their sexuality in early adulthood are relatively satisfied and comfortable with their sexual situations. However, a number of studies have reported high prevalence rates of sexual difficulties and concerns in young women. For example, in a large-scale survey of women and men living in the United States, Laumann, Paik and Rosen (1999) found that in the past year women aged 18 to 29 years reported: a lack of interest in sex (32%), anorgasmia (26%), pain during sex (21%), sex without pleasure (27%), performance anxiety (16%), and lubrication problems (19%). Similarly, high prevalence rates were reported in a Swedish study of 526 women (Fugl-Meyer & Sjogren Fugl-Meyer, 1999) and in a longitudinal study of young Swiss adults (Ernst et al., 1993). In the latter study, 299 females were followed over a period of 10 years. At the last interview (age 30), 50% of women had experienced sexual dysfunction at least once over the course of 10 years, with 21% reporting current sexual difficulties.

Finally, Bancroft, Loftus and Long (2003) also found high prevalence rates for sexual difficulties in a sample of 331 young women, and observed that young women reported significantly more distress with regard to their sexual difficulties than did older women. Despite such reports of high prevalence rates of sexual dysfunction in young women, few studies have directly addressed the etiology of sexual difficulties in this population. The present study thus investigated the role of sexual self-schema, sexual self-efficacy, sexual aversion, and body attitudes in the sexual adjustment of young women.

Sexual self-schema, a cognitive representation of the self as sexual, has repeatedly been identified as a strong predictor of sexual adjustment in women regardless of age (e.g., Andersen & Cyranowski, 1994; Cyranowski & Andersen, 2000) who experienced an adverse event such as gynecological cancer (e.g., Andersen, Woods, & Copeland, 1997; Reissing, Binik, Khalife, Cohen, & Amsel, 2003; Yurek, Farrar, & Andersen, 2000). A positive sexual self-schema is defined by characteristics of openness, warmth, directness, and romance whereas a negative sexual self-schema is defined by inexperience, conservative attitudes, and self-consciousness (Cyranowski & Andersen, 2000). Young women with a positive sexual self-schema describe having experienced a broader range of sexual activities, are more easily aroused, have more positive attitudes regarding sex in general, and have longer lasting sexual and affective relationships (Andersen & Cyranowski, 1994).

Sexual self-efficacy refers to the belief in one's capabilities to successfully accomplish behaviours and affective responses in a sexual context (Bailes et al., 1998). Positive sexual self-efficacy has been associated with better sexual adjustment and increased frequency of sexual activity in men and women (Creti & Libman, 1989). Negative or positive feedback on sexual arousal will affect sexual self-efficacy and in turn will affect sexual arousal in the direction of the feedback (Bach, Brown & Barlow, 1999; Palace, 1995). Sexual self-efficacy has most frequently been examined in research pertaining to the practice of safer sex (e.g., Basen-Engquist, 1992; Devieux et al., 2002). It has been consistently reported that low sexual self-efficacy is a leading predictor of risky sexual practices among undergraduate populations (Basen-Engquist, 1992; Cohen & Fromme, 2002; Dilorio, Dudley, Soet, Watkins, & Maibach, 2000; Wulfert & Wan, 1993).