Sexual well-being—sexual desire, frequency, and satisfaction—is vital to relationship satisfaction and quality of life, yet it often declines across the course of romantic relationships (Impett et al., 2014). Indeed, over 50% of individuals in long-term relationships report that they are sexually-dissatisfied. The importance of relationships for well-being is evident from meta-analytic studies revealing that a high quality relationship, which is known to be facilitated by having a strong sexual connection, is a better predictor of reduced mortality than is obesity, cardiovascular disease, and quitting smoking (Holt-Lunstad et al., 2010). Identifying factors that promote sexual well-being is critical, given the high prevalence of sexual problems faced by couples (MacNeil & Byers, 1997). Unfortunately, our current knowledge of factors that bolster couples’ sexual well-being is limited. There is new evidence, however, that online psychoeducation-based interventions focused on positive relationship processes are effective for bolstering sexual well-being (Muise et al., 2016; Muise et al., 2018).
The Problem & Solution
Almost everyone at one time or another finds themselves distracted during sex, contributing to lower sexual well-being (Barlow et al., 1986). Mindfulness during sex combats distraction and increases sexual well-being by increasing awareness and attention to the sexual sensations during sexual activity (Brotto et al., 2015). The objective of the proposed research is to examine if providing information about the benefits of mindfulness alongside simple strategies to promote attention to positive sexual cues bolsters couples’ sexual well-being.
Study Overview: This is a dyadic longitudinal experimental study. Couples will be recruited through Prolific and will be randomly assigned to either a control or experimental condition. The two conditions will allow me to test whether the intervention leads couples to experience meaningful change in their sexual well-being over time. The use of longitudinal methods will minimize recall bias and account for within-person shifts in attention, as well as corresponding changes in sexual well-being overtime (Rosen et al., 2018). Sampling couples enables examination of how attentional focus impacts sexual well-being of both members of a dyad.
Participants: Power analyses informed by previous studies with similar designs (Muise et al., 2016; Muise et al., 2018; Rosen et al., 2018) revealed that 250 couples are necessary (125 couples randomized per condition) to detect a large actor effect and a small partner effect (α = .05) with 80% power. Mixed and same-sex couples will be recruited online using Prolific using the pre-screener selection function. To be eligible, participants will be over the age of 18, and in a sexually-active, committed relationship of at least 12-months, the point when sexual well-being typically starts to decline.
Methods: Participants will independently complete validated measures that assess sexual well-being and attentional focus during sex at baseline (30 mins). Next, couples will be randomized to the experimental or control condition. Couples randomized to the experimental condition will watch a brief psychoeducational video on the benefits of mindfulness for sexual well-being with specific strategies to try over the 4-week study period ([OSF | moovad9f0fff-c7b3-11eb-a69f-0699ff9171cb64061video.mp4]) (Brotto et al., 2015). Couples in the control condition will not receive any information. Participants in both conditions will again complete the measures administered at baseline each week for 3 weeks. This longitudinal design will enable me to determine whether the observed effects are specific to the experimental condition and whether the benefits of attending to positive sexual cues are maintained over time.
Predictions: 1) On weeks when individuals have sex and report greater attention to positive sexual cues (compared to their average across all weeks), they and their partners will report greater sexual well-being on that week. It is expected that the experimental condition will moderate the associations between attention and sexual well-being described above, such that: 2) Compared to those in the control condition, on weeks when participants in the experimental condition report greater attention to positive sexual cues, they and their partners will report even greater sexual well-being that week; and 3) Compared to those in the control condition, participants in the experimental condition will experience a greater overall increase in their sexual well-being from baseline to 4-week follow-up.
Statistical Analysis: Analyses will be informed by the Actor-Partner Independence Model (Cook & Kenny, 2005) to identify both actor effects (i.e., how one’s attentional focus relates to their own sexual well-being), and partner effects (i.e., how one’s attentional focus relates to their partner’s sexual well-being). Multilevel modelling (Kenny et al., 2006) will account for the non-independence of the dyadic data and test the moderation effects by experimental condition.
We are requesting $14,000 in credit based on Prolific’s costing tool for sampling couples over multiple time points. Compensation is based on recommendations ($10 per hour).
Breakdown: 500 participants X 4 surveys ($5/30 min survey) + Service Fee (33%) = $13,333.00 (the remaining budget will be used for participant payment should we need to over sample due to attrition).
Data and dissemination
The full study protocol will be available on the Open Science Framework (OSF; [OSF | Building Satisfying Sexual Relationships OSF.docx]). Prior to the study launch the hypotheses and analysis plan will be preregistered on the OSF. Upon submission for publication data and analysis scripts will be posted on the OSF. The findings will be disseminated through traditional academic platforms (e.g., conferences) and social media channels (e.g., @swell.lab, @UBCSWell).
Contributions and Impact
The immediate benefit of this research is the identification of a modifiable process—attentional focus—that couples can use to promote the sexual well-being of both partners, as well as to protect against expected declines in sexual well-being over time. This, in turn, has significant implications for relationship satisfaction and maintenance (Impett et al., 2014). Identifying factors that promote sexual well-being is critical, given the high prevalence of sexual problems faced by couples (MacNeil & Byers, 1997), the importance of romantic relationships for health and well-being (Holt-Lunstad et al., 2010), and the social and personal costs associated with the dissolution of romantic relationships (Halford et al., 2008).
Brotto, L. A., Basson, R., Smith, K. B., Driscoll, M., & Sadownik, L. (2015). Mindfulness-based group therapy for women with provoked vestibulodynia. Mindfulness, 6, 417-432.
Cook, W. L., & Kenny, D. A. (2005). The actor–partner interdependence model: A model of bidirectional effects in developmental studies. International Journal of Behavioral Development, 29, 101-109.
Halford, W. K., Markman, H. J., & Stanley, S. (2008). Strengthening couples’ relationships with education: Social policy and public health perspectives. Journal of Family Psychology, 22, 497-505.
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7.
Impett, E. A., Muise, A., & Peragine, D. (2014). Sexuality in the context of relationships. In L. M. Diamond, D. L. Tolman, J. A. Bauermeister, W. H. George, J. G. Phaus, & L. M. Ward (Eds.), APA Handbook of Sexuality and Psychology (Vol. 1, pp. 269-315). American Psychological Association.
Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic Data Analysis. Guilford Press.
MacNeil, S., & Byers, E. S. (1997). The relationships between sexual problems, communication, and sexual satisfaction. Canadian Journal of Human Sexuality, 6, 277-283.
Muise, A., Boudreau, G., & Rosen, N. O. (2016). Seeking connection versus avoiding disappointment: An experimental manipulation of approach and avoidance sexual goals and the implications for desire and satisfaction. The Journal of Sex Research, 54, 296-307.
Muise, A., Harasymchuk, C., Day, L. C., Bacev-Giles, C., Gere, J., & Impett, E. A. (2018). Broadening your horizons: Self-expanding activities promote desire and satisfaction in established romantic relationships. Journal of Personality and Social Psychology.
Rosen, N. O., Muise, A., Impett, E. A., Delisle, I., Baxter, M. L., & Bergeron, S. (2018). Sexual cues mediate the daily relations between interpersonal goals, pain, and wellbeing in couples coping with vulvodynia. Annals of Behavioral Medicine, 52, 216-227.