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Heterosexual Women’s Causal Attributions Regarding Impairment in Sexual Function: Factor Structure and Associations with Well-Being

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Abstract

Theory and interventions for female sexual dysfunction typically emphasize the role of cognitions, including the perceived causes of impaired sexual function (causal attributions). Although causal attributions have been extensively studied in the context of mood disorders and relational distress, research in the area of sexual dysfunction has been limited. The current study explored the factor structure of women’s causal attributions regarding their impaired sexual function and the association between these attributions and multiple indicators of subjective well-being. Women in heterosexual relationships reporting current impairments in sexual function (N = 147) completed self-report scales assessing 13 distinct causal attributions, sexual function, and subjective well-being. Results suggested moderately reliable patterns of attributions regarding responsibility (e.g., self vs. partner), specificity to sexual activity, and the degree to which women could effectively address the causes of their difficulties. Beliefs that impaired sexual function was the fault of one’s self or one’s partner, caused by wider issues in the relationship, and difficult to effectively address were generally associated with lower well-being over and above severity of functional impairment. These findings support multiple theories of sexual dysfunction, and highlight the potential importance of cognitive factors in understanding and treating female sexual dysfunction.

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Authors and Affiliations

  1. Department of Psychology, Willamette University, 900 State Street, Salem, OR, 97301, USA

    Kyle R. Stephenson

  2. Department of Psychology, The University of Texas at Austin, Austin, TX, USA

    Cindy M. Meston

Authors
  1. Kyle R. Stephenson
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Correspondence to Kyle R. Stephenson.

Appendix: The Sexual Dysfunction Attributions Scale

Appendix: The Sexual Dysfunction Attributions Scale

For the following scale, we are defining sexual difficulties as problems you have experienced with sexual functioning. Sexual functioning has four primary areas:

Sexual desire: a feeling that includes wanting to have a sexual experience, feeling receptive to a partner’s sexual initiation, and thinking or fantasizing about sex.

Sample difficulty: feeling low or no desire to engage in sexual activity

Sexual arousal: a feeling that includes both physical and mental aspects of sexual excitement. It may include feelings or warmth or tingling in the genitals, or vaginal lubrication. It may also include feeling “into it “or “turned on” during sexual activity.

Sample difficulty: a lack of genital lubrication, or, not feeling turned on during sex.

Orgasm: the frequency and ease with which you experience climax or orgasm during sexual activity

Sample difficulty: lack of orgasm, or taking too long to climax

Sexual pain: pain or discomfort during sexual activity.

Sample difficulty: a sharp pain felt during vaginal penetration.

While many women are bothered by issues not included in the list above, we would like you to focus on difficulties in these four areas when answering the following questions.

Sexual difficulties can be caused by many factors related to the individual, the relationship, external concerns (work, children, etc.), or the wider culture. While it is usually difficult to identify one specific cause of a sexual difficulty, most people have an opinion as to what causes their sexual difficulties. Please answer the questions below regarding what you see as causing your sexual difficulties. These responses will be based on your opinion only; there are no right or wrong answers.

Anchor points are specified below each item.

1. Something about me physically causes my sexual difficulties (e.g., my own physical/medical issues).

1 – Strongly disagree

6 – Strongly agree

2. Something about me personally causes my sexual difficulties (e.g., the type of person I am, the mood I am in).

1 – Strongly disagree

6 – Strongly agree

3. Something about my partner causes my sexual difficulties (e.g., the type of person he/she is, the mood he/she is in, his/her physical/medical issues).

1 – Strongly disagree

6 – Strongly agree

4. Outside circumstances cause my sexual difficulties (e.g., lack of privacy, social pressures).

1 – Strongly disagree

6 – Strongly agree

5. The cause of my sexual difficulties is specific to sexual activity.

1 – Strongly disagree

6 – Strongly agree

6. The cause of my sexual difficulties affects many areas of my relationship.

1 – Strongly disagree

6 – Strongly agree

7. How stable are the causes of your sexual difficulties?

1 – Causes will never again be present

6 – Causes will always be present

8. To what extent do you have control over the causes of your sexual difficulties?

1 – I have no control

6 – I have complete control

9. To what extent does your partner have control over the causes of your sexual difficulties?

1 – He/she has no control

6 – He/she has complete control

10. To what extent does your partner purposefully affect your sexual functioning?

1 – Not at all

6 – Very much

11. Is your partner’s intent generally positive (he/she trying to help) or negative (he/she trying to be detrimental)?

1 – Negative

6 – Positive

12. Does your partner deserve to be blamed for your sexual difficulties?

1 – Deserves no blame

6 – Deserves all blame

13. Do you deserve to be blamed for your sexual difficulties?

1 – Deserve no blame

6 – Deserve all blame

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Stephenson, K.R., Meston, C.M. Heterosexual Women’s Causal Attributions Regarding Impairment in Sexual Function: Factor Structure and Associations with Well-Being. Arch Sex Behav 45, 1989–2001 (2016). https://doi.org/10.1007/s10508-016-0741-3

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