by A team of researchers has developed and tested a new scale to measure sexual anxiety sensitivity – a fear of physiological arousals during sex. The scale predicted sexual well-being across several indicators, beyond an existing scale that measures fear of arousal sensations in general. The findings were published in Journal of Sex & Marital Therapy.
People with anxiety sensitivity experience fear of their own physiological sensations. This fear is provoked by a belief that these feelings will bring them great harm. For example, a person who experiences a rapid heartbeat after exercise may interpret this as a sign of an impending heart attack. Or someone who experiences difficulty concentrating may interpret this as a sign that they are losing their mind.
Individuals with high anxiety sensitivity tend to experience a variety of adverse outcomes related to well-being. Since sexual activity involves physiological arousal, it is not surprising that one of these unfortunate outcomes is poorer sexual well-being. Study author E. Sandra Byers and her team wanted to shed further light on the link between anxiety sensitivity and sexual well-being.
“This research brings together my own and Dr. Lucia O’Sullivan’s expertise in human sexuality and Dr. Olthuis’ expertise in anxiety sensitivity, the fear of physiological sensations,” explained Byers, professor and chair at the University of New Brunswick. “Higher anxiety sensitivity is a transdiagnostic factor that has been linked to many poor mental health outcomes. However, researchers have not assessed anxiety sensitivity that is specific to the sexual context, that is, sexual anxiety sensitivity.
While anxiety sensitivity is typically measured via the Anxiety Sensitivity Index-3 (ASI-3), the researchers attempted to develop a measure that assesses anxiety sensitivity specifically for a sexual context. They called this the Sexual Anxiety Sensitivity Index and tested whether it would be an even stronger predictor of sexual well-being.
“We wanted to investigate the role of sexual anxiety sensitivity in sexual well-being specifically, as well as to develop an instrument that could be used to assess sexual anxiety sensitivity,” Byer said.
To do this, the researchers distributed an online survey among 484 adults between the ages of 19 and 60. Most participants (65%) identified as heterosexual, while 20% identified as bisexual, 5% as gay or lesbian, 5% as another identity, 3% as unlabeled, 2% as unsure or questioning, and 0.4 % as asexual.
Participants completed the 18-item ASI-3, which includes items such as: “When my chest feels tight, I’m afraid I won’t be able to breathe.” Subjects also responded to the newly created Sexual Anxiety Sensitivity Index (SASI), which was designed with parallel items to the ASI-3. An example was: “When my chest feels tight during sex, I’m afraid I won’t be able to breathe properly.” Participants further completed measures of sexual well-being, which included sexual confidence, sexual frequency, sexual satisfaction, sexual distress, and sexual functioning.
“People are aware that sexual activity provides a context in which they will experience a range of physiological sensations that resemble a fear response. “We were surprised that even in a non-clinical sample of mostly young people, quite a few participants reported concerns about their physiological arousal in this context,” Byers told PsyPost.
Using a statistical technique called confirmatory factor analysis, the researchers found that the SASI had strong psychometric properties—suggesting that it is a valid and reliable test of sexual anxiety sensitivity. Participant scores on the SASI were also significantly associated with scores on the ASI-3, providing further evidence in support of the scale.
“The measure we created is a practical assessment tool that we envision as useful for both clinicians working with individuals suffering from sexual anxiety sensitivity, as well as researchers interested in further exploration of the consequences of this type of anxiety,” Byers said.
Next, the results revealed that sexual anxiety sensitivity was significantly related to all ten measures of sexual well-being. Moreover, six of these associations remained significant after controlling for general anxiety sensitivity.
These measures were the number of previous sexual partners, frequency of sexual activity in the genitals, sexual self-esteem, sexual avoidance, sexual distress and sexual function. Since the SASI was able to predict these six aspects of sexual well-being beyond the ASI-3, this suggests that the new scale was able to explain more of the variance in sexual well-being than the general scale could alone. .
The authors note that their study adds to the current literature by showing that sexual anxiety sensitivity is associated with many indicators of sexual well-being, including those that had not yet been examined in relation to anxiety sensitivity.
“Higher sensitivity to sexual anxiety — that is, fear of normal physiological arousal that people typically experience when engaging in sexual activity, such as heart palpitations, increased sweating, even butterflies in the stomach — may play a role in poorer sexual well-being,” Byers told PsyPost. “That is, it probably causes people to avoid sexual activity and romantic and sexual relationships altogether and contributes to poorer sexual self-esteem and sexual satisfaction, higher sexual distress and more sexual problems.”
“Thus, reducing sexual anxiety sensitivity may result in better sexual well-being; in turn, sexual well-being is important for quality of life and, of course, the quality and longevity of romantic relationships.”
Regarding limitations, the study explored a new construct, so the results need to be replicated in future research. Future studies will also be needed to determine whether the findings generalize to other populations such as older groups and clinical samples.
“This is the first of what we hope will be a series of studies in the area,” Byers said. “This first study was exploratory – we weren’t even sure that people would experience sexual anxiety sensitivity and/or that it would have such a clear link to their sexual well-being. We need to replicate our findings with more samples that are more varied, as well as to consider the context sexual activity occurs in to fully understand the impact of sexual anxiety sensitivity on people’s lives.”
The study, “Anxiety sensitivity in the sexual context: links between sexual anxiety sensitivity and sexual well-being,” was written by E. Sandra Byers, Janine V. Olthuis, Lucia F. O’Sullivan, and Emma M. Connell.
