Roles of Genital Self-Image, Distraction, and Anxiety in Women’s Sexual Pleasure: A Preregistered Study

Abstract

Women with negative genital self-image are more likely to experience sexual dysfunction , but the processes underlying this association are unknown. We theorized that this association is mediated by distraction from the arousing sexual cues that foster pleasure and orgasm . In a sample of 1,619 women who had sex in the previous four weeks, women with negative genital self-image were more likely to be distracted by self-critical concerns (i.e., appearance- and performance-based distraction and embarrassment) during sex, and in turn, experienced less sexual pleasure and worse sexual function. Additionally, this indirect effect via appearance-based distraction was strongest among women with trait-level anxiousness and social anxiety. We found a similar pattern of results when investigating the indirect effect of genital self-image on sexual function. Implications for understanding sexual function and therapeutic approaches are discussed.

Keywords:

• Genital self-image
• sexual pleasure
• sexual function
• anxiousness
• social anxiety

Acknowledgments

We thank Kia Asberg and David McCord for feedback on study design and this manuscript.

Author note

This study was preregistered with AsPredicted.org (https://aspredicted.org/57m2w.pdf).

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Though a significant decrease from the c to the c’ path is not required for evidence of significant mediation (Hayes & Rockwood, 2017), in tables we report these path estimates for informational purposes.

2 To further assess effect sizes for mediation, we calculated mediation ratios of indirect effects compared to total effects with the following equation, $P_M= \frac{ab}{c}$(Preacher & Kelley, 2011; Hayes, 2018). This measure of effect size for indirect effects is suitable for these analyses because sample sizes exceed the minimum (N > 500) required to stabilize this measure. However, due to the instability of this measure across different samples and the fact that this value is not necessarily constrained within the values of 0 and 1, this measure of effect size should be interpreted with caution (Hayes, 2018).