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Genetic and environmental risk factors for sexual distress and its association with female sexual dysfunction

Published online by Cambridge University Press:  14 June 2011

A. Burri*
Affiliation:
Department of Twin Research and Genetic Epidemiology, King's College London, UK Biological and Experimental Psychology Group, School of Biological and Chemical Sciences, Queen Mary University of London, UK
Q. Rahman
Affiliation:
Biological and Experimental Psychology Group, School of Biological and Chemical Sciences, Queen Mary University of London, UK
T. Spector
Affiliation:
Department of Twin Research and Genetic Epidemiology, King's College London, UK
*
*Address for correspondence: Dr A. Burri, Biological and Experimental Psychology Group, School of Biological and Chemical Sciences, Queen Mary University of London, Mile End Road, London E1 4NS, UK. (Email: [email protected])

Abstract

Background

The DSM-V Working Group is currently re-evaluating distress as a primary diagnostic criterion for female sexual dysfunction (FSD). Here, for the first time, we explored the epidemiology of sexual distress and its putative aetiological relationship to FSD by estimating the influence of genetic and environmental risk factors.

Method

Questionnaire data on a representative sample of 930 British female twins using validated scales of FSD and sexual distress were subject to variance components analyses to quantify latent genetic and environmental factors influencing phenotypic variation and covariation. Multiple regression analyses were used to identify other potential risk factors of sexual distress.

Results

Of 319 women with any sexual problems, only 36.5% reported distress. Of women classified as functional, 16.5% felt sexual distress. Sexual distress had a heritability of 44% [95% confidence interval (CI) 0.33–0.54]. Bivariate analysis suggested that the majority (91% CI 86–99%) of the covariance between sexual distress and FSD was due to unique environmental effects common to both traits. Associations were found between sexual distress and other risk variables, including relationship dissatisfaction [odds ratio (OR) 1.6, p<0.001], anxiety sensitivity and obsessive–compulsive symptomatology (OR 1.2, p<0.01, for both).

Conclusions

There seems to be a weak phenotypic and genetic basis for including sexual distress as a diagnostic indicator of FSD. Instead, the data indicate that unrelated psychological factors play an important role in sexual distress and tentatively suggest that sexual distress is less a consequence of FSD and more related to general anxiety among women.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Abdo, CH, Oliveira, WM, Moreira, ED, Fittipaldi, JA (2004). Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women – results of the Brazilian study on sexual behavior (BSSB). International Journal of Impotence Research 16, 160166.CrossRefGoogle Scholar
Althof, S (2001). My personal distress over the inclusion of personal distress. Journal of Sex and Marital Therapy 27, 123125.CrossRefGoogle ScholarPubMed
Andrews, T, Hart, DJ, Snieder, H, de Lange, M, Spector, TD, MacGregor, AJ (2001). Are twins and singletons comparable? A study of disease-related and lifestyle characteristics. Twin Research 4, 464477.CrossRefGoogle Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Bailey, JM, Dunne, MP, Martin, NG (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology 78, 524536.CrossRefGoogle Scholar
Bancroft, J, Loftus, J, Long, JS (2003). Distress about sex: a national survey of women in heterosexual relationships. Archives of Sexual Behavior 32, 193208.CrossRefGoogle ScholarPubMed
Basson, R, Berman, J, Burnett, A, Derogatis, L, Ferguson, D, Fourcroy, J, Goldstein, I, Graziottin, A, Heiman, J, Laan, E, Leiblum, S, Padma-Nathan, H, Rosen, R, Segraves, K, Segraves, RT, Shabsigh, R, Sipski, M, Wagner, G, Whipple, B (2000). Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. Journal of Urology 163, 888893.CrossRefGoogle ScholarPubMed
Basson, R, Althof, S, David, S, Fugl-Meyer, K, Goldstein, I (2004). Summary of the recommendations on sexual dysfunctions in women. Journal of Sexual Medicine 1, 2434.CrossRefGoogle ScholarPubMed
Burri, A, Cherkas, L, Spector, T (2009). Emotional intelligence and its association with orgasm frequency in women. Journal of Sexual Medicine 6, 19301937.CrossRefGoogle ScholarPubMed
Burri, A, Spector, T (in press). Recent and lifelong sexual dysfunction in a female UK population sample: prevalence and risk factors. Journal of Sexual Medicine.Google Scholar
Dawood, K, Kirk, KM, Bailey, JM, Andrews, PW, Martin, NG (2005). Genetic and environmental influences on the frequency of orgasm in women. Twin Research 8, 2733.Google ScholarPubMed
Dennerstein, L, Alexander, JL, Kotz, K (2003). The menopause and sexual functioning: a review of the population-based studies. Annual Review of Sex Research 14, 6482.Google ScholarPubMed
Dennerstein, L, Hayes, RD (2005). Confronting the challenges: epidemiological study of female sexual dysfunction and the menopause. Journal of Sexual Medicine 2, 118132.CrossRefGoogle ScholarPubMed
Dennerstein, L, Smith, A, Morse, C, Burger, H (1994). Sexuality and the menopause. Journal of Psychosomatic Obstetrics and Gynecology 15, 5966.CrossRefGoogle ScholarPubMed
Derogatis, L, Clayton, A, Lewis-D'Agostino, D, Wunderlich, G, Fu, Y (2008). Validation of the female sexual distress scale – revised for assessing distress in women with hypoactive sexual desire disorder. Journal of Sexual Medicine 5, 357364.CrossRefGoogle ScholarPubMed
Derogatis, LR, Rosen, R, Leiblum, S, Burnett, A, Heiman, J (2002). The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex and Marital Therapy 28, 317330.CrossRefGoogle ScholarPubMed
Dunn, KM, Croft, PR, Hackett, GI (1999). Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. Journal of Epidemiology and Community Health 53, 144148.CrossRefGoogle ScholarPubMed
Dunn, KM, Cherkas, LF, Spector, TD (2005). Genetic influences on variation in female orgasmic function: a twin study. Biology Letters 22, 260–226.CrossRefGoogle Scholar
Dunne, MP, Bailey, JM, Kirk, KM, Martin, NG (2000). The subtlety of sex atypicality. Archives of Sexual Behavior 29, 549565.CrossRefGoogle ScholarPubMed
Foa, EB, Huppert, JD, Kichic, R, Hajcak, G, Salkovskis, PM (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment 14, 485496.CrossRefGoogle ScholarPubMed
Frohlich, P, Meston, C (2002). Sexual functioning and self-reported depressive symptoms among college women. Journal of Sex Research 39, 321325.CrossRefGoogle ScholarPubMed
Graham, CA (2010). The DSM diagnostic criteria for female sexual arousal disorder. Archives of Sexual behavior 39, 240255.CrossRefGoogle ScholarPubMed
Hayes, RD, Dennerstein, L, Bennett, CM, Sidat, M, Gurrin, LC, Fairley, CK (2008). Risk factors for female sexual dysfunction in the general population: exploring factors associated with low sexual function and sexual distress. Journal of Sexual Medicine 5, 16811693.CrossRefGoogle ScholarPubMed
Hu, LT, Bentler, PM (1995). Evaluating model fit. In Structural Equation Modelling: Concepts, Issues and Applications (ed. Hoyle, R. H.), pp. 7699. Sage: Thousand Oaks, CA.Google Scholar
King, M, Holt, V, Nazareth, I (2007). Women's views of their sexual difficulties: agreement and disagreement with clinical diagnoses. Archives of Sexual Behavior 36, 281288.CrossRefGoogle ScholarPubMed
Loehlin, JC (1995). The Cholesky approach: a cautionary note. Behavior Genetics 26, 1926.Google Scholar
Masters, WH, Johnson, VE (1966). Human Sexual Response. Little Brown: Boston.Google Scholar
Meston, CM (2003). Validation of the Female Sexual Function Index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire disorder. Journal of Sex and Marital Therapy 29, 3946.CrossRefGoogle ScholarPubMed
Neale, MC, Boker, SM, Xie, G, Maes, HH (2006). Mx: Statistical Modeling, 7th edn. Virginia Commonwealth University: Richmond, VA.Google Scholar
Neale, MC, Cardon, LR (1992). Methodology for Genetic Studies of Twins and Families. Kluwer Academic: Dordrecht, The Netherlands.CrossRefGoogle Scholar
Oberg, K, Fugl-Meyer, AR, Fugl-Meyer, KS (2004). On categorization and quantification of women's sexual dysfunctions: an epidemiological approach. International Journal of Impotence Research 16, 261269.CrossRefGoogle ScholarPubMed
Peterson, RA, Plehn, K (1999). Measuring anxiety sensitivity. In Anxiety Sensitivity: Theory, Research, and Treatment of the Fear of Anxiety (ed. Taylor, S.), pp. 6181. Erlbaum: Mahwah, NJ, 1999.Google Scholar
Peterson, RA, Reiss, RJ (1992). Anxiety Sensitivity Index Manual (2nd edn). International Diagnostic Systems: Worthington, OH, 1992.Google Scholar
Petrides, KV, Furnham, A (2006). The role of trait emotional intelligence in a gender-specific model of organizational variables. Journal of Applied Social Psychology 36, 552569.CrossRefGoogle Scholar
Posthuma, D, Beem, AL, de Geus, EJC, van Baal, GCM, von Hjelmborg, JB, Iachine, I, Boomsma, DI (2003). Theory and practice in quantitative genetics. Twin Research 6, 361376.CrossRefGoogle ScholarPubMed
Reiss, S, Peterson, RA, Gursky, M, McNally, R (1986). Anxiety, sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy 24, 18.CrossRefGoogle ScholarPubMed
Rosen, R, Brown, C, Heiman, J, Leiblum, S, Meston, C, Shabsigh, R, Ferguson, D, D'Agostino, R (2000). The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy 26, 191208.CrossRefGoogle ScholarPubMed
Segraves, R, Balon, R, Clayton, A (2007). Proposal for changes in diagnostic criteria for sexual dysfunctions. Journal of Sexual Medicine 3, 567580.CrossRefGoogle Scholar
Shifren, JL, Monz, BU, Russo, PA, Segreti, A, Johannes, CB (2008). Sexual problems and distress in United States women. Obstetrics and Gynecology 112, 970978.CrossRefGoogle ScholarPubMed
Spector, T, Williams, F (2006). The UK Adult Twin Registry (TwinsUK). Twin Research and Human Genetics 9, 899906.CrossRefGoogle ScholarPubMed
StataCorp (2007). STATA Statistical Software: Release 10. Stata Corporation: College Station, TX.Google Scholar
Stephenson, KR, Meston, CM (2010). When are sexual difficulties distressing for women? The selective protective value of intimate relationships. Journal of Sexual Medicine 7, 36833694.CrossRefGoogle ScholarPubMed
Wiegel, M, Meston, C, Rosen, R (2005). The Female Sexual Function Index (FSFI): cross-validation and development of clinical cut-off scores. Journal of Sex and Marital Therapy 31, 120.CrossRefGoogle Scholar
Witting, K, Santilla, P, Rijsdijk, F, Varjonen, M, Stern, P, Johansson, A, von der Prahlen, B, Alanko, K, Sandnabba, NK (2009). Correlated genetic and non-shared environmental influences account for the co-morbidity between female sexual dysfunctions. Psychological Medicine 26, 18.Google Scholar
Witting, K, Santtila, P, Varjonen, M, Jern, P, Johansson, A, von der Pahlen, B, Sandnabba, K (2008). Female sexual dysfunction, sexual distress, and compatibility with partner. Journal of Sexual Medicine 5, 25872599.CrossRefGoogle ScholarPubMed
Woods, SA, Hampson, SE (2005). Measuring the Big Five with single items using a bipolar response scale. European Journal of Personality 19, 373390.CrossRefGoogle Scholar