A team of researchers has developed and tested a new scale to measure sexual anxiety sensitivity — a fear of physiological arousal sensations during sex. The scale predicted sexual well-being across multiple indicators, over and above an existing scale that measures fear of arousal sensations in general. The findings were published in the Journal of Sex & Marital Therapy.
People with anxiety sensitivity experience a fear of their own physiological sensations. This fear is provoked by a belief that these sensations will bring them great harm. For instance, a person who experiences a racing 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.
People with high anxiety sensitivity tend to experience a range of adverse outcomes related to well-being. Since sexual activity involves physiological arousal, it is unsurprising that one of these adverse 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, a 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 considered 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 sought to develop a measure that assesses anxiety sensitivity specific to 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 examine 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 like, “When my chest feels tight, I get scared that 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 item was, “When my chest feels tight during sex, I get scared that I won’t be able to breathe properly.” Participants further completed measures of sexual well-being, which included sexual self-esteem, sexual frequency, sexual satisfaction, sexual distress, and sexual function.
“People are aware that sexual activity provides a context where they are going to experience a number of physiological sensations that resemble a fear response. We were surprised that even in a non-clinical sample of mostly young people, there were quite a few participants who 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 being useful to both clinicians working with individuals who suffer from sexual anxiety sensitivity as well as researchers interested in further exploration of the ramifications 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 number of past sexual partners, frequency of genital sexual activity, sexual self-esteem, sexual avoidance, sexual distress, and sexual function. Since the SASI was able to predict these six aspects of sexual well-being over and above the ASI-3, this suggests that the new scale was able to explain more of the variability in sexual well-being than the general scale could on its own.
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 ones that had not yet been investigated in relation to anxiety sensitivity.
“Higher sexual anxiety sensitivity — that is fear of normal physiological arousal that people typically experience when engaging in sexual activity such as one’s heart racing, increased perspiration, even butterflies in one’s stomach — may play a role in poorer sexual well-being,” Byers told PsyPost. “That is, it likely leads 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 to quality of life and, of course, the quality and longevity of romantic relationships.”
As far as limitations, the study explored a new construct so the results will need to be replicated in future research. Future studies will also be needed to determine whether the findings generalize to other populations like older groups and clinical samples.
“This is the first of what we hope is a number 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 diverse as well as to consider the context in which sexual activity occurs 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 authored by E. Sandra Byers, Janine V. Olthuis, Lucia F. O’Sullivan, and Emma M. Connell.
