(017) Attachment and Sexual Satisfaction in Couples with Sexual Interest/Arousal Disorder: The Role of Emotion Regulation

Abstract Introduction Sexual Interest/Arousal Disorder (SIAD) is one of the most common sexual difficulties in women and is characterized by lower sexual satisfaction, both in individuals with SIAD and their partners (Rosen et al., 2019). The Interpersonal Emotion Regulation Model (IERM) of women’s sexual dysfunction posits that interpersonal factors, such as insecure attachment (anxious/avoidant), affect both partners’ emotion regulation strategies (eg, acceptance, suppression), which in turn influence the couple’s sexuality outcomes (Rosen & Bergeron, 2019). Existing work showed that women with SIAD report more difficulties in emotion regulation than controls (Sarin et al., 2016), and that these difficulties are associated with poorer sexual adjustment for both partners (Dubé et al., 2019). Although insecure attachment has been recognized as a predictor of lower sexual satisfaction (Mark et al., 2018) and is linked to more emotion regulation difficulties (Girme et al., 2021), these associations have not been studied in the context of SIAD. Importantly, research on SIAD has been mostly cross-sectional, and assessed general rather than sexuality-specific emotion regulation, limiting our understanding of how regulation strategies in sexual contexts influence sexual satisfaction. Findings may underscore the relevance of attachment insecurities and emotion regulation strategies as potential intervention targets, while providing empirical support for theoretical models of SIAD. Objective As per the IERM, this study examined dyadic associations between insecure attachment and the average level of sexual satisfaction over a 56-day period among couples coping with SIAD, and the potential indirect role of sexuality-specific emotion regulation strategies (adaptive, ie, acceptance, and less adaptive, ie, suppression) in these associations. Methods Participants were 199 diverse couples in which self-identified women or female-bodied people were diagnosed with SIAD via structured clinical interview. Using a dyadic daily diary design, they completed online measures of attachment at baseline, and daily sexuality-specific emotion regulation strategies and sexual satisfaction over 56 consecutive days. Direct and indirect associations were tested with multilevel modeling within the Actor-Partner Interdependence Model framework. Because regulation strategies were only collected on days of partnered sexual activity, analyses were restricted to those days. As attachment was only assessed at baseline, results were interpreted at the between-person level. Results For both individuals with SIAD and their partners, higher attachment anxiety and avoidance were associated with one’s own lower average sexual satisfaction across days of partnered sexual activity. Additionally, partners’ greater attachment anxiety was associated with the individuals with SIAD’s lower satisfaction, while greater attachment avoidance among individuals with SIAD was associated with their partners’ lower satisfaction. One indirect effect emerged through regulation strategies: among individuals with SIAD, higher attachment avoidance was related to their own lower average sexual satisfaction through their own greater average suppression across days of partnered sexual activity. No indirect effects were found for acceptance. Conclusions Findings highlight attachment insecurities as key relational vulnerabilities in couples coping with SIAD, with greater avoidance linked to lower sexual satisfaction partly through suppression for individuals with SIAD. This dyadic, daily-diary design provides empirical support for theoretical models of SIAD and extends prior cross-sectional work by clarifying interpersonal mechanisms underlying SIAD, underscoring the potential value of targeting attachment dynamics and emotional suppression in interventions. Disclosure No.