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The Transaction Between Depression and Anxiety Symptoms and Sexual Functioning: A Prospective Study of Premenopausal, Healthy Women

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Abstract

A number of studies have called attention to the problematic interplay between depression and anxiety symptoms and sexual difficulties. However, despite the bidirectional conceptualization of the association between affective and sexual problems, few studies have adequately examined temporal precedence or state-level fluctuations between these two constructs. Using Clark and Watson’s (1991) tripartite model of anxiety and depression, the current study employed a repeated measures design to examine how weekly changes in affective symptoms were related to weekly changes in sexual functioning in a non-clinical sample of premenopausal women. First, we examined how general distress, anxious arousal, and anhedonia were concurrently related to various indices of sexual functioning. Next, we examined lagged effects of mood and anxiety symptoms predicting later levels of sexual functioning. Finally, we tested sexual functioning’s influence on later reports of affective symptoms. Hierarchical linear modeling analyses revealed that, of the three symptom types tested, anhedonic depression was the most consistently related to sexual problems, and that these relations were more proximal than distal. The preponderance of data suggested temporal precedence of mood on sexual symptoms. These findings emphasize the importance of prospective studies in the investigation of mental and sexual health.

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Notes

  1. See Tables 7 and 8 in Appendix for results from covariance models regressing sexual function indices onto anhedonia and anxious arousal (i.e., without general distress or menstruation as covariates). These were conducted in order to observe independent relations between symptoms of depression and anxiety and sexual function, without the influence of general distress or menstruation in the models.

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Author information

Authors and Affiliations

  1. Department of Psychology, Kent State University, Kent, OH, USA

    David A. Kalmbach & Jeffrey A. Ciesla

  2. Sleep and Chronophysiology Laboratory, University of Michigan, Ann Arbor, MI, 48109, USA

    David A. Kalmbach

  3. Sleep Disorders & Research Center, Henry Ford Hospital, Detroit, MI, USA

    Vivek Pillai

  4. Departments of Reproductive Biology and Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Sheryl A. Kingsberg

Authors
  1. David A. Kalmbach
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  2. Vivek Pillai
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  3. Sheryl A. Kingsberg
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  4. Jeffrey A. Ciesla
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Corresponding author

Correspondence to David A. Kalmbach.

Appendix

Appendix

See Tables 7 and 8.

Table 7 Covariance models regressing sexual functioning, as measured by the FSFI, onto anhedonia and anxious arousal
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Table 8 Covariance models regressing sexual functioning, as measured by the PFSF, onto general distress, anhedonic depression, and anxious arousal, while controlling for the presence of menstruation
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Kalmbach, D.A., Pillai, V., Kingsberg, S.A. et al. The Transaction Between Depression and Anxiety Symptoms and Sexual Functioning: A Prospective Study of Premenopausal, Healthy Women. Arch Sex Behav 44, 1635–1649 (2015). https://doi.org/10.1007/s10508-014-0381-4

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