THE EFFECT OF FIRST INTERCOURSE ON SEXUAL SELF EFFICACY, SEXUAL AVERSION AND CURRENT SEXUAL FUNCTION IN YOUNG ADULTS

1
THE EFFECT OF FIRST INTERCOURSE ON SEXUAL SELF
EFFICACY, SEXUAL AVERSION AND CURRENT SEXUAL
FUNCTION IN YOUNG ADULTS

• Presented at the 31st Annual Meeting of the
  Society for Sex Therapy and Research.
• Elke D. Reissing, Ph.D.

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First timebut not the last time! (?)

• Vaginismus
• I didnt know I had a problem until we tried to
  have sex for the first time it was awful it
  took us months before we tried again over the
  past 3 years we have tried to have intercourse
  maybe 2 times.
• First intercourse is a remarkable experience in
  peoples lives - a rite of passage, a pivotal
  moment, a ready memory to recall at any time.
• What role does the first intercourse experience
  play in subsequent sexual adjustment?

3
Young adults sexuality

• High prevalence of sexual dysfunction in young
  adults
• (e.g., Lauman et al., 1999).
• During the decade of 20 30 years of age, every
  2nd woman and every 3rd man reported at least one
  sexual problem
• (Ernst et al., 1993).
• Younger people tend to experience more distress
  about sexual problems (e.g., Barlow et al.,
  2003).

4
Factors related to sexual satisfaction in young
adults

• Preponderance of studies on teenage pregnancy
  and risk of contracting a SDI.
• Limited information on sexual experiences of
  young adults and what factors may be related to
  positive sexual adjustment
• (e.g., Reissing, Laliberté, Davis, 2005)

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First Intercourse Experience

• In general lack of empirical information
• Some information on the qualitative experience
  of girls and young women.
• Limited but more recent information on
  comparative studies of young men and women.
• Surprising paucity of information on the
  experience of young men.
• NO information on how positive or negative first
  experiences may set in place reinforcement
  contingencies for future sexual experiences.

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1st Intercourse ? / ?

• Different social meaning
• - Loss of virginity vs. loss of inexperience and
  becoming a man
• - Losing the gift of virginity vs. the social
  stigma of being a virgin. (Carpenter, 2002
  Holland, 2000)

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1st Intercourse ? / ?

• Different social meaning
• Loss of virginity vs. loss of inexperience and
  becoming a man
• Losing the gift of virginity vs. the social
  stigma of being a virgin
• (Carpenter, 2002 Holland, 2000)
• Different expectations
• Pain vs. Orgasm (Weis, 1983Tsio Nicoladis,
  2004)

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1st Intercourse ? / ?

• Different social meaning
• Loss of virginity vs. loss of inexperience and
  becoming a man
• Losing the gift of virginity vs. the social
  stigma of being a virgin
• (Carpenter, 2002 Holland, 2000)
• Different expectations
• Pain vs. Orgasm (Weis, 1983 Tsio Nicoladis,
  2004)
• Different affective response
• ? experienced fewer positive and more negative
  emotions, more anxiety and guilt, and less
  pleasure and satisfaction.
• ? experienced more pleasure satisfaction and
  less guilt, but also experience anxiety.
• (Darling et al., 1992 Guggino Ponzetti, 1997
  Sprecher et al., 1995 Weiss, 1983)

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Affective reactions to 1st intercourse

• A large number of variables seem to affect
  whether or not a first experience is considered
  as subjectively pleasurable (??).
• Later age at 1st intercourse (gt16 ?)
• close, long-term relationship
• experience of orgasm
• contraception use
• first experience took place at home
• minimal to moderate pain experience (vs. strong
  pain) (?)
• having expected pain (?)
• no age discrepancy b/w partners
• no alcohol and drug use
• more rehearsal (prior non-coital activities
  including masturbation)
• (e.g., Guggino Ponzetti, 1997 Schwartz, 1993
  Sprecher et al., 1995 Tsui Nicoladis, 2004
  Weis, 1983)

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1st Intercourse affecting subsequent sexual
adjustment

• Surprisingly lack of research
• Indirect evidence from clinical studies with
  reports of negative or disappointing 1st
  intercourse experiences.
• (Allen et al., 2003 Lamont et al., 2001
  McCarthy, 2002)
• A focus on the interpersonal closeness with
  1st-time partner is related to better sexual
  satisfaction for both men and women.
• ? Study only looked at relationships wherein the
  first experience took place (Cate et al., 1993)

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Purpose of study

Current sexual function
1st Intercourse
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Sexual Self-Efficacy

Current sexual function
1st Intercourse
13

Sexual Self-Efficacy


Current sexual function
1st Intercourse
14

Sexual Self-Efficacy


Current sexual function
1st Intercourse
-
Sexual Aversion
15

Sexual Self-Efficacy


Current sexual function
1st Intercourse

-
Sexual Aversion
16

Sexual Self-Efficacy


Current sexual function
1st Intercourse
-
-
Sexual Aversion
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• A word about the directionality of our model
• We impose directionality between the constructs
  consistent with our assumption that successful
  behavioural outcomes increase ones expectations
  of personal mastery.
• Subsequent behaviours are guided by strong
  self-efficacy beliefs further predicting
  successful behaviour.
• Following a negative behavioural outcome, lack
  of exposure to sexual activity (aversion to and
  avoidance of sexual behaviour) further
  contributes ? efficacy beliefs because of a lack
  of disconfirming opportunities.

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Method

• Recruitment
• University Sample
• (Integrated System of Participation in Research,
  Introduction to Psychology, U of O)

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Method

• Measures
• Demographics Form
• First Coital Affective Reaction Scale
• (Schwartz, 1993)
• Sexual Self-Efficacy ScaleFemale Functioning
• (Bailes, Creti, Fichten, Libman, Brender,
  Amsel, 1998)
• Sexual Self-Efficacy ScaleErectile Functioning
  (Libman, Rothenburg, Fichten, Amsel, 1985)
• The Sexual Aversion Scale
• (Katz, Gipson, Kearl, Kriskovich, 1989)
• The Sexual History Form
• (Nowinski Lopiccolo, 1979)

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Method

• Procedure
• Chose study from a list of available studies
  online
• Register for participation by signing up for a
  time slot online
• Come to lab, welcome and brief description of
  study
• Retreat to private testing area and complete
  questionnaires
• Questionnaires place in envelope and dropped in a
  box

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Method

• Sample
• 536 participants
• 475 were included in analyses
• ?322 ?153
• Main reasons for exclusion Missing Data
• Sexual Orientation (other than hetero)
• No experience with sexual intercourse

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Participant characteristics

• Men (N153) Women (N322)
• Age M 20.6 yrs M 19.6 yrs
• SD 2.4 SD 2.0 yrs
• Range 18-29 Range 18-29
• Age at 1st intercourse M 17.0 M 16.7
• Age of partner M 16.8 M 17.7
• Orgasm at 1st intercourse Yes 62.1 Yes 6.3
• Use of drugs/alcohol Yes 29.4 Yes 19.3

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Overall scores and gender differences
Men Women
Mean (SD) Mean (SD)
Affective Reaction to 1st Intercourse 36.20 (10.41) a 43.47 (15.27) a
Sexual Self-Efficacy (1-100) 83.66 (10.30) b 76.44 (13.99) b
Current Sexual Function .31 (.09) c .43 (.12) c
Sexual Aversion 44.68 (11.95) 44.78 (10.79)
aMen demonstrated more positive emotional
reactions to first intercourse, t(473) -5.32, p
lt .001. b Men demonstrated higher sexual
self-efficacy than women, t(473) 5.66, p lt
.001. cMen demonstrated better sexual function
than women, t(473) -11.15, p lt .001.
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Do you think your 1st intercourse experience
changed the way you think or feel about sexuality?

• Men (N153) Women (N322)
• Negative (very to somewhat) 14 16
• No effect 41 36
• Positively (very to somewhat) 45 49
• Note ns ?2 , p.639.

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Correlations b/w reaction to 1st intercourse,
sexual self-efficacy, sexual aversion, and
current sexual function in ?a
Measure 1 2 3 4
1. Affective React. to 1st Intercourse -- -.22 .29 .19
2. Sexual Self-Efficacy -- -.41 -.43
3. Sexual Aversion -- .29
4. Current Sexual Function --
an 153 for all correlations. p lt .01. p lt
.05
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Correlations b/w reaction to 1st intercourse,
sexual self-efficacy, sexual aversion, and
current sexual function in ?a
Measure 1 2 3 4
1. Affective Reaction to First Intercourse -- -.23 .36 .20
2. Sexual Self-Efficacy -- -.43 -.58
3. Sexual Aversion -- .36
4. Current Sexual Function --
an 322 for all correlations. p lt.01.
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Mediating effects of sexual self-efficacy and
sexual aversion on reaction to 1st intercourse
and current sexual function in ?
Mediators
Sexual Self-Efficacy Sexual Aversion
Predictor r ß r ß
Reaction to First Intercourse .19 .11 .19 .12
Note. The ß values are the correlations after
controlling for mediator effects. p lt .05.
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Mediating effects of sexual self-efficacy and
sexual aversion on reaction to 1st intercourse
and current sexual function in ?
Mediators
Sexual Self-Efficacy Sexual Aversion
Predictor r ß r ß
Reaction to First Intercourse .20 .07 .20 .08
Note. The ß values are the correlations after
controlling for mediator effects. p lt .05.
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Mediation model ?Direct correlation (r)

Current sexual function
.19
1st Intercourse
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Mediation model ? Direct correlations (r)
Predictor and Mediators

Sexual Self-Efficacy
- .40
- .22
Current sexual function
1st Intercourse
Sexual Avoidance
.25
.29
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Mediation model ?Indirect correlations (r)

Sexual Self-Efficacy
- .40
- .22
.11
NS
Current sexual function
1st Intercourse
.12
NS
Sexual Avoidance
.25
.29
32
Mediation model ?Direct correlation (r)

Current sexual function
.20
1st Intercourse
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Mediation model ? Direct correlations (r)
Predictor and Mediators

Sexual Self-Efficacy
- .56
- .23
Current sexual function
1st Intercourse
Sexual Avoidance
.33
.36
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Mediation model ?Indirect correlations (r)

Sexual Self-Efficacy
- .56
- .23
.07
NS
Current sexual function
1st Intercourse
.08
NS
Sexual Avoidance
.33
.36
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Summary

• The affective reaction to the first intercourse
  experience appears to affect subsequent sexual
  adjustment via
• increasing or decreasing the belief of the young
  man or woman to be a competent lover and,
• by increasing or decreasing sexual avoidance and
  aversion.

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Limitations

• Relatively low N for men
• Self selected university sample
• Self report based on recall of the event (other
  circumstantial factors)
• Relationships are correlational, hence causation
  can not be assumed.
• Sexual Aversion Scale not optimal measure of
  sexual avoidance
• Direction of our model is theoretical /
  heuristic model to help exploration of the
  relationship b/w 1st intercourse and sexual
  adjustment.

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Implications

• The first, consensual, heterosexual intercourse
  may be more important to subsequent sexual
  development than previously assumed.
• An assessment of the first time and the
  efficacy beliefs and aversive/avoidant beliefs
  and behaviours that may have resulted from a
  negative experience may need to be taken into
  account when conducting a thorough clinical
  assessment for sexual problems.
• This study indirectly supports the importance
  C in CBT for sexual problems, but it also
  highlights the importance of the B.

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Implications

• Potential vicious cycle
• Negative sexual self schema may predispose a
  young person to sexual dysfunctions via a
  negative 1st intercourse experience reinforcing
  negative expectancies and behavioural avoidance.
• Sex education and early intervention may help
  break the cycle or prevent it from spinning
  into dysfunction.
• Recruitment of a community sample
• Closer examination of gender differences
• As well as confirming gender similarities.

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Vaginismus ?

• Low sexual self efficacy and distorted beliefs
  about herself being able to engage in
  penile-vaginal intercourse.
• Significant aversion to and avoidance of
  intercourse following very negative first
  experience.
• Important not to discount first experience even
  if not consummated. Assess
• Intervention preventing avoidance of
  disconfirming opportunities, and increasing
  sexual self efficacy by eliminating distorted
  beliefs is typically part of the treatment for
  vaginismus.
• BUT Highlights the importance of engaging in
  BEHAVIOUR to disconfirm beliefs.