The Use of an Online Culturally Oriented Marital Enrichment Package on the Sexual Behaviors of Sexually Distressed Women: A Randomized Clinical Trial

Document Type : Original Article

Authors

1 Department of Psychology, Islamic Azad University, Bushehr Branch, Bushehr, Iran

2 Department of Sexology, National Center for Addiction Studies of Iran, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Introduction: This study was carried out in order to investigate the online "marital enrichment package with a cultural approach" on the sexual behaviors of women suffering from sexual distress.
Method: In this randomized clinical trial, 79 women were recruited. Forty were assigned to the experimental group and attended the four-week program (6 hours), and 39 were assigned to the control group. Sexual behaviours, sexual scripts, and sexual distress were determined by a questionnaire that was completed before and after, eight and 12 weeks post intervention. The control group received the intervention based on the sexual health model post experiment. Independent samples t-test were used for statistical analysis.
Results: According to the findings of the present study, significant differences were observed between the groups for the scores of sexual behavior in the follow-ups (P=.001; F=26.582).
Conclusion: The utilization of the four-session culture-oriented marital enrichment packa significantly improved sexual behaviors, altered sexual scripts, and decreased sexual distress. Our findings provide the basis for a larger Randomized-Controlled Trial (RCT) with a longer follow-up period among couples.

Keywords


  1. 1. Taheri z, mahvi shirazi m. Investigating the Relationship Between Marriage Expectations and Tolerance of Distress with Marital Adjustment in Women. Women Studies. 2019;10(27):99-116. 30465/WS.2019.4031
  2. 2. Ashmore JA, Emery CF, Hauck ER, MacIntyre NR. Marital adjustment among patients with chronic obstructive pulmonary disease who are participating in pulmonary rehabilitation. Heart & Lung. 2005;34(4):270-8. https://doi.org/10.1016/j.hrtlng.2004.12.005
  3. 3. Srithanaviboonchai K, Sitthi W, Musumari PM, Tangmunkongvorakul A, Rerkasem K, Techasrivichien T. Sexual Behavior and Attitudes Toward Sex of Older Adults Living with HIV. AIDS and Behavior. 2020;24(6):1825-34. https://doi.org/10.1007/s10461-019-02756-6
  4. 4. Masters WH, Johnson, V. E., & Kolodny, R. C Human sexuality. Boston: Longman 2017.
  5. 5. Bancroft J, Janssen E, Strong D, Carnes L, Vukadinovic Z, Long JS. The relation between mood and sexuality in heterosexual men. Archives of sexual behavior. 2003;32(3):217-30. https://doi.org/10.1023/A:1023409516739
  6. 6. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric validation of the sexual distress scale in male and female Portuguese samples. The Journal of Sexual Medicine. 2022;19(5):834-45. https://doi.org/10.1016/j.jsxm.2022.02.026
  7. 7. Felmingham K, Williams LM, Kemp AH, Liddell B, Falconer E, Peduto A, et al. Neural responses to masked fear faces: sex differences and trauma exposure in posttraumatic stress disorder. Journal of abnormal psychology. 2010;119(1):241. https://doi.org/10.1037/a0017551
  8. 8. Dennerstein PL, Emma Dudley, Lorraine. Short scale to measure female sexuality: adapted from McCoy Female Sexuality Questionnaire. Journal of Sex & Marital Therapy. 2001;27(4):339-51. https://doi.org/10.1080/009262301317081098
  9. 9. Clayton AH, McGarvey EL, Clavet GJ, Piazza Comparison of sexual functional in clinical and nonclinical populations using the changes in Sexual Functioning Questionnaire (CSFQ). Psychopharmacology Bulletin. 1997;33(4):747. PMID: 9493487.
  10. 10. Ghorashi Z, Yousefy A, Merghati-koei E. Developing and validating a questionnaire to measure Women’s sexual behaviors: a psychometric process. Galen Medical Journal. 2016;5(4):208-14. https://doi.org/10.31661/gmj.v5i4.698
  11. 11. Avasthi A, Kaur R, Prakash O, Banerjee A, Kumar L, Kulhara P. Sexual behavior of married young women: A preliminary study from north India. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2008;33(3):163. doi: 4103/0970-0218.39677
  12. 12. Sepahvand T, Rasoulzade Tabatabaei SK, Besharat MA, Allahyari AA. Comparison of integrated model of self regulation-attachment couple therapy and marital enrichment program in marital satisfaction and psychological wellbeing of couples. Contemporary Psychology, Biannual Journal of the Iranian Psychological Association. 2014;9(1):55-70.
  13. 13. Olson D, Olson A. Prepare/enrich program. Handbook of preventative approaches in couple therapy. 1999:196-216.
  14. 14. Olson DH. Prepare/Enrich Program: Version 2000 David H. Olson & Amy K. Olson.
  15. 15. Zahra B. The effectiveness of relationship enrichment program on sexual satisfaction and marital boredom of married women referring to cultural centers in Isfahan.: Shahid Ashrafi Isfahani University; 2020.
  16. 16. Ryle R. Questioning gender: A sociological exploration: Sage Publications; 2011.
  17. 17. Moeini B, Khoei EM, Barati M, Soltanian A, Sharma M, Khadivi R, et al. Randomized controlled trial protocol to evaluate the effect of an educational intervention using information, motivation and behavioral skills model on sexual satisfaction of new couples in Iran. Reproductive health. 2019;16(1):1- https://doi.org/10.1186/s12978-019-0821-7
  18. 18. DeRogatis L, Clayton A, Lewis-D'Agostino D, Wunderlich G, Fu Y. Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. The journal of sexual medicine. 2008;5(2):357-64. https://doi.org/10.1111/j.1743-6109.2007.00672.x
  19. 19. Azimi Nekoo E, Burri A, Ashrafti F, Fridlund B, Koenig HG, Derogatis LR, et al. Psychometric properties of the Iranian version of the female sexual distress scaleā€revised in women. The journal of sexual medicine. 2014;11(4):995-1004. https://doi.org/10.1111/jsm.12449
  20. 20. roshan chesli r, mirzaei s, nikazin a. Validity and Reliability of Multidimensional Sexual Satisfaction Scale for Women (SSSW) in One Sample of Iranian Women. Clinical Psychology and Personality. 2014;12(1):129-40. 1001.1.23452188.1393.12.1.11.4
  21. 21. Ghassami m, Shairi MR, Asghari Moghadam MA, Rahmati N. The Study of the Psychometric Properties of the 6-Item Version of the Female Sexual Function Index (FSFI-6) Amongst Iranian Women. Nursing and Midwifery Journal. 2014;12(7):532-43. URL: http://unmf.umsu.ac.ir/article-1-1619-en.html
  22. 22. ghorashi Z. Clarifying the concept of sexual behavior and developing a scale for evaluating sexual behaviors of married women of childbearing age, exploratory method.: Isfahan University; 2012.
  23. 23. MacKian SC. What the papers say: Reading therapeutic landscapes of women's health and empowerment in Uganda. Health & place. 2008;14(1):106-15. https://doi.org/10.1016/j.healthplace.2007.05.005
  24. 24. bagheri f. investigating the effectiveness of marital relationship enrichment training on the sexual health of couples: Hamedan University of Medical Sciences; 2019.
  25. 25. Amini M, Heydari H. Effectiveness of relationships enrichment education on improvement of life quality and marital satisfaction in married female students. Journal of Education and Community Health. 2016;3(2):23-31. doi:24-jech/21859.10: D
  26. 26. Mohammadi M, Alibakhshi SZ. The Effectiveness of the Self-differentiation Training Based on the Bowen Theory on Marital Satisfaction. Journal of Research and Health. 2021;11(5):333-40. ‎32598/JRH.11.5.1574.1
  27. 27. badihi Z. The effectiveness of the relationship enrichment program on sexual satisfaction and marital dissatisfaction of married women referring to culture centers in Isfahan city.: Shahid Ashrafi of Isfahani; 2020.
  28. 28. Tavaloli T, Kimiaei SA, Agha Mohammadian H. The Effectiveness of Marriage Enrichment Training of TIME Plan on improving marital intimacy and psychological security of women. Practice in Clinical Psychology. 2022;10(3):0-. ‎32598/jpcp.10.3.857.1
  29. 29. Khamsei A. Investigating the relationship between sexual behavior and gender role schemas in two groups of married students: Comparison of sexual behavior of women and men in the family. Family Studies. 2006;2(8):327-39.
  30. 30. Issanejad O, Ahmady S, Bahrami F, Baghban I, Shojaheidari M. The Effect of Relationship Enhancement Training on Marital Happiness and Optimism. Journal of Modern Psychological Researches. 2011;6(21):129-49.
  31. 31. Cobb RJ, Sullivan KT. Relationship education and marital satisfaction in newlywed couples: A propensity score analysis. Journal of Family Psychology. 2015;29(5):667. 2016 Spring (1).zip
  32. 32. Mercer Kollar LM, Davis TL, Monahan JL, Samp JA, Coles VB, Bradley EL, et al. Do as I say: Using communication role-plays to assess sexual assertiveness following an intervention. Health Education & Behavior. 2016;43(6):691-8. https://doi.org/10.1177/1090198116630
  33. 33. Javadivala Z, Allahverdipour H, Merghati-Khoei E, Mirghafourvand M. Exploration, designing, and effectiveness of a comprehensive model of prevention and counseling on improving sexual motivation and function of women at menopausal ages: A Sequential Exploratory Mixed Methods Study. The 7th International Women's Health Seminar1397. WHMED07_227
  34. 34. Maines RP. The technology of orgasm:" Hysteria," the vibrator, and women's sexual satisfaction: JHU Press; 2001.
  35. 35. Kilimnik CD, Boyd RL, Stanton AM, Meston CM. Identification of nonconsensual sexual experiences and the sexual self-schemas of women: Implications for sexual functioning. Archives of Sexual Behavior. 2018;47(6):1633-47. https://doi.org/10.1007/s10508-018-1229-0
  36. 36. Andersen BL, Cyranowski JM. Women's sexual self-schema. Journal of personality and social psychology. 1994;67(6):1079. https://doi.org/10.1037/0022-3514.67.6.1079
  37. 37. Meskó N, Zsidó AN, Birkás B, Meston CM, Buss DM. Why Hungarians Have Sex: Development and Validation of a Brief 15-Item Instrument (YSEX?-15H). Archives of Sexual Behavior. 2022;51(8):4007-22. https://doi.org/10.1007/s10508-022-02380-x
  38. 38. Hatfield E, Luckhurst C, Rapson RL. Sexual motives: Cultural, evolutionary, and social psychological perspectives. Sexuality & Culture. 2010;14(3):173-90. https://doi.org/10.1007/s12119-010-9072-z
  39. 39. Mazinani R, Akbari Mehr M, Kaskian A, Kashanian M. Evaluation of prevalence of sexual dysfunctions and its related factors in women. Razi Journal of Medical Sciences. 2013;19(105):59-66. URL: http://rjms.iums.ac.ir/article-1-2402-en.html
  40. 40. Firuzi H, Amiri F, Saadati N, Rostami M. The effects of childhood abuse on women's body image and sexual function. Journal of Fundamentals of Mental Health. 2016;18(6):313-20. URL: http://jfmh.mums.ac.ir/article_7754.html
  41. 41. Woertman L, Van den Brink F. Body image and female sexual functioning and behavior: A review. Journal of sex research. 2012;49(2-3):184-211. DOI:10.1080/00224499.2012.658586
  42. 42. Khodamoradi M, ESMAEILI A. The Effectiveness of Marriage Enrichment Training in Fear of Intimacy and Improving Sexual Function. 2020.Doi: 52547/jarcp.1.2.85