Relationship Satisfaction as a Predictor of Treatment Response During Cognitive Behavioral Sex Therapy

Abstract

Impairments in sexual desire, arousal, and orgasm are common problems reported by women with female sexual dysfunction (FSD). Sex therapy using cognitive-behavioral therapy (CBT) is a promising method for FSD. The primary goals of CBT are to help a woman improve her sexual satisfaction and to reduce or eliminate her sexual distress. Identification of predictors of treatment response in women receiving CBT could help determine which women will benefit most from this therapy. Little information is available on predictors of treatment response. It has been suggested that low relationship satisfaction may impair the effectiveness of individual CBT for sexual dysfunction. Women reporting low relationship satisfaction before CBT could show a weaker association between changes in sexual functioning and changes in sexual satisfaction/distress. The present study assessed the degree to which pretreatment relationship satisfaction predicted treatment response to CBT. A total of 31 women with sexual dysfunction (average age = 28 years, 77.4% white) were randomized to receive CBT with or without ginkgo biloba as part of a previously published randomized clinical trial. Gingko biloba extract is hypothesized to have beneficial effects on peripheral circulation, which may facilitate genital engorgement during sexual activities. Pretreatment and posttreatment data were compared using validated self-reported measures of sexual satisfaction, sexual distress, sexual functioning, and relationship satisfaction. The level of pretreatment relationship satisfaction was predictive after CBT for changes in sexual satisfaction and distress, but not sexual functioning. Women with high relationship satisfaction before CBT experienced improvements in sexual functioning and decreasing sexual distress levels, whereas changes in sexual functioning among those with low pretreatment relationship satisfaction were associated with increased levels of sexual distress. Relationship satisfaction before therapy was a moderator of the association between changes in sexual functioning and changes in sexual distress. Improved sexual functioning was associated with decreased levels of sexual distress only among women with high pretreatment relationship satisfaction. These data show that small improvements in sexual functioning produced by CBT among women who entered therapy with low levels of relationship satisfaction were unable to alleviate their sexual distress. Low pretreatment relationship satisfaction may be predictive for poor response to CBT.