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Sexual and Relationship Therapy , 2014 Vol. 29, No. 2, 229–244, http://dx.doi.org/10.1080/14681994.2013.870335

229–244, http://dx.doi.org/10.1080/14681994.2013.870335 Emotional intimacy, sexual desire, and sexual satisfaction

Emotional intimacy, sexual desire, and sexual satisfaction among partnered heterosexual men

Aleksandar Stulhofer a * , Luana Cunha Ferreira b and Ivan Landripet a

a Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia; Department of Clinical Systemic Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal

b

( Received 17 June 2013; accepted 25 November 2013)

In spite of a mostly positive impact of emotional intimacy on sexual desire and satisfaction, emotional merging and the safety and comfort of emotional closeness have been linked with diminished sexual desire. Aiming at a better understanding of the role of intimacy in male sexuality, this paper explored (1) a likely mechanism behind the association between emotional intimacy and sexual satisfaction and (2) whether there is empirical evidence of a negative impact of intimacy on sexual desire. Among 506 heterosexual Croatian men ( M ¼ 38.2 years, SD ¼ 8.43) currently living with their partners who participated in a large-scale online survey carried out in 2011, sexual satisfaction was dependent on both intimacy and sexual desire. Emotional intimacy was strongly associated with the partner-centered component of personal sexual satisfaction, pointing to a possible mechanism through which intimacy affects sexual well-being. Despite employing different analytical approaches and controlling for age and the length of intimate relationship, no evidence was found of a negative association between relationship intimacy and male sexual desire. Our study supports the notion that intimacy has an important and positive role in male sexuality.

Keywords: emotional intimacy; sexual desire; sexual satisfaction; men; relationships

Introduction

Emotional intimacy plays an important role in human sexuality, and it appears to be asso- ciated with different sexual dimensions, such as sexual motivation, responsivity, and sex- ual satisfaction. However, the specific impact of intimacy on male sexual desire and sexual satisfaction is yet to be accounted for. Although it is often used indistinguishably from emotional closeness or sexual involvement, intimacy has been mostly conceptual- ized as a multidimensional construct, or process, that includes mutual self-disclosure, per- sonal validation, trust, and love or affection (Baumeister & Bratslavsky, 1999 ; Hook, Gerstein, Detterich, & Gridley, 2003 ). A number of beneficial individual and dyadic pro- cesses have been positively associated with emotional intimacy, such as adjustment and psychological well-being (Prager, 1995 ), mental health and relationship quality (Frost, 2012 ), marital satisfaction (Patrick, Sells, Giordano, & Tollerud, 2007 ), trust (Larson, Hammond, & Harper, 1998 ), and sexual satisfaction (Moret, Glaser, Page, & Bargeron, 1998 ). Though previous research suggests that male sexual desire tends to be more spontaneous and focused on physical pleasure, in contrast to a more responsive and relationship-oriented

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female sexual desire (for a review, see Leiblum, 2002), a more recent study pointed to a more significant role of emotional intimacy and relational factors for men (Patrick & Beck- enbach, 2009). In this study, we explored the specific role of intimacy in mediating the asso- ciation between sexual desire and sexual satisfaction among heterosexual men who are married or living in a cohabiting relationship with a partner.

Defining the core constructs

Although intimacy is a much researched subject, some inconsistencies in its definition still permeate scholarly literature. Not surprisingly, psychometric assessments of inti- macy reflect this diversity, which makes in-depth comparisons a challenge (see Ferreira, Narciso, & Novo, 2012 , for a review). Most definitions of intimacy, however, encom- pass some of the following dimensions: mutual self-disclosure, personal validation, trust, favorable attitudes, and mutual expression of affection (Baumeister & Bratslavsky, 1999 ; Hook et al., 2003 ). Because some definitions of intimacy include sexuality (cf. Schaefer & Olson, 1981 ), in this study we specifically focus on emotional intimacy defined, following Sinclair and Dowdy (2005 , p. 194), as “a perception of closeness to another that is conducive to the sharing of personal feelings, accompanied by expecta- tions of understanding, affirmation, and demonstrations of caring”. There is a consensus that emotional intimacy is important for adjustment and psychological well-being and a characteristics of a healthy relationship that buffers daily stress (Miller & Lefcourt, 1982 ; Prager, 1995) . The definition of sexual desire carries many methodological, clinical, and even politi- cal implications (cf. Brotto, 2010 ). Routinely defined as a motivational state that directs individuals toward sexual activity, sexual desire has also been conceptualized through emotional, cognitive, and interpersonal lenses (Meana, 2010 ; Regan & Berscheid, 1999 ). According to the more recent descriptions, desire is a complex interplay of motives, per- ceptions, and sensations that neither easily fits into the standard sexual cycle, nor serves an exclusively sexual function. According to Basson (2002) , sexual desire is a subjective experience that can be concomitant with and reinforced by other sexual (e.g., arousal, sex- ual satisfaction) and non-sexual experiences (intimacy, emotional satisfaction, etc.). Unsurprisingly, maintaining a satisfactory level of sexual desire has been found to con- tribute to couple satisfaction, sexual satisfaction, and relationship stability (Chao et al., 2011 ; Hinchliff & Gott, 2004 ; Impett, Strachman, Finkel, & Gable, 2008) . Sexual desire seems to decrease with age (Eplov, Giraldi, Davidsen, Garde, & Kamper-Jørgensen, 2007 ) and relationship duration (Sprecher & Regan, 1998 ), regardless of the factors that contribute to the clinical diagnosis of Hypoactive Sexual Desire Disorder (Brotto, 2010 ; Nobre, Pinto-Gouveia, & Gomes, 2006 ). Sexual satisfaction is currently conceptualized as a complex construct consisting of emotional, relational, physical, and cultural dimensions (Carpenter, Nathanson, & Kim, 2009 ; Christopher & Sprecher, 2000 ). It contributes to the individual’s well-being, quality of life, mental health, and is also positively related to relationship stability and satisfac- tion (Ade-Ridder, 1990 , Chao et al., 2011 ; Henderson-King & Veroff, 1994 ; Sprecher, 2002 ). Young adults, people with sexually permissive beliefs, and individuals in the first years of a committed relationship tend to report higher rates of sexual satisfaction than older adults, less permissive individuals, or those in longer relationships (Haavio-Mannila & Kontula, 1997 ; Laumann, Gagnon, Michael, & Michaels, 1994 ; Waite & Joyner, 2001 ). However, a recent cross-cultural study found longer relationships associated with greater sexual satisfaction among partnered men in five countries, suggesting a more complex

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relationship between the length of relationship and male sexual satisfaction (Heiman et al., 2011 ). In regard to gender differences, men tend to report lower levels of emotional intimacy (Heller & Wood, 1998 ) and higher intensity and frequency of sexual desire (Eplov et al., 2007 ; Peplau, 2003 ; Regan & Atkins, 2006 ) than women. The evidence on sexual satis- faction is, however, mixed. Some studies reported higher levels of sexual satisfaction among men (Haavio-Mannila & Kontula, 1997 ; Laumann et al., 1994 ; Waite & Joyner, 2001 ), while other noted lower levels when compared to women’s sexual satisfaction (American Association for Retired Persons, 1999 ; Carpenter et al., 2009 ; Dunn, Croft, & Hackett, 2000 ; Moret et al., 1998 ).

Associations among intimacy, sexual desire, and sexual satisfaction

Intimacy has been found to be associated with sexuality in a mostly positive manner. Higher levels of intimacy have been linked to greater sexual satisfaction (Haning et al., 2007 ) and positive changes in intimacy predict heightened sexual satisfaction, sexual frequency, and relationship passion with one’s partner (Rubin & Campbell, 2012 ). Although very few studies have explicitly explored the relationship between intimacy and sexual desire, particularly among couples, several have suggested a positive associa- tion. Rubin and Campbell (2012) found intimacy and relationship passion correlated on daily basis, while Impett et al. (2008) reported that having strong relationship approach goals – such as the pursuit of positive relational experiences with the partner, which relates to emotional intimacy – is associated with higher and more resilient sexual desire. Direct evidence of the positive association between emotional intimacy and sexual satisfaction and/or sexual desire is still scarce. One notable exception is the Haning et al. (2007) study, which reported a significant positive association between emotional inti- macy and sexual satisfaction in the sampled participants. Indirect evidence of this rela- tionship may be found in studies that documented higher sexual satisfaction among married individuals than cohabitating individuals and singles (Laumann et al., 1994) , and a higher level of sexual satisfaction among committed daters compared to unattached but sexually active individuals (Pedersen & Blekesaune, 2003 ). However, empirical support for the assumption that emotional intimacy increases with the relationship duration is mixed (Acker & Davis, 1992 ; Baumeister & Bratslavsky, 1999 ). Relationship quality has also been associated with sexual satisfaction (Christopher & Sprecher, 2000 ; Henderson- King & Veroff, 1994 ; Sprecher, 2002 ). Can intimacy have a negative impact on sexual satisfaction and desire? Again, there is little, if any, direct evidence. Intimacy has a tendency to increase with relationship dura- tion (Hatfield & Rapson, 1993 ) and relationship duration may be negatively associated with sexual satisfaction (Pedersen & Blekesaune, 2003 ; Waite & Joyner, 2001 ). Being in an intimate relationship usually involves risks. They can be related to personal vulnerabil- ity, including the fear of rejection, exposure, loss of control or betrayal (Hatfield, 1984 ; Patrick & Beckenbach, 2009 ), or to the boredom and routine that characterize many long- term relationships (Pedersen & Blekesaune, 2003 ; Sims & Meana, 2010 ). In the clinical context, emotionally fused or poorly differentiated intimate relationships, characterized by overreliance on other-validation and a lack of autonomy, have been proposed as being particularly damaging to sexual desire (Perel, 2007 ; Schnarch, 2009 ). In his conceptuali- zation of the relationship between sexual desire and the dyadic processes of intimacy building, Schnarch (2009) emphasized the importance of differentiation of self, as the

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ability to maintain an integral and authentic self while in an intimate relationship and the capacity to tolerate occasional anxiety and strain related to being in a close relationship. In contrast to poorly differentiated partners, a well-differentiated couple does not trade passion for emotional safety (Schnarch, 1997 , 2009). A different but compatible perspec- tive was recently suggested by Perel (2007) who highlighted the importance of the con- cept of otherness in preventing couples’ de-eroticization. The concept of otherness conveys the idea of acknowledging and appreciating the familiar and safe romantic part- ner as someone not fully known, as someone with thoughts, feelings, and experiences that are independent from our own – a notion markedly different from the romantic ideal of emotionally merged partners, in which otherness is intentionally obliterated. According to Perel (2007 , 2010) , emotional intimacy that has eradicated otherness puts couples at risk for a diminished sexual desire. Domestication might negatively affect desire, but the effect may be gender-specific. In a recent study, men’s sexual desire was not associated with relationship duration (Murray & Milhausen, 2012 ).

Study aims

Researchers have been advocating the need to further investigate men’s definitions and expressions of emotional intimacy, particularly as most studies have used a conceptuali- zation of intimacy that favors communication and expression of affection – which are tra- ditionally the domains of women’s relational expertise – possibly ignoring the specific meanings of intimacy among men (Ferreira et al., 2012 ; Patrick et al., 2007 ; Patrick & Beckenbach, 2009 ). Interestingly, a recent study found relational factors stronger predic- tors of male than female sexual satisfaction (Carpenter et al., 2009 ). An additional issue is clinical suggestions that high levels of intimacy may have a negative impact on sexual desire, possibly through the processes of familiarity/habituation or lack of autonomy (Perel, 2007 ; Schnarch, 1997 , 2009 ). To the best of our knowledge, this concern has not been addressed either in clinical or non-clinical research. The lack of systematic and comparable research regarding the role of emotional inti- macy in male sexuality satisfaction is challenging for research, clinical interventions, and sex education. Aiming to contribute to the literature, this study explored the following three research questions:

(1) Does intimacy contribute to men’s sexual satisfaction? Compared to desire, how well does intimacy “predict” male sexual satisfaction? (2) If intimacy is (robustly) associated with sexual satisfaction, what may be the underlying mechanism (Hedstr om & Swedberg, 1996 )? In other words, what is a plausible explanation for the contribution of intimacy to male sexual satisfaction? (3) Finally, is there empirical evidence to support clinical insights about a negative impact of intimacy on sexual desire? Are higher levels of intimacy associated with a reduced or lower sexual desire?

The conceptual rationale underlying our assessment was based on the observation that intimacy and sexual desire may not have a clear temporal sequence (see Figure 1 ). In some cases, erotic interest may be instrumental in generating intimacy, while in other cases increasing intimacy may enhance sexual desire (Rubin & Campbell, 2012 ; Schnarch, 1997 ). Furthermore, based on the literature (Carpenter et al., 2009 ; Jannsen, McBride, Yarber, Hill, & Butler, 2008 ), it was assumed that both emotional intimacy and sexual desire “predict” male sexual satisfaction.

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Addressing the above research questions has clear educational and clinical implica- tions. That male sexual desire and sexual satisfaction are closely related to emotional inti- macy and go against the popular stereotype, which asserts that men – unlike women – have no need for mixing sex and emotions (Zilbergeld, 1999 ). This widely perceived “truth” affects sexual socialization and may have consequences for common assumptions about sexual dynamics in long-term relationships. In the clinical context, it has been sug- gested that intimacy may sustain erotic passion (Schnarch, 1997 ), but also that excessive closeness and emotional merging can cripple sexual desire (Perel, 2010 ). Further empiri- cal evidence regarding this link between intimacy and desire is needed, both to clarify the role of relationship intimacy in male sexuality and to increase the therapeutic resources for dealing with clients’ understanding of the complex interplay between eroticism, sex, and couplehood.

Method

Participants and procedures

From September to October 2011, an online survey focusing on male sexual desire was carried out in Croatia. The study banner, which called for participation in a study focusing on men’s sexual health, was featured on several websites dedicated to general health information, men’s health, and online dating. Of the 2408 individuals who accessed the survey site, 1578 were men over 18 years of age who completed the questionnaire (65.5%). Participants who had more than 10% of missing information were excluded from analyses. The final sample was reduced to 506 participants in the 21–68 age range after the following six inclusion criteria were applied: (1) being in a relationship or mar- ried for at least two years; (2) currently living together with this partner/spouse; (3) hav- ing exclusively female sexual partners in the past five years; (4) not taking antidepressants at the time of the survey (cf. Higgins, Nash, & Lynch, 2010 ; Phillips & Slaughter, 2000 ); (5) not being treated for a mental health problem in the past two years (Meuleman & van Lankveld, 2004 ; Zemishlany & Weizman, 2008 ); and (6) never being diagnosed with erectile dysfunction. The average age in the sample was 38.2 years (SD ¼ 8.43). Over three quarters of men (77.3%) were married and 72.9% reported being fathers. Most participants had a col- lege education (61.8%) and an “above average” income (55.0%). A majority of men included in this study (68.4%) participated in religious services up to twice per year. The questionnaire, which consisted of 169 items, was hosted on a commercial online surveying site. On average, it required about 20 minutes to complete. Despite the risk of duplicate surveys, IP addresses were not permanently recorded to ensure anonymity. Sub- sequent data set scanning did not reveal identical response patterns. Information about the study that was needed for informed consent was provided on the first survey screen. Prospective participants were asked to confirm that they are of legal age ( 18 years) and that they agree to participate in the study. All study procedures were approved by the Eth- ical Review Board of the Department of Sociology, Faculty of Humanities and Social Sci- ences, University of Zagreb, Croatia.

Measures

Current levels of sexual desire were assessed by two strongly correlated items ( r ¼ .84, p < .001): “How would you rate the degree of your current sexual interest (i.e., sexual

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thoughts and fantasies, motivation to have sex, being receptive to have sex, etc.)?” and “How would you rate your current desire for sexual activity?” The same 5-point scale – with response options 1 ¼ very high, 2 ¼ high, 3 ¼ moderate, 4 ¼ low, and 5 ¼ very low or non-existent – was used to anchor answers to both questions. To assess concurrent validity of the sexual desire measure, the summed indicator was correlated with the reported frequency of sexual intercourse in the past 3 months (answers were anchored using a 6-point scale ranging from 1 ¼ never to 6 ¼ daily or more often). As expected, a moderate association was found ( r ¼ .34, p < .001). Decreased sexual interest was indicated by affirmative answer to the following ques- tion: “Did you notice a decrease in your sexual interest (i.e., sexual thoughts and fanta- sies, motivation to have sex, being receptive to have sex, etc.) during the past six months?” To assess whether the reported decrease corresponded to sexual interest at the time of data collection, we compared the summed levels of current sexual desire among men who reported a decrease in their sexual desire in the past 6 months and those who did not. Participants who reported decreased sexual desire also reported significantly lower current levels of sexual desire and interest ( t(251.9) ¼ 13.2, p < .001) in compari- son to men who did not experienced recently decreased desire ( M ¼ 6.5, SD ¼ 1.9 and M ¼ 8.8, SD ¼ 1.5, respectively). The difference had large effect size (Cohen’s d ¼ 1.34; cf. Cohen, 1988 ). Sexual satisfaction was measured using a short, 12-item version of the New Scale of Sexual Satisfaction ( Stulhofer, Bu sko, & Brouillard, 2011 ). Participants were asked to rate their satisfaction with the quality of their orgasms during the past 6 months, the plea- sure they provide to their partner, the partner’s sexual creativity, the frequency of sexual activity, etc. The scale had high internal consistency (Cronbach’s a ¼ .94). Higher scores indicate more sexual satisfaction. Principal component analysis extracted two factors with eigenvalues larger than one (the two components explained 71.4% variance in items). Based on this analysis, two composite indicators were constructed (cf. Stulhofer, Bu sko, & Brouillard, 2010 ): (1) the six-item ego-centered sexual satisfaction scale (e.g., satisfaction with “The way I sexually react to my partner”, “My mood after sexual activity”, “The balance between what I give and receive in sex”) and (2) three-item part- ner-centered sexual satisfaction scale (personal satisfaction with “My partner’s emotional opening up during sex”, “My partner’s sexual creativity”, and “My partner’s ability to orgasm”). Both measures had satisfactory internal consistency (Cronbach’s a ¼ .90 and .86, respectively). Finally, emotional intimacy was assessed with the five-item Emotional Intimacy Scale (Sinclair & Dowdy, 2005 ). Each of the included items (“This person completely accepts me as I am”, “I can share my deepest thoughts and feelings with this person”, “This per- son cares deeply for me”, etc.) assessed a different aspect of emotional intimacy: accep- tance, self-disclosure, caring, support, and affirmation. The total score was calculated as a sum of scores across the items, with higher scale scores reflecting a higher level of emo- tional intimacy. In this study, Cronbach’s a for the scale was .92.

Analytical strategy

Path analysis was carried out using path analysis option in AMOS 17 statistical software (Arbuckle, 2008 ); missing information on the key indicators were replaced by mean val- ues. Possible moderation effects of age and length of relationship were assessed by multi- group analysis, in which all paths were assumed to be invariant between the groups. Finally, a non-linear association between intimacy and sexual desire was explored using

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multivariate logistic regression (two models were built), in which the effect of age, length of relationship, and their interaction were controlled for. To reduce multicollinearity, the interaction term was created from the centered scale scores.

Results

The role of emotional intimacy

Our first research question asked was whether emotional intimacy contributes to men’s sexual satisfaction. Path analysis revealed that both intimacy (b ¼ .48, p < .001) and sex- ual desire (b ¼ .31, p < .001) moderately predicted sexual satisfaction ( Figure 1 ). As expected, the predictors were weakly albeit significantly correlated ( r ¼ .24, p < .001). The model accounted for almost 40% of the variance in sexual satisfaction.

Mechanism underlying the association between intimacy and sexual satisfaction

The assumed structure of associations between the studied constructs being confirmed, we next explored a possible mechanism behind the intimacy – sexual satisfaction link. Informed by the literature on the role of emotional intimacy in couples’ sexuality (Rubin & Campbell, 2012 ; Schnarch, 1997 ), we expected that intimacy would affect sexual satis- faction by increasing the importance of partner’s sexual reactions, enjoyment, and plea- sure for one’s sexual satisfaction. The partner-centered facet of sexual satisfaction (PCSS) was thus assumed to be more influenced by intimacy than the ego-centered com- ponent (ECSS). The opposite pattern – a stronger association with ECSS than with PCSS – was expected in the case of sexual desire. The analysis presented in Figure 2 supported the hypothesis. Emotional intimacy was moderately associated with ECSS (b ¼ .33, p < .001) and strongly with PCSS ( b ¼ .53, p < .001). While sexual desire had a substantially stronger direct effect on the ego-cen- tered component of sexual satisfaction, intimacy was more strongly associated with the partnered-centered component. The finding that sexual desire was moderately to strongly associated with ECSS ( b ¼ .46, p < .001) but only weakly, though significantly, with PCSS ( b ¼ .09, p < .05) supported the notion that intimacy-related increase in the impor- tance of partner’s sexual pleasure for male sexual satisfaction may be a mechanism under- lying the relationship between intimacy and sexual satisfaction.

the relationship between intimacy and sexual satisfaction. Figure 1. Relationship intimacy and sexual desire as
the relationship between intimacy and sexual satisfaction. Figure 1. Relationship intimacy and sexual desire as

Figure 1. Relationship intimacy and sexual desire as predictors of sexual satisfaction among partnered heterosexual men ( N ¼ 506). Standardized path coefficients are presented: p < .001.

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236 A. Stulhofer et al. Figure 2. Relationship intimacy and sexual desire as predictors of ego-centered

Figure 2. Relationship intimacy and sexual desire as predictors of ego-centered and partner- centered sexual satisfaction among partnered heterosexual men ( N ¼ 506). Standardized path coefficients are presented: p < .05; p < .001.

Emotional intimacy and the “suppression” of male sexual desire?

Different analytical strategies were used to address the third research question which focused on a specific risk of intimacy (Can high emotional intimacy negatively affect sex- ual desire?). First, a bivariate analysis was used to explore whether intimacy was related to a self-reported recent decrease in sexual interest. The association between intimacy (the composite scale was transformed into quartiles) and reduced sexual interest in the past 6 months was significant in this community sample ( x 2 (3) ¼ 33.31, p < .001), but the findings pointed to a positive direction of the relationship. Lower levels of intimacy were observed among men who did experience a decrease in sexual interest. Among par- ticipants who reported decreased interest (29.2%, n ¼ 147), 45.6% scored in the lowest intimacy quartile, while 12.2% scored in the highest quartile. In contrast, among the men who did not report decreased sexual interest (70.8%, n ¼ 357), 22.7% scored in the lowest intimacy quartile and 30.5% in the highest quartile. For a more comprehensive analysis of the relationship between emotional intimacy and sexual desire, we returned to the path model presented in Figure 1 . To assess if higher levels of intimacy are related to lower sexual desire levels, a multigroup path analysis was employed, in which all path estimates were compared across two groups of participants that differed by age and length of relationship. As the two characteristics are interrelated, to apply the polar opposites approach (Hair, Anderson, Tatham, & Black, 1998 , p. 257) – where groups from the ends of the distribution are compared – age and relationship dura- tion had to be combined. The analysis contrasted a group of 142 younger men (aged up to or equal to the sample median of 37 years) who reported relationship duration in the low- est quartile (M ¼ 4.4 years) with a group of 134 older men ( 38 years) who reported a relationship of 15 or more years (the highest relationship length quartile; M ¼ 16.0 years). The finding of invariance in the model path estimates ( Dx 2 ¼ .81, Ddf ¼ 2, p < .67) showed that the structure of associations among sexual desire, emotional intimacy, and sexual satisfaction was not moderated by (this particular combination of) age and length of relationship.

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Table 1. Sexual desire and sexual satisfaction by levels of relationship intimacy.

Current levels of sexual desire/interest M (SD)

Sexual satisfaction

M (SD)

Intimacy

A – first quartile ( N ¼ 161)

7.37 (2.17)

35.45 (8.04)

B – second quartile (N ¼ 115)

8.04 (1.69)

41.79 (8.28)

C – third quartile (N ¼ 125)

8.18 (1.89)

44.21 (7.98)

D – fourth quartile ( N ¼ 130)

8.88 (1.53)

50.56 (8.82)

F ¼ 15.29, p < .001 A B, C, D; B, C D

F ¼ 78.34, p < .001 A B, C, D; B, C D

Bonferroni post hoc test.

The above approach, however, is limited by the presumption of a linear relationship between the constructs. Moreover, it failed to fully assess a possible influence of the inter- action between age and length of relationship on the relationship between emotional inti- macy and sexual desire. For example, to establish a high level of intimacy with the partner may require less time (i.e., shorter relationship duration) for older men, as they are more likely than younger men to have already experienced the process in their previ- ous relationships. We conducted several additional analyses in an effort to examine both potential shortcomings. First, to address the issue of linearity, we carried out two analysis of variance (ANOVA) procedures with intimacy as factor ( Table 1 ). An increase in the level of inti- macy (the composite indicator was transformed into quartiles) was almost invariably reflected in significantly higher mean scores of sexual desire and sexual satisfaction, which indicated linear association between the variables. Second, to address whether the interaction of age and length of relationship affects the association between emotional intimacy and male sexual desire, we conducted two logis- tic regression analyses with dichotomized current sexual desire indicator as dependent variable. Controlling for age, relationship duration, and their interaction term, we assessed the predictive strength of emotional intimacy, as well as the direction of its asso- ciation with the outcome. In the first regression analysis, the indicator of sexual desire was dichotomized into 1 ¼ participants who scored low on desire (i.e., in the lowest desire quartile) and 0 ¼ all others. In the second analysis, the indicator was dichotomized so that men who had the maximum score on sexual desire scale were coded 1, while all others were coded 0. The findings are presented in Table 2 . The age–relationship duration interaction term remained insignificant in both models. Intimacy, however, was significantly associated with the odds of reporting both low and high sexual desire. It decreased the odds of being in the low-desire group by 58%–79%, depending on the level of emotional intimacy reported. In the case of high sexual desire, there seemed to be a threshold effect. Only the men who scored in the highest intimacy quartile were characterized by significantly higher odds of reporting high desire. More precisely, they were over 3.5 times more likely than other participants to belong to the high-desire group. Once again, the relationship between emotional intimacy and male sexual desire appeared substantial and in the posi- tive direction.

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Table 2. Levels of relationship intimacy as predictors of low vs. high sexual desire/interest among partnered heterosexual men (logistic regression analysis: n ¼ 531).

Low desire participants a (1) vs. others (0) OR (95% CI)

High desire participants b (1) vs. others (0) OR (95% CI)

Age

Intimacy

1.03 (1.00–1.07)

.96 (.93–99)

Length of relationship

.96 (.90–1.01)

1.05 (.99–1.10)

Age length of relationship

1.00 (.99–1.00)

1.00 (1.00–1.01)

First quartile (reference)

1

1

Second quartile Third quartile Fourth quartile

.38 (.22–.67) .39 (.22–.67) .20 (.11–.38)

1.22 (.71–2.08) 1.38 (.82–2.29) 3.54 (2.15–5.85)

Hosmer–Lemeshow test

x 2 (8) ¼ 4.44, p > .81

x 2 (8) ¼ 5.99, p > .64

a n ¼ 123, b n ¼ 192; p < .01, p < .001.

Non-significant values of the Hosmer–Lemeshow test, which point to agreement between the fitted values of the model and the actual data by rejecting the null hypothesis, indicated good fit of the both regression models. As children can impact the sexual dynamics of a couple, we additionally controlled for their presence and age in the low desire regression analysis. (The indicator was cate- gorized as: 1 ¼ no children, 2 ¼ one or more children aged five or older, and 3 ¼ one or more children under 5 years of age. 1 ) No significant association was found between the outcome and the added independent indicator (adjusted ORs for category 2 and 3 were .79, 95% CI ¼ .39–1.59, and .99, 95% CI ¼ .54–1.81, respectively).

Discussion

This study aimed to advance our understanding of the role of emotional intimacy in male sexuality by exploring in more detail its association with sexual satisfaction. The data were collected online, using a community sample of coupled heterosexual men. Accord- ing to the study findings, intimacy moderately and significantly predicted sexual satisfac- tion. Increasing the contribution of one’s partner’s sexual satisfaction to personal sexual satisfaction was indicated as the likely mechanism behind the mediation. We also assessed a possible detrimental effect of emotional intimacy on sexual desire, which has been suggested by some clinicians (Perel, 2007 ; Schnarch, 1997 , 2010 ). Most men who reported a recent decline in sexual interest scored low on intimacy, unlike the participants who did not report decreased interest. In addition, higher emotional intimacy significantly decreased the odds of low sexual desire in multivariate analyses, while the highest intimacy levels also increased the odds of reporting high sexual desire. These associations were not moderated by age, relationship duration, or their interaction, as well as the presence of children. Overall, we consistently failed to detect a negative asso- ciation between emotional intimacy and male sexual desire. Equally robust was the find- ing of a relatively strong positive association between the two constructs. Before discussing the findings, it is important to note several study limitations. Due to cross-sectional nature of the data used, the causality implying path model tested in the

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paper, as well as our analysis of the plausible mechanism of influence, should be at best understood as provisional. The usefulness of the proposed model depends on how com- pelling one finds its conceptual rationale, as our study cannot ascertain the direction of the associations among sexual satisfaction, sexual desire, and emotional intimacy (some of which are likely bi-directional). Next, our sample was not probability based, which limits the generalizability of the results (regardless of the sample size), as convenience sampling is open to various selec- tion biases. The generalizability may also be limited by culture-specific characteristics of our sample of partnered, predominantly Roman Catholic, Croatian men. A couple of recent studies, for example, reported notable differences in sexual behaviors and sexual health difficulties between Croatian and Norwegian men of different generations ( Stulhofer, Træen, & Carvalheira, 2013 ; Træen, Stulhofer, & Landripet, 2011 ). As the original study was advertised as focusing on male sexual health, it is plausi- ble that more sexually open men were more likely to respond to the call for participa- tion. In addition, it may be that men with sexual difficulties were somewhat overrepresented in the sample, which leads to an interesting question of whether men with sexual concerns would be more likely to place a greater importance on intimacy than those without such experience – as was recently found among women (Sand & Fisher, 2007 ). Another important limitation pertains to the measures used. Length of cohabitation and relationship duration are two related but distinct characteristics that may not be equally relevant for generating and maintaining emotional intimacy. In this study, we only assessed the latter characteristics. The current sexual desire scale used in this study did not specifically assess the sexual desire participants’ felt for their spouse or long-term partner, as it only accounted for the overall level of sexual motivation. This is clearly a problem, because the theories about the dampening effect of intimacy focus on the desire for partner and not on sexual desire in general. In addition, the intimacy measure used in this study did not allow for a more detailed insight into the characteristics of emotional intimacy reported by participants. Unlike a few measures that have been developed to assess different types and components of relationship intimacy (cf. Schnarch & Regas, 2012 ), the composite scale employed in the presented analyses could not distinguish between emotional intimacy reported by well-differentiated in contrast to poorly differen- tiated men. According to the theoretical model and clinical concept developed by Schnarch (1997 , 2010) , this omission could have affected our exploration of the associa- tion between intimacy and desire. Overall, the results presented in this study provide robust support for the idea that inti- macy is an important component of male sexuality (Haning et al., 2007 ; Jannsen et al., 2008 ; Rubin & Campbell, 2012 ; Stulhofer et al., 2013 ). More specifically, we found higher levels of emotional intimacy associated with higher levels of sexual desire and overall sexual satisfaction. The traditional view of male sexuality as a predominant physi- cal phenomenon seems particularly challenged by the data suggesting that emotional intimacy can affect sexual satisfaction structurally, by enhancing its partner’s pleasure- related component. These findings seem to correspond with the notion, suggested by Moret et al. (1998) as well as Whitbourne and Ebmeyer (1990) , that in the last two deca- des the importance of emotional intimacy may be increasing among men – possibly reflecting a contemporary shift in social norms and gender role expectations (Haavio-Mannila & Kontula, 1997 ; Leiblum, 2002 ; Pedersen & Blekesaune, 2003 ). Such sociocultural change would be in stark contrast to the traditional gender roles, beliefs, and perceptions that underlined the salience of male sexual gratification. However, as

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intimacy has been mostly conceptualized along the lines of communication and expres- sion of feelings (Patrick & Beckenbach, 2009) , we cannot rule out the possibility that what changed was not the importance of intimacy for men but their readiness to talk about it. This would be consistent with an increased acceptance and even encouragement of the male expression of relational feelings (see Giddens, 1992 ). Although caution is warranted – as partner-centered sexual satisfaction may some- times reflect a men’s pride and sexual prowess more than a genuine concern for his partner’s pleasure – the observed association between intimacy and the partner-centered component of the overall sexual satisfaction supports the idea that male sexuality, par- ticularly in the context of a relationship, is far from simplistic and straightforward (Carpenter et al., 2009 ; Jannsen et al., 2008 ). Moreover, some clinicians have been arguing that the widespread belief about male sexual satisfaction being disconnected from emotional intimacy is not just inaccurate, but harmful (Bader, 2009 ). That male sexual desire and satisfaction are linked with emotional intimacy has a number of impli- cations for clinical intervention with couples and coupled men. New clinical approaches to treating sexual desire problems and distress emphasize the importance of emotional intimacy for women’s sexual response (Basson, 2002 ), the couples’ dyadic processes (Schnarch, 2009 , 2010 ), or both (Gehring, 2011 ). According to the study findings, emo- tional context is also important for male sexual desire. High sexual desire was associ- ated with high emotional intimacy. The evidence that male sexual desire may be embedded in relationality and emotional interaction, similarly to female desire, could be useful in clinical interventions, particularly in regard to men’s idiosyncratic ways of expressing their emotional needs. As the expression of and communication about emo- tions have been commonly viewed as a female domain (Perel, 2007 ), and potentially threatening to the traditional masculine role, education about the (often unrecognized) links among male intimacy, desire, and sexual satisfaction should be used in individual therapy and couple interventions to normalize sexual difficulties related to emotional processes and dynamics, as well as to enable a better understanding of the erotic impor- tance of intimacy. Similar to Schnarch (1997 , 2010) , Perel has suggested that intimacy which “collapses into fusion” may be problematic for sexual passion: “It is not a lack of closeness, but too much closeness that impedes desire” (Perel, 2007 , p. 25). In the present study, however, higher levels of intimacy decreased the odds of reporting low sexual desire. One possibil- ity is that the experience of fusion and its detrimental effects is not adequately represented by the construct of emotional intimacy and its standard measures. Constructs such as self vs. other-validated intimacy (Schnarch, 1997 , 2010 ), undifferentiated intimacy (Ferreira et al., 2012 ), or emotional merging (Perel, 2010 ) may enable a more precise assessment of the detrimental process proposed by some couple therapists. Alternatively, the adverse effects of emotional intimacy on sexual desire may be relatively rare and have more to do with individual characteristics and/or specific partner interaction patterns than with (the achieved level of) emotional intimacy per se. Using a reasonably large sample of part- nered heterosexual men and different statistical approaches, we have failed to find any negative relationship between intimacy and desire.

Conclusion

The paucity of studies focusing on the role of intimacy in male sexuality leaves many important questions unanswered. Little is known about the moderating effects of national, ethnic, or class (sub)cultures on the relationship between intimacy and male sexual well-

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being. Future studies should also pay more attention to middle-aged and older men, which would contribute to a much needed balance within the field, considering that most of the current research focused on younger men, mostly college students. Additionally, analyses of the interplay of sexual orientation, gender identity, gender roles, and sexual expression might further our understanding of associations among intimacy, sexual satisfaction, and desire. Longitudinal research that would sample newly formed couples among individuals of different ages is needed for a rigorous assessment of the effects of developing emotional intimacy on sexual desire and sexual satisfaction. Such studies would also enable a robust control of the contribution of age, age cohort/generation, and their interaction with gender (cf. Carpenter et al., 2009). Following the dyadic nature of emotional intimacy, panel stud- ies should involve both partners. Finally, qualitative explorations – in both clinical and non-clinical settings – of the meanings, expectations, and attributions related to the com- plex interplay of intimacy, desire, and sexual satisfaction would add depth and clarity to our understanding of the scope and role of emotional intimacy in male sexual well-being. In their recent narrative-based exploratory study that investigated men’s perceptions of inti- macy, Patrick and Beckenbach (2009) found that meaningful communication, emotional sharing, and the physical expressions of appreciation and affection were the most prevalent components of the reported definitions of intimacy. In their approach to measuring emo- tional intimacy, future studies should acknowledge this multidimensionality.

Note

1. The cut-off point of five was chosen in accordance with the World Health Organization indica- tor of child mortality under 5 years of age (World Health Organization, 2013) ; children under 5 years of age require substantially more parental investment than older children.

Notes on contributors

Aleksandar Stulhofer is Professor of Sociology and the Head of Sexology Unit at the University of Zagreb, Croatia. Since 2008, he is Affiliated Faculty of the Kinsey Institute for Research in Gender, Sex and Reproduction. His research focuses on sexual health, behavioral aspects of HIV, and por- nography use. Dr Stulhofer also works as sex therapist.

Luana Cunha Ferreira (MSc) is a PhD student in the Interuniversity Doctoral Program in Clinical Psychology – Family Psychology and Intervention (Faculty of Psychology, University of Lisbon). She is a licensed clinical psychologist, currently researching intimacy, desire and differentiation of self in couples. She practices individual, couple and family therapy.

Dr. Ivan Landripet is a Senior Teaching and Research Assistant at the Methodology Unit, Depart- ment of Sociology, University of Zagreb, Croatia. His research in sexuality focuses on attitudinal and behavioral aspects of sexual health, as well as pornography use.

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