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A Qualitative Study of Hypoactive Sexual Desire Disorder in Married Women UNLV Retrospective Theses & Dissertations 1-1-2007 Why does passion wane? A qualitative study of Hypoactive Sexual Desire Disorder in married women Karen E Sims University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/rtds Repository Citation Sims, Karen E, "Why does passion wane? A qualitative study of Hypoactive Sexual Desire Disorder in married women" (2007). UNLV Retrospective Theses & Dissertations. 2777. http://dx.doi.org/10.25669/29j8-aqlo This Dissertation is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Dissertation in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/or on the work itself. This Dissertation has been accepted for inclusion in UNLV Retrospective Theses & Dissertations by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. WHY DOES PASSION WANE? A QUALITATIVE STUDY OF HYPOACTIVE SEXUAL DESIRE DISORDER IN MARRIED WOMEN by Karen E. Sims Bachelor of Arts University of Nevada, Las Vegas 1994 Master of Arts University of Nevada, Las Vegas 1996 A dissertation submitted in partial fulfilment of the requirements for the Doctor of Philosophy Degree in Psychology Department of Psychology College of Liberal Arts Graduate College University of Nevada, Las Vegas December 2007 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: 3302364 Copyright 2008 by Sims, Karen E. All rights reserved. INFORMATION TO USERS The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleed-through, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. UMI UMI Microform 3302364 Copyright 2008 by ProQuest LLC. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 E. Eisenhower Parkway PC Box 1346 Ann Arbor, Ml 48106-1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Dissertation Approval The Graduate College University of Nevada, Las Vegas November 5 ■ 20 07 The Dissertation prepared by Karen Elizabeth Sims Entitled Why Does Passion Wane? A Qualitative Study of Hypoactive Sexual Desire Disorder in Married Women is approved in partial fulfillment of the requirements for the degree of Doctorate of Philosophy in Psychology________________ Examination Committee Chair Dean of the Graduate College Examination Committee Member Examination Committee Mem Graduate College Faculty Representative 11 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ABSTRACT Why Does Passion Wane? A Qualitative Study of Hypoactive Sexual Desire Disorder in Married Women by Karen E. Sims Dr. Marta Meana, Examination Committee Chair Associate Professor of Psychology University of Nevada, Las Vegas Hypoactive Sexual Desire Disorder (HSDD) is a prevalent and disabling condition for women and their partners. With one in three women experiencing a significant lack of interest in sexual activity, it is the most common female sexual dysfunction. It is also the most treatment resistant. Despite increased awareness of the problem, we have seen an increase in cases of low sexual desire over the past two decades. There is currently no standard treatment modality recommended for HSDD because of difficulties (1) defining the vague concept and (2) establishing what is “normal.” Recently, clinicians have favored a treatment relational approach because of the importance of interpersonal influences for women. Yet, treatment outcomes have not improved and HSDD remains poorly understood. Using semi-structured interviews, participants were asked what causal attributions they make and barriers they perceive to their loss of sexual desire. Grounded theory methodology was utilized to identify emergent themes and build a comprehensive theory about loss of desire. Three core themes emerged from the data which appeared to 111 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. represent dragging forces on sexual desire. They are (1) institutionalization o f relationships, (2) over-familiarity with one’s partner, and (3) the de-sexualization o f roles within these relationships. Based on these core themes, a model of female sexual desire is presented. It is a model of dilemmas, or paradoxes, that women appear to experience related to sex. On one hand, women work toward and value marriage and the meanings associated with it, such as security and family. Ironically, however, their sexual needs are in direct competition with its very ideals. The extent to which couples navigate these dilemmas may be a determinant in successful treatment for HSDD. Until now, anger, communication problems and other relationship influences have been stressed in the literature as reasons for loss of desire and the focus of clinical interventions. However, our data suggest that reasons that married women lose desire may have more to do with factors such as physical attraction, lack of sexual novelty, and role incompatibility than relationship factors. Clinical implications are discussed and possibilities for future research explored. IV Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS ABSTRACT..................................................................... ni ACKNOWLEDGMENTS .............................. vii CHAPTER 1 INTRODUCTION...................................................................................................1 CHAPTER 2 LITERATURE REVIEW ......................................................................................6 Characteristics of HSDD .............................................................................................................. 6 Early Proposed Etiologies .......................................................................................................... 13 Psychodynamic Theories ............................................................................................................. 15 Systems Theories ...........................................................................................................................21 Cognitive Behavioral Theories .................................................................................................. 29 Interaetional/Integrative Theories .............................................................................................40 New Approaches to HSDD .........................................................................................................43 Summary of Proposed Etiologies .............................................................................................49 Purpose of Present Study ........................................................................................................... 52 CHAPTER 3 METHODOLOGY...............................................................................................54 Participants ......................................................................................................................................54 Procedure ......................................................................................................................................... 55 Research Approach ....................................................................................................................... 57 Data Collection and Analysis ..................................................................................................... 58 Reliability and Validity ................................................................................................................62 Semi-Structured Interview ......................................................................................................... 65 CHAPTER 4 R ESU LTS .............................................................................................................. 66 Reliability Analysis ......................................................................................................................66 Emergent Themes/Model/Theory ........................................................................................... 66 Institutionalization ................................................................................................. 71 Over-familiarity ...................................................................................................... 75 De-sexualized Roles .............................................................................................. 81 Impact of HSDD .........................................................................................................87 A new model o f female sexual desire.................................................................93
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