Arch Sex Behav (2007) 36:357–368 DOI 10.1007/s10508-006-9071-1

ORIGINAL PAPER

In the Mood for or Vice Versa? Exploring the Relations Among Sexual Activity, Physical , Affect, and Stress in the Daily Lives of Mid-Aged Women

Mary H. Burleson · Wenda R. Trevathan · Michael Todd

Received: 14 September 2005 / Revised: 20 February 2006 / Accepted: 1 May 2006 / Published online: 16 November 2006 C Springer Science+Business Media, Inc. 2006

Abstract How do physical affection, sexual activity, mood, Keywords Sexual behavior . Mood . Mid-aged women . and stress influence one another in the daily lives of mid- Physical affection . Daily diary aged women? Fifty-eight women (M age, 47.6 yrs) recorded physical affection, several different sexual behaviors, stress- Introduction ful events, and mood ratings every morning for 36 weeks. Using multilevel modeling, we determined that physical af- Although conventional wisdom holds that a satisfactory sex- fection or sexual behavior with a partner on one day signifi- ual interaction will improve mood, little empirical evidence cantly predicted lower negative mood and stress and higher exists to support this assumption. Surprisingly few studies positive mood on the following day. The relation did not hold have investigated relations between sexual activity or physi- for without a partner. Additionally, positive mood on cal intimacy and affect, and most address the issue of whether one day predicted more physical affection and sexual ac- mood (or mood disorder) affects sexual desire or arousal. To tivity with a partner, but fewer solo the following our knowledge, none have asked whether sexual activity or day. Negative mood was mostly unrelated to next-day sexual physical affection alters affective state or perceived stress on activity or physical affection. , living with a daily basis. The current study addresses these questions us- a partner, and duration of relationship moderated some of ing daily diary methodology in a sample of mid-aged women. these effects. Results support a bidirectional causal model The idea that sex and affect are related is not new. Almost in which dyadic sexual interaction and physical affection 50 years ago, Wolpe (1958) postulated that improve mood and reduce stress, with improved mood and and were mutually inhibitory. Mood disorders, in- reduced stress in turn increasing the likelihood of future sex cluding depression (Cyranowski et al., 2004; Kennedy, and physical affection. Dickens, Eisfeld, & Bagby, 1999) and anxiety (Bodinger et al., 2002), are linked to changes in sexual interest and arousal. A rewarding sex life is considered an important con-  M. H. Burleson ( ) tributor to life satisfaction (Apt, Hurlbert, Pierce, & White, Department of Social and Behavioral Sciences, Arizona State University, West Campus, 1996), which in turn correlates with positive mood (Suh, 4701 W. Thunderbird Rd., Phoenix, Arizona 85069-7100 Diener, Oishi, & Triandis, 1998). Indeed, a recent panel e-mail: [email protected] study of over 15,000 randomly selected adults showed that amount of sexual activity was strongly positively related to W. R. Trevathan Department of Sociology and Anthropology, overall happiness (Blanchflower & Oswald, 2004). Many New Mexico State University, models of sexual behavior, even in rodents, assume that Las Cruces, New Mexico sex causes positive affect (Agmo, 1999). Moreover, there are physiological reasons to expect sex or physical affec- M. Todd Prevention Research Center, tion to influence emotions and stress. For example, orgasm Berkeley, California causes release (Blaicher et al., 1999; Carmichael et al., 1987), which is associated with stress relief and positive social interactions in some contexts (Heinrichs,

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Baumgartner, Kirschbaum, & Ehlert, 2003; Uvnas-Moberg, to reduce anxiety or stress (Graham, Sanders, Milhausen, & 1997). McBride, 2004). Sexual function is multifaceted, and mood may influence One study of mood-sex relationships in adolescent its various aspects (e.g., desire vs. arousal) in different ways. females used daily diary methodology. Participants prospec- Most non-clinical studies of these effects are of two main tively recorded mood and occurrence of types: laboratory studies with experimentally manipulated (along with other variables) for an average of 194 days. mood and surveys or other studies where individuals describe Multivariate results indicated that negative mood decreased their usual sexual interest or response when they experience the likelihood of having intercourse on the same day particular moods or affective states. (Fortenberry et al., 2005); however, the potential effects of Experimental studies suggest induction can reduce prior-day intercourse on mood were not reported. sexual arousal in sexually functional men (Bozman & Beck, Finally, several laboratory studies have examined affec- 1991); both anger and anxiety lead to lower reported sexual tive responses after sexual stimulus presentation. One study desire in sexually functional men and women (Beck & Boz- of adult men found high genital arousal during an erotic film man, 1995; Bozman & Beck, 1991). On the other hand, in- predicted higher elation and lower depression ratings after- ducing anxiety before or during erotic stimulation enhances ward, independent of mood beforehand (Meisler & Carey, sexual arousal in sexually functional men (Barlow, Sakheim, 1991). Heiman (1980) found women’s sexual arousal during & Beck, 1983; Wolchik et al., 1980) and women (Hoon, erotic audiotapes and films was positively correlated with Wincze, & Hoon, 1977; Palace & Gorzalka, 1990). Effects positive affective ratings of those stimuli. Three studies of of elated/happy and depressed/sad mood have also been in- women (Hackbert & Heiman, 2002; Laan, Everaerd, van vestigated experimentally. Laan, Everaerd, van Berlo, and Bellen, & Hanewald, 1994; Senn & Desmarais, 2004)re- Rijs (1995) and Meisler and Carey (1991) found induced ported increased positive affect or decreased negative affect positive mood did not affect subsequent sexual arousal in after viewing erotic material. However, some of the affect women, although it attenuated negative emotions elicited by measures included self-ratings such as “sexy” and “easy to an erotic film. Similarly, Meisler and Carey (1991) found arouse” along with nonsexual descriptors, making their in- no effect of elation on arousal or response in adult men; terpretation somewhat difficult. depressed mood delayed subjective sexual arousal but did Women’s sexuality changes throughout life, and there is not affect genital arousal. In contrast, Mitchell, DiBartolo, evidence to suggest that sexual interest and frequency often Brown, and Barlow (1998) found induced elated mood facil- decline with the natural menopause transition (Avis, Stel- itated both subjective and genital arousal, whereas induced lato, Crawford, Johannes, & Longcope, 2000; Dennerstein, depressed mood reduced genital arousal. Dudley, & Burger, 2001). To our knowledge, however, the As in experimental studies, the results from correlational only study to longitudinally monitor both sexual functioning research suggest complex effects of affect on sexual func- and mood for a period of time during the menopause tran- tioning. In a very large retrospective study of their previous sition used annual interviews (e.g., Dennerstein, Randolph, menstrual cycles, women’s sexual interest, , and en- Taffe, Dudley, & Burger, 2002). Therefore, nothing is known joyment were strongly related to levels of positive mood about the relations between daily sexual activity and mood and energy (Warner & Bancroft, 1988). In other studies, gay or stress in this age group. (Bancroft, Janssen, Strong, & Vukadinovic, 2003) and het- Similarly, very little is known about how social relation- erosexual (Bancroft et al., 2003) men were asked to describe ships and personal characteristics may influence the relations how they typically behaved sexually when depressed or anx- between sex and mood. A previous study of adult women ious. Most reported no change in sexual interest or erectile found that sexual orientation and partner availability (i.e., response. For depressed mood, those who reported a change living with one’s sexual partner) were related to amount of in desire or response largely experienced reductions (only sexual activity (Burleson, Trevathan, & Gregory, 2002), and 9% of heterosexual and 16% of gay men reported an in- longer relationship duration is associated with lower sex- crease). For anxiety, those who reported a change in desire ual frequency (Call, Sprecher, & Schwartz, 1995). Given or response were more evenly distributed between increase that these three characteristics have also been linked in some and decrease in sexual interest or performance. More than studies with mood-related variables, such as global happiness half the participants in the heterosexual study reported occa- (Biernbaum & Ruscio, 2004), well being (Kurdek, 1991), or sional to regulate mood, especially to reduce depression (Thompson et al., 2005), we elected to explore anxiety and stress. Similarly, in a focus group study with them as potential moderators of the relationships between both lesbian and heterosexual participants, women most of- mood and sexual behavior. ten reported that depressed mood and anger had a negative In sum, most previous research suggests that negative effect on sexuality. Several stated that anxiety sometimes mood states, particularly depressed mood and hostility, are added to arousal, and self-stimulation was occasionally used likely to interfere with sexual functioning in some way, that

Springer Arch Sex Behav (2007) 36:357–368 359 positive mood states may have the opposite effect, and that number of years employed was 21.1 (SD = 6.3). Finally, sexual arousal may influence mood, at least in men. However, 35 (60.3%) reported annual family incomes of more than all of the laboratory effects occurred within a very short time $50,000. frame, and the question remains as to whether these transi- tory effects have discernible consequences in daily life. Only Procedure one of the studies prospectively monitored sexual behavior and mood on a daily basis, and this study was carried out Although the current study used only the first 36 weeks of in adolescent girls. No study addressed directly the issue collected data (see below), women were recruited to partic- of whether or how sexual interactions with others influence ipate for five years or until one year without menstruation. moods. In the current study, we used daily diary methodol- Each was mailed detailed instructions, an initial question- ogy to investigate temporal relations among sexual activity, naire, sufficient Daily Datasheets for 252 days (36 weeks) physical affection, mood, and stress in the daily lives of of recording, a prepaid postcard for requesting a new packet mid-aged women, a group that has not been studied in this when she began recording the final 42 days, and a stamped context. In other words, we asked whether physical affection envelope for returning completed data sheets after 36 weeks. or sexual activity predicted mood or stress on the following Subsequent packets included only the Daily Datasheets for day, and vice versa. We also asked whether sexual orien- 252 days, the prepaid postcard, and the prepaid manila enve- tation, partner availability, or relationship length moderated lope. At entry, participants recorded demographic and per- these associations. Finally, we also tested whether physical sonal history data as described above. From then on, they affection or sexual activity was related to mood or stress on completed a datasheet upon arising each morning, covering the same day. the previous 24-hour period. Morning data recording was selected to maximize recollection of sexual activities.

Method Measures

Participants To enhance accurate recording of physical and sexual in- timacy variables, we included highly detailed instructions Women were recruited nationally through advertisements in regarding how these items should be interpreted. They were women’s publications to participate in a large longitudinal reported as occurrence or non-occurrence since last data study of the menopause transition “as experienced in the recording and were defined as follows. Physical affection: context of daily life events.” To ensure a sufficient number intimate physical contact not necessarily associated with sex; of lesbian participants, we also advertised in the gay and les- stimulation: sexually-related breast stimulation by self bian press. Women were eligible if they were aged 42 to 52, or other; genital stimulation: any form of genital stimulation were not pregnant, lactating, or postmenopausal, had not had by another person, with or without intercourse; intercourse: reproductive surgery, and were not taking estrogen or pro- sexual intercourse with a man with intravaginal gesterone or using an IUD. Of the 113 who wrote to request and no . We derived two additional variables: orgasm study materials, 52 returned no data, 3 returned fewer than with partner (orgasm in the context of genital stimulation or 4 weeks, and data from one woman were judged unreliable, intercourse, as defined above) and orgasm without partner leaving 58 participants. Participants were not paid. (orgasm without genital stimulation by another person or Mean age at entry was 47.6 years (SD = 2.2) and mean intercourse). BMI at entry was 23.28 (SD = 3.5). Forty-four (75.9%) par- The stress variable was occurrence of a stress event (de- ticipants described themselves as exclusively heterosexual, fined as any event that upset the participant), and thus incor- whereas 14 (24.1%) described themselves as exclusively or porated perceived stress. Mood items included seven posi- primarily lesbian. Forty (69%) were married or cohabiting, tive (enthusiastic, determined, alert, happy, cheerful, proud, and 18 (31%) were not living with their sexual partners. For and contented) and eight negative (anxious, depressed, dis- those in a relationship (n = 47), the mean duration of that tressed, nervous, hostile, ashamed, guilty, and irritable) ad- relationship was 15.6 years (SD = 8.3, range 0.4–31 yrs). jectives, rated from 1 (experienced slightly or not at all)to Thirty-nine (67%) were premenopausal (i.e., showed little 5(experienced extremely). Composite positive and negative or no variation in their menstrual cycles) and 19 (33%) scores were derived for each day. In addition, to facilitate were perimenopausal (i.e., had irregular cycles) at study comparisons with previous studies of mood effects on sex- entry. Six (10.3%) participants had less than a baccalau- ual functioning, we created separate composite scores called reate degree, six (10.3%) had earned a baccalaureate de- anxiety (anxious, distressed, nervous), and hostility (hos- gree, and 46 (79.3%) had post-graduate education. Fifty-two tile, irritable), and analyzed the depressed mood score as a (89.7%) were employed outside the home, and the mean single-item indicator.

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Data analysis stress predicting next-day physical contact or sexual behavior (see Appendix for example equations). Level 1 (daily-level) Missing data predictor variables were person mean-centered and Level 2 (person-level) variables were grand mean-centered. In gen- For the entire study, durations of data recording ranged from eral, centering helps to minimize multicollinearity among 116 to over 2500 days. Nine participants did not fully com- interaction terms and their constituent “main effect” terms plete the first packet of questionnaires, and eight dropped (Aiken & West, 1991), and person-mean centering of daily out after completing the first packet. Thus, to maximize the predictors facilitates interpretation of Level 1 coefficients as number of participants included in the current analyses, we purely within-person effects. However, one consequence of chose to use the first 252 days (36 weeks) of data. Of the 58 person-mean centering of the Level 1 predictors is the re- participants included, 49 participated for at least 252 days, moval of person-level variation in the predictors, thus leav- and the remaining nine ranged from 116 to 250 days, for a ing person-level covariation between daily-level predictors total of 14,218 possible person-days of data, and an aver- and the outcomes unmodeled (Hofmann & Gavin, 1998). age duration of 35 weeks.1 For various reasons (e.g., illness, Accordingly, we added grand-mean centered person-level travel, “forgot,” and unknown), participants failed to record means on daily-level predictor variables as person-level pre- any data on 276 of these person-days, yielding a panelwise dictors in our models. We also included sexual orientation, missingness rate of 1.94%. proportion of study days cohabiting with sexual partner, and As noted above, nine participants contributed less than duration of current sexual relationship, along with their in- 252 days of data. They withdrew from the study for vari- teractions with the primary variables, as predictors in the ini- ous reasons, including their lives becoming too complicated tial prospective models. In keeping with recommendations to continue participation (e.g., family illness; 2 participants) for model building in the absence of strong theory-based and vacation periods interrupting their daily recordings so predictions, non-significant interaction terms were trimmed extensively that they did not continue (2 participants). Five from subsequent models (Aiken & West, 1991). Significant participants stopped recording for no stated reason and re- interactions were probed by examining simple slopes at se- turned to us the records that they had completed. lected values of the moderator variables (i.e., M ± 1SD for relationship duration; 0 and 1 for cohabitation and sexual Analysis plan orientation), using methods described in Bauer and Curran (2005). An alpha level of .05 was used for all statistical tests. The data were intrinsically hierarchical with multiple daily observations (Level 1) nested within participants (Level 2), so we used multilevel modeling to take full advantage of the Results data structure. We tested same-day relations using pooled within-person correlations computed in Mplus 2.13 (Muthen Preliminary analyses, descriptive statistics, & Muthen, 1998) and prospective associations (predicting and Pearson correlations outcomes from previous day’s predictor scores) via multi- level regression models in SAS PROC MIXED under SAS Preliminary analyses were conducted controlling for month, 9.1.2 The latter analyses allowed simultaneous estimation of day of week, and serial autocorrelation. Positive mood was a within-person relations between variables measured daily, strong negative same-day predictor of overall negative mood, their average magnitude (and sign) across all participants, hostility, depressed mood, and anxiety. Therefore, we in- and the effects of several potential moderators. To account cluded positive mood as a predictor in all lagged models for cyclical dependencies and serial autocorrelation, we in- with these four predictors. Older age predicted fewer stres- cluded dummy predictor variables coding for month and sors and lower levels of all of the negative affective states, day of week and an AR(1) parameter in the lagged models so age was included in all subsequent models. (West & Hepworth, 1991). Two sets of prospective mod- Mean daily frequencies of physical intimacy, sexual be- els were specified, with sexual behavior or physical con- havior, and stress variables, mean daily averages for the mood tact predicting next-day mood or stress, and with mood or variables, percentage of participants with the minimum pos- sible values for these variables (e.g., zero frequency of in- tercourse for the 36-wk data collection period), and Pearson 1 Complete information can be obtained from the corresponding author. correlations across participants are shown in Table 1.Only 2 When outcomes were dichotomous, we used the GLIMMIX macro two significant correlations were found between physical (under PROC MIXED) specifying binomial-distributed errors and a logit link. Models were first estimated with random Level 1 slopes, contact and mood variables: physical affection was posi- and if random components were non-significant or unestimable, re- tively related to positive mood, and breast stimulation was estimated with slopes fixed. negatively related to hostility.

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Table 1 Means, standard deviations, percentage of sample with minimum value, and Pearson correlations for overall average daily frequencies of physical affection, sexual activity, and stress, and overall daily means of mood

Variable MSD%min1234567891011

1. Physical affectiona .43 .36 6.9 — 2. Breast stimulationa .15 .18 17.2 .54∗∗∗ — 3. Genital stimulationa .12 .14 12.1 .57∗∗∗ .83∗∗∗ — 4. Intercoursea,b .11 .12 15.9 .47∗∗ .68∗∗∗ .84∗∗∗ — 5. Orgasm with partnera .10 .11 17.2 .58∗∗∗ .78∗∗∗ .95∗∗∗ .80∗∗∗ — 6. Orgasm no partnera .06 .09 25.9 − .20 − .06 − .17 − .22 − .16 — 7. Positive moodc 2.84 .74 0.0 .29∗ .24 .22 .03 .21 − .00 — 8. Negative moodc 1.43 .33 0.0 − .07 − .20 − .16 − .15 − .17 .12 − .14 — 9. Hostilityc 1.33 .31 0.0 − .19 − .26∗ − .22 − .21 − .19 .17 − .19 .89∗∗∗ — 10. Depressed affectc 1.46 .34 1.8 .02 − .26 − .17 − .17 − .16 .21 − .26 .81∗∗∗ .65∗∗∗ — 11. Anxietyc 1.61 .43 0.0 − .05 − .16 − .11 − .06 − .12 .05 − .13 .96∗∗∗ .79∗∗∗ .80∗∗∗ — 12. Stress occurrencea .16 .14 3.4 − .08 .01 .08 .10 .04 .07 .01 .35∗∗ .23 .29∗ .39∗∗

Note. N = 58 for variables 1–6 and 12, N = 55 for variables 7–11. aValues could range from 0.00 (never occurred) to 1.00 (occurred at least one time every day of measurement period). bStatistics involving intercourse were estimated excluding participants who self-identified as lesbian (N = 44 for variables 1–6, and 12, N = 41 for variables 7–11). cValues could range from 1.00 to 5.00. ∗p < .05 ∗∗p < .01 ∗∗∗p < .001.

Same-day associations between daily mood or stress Probing of these interactions revealed that the relations be- and daily physical contact or sexual behavior tween the sex variables and positive mood were significant for the lesbian participants (ωs = .10, .10, both ps < .001, Pooled within-person correlations between physical contact where ω represents the parameter estimate for the simple or sexual behavior and mood or stress reported concurrently slope), but not for the heterosexual participants (ωs = .01, are shown in Table 2. Breast stimulation, genital stimulation, .01, both ns). and orgasm with partner were positively related to positive Physical affection, breast stimulation, genital stimulation, mood and negatively related to all negative moods and stress. orgasm with a partner, and intercourse were all significant Physical affection and intercourse showed very similar pat- predictors of lower overall negative mood and lower anxiety terns, except physical affection was unrelated to stress and on the following day. Daily physical affection, genital stimu- intercourse was unrelated to depressed mood. Orgasm with- lation, and partnered orgasm predicted lower next-day stress. out partner was significantly related only to stress, and the However, significant interactions with relationship duration relation was negative. qualified the effects of genital stimulation (γ = .02, p < .01) and orgasm with a partner (γ = .02, p < .01) on stress. In- Predicting next-day mood and stress from daily physical teraction probes revealed that both of these negative effects contact and sexual behavior were significant for women with relatively short-duration relationships (respectively, ωsat2.5yrs=−.52, and −.46, Figure 1 illustrates significant first order effects and their un- both ps < .01, ωsat12yrs=−.29, and −.23, both ps < .01), standardized parameter estimates (γ ) from the prospective but not for those with relatively long-duration relationships multilevel regression analyses.3 In general, physical affec- (ωs at 21.5 yrs =−.06 and .01, both ns). tion and sexual behavior were consistently associated with All of the significant associations involved behavior with reduced negative states, fewer stressors, and/or increased other individuals and improvements in mood except that positive mood the following day. orgasm without partner predicted higher next-day negative Breast stimulation, genital stimulation, and orgasm with mood and anxiety. Next-day hostility and depressed mood a partner predicted higher next-day positive mood. However, were associated with no predictors. Significant random ef- there were significant interactions with sexual orientation fects noted in Fig. 1 indicate instances where there was sig- for the effects of genital stimulation (γ = .08, p < .01) and nificant variation between participants in the nature of the orgasm with a partner (γ = .09, p < .01) on positive mood. relation between predictor and outcome variable. For ex- ample, for genital stimulation predicting next-day negative mood, the slopes ranged from − 0.11 to 0.07. 3 Complete results, including parameter estimates and standard errors for all models, can be obtained from the corresponding author.

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Table 2 Pooled within-person correlations between physical affection or sexual behavior and same-day mood or stress

Positive mood Negative mood Hostility Depressed mood Anxiety Stress occurrence

Physical affection .09∗∗∗ − .04∗∗∗ − .04∗∗∗ − .03∗∗ − .05∗∗∗ − .01 Breast stimulation .08∗∗∗ − .04∗∗∗ − .03∗∗ − .02∗ − .05∗∗∗ − .02∗ Genital stimulation .09∗∗∗ − .04∗∗∗ − .04∗∗∗ − .03∗∗ − .05∗∗∗ − .03∗∗∗ Intercoursea .07∗∗∗ − .03∗∗ − .04∗∗∗ − .01 − .03∗∗ − .02∗ Orgasm with partner .09∗∗∗ − .04∗∗∗ − .04∗∗∗ − .03∗∗ − .04∗∗∗ − .04∗∗∗ Orgasm no partner − .02 − .01 − .01 − .02 − .00 − .03∗∗∗

Note. Ns (number of person-days) for these analyses ranged from 13,011 to 13,919. aCorrelations involving intercourse were estimated without participants who self-identified as lesbian. ∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

Predicting next-day physical affection and sexual ual orientation in all of these models (γ s = .45 to .46, all behavior from daily mood and stress ps < .0001). Probing of these interactions revealed that all of them were of the same form, such that the positive relation- As shown in Fig. 1, positive mood was the only significant ship between positive mood and next-day physical affection first order predictor of next-day physical affection or sexual was significant for the lesbian participants (ωs = .46 to .50, behavior. Regardless of which negative mood variable was all ps < .0001), but not for the heterosexual participants in the model, higher positive mood predicted more next-day (ωs = .01 to 05, all ns). Interactions between positive mood physical affection, breast stimulation, genital stimulation, and sexual orientation did not approach significance for any and orgasms with a partner and fewer orgasms without a other sexual behavior outcome. partner. However, for the physical affection outcome, there No negative mood variable or stress was significantly were significant interactions between positive mood and sex- related across all participants to any next-day physical

Fig. 1 Summary of significant conditional (main) effects and unstan- with one of the negative mood indicators. Subscript r indicates random dardized parameter estimates from prospective analyses. Coefficient effect. Subscript a indicates simple slope significant only for lesbian for positive mood predicting next-day affection or sex is average of co- participants; subscript b indicates effect stronger for shorter duration efficients for four separate models, each including positive mood along relationships. See text for description. ∗p < .05, ∗∗p < .01, ∗∗∗p < .001

Springer Arch Sex Behav (2007) 36:357–368 363 contact or sexual behavior variable. However, there were stimulation, or intercourse as predictors, longer duration three interactions involving negative mood variables. Sexual of the relationship predicted lower overall negative mood orientation interacted significantly with anxiety (γ =−.29, (γ s =−.01 to − .02, all ps < .05) and in the model with p < .05), such that higher anxiety predicted fewer orgasms physical affection, it predicted lower hostility (γ s =−.01, without a partner for heterosexual (ω =−.13, p < .05), p < .05). Older age predicted higher positive mood (γ s = .26 but not lesbian (ω = .15, ns), women. It also interacted to .37, all ps < .0001), lower anxiety (γ s =−.05 to -.06, significantly with stressor occurrence (γ =−.53, p < .01) all ps < .05), and fewer stressor occurrences in all models such that higher stress predicted less breast stimulation in (γ s =−.25 to − .33, all ps < .001). lesbian (ω =−.50, p < .01), but not heterosexual (ω = .03, ns), women. Finally, there was a significant interaction Models with affection or sexual behavior outcomes between depressed mood and cohabitation (γ = .45, p < .05), such that higher depressed mood predicted more In all models with positive mood and one of the negative next-day intercourse for participants who lived with their affect variables as predictors, living with one’s sexual partners (ω = .13, p < .05), but not for those who did not partner predicted more physical affection (γ s = 3.02 to 3.12, live with their partners (ω =−.33, ns). all ps < .001) and fewer unpartnered orgasms (γ s =−1.96 Straightforward effect size measures paralleling those for to − 2.21, all ps < .01). In models including positive mood traditional “single-level” multiple regression models have with hostility or anxiety, or stressor occurrence, it predicted yet to be developed for multilevel regression approaches. more partnered orgasms (γ s = 1.43 to 1.72, all ps < .05). However, based on the rather small same-day within-person Older age was associated with lower average frequency of correlations reported here, we can assume that the prospec- breast stimulation (γ s =−.23 to − .35, all ps < .05) and tive effects were similarly small. genital stimulation (γ s =−.19 to − .34, all ps < .05) in all models. Neither sexual orientation nor relationship duration First order effects of moderators4 was associated with average frequency of physical affection or any of the sexual behaviors. Models with mood or stress outcomes Discussion In all models with affection or partnered sex as predictors, lesbian participants reported less hostility than heterosexual In the current study, mid-aged women provided detailed daily participants (γ s =−.22 to − .25, all ps < .05). In addition, records of sexual behavior, physical affection, mood, and they reported less overall negative mood in the breast stimu- stress for an average duration of 35 weeks. To our knowl- lation and genital stimulation models (γ s =−.28 and − .24, edge, this study is the first to evaluate relations between both ps < .05). Somewhat surprisingly, living with one’s physical contact or sexual behavior and mood or stress in sexual partner predicted higher average levels of negative adults on a prospective daily basis. Two advantages of our affective states. In models with physical affection or genital study over most previous work are enhanced ecological va- stimulation as predictors, cohabitation predicted higher lidity compared to laboratory studies and collection of daily overall negative mood (γ s = .43 and .30, both ps < .05); rather than long-term retrospective reports. This design al- and in models with breast stimulation, genital stimulation, lowed us to examine the extent to which occasions of relative partnered orgasm, orgasm without a partner, or intercourse, increases or decreases in sexual behavior or physical affec- it predicted higher depressed mood (γ s = .29 to .56, all ps < tion were temporally associated with occasions of relatively .05). In general, however, as the duration of the relationship more intense mood or stress within individual participants. increased, average levels of negative affect decreased. In We also evaluated potential causal effects by testing lagged models with physical affection, breast stimulation, genital relations between variables. The results were consistent with bidirectional causal relations in which dyadic sexual inter- action and physical affection improved mood and reduced 4 In addition to the effects that were the focus of the study, the lagged models included grand mean-centered person means of the daily pre- stress, which in turn increased the likelihood of future sex dictors. Inclusion of these variables was necessary in order to ensure and physical intimacy. Sexual orientation, living with one’s the correct apportionment of variance in outcomes and thus allow the partner, and relationship duration moderated some of these correct interpretation of parameter estimates associated with the vari- lagged daily effects. ables of primary interest. Some of these between-subject variables were statistically significant predictors. However, given that the current study focuses on the relations between daily physical contact and daily mood Same-day relationships or stress, and that the sample size was 58 or fewer for these between- subject effects, we elected not to present them in this report. Complete With few exceptions, physical affection or sexual activ- information about these findings can be obtained from the authors. ity variables were positively related to same-day positive

Springer 364 Arch Sex Behav (2007) 36:357–368 mood and negatively related to same-day negative moods In contrast, we found that orgasm without a partner was and stress. These results are similar to the findings of Forten- actually associated with higher anxiety and negative mood berry and colleagues (Fortenberry et al., 2005), in which the following day. Thus, for our mid-aged female partici- univariate analyses showed negative and positive mood were pants, social aspects of a dyadic relationship were important negatively and positively related, respectively, to same-day for any mood-elevating effects of sexual activity; sensory as- intercourse in adolescent women. Given that sex is an ef- pects alone (or physiological changes accompanying them) fective reinforcer in many species and can elicit positive were insufficient. We speculate that unpartnered sexual re- affective states in male and female rodents that persist af- lations may have served to highlight what was missing in ter sexual behavior ends (Agmo & Berenfeld, 1990; Paredes our participants’ social lives, which in turn could have led & Vazquez, 1999), perhaps these results are not surprising. to lower mood on the following day. Alternatively, because However, it is important to note that, whereas orgasm with self-stimulation was viewed as socially unacceptable during a partner was significantly related to all mood and stress their formative years, some of our participants may have had variables in the current study, orgasm without a partner was negative feelings associated with it. related only to stress. For our participants, all orgasms were Beneficial effects of social connectedness on stress not equal, at least in terms of their associations with mood management and health are noted in many studies (House, states. Landis, & Umberson, 1988), but the pathways through Because the variables were assessed concurrently, their which they occur are not fully explained (House, 2001). temporal relations to one another could not be established Our results suggest they are mediated, at least partially, and no causal pathway could be eliminated by these analyses. through physical affection or sexual interactions (Carter, We note, however, that surveys suggest most sexual interac- 1998; Uvnas-Moberg, 1997, 1998). Those with effective tion between individuals occurs after retiring to bed and be- social support networks may experience more pleasing fore arising (Dutton, 2003), whereas moods are experienced physical contact in daily life, or a loving social relation- throughout waking hours. With this in mind, it is arguably ship may bring about more, or at least more satisfying, more likely that these within-subject correlations reflect a sexual activity. Both could enhance mood and lower mood effect on same-day sexual behavior than vice-versa. If stress. true, this suggests positive moods may have promoted sexual If affection and sex do enhance mood and reduce stress, expression in our participants, whereas negative moods may what physiological mechanisms might mediate these effects? have discouraged it. Giving or receiving positive physical contact (e.g., touch, ) can influence cardiovascular and neuroendocrine Does sex or physical affection influence mood functioning to counteract some effects of stress (Moyer, or experience of stress? Rounds, & Hannum, 2004; Uvnas-Moberg, 1997). For ex- ample, massage-like touch causes release of oxytocin in rats Affectionate physical contact or any of several forms of sex- (Lund et al., 2005) and sexual arousal and orgasm cause ual activity with another person (e.g., genital stimulation) enhanced release of oxytocin in males and females on a given day predicted reports of lower levels of negative (Carmichael et al., 1987). Oxytocin is a neuropeptide that affective states and fewer stress reports the following day, promotes attachment, prosocial, and reproductive behav- particularly for participants whose relationships were rela- iors in many mammalian species, possibly including hu- tively newer. Further, genital stimulation or orgasm with a mans (Carter, 1998). Intranasally administered exogenous partner on a given day predicted more positive mood the oxytocin can reduce men’s anxiety and cortisol responses following day for lesbian participants. These prospective as- to stress (Heinrichs et al., 2003), likely through its regula- sociations are consistent with the idea that physical affection tory effects on the hypothalamic-pituitary-adrenal axis (Neu- and partnered sexual activity may have improved partici- mann, Wigger, Torner, Holsboer, & Landgraf, 2000). In ad- pants’ mood and reduced perceived stress. Previous studies dition, greater oxytocin responses to laboratory stress were have reported that anxiety or stress might serve to motivate associated with lower blood pressure (BP) before and after sexual interactions as a form of mood repair for some individ- the stressor and faster diastolic BP recovery (Light et al., uals (Bancroft et al., 2003; Graham, Sanders, Milhausen, & 2000). In rats, repeated oxytocin administration causes long- McBride, 2004). Although we have little evidence to support term decreases in BP, suggesting potential oxytocin-related this idea in our sample (the only predictive effects of stress stress-reducing effects of satisfying sexual activity could be or anxiety on sexual behavior were negative and differed relatively long-lasting (Uvnas-Moberg, 1997). according to sexual orientation), such interactions might ef- Both lagged and concurrent relations reported here were fectively improve mood on a continuing basis, especially in consistent with previous research suggesting that sexual the earlier stages of a relationship. arousal leads to higher positive or lower negative mood

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(Meisler & Carey, 1991) on a short-term basis. Indeed, our this result was somewhat unexpected, but may represent a results go further and indicate that mood-enhancing effects previously unreported form of mood-repair. of sexual behavior and physical affection may remain active In previous research, the best-established causal effect of for at least an entire day and night. mood on sexual arousal is the ability of anxiety to enhance it. Anxiety activates the sympathetic nervous system, and Does mood or experience of stress influence occurrence experiments show that non-sex-related anxiety (Hoon of sex or physical affection? et al., 1977; Palace & Gorzalka, 1990), sex-related anxiety (Barlow et al., 1983; Bozman & Beck, 1991), and even Increased positive mood predicted more next-day physical sympathetic activation from exercise (Meston & Gorzalka, affection for the lesbian participants. It also predicted higher 1996) can all enhance sexual arousal. However, all of levels across participants of all partnered sexual behaviors these effects occurred within a very short time frame—any except for intercourse, but predicted fewer unpartnered or- influence of mood induction or sympathetic activation was gasms. These results lend causal weight to prior reports detected within the laboratory session. In the current study, that women are more likely to express themselves sexu- we measured mood and sexual behavior only once daily, ally when experiencing a positive affective state (Sanders, and did not assess arousal per se; thus, it is difficult to make Warner, Backstrom, & Bancroft, 1983; Warner & Bancroft, direct comparisons with our findings. However, our design 1988). It is important to note they do not mean that happier could potentially detect whether short-term mood effects individuals had more affection or sex. The results indicated accumulated over time to influence actual occurrence of instead that when positive mood was higher than usual, par- sexual activity. For example, if anxiety intensified arousal ticipants were more likely to be affectionate or engage in within each sexual episode, it might become associated with partnered sexual activity (except intercourse) the next day. enhanced pleasure and hence increase the likelihood of sex Because of the strong interaction between sexual orientation occurring. Our results did not support that possibility. The and positive mood in predicting next-day affection, along only lagged effect of higher anxiety was a negative effect with the absence of a significant relationship between posi- on orgasm without a partner, and the effect was limited to tive mood and intercourse (which was estimated excluding heterosexual women. In our same-day analyses, we found all lesbian participants), we were concerned that all of the re- negative mood indicators and stress, including anxiety, were lationships between positive mood and next-day sexual be- negatively related to affection and partnered sex variables. havior might be due primarily to effects for the lesbian but Perhaps anxiety interfered with sexual desire before the not the heterosexual participants. However, none of the other arousal stage, as reported by Bozman and Beck (1991). orientation by mood interactions was significant. Thus, the Experimental studies of adults also suggest that anger and strength of the relations between positive mood and next-day depressed mood are likely to interfere with sexual arousal sexual behaviors did not differ by sexual orientation. (Bozman & Beck, 1991; Mitchell et al., 1998), but positive As noted above, intercourse was the only sexual activity mood is more likely to enhance it (Mitchell et al., 1998). that was unrelated to women’s prior-day positive mood in the Our same-day results were consistent with these findings, current study. By definition, sexual intercourse occurs only as were most of the lagged analyses showing positive mood when a male partner maintains an long enough for predicted more sexual behavior on the following day. That vaginal penetration, whereas the other partnered sexual activ- is, if positive mood enhanced arousal in our participants, it ities we monitored do not have this requirement. Because of may have also enhanced sexual motivation, leading to more this difference, we speculate that occurrence of intercourse sexual interactions. was more heavily influenced by men’s mood state, rather As found in previous research (Burleson et al., 2002), part- than women’s. ner availability was positively related to frequency of part- In the current study, daily negative affect and stress gen- nered sexual behavior and negatively related to frequency erally were not related to affection or sexual behavior on the of unpartnered sexual behavior. However, sexual orientation following day. Thus, if negative moods or stress influenced was unrelated to frequency of either partnered or unpart- the occurrence of affectionate or sexual behaviors, most of nered sexual behavior. Average age in the current study was the effects did not carry over to the next day. One exception 14 years older than in the previous study, which may help to to this involved the only significant lagged daily relationship account for this difference in findings. In the current study, found for depressed mood as either predictor or outcome, and older age was associated with less frequent breast and genital the only case in which women’s mood predicted next-day in- stimulation, higher positive mood and lower anxiety ratings, tercourse. Higher depressed mood predicted more next-day and fewer stressor occurrences. These findings fit well with intercourse for women who lived with their partners. Given previous cross-sectional results showing less frequent sexual that induced depressed mood can reduce both subjective and activity (Leigh, Temple, & Trocki, 1993) and higher levels genital arousal (Meisler & Carey, 1991; Mitchell et al., 1998), of positive affect correlated with increasing age (Carstensen,

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Pasupathi, Mayr, & Nesselroade, 2000; Mroczek & Kolarz, out a day were summarized in the evening or the following 1998). Interestingly, living with one’s sexual partner pre- morning, but the summary followed the same pattern of rela- dicted higher overall levels of negative affective states in the tive mood levels as the target day’s multiple ratings. Thus, as current study. However, as the duration of the relationship relative ranks are more important than absolute levels in our increased (controlling for age), average levels of negative analyses, this potential bias may be relatively unproblematic. affect declined. Finally, the lesbian participants reported less With notable exceptions (Exton et al., 2001), much of hostility and depression than the heterosexual participants. what is known about neuroendocrine changes during and after sexual activity has been learned studying arousal and Limitations and implications for future research orgasm in the laboratory, with no partner present. In all our analyses, we found differences between effects or correlates The current study has several limitations. Perhaps the most of partnered versus non-partnered sexual activities. If these consequential is the nature of our sample, which comprised effects are mediated, even partially, by biochemical changes, a relatively small group of mid-aged women with a limited it follows that self-stimulated arousal and orgasms may be age range. As in many longitudinal daily studies, our par- physiologically different from those occurring with a partner. ticipants were very highly motivated. They were also more This emphasizes the importance of studying sexuality in educated and wealthier than average, and comprised a higher a more realistic social context whenever possible (Senn & than average proportion of lesbian women. Therefore, fur- Desmarais, 2004). ther study is needed to determine whether the results we Future longitudinal field studies should make more fre- found are borne out in the general population. Although we quent assessments. This would improve the accuracy of the report differences between lesbian and heterosexual women, data, but more importantly, allow stronger causal tests. For there were relatively few lesbian participants, so these find- example, Bancroft et al. (2003) reported that many men use ings should be interpreted cautiously. In addition, although sex (either alone or with a partner) to improve their mood many of the effects were highly significant, they were small. or reduce stress. If true, this suggests that for some indi- The small effect sizes are not surprising, given that the data viduals, bad mood or stress causes sexual activity to occur, were collected in a natural setting, within the context of mul- which in turn causes improved mood or reduced stress. To tiple social and environmental influences, rather than in a test this pathway, assessments of mood both before and after laboratory. sexual activity are needed, which requires, at minimum, two Measurement issues also deserve mention. Because the measurements per day. study continued for several years, we reduced measurement Despite its limitations, our study is the first to report burden by using a short daily instrument with dichotomous prospective daily associations between sexual behavior or response formats where possible. Therefore, our sexual ac- physical affection and affective state or stress in an adult tivity and affection measures included no ratings of desire, sample. Our results suggest the conventional wisdom may arousal, satisfaction, or other qualitative aspects. Nor did be true. For our sample of mid-aged women, physical affec- we ask who initiated the encounter or gather data about any tion or sexual activity with another person were related to interpersonal activities not listed on the daily datasheet. Sim- improved mood, for at least one day. Unpartnered sexual ac- ilarly, our stress measure asked only if a stressor occurred. tivity, however, did not have the same effect, highlighting the We did not obtain intensity ratings or inquire about content importance of social relationships in the association between or type of stressor. Approximately one third of the sample sex and mood. In addition, positive mood was related to in- had entered the menopause transition. Because we did not creased likelihood of next-day sex or affection. These results measure hormones, any potential effects of changes in hor- suggest that the associations between physical contact and monal status were not detected. All of this information would mood are driven by complex and intertwined processes that be useful to better understand relations among the variables unfold over time. we measured. To facilitate regular data collection, our participants Acknowledgments This project was supported by an internal grant from the College of Arts and Sciences at New Mexico State University. completed daily recordings immediately upon arising, Data analysis and manuscript preparation were additionally supported before the day’s activities had been initiated and distractions by the National Science Foundation (BCS 0129922) and the New Col- could occur. Therefore, a sleep period occurred between lege of Interdisciplinary Arts and Sciences at Arizona State University. data recording and most moods, stressors, or incidences of sexual activity or affection that were reported. Processes References that occur during sleep may influence memory (Benington & Frank, 2003). In fact, Fahrenberg and colleagues (Fahren- Agmo, A. (1999). Sexual motivation–an inquiry into events determining berg, Bruegner, Foerster, & Kaeppler, 1999) reported a bias the occurrence of sexual behavior. Behavioural Brain Research, towards reporting more negative affect when moods through- 105, 129–150.

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