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Home , Religion and sexuality, Sexual desire, Sexual guilt

Arch Behav (2012) 41:1485–1495 DOI 10.1007/s10508-012-9918-6

ORIGINAL PAPER

Sex Mediates the Relationship Between Religiosity and Sexual in East Asian and Euro-Canadian College-Aged Women

Jane S. T. Woo • Negar Morshedian • Lori A. Brotto • Boris B. Gorzalka

Received: 14 January 2011 / Revised: 13 December 2011 / Accepted: 13 December 2011 / Published online: 23 March 2012 Springer Science+Business Media, LLC 2012

Abstract Research has examined the relationship between Introduction religiosity and sexuality but few studies have explored the mech- anisms by which sexual variables are influenced by religiosity. Sex is a sphere of behavior high in religious applicability The purpose of the present study was to investigate the role of and, throughout history, has regulated sexual behavior sex guilt in the relationship between religiosity and (Regnerus, 2007). Indeed, sex is considered a topic that has more in women. Euro-Canadian (n = 178) and East Asian (n = 361) religious relevance and is more clearly addressed in most reli- university students completed a battery of questionnaires. gious traditions than many other topics (Regnerus, 2007). Most, Higher levels of religious fundamentalism, intrinsic religiosity if not all, of the world’s major designate what constitutes and were associated with higher levels of sex guilt in virtuous or acceptable sexual activity for their adherents (Ahrold, both ethnic groups. Paranormal belief was not associated with sex Farmer,Trapnell,&Meston,2011; Cowden & Bradshaw, 2007). guilt in either ethnic group. The Euro-Canadian women reported For example, with the possible exception of Buddhism, most significantly higher levels of sexual desire and significantly less religions condemn premarital and (Miracle, sex guilt than the East Asian women. Among the Euro-Canadian Miracle, & Baumeister, 2003). However, whereas individuals’ women, sex guilt mediated the relationships between spirituality social, cultural, and moral identities were once strongly tied to and sexual desire, and fundamentalism and sexual desire; among religion, there has been a significant increase in the percentage the East Asian women, sex guilt mediated the relationships between of Americans who report no religious affiliation since the 1960s spirituality and sexual desire, fundamentalism and sexual desire, and (Putnam & Campbell, 2010; Stark & Bainbridge, 1985). More- intrinsic religiosity and sexual desire. These findings suggest that sex over, since some religions are more present in certain cultural guilt may be one mechanism by which religiosity affects sexual groups, recent research has also found that sexuality is influ- desire among women. enced by the interaction of cultureandreligion(e.g.,Ahrold& Meston, 2010; McCree, Wingood, DiClemente, Davies, & Keywords Religiosity Á Sexual desire Á Sex guilt Á Harrington, 2003). As a result, any direct effect of religion on East Asian Á Euro-Canadian sexuality sexuality has become less clear (Farmer, Trapnell, & Meston, 2009). Researchers have observed that there is as much diversity in religiosity within religious groups as there is between groups; thus, consideration of individual differences in religiosity is essential to improve the understanding of the effects of reli gion on sexuality (Ahrold et al., 2011; Cowden & Bradshaw, J. S. T. Woo Á N. Morshedian Á B. B. Gorzalka 2007). Department of , University of British Columbia, Vancouver, BC, Canada Religiosity can be defined as the role and importance of religion in one’s life (Cowden & Bradshaw, 2007). Despite L. A. Brotto (&) advances in research into the relationship between religiosity Department of Obstetrics and Gynecology, University of British and sexuality, the specific mechanisms by which religiosity Columbia, 2775 Laurel St., 6th Floor, Vancouver, BC V5Z 1M9, Canada affects sexuality have received little empirical and are e-mail: [email protected] not well-delineated. The purpose of the current study was to 123 1486 Arch Sex Behav (2012) 41:1485–1495 investigate the potential role that sex guilt may play in the rela- 1990). Kinsey, Pomeroy, and Martin (1948)werethefirstto tionship between religiosity and sexual desire. suggest that variation in devoutness within religious groups was The relationship between religion and various aspects of more important than religious affiliation per se in determining sexuality has been a subject of scientific study since the early patterns of sexual behavior, such as to , days of sex research. In their classic work, Human Sexual Inad- premarital petting, and . Therefore, conclusions equacy, (1970) examined differences in drawn about the relationship between that sexual , orgasm, satisfaction, and in relation to reli- are based on the use of religious affiliation or attendance as a gious upbringing. They found that a strict religious upbring- proxy for religiosity should be viewed with caution. ing in , Catholicism, and was associated By studying other domains of religiosity, including intrinsic with different types of , including impotence religiosity, spirituality, religious fundamentalism, and paranor- (i.e., ), anorgasmia, and vaginismus. More mal belief, this may provide more clarity on the relationship recent research on the influence of religion on sexuality has found between religiosity and sexuality. Specifically, they provide a that non-religious individuals report more sexual experiences and richer picture of the influence of religion in individuals’ lives. greater frequency of masturbation than those individuals who identify as Protestant, Catholic, or Jewish (Laumann, Gagnon, Intrinsic Religiosity Michael, & Michaels, 1994; Leiblum, Wiegel, & Brickle, 2003; Pluhar, Frongillo, Stycos, & Dempser-McClain, 1998). More fre- Intrinsic religiosity refers to the individual’s perception of the quent religious service attendance has been found to be associated impact of religion in their daily life and has been conceptually with greater sexual , less sexual activity, less frequent associated with personal religious commitment, as opposed to , fewer lifetime sexual partners, and older age the more socially visible aspects of religiosity, such as religious at first intercourse (Barkan, 2006; Cochran & Beeghley, 1991). service attendance (Donahue, 1985; Kirkpatrick & Hood, 1990). With regard to sexual attitudes, more frequent religious atten- Adherents of Buddhism and Christianity may consider them- dance has been linked to more conservative attitudes toward pre- selves to be equally devout, but this would not be apparent in a marital sex as well as more negative attitudes toward oral and anal measure of religious service attendance as there is no explicit sex (Ahrold et al., 2011; Davidson, Moore, & Ullstrup, 2004). requirement in Buddhism that devotees attend religious services Those who attend religious services weekly were also more likely regularly. Instead, measuring intrinsic religiosity directly pro- to cite as a prerequisite for engaging in intercourse, to want to motes a more comprehensive understanding of religiosity. marry a virgin, and to want to marry someone who had not pre- Research has found a link between intrinsic religiosity and viously had sexual intercourse (Davidson et al., 2004). Whether reli- sexual conservatism such that greater intrinsic religiosity is asso- giosity is associated with sexual dysfunction has never been tested. ciated with more conservative sexual attitudes in both men and Measures such as frequency of religious service attendance women (Ahrold et al., 2011) and with less openness towards implicitly assume that frequent attendance denotes greater reli- casual sexual encounters and to pursue casual sexual giosity. The use of such attendance as an indicator of religiosity partners among women (Rowatt & Schmitt, 2003). - across groups is problematic, as members of religious affi- ingly, the effect of intrinsic religiosity on sexual conservatism liations differ dramatically in their expectations of participation was found even in a sample of individuals identifying with reli- in formal religious services. For example, one study of Austra- gious groups whose religious practices varied in terms of per- lian adults found that more frequent religious service attendance formance of formalized rituals and expectations of attendance at was generally linked to more conservative sexual attitudes and formal religiousservices (Ahrold et al., 2011). Thissuggests that behaviors, but religious individuals who seldom attended ser- intrinsic religiosity as a construct may be relevant across mem- vices resembled their non-religious peers more than their more bers of various religious groups regardless of their religious ser- religious counterparts (de Visser, Smith, Richters, & Rissel, 2007). vice attendance. This measure (i.e., religious attendance) seems to be biased towards members of Christian denominations who are expected to attend church services weekly or sometimes daily, and does not take into Spirituality account the religious practices of Muslims who are expected to pray several times a day, or Buddhists who are not expected Whereas intrinsic religiosity is an indicator of the impact of reli- to attend formal services regularly (Welwood, 2000). Further- gion on one’s daily life, spirituality connotes an internalized more, the use of religious attendance as a proxy for religiosity subjective experience of belief in a divine or being or does not capture specific attitudes and that are force (Zinnbauer, Pargament, & Scott, 1999). Like intrinsic associated with religiosity nor does it consider external influ- religiosity, however, greater spirituality was associated with ences, such as the social influence of peers and , which more conservative sexual attitudes as well as more conserva- can religious attendance but which may not necessarily tive attitudes toward specific sexual practices (Beckwith & Morrow, affect religiosity in the same manner (Kirkpatrick & Hood, 2005). Spirituality has also been linked to voluntary sexual 123 Arch Sex Behav (2012) 41:1485–1495 1487 activity such that greater spirituality was associated with a lower mechanisms by which the various domains of religiosity influ- likelihood of ever having engaged in voluntary sexual activity ence sexual desire in women. in urban youth (Holder et al., 2000). In studying the effects of religiosity on sexuality, it is also important to consider cultural influences. Some religions are more prevalent in some cultural groups and as culture is strongly Religious Fundamentalism linked to sexual attitudes, behaviors, knowledge, and function, it is crucial to take culture into account when attempting to under- Religious fundamentalism is another area of religiosity that has stand religiosity influences on sexuality. In the research that has been studied by researchers in sexuality. Fundamentalism refers compared Western with Asian sexuality, Asians have consis- to the belief that there exists only one correct religious doctrine tently been found to possess less accurate sexual knowledge that articulates the essential truth about humanity and deity, and (Brotto, Chik, Ryder, Gorzalka, & Seal, 2005; Meston, Trap- that those whose attitudes and behaviors adhere strictly to this nell, & Gorzalka, 1998; Woo, Brotto, & Gorzalka, 2009)and doctrine have a special relationship with the deity (Altemeyer & report greater sexual conservatism (Ahrold & Meston, 2010; Hunsberger, 1992). Religious fundamentalism is distinct from Higgins & Sun, 2007; Meston, Trapnell, & Gorzalka,1996;Woo, intrinsic religiosity in that individuals who are high in funda- Brotto, & Gorzalka, 2011a), more of sexual harass- mentalism regard religious dogma as the sole source of moral ment (Kennedy & Gorzalka, 2002), and higher rates of sexual authority whereas those who are high in intrinsic religiosity may difficulties (Brotto et al., 2005;Wooetal.,2011a)comparedto acknowledge other sources of faith, including traditions, rituals, their Western counterparts. They also demonstrate a narrower and personal reasoning or interpretation (Hood, Spilka, Huns- repertoire of sexual behaviors (Meston & Ahrold, 2010;Meston berger, & Gorsuch, 1996). In general, greater fundamentalism is et al., 1998; Woo et al., 2009). associated with more negative attitudes towards premarital sex Although a large body of research has detailed the dimen- (Bassett, Smith, Newell, & Richards, 1999), and more conser- sions along which Western and Asian sexuality differ, much less vative attitudes towards , , and gender has been published about the mechanisms that underlie these role traditionality (Ahrold & Meston, 2010). cultural differences. In seeking to explain the cultural disparity in sexuality-related variables, most studies simply referred to Paranormal Belief general culture-linked differences in sexual conservatism although this had not been empirically investigated. A recent study of With the rising influence of new-age religious and spiritual sexual desire differences among East Asian (Chinese, Japanese, groups, research has pointed to theincreasingneedtostudypara- Korean) and Euro-Canadian women, however, examined the normal belief (Ahrold et al., 2011;Hirschman,2004). Paranormal roles of sex guilt and sexual conservatism in the relationship belief encompasses beliefs in supernatural phenomena both in between ethnic group and sexual desire (Woo et al., 2011a). Sex- traditionally religious contexts, such as belief in life after death or ual conservatism was conceptualized as self-imposed restric- belief in angels and demons, and quasi-religious beliefs, such as tions on various facets of sexuality, such as the appropriateness (Irwin, 1993). Greater paranormal belief has been of specific sexual partners and sexual activities as well as con- found to be associated with greater interest in pursuing short-term texts in which sexual activity was permissible. In contrast, sex sexual partners (Weiss, Egan, & Figueredo, 2004). The inves- guilt was defined as a personality disposition characterized by‘‘a tigators proposed that an affinity for‘‘sensational interests,’’of generalized expectancy for self-mediated punishment for vio- which the paranormal forms an element, may be one strategy in lating or for anticipating violating standards of proper sexual intrasexual competition for sexual partners. Knowledge of sen- conduct’’(Mosher & Cross, 1971, p. 27). This study found that sational information that implies familiarity with means of acquir- sexual conservatism and sex guilt separately mediated the rela- ing power may reflect qualities such as motivation and mental tionship between ethnic group and sexual desire, in that women capacity, which may impress other same-sex individuals during with higher sex guilt and those who were more sexually conser- contests of symbolic dominance. Thus, greater mating effort—the vative reported lower sexual desire. On the other hand, among mating strategy of investing resources in the acquisition and guard- the East Asian women, sex guilt but not sexual conservatism ing of many short-term is hypothesized to be pre- mediated the relationship between degree of Westernization dictive of higher levels of sensational interests. and sexual desire. As a result, it was concluded that sex guilt had Regardlessofone’s religious affiliation,everyonewould be greater utility than sexual conservatism in improving the under- expected to embody the four domains of religiosity—intrinsic standing of cultural effects on sexual desire. religiosity, spirituality, religious fundamentalism, and paranor- The role of sex guilt has also been explored in the religiosity mal belief—to some extent. The current study expanded on literature. Although church attendance was used as a proxy for past literature that has utilized a multidimensional measure of religiosity in this work, these studies represent important first religiosity that assesses all four domains (e.g., Ahrold & Meston, steps toward improving the understanding of the relationship 2010; Ahrold et al., 2011) and used this measure to examine the between sex guilt and religiosity. In a multiethnic sample of 123 1488 Arch Sex Behav (2012) 41:1485–1495

African American and Euro-American women, religiosity, as Table 1 Demographic information on Euro-Canadian (n = 178) and measured by church attendance, was a better predictor of sex East Asian (n = 361) participants guilt than ethnicity and socioeconomic status (Wyatt & Dunn, Variable Euro-Canadian East Asian 1991). Using church attendance as a proxy for religiosity, Gun- derson and McCary (1979) found that frequency of church atten- Mean age in years (SD)* 20.6 (3.4) 19.9 (3.0) dance was linked to sex guilt, such that individuals who attended Place of birth (%)*** church more frequently also reported higher sex guilt, which, in Canada or US 79.8 21.6 turn, was predictive of more conservative sexual atti- China/Hong Kong/ 0 54.0 tudes, less accurate sexual knowledge, and more restricted sex- Japan/Korea 0 17.7 ual activity. However, to our knowledge, the potential medi- Southeast Asia 0 5.0 ating role of sex guilt in the relationship between religiosity and Europe 14.0 0 sexuality-related variables has not received empirical attention. Other 6.2 1.7 Years of residency in Canada (SD)*** 16.3 (8.1) 10.3 (6.6) Years of formal education (SD)** 14.5 (1.6) 14.1 (1.8) The Present Study Relationship status (%)*** In a relationship 56.7 41.8 The purpose of the current study was to improve the under- Religious affiliation (%) standing of the role of sex guilt in explaining the relationship Christian 41.9 35.3 between religiosity and sexual desire as a first step towards Jewish 7.6 0 accounting for the observed effects of religiosity on sexuality. Buddhist 1.7 19.3 We chose to study sexual desire because it is a construct that has Agnostic 4.1 3.7 been found to differ cross-culturally (e.g., Brotto et al., 2005; Woo et al., 2011a) and is sensitive to the influence of sex guilt Atheist 9.3 5.7 (Woo et al., 2011a); however, it has never been explored with None 26.7 29.3 regard to religiosity. We speculated that the relationship between Spiritual, no label 1.7 0 religiosity and sexual desire would be mediated by sex guilt such Other 7.0 6.3 that higher religiosity would be predictive of greater sex guilt, and Significant group differences at * p\.05. ** p\.01. *** p\.001 greater sex guilt would, in turn, be predictive of lower sexual desire. Based on our earlier finding that sex guilt mediated the relationship between ethnicity and sexual desire such that sex guilt played a more pronounced role in the East Asian group compared to a Euro- Measures Canadian comparison group, we hypothesized here that sex guilt may mediate the relationship between religiosity and sexual desire Demographics Questionnaire more strongly among the East Asian compared to the comparison group. An investigator-derived questionnaire assessing demographic variables, sexual intercourse history, and experience with a variety of different types of sexual activity was administered. Method Religiosity Measures Participants Participants rated their religiosity on all four measures on a 5-point Participants were recruited from the psychology department’s Likert scale that ranged from 1 (Strongly Disagree) to 5 (Strongly human subject pool at a large Canadian university. East Asian Agree), with some items reverse scored. Higher scores indicate (Chinese, Japanese, and Korean) and Euro-Canadian women greater religiosity in each domain. who were fluent in English and at least 18 years of age were Paranormal Beliefs. Belief in paranormal phenomena, includ- eligible to participate. A total of 549 women participated. Of ing supernatural powers and superstitions, was assessed using a these, 178 self-identified as Euro-Canadian and 361 self-iden- 10-item scale developed by Trapnell (2005). An example of an tified as East Asian. The remaining 10 participants self-identi- item that comprises the paranormal beliefs measure is:‘‘I’m very fied as other ethnic groups or mixed ethnicity and were excluded receptive to magical or supernatural experiences, rather than skep- from further analyses. Information on religious group was col- tical.’’This measure has not been standardized, but internal con- lected with the open-ended question ‘‘What is your religion?’’ sistency of the scale in a previous study was adequate (Cronbach’s Demographic data, including religious group, are shown in a=.80; Farmer et al., 2009). Internal consistency in the current Table 1. sample was good (Cronbach’s a=.85). 123 Arch Sex Behav (2012) 41:1485–1495 1489

Spirituality good psychometric properties, with high test–retest reliability (r = .83) as well as high internal consistency (Cronbach’s Spirituality was assessed with a questionnaire consisting of 8 a = .92). Scores on the desire subscale may be meaningfully items developed by Trapnell (2005). An example of an item that interpreted for women who are sexually active as well as those comprises the spirituality measure is:‘‘I tend to think of myself who are not (Brotto, 2009; Meyer-Bahlburg & Dolezal, 2007). as especially spiritually-oriented.’’ This measure has not been standardized, but internal consistency of the scale in two pre- Revised Mosher Guilt Inventory (RMGI) vious studies was acceptable (Cronbach’s a = .88) (Ahrold et al., 2011;Farmeretal.,2009) and in the current sample was The RMGI (Mosher, 1988) is a self-report questionnaire that good (Cronbach’s a = .91). measures sex guilt, guilt, and guilty conscience. For the purposes of the current study, only the 50 items that constitute Intrinsic Religiosity the sex guilt subscale were administered. Participant responses were rated on a 7-point Likert scale that ranged from 0 (Not at all Intrinsic religiosity was measured using the intrinsic religiosity true for me) to 6 (Extremely true for me). Total scores on this subscale of the Age Universal Religious Orientation Scale subscale ranged from 0 to 300, with higher scores indicating (Gorsuch & Venable, 1983). One item (‘‘I enjoy reading about higher sex guilt. Internal consistency in the current sample was my religion’’) was inadvertently left out of the version of the high (Cronbach’s a = .96). The psychometric properties of measure used in the current study because of mislabeling in the earlier versions of the RMGI have been established by a number original publication. This resultedinan8-itemmeasureofin- of studies (e.g., Abramson & Mosher, 1979;Ruma&Mosher, trinsic religiosity in the current study. An example of an item that 1967), with convergent validity estimates ranging from 0.66 to comprises the intrinsic religiosity measure is:‘‘Itis important for 0.86. me to spend time in private thought and prayer.’’Internal con- sistency of this measure in the standardization sample ranged Procedure from .68 for children to .73 for adults. Internal consistency of this measure in the current study was good (Cronbach’s a = .93). The study was publicized using the online experiment manage- ment system for the university’s human subject pool. Partici- Fundamentalism pants completed abatteryofquestionnairesin groups of 15-20 in a large testing room. Written informed consent was obtained An abbreviated version of the Religious Fundamentalism Scale and then questionnaires were administered by a female research developed by Altemeyer and Hunsberger (1992)wasusedto assistant. Participants received extra course credit for their par- measure religious fundamentalism. This short form version ticipation in this study. All procedures were approved by the consisted of 10 items. An example of an item comprising the university’s behavioral research board. fundamentalism scale is: ‘‘To lead the best, most meaningful life, one must belong to the one, true religion.’’This abbreviated Data Analysis version demonstrated good internal consistency in two prior studies (Cronbach’s a = .87; Ahrold et al., 2011;Farmeretal., SPSS version 13 was used for all statistical analyses. T-tests were 2009) as well as in the current sample (Cronbach’s a = .84). used in analyses comparing the two ethnic groups on various domains of religiosity, sex guilt, and sexual desire. In analyses of Female Sexual Function Index (FSFI) the association between ethnicity and sexual variables, the point- biserial statistic was used. The FSFI (Rosen et al., 2000) is a self-report questionnaire that The bootstrap procedure for mediation analysis advocated by consists of 19 items and assesses six domains of sexual func- Shrout and Bolger (2002) was used in all mediation analyses tioning, including sexual desire, over the previous 4 weeks. because it has been suggested that bootstrap methods are more Higher scores on each subscale indicated higher sexual func- appropriate than more traditional approaches to mediation (e.g., tioning. In this study, only the desire domain, which consists of Baron & Kenny, 1986) when the hypothesized mediation process two items, was examined. The first question that comprises this is temporally distal, such as that between religiosity and sexual domain is‘‘Over the past 4 weeks, how often did you feel sexual desire. Other advantages of the bootstrap method include not desire or interest?’’with responses ranging from‘‘Almost never requiring the distribution of the indirect effect to meet the nor- or never’’to ‘‘Almost always or always.’’The second question mality assumption, greater power, and better Type I error control that comprises this domain is ‘‘Over the past 4 weeks, how (Hayes, 2009). Three thousand samples, with replacement, were would you rate your level (degree) of sexual desire or interest?’’ used in each mediation analysis. All mediation analyses were with responses ranging from‘‘Very low or none at all’’to‘‘Very conducted using an SPSS macro developed by Preacher and high.’’Scores on this subscale ranged from 1 to 5. The FSFI has Hayes (2004) which sampled randomly with replacement from 123 1490 Arch Sex Behav (2012) 41:1485–1495

sexual desire than the East Asian women (M = 3.29, SD = 1.18, t(526) = 7.25, p\.001; Cohen’s d = 0.69). With regard to sex guilt, the Euro-Canadian women (M = 65.86, SD = 37.48) scored significantly lower on the RMGI Sex Guilt subscale, indicating less sex guilt than the East Asian women, (M = 119.07, SD = 44.88, t(369) =-13.94, p\.001; Cohen’s d = Fig. 1 A simple mediation model. a represents the effect of the initial variable X on the mediating variable M; b represents the effect of M on -1.29). Because there were significant ethnic differences in the outcome variable Y after controlling for the effect of X; and c and c’ both religiosity and sexual desire, subsequent analyses of reli- represent the direct effect of X on Y, and the effect of X on Y after giosity effects on sex guilt and sexual desire were conducted controlling for M, respectively. The bootstrap method does not require separately for each ethnic group to avoid confounding the tests of a, b or c to demonstrate mediation; rather, a mediation effect is established when the product ab is significantly different from zero effects of ethnicity and religiosity. (Hayes, 2009) There were significant positive correlations between scores on some of the religiosity measures and the RMGI in both ethnic the dataset. The mediation model used in the current study is groups. Among the East Asian women, the correlations between illustrated in Fig. 1. RMGI scores and scores on the measures of religious funda- mentalism, r(334) = .51, p\.001, intrinsic religiosity, r(338) = .48, p\.001, and spirituality, r(337) = .34, p\.001, were sig- Results nificant. Similarly, among the Euro-Canadian women, the correlations between RMGI scores and scores on the measures Ethnic Group, Religiosity, and Sexuality Measures of religious fundamentalism, r(159) = .62, p\.001, intrinsic religiosity, r(157) = .53, p\.001, and spirituality, r(160) = .39, The two ethnic groups differed significantly on all sexual activ- p\.001, were significant. ities that were assessed in this study, including kissing, hugging, There were also significant correlations among some of the and holding hands; touching with clothing removed;touching of religiosity measures in both ethnic groups. These correlations partner’s genitals; giving and receiving ; and engaging are shown in Tables 3 and 4. in sexual intercourse (all ps\.001), with the Euro-Canadian women more likely to have engaged in each of these activities. The Mediating Role of Sex Guilt in the Relationship In comparing the two ethnic groups on religiosity, sex guilt, and Between Religiosity and Sexual Desire sexual desire, we adjusted for large family-wise error rate, applying a Bonferroni correction by dividing the standard alpha Among the Euro-Canadian women, sex guilt mediated the rela- level of .05 by six (the number of comparisons being made). tionships between spirituality and sexual desire, and funda- Thus, ethnic differenceswere considered statistically significant mentalism and sexual desire. For example, the effect of spiri- only if p\.008 (.05/6 comparisons). Comparisons between the tuality on sex guilt was demonstrated (b = 12.39, p\.001), two ethnic groups revealed significant differences in three of the indicating that higher spirituality was associated with signifi- religiosity measures- intrinsic religiosity, religious fundamen- cantly greater sex guilt. The effect of sex guilt on sexual desire, talism and paranormal belief—with the East Asian group holding spirituality constant, was also significant (b =-.01, p\ scoring higher on each of these measures, indicating greater .01), showing that increased sex guilt was linked to less sexual religiosity among the East Asian women in these domains desire. The indirect effect of spirituality on sexual desire, com- (Table 2). puted by multiplying the effect of spirituality on sex guilt with The Euro-Canadian women (M=4.06, SD =1.06) scored sig- the effect of sex guilt on sexual desire while controlling for spir- nificantly higher on the FSFI Desire subscale, indicating greater ituality, was also significant (ab =-.09, SE = .03, CI95 =-.16,

Table 2 Ethnic differences in measures of religiosity Religiosity measures Euro-Canadian East Asian t(df) Effect sizea M (SD) M (SD)

Paranormal belief*** 2.58 (.90) 2.92 (.74) -4.40 (291) .41 Spirituality 2.81 (1.18) 3.11 (.94) -2.98 (288) .28 Intrinsic religiosity*** 1.76 (.89) 2.20 (1.10) -4.93 (416) .44 Religious fundamentalism*** 1.75 (.60) 2.42 (.83) -10.55 (457) .93 Note: Higher scores denote greater religiosity on each measure Significant group differences at *** p\.001 a 2 2 Effect size (Cohen’s d) was calculated as d = (M1 - M2)/s, where s = H[(n1 - 1)s1 ? (n2 - 1)s2]/(n1 ? n2) 123 Arch Sex Behav (2012) 41:1485–1495 1491

Table 3 Correlations among measures of religiosity: Euro-Canadian Women Religiosity measures Paranormal belief Spirituality Intrinsic religiosity Religious fundamentalism

Paranormal belief – Spirituality .49** – Intrinsic religiosity .15* .67** – Religious fundamentalism -.07 .24** .48** – Significant correlations at * p\.05, ** p\.01

Table 4 Correlations among measures of religiosity: East Asian women Religiosity measures Paranormal belief Spirituality Intrinsic religiosity Religious fundamentalism

Paranormal belief – Spirituality .35** – Intrinsic religiosity .05 .72** – Religious fundamentalism -.03 .53** .69** – Significant correlations at ** p\.01

Table 5 Results of mediation analyses for Euro-Canadian women -.03). Hence, sex guilt mediated the relationship between spiri- Religiosity ab cc’abCI95 tuality and sexual desire. The complete results of the mediation measures analyses are presented in Table 5. Among the East Asian women, mediation analyses revealed Paranormal belief -.26 -.01 .02 .01 .002 (-.04, .04) that sex guilt mediated the relationships between spirituality and Spirituality 12.39 -.01 -.05 .03 -.09* (-.16, -.03) sexual desire, fundamentalism and sexual desire, as well as Intrinsic 22.49 -.004 -.26 -.16 -.1 (-.24, .01) intrinsic religiosity and sexual desire. For example, the indirect religiosity effect of spirituality on sexual desire, computed by multiplying Fundamentalism 39.27 -.007 -.24 .039 -.28* (-.54, -.04) the effect of spirituality on sex guilt with the effect of sex guilt on Note: a represents the effect of the religiosity measure on sex guilt. b sexual desire while controlling for spirituality, was significant represents the effect of sex guilt on sexual desire after controlling for the (ab =-.18, SE =.04, CI =-.26, -.11). Hence, sex guilt medi- effect of the religiosity measure. c represents the direct effect of 95 the religiosity measure on sexual desire. c’ represents the effect of the ated the relationship between spirituality and sexual desire religiosity measure on sexual desire after controlling for sex guilt. ab among the East Asian women. The complete results of these represents the indirect effect of the religiosity measure on sexual desire. mediation analyses are presented in Table 6. CI95 represents the 95% confidence interval for the indirect effect of the religiosity measure on sexual desire. Mediation effects significant at *p\.05 Discussion Table 6 Results of mediation analyses for East Asian women The purpose of this study was to investigate the potential medi- ating role of sex guilt in the link between religiosity and sexual Religiosity measures abcc’abCI95 desire in East Asian and Euro-Canadian women. The results of Paranormal belief -3.15 -.01 .15 .11 .03 (-.04, .11) the analyses of ethnic differences in religiosity revealed that Spirituality 16.17 -.01 -.13 .05 -.18* (-.26, -.11) East Asian women scored higher than their Euro-Canadian coun- Intrinsic religiosity 19.01 -.01 -.05 .20 -.25* (-.33, -.18) terparts on most of the religiosity measures and thus the effects of Fundamentalism 27.80 -.01 -.12 .24 -.36* (-.48, -.25) religiosity on sex guilt and sexual desire were analyzed separately for the two ethnic groups. Analyses of ethnic differences in sexual Note: a represents the effect of the religiosity measure on sex guilt. b represents the effect of sex guilt on sexual desire after controlling for the desire showed that the Euro-Canadian women reported higher effect of the religiosity measure. c represents the direct effect of the levels of sexualdesire and lowerlevels of sex guilt. These findings religiosity measure on sexual desire. c’ represents the effect of were consistent with the literature on ethnic differences in sexual the religiosity measure on sexual desire after controlling for sex guilt. ab response and sex guilt (Abramson & Imai-Marquez, 1982;Brotto represents the indirect effect of the religiosity measure on sexual desire. CI95 represents the 95% confidence interval for the indirect effect of the et al., 2005;Cainetal.,2003; Laumann et al., 2005;Wooetal., religiosity measure on sexual desire. Mediation effects significant at 2010). * p\.05 123 1492 Arch Sex Behav (2012) 41:1485–1495

As expected, we found that, among the Euro-Canadian wo- As these groups do not regulate sexuality in the same way that men, sex guilt mediated the relationship betweenspirituality and most of the major religions do, it may follow that higher levels of sexual desire, and between fundamentalism and sexual desire. paranormal belief are not necessarily associated with greater sex Among the East Asian women, mediation analyses revealed that guilt. This conjecture is consistent with a study that found that sex guilt mediated the relationships between spirituality and sex- believers in traditional Chinese ethnocultural religions reported ual desire, fundamentalism and sexual desire, as well as intrinsic higher levels of paranormal belief compared to Christian indi- religiosity and sexual desire. In both groups of women, higher viduals (Shiah, Tam, Wu, & Chang, 2010). levels of each measure of religiosity were associated with higher While sex guilt mediated the relationships between spiritu- levels of sex guilt, which, in turn, were linked to lower levels of ality and fundamentalism with sexual desire in both groups, sex sexual desire. This is a novel finding because the specific mech- guilt mediated the relationship between intrinsic religiosity and anisms that underlie the association between religiosity and sexual desire only in the East Asian women but not the Euro- sexual desire have not received empirical attention. Canadian group. This finding suggests that all aspects of reli- Why does sex guilt mediate the relationship between religi- giosity impact desire through sex guilt for East Asian women osity and sexual desire? A more in-depth examination of the con- whereas the impact of intrinsic religiosity on desire in Euro- nection between sex guilt and religion may shed light on this Canadian women is not via sex guilt, but perhaps through other question. As described earlier, Mosher and Cross (1971)con- mechanisms. One potential interpretation of this finding is that ceived of sex guilt as a negatively-valenced arising from the East Asian women were more influenced by the activation of the violation or anticipated violation of ‘‘standards of proper sex guilt than were the Euro-Canadian women. It also highlights sexual conduct that may manifest itself by inhibited sexual behav- the fact that there is ethno-cultural variation in the mechanisms ior, or by the disruption of cognitive processes in sex-related situ- by which religion affects sexual desire. Future research should ations.’’Other than some sexual acts, such as and forced aim to explore other mechanisms by which religiosity influences sexual relations (such as ) which are almost universally pro- sexuality and how such mechanisms differ by ethnic groups. hibited, what constitutes acceptable sexual behaviors varies The finding that the relationship between various domains of greatly between cultures and is often inextricably intertwined religiosity and sexual desire is mediated by sex guilt may have with religious tradition (Davidson et al., 2004; DeLamater, 1987). implications for understanding the etiology and the treatment of In Christianity, for example, the only sexual activity that is con- low sexual desire in women. We chose to study sexual desire sidered morally acceptable is heterosexual intercourse occurring because it continues to be a great conundrum for sex researchers within the context of a marital relationship and for the purpose of and therapists to define, understand, and adequately treat (Brotto, procreation (Curran, 1992). By extension, sexual activity for the 2010). Specifically, sex guilt may underlie problems with low purpose of sexual is considered sinful in many Christian sexual desire among Euro-Canadian women who endorse high denominations (Runkel, 1998). Thus, it is possible that clerical levels of spirituality and religious fundamentalism, and East condemnation of other types of sexual activity, or sexual activity Asian women who endorse high levels of spirituality, intrinsic occurring in other contexts, may elicit guilty relating to religiosity and religious fundamentalism. To date, cognitive behav- expressions of sexuality, with higher levels of religiosity being ioral and couples counseling interventions have been commonly associated with higher levels of sex guilt. This was borne out in used in the psychological treatment of problems with low sexual the current study as religious fundamentalism, intrinsic religios- desire. Although the scientific literature on treatment efficacy ity, and spirituality were significantly and positively correlated remains limited, the evidence suggests that these treatments are with sex guilt in both the Euro-Canadian and East Asian groups. generally effective (Brotto, Basson, & Luria, 2008; Brotto, Bit- Interestingly, paranormal belief was not significantly cor- zer, Laan, Leiblum, & Luria, 2010; Hawton, Catalan, & Fagg, related with sex guilt in either ethnic group. Although the reason 1991; Hurlbert, 1993; McCabe, 2001; Schover & LoPiccolo, for this is unclear based on the current study, one possibility 1982;Trudeletal.,2001). Given that the current study found that could be that paranormal belief may be qualitatively different sex guilt may play a role in the sexual desire problems of highly from the other three domains of religiosity that were examined religious women, it is possible that incorporating sex guilt as a in this study. Whereas all four domains of religiosity may reflect treatment target in existing interventions may improve treatment varying degrees of devoutness in relation to a major world reli- outcome. gion, belief in paranormal phenomena in particular may also be The current study has limitations that must be addressed. pertinent to ethnocultural folk religions and new age quasi- Firstly, the university sample was significantly younger than religious groups. Although ethonocultural folk religions can be women in the general population, which limits the generaliz- associated with major religions, they are often infused with ability of our findings to the large population of treatment seekers beliefs such as that spirits of nature and souls of the dead are who may be considerably older. This is of particular concern in close by. These folk religions also frequently characterized by this study because most of the women in our sample were regular participation in rituals that are believed to bring good unmarried and it is not possible to draw conclusions about the fortune and cure illness, as well as magical beliefs and animism. relationships among religiosity, sex guilt, and sexual desire in 123 Arch Sex Behav (2012) 41:1485–1495 1493 married women based on the current study. Given that sexual Altemeyer, B., & Hunsberger, B. (1992). Authoritarianism, religious activity, and therefore sexual desire, within the marital rela- fundamentalism, quest, and prejudice. International Journal for the , 2, 113–133. tionship is acceptable in most major religions, it is especially Barkan, S. E. (2006). Religiosity and premarital sex in adulthood. important that future research examine the interrelationships Journal for the Scientific Study of Religion, 45, 407–417. among these variables in married individuals. Secondly, the use Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable of a university sample does not allow for the consideration of distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social other relevant interconnected factors that may relate to sex guilt, Psychology, 51, 1173–1182. such as socioeconomic status and age. Data from a separate study Bassett,R.L.,Smith,H.L.,Newell,R.L.,&Richards,A.H.(1999).Thou indicate that there is a positive correlation between sex guilt shalt not like sex: Taking another look at religiousness and sexual and age, such that older age is associated with higher levels of sex attitudes. Journal of Psychology and Christianity, 18, 205–216. Beckwith, H. D., & Morrow, J. A. (2005). Sexual attitudes of college guilt (Woo, Brotto, & Gorzalka, 2011b). Thirdly, because only students: The impact of religiosity and spirituality. College Student women were included in the current study, it is not possible to Journal, 39, 357–367. determine the extent to which these findings would hold for men. Brotto, L. A. (2009). The Female Sexual Function Index: A method- Prior research indicates that there are significant sex differences in ological critique and suggestions for improvement. Journal of Sex and Marital Therapy, 35, 161–163. levels of sex guilt, with women consistently being found to have Brotto, L. A. (2010). The DSM diagnostic criteria for hypoactive sexual greater sex guilt than men (Abramson & Imai-Marquez, 1982; desire disorder in women. Archives of Sexual Behavior, 39, 221– Abramson & Mosher, 1979; Plaud, Gaither, & Weller, 1998). 239. Thus, the mechanism that underlies the relationship between reli- Brotto, L. A., Basson, R., & Luria, M. (2008). A mindfulness-based group psychoeducational intervention targeting giosity and male sexual desire may differ from that found in disorder in women. Journal of , 5, 1646–1659. women. Fourthly, sexual desire was measured with two items on a Brotto, L. A., Bitzer, J., Laan, E., Leiblum, S., & Luria, M. (2010). Women’s self-report questionnaire which may not capture the multidimen- sexual desire and arousal disorders. Journal of Sexual Medicine, 7, sional and multi-determined nature of sexual desire. Finally, the 586–614. Brotto,L.A.,Chik,H.M.,Ryder,A.G.,Gorzalka,B.B.,&Seal,B.N. social desirability of acknowledging high levels of sexual desire (2005). Acculturation and sexualfunctioninAsianwomen.Archives may vary with religiosity. Thus, it is possible that the relationship of Sexual Behavior, 34, 613–626. between religiosity andsexual desire may be accounted for by vari- Cain, V. S., Johannes, C. B., Avis, N. E., Mohr, B., Schocken, M., ations in social desirability rather than sex guilt. Skurnick, J.,…& Ory, M. (2003). Sexual functioning and practices in a multi-ethnic study of midlife women: Baseline results from In conclusion, novel to this study were the findings that SWAN. Journal of Sex Research, 40, 266–276. religiosity is associated with lower levels of sexual desire, and Cochran, J. K., & Beeghley, L. (1991). The influence of religion on that sex guilt mediates the relationship between a number of attitudes toward nonmarital sexuality: A preliminary assessment of domains of religiosity and sexual desire in Euro-Canadian and reference group theory. Journal for the Scientific Study of Religion, 30, 45–62. East Asian women. These findings advance our understanding Cowden, C. R., & Bradshaw, S. D. (2007). Religiosity and sexual of the mechanisms by which religiosity influences sexual desire concerns. International Journal of Sexual , 19, 15–24. and may have implications for the assessment and treatment of Curran, C.E. (1992). inthe Roman Catholic tradition. In R. low sexual desire in clinical practice. M. Green (Ed.), Religion and sexual health (pp. 17–35). Boston: Kluver Academic Publishers. Davidson, J. K., Moore, N. B., & Ullstrup, K. M. (2004). Religiosity and Acknowledgments Funding for this study came from a Hampton sexual responsibility: Relationships of choice. American Journal Research Fund from the University of British Columbia awarded to L. A. of Health Behavior, 28, 335–346. Brotto. J. S. T. Woo was funded by a Predoctoral Fellowship from the de Visser, R. O., Smith, A. M., Richters, J., & Rissel, C. E. (2007). Canadian Institutes of Health Research and a Predoctoral Research Trainee Associations between religiosity and sexuality in a representative Award from the Michael Smith Foundation for Health Research. sample of Australian adults. Archives of Sexual Behavior, 36, 33–46. DeLamater, J. (1987). A sociological perspective. In J. H. Geer & W. T. O’Donohue (Eds.), Theories of (pp. 237–256). New York: Plenum. References Donahue, M. J. (1985). Intrinsic and extrinsic religiousness: Review and meta-analysis. Journal of Personality and Social Psychology, 48, Abramson, P. R., & Imai-Marquez, J. (1982). The Japanese-American: 400–419. A cross-cultural, cross-sectional study of sex guilt. Journal of Farmer, M. A., Trapnell, P. D., & Meston, C. M. (2009). The relation Research in Personality, 16, 227–237. between sexual behavior and religiosity subtypes: A test of the Abramson, P. R., & Mosher, D. L. (1979). An empirical investigation of secularization hypothesis. ArchivesofSexual Behavior, 38, 852–865. experimentally induced masturbatory fantasies. Archives of Sexual Gorsuch, R. L., & Venable, G. D. (1983). Development of an ‘‘age Behavior, 8, 27–39. universal’’I-E scale. Journal for the Scientific Study of Religion, 22, Ahrold, T. K., Farmer, M. A., Trapnell, P. D., & Meston, C. M. (2011). 181–187. The relationship among sexual attitudes, , and Gunderson, M. P., & McCary, J. L. (1979). and religion. The religiosity. Archives of Sexual Behavior, 40, 619–630. Family Coordinator, 28, 353–357. Ahrold, T. K., & Meston, C. M. (2010). Ethnic differences in sexual Hawton, K., Catalan, J., & Fagg, J. (1991). Low sexual desire: Sex attitudes of U.S. college students: Gender, acculturation, and therapy results and prognostic factors. Behaviour Research and religiosity factors. Archives of Sexual Behavior, 39, 190–202. Therapy, 29, 217–224.

123 1494 Arch Sex Behav (2012) 41:1485–1495

Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation Mosher, D. L. (1988). Revised Mosher guilt inventory. In C. M. Davis, analysis in the new millennium. Communication Monographs, 76, W. L. Yarber, & S. L. Davis (Eds.), Sexuality-related measures (pp. 408–420. 152–155). Lake Mills, IA: Graphic Publishing. Higgins, L. T., & Sun, C. H. (2007). Gender, social background and sexual Mosher, D. L., & Cross, H. J. (1971). Sex guilt and premarital sexual attitudes among Chinese students. Culture, Health & Sexuality, 9, experiences of college students. Journal of Consulting and Clinical 31–42. Psychology, 36, 27–32. Hirschman, C. (2004). The role of religion in the origins and adaptation of Plaud, J. J., Gaither, G. A., & Weller, L. A. (1998). Gender differences in immigrant groups in the United States. International Migration Review, the sexual rating of words. Journal of Sex and Marital Therapy, 24, 38, 1206–1233. 13–19. Holder, D. W., DuRant, R. H., Harris, T. L., Daniel, J. H., Obeidallah, D., Pluhar, E., Frongillo, E. A., Stycos, J. M., & Dempser-McClain, D. (1998). & Goodman, E. (2000). The association between adolescent Understanding the relationship between religion and the sexual spirituality and voluntary sexual activity. Journal of Adolescent attitudes and behaviors of college students. Journal of Health, 26, 295–302. and Therapy, 23, 288–296. Hood, R. W., Spilka, B., Hunsberger, B., & Gorsuch, R. (1996). The Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for psychology of religion: An empirical approach. New York: Guilford estimating indirect effects in simple mediation models. Behavior Press. Research Methods, Instruments, and Computers, 36, 717–731. Hurlbert, D. F. (1993). A comparative study using orgasm consistency Putnam, R. D., & Campbell, D. E. (2010). American grace: How training in the treatment of women reporting hypoactive sexual religion divides and unites us. New York: Simon & Schuster. desire. Journal of Sex and Marital Therapy, 19, 41–55. Regnerus, M. (2007). Forbidden fruit: Sex & religion in the lives of Irwin, H. J. (1993). Belief in the paranormal: A review of the empirical American teenagers. New York: Oxford University Press. literature. Journal of the American for Psychical Research, Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., 87, 1–39. & D’Agostino, R. (2000). The Female Sexual Function Index Kennedy, M. A., & Gorzalka, B. B. (2002). Asian and non-Asian atti- (FSFI): A multidimensional self-report instrument for the assessment tudes toward rape, sexual harrassment, and sexuality. Sex Roles, of female sexual function. Journal of Sex and Marital Therapy, 26, 46, 227–238. 191–208. Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior Rowatt, W. C., & Schmitt, D. P. (2003). Associations between religious in the human male. Philadelphia: W. B. Saunders. orientation and varieties of sexual experience. Journal for the Kirkpatrick, L. A., & Hood, R. W. (1990). Intrinsic-extrinsic religious orien- Scientific Study of Religion, 42, 455–465. tation: The boon or bane of contemporary psychology of religion? Ruma, E. H., & Mosher, D. L. (1967). Relationship between moral Journal for the Scientific Study of Religion, 29, 442–462. judgment and guilt in delinquent boys. Journal of Abnormal Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). Psychology, 72, 122–127. The social organization of sexuality: Sexual practices in the United Runkel, G. (1998). Sexual of Christianity. Journal of Sex and Mar- States. Chicago: University of Chicago Press. ital Therapy, 24, 103–122. Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Schover, L. R., & LoPiccolo, J. (1982). Treatment effectiveness for dys- Moreira, E., & Wang, T. (2005). Sexual problems among women functions of sexual desire. Journal of Sex and Marital Therapy, 8, and men aged 40–80y: Prevalence and correlates identified in the 179–197. Global Study of Sexual Attitudes and Behaviors. International Shiah, Y. J., Tam, W. C., Wu, M. H., & Chang, F. (2010). Paranormal Journal of Impotence Research, 17, 39–57. beliefs and religiosity: Chinese version of the Revised Paranormal Leiblum, S., Wiegel, M., & Brickle, F. (2003). Sexual attitudes of US and Belief Scale. Psychological Reports, 107, 367–382. Canadian medical students: The role of ethnicity, gender, religion, Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and and acculturation. Sexual and Relationship Therapy, 18, 473–491. nonexperimental studies: New procedures and recommendations. Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Psychological Methods, 7, 422–445. Boston: Little, Brown. Stark, R., & Bainbridge, W. S. (1985). The future of religion: Secu- McCabe, M. P. (2001). Evaluation of a cognitive behavior therapy larization, revival and cult formation. Berkeley: University of program for people with sexual dysfunction. Journal of Sex and California Press. Marital Therapy, 27, 259–271. Trapnell, P. (2005). A brief, balanced measure of new age paranormal McCree, D. H., Wingood, G. M., DiClemente, R., Davies, S., & beliefs. Unpublished raw data, University of Winnipeg. Harrington, K. F. (2003). Religiosity and risky sexual behavior in Trudel,G.,Marchand,A.,Ravart,M.,Aubin,S.,Turgeon,L.,&Fortier,P. African-American adolescent . Journal of Adolescent (2001). The effect of a cognitive-behavioural group treatment program Health, 33, 260–266. on hypoactive sexual desire in women. Sexual and Relationship Ther- Meston, C. M., & Ahrold, T. K. (2010). Ethnic, gender, and accultur- apy, 16, 145–164. ation influences on sexual behaviors. Archives of Sexual Behavior, Weiss, A., Egan, V., & Figueredo, A. J. (2004). Sensational interests as a 39, 179–189. form of intrasexual competition. Personality and Individual Meston, C. M., Trapnell, P. D., & Gorzalka, B. B. (1996). Ethnic and gender Differences, 36, 563–573. differences in sexuality: Variations in sexual behavior between Asian Welwood, J. (2000). Toward a psychology of awakening: Buddhism, and non-Asian university students. Archives of Sexual Behavior, 25, psychotherapy, and the path of personal and spiritual transfor- 33–72. mation. Boston: Shambhala Publications. Meston, C. M.,Trapnell, P.D., &Gorzalka, B.B. (1998). Ethnic, gender, Woo, J. S. T., Brotto, L. A., & Gorzalka, B. B. (2009). The role of sexuality in and length-of-residency influences on sexual knowledge and cervical screening among Chinese women. Health Psychology, attitudes. Journal of Sex Research, 35, 176–188. 28, 598–604. Meyer-Bahlburg, H. F., & Dolezal, C. (2007). The Female Sexual Function Woo,J.S.T.,Brotto,L.A.,&Gorzalka,B.B.(2010).Sexguiltandculture- Index: A methodological critique and suggestions for improvement. linked barriers to testicular examinations. International Journal of Journal of Sex and Marital Therapy, 33, 217–224. Sexual Health, 22, 144–154. Miracle, T. S., Miracle, A. W., & Baumeister, R. F. (2003). Human Woo, J. S. T., Brotto, L. A., & Gorzalka, B. B. (2011a). The role of sex sexuality: Meeting your basic needs. Upper Saddle River, NJ: guilt in the relationship between culture and women’s sexual Prentice Hall. desire. Archives of Sexual Behavior, 40, 385–394.

123 Arch Sex Behav (2012) 41:1485–1495 1495

Woo, J. S. T., Brotto, L. A., & Gorzalka, B. B. (2011b). The relationship Zinnbauer, B. J., Pargament, K. I., & Scott, A. B. (1999). The emerging between sex guilt and sexual desire in a community sample of Chi- meanings of religiousness and spirituality: Problems and pros- nese and Euro-Canadian women. Journal of Sex Research. doi: pects. Journal of Personality, 67, 889–919. 10.1080/00224499.2010.551792. Wyatt, G. E., & Dunn, K. M. (1991). Examining predictors of sex guilt in a multiethnic sample of women. Archives of Sexual Behavior, 20, 471–485.

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